Clinical profile of patients treated with cefepime/tazobactam: A new ß-lactam-ß-lactamase inhibitor combination

Yıl 2012, Cilt: 2 Sayı: 03, 79 - 86, 01.09.2012

Abdul Ghafur Ashwini Tayade Priyadarshini Kannaian

https://doi.org/10.5799/ahinjs.02.2012.03.0049

Cited By: 10

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Abdul Ghafur, Ashwini Tayade, Priyadarshini Kannaian Background and Purpose: Cefepime-tazobactam is a new ß-lactam ß-lactamase inhibitor combination licensed for clinical use by Drugs Controller General of India. Aim of our study was to analyze the clinical efficacy and safety of cefepime-tazobactam in patients with sepsis. To the best of our knowledge, this is the first published clinical study on this drug. Materials and Methods: A retrospective observational study on the efficacy and safety of cefepime-tazobactam was conducted at tertiary care hospital, South India. Patients who had a clear source of infection, having a single organism as the causative agent and being treated with cefepime-tazobactam alone were analyzed for efficacy and those cases who had a clear source of infection but either had multiple organism grown or cultures being negative or those patients who received a combination of antibiotics were analyzed for the safety analysis. Results: Thirty two patients satisfied our study criteria. All 15 patients in the efficacy group (nine with ventilator associated pneumonia, three tracheitis, two bacteraemia and one with urosepsis) had complete clinical cure, with microbiological cure in cases where a repeat culture was indicated. There were no significant side effects in any of the evaluable 32 patients assessed for safety. Conclusion: Cefepime-tazobactam is a safe and effective agent to treat patients with nonlife threatening sepsis due to Gram negative bacteria.

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Clinical profile of patients treated with cefepime/tazobactam: A new ß-lactam-ß-lactamase inhibitor combination

