Pharmacodynamics of cefepime in patients with Gram-negative infections

• DOI: 10.1093/jac/dkf130
• Publication Date: 2002-08-30T20:38:44Z
• Authors: V. H. Tam
• Keywords: Male; 0301 basic medicine; 0303 health sciences; Microbial Sensitivity Tests; Middle Aged; United States; Anti-Bacterial Agents; Cephalosporins; 3. Good health; Hospitals, University; 03 medical and health sciences; Hospitals, Urban; Treatment Outcome; Gram-Negative Bacteria; Humans; Regression Analysis; Female; Prospective Studies; Cefepime; Gram-Negative Bacterial 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.