Belgian multicentre study on the in vitro activity of cefepime against gram-negative bacilli

The in vitro activity of cefepime has been compared with that of cefotaxime, ceftazidime, aztreonam, and piperacillin against 1826 Enterobacteriaceae including 537 inducible Enterobacteriaceae (Enterobacter spp., Serratia spp., Citrobacter spp,. Morganella morganii) and 572 non-fermenters, including 401 Pseudomonas aeruginosa and 111 Acinebacter spp. isolated from hospitalized patients in 28 Belgian hospitals. Overall, cefepime was found substantially more active than the third-generation cephalosporins, aztreonam and piperacillin against Enterobacteriaceae species producing inducible type I cephalosporinases. Notably, cefepime remained active against 96% of Enterobacteriaceae resistant to cefotaxime, ceftazidime or aztreonam while it displayed a similar activity against E. coli and the other Enterobacteriaceae. Against non-fermenters, cefepime was found less active than ceftazidime but more than cefotaxime or aztreonam.