Pharmacodynamics of cefepime in patients with Gram-negative infections.
We conducted a prospective, open-label study to delineate a relationship between exposure and outcomes in 36 patients treated with cefepime. Twenty patients had documented Gram-negative infections. Timed blood and urine samples were obtained at steady state to determine pharmacokinetic and pharmacodynamic parameters. Microbiological success was significantly correlated with the proportion of the dosing interval that cefepime concentrations exceeded 4.3 x MIC. Our results support in vitro data that suggest bactericidal activity of beta-lactams is optimized at concentrations approximately 4 x MIC. These results should be validated by large prospective clinical trials.
Tam
Vincent H
VH
The Anti-Infective Research Laboratory, Department of Pharmacy Services, Detroit Receiving Hospital and University Health Center, Wayne State University, MI, USA.
McKinnon
Peggy S
PS
Akins
Ronda L
RL
Rybak
Michael J
MJ
Drusano
George L
GL
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome; D014481:United States
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime