Table 2. Open in new tab Susceptibility...

Dosing regimen	Cefepime/sulbactam target MIC (mg/L), 60% fT_>MIC	Percentage susceptible
		sulbactam 3 g	sulbactam 1.5 g	sulbactam 6 g
Cefepime 3 g	bolus	≤2/≤0.25	≤2/≤0.25	≤2/≤0.5	33	40	53	6	10	10	5	3	5	0	14	0	11	10	11
	extended infusion	≤4/≤1	≤4/≤0.5	≤4/≤2	53	43	73	17	12	17	9	6	8	14	43	0	21	15	24
	continuous infusion	≤4/≤2	≤4/≤1	≤4/≤4	60	46	73	23	19	17	19	9	9	43	57	29	30	19	26
		sulbactam 4 g	sulbactam 2 g	sulbactam 8 g
Cefepime 4 g	bolus	≤4/≤0.5	≤4/≤0.25	≤4/≤1	47	40	53	12	10	10	5	6	6	0	14	0	15	10	17
	extended infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
	continuous infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
		sulbactam 6 g	sulbactam 3 g	sulbactam 12 g
Cefepime 6 g	bolus	≤4/≤0.5	≤4/≤0.5	≤4/≤1	47	43	53	12	12	10	5	6	6	0	43	0	15	15	17
	extended infusion	≤8/≤2	≤8/≤1	≤8/≤4	60	46	73	23	19	25	19	6	47	43	57	29	30	19	26
	continuous infusion	≤8/≤4	≤8/≤8	≤8/≤8	63	63	83	31	23	25	38	28	47	57	86	43	42	33	48
		sulbactam 8 g	sulbactam 4 g	sulbactam 16 g
Cefepime 8 g	bolus	≤8/≤1	≤8/≤0.5	≤8/≤2	53	43	73	16	15	17	9	6	47	14	43	29	21	15	27
	extended infusion	≤16/≤8	≤16/≤4	≤16/≤8	67	63	83	37	23	33	73	28	73	100	86	43	62	47	48
	continuous infusion	≤16/≤8	≤16/≤4	≤16/≤16	67	63	83	37	23	33	73	28	73	100	86	57	62	47	62

Dosing regimen

Cefepime/sulbactam target MIC (mg/L), 60% fT_>MIC

Percentage susceptible

E. coli

Klebsiella spp.

A. baumannii

P. aeruginosa

all isolates

cefepime/ sulbactam ratio

1:1

2:1

1:2

1:1

2:1

1:2

1:1

2:1

1:2

1:1

2:1

1:2

1:1

2:1

1:2

sulbactam 3 g

sulbactam 1.5 g

sulbactam 6 g

Cefepime 3 g

bolus

≤2/≤0.25

≤2/≤0.5

extended infusion

≤4/≤1

≤4/≤0.5

≤4/≤2

continuous infusion

≤4/≤2

≤4/≤1

≤4/≤4

sulbactam 4 g

sulbactam 2 g

sulbactam 8 g

Cefepime 4 g

bolus

≤4/≤0.5

≤4/≤0.25

≤4/≤1

extended infusion

≤8/≤4

≤8/≤2

≤8/≤8

continuous infusion

≤8/≤4

≤8/≤2

≤8/≤8

sulbactam 6 g

sulbactam 3 g

sulbactam 12 g

Cefepime 6 g

bolus

≤4/≤0.5

≤4/≤1

extended infusion

≤8/≤2

≤8/≤1

≤8/≤4

continuous infusion

≤8/≤4

≤8/≤8

sulbactam 8 g

sulbactam 4 g

sulbactam 16 g

Cefepime 8 g

bolus

≤8/≤1

≤8/≤0.5

≤8/≤2

extended infusion

≤16/≤8

≤16/≤4

≤16/≤8

100

continuous infusion

≤16/≤8

≤16/≤4

≤16/≤16

100

Dosing regimen	Cefepime/sulbactam target MIC (mg/L), 60% fT_>MIC	Percentage susceptible
		sulbactam 3 g	sulbactam 1.5 g	sulbactam 6 g
Cefepime 3 g	bolus	≤2/≤0.25	≤2/≤0.25	≤2/≤0.5	33	40	53	6	10	10	5	3	5	0	14	0	11	10	11
	extended infusion	≤4/≤1	≤4/≤0.5	≤4/≤2	53	43	73	17	12	17	9	6	8	14	43	0	21	15	24
	continuous infusion	≤4/≤2	≤4/≤1	≤4/≤4	60	46	73	23	19	17	19	9	9	43	57	29	30	19	26
		sulbactam 4 g	sulbactam 2 g	sulbactam 8 g
Cefepime 4 g	bolus	≤4/≤0.5	≤4/≤0.25	≤4/≤1	47	40	53	12	10	10	5	6	6	0	14	0	15	10	17
	extended infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
	continuous infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
		sulbactam 6 g	sulbactam 3 g	sulbactam 12 g
Cefepime 6 g	bolus	≤4/≤0.5	≤4/≤0.5	≤4/≤1	47	43	53	12	12	10	5	6	6	0	43	0	15	15	17
	extended infusion	≤8/≤2	≤8/≤1	≤8/≤4	60	46	73	23	19	25	19	6	47	43	57	29	30	19	26
	continuous infusion	≤8/≤4	≤8/≤8	≤8/≤8	63	63	83	31	23	25	38	28	47	57	86	43	42	33	48
		sulbactam 8 g	sulbactam 4 g	sulbactam 16 g
Cefepime 8 g	bolus	≤8/≤1	≤8/≤0.5	≤8/≤2	53	43	73	16	15	17	9	6	47	14	43	29	21	15	27
	extended infusion	≤16/≤8	≤16/≤4	≤16/≤8	67	63	83	37	23	33	73	28	73	100	86	43	62	47	48
	continuous infusion	≤16/≤8	≤16/≤4	≤16/≤16	67	63	83	37	23	33	73	28	73	100	86	57	62	47	62

