Wang F D, Liu I M, Liu C Y
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1998 Jul;61(7):408-13.
Cefepime is a new, parenteral, fourth-generation antibiotic that is stable in the presence of Bush group 1 beta-lactamases. In vitro activity of cefepime, cefuroxime, ceftazidime, ciprofloxacin and imipenem against Gram-positive cocci and cefuroxime-resistant Gram-negative bacilli was studied.
The agar dilution method described by the US National Committee for Clinical Laboratory Standards was used to determine the minimum inhibitory concentrations of antibiotics tested. These included cefepime, cefuroxime, ceftazidime, ciprofloxacin and imipenem. The tested clinical isolates included Gram-positive cocci (methicillin-sensitive coagulase-negative staphylococci, methicillin-resistant coagulase-negative staphylococci, methicillin-sensitive Staphylococcus aureus, methicillin-resistant S aureus, Streptococcus pyogenes, viridans streptococci, Streptococcus pneumoniae, group D enterococci) and cefuroxime-resistant Gram-negative bacilli (Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp, Pseudomonas aeruginosa, Enterobacter cloacae, Serratia marcescens, Burkholderia cepacia and Xanthomonas maltophilia).
The activity of cefepime against most Gram-negative bacilli other than B cepacia and X maltophilia is better than that of ceftazidime. However, cefepime is less active against these Gram-negative bacilli than ciprofloxacin and imipenem. The activity of cefepime against B cepacia and X maltophilia is less than that of ceftazidime or ciprofloxacin. Among Gram-positive cocci, cefepime was active against most isolates of methicillin-sensitive staphylococci, S pyogenes, viridans streptococci and S pneumoniae. However, cefepime has poor activity against methicillin-resistant S aureus and enterococci.
Due to its extended spectrum of activity, cefepime has potential use as suitable empiric monotherapy for the treatment of a variety of community- and hospital-acquired infections.
头孢吡肟是一种新型的胃肠外给药的第四代抗生素，在布什1组β-内酰胺酶存在的情况下稳定。研究了头孢吡肟、头孢呋辛、头孢他啶、环丙沙星和亚胺培南对革兰氏阳性球菌及耐头孢呋辛革兰氏阴性杆菌的体外活性。
采用美国国家临床实验室标准委员会描述的琼脂稀释法测定受试抗生素的最低抑菌浓度。这些抗生素包括头孢吡肟、头孢呋辛、头孢他啶、环丙沙星和亚胺培南。受试临床分离株包括革兰氏阳性球菌（甲氧西林敏感凝固酶阴性葡萄球菌、甲氧西林耐药凝固酶阴性葡萄球菌、甲氧西林敏感金黄色葡萄球菌、甲氧西林耐药金黄色葡萄球菌、化脓性链球菌、草绿色链球菌、肺炎链球菌、D组肠球菌）和耐头孢呋辛革兰氏阴性杆菌（大肠埃希菌、肺炎克雷伯菌、不动杆菌属、铜绿假单胞菌、阴沟肠杆菌、粘质沙雷菌、洋葱伯克霍尔德菌和嗜麦芽窄食单胞菌）。
除洋葱伯克霍尔德菌和嗜麦芽窄食单胞菌外，头孢吡肟对大多数革兰氏阴性杆菌的活性优于头孢他啶。然而，头孢吡肟对这些革兰氏阴性杆菌的活性低于环丙沙星和亚胺培南。头孢吡肟对洋葱伯克霍尔德菌和嗜麦芽窄食单胞菌的活性低于头孢他啶或环丙沙星。在革兰氏阳性球菌中，头孢吡肟对大多数甲氧西林敏感葡萄球菌、化脓性链球菌、草绿色链球菌和肺炎链球菌分离株有活性。然而，头孢吡肟对甲氧西林耐药金黄色葡萄球菌和肠球菌活性较差。
由于其抗菌谱广，头孢吡肟有潜力作为合适的经验性单药治疗用于多种社区获得性和医院获得性感染的治疗。
