[Cefepime in the treatment of patients with surgical infections]

Between March 1988 and June 1990, we gave cefepime to 5 subjects after surgery and studied the pharmacokinetics of the drug. In the same period, we treated 23 patients with surgical infections with the same drug and evaluated its clinical efficacy. In the pharmacokinetic study, 1 g was given intravenously to each individual over a 30 minutes period. The peak levels in the plasma, 59.9-118 micrograms/ml, were obtained at around the end of this time. The peak levels in the bile, 7.1-28.2 micrograms/ml, were reached at 1-5 hours after administration, depending on the patient. At hours 5 and 6, the range of plasma concentration was 3.7-12.3 micrograms/ml. In the 22 patients with surgical infections, clinical efficacy of the drug was excellent in 12, good in 5, fair in 1, and poor in 4, with an overall efficacy rate of 77%. The bacteriological response was evaluated in the 16 patients for whom the species of the probable causative organisms were identified. Those bacteria were eradicated in 10 patients, decreased in 3, and were persisted in 3, with an eradication rate of 63%. Against 5 strains of Escherichia coli isolated, the highest MIC was 0.05 micrograms/ml, and against 2 strains of Pseudomonas aeruginosa isolated, the MIC was 1.56 micrograms/ml, so this drug should be highly effective toward these species. Three strains of Staphylococcus aureus were isolated, one of which was resistant to methicillin. It was not eradicated.