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28-Jul-2000
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Arch Hellen Med, 16(6), November-December 1999, 590–594
ORIGINAL PAPER
Comparative in vitro activity
of cefepime
and ceftazidime
on multiresistant Enterobacter cloacae
and Klebsiella pneumoniae
H. SAMBATAKOU,1
E.J. GIAMARELLOS-BOURBOULIS,2 D. KAVATHA,3
H. GIAMARELLOU3
1Department of Special Infections,
Athens General Hospital “G. Gennimatas”,
21st Department of Propedeutic Medicine, Athens General Hospital “Laiko”,
34th Department of Internal Medicine, Athens General Hospital “Sismanoglio”,
Athens, Greece
OBJECTIVE
Infectious diseases by nosocomial enterobacteriaceae including Enterobacter
spp and Klebsiella spp showing resistance to third generation cephalosporins,
to aminoglycosides and to newer quinolones are nowadays a worldwide threat.
Cefepime is a broad spectrum fourth generation cephalosporin, resistant to hydrolysis
by both chromosomal-mediated and plasmid-mediated â-lactamases, which might
be administered for the thera py of infections by these strains.
METHOD The in vitro activity of cefepime was
compared with that of ceftazidime on 84 nosocomial isolates of Enterobacter
cloacae and on 100 of Klebsiella pneumoniae by determination of their
Minimal Inhibitory and Bactericidal Concentrations (MICs and MBCs).
RESULTS Cefepime and ceftazidime inhibited 89% and 39%
of K. pneumoniae isolates and 92.9% and 67.9% of E. cloacae isolates
respectively. MIC and MBC levels of cefepime were in general 16–64 times higher
than those of ceftazidime. Cefepime inhibited 81.7% and 77.8% respectively of
Ê. pneumoniae and E. cloacae isolates which were resistant to
ceftazidime.
CONCLUSIONS Cefepime appears to be a promising newer
compound for the therapy of nosocomial infections by enterobacteriaceae resistant
to third generation cephalosporins.
Key words: Cefepime, Ceftazidime, Enterobacteriaceae, Resistant strains.