Antimicrobial Coverage of Cefepime-Sulbactam

Notable Limitations

Cefepime-sulbactam is not effective against some carbapenemase-producing organisms, such as KPC producers, which may remain resistant 1

The Infectious Diseases Society of America recommends cefepime alone as monotherapy for empirical treatment of febrile neutropenia, covering P. aeruginosa and other serious gram-negative pathogens 1
Cefepime-sulbactam is particularly valuable for treating infections in settings with high prevalence of ESBL-producing organisms, such as hospital-acquired infections with suspected multidrug-resistant pathogens 2
For intra-abdominal infections, cefepime requires combination with metronidazole for anaerobic coverage, as recommended by the World Society of Emergency Surgery 4

The American College of Clinical Pharmacy notes that cefepime has broader spectrum activity than third-generation cephalosporins, particularly against gram-positive bacteria, and unlike ceftazidime, cefepime maintains good activity against both gram-negative organisms and gram-positive pathogens such as streptococci 1