title: Clinical and bacteriological results from the administration of Cefepime (Maxipime) in patients with severe sepsis.
abstract: BACKGROUND
  The aim of the present study was to investigate the clinical and bacteriological efficacy of Cefepime administered to critically ill sepsis patients, as well as possible adverse reactions and interactions.
  
  
  METHODS
  30 patients with severe sepsis of different origin were treated with Cefepime a dosage of 2.0 g bid. Of these patients, 26 survived (86.67%). The clinical and bacteriological effects of antibiotic administration were recorded at the end of treatment.
  
  
  RESULTS
  The treatment outcomes in terms of clinical results were as follows: 17 patients cured (56.67%), 7 improved (23.33%), 2 with unsatisfactory outcome (6.67%), and 4 failures (13.33%). Cefepime treatment resulted in a reduction of the APACHE II score from ca. 20 at the beginning to 9.44 at the end, while the SOFA score fell from 7 to 2.62. This indicates improved clinical status and reversal of multiple organ failure. The bacteriological results were as follows: pathogen eradication in 17 cases (56.67%), pathogen persistence in 8 cases (26.67%), and superinfection in 5 cases (16.66%). Out of 80 total hemocultures, 63 proved to be sterile. In two cases in vitro Enterococcus faecium was isolated with antibiotic resistance. Of 81 total cultures of infectious foci, 10 showed resistance: 4 Pseudomonas aeruginosa, 4 Acinetobacter baumannii, and 2 Enterococcus faecalis. No side effects of Cefepime administration were recorded.
  
  
  CONCLUSIONS
  Cefepime administration resulted in low mortality, clinical improvement, minimal resistance, and lack of side effects. Cefepime is an effective drug of first choice for critically ill sepsis patients
authors.affiliation: Department of Anesthesiology, Resuscitation, and Intensive care, Medical University, Plovdiv, Bulgaria. chavdar_stefanov@hotmail.com
authors.forename: Chavdar
authors.initials: C
authors.lastname: Stefanov
authors.forename: Ilian
authors.initials: I
authors.lastname: Doikov
authors.forename: Rossen
authors.initials: R
authors.lastname: Dimov
authors.forename: George
authors.initials: G
authors.lastname: Deenichin
authors.forename: George
authors.initials: G
authors.lastname: Delikostadinov
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000378:metabolism; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime