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Epidemiology and Surveillance

Antimicrobial Activity of High-Proportion Cefepime-Tazobactam (WCK 4282) against a Large Number of Gram-Negative Isolates Collected Worldwide in 2014

Helio S. Sader, Mariana Castanheira, Rodrigo E. Mendes, Robert K. Flamm, Ronald N. Jones
Helio S. Sader
JMI Laboratories, North Liberty, Iowa, USA
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Mariana Castanheira
JMI Laboratories, North Liberty, Iowa, USA
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Rodrigo E. Mendes
JMI Laboratories, North Liberty, Iowa, USA
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Robert K. Flamm
JMI Laboratories, North Liberty, Iowa, USA
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Ronald N. Jones
JMI Laboratories, North Liberty, Iowa, USA
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DOI: 10.1128/AAC.02409-16
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Tables

  • TABLE 1

    Cumulative frequency distributions of cefepime and cefepime-tazobactam (with tazobactam at fixed concentration of 8 μg/ml) MIC results when tested against bacterial isolatesa

    Organism (no. of isolates) and antimicrobialNo. of organisms (cumulative % inhibited) at MIC (μg/ml) of:
    ≤0.030.060.120.250.51248163264>64
    Enterobacteriaceae (6,219)
        Cefepime2,625 (42.2) 1,469 (65.8) 519 (74.2)244 (78.1)155 (80.6)93 (82.1)122 (84.0)92 (85.5)147 (87.9) 151 (90.3) 131 (92.4)166 (95.1)305 (100.0)
        Cefepime-tazobactam 3,175 (51.1) 1,585 (76.5)596 (86.1) 304 (91.0) 141 (93.3)84 (94.6)68 (95.7)40 (96.4)36 (96.9)42 (97.6)26 (98.0)54 (98.9)68 (100.0)
    E. coli (2,211)
        Cefepime1,000 (45.2) 535 (69.4) 162 (76.8)48 (78.9)38 (80.6)20 (81.5)44 (83.5)37 (85.2)67 (88.2) 65 (91.2) 52 (93.5)58 (96.2)85 (100.0)
        Cefepime-tazobactam 1,290 (58.3) 551 (83.3) 207 (92.6) 93 (96.8)27 (98.1)10 (98.5)14 (99.1)7 (99.5)6 (99.7)3 (99.9)1 (99.9)0 (>99.9)2 (100.0)
    E. coli with ESBL phenotype (471)
        Cefepime5 (1.1)14 (4.0)18 (7.9)10 (10.0)18 (13.8)12 (16.3)33 (23.4)35 (30.8)66 (44.8) 65 (58.6) 52 (69.6)58 (82.0) 85 (100.0)
        Cefepime-tazobactam87 (18.5)148 (49.9) 112 (73.7) 65 (87.5) 22 (92.1) 5 (93.2)14 (96.2)6 (97.5)6 (98.7)3 (99.4)1 (99.6)0 (99.6)2 (100.0)
    Klebsiella spp. (2,138)
        Cefepime981 (45.9) 343 (61.9) 113 (67.2)60 (70.0)39 (71.8)32 (73.3)31 (74.8)27 (76.1)61 (78.9)73 (82.3)72 (85.7) 97 (90.2) 209 (100.0)
        Cefepime-tazobactam 1,139 (53.3) 410 (72.5)142 (79.1)87 (83.2)58 (85.9)40 (87.7)34 (89.3) 29 (90.7) 25 (91.9)36 (93.5)22 (94.6)52 (97.0)64 (100.0)
    Klebsiella spp. with ESBL phenotype (661)
        Cefepime2 (0.3)7 (1.4)12 (3.2)16 (5.6)26 (9.5)28 (13.8)31 (18.5)27 (22.5)61 (31.8)73 (42.8) 72 (53.7) 97 (68.4) 209 (100.0)
