Cefepime versus extended spectrum β-lactamase-producing Enterobacteriaceae
Nogueira, Keite da Silva
Daur, Alessandra Vale
Reason, Iara Taborda de Messias
Gales, Ana Cristina [UNIFESP]
Costa, Libera Maria Dalla
Is part ofBrazilian Journal of Infectious Diseases
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The objective of this study was to evaluate the susceptibility to cefepime of a large group of ESBL- producing enterobacteria recently isolated in a Brazilian teaching hospital . The study included 280 strains of ESBL-producing enterobacteria, isolated between 2005 and 2008. The presence of the genes blaCTX-M, blaTEM and blaSHV was determined by PCR and confirmed by nucleotide sequencing. Susceptibility testing for cefepime was performed by disc-diffusion, agar dilution method and E-test®. Among the isolates, 34 (12.1%) presented a cefepime inhibition zone > 21 and MIC < 8 mg/L by agar dilution and E-strip methods. The use of cefepime for the treatment of infections caused by ESBL-producing bacteria has been controversial. Some studies of PD/PK show the probability of achieving the required PD parameters for cefepime, when the MICs were < 8 mg/L, whereas others have reported therapeutic failure with the same MIC. Additional data is essential to come to terms about the report and treatment with cefepime in ESBL-producing organisms especially when these microorganisms are isolated from sterile sites and from critically ill patients.
CitationBrazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 15, n. 2, p. 167-169, 2011.
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