Cefepime versus ceftazidime: considerations for empirical use in critically ill patients.
Sepsis and nosocomial infections continue to be a significant problem in intensive care, contributing heavily to mortality and prolonged hospital stay. Early and appropriate antibiotic therapy is critical for optimising outcomes. However, the emergence of highly resistant bacteria, coupled with reduced development of novel antibiotics, means that there is a real threat of development of untreatable nosocomial infections. Cefepime and ceftazidime are broad-spectrum cephalosporins that are widely used to treat Gram-negative nosocomial infections in critically ill patients. Available data suggest that cefepime may have advantages over ceftazidime owing to a broader spectrum of activity and reduced potential for development of bacterial resistance. However, whether either of these agents is superior can only be determined by a head-to-head study evaluating clinical and bacteriological outcomes. Such a study to determine whether apparent differences translate into clinically relevant differences in outcome is indicated.
Roberts
Jason A
JA
Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane, Qld 4029, Australia.
Webb
Steven A R
SA
Lipman
Jeffrey
J
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000077723:Cefepime; D002442:Ceftazidime / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy; D016638:Critical Illness; D003428:Cross Infection / Q000188:drug therapy; D004351:Drug Resistance; D017850:Economics, Pharmaceutical; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime; D002442:Ceftazidime