Data/hora: 01/06/2024 07:30:18

Provedor de dados: 	55	
País: 	Brazil	
Título: 	A multicenter comparative study of cefepime versus broad-spectrum antibacterial therapy in moderate and severe bacterial infections	
Autores: 	Badaró,Roberto; Molinar,Fernando; Seas,Carlos; Stamboulian,Daniel; Mendonça,João; Massud,João; Nascimento,Luiz Olympio.	
Data: 	2002-10-01	
Ano: 	2002	
Palavras-chave: 	Cefepime; Ampicillin; Caphalotin; Ceftriaxone; Aminoglycoside; Urinary tract infections; Intra-abdominal infections; Sepsis.	
Resumo: 	The safety and efficacy of cefepime empiric monotherapy compared with standard broad-spectrum combination therapy for hospitalized adult patients with moderate to severe community-acquired bacterial infections were evaluated. In an open-label, multicenter study, 317 patients with an Acute Physiology and Chronic Health Evaluation (APACHE II) score ranging from &gt;5 to =19 were enrolled with documented pneumonia (n=196), urinary tract infection (n=65), intra-abdominal infection (n=38), or sepsis (n=18). Patients were randomly assigned 1:1 to receive cefepime 1 to 2 g IV twice daily or three times a day or IV ampicillin, cephalothin, or ceftriaxone ± aminoglycoside therapy for 3 to 21 days. For both treatment groups, metronidazole, vancomycin, or macrolide therapy was added as deemed necessary. The primary efficacy variable was clinical response at the end of therapy. Two hundred ninety-six (93%) patients met evaluation criteria and were included in the efficacy analysis. Diagnoses included the following: 180 pneumonias (90 cefepime, 90 comparator), 62 urinary tract infections (29 cefepime, 33 comparator), 37 intra-abdominal infections (19 cefepime, 18 comparator), and 17 sepses (8 cefepime, 9 comparator). At the end of therapy, overall clinical success rates were 131/146 (90%) for patients treated with cefepime vs 125/150 (83%) for those treated with comparator (95% confidence interval [CI]: - 2.6% to 16.3%). The clinical success rate for patients with community-acquired pneumonia, the most frequent infection, was 86% for both treatment groups. Among the patients clinically evaluated, 162 pathogens were isolated and identified before therapy. The most commonly isolated pathogens were Escherichia coli (n=49), Streptococcus pneumoniae (n=29), Haemophilus influenzae (n=14), and Staphylococcus aureus (n=11). Bacteriologic eradication/presumed eradication was 97% for cefepime vs 94% for comparator-treated patients. Drug-related adverse events were reported in 16% of cefepime patients and 19% of comparator patients. In conclusion, cefepime had higher cure rates compared with broad-spectrum combination therapy as an initial empiric treatment for hospitalized patients with moderate to severe community-acquired infections, including urinary tract infections, intra-abdominal infections, and sepsis.	
Tipo: 	Info:eu-repo/semantics/article	
Idioma: 	Inglês	
Identificador: 	http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702002000500001	
Editor: 	Brazilian Society of Infectious Diseases	
Relação: 	10.1590/S1413-86702002000500001	
Formato: 	text/html	
Fonte: 	Brazilian Journal of Infectious Diseases  v.6 n.5 2002	
Fonte: 	info:eu-repo/semantics/openAccess