Cefepime vs. Imipenem-Cilastatin in Severe Nosocomial Pneumonia

Nosocomial pneumonia, the most common infection in intensive care units (ICUs), often causes mortality. The efficacy of initial antibiotic therapy is an independent predictor of . . .

Nosocomial pneumonia, the most common infection in intensive care units (ICUs), often causes mortality. The efficacy of initial antibiotic therapy is an independent predictor of death. In this manufacturer-sponsored randomized trial, authors in Europe compared cefepime (2 g, 3 times daily) with imipenem-cilastatin (500 mg, 4 times daily) for treating nosocomial pneumonia in 281 ICU patients at 13 centers in 6 countries. Clinical response (cure or improvement) was assessed in 209 patients (cefepime, 108 patients; imipenem-cilastatin, 101 patients). The 2 groups had similar baseline characteristics; mean APACHE II score was 15, and most patients were mechanically ventilated. Pneumonia was culture-confirmed in 71% of patients.

The most common p…

Reviewing Author

Hartmut M. Lode, MD