Empiric use of cefepime in the treatment of lower respiratory tract infections in children

Background, These studies were designed to assess the efficacy and safety o f cefepime, a fourth generation cephalosporin, for the treatment of serious infections, including lower respiratory tract infections (LRTI) in childre n. Methods. Four clinical. trials of cefepime for the treatment of serious bac terial infections enrolled 259 children with LRTI. In 3 trials cefepime was compared with ceftazidime (n = 166), cefotaxime (n = 16) or cefuroxime (n = 12), One trial was noncomparative (n = 65). Results, Treatment with cefepime 50 mg/kg/ dose administered every 8 to 12 h produced a satisfactory clinical response (clinical signs of infection re solved or improved with no evidence of recurrent infection at posttreatment followup) in 88 to 100% of patients, comparable with comparator therapy, I n children from whom a causative pathogen was identified, bacteriologic era dication was comparable between cefepime and comparator therapy, Cefepime w as as safe and well-tolerated as comparator therapy, Few treatment-related clinical or laboratory adverse events were noted and were equivalent to com parator in all studies. Conclusion, Cefepime is as effective, safe and well-tolerated for the empir ic treatment of children with LRTI as comparator agents but offers the adva ntage of an enhanced spectrum of activity for Gram-positive and Gram-negati ve pathogens compared with second or third generation cephalosporins.