[Treatment of pneumonia in hospitalized patients--results of a multicenter study using a fourth-generation cephalosporin (cefepime)].
OBJECTIVE
To evaluate efficacy and safety of cefepime in severe pneumonia of hospitalized patients.


METHODS
A prospective, multicenter, open trial was performed with 148 patients (62 patients with nosocomial pneumonia; 34 with community-acquired pneumonia and 52 undefined forms). Cefepime was intravenously administered (1,000 to 2,000 mg every 12 hours), and doses were adjusted for renal function. The efficacy endpoint was clinical response at 48 hours after completion of therapy.


RESULTS
The mean age was 56.4 +/- 20.31 years. The most common bacterias isolated from patients with nosocomial pneumonia were: 5 (8.06%) Pseudomonas aeruginosa; 7 (11.29%) Pseudomonas sp.; 6 (9.68%) Klebsiella sp.; 3 (4.84%) E. coli; 2 (3.23%) Acinetobacter baumannii; 3 (4.84%) Staphylococcus aureus; 3 (4.84%) Streptococcus pneumoniae; 5 (8.06%) others. The most common isolates from patients with community-acquired pneumonia were: 2 (5.88%) Streptococcus pneumoniae; 1 (2.94%) S. aureus; 2 (5.88%) P. aeruginosa and 2 (5.88%) K. pneumoniae. Clinical efficacy was demonstrated in 137/148 (92.56%) of the cases since improvement was obtained in 20.27% and healing in 72.29%. Failure of the treatment was observed in 10 patients (6.75%) and one patient the evaluation was not possible. Adverse events were reported for 5/148 patients (3.38%).


CONCLUSIONS
Our data suggest that cefepime was safe and effective for treatment of severe pneumonia in hospitalized patients.
de Medeiros
E A
EA
Disciplina de Doenças Infecciosas e Parasitárias da Universidade Federal de São Paulo.
D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy* / Q000209:etiology / Q000635:transmission; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000209:etiology / Q000635:transmission; D011446:Prospective Studies; D016896:Treatment Outcome
D002511:Cephalosporins; D000077723:Cefepime
Tratamento de pneumonia em pacientes hospitalizados--resultado de um estudo clínico multicêntrico utilizando uma cefalosporina de quarta geração (cefepima).