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21 November 2002

Clinical and bacteriological results from the administration of Cefepime (Maxipime(r)) in patients with severe sepsis.

Chavdar Stefanov Stefanov, Ilian Doikov, Rossen Dimov, George Deenichin, George Delikostadinov

Med Sci Monit 2002; 8(11): PI97-102 :: ID: 4826

Abstract

BACKGROUND: The aim of the present study was to investigate the clinical and bacteriological efficacy of Cefepime administered to critically ill sepsis patients, as well as possible adverse reactions and interactions. MATERIAL/METHODS: 30 patients with severe sepsis of different origin were treated with Cefepime a dosage of 2.0 g bid. Of these patients, 26 survived (86.67%). The clinical and bacteriological effects of antibiotic administration were recorded at the end of treatment. RESULTS: The treatment outcomes in terms of clinical results were as follows: 17 patients cured (56.67%), 7 improved (23.33%), 2 with unsatisfactory outcome (6.67%), and 4 failures (13.33%). Cefepime treatment resulted in a reduction of the APACHE II score from ca. 20 at the beginning to 9.44 at the end, while the SOFA score fell from 7 to 2.62. This indicates improved clinical status and reversal of multiple organ failure. The bacteriological results were as follows: pathogen eradication in 17 cases (56.67%), pathogen persistence in 8 cases (26.67%), and superinfection in 5 cases (16.66%). Out of 80 total hemocultures, 63 proved to be sterile. In two cases in vitro Enterococcus faecium was isolated with antibiotic resistance. Of 81 total cultures of infectious foci, 10 showed resistance: 4 Pseudomonas aeruginosa, 4 Acinetobacter baumannii, and 2 Enterococcus faecalis. No side effects of Cefepime administration were recorded. CONCLUSIONS: Cefepime administration resulted in low mortality, clinical improvement, minimal resistance, and lack of side effects. Cefepime is an effective drug of first choice for critically ill sepsis patients

Keywords: Anti-Bacterial Agents - therapeutic use, Bacteria - metabolism, Cephalosporins - therapeutic use, Sepsis - drug therapy, Sepsis - microbiology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750