        Cefepime-tazobactam103 (15.6)103 (31.2)58 (39.9)53 (48.0) 46 (54.9) 36 (60.4)34 (65.5)29 (69.9)25 (73.7)36 (79.1)22 (82.5) 52 (90.3) 64 (100.0)
    K. pneumoniae (1,788)
        Cefepime747 (41.8) 293 (58.2) 96 (63.5)50 (66.3)32 (68.1)23 (69.4)23 (70.7)23 (72.0)57 (75.2)70 (79.1)70 (83.0)95 (88.3) 209 (100.0)
        Cefepime-tazobactam879 (49.2) 372 (70.0) 129 (77.2)78 (81.5)51 (84.4)31 (86.1)28 (87.7)26 (89.1) 21 (90.3) 36 (92.3)21 (93.5)52 (96.4)64 (100.0)
    K. pneumoniae with ESBL phenotype (602)
        Cefepime1 (0.2)3 (0.7)5 (1.5)8 (2.8)19 (6.0)19 (9.1)23 (13.0)23 (16.8)57 (26.2)70 (37.9)70 (49.5) 95 (65.3) 209 (100.0)
        Cefepime-tazobactam92 (15.3)96 (31.2)53 (40.0)47 (47.8) 39 (54.3) 27 (58.8)28 (63.5)26 (67.8)21 (71.3)36 (77.2)21 (80.7)52 (89.4) 64 (100.0)
    MEM-nonsusceptible K. pneumoniae (183)
        Cefepime 1 (0.5)6 (3.8)6 (7.1)17 (16.4)33 (34.4) 120 (100.0)
        Cefepime-tazobactam 6 (3.3)10 (8.7)12 (15.3)32 (32.8)16 (41.5) 49 (68.3) 58 (100.0)
    Klebsiella oxytoca (345)
        Cefepime 230 (66.7) 50 (81.2)16 (85.8)10 (88.7) 7 (90.7) 9 (93.3)8 (95.7)4 (96.8)4 (98.0)3 (98.8)2 (99.4)2 (100.0)
        Cefepime-tazobactam 256 (74.2) 38 (85.2)12 (88.7) 9 (91.3) 7 (93.3)9 (95.9)6 (97.7)3 (98.6)4 (99.7)0 (99.7)1 (100.0)
    Klebsiella oxytoca with ESBL phenotype (59)
        Cefepime1 (1.7)4 (8.5)7 (20.3)8 (33.9)7 (45.8) 9 (61.0) 8 (74.6)4 (81.4)4 (88.1) 3 (93.2) 2 (96.6)2 (100.0)
        Cefepime-tazobactam11 (18.6)7 (30.5)5 (39.0)6 (49.2) 7 (61.0) 9 (76.3)6 (86.4) 3 (91.5) 4 (98.3)0 (98.3)1 (100.0)
    P. mirabilis (228)
        Cefepime27 (11.8) 144 (75.0) 32 (89.0) 8 (92.5) 1 (93.0)7 (96.1)1 (96.5)1 (96.9)3 (98.2)0 (98.2)0 (98.2)1 (98.7)3 (100.0)
        Cefepime-tazobactam39 (17.1) 155 (85.1) 29 (97.8) 4 (99.6)1 (100.0)
    P. mirabilis with ESBL phenotype (19)
        Cefepime 2 (10.5)1 (15.8) 7 (52.6) 1 (57.9)1 (63.2)3 (78.9)0 (78.9)0 (78.9)1 (84.2) 3 (100.0)
        Cefepime-tazobactam 4 (21.1) 10 (73.7) 4 (94.7) 1 (100.0)
    Enterobacter spp. (629)
        Cefepime208 (33.1) 151 (57.1) 78 (69.5)55 (78.2)39 (84.4)15 (86.8) 30 (91.6) 19 (94.6)11 (96.3)9 (97.8)4 (98.4)5 (99.2)5 (100.0)
        Cefepime-tazobactam233 (37.0) 151 (61.0) 92 (75.7)63 (85.7) 38 (91.7) 25 (95.7)13 (97.8)4 (98.4)3 (98.9)3 (99.4)2 (99.7)1 (99.8)1 (100.0)
    CAZ-nonsusceptible Enterobacter spp. (179)
        Cefepime 4 (2.2)17 (11.7)33 (30.2)31 (47.5) 15 (55.9) 28 (71.5)18 (81.6)10 (87.2) 9 (92.2) 4 (94.4)5 (97.2)5 (100.0)
        Cefepime-tazobactam1 (0.6)11 (6.7)41 (29.6) 45 (54.7) 32 (72.6)23 (85.5) 12 (92.2) 4 (94.4)3 (96.1)3 (97.8)2 (98.9)1 (99.4)1 (100.0)
    Morganella morganii (165)
        Cefepime 104 (63.0) 47 (91.5) 6 (95.2)4 (97.6)1 (98.2)0 (98.2)1 (98.8)2 (100.0)
