[Cefepime (maxipime), large spectrum 4th generation cephalosporin, resistant to beta-lactamases].
As a result of the appearance of bacterial strains resistant to 3rd generation cephlosporin, since 1993 cephalosporins of 4th generation have been developed and introduced in therapy; among them are: cefepime and cefpirome. Cefepime is the most active 4th generation cephalosporin possessing the following advantages over the 3rd generation cephalosporins: high intrinsic potency due to rapid penetration into the periplasmic space; an extended spectrum of activity that includes many Gram-positive and Gram-negative organisms; Activity against multi-resistant Gram-negative bacteria, including Enterobacter and Klebsiella species; Low potential for beta-lactamase induction, especially Bush group 1 beta-lactamases, even ar low periplasmic concentrations; Minimal selection of resistant mutant strains. Its spectrum is very large being very active against Gram-negative bacilii: Enterobacter, Pseudomonas aeruginosa, Klebsiella pneumoniae, Serratia, Citrobacter, Proteus mirabilis and less active against Bacillus fragillis. Cefepime is also very active against Gram-positive cocci: Staphylococcus aureus (methicillin-susceptible strains only), Streptococcus pneumoniae, Streptococcus pyogenes. Some of the methicillin-resistant strains of staphylococcus are susceptible to cefepime; Enterococcus is resistant. Due to its high resistance against beta-lactamases Cefepime (Maxipime) is the best choice in life threatening nosocomial infections occuring in patients in the intensive care units. Cefepime can be synergically associated with aminoglycosides and fluoroquinolones.
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Angelescu
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Apostol
D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000494:pharmacology*; D000077723:Cefepime; D002511:Cephalosporins / Q000378:metabolism / Q000494:pharmacology*; D016983:Enterococcus / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007711:Klebsiella pneumoniae / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013211:Staphylococcus aureus / Q000187:drug effects; D001618:beta-Lactamases / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime; D001618:beta-Lactamases