• Journal of Neurocritical Care
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• v.7 no.2
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• pp.104-110
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• 2014

Background: Cefepime is a fourth-generation cephalosporin widely used for empiric treatment of severe infections. Neurotoxicity by cefepime have been reported due to γ-aminobutyric acid A receptor inhibition or other mechanisms. The aim of this study was to evaluate the risk factors for cefepime-induced neurotoxicity between group showing cefepime-induced neurotoxicity and group without neurotoxicity. Methods: From Jan 2005 to June 2010, a total of 2,461 patients (older than 20) who used cefepime were considered in this study. We compared patients who developed cefepime-induced neurotoxicity (patient group, n=21) to patients who had no cefepime-induced neurotoxicity (control group, n=31). We analyzed demographic, underlying diseases, and metabolic parameters before cefepime treatment and during cefepime treatment between the two groups. Statistical analysis was performed using SPSS 18 software. Results: Of the total 2461 patients, 21 (0.85%) were diagnosed with cefepime-induced neurotoxicity. Impaired glomerular filtration rate (GFR at 15-30 ml/min) before cefepime use were significantly (P<0.05) higher risk for developing cefepime-induced neurotoxicity in patient group compared to that in the control group. Age, sex, and other metabolic parameters except GFR before and during, usage of cefepime did not show any statistical difference between the two groups. Conclusion: The present study revealed that cefepime-induced neurotoxicity was prone to develop in patients with impaired renal function before cefepime usage.

• Annals of Clinical Neurophysiology
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• v.20 no.2
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• pp.97-100
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• 2018

Nonconvulsive status epilepticus (NCSE) is an unusual complication in patients treated with cefepime. An 82-year-old woman on maintenance hemodialysis was given cefepime for pneumonia. Her level of consciousness decreased since the administration of cefepime, and she was diagnosed with NCSE based on electroencephalography (EEG) findings. After discontinuation of cefepime, improvement was seen both in the level of consciousness and EEG findings. Clinicians should be aware of cefepime-induced NCSE, particularly in patients with renal failure.

• The Korean Journal of Physiology and Pharmacology
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• v.7 no.4
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• pp.247-250
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• 2003

A simple and sensitive assay method was developed for cefepime in human plasma using high performance liquid chromatography (HPLC). Cefepime and cefadroxil (the internal standard) were extracted from heparinized human plasma by simple deproteination with perchloric acid. The extract was injected into an Atlantis dC18 column ($250{\times}4.6$ mm; particle size $5{\mu}m$, Waters) and the column was eluted with methanol and 0.01 M dihydrogen phosphate at pH 3.0 (15：85 v：v) as a mobile phase at a flow rate of 0.7 mL/min. Linearity was confirmed for the range 0.25 to $200{\mu}L/mL$ and the limit of quantitation was $0.25{\mu}L/mL$. The retention times were 10.2 min and 13.4 min for cefepime and cefadroxil, respectively. This method was successfully applied to a pharmacokinetic study of cefepime in plasma from bone marrow transplant patients.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.305-310
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• 2011

조혈모세포이식술(또는 HSCT)을 받은 환자에게는 이식관련 부작용의 예방 또는 치료를 위해 면역억제 약물이 투여되는데, 그 중 하나인 cyclosporine은 therapeutic index가 작고 다양한 요인에 의해 혈중농도가 변화되므로 사용시에는 세심한 관찰과 조절이 필요하다. 특히 HSCT 환자에서 발생하는 호중구 감소성 발열(또는 NPF)의 치료목적으로 투여하는 항생제에 의하여 cyclosporine의 혈중농도가 변화될 수 있고, 또 임상적 경과에 따라 항생제 처방이 중도에 변경되는 경우도 빈번하지만, 실제로 항생제 처방의 중간변경에 의한 cyclosporine의 혈중농도 변화양상을 연구한 결과는 많지 않다. 이에, 과거 2년 동안 한 상급종합병원에서 HSCT후 cyclosporine을 투여 받았던 환자 중에서 통상적인 NPF 치료용 항생제인 ciprofloxacin을 투여하다가 치료성과를 높이기 위하여 cefepime으로 대체 투여했던 환자들의 의무기록을 후향적으로 분석하였다. 1차 선택약인 ciprofloxacin에서 항생제를 변경했을 때 cyclosporine의 혈중농도가 유의성 있게 증가했는데, 이는 ciprofloxacin 보다 cefepime이 간에서 cyclosporine을 분해시키는 효소생성을 억제시켰기 때문일 것으로 예측되며, HSCT 환자에서 NPF 치료용 항생제를 ciprofloxacin에서 cefepime으로 변경 시에는 병용중인 cyclosporine 유지용량을 약 13% 감량하는 것이 cyclosporine의 효과는 유지하면서 부작용의 발생위험을 감소시키는 데 유용한 방안이 될 것으로 사료된다.

