Efficacy of Cefepime Continuous Infusion Versus an Intermittent Dosing Regimen

Inclusion criteria

• Patients with sepsis, severe sepsis o septic shock diagnosis hospitalized in Intensive care Unit.
• Presence or suspect of Gram negative bacilli bacteremia
• To be possible the follow up according to planned visits
• Patients should be venous access to administrate the antibiotic
• Patients, whom the physicians consider cefepime like election treatment

Exclusion criteria

• Patients with a high degree of immunosuppression defined by:

• The presence of neutropenia (Neutrophils count less than 500 cells/mL, or Infection with HIV-AIDS with count of less than 50 CD4 cells/mL, or chronic Administration of immunosuppressive drugs (prednisone more than 5 mg/per day, azathioprine, cyclophosphamide, mycophenolate mofetil, etc.)
• Patients with chronic renal failure.
• Pregnant female patients
• Patients in whom to approach the doctor is considered with a high probability of dying in the next 48 hours (e.g. multiorgan system failure with more than 5 organs engaged according to the criteria of MarshalL et al. or shock irreversible.
• Patients with chronic infections as osteomyelitis or have prosthesis that would perpetuate the infection and requiring the administration of antibiotics for an extended time (including Endocarditis). -Patients with mixed infections that include Gram positive microorganisms or fungal infections.
• -Patients who have received in the past 30 days cefepime.
• Patients with presence of a gram negative bacillus resistant to cefepime. -Patients who are not able to identify them a bacillus gram negative.
• Patients who they are not able to confirm the antibiotic susceptibility of gram negative bacillus. -Patients with concomitant with antimicrobial activity for Gram negative bacilli (e.g. fluoroquinolones, aminoglycosides, etc.)
• Patients who have known hypersensitivity to B lactams or cefepime