        Cefepime-tazobactam 129 (78.2) 30 (96.4) 3 (98.2)3 (100.0)
    Citrobacter spp. (311)
        Cefepime 197 (63.3) 45 (77.8)12 (81.7)14 (86.2) 15 (91.0) 10 (94.2)6 (96.1)4 (97.4)1 (97.7)1 (98.1)2 (98.7)3 (99.7)1 (100.0)
        Cefepime-tazobactam 200 (64.3) 57 (82.6)18 (88.4) 19 (94.5) 7 (96.8)5 (98.4)3 (99.4)0 (99.4)1 (99.7)0 (99.7)0 (99.7)1 (100.0)
    Serratia marcescens (245)
        Cefepime8 (3.3)98 (43.3) 81 (76.3) 31 (89.0) 11 (93.5) 4 (95.1)4 (96.7)1 (97.1)3 (98.4)2 (99.2)0 (99.2)1 (99.6)1 (100.0)
        Cefepime-tazobactam8 (3.3) 116 (50.6) 72 (80.0) 33 (93.5) 10 (97.6)2 (98.4)3 (99.6)0 (99.6)1 (100.0)
    Proteus vulgaris (144)
        Cefepime11 (7.6) 76 (60.4) 31 (81.9) 15 (92.4) 6 (96.5)1 (97.2)3 (99.3)1 (100.0)
        Cefepime-tazobactam32 (22.2) 84 (80.6) 26 (98.6) 2 (100.0)
    Providencia spp. (148)
        Cefepime 89 (60.1) 30 (80.4)4 (83.1)9 (89.2) 5 (92.6) 4 (95.3)2 (96.6)0 (96.6)1 (97.3)1 (98.0)1 (98.6)1 (99.3)1 (100.0)
        Cefepime-tazobactam 105 (70.9) 31 (91.9) 7 (96.6)0 (96.6)0 (96.6)2 (98.0)1 (98.6)0 (98.6)0 (98.6)0 (98.6)1 (99.3)0 (99.3)1 (100.0)
    P. aeruginosa (1,171)
        Cefepime 4 (0.3)4 (0.7)36 (3.8)136 (15.4) 414 (50.7) 184 (66.4)169 (80.9) 110 (90.3) 63 (95.6)24 (97.7)27 (100.0)
        Cefepime-tazobactam 1 (0.1)5 (0.5)6 (1.0)17 (2.5)171 (17.1) 404 (51.6) 184 (67.3)177 (82.4) 108 (91.6) 61 (96.8)15 (98.1)22 (100.0)
    CAZ-nonsusceptible P. aeruginosa (252)
        Cefepime 1 (0.4)3 (1.6)17 (8.3)40 (24.2) 79 (55.6) 61 (79.8)24 (89.3) 27 (100.0)
        Cefepime-tazobactam 2 (0.8)4 (2.4)24 (11.9)45 (29.8) 82 (62.3) 58 (85.3) 15 (91.3) 22 (100.0)
    MEM-nonsusceptible P. aeruginosa (244)
        Cefepime 1 (0.4)15 (6.6)23 (16.0)52 (37.3) 62 (62.7) 45 (81.1)20 (89.3) 26 (100.0)
        Cefepime-tazobactam 4 (1.6)13 (7.0)26 (17.6)56 (40.6) 65 (67.2) 46 (86.1) 14 (91.8) 20 (100.0)
    A. baumannii (591)
        Cefepime 1 (0.2)5 (1.0)8 (2.4)42 (9.5)54 (18.6)25 (22.8)21 (26.4)42 (33.5) 105 (51.3) 288 (100.0)
        Cefepime-tazobactam53 (9.0)17 (11.8)11 (13.7)14 (16.1)9 (17.6)15 (20.1)18 (23.2)8 (24.5)9 (26.1)31 (31.3)55 (40.6) 90 (55.8) 261 (100.0)
    • ↵a Tazobactam was used at a fixed concentration of 8 μg/ml, and the results are for 7,981 bacterial isolates from all geographic regions combined. Values in bold indicate MIC50s and MIC90s. Abbreviations: ESBL phenotype, extended-spectrum β-lactamase (ESBL)-screen-positive phenotype, defined as an MIC of ≥2 μg/ml for ceftriaxone, ceftazidime, and/or aztreonam; CAZ nonsusceptible, ceftazidime nonsusceptible (MICs, ≥8 μg/ml for Enterobacteriaceae and ≥16 μg/ml for P. aeruginosa); MEM nonsusceptible, meropenem nonsusceptible (MICs, ≥2 μg/ml for Enterobacteriaceae and ≥4 μg/ml for P. aeruginosa) (7).

