Cefepime versus ceftriaxone for empiric treatment of hospitalized patients with community-acquired pneumonia

M. Zervos, M. Nelson, J. Bernstein, D. Kernodle, R. McCabe, N. Memon, R. Player, A. Quartin, C. VanHook, S. Willsie

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and gram-positive pathogens, including drug-resistant isolates. We compared the safety and efficacy of intravenous (i.v.) cefepime (2 g administered every 12 h) to those of i.v. ceftriaxone (1 g administered every 12 h) for the empiric treatment of hospitalized patients with community-acquired pneumonia. Of the 115 patients randomized to the study, 86 (cefepime recipients, n = 40; ceftriaxone recipients, n = 46) were evaluated for clinical efficacy (clinically evaluated patients). Favorable clinical outcomes (cure or improvement) were comparable among clinically evaluated patients in the cefepime and ceftriaxone treatment arms (95.0 versus 97.8%, respectively; 95% confidence interval for treatment difference [data for ceftriaxone group minus data for cefepime group], -5.1 to +10.8%). The most common bacteria isolated from patients in both treatment groups were Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. In clinically evaluated patients with a microbiologic response, all (100%) of the 32 pathogens from cefepime-treated patients and 97.4% (38 of 39) of the pathogens from ceftriaxone-treated patients were eradicated (documented or presumed eradication). The one persistent infection in the ceftriaxone group was caused by Pseudomonas fluorescens. Both treatments were well tolerated. Our data thus suggest that cefepime and ceftriaxone have comparable safety and efficacy for the treatment of pneumonia in hospitalized patients.

Original languageEnglish (US)
Pages (from-to)729-733
Number of pages5
JournalAntimicrobial agents and chemotherapy
Volume42
Issue number4
DOIs
StatePublished - Apr 1998

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Cefepime versus ceftriaxone for empiric treatment of hospitalized patients with community-acquired pneumonia'. Together they form a unique fingerprint.

  • Cite this

    Zervos, M., Nelson, M., Bernstein, J., Kernodle, D., McCabe, R., Memon, N., Player, R., Quartin, A., VanHook, C., & Willsie, S. (1998). Cefepime versus ceftriaxone for empiric treatment of hospitalized patients with community-acquired pneumonia. Antimicrobial agents and chemotherapy, 42(4), 729-733. https://doi.org/10.1128/aac.42.4.729