Journal of Antimicrobial Chemotherapy (2002) 50, 425-428
© 2002 The British Society for Antimicrobial Chemotherapy
Pharmacodynamics of cefepime in patients with Gram-negative infections
1 The Anti-Infective Research Laboratory, Department of Pharmacy Services, Detroit Receiving Hospital and University Health Center; 3 School of Medicine, Wayne State University, Detroit, MI; 2 Division of Clinical Pharmacology, Clinical Research Institute, Albany Medical College, 47 New Scotland Avenue (MC142), Albany, NY 12208, USA
Received 2 January 2002; returned 25 March 2002; revised 7 May 2002; accepted 25 May 2002
We conducted a prospective, open-label study to delineate a relationship between exposure and outcomes in 36 patients treated with cefepime. Twenty patients had documented Gram-negative infections. Timed blood and urine samples were obtained at steady state to determine pharmacokinetic and pharmacodynamic parameters. Microbiological success was significantly correlated with the proportion of the dosing interval that cefepime concentrations exceeded 4.3 x MIC. Our results support in vitro data that suggest bactericidal activity of ß-lactams is optimized at concentrations 
4 x MIC. These results should be validated by large prospective clinical trials.
* Present address. Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Science Center, Amarillo, TX 79106, USA.
Corresponding author. Tel: +1-518-262-6330; Fax: +1-518-262-6333; E-mail: gldrusano{at}aol.com
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