Randomized comparison of cefepime and ceftazidime for treatment of hospitalized patients with gram-negative bacteremia

Clin Infect Dis. 1995 Jan;20(1):56-8. doi: 10.1093/clinids/20.1.56.


We conducted a randomized, prospective, open comparison to evaluate the efficacy and safety of cefepime and ceftazidime in the treatment of hospitalized patients with suspected gram-negative bacteremia. Twenty-eight patients with signs and symptoms of sepsis were prospectively randomized to receive cefepime (13 patients) or ceftazidime (15 patients). Cultures of blood obtained at entry into the study were positive for 24 (85.7%) of 28 patients. Eight patients had two or more positive pretreatment blood cultures, and the remaining 16 had one positive pretreatment blood culture. The most commonly isolated blood pathogen was Escherichia coli. Eleven of 13 patients treated with cefepime and 12 of 15 patients treated with ceftazidime were clinically cured. Adverse effects attributable to therapy with the study drugs were minimal in both groups of patients and included rash, headache, nausea, and diarrhea. Our results suggest that cefepime is an efficacious and well tolerated as is ceftazidime in the treatment of hospitalized patients with documented gram-negative bacteremia.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bacteremia / drug therapy*
  • Cefepime
  • Ceftazidime / adverse effects
  • Ceftazidime / therapeutic use*
  • Cephalosporins / adverse effects
  • Cephalosporins / therapeutic use*
  • Drug Eruptions / etiology
  • Escherichia coli Infections / drug therapy
  • Female
  • Gram-Negative Bacterial Infections / drug therapy*
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella pneumoniae
  • Male
  • Middle Aged
  • Prospective Studies
  • Safety


  • Cephalosporins
  • Cefepime
  • Ceftazidime