Shahid Sukhbir K
Consultant Pediatrician and Neonatologist, Mumbai-400 077, India.
Recent Pat Antiinfect Drug Discov. 2008 Jun;3(2):145-8. doi: 10.2174/157489108784746614.
Cefepime is a semi-synthetic fourth generation cephalosporin with broader Gram-positive and excellent Gram-negative bacterial coverage. Its extended anti-microbial activity and infrequent tendency to develop resistance makes it popular for treatment of infections due to multi-drug resistant organisms. It has good efficacy against beta-lactamase and ESBL (extended spectrum beta-lacatamase)-secreting pathogens, and it has shown great promise in management of children with severe and nosocomial infections. It possesses superior bactericidal action compared to other cephalosporins and is a cheaper and safe alternative to the carbapenems. It is well-tolerated but needs dose adjustments in newborns, and in children with renal insufficiency. Cefepime is a valuable antibiotic but it should be used judiciously as unnecessary, improper and prolonged use may lead to emergence of cefepime-insensitive bacteria and risk of drop in the efficacy of cefepime. Various recent patents of cefepime have been launched which deal with improvements in its preparation, and with its combinations with beta-lactamase inhibitors and newer antibiotics such as linezolid. These developments may further augment the usefulness of cefepime in pediatric infections.
头孢吡肟是一种半合成的第四代头孢菌素，对革兰氏阳性菌有更广泛的覆盖范围，对革兰氏阴性菌有优异的覆盖效果。其抗菌活性的扩展以及耐药性产生频率较低，使其在治疗多重耐药菌引起的感染方面很受欢迎。它对分泌β-内酰胺酶和超广谱β-内酰胺酶（ESBL）的病原体有良好疗效，并且在治疗患有严重感染和医院感染的儿童方面显示出巨大潜力。与其他头孢菌素相比，它具有卓越的杀菌作用，是碳青霉烯类药物更便宜且安全的替代品。它耐受性良好，但在新生儿和肾功能不全的儿童中需要调整剂量。头孢吡肟是一种有价值的抗生素，但应谨慎使用，因为不必要、不恰当和长期使用可能导致头孢吡肟不敏感细菌的出现以及头孢吡肟疗效下降的风险。最近已经发布了各种关于头孢吡肟的专利，涉及改进其制剂，以及它与β-内酰胺酶抑制剂和新型抗生素（如利奈唑胺）的联合使用。这些进展可能会进一步提高头孢吡肟在儿科感染中的效用。