  • TABLE 2

    Activity of cefepime-tazobactam combination and comparator agents tested against bacterial isolates collected worldwide in 2014

    Organism and antimicrobial agentMIC50 (μg/ml)MIC90 (μg/ml)% susceptible by use of CLSI/EUCAST breakpoint criteriaa (no. of isolates)
    United StatesEuropeLatin AmericaAPACdChinaAll regions
    Enterobacteriaceae (2,466)(2,351)(466)(693)(243)(6,219)
        Cefepime-tazobactam (tazobactam at fixed 8 μg/ml)≤0.030.2598.3/97.6b95.8/94.3b94.4/91.4b98.7/97.8b93.8/92.6b96.9/95.7b
        Cefepime-tazobactam (tazobactam at fixed 4 μg/ml)0.060.598.1/97.1b94.7/93.2b92.9/90.3b98.1/96.5b93.4/91.8b96.2/94.9b
        Cefepime0.061692.2/90.481.1/79.264.8/63.386.3/83.860.5/56.484.0/82.1
        Ceftazidime0.25>1688.9/86.478.4/74.665.9/60.382.5/78.268.7/58.881.7/78.0
        Ceftriaxone≤0.06>884.5/84.572.1/72.158.4/58.477.3/77.349.0/49.075.7/78.0
        Piperacillin-tazobactam23292.0/88.984.2/79.582.6/78.889.2/85.084.6/79.387.7/83.8
        Meropenem0.030.0697.9/98.295.5/95.994.8/95.598.6/98.794.2/94.296.7/97.0
        Levofloxacin≤0.12>884.4/83.178.0/75.963.5/62.782.7/81.163.2/61.279.4/77.8
        Gentamicin≤1490.1/88.485.3/84.172.7/71.984.6/84.363.0/62.685.3/84.1
    P. aeruginosa (390)(391)(109)(197)(84)(1,171)
        Cefepime-tazobactam (tazobactam at fixed 8 μg/ml)21685.9c79.8c79.8c85.8c73.8c82.4b
        Cefepime-tazobactam (tazobactam at fixed 4 μg/ml)21686.2c78.5c78.9c85.8c73.8c82.0b
        Cefepime21684.4/84.478.3/78.377.1/77.184.8/84.872.6/72.680.9/80.9
        Ceftazidime2>1687.2/87.273.1/73.170.6/70.679.7/79.770.2/70.278.5/78.5
        Piperacillin-tazobactam4>6486.2/86.274.7/74.776.1/76.181.7/81.766.7/66.779.2/79.2
        Meropenem0.5885.6/85.673.9/73.975.2/75.283.2/53.269.0/69.079.2/79.2
        Levofloxacin0.5>479.0/67.771.1/63.767.0/59.680.7/72.676.2/67.975.3/66.4
        Amikacin2897.2/92.891.0/86.790.8/89.994.4/91.991.7/88.193.7/90.0
    Acinetobacter spp. (152)(184)(72)(93)(90)(591)
        Cefepime-tazobactam (tazobactam at fixed 8 μg/ml)64>6453.9c18.5c9.7c18.3c15.6c26.1b
        Cefepime-tazobactam (tazobactam at fixed 4 μg/ml)64>6453.3c17.4c8.3c18.3c15.6c25.9b
        Cefepime64>6446.7/—16.3/—6.9/—17.2/—14.4/—22.8/—
        Ceftazidime>32>3254.6/—17.4/—9.7/—19.4/—14.4/—25.9/—
        Piperacillin-tazobactam>64>6453.9/—19.6/—6.9/—17.2/—12.4/—25.4/—
        Ampicillin-sulbactam32>3263.6/—24.5/—18.1/—16.1/—15.6/—31.0/—
        Meropenem>32>3256.6/56.626.1/26.111.1/11.117.2/17.216.7/16.729.3/—
        Levofloxacin>4>453.3/52.618.5/17.411.1/11.118.3/18.315.6/15.626.1/25.4
        Amikacin>32>3278.1/74.828.8/26.613.9/12.530.1/26.921.1/18.938.6/36.1
    • ↵a Unless indicated otherwise, the data are based on the criteria published by CLSI (7) and EUCAST (12). For cefepime-tazobactam, only CLSI criteria were applied. — indicates that breakpoints have not been established.

