Cefepime
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Am J Respir Med 2003; 2 (1): 75-107 1175-6365/03/0001-0075/$30.00/0 © Adis International Limited. All rights reserved.
Cefepime A Review of its Use in the Management of Hospitalized Patients with Pneumonia Therese M. Chapman and Caroline M. Perry Adis International Inc., Langhorne, Pennsylvania, USA Various sections of the manuscript reviewed by: K.A. Bachmann, Center for Applied Pharmacology, University of Toledo, Toledo, Ohio, USA; B.A. Cunha, Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, New York, USA; S. Kohno, Second Department of Internal Medicine, Nagasaki University, Nagasaki, Japan; M.P. Okamoto, Western University of Health Sciences, Pomona, California, USA; J. Segreti, Rush Medical College, Chicago, Illinois, USA; M. Zervos, Infectious Diseases Division, Wayne State University, Detroit, Michigan, USA. Data Selection Sources: Medical literature published in any language since 1980 on cefepime, identified using Medline and EMBASE, supplemented by AdisBase (a proprietary database of Adis International). Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from the company developing the drug. Search strategy: Medline search terms were ‘cefepime’ and (‘lower respiratory tract infection*’ or ‘pneumonia’). EMBASE search terms were ‘cefepime’ and (‘lower respiratory tract infection*’ or ‘pneumonia’). AdisBase search terms were ‘cefepime’ and (‘PK’ or ‘PD’ or ‘in-vitro’) and ‘cefepime’ and (‘lower respiratory tract infection*’ or ‘pneumonia’). Searches were last updated 17 January 2003. Selection: Studies in patients with pneumonia who received cefepime. Inclusion of studies was based mainly on the methods section of the trials. When available, large, well controlled trials with appropriate statistical methodology were preferred. Relevant pharmacodynamic and pharmacokinetic data are also included. Index terms: cefepime, community-acquired pneumonia, nosocomial pneumonia, pharmacodynamics, pharmacokinetics, therapeutic use.
Contents Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Antibacterial Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 Mechanism of Action . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 In Vitro Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2.1 Gram-Positive Aerobic Bacteria . . . . . . . . . . . . . . . . . 2.2.2 Gram-Negative Aerobic Bacteria . . . . . . . . . . . . . . . . 2.2.3 Anaerobic Bacteria . . . . . . . . . . . . . . . . . . . . . . . . 2.3 Resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 Effect on Fecal Flora . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 Pharmacodynamic/Pharmacokinetic Considerations . . . . . . . 3. Pharmacokinetic Properties . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 Plasma Concentrations
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