antibioticsbooks

82 PART 2 Antibacterial Drugs
but overkill for most community-acquired
infections. Be sure to deescalate therapy if possible
when you treat empirically with cefepime.
• For monotherapy of febrile neutropenia,
cefepime is a better choice than ceftazidime
because of its better Gram-positive activity. It
may also induce less resistance in GNRs than
third-generation cephalosporins, but it is still
not a good drug to overuse.
• Cefepime briefly had a bad reputation after
a meta-analysis showed increased mortality
with its use compared with other drugs. Many
clinicians were skeptical, however, and a more
thorough FDA analysis exonerated cefepime.
What It’s Good For
Febrile neutropenia, nosocomial pneumonia, postneurosurgical
meningitis, other nosocomial infections.
Don’t Forget!
Cefepime is used primarily for nosocomial infections.
Although it is indicated for infections of the
urinary tract and lower respiratory tract, it is overkill
for most community-acquired sources of these
infections.