Failure of Current Cefepime Breakpoints To Predict Clinical Outcomes of Bacteremia Caused by Gram-Negative Organisms

• DOI: 10.1128/aac.01487-06
• Publication Date: 2007-10-16T00:34:15Z
• Authors: Sunil V. Bhat; Anton Y. Peleg; Thomas P. Lodise; Kathleen A. Shutt; Blair Capitano; Brian A. Potoski; David L. Paterson
• Keywords: Cefepime; Bacteremia

ABSTRACT For commonly encountered gram-negative bacilli, a MIC of cefepime 8 μg/ml or less was defined by the Clinical and Laboratory Standards Institute as “susceptible” prior to commercial release antibiotic. We assessed 204 episodes bacteremia caused organisms for which patients received (typically 1 2 g every 12 h) primary mode therapy. The breakpoint derived classification regression tree (CART) software analysis delineate risk 28-day mortality μg/ml. Patients infected with treated at ≥8 had rate 54.8% (17/31 died), compared 24.1% (35/145 died) those <8 56.3% (9/16 53.3% (8/15 >8 A multivariable including severity illness indices showed that treating due an independent predictor ( P ≤ 0.001). There no significant difference in outcome according dosage regimen utilized. Pharmacodynamic assessments were presented previously would suggest treatment (particularly has low probability target attainment associated successful vivo when is It appear reasonable, based on pharmacodynamic clinical grounds, lower breakpoints countries where h licensed therapy serious infections, so are longer regarded susceptible