EFFICACY OF CEFEPIME IN THE TREATMENT OF INFECTIONS DUE TO MULTIPLY RESISTANT ENTEROBACTER SPECIES

Cefepime is a new cephalosporin with an enhanced antibacterial potency and spectrum. More rapid penetration into many gram-negative bacilli, targeting of multiple penicillin-binding proteins, and resistance to inactivation by many beta-lactamases account for its activity against organisms that have developed resistance to agents such as ceftazidime , cefotaxime, or ceftriaxone. This study identified 16 patients with 1 7 infections due to Enterobacter species organisms with reduced suscep tibility or resistance to ceftazidime. Most isolates were multiply res istant to other beta-lactam drugs as well, but all were susceptible to cefepime. All 17 infections, which included pneumonia, urinary tract infection, intraabdominal infection, and bacteremia, responded clinica lly to intravenous cefepime. In particular, cefepime was successfully used in the management of cases of chronic infection that had responde d poorly to repeated therapy with imipenem, aminoglycosides, or ciprof loxacin. Eradication of Enterobacter species organisms occurred at 15 (88.2%) of the 17 sites of infection. No emergence of resistance to ce fepime was noted.