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Cefepime

Cefepime is a fourth generation intravenous cephalosporin antibiotic developed in 1994. Cefepime has broad spectrum activity against Gram positive and Gram negative bacteria. It has good activity against Pseudomonas aeruginosa, Staphylococcus aureus, and multiple drug resistant Streptococcus pneumoniae. A particular strength is its activity against Enterobacteriaceae. more...

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Whereas other cephalosporins are degraded by many plasmid- and chromosome-mediated beta-lactamases, cefepime is stable and is a front line agent when infection with Enterobacteriaceae is known or suspected. Cefepime is commonly used to treat severe nosocomial pneumonia and neutropenic fever.

Cefepime is marketed under the trade names Maxipime, Maxcef, Cepimax, Cepimex, and Axepim.

Read more at Wikipedia.org


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Clinical characteristics and risk factors of mortality among severe burn patients with isolates of vancomycin-resistant enterococci
From CHEST, 10/1/05 by Heung J. Woo

PURPOSE: Vancomycin-resistant enterococci (VRE) are multi-drug resistant organisms that have emerged as important nosocomial pathogens in recent years. VRE emergence has been blamed mainly on the increased and inappropriate use of antibiotics, in particular, the cephalosporins and the glycopeptide, vancomycin. Burn patients are highly vulnerable to acquiring VRE infection. This study was focused on the clinical characteristics and risk factors of mortality among severe burn patients with VRE isolation during recent 4 years.

METHODS: 104 cases (M:F=69:35) that had VRE isolation from January 1, 2000 to December, 2003, were reviewed. We analyzed clinical characteristics and the risk factors that contribute to death by using univariate and multivariate analyses, retrospectively.

RESULTS: Mean percent total body surface area (%TBSA) of survivors (n=80) and non-survivors (n=24) were 41.64 [+ or -] 20.68% and 58.08 [+ or -] 22.64% (p=0.003). Total 144 strains of VRE were isolated from 104 patients. Most of VRE colonization or infection were caused by Enterococcus faecium (82.6%) and E. casseliflavus (14.6%). There were no significant difference in VRE species distribution between survivors and non-survivors (p> 0.05). The risk factors for mortality were %TBSA burn, APACHE II scores, mechanical ventilation, nasogastric tube, previous use of cefepime and ticarcillin/clavulanate, rectal VRE colonization and initial VRE bacteremia in univariate analysis. However, independent risk factor of death were APACHE II score, mechanical ventilation and initial VRE bacteremia in multivariate analyses.

CONCLUSION: Severe burn patients with VRE isolation should be reassessed carefully, especially in those who had high APACHE II scores at ICU admission, mechanical ventilation and initial VRE bacteremia.

CLINICAL IMPLICATIONS: More strict infection control and efforts to eradicate VRE may be needed among severe burn patients with VRE isolation.

DISCLOSURE: Heung Woo, None.

Heung J. Woo MD * Cheol H. Kim MD Jin K. Kim MD Young I. Park MD In G. Hyun MD Young M. Ahn MD Department of Internal Medicine, Hallym University College of Medicine, Seoul, South Korea

COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group

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