Comparative in vitro activity of cefepime against strains isolated from intensive care and haematology patients.

The aim of the study was to evaluate cefepime, a "fourth generation" cephalosporin, for its in vitro activity in comparison with 5 other broad spectrum antibiotics against clinical isolates from ICU and haematology patients. The strains were isolated from blood (8%), lower respiratory tract (41%), upper respiratory tract (14%), urine (20%) and other sites (17%). They were divided into: 28 non-inducible Enterobacteriaceae, 35 inducible Enterobacteriaceae, 20 non-fermenters, 10 S. aureus and 10 Streptococcus spp. The MIC-values were determined by E-test. Overall, the rank order of susceptibility was cefepime (93%), imipenem (90%), piperacillin-tazobactam (81%), ciprofloxacin (79%), ceftriaxone (75%) and ceftazidime (74%). Only cefepime was able to inhibit all inducible Enterobacteriaceae. Against Pseudomonas aeruginosa, cefepime had the same activity as ceftazidime. With the exception of ceftazidime (65%), all beta lactams demonstrated good activity against Gram positive cocci. The excellent activity against most Gram negative and Gram positive pathogens suggests that cefepime may be useful in the treatment of serious infections in the described patient population.