Pharmacodynamics of cefepime in patients with Gram-negative infections

J Antimicrob Chemother. 2002 Sep;50(3):425-8. doi: 10.1093/jac/dkf130.


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 beta-lactams is optimized at concentrations approximately 4 x MIC. These results should be validated by large prospective clinical trials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Cefepime
  • Cephalosporins / pharmacology*
  • Cephalosporins / therapeutic use
  • Female
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Hospitals, University
  • Hospitals, Urban
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Prospective Studies
  • Regression Analysis
  • Treatment Outcome
  • United States


  • Anti-Bacterial Agents
  • Cephalosporins
  • Cefepime