Sanders C C
Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska 68178.
Clin Infect Dis. 1993 Sep;17(3):369-79.
Cefepime is a new aminothiazolylacetamido cephalosporin with a wider spectrum and greater potency than many currently available cephalosporins. It appears that these characteristics result from multiple properties of the molecule. In contrast to older cephalosporins, cefepime more rapidly penetrates the gram-negative cell, targets multiple essential penicillin-binding proteins, and escapes the effects of many beta-lactamases due to the enzymes' low affinity for the drug. The latter characteristic is most apparent in studies of Bush group 1 beta-lactamases. Derepression of this class of beta-lactamases has less effect on the in vitro activity of cefepime than on that of other cephalosporins. The results of clinical trials should now be carefully analyzed to determine whether these advantages carry over into the clinical arena.
头孢吡肟是一种新型氨噻唑基乙酰氨基头孢菌素，与许多现有头孢菌素相比，具有更广泛的抗菌谱和更强的抗菌效力。这些特性似乎源于该分子的多种性质。与 older cephalosporins 相比，头孢吡肟能更迅速地穿透革兰氏阴性菌细胞，作用于多种重要的青霉素结合蛋白，并且由于许多β-内酰胺酶对该药物的低亲和力，它能免受这些酶的影响。后一特性在对布什 1 组β-内酰胺酶的研究中最为明显。这类β-内酰胺酶的去阻遏对头孢吡肟体外活性的影响比对其他头孢菌素的影响小。现在应该仔细分析临床试验结果，以确定这些优势是否能在临床领域得以体现。
