A multicenter comparative study of cefepime versus broad-spectrum antibacterial therapy in moderate and severe bacterial infections



Título del documento: A multicenter comparative study of cefepime versus broad-spectrum antibacterial therapy in moderate and severe bacterial infections
Revista: The brazilian journal of infectious diseases
Base de datos: PERIÓDICA
Número de sistema: 000290737
ISSN: 1413-8670
Autores: 1





Instituciones: 1Universidade Federal da Bahia, Hospital Prof. Edgar Santos, Salvador, Bahia. Brasil
Año:
Periodo: Oct
Volumen: 6
Número: 5
Paginación: 206-218
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés The safety and efficacy of cefepime empiric monotherapy compared with standard broad-spectrum combination therapy for hospitalized adult patients with moderate to severe community-acquired bacterial infections were evaluated. In an open-label, multicenter study, 317 patients with an Acute Physiology and Chronic Health Evaluation (APACHE II) score ranging from >5 to =19 were enrolled with documented pneumonia (n=196), urinary tract infection (n=65), intra-abdominal infection (n=38), or sepsis (n=18). Patients were randomly assigned 1:1 to receive cefepime 1 to 2 g IV twice daily or three times a day or IV ampicillin, cephalothin, or ceftriaxone ± aminoglycoside therapy for 3 to 21 days. For both treatment groups, metronidazole, vancomycin, or macrolide therapy was added as deemed necessary. The primary efficacy variable was clinical response at the end of therapy. Two hundred ninety-six (93%) patients met evaluation criteria and were included in the efficacy analysis. Diagnoses included the following: 180 pneumonias (90 cefepime, 90 comparator), 62 urinary tract infections (29 cefepime, 33 comparator), 37 intra-abdominal infections (19 cefepime, 18 comparator), and 17 sepses (8 cefepime, 9 comparator). At the end of therapy, overall clinical success rates were 131/146 (90%) for patients treated with cefepime vs 125/150 (83%) for those treated with comparator (95% confidence interval [CI]: - 2.6% to 16.3%). The clinical success rate for patients with community-acquired pneumonia, the most frequent infection, was 86% for both treat
Disciplinas: Medicina
Palabras clave: Farmacología,
Microbiología,
Terapéutica y rehabilitación,
Cefepima,
Ampicilina,
Caphalotin,
Infecciones,
Vías urinarias,
Sepsis
Keyword: Medicine,
Microbiology,
Pharmacology,
Therapeutics and rehabilitation,
Cefepime,
Ampicillin,
Caphalotin,
Infections,
Urinary tract,
Sepsis
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