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Kaynakça

• Falagas ME, Bliziotis IA, Kasiakou SK, Samonis G, Atha- nassopoulou P, Michalopoulos A. Outcome of infections due to pandrug- resistant (PDR) Gram-negative bacteria. BMC Infect Dis 2005 ; 5: 24-28.
• Marchaim D, Chopra T, Jason M Pogue, et al. Outbreak of Colistin-Resistant, Carbapenem-Resistant Klebsiella pneu- monia in Metropolitan Detroit, Michigan. Antimicrob Agent Chemother 2011; 55: 2593-2599.
• Taneja N, Singh G, Singh M, Sharma M. Emergence of tigecy- cline & colistin resistant Acinetobacter baumanii in patients with complicated urinary tract infections in north India. Indian J Med Res 2011; 133: 681-684.
• Rodríguez-Baño J, Navarro MD, Retamar P, et al. β-Lactam/β- Lactam inhibitor combinations for the treatment of bacte- remia due to extended-spectrum β-lactamase-producing Eschıerichia coli: A post hoc analysis of prospective cohorts. Clin Infect Dis 2012: 54:167-174.
• Livermore DM, Hope R, Mushtaq S, Warner M. Orthodox and unorthodox clavulanate combinations against extended spectrum ß-lactamase producers. Clin Microbiol Infect 2008; 14:189-193.
• Deshpande P, Rodrigues C, Shetty A, Kapadia F, Hegde A, Soman R. New Delhi Metallo-ß-lactamase (NDM-1) in En- terobacteriaceae: Treatment options with Carbapenems Compromised. J Assoc Physicians India 2010; 58:147-149.
• Chaudhuri BN, Rodrigues C, Balaji V, et al. Incidence of ESBL Producers amongst Gram-negative Bacilli Isolated from Intra-abdominal Infections across India (Based on SMART Study, 2007 Data). J Assoc Physicians India 2011; 59:1-6.
• Abdul Ghafur K. An obituary- On the Death of antibiotics J As- soc Physicians India 2010; 58:143-144.
• Abdul Ghafur K. Can India be the Wing Commander in the Global fight against Antimicrobial Resistance? J Assoc Phy- sicians India 2012; 60:42-43.
• Jauregui LE, Appelbaum PC, Fabian TC, Hageage G, Straus- baugh L, Martin LF. A randomized clinical study of cefopera- zone and sulbactam versus gentamicin and clindamycin in the treatment of intra-abdominal infections. J Antimicrob Chemother 1990; 25:423-433.
• Karaman S, Vural S, Yildirmak Y, Emecen M, Erdem E, Ke- budi R. Comparison of piperacillin tazobactam and cefopera- zone sulbactam monotherapy in treatment of febrile neutro- penia. Pediatr Blood Cancer 2012; 58:579-583
• Bodey G, Abi-Said D, Rolston K, Raad I, Whimbey E. Imipe- nem or cefoperazone-sulbactam combined with vancomycin for therapy of presumed or proven infection in neutropenic cancer patients. Eur J Clin Microbiol Infect Dis 1996; 15:625- 634.
• Goel N, Wattal C, Oberoi JK, Raveendran R, Datta S, Prasad KJ. Trend analysis of antimicrobial consumption and devel- opment of resistance in non-fermenters in a tertiary care hos- pital in Delhi, India. JAC 2011; 66:1625-30
• Ghafur A, Nagvekar V, Thilakavathy S, Chandra K, Gopal- akrishnan R, Vidyalakshmi P. “Save antibiotics, save lives”: an Indian success story of infection control through persua- sive diplomacy. Antimicrob Resist Infect Control 2012, 1:29- 34.
• Maxipime® (Cefepime). U.S. Food and Drug Administra- tion. [Online]. 2009 (Cited 2012 July 25). Available from: URL:http://www.accessdata.fda.gov/drugsatfda_docs/ label/2009/050679s032lbl.pdf
• Perry CM, Markham A. Piperacillin/Tazobactam an updated review of its use in the treatment of bacterial infections. Drugs 1999; 57: 805-843.
• Zosyn® (Cefepime). U.S. Food and Drug Administration. [Online]. 2012 (Cited 2012 July 25). Available from: URL: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/ 050684s055s061_050750s016s020lbl.pdf.
• Mouton JW, Melchers R, Mil AV. In Vitro Activity of Cefepime alone and in combination with Tazobactam against ESBL producers. Poster session presented at ICAAC 2010, 12- 15 Sept; Boston, USA; A- 2251.
• Ghafur A, Pushparaju R, Nalini S, Rajkumar K, Sureshkumar D. Sensitivity pattern of Gram negative bacteria to the new ß-lactam/ß-lactamase inhibitor combination: Cefepime/tazo- bactam. J Microbiol Infect Dis 2012;2(1):120-125.
• Manoharan A, Madhan S, Kronvall G, Mathai D. Establishing interpretative breakpoints for cefepime/tazobactam: a novel B-lactam/ B-lactam inhibitor combination. 22nd European Congress of Clinical Microbiology and Infectious Diseases 2012;. 31st March-3rd April. London, UK. Abstract no: 947.
• Sharma A, Gupta A, Arora A. Cefepime/tazobactam: A new BL/BLI combination against ESBL producing Gram negative Bacilli. Int J Pharm Biomed Sci 2012; 3(2): 35-38.
• Panchatcharam SN, Ramasubramanian V, Gopalakrish- nan R, Ghafur A, Thirunarayan M. Cefepime/tazobactam: a promising therapeutic option. Abstract No: 50.011, 15th ICID, Bangkok, Thailand, June 13-16, 2012.
• Knaus WA, Draper EA, Wagner DP, Zimmerman JE. “APACHE II: a severity of disease classification system”. Critical Care Medicine 1985; 13 (10): 818–829.
• Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice Guidelines for Bacterial Meningitis .Clin Infect Dis 2004; 39:1267-1284.
• IDSA/ATS Guidelines for CAP in Adults. Clin Inf Dis 2007:44 (Suppl 2); S29-71.