Clinical Medicine Reviews in Therapeutics

Serious bacterial infections with their high bioburden are often difficult to treat. Emergence of drug-resistant bacteria has worsened the situation, and management of these cases has become a therapeutic challenge. Prompt institution of appropriate antibiotic is vital in order to decrease complications and fatalities. Cefepime is a new fourth generation parenteral cephalosporin which holds promise for management of these severe infections. It has been shown to be useful in critical pneumonias, soft and bone tissue infections, urinary tract infections and febrile neutropenia. It eradicates organisms which have shown resistance to other β-lactam antibiotics. It is stable to hydrolysis by the common plasmid and chromosomally mediated β-lactamases. The twice daily dosing and improved efficacy even at low dosage makes it a suitable alternative to ceftazidime and carbapenems. It is well tolerated by all age groups and is safe even for newborns. Cefepime monotherapy gives both a good clinical response and an excellent microbiological clearance. In order to preserve its anti-bacterial potency, prudent use of cefepime is warranted. Research into its efficacy and safety with other β-lactamase inhibitors is ongoing and will benefit mankind.