English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  We assessed the influence of current cefepime minimal inhibitory concentration (MIC) breakpoints and the maximal cefepime dose on treatment outcomes in patients with bacteremia caused by cefepime-susceptible  Pseudomonas aeruginosa .    Methods  Adult patients hospitalized between July 2010 and June 2014 with a positive blood culture for cefepime-susceptible  P. aeruginosa  and receipt of cefepime as the primary therapy throughout the course were reviewed. Cefepime Etest ®  MICs and clinical outcomes for  P. aeruginosa  bacteremia were reviewed to identify the MIC breakpoint influencing treatment outcomes.    Results  Of the 90 patients enrolled, 49 (54.4%) were male (mean age = 66.8 years). The mean Acute Physiology and Chronic Health Evaluation II score was 22.01. Sixty patients (66.7%) received a maximal cefepime dose, and the 30-day crude mortality rate was 36.7%. MIC 90  of cefepime for  P. aeruginosa  was 8 mg/L. The cumulative survival rate at 30 days revealed that a lower cefepime MIC (<4 mg/L) for  P. aeruginosa  was associated with a higher survival rate than a higher MIC (≥4 mg/L) (72.6% vs. 23.5%,  p  < 0.0001). A cefepime MIC of ≥4 mg/L and age were independent risk factors for mortality, whereas the maximal cefepime dose was the independent protective factor. The use of a maximal cefepime dose did not improve the outcomes of patients with  P. aeruginosa  bacteremia at a MIC of ≥4 mg/L.    Conclusions  A cefepime MIC of 4 mg/L may predict an unfavorable outcome among patients with serious infections caused by  P. aeruginosa , even the MICs still within the CLSI susceptibility breakpoint.

annals of clinical microbiology and antimicrobials

Influence of borderline cefepime MIC on the outcome of cefepime-susceptible Pseudomonas aeruginosa bacteremia treated with a maximal cefepime dose: a hospital-based retrospective study