头孢吡肟:回顾它的使用与肺炎住院病人的管理。

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查普曼TM,佩里厘米

头孢吡肟:回顾它的使用与肺炎住院病人的管理。

和医学。2003;2 (1):75 - 107。

PubMed ID

14720024 (在PubMed

]

文摘

头孢吡肟(马斯平)、Maxcef Cepimax, Cepimex, Axepim,肠外第四代头孢菌素,是主动对许多生物引起肺炎。头孢吡肟对革兰氏阳性微生物体外活动包括金黄色葡萄球菌和penicillin-sensitive,中间和多重肺炎链球菌与头孢噻肟和头孢曲松钠相似。头孢吡肟也有好的活动对革兰氏阴性细菌,包括铜绿假单胞菌,头孢他啶相似。重要的是,头孢吡肟是稳定的对许多常见的质粒和chromosome-mediated beta-lactamases和是一个可怜的诱导物AmpC beta-lactamases。因此,保留活动对第三代头孢菌素对肠杆菌科,如实行去阻遏突变体的肠杆菌spp。头孢吡肟可能水解extended-spectrum beta-lactamases由肠杆菌科的一些成员,但程度低于第三代头孢菌素。头孢吡肟单1或2 g,通常每天喝两次静脉注射,是有效的临床和细菌学的反应如头孢他啶,头孢曲松钠、头孢噻肟单一疗法(1或2 g每日两到三次)的随机临床试验的住院成人,或更少通常,儿科,患者一般中度到重度的社区或医院内肺炎。更有限的数据表明,单一疗法与头孢吡肟每日三次,每次2 g也一样有效地治疗院内肺炎患者imipenem / cilostatin 0.5 g每天四次,加上阿米卡星,头孢吡肟和头孢他啶+阿米卡星一样有效。肺炎患者未能回复以前的抗菌疗法与其他青霉素或头孢菌素反应与头孢吡肟治疗。头孢吡肟一般耐受性良好,耐受性相似的其他肠外头孢菌素。在临床试验中,大多数的不良事件,头孢吡肟接受者是轻度至中度和可逆的。 The most common adverse events with a causal relationship to cefepime reported in clinical trials included rash and diarrhea. Other, less common, adverse events included pruritus, urticaria, nausea, vomiting oral candidiasis, colitis, headache, fever, erythema and vaginitis. CONCLUSION: Cefepime is an established and generally well tolerated parenteral drug with a broad spectrum of antibacterial activity which, when administered twice daily, provides coverage of most of the pathogens that may be causative in pneumonia. In randomized clinical trials in hospitalized patients with generally moderate to severe community-acquired or nosocomial pneumonia, cefepime monotherapy exhibited good clinical and bacteriological efficacy. Cefepime may become a preferred antibacterial agent for infections caused by Enterobacter spp. With prudent use in order to prevent the emergence of resistant organisms, cefepime will continue to be a suitable option for the empiric treatment of pneumonia.

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头孢吡肟