Hardin T C, Jennings T S
Pharmacy Service, Audie L. Murphy Memorial Veterans Hospital, San Antonio, TX 78284.
Pharmacotherapy. 1994 Nov-Dec;14(6):657-68.
Cefepime is a potent, broad-spectrum, fourth-generation cephalosporin with enhanced activity against most gram-positive aerobic bacterial pathogens and many gram-negative aerobic bacteria that are resistant to other cephalosporins. The drug's zwitterionic structure contributes to more rapid penetration of gram-negative bacterial cell membranes, and its low affinity for most type I beta-lactamases leads to significantly reduced enzymatic degradation compared with other cephalosporins. Cefepime has a good toxicity profile, with minor gastrointestinal and central nervous system symptoms being most prevalent. At dosages ranging from 1-2 g every 8-12 hours, it is an alternative option for infections of the lower respiratory tract, urinary tract, and skin and skin structures, as well as febrile episodes in neutropenic patients with cancer, and bacteremia or septicemia in critically ill patients.
头孢吡肟是一种强效、广谱的第四代头孢菌素,对大多数革兰氏阳性需氧菌病原体以及许多对其他头孢菌素耐药的革兰氏阴性需氧菌具有增强的活性。该药物的两性离子结构有助于更快速地穿透革兰氏阴性细菌细胞膜,并且与其他头孢菌素相比,它对大多数I型β-内酰胺酶的低亲和力导致酶促降解显著减少。头孢吡肟具有良好的毒性特征,最常见的是轻微的胃肠道和中枢神经系统症状。在每8 - 12小时1 - 2克的剂量范围内,它是治疗下呼吸道、泌尿道、皮肤及皮肤结构感染的替代选择,也是癌症中性粒细胞减少患者发热发作以及重症患者菌血症或败血症的替代选择。