    • ↵b Percentage inhibited by ≤8 μg/ml cefepime/≤2 μg/ml cefepime, according to the CLSI breakpoint criteria for cefepime susceptibility for high and low dosages (2 g every 8 h and 1 g every 12 h, respectively), as published in CLSI document M100-S26 (7).

    • ↵c Percentage inhibited at ≤8 μg/ml, according to the CLSI breakpoint for cefepime susceptibility published by the CLSI (7) and EUCAST (12) (P. aeruginosa only).

    • ↵d APAC, Asia-Pacific region excluding China.

  • TABLE 3

    Summary of activity of cefepime-tazobactam with tazobactam at fixed 8 μg/ml stratified by geographic region

    Organisms (no. of isolates for all regions combined)bMIC50/MIC90 (μg/ml) of cefepime-tazobactam with tazobactam at fixed 8 μg/ml (% isolates inhibited at ≤8 µg/ml)a
    United StatesEuropeLatin AmericaAPACbChinaAll regions
    Enterobacteriaceae (6,219)≤0.03/0.25 (98.3)≤0.03/0.5 (95.8)0.06/1 (94.4)≤0.03/0.25 (98.7)0.06/0.5 (93.8)≤0.03/0.25 (96.9)
    E. coli (2,211)≤0.03/0.12 (99.9)≤0.03/0.12 (100.0)0.06/0.25 (100.0)≤0.03/0.06 (99.7)0.06/0.25 (96.2)≤0.03/0.12 (99.7)
        ESBL phenotype (471)0.12/0.25 (99.0)0.12/1 (100.0)0.12/0.25 (100.0)0.06/0.25 (98.4)0.06/0.25 (94.2)0.12/0.5 (98.7)
    Klebsiella spp. (2,138)≤0.03/0.25 (95.9)0.06/32 (87.4)0.06/64 (85.0)≤0.03/0.25 (96.5)0.06/64 (86.1)≤00.03/4 (91.9)
        ESBL phenotype (661)0.5/32 (78.8)0.5/>64 (71.8)1/>64 (72.2)0.12/64 (87.9)0.12/64 (66.7)0.5/64 (73.7)
    K. pneumoniae (1,788)≤0.03/0.25 (94.9)0.06/64 (85.0)0.06/64 (83.3)≤0.03/0.5 (96.2)0.06/64 (85.1)0.06/8 (90.3)
        MEM-non-susceptible (183)16/>64 (20.0)64/>64 (14.6)64/>64 (20.8)>64/— (0.0)64/>64 (0.0)64/>64 (15.3)
    Klebsiella oxytoca (345)≤0.03/0.12 (100.0)≤0.03/1 (99.2)≤0.03/1 (100.0)≤0.03/0.12 (100.0)≤0.03/— (100.0)≤0.03/0.25 (99.7)
        ESBL-phenotype (59)0.5/4 (100.0)1/8 (96.4)1/— (100.0)0.12/— (100.0) 0.5/4 (98.3)
    P. mirabilis (228)0.06/0.12 (100.0)0.06/0.12 (100.0)0.06/0.12 (100.0)0.06/0.06 (100.0)0.06/— (100.0)0.06/0.12 (100.0)
        ESBL phenotype (19)0.12/— (100.0)0.12/0.25 (100.0)0.25 (100.0) 0.06/— (100.0)0.12/0.25 (100.0)
    Enterobacter spp. (629)0.06/0.25 (99.2)0.06/0.5 (98.7)0.06/1 (98.2)0.06/1 (100.0)0.06/1 (97.4)0.06/0.5 (98.9)
        CAZ nonsusceptible (179)0.25/2 (96.2)0.25/2 (95.5)0.25/2 (95.2)0.25/2 (100.0)0.25/8 (93.3)0.25/2 (96.1)
    Morganella morganii (165)≤0.03/0.06 (100.0)≤0.03/0.06 (100.0)≤0.03/— (100.0)≤0.03/≤0.03 (100.0)≤0.03/— (100.0)≤0.03/0.06 (100.0)
    Citrobacter spp. (311)≤0.03/0.12 (100.0)≤0.03/0.25 (99.2)0.06/— (100.0)≤0.03/0.25 (100.0)0.12/— (100.0)≤0.03/0.25 (99.7)
    Serratia marcescens (245)0.06/0.25 (100.0)0.06/0.25 (100.0)0.06/0.12 (100.0)0.06/0.12 (100.0)0.06/0.25 (100.0)0.06/0.25 (100.0)
    Proteus vulgaris (144)0.06/0.12 (100.0)0.06/0.12 (100.0)≤0.03/— (100.0)0.06/— (100.0)0.06/— (100.0)0.06/0.12 (100.0)
    Providencia spp. (148)≤0.03/0.12 (98.9)≤0.03/0.06 (98.1)≤0.03/— (100.0)≤0.03/— (100.0) ≤0.03/0.06 (98.6)
    P. aeruginosa (1,171)2/16 (85.9)4/16 (79.8)4/32 (79.8)2/16 (85.8)4/32 (73.8)2/16 (82.4)
        CAZ nonsusceptible (252)16/64 (22.0)16/32 (31.4)16/>64 (37.5)16/>64 (35.0)32/>64 (20.0)16/64 (29.8)
        MEM nonsusceptible (244)16/64 (37.5)16/32 (42.2)16/>64 (44.4)16/>64 (39.4)32/>64 (15.6)16/64 (40.6)
    A. baumannii (591)4/>64 (53.9)64/>64 (18.5)>64/>64 (9.7)>64/>64 (18.3)>64/>64 (15.6)64/>64 (26.1)
    • ↵a According to the breakpoint for cefepime susceptibility for a high dosage (2 g every 8 h) published in CLSI document M100-S26 (7). —, there were too few isolates (<10) with which to calculate the MIC90.

