Antimicrobial activity of cefepime tested against Bush group I beta-lactamase-producing strains resistant to ceftazidime. A multilaboratory national and international clinical isolate study.
The potency of cefepime, a parenteral aminothiazolyl methoxyimino cephalosporin, was assessed against 256 ceftazidime-resistant Gram-negative bacilli from five medical centers in the United States. In addition, cefepime activity was compared with that of ciprofloxacin and imipenem against 506 ceftazidime-resistant Gram-negative bacilli collected during an 11-medical-center international study. All US clinical isolates were susceptible (< or = 8 micrograms/ml) to cefepime except Enterobacter cloacae (94% susceptible) and Pseudomonas aeruginosa (19% susceptible). Enterobacteriaceae isolates from the 11-nation sample were > 80% cefepime susceptible with the exception of those from Brazil (48% susceptible) and Italy (55% susceptible). These international, enteric isolates were also very susceptible to ciprofloxacin (55%-100% susceptible) and imipenem (84%-100% susceptible). Nonenteric organisms (Pseudomonas, Xanthomonas, and Acinetobacter) from the same international locations had overall rates of susceptibility of 47% for ciprofloxacin, 28% for imipenem, and only 5% for cefepime. Cross-resistance between the broad-spectrum cephalosporins (cefepime or ceftazidime) with either imipenem or ciprofloxacin was incomplete. Cefepime appears to have a spectrum of use against a significant number of contemporary, ceftazidime-resistant Gram-negative bacillus isolates worldwide.
Department of Pathology, University of Iowa College of Medicine, Iowa City 52242.
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Jones
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Marshall
D000077723:Cefepime; D002442:Ceftazidime / Q000494:pharmacology*; D018550:Cephalosporin Resistance; D002511:Cephalosporins / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology; D003428:Cross Infection / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007391:International Cooperation; D008826:Microbial Sensitivity Tests; D001618:beta-Lactamases / Q000096:biosynthesis
D002511:Cephalosporins; D002939:Ciprofloxacin; D015378:Imipenem; D000077723:Cefepime; D002442:Ceftazidime; D001618:beta-Lactamases