Bacteriological, pharmacokinetic and clinical studies on cefepime in urology

The antibacterial activity, pharmacokinetics and clinical efficacy of cefepime (CFPM), a new cephalosporin antibiotic were studied in the urological field. The results were as follows. 1) Antibacterial activity : The MICs of CFPM against clinical isolates (209 strains of 14 species) from urinary tract infections were determined and compared with those of ceftazidime (CAZ), latamoxef (LMOX) and cefoperazone (CPZ). The overall antibacterial activities of CFPM were excellent and superior to those of other control antibiotics. 2) Pharmacokinetics : The pharmacokinetics were studied using 4 healthy volunteers and 7 patients with impaired renal function. The mean peak serum level and mean serum half-life of CFPM in healthy volunteers were 84.6 μ/ml and 1.76 h, respectively. The serum half-lives and urinary excretion rates of CFPM tended to be prolonged in parallel with lower decrease in creatinine clearance. 3) Clinical efficacy : In chronic complicated urinary tract infection, the overall clinical efficacy rate was 73.1 % according to the criteria of the Japanese UTI Committee. Bacteriologically 30 of 32 strains (93.8 %) were eradicated. Side effects : No symptoms or signs related to side effects were noted. Abnormal laboratory findings were observed in 7 patients, but all of them were mild and transient.