• The Journal of the Korea Contents Association
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• v.9 no.4
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• pp.275-285
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• 2009

During an 8 month period from January to August 2007, complete blood count (CBC) samples were taken from various wards and from the outpatient department at Samsung Medical Center. In order to determine whether or not the total white blood cells were over counted, results were obtained from both the 4Diff/channel and the white blood cell channel from the automated blood analysis equipment from S company for comparison. Among patients who were on long term treatments, the number of cases determined to be over counted by comparing the WBC counts during this 8 month period was 25. Clinical chemistry tests were also conducted on the same day on the 25 samples taken. 68% of the patients showed to exceed normal range of aspartate transaminase (AST) and alanine aminotransferase (ALT) indicating abnormal liver function, and the total bilirubin range were also in excess in 60% of the total samples taken. Further clinical information which was obtained from the patients showed 98% of the patients were administered with cefepime which is the 4th generation cephalosporin at the time when the WEC were over counted. It is assumed that a multiple of factors investigated caused the over count of the WEC rather than a single factor.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.178-185
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• 2015

Purpose: We investigated trends in antibiotic pressure and the antibiotic susceptibility of gram negative bacteria isolated from Korean children over 10 consecutive years. Methods: From January 2004 to December 2013, the antibiotic susceptibility of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii blood isolates obtained from children <18 years of age was determined according to the 2009 Clinical and Laboratory Standards Institute guidelines. Antibiotic consumption data were also analyzed. Results: The prevalence of K. pneumoniae, E. coli, P. aeruginosa, and A. baumannii bacteremia was 4.6, 3.5, 3.4, and 2.2 cases/1,000 blood cultures/year, respectively. In K. pneumoniae, resistance to the third and fourth cephalosporin did not increase significantly. However, carbapenem-resistant K. pneumoniae first appeared in 2010, and the resistance rate increased to 9% between 2012 and 2013. Resistance to 3rd and 4th cephalosporin increased from 10% to 50% in E. coli, and resistance to carbapenem rose abruptly from 11% to 71% in A. baumannii (P for trend <0.01). However, such an increase of resistance was not observed in P. aeruginosa. There is a positive correlation between the resistance rate of cefepime in E. coli and the consumption of cefepime (r=0.900, P=0.037). Conclusion: The significant burden of antibiotic consumption and the high prevalence of antibiotic resistance to gram negative pathogen isolated from bacteremic children were observed. Empirical antibiotics should be wisely selected, and continued efforts to decrease the overall antibiotic pressure are mandatory, especially in highly resistant situations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.653-659
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• 2016

The purpose of the study is to investigate the correlation between the amount of antimicrobial agent (Defined Daily Dose, DDD) and antimicrobial resistance rate (%). The treatment of infectious diseases is becoming increasingly difficult, due to the increase in the number of multi-drug resistant bacteria, making it a clinically significant problem. Among the various factors, antimicrobial abuse is a major cause of antimicrobial resistance. The study was conducted on inpatients in a secondary university hospital in the central region utilizing the hospital's computerized statistical data and microbiological program of laboratory medicine from January 2010 to December 2014 pertaining to the dose of antimicrobial drugs for Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli strains isolated from blood culture. We analyzed the antimicrobial resistance rate per dose with the Pearson correlation coefficient. A significant (positive?) correlation was detected between the cefepime dose and the resistance of E. coli (P<0.033; r=0.907), while a significant negative correlation was found between the tobramycin dose and the resistance of E.coli. (P<0.028; r=-0.917). The aminoglycoside resistance of A. baumannii showed a significant negative correlation (P<0.048; r=-0.881), and the aminoglycoside resistance of E. coli showed a significant negative correlation as well (P<0.001; r=-0.992). In conclusion, the amount of antimicrobial agent (Defined Daily Dose, DDD) (is partly related to) the bacterial strain and its antimicrobial resistance rate (%).

• Korean Journal of Food Science and Technology
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• v.53 no.4
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• pp.495-500
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• 2021

This study investigated the prevalence, serotypes, virulence genes, and antimicrobial resistance patterns of Listeria monocytogenes isolates collected from salmon products. A total of 16 out of 65 salmon products (24.6%) were positive for L. monocytogenes. Bacteria were most frequently identified in smoked salmon products (15/53, 28.3%). Serological tests revealed that serotype 1/2b (62.5%) was the predominant serotype of L. monocytogenes, followed by 1/2a (37.5%). All isolates harbored 10 virulence-associated genes (inlA, inlB, plcA, plcB, hlyA, actA, prf, fbpA, iap, and mpl), confirming their potential pathogenicity. The isolates of L. monocytogenes showed resistance to cefotetan (100%), cefotaxime (87.5%), cefepime (31.3%), erythromycin (6.3%), and tetracycline (6.3%); however, most of the strains were susceptible to antimicrobials except cephalosporins. These results provide useful information regarding the contamination of salmon products with L. monocytogenes, which may have implications for public health.

• Archives of Pharmacal Research
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• v.14 no.3
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• pp.279-281
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• 1991

In the field of cephalosporins, introduction of quaternary heterocyclic methyl goups at the C-3 position has led to a new class of cephalosporins such as cefepime and cefpirome, the so-called 4th generation cephalosporins which are characterized by their potent activity. Since than many efforts were attempted to synthesize more effective analogs.

• Korean Journal of Veterinary Service
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• v.27 no.2
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• pp.153-157
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• 2004

Bacteria isolated from nasal cavity of 50 Thoroughbred horses with respiratory tract infection were examined. There were isolated Pseudomonas aeruginosa(33.5%), Escherichia coli(10.2%), Pseudomonas spp(7.6%), Klebsiella oxytoca(5.9%), Streptococcus equi subsp zooepidemious(6.2%), Klebsiella pneumoniae(3.4%), Acinetobacter spp(5.5%) and coagulase negative staphylococcus(2.1%). The majority of isolates were highly susceptible to amikacin, amoxicillin, aztreonam, cefotaxime, cefepime, cefotetan, ceftazidime, cefuroxime, chloramphenicol, ciprofloxacin, clindamycin, erythromycin, gentamicin, imipenem, tetracyclin and vancomycin. These results can provide basic information for the treatments of respiratory tract infections in Thoroughbred horses.