    • ↵b Abbreviations: APAC, Asia-Pacific region excluding China; ESBL phenotype, extended-spectrum β-lactamase (ESBL)-screen-positive phenotype, defined as an MIC of ≥2 μg/ml for ceftriaxone, ceftazidime, and/or aztreonam; CAZ nonsusceptible, ceftazidime nonsusceptible (MICs, ≥8 μg/ml for Enterobacteriaceae and ≥16 μg/ml for P. aeruginosa); MEM nonsusceptible, meropenem nonsusceptible (MICs, ≥2 μg/ml for Enterobacteriaceae and ≥4 μg/ml for P. aeruginosa) (7).

  • TABLE 4

    Regional occurrence of resistance phenotypesa

    Geographic region% of isolates
    ESBL phenotypeMEM-NSCAZ-NS
    E. coliK. pneumoniaeK. oxytocaP. mirabilisK. pneumoniaeP. aeruginosaEnterobacter spp.P. aeruginosa
    United States14.416.212.91.16.026.122.226.9
    Europe19.349.322.614.915.714.428.912.8
    Latin American37.458.018.813.316.024.839.329.4
    APAC18.829.322.70.03.816.833.820.3
    China66.344.80.020.014.931.039.529.8
    All regions combined21.333.717.18.310.220.828.521.5
    • ↵a Abbreviations: ESBL phenotype, extended-spectrum β-lactamase (ESBL)-screen-positive phenotype, defined as an MIC of ≥2 μg/ml for ceftriaxone, ceftazidime, and/or aztreonam (20); MEM-NS, meropenem nonsusceptible (MICs, ≥2 μg/ml for K. pneumoniae and ≥4 μg/ml for P. aeruginosa) (7); CAZ-NS, ceftazidime nonsusceptible (MICs, ≥8 μg/ml for Enterobacter spp. and ≥16 μg/ml for P. aeruginosa) (7); APAC, Asia-West Pacific region excluding China.

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Antimicrobial Activity of High-Proportion Cefepime-Tazobactam (WCK 4282) against a Large Number of Gram-Negative Isolates Collected Worldwide in 2014
Helio S. Sader, Mariana Castanheira, Rodrigo E. Mendes, Robert K. Flamm, Ronald N. Jones
Antimicrobial Agents and Chemotherapy Mar 2017, 61 (4) e02409-16; DOI: 10.1128/AAC.02409-16

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Antimicrobial Activity of High-Proportion Cefepime-Tazobactam (WCK 4282) against a Large Number of Gram-Negative Isolates Collected Worldwide in 2014
Helio S. Sader, Mariana Castanheira, Rodrigo E. Mendes, Robert K. Flamm, Ronald N. Jones
Antimicrobial Agents and Chemotherapy Mar 2017, 61 (4) e02409-16; DOI: 10.1128/AAC.02409-16
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KEYWORDS

cephalosporins
Gram-negative bacteria
Penicillanic Acid
cefepime-tazobactam

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