Table 2.

Open in new tab

Susceptibility of carbapenem-resistant strains to simulated cefepime (3–8 g/day)/sulbactam (1:1, 1:2 and 2:1) dosing regimens; PTA (>0.9) for isolates with MIC ≤2 to ≤16 mg/L

Dosing regimen		Cefepime/sulbactam target MIC (mg/L), 60% fT_>MIC			Percentage susceptible
					E. coli			Klebsiella spp.			A. baumannii			P. aeruginosa			all isolates
					cefepime/ sulbactam ratio			cefepime/ sulbactam ratio			cefepime/ sulbactam ratio			cefepime/ sulbactam ratio			cefepime/ sulbactam ratio
					1:1	2:1	1:2	1:1	2:1	1:2	1:1	2:1	1:2	1:1	2:1	1:2	1:1	2:1	1:2
		sulbactam 3 g	sulbactam 1.5 g	sulbactam 6 g
Cefepime 3 g	bolus	≤2/≤0.25	≤2/≤0.25	≤2/≤0.5	33	40	53	6	10	10	5	3	5	0	14	0	11	10	11
	extended infusion	≤4/≤1	≤4/≤0.5	≤4/≤2	53	43	73	17	12	17	9	6	8	14	43	0	21	15	24
	continuous infusion	≤4/≤2	≤4/≤1	≤4/≤4	60	46	73	23	19	17	19	9	9	43	57	29	30	19	26
		sulbactam 4 g	sulbactam 2 g	sulbactam 8 g
Cefepime 4 g	bolus	≤4/≤0.5	≤4/≤0.25	≤4/≤1	47	40	53	12	10	10	5	6	6	0	14	0	15	10	17
	extended infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
	continuous infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
		sulbactam 6 g	sulbactam 3 g	sulbactam 12 g
Cefepime 6 g	bolus	≤4/≤0.5	≤4/≤0.5	≤4/≤1	47	43	53	12	12	10	5	6	6	0	43	0	15	15	17
	extended infusion	≤8/≤2	≤8/≤1	≤8/≤4	60	46	73	23	19	25	19	6	47	43	57	29	30	19	26
	continuous infusion	≤8/≤4	≤8/≤8	≤8/≤8	63	63	83	31	23	25	38	28	47	57	86	43	42	33	48
		sulbactam 8 g	sulbactam 4 g	sulbactam 16 g
Cefepime 8 g	bolus	≤8/≤1	≤8/≤0.5	≤8/≤2	53	43	73	16	15	17	9	6	47	14	43	29	21	15	27
	extended infusion	≤16/≤8	≤16/≤4	≤16/≤8	67	63	83	37	23	33	73	28	73	100	86	43	62	47	48
	continuous infusion	≤16/≤8	≤16/≤4	≤16/≤16	67	63	83	37	23	33	73	28	73	100	86	57	62	47	62

Dosing regimen		Cefepime/sulbactam target MIC (mg/L), 60% fT_>MIC			Percentage susceptible
					E. coli			Klebsiella spp.			A. baumannii			P. aeruginosa			all isolates
					cefepime/ sulbactam ratio			cefepime/ sulbactam ratio			cefepime/ sulbactam ratio			cefepime/ sulbactam ratio			cefepime/ sulbactam ratio
					1:1	2:1	1:2	1:1	2:1	1:2	1:1	2:1	1:2	1:1	2:1	1:2	1:1	2:1	1:2
		sulbactam 3 g	sulbactam 1.5 g	sulbactam 6 g
Cefepime 3 g	bolus	≤2/≤0.25	≤2/≤0.25	≤2/≤0.5	33	40	53	6	10	10	5	3	5	0	14	0	11	10	11
	extended infusion	≤4/≤1	≤4/≤0.5	≤4/≤2	53	43	73	17	12	17	9	6	8	14	43	0	21	15	24
	continuous infusion	≤4/≤2	≤4/≤1	≤4/≤4	60	46	73	23	19	17	19	9	9	43	57	29	30	19	26
		sulbactam 4 g	sulbactam 2 g	sulbactam 8 g
Cefepime 4 g	bolus	≤4/≤0.5	≤4/≤0.25	≤4/≤1	47	40	53	12	10	10	5	6	6	0	14	0	15	10	17
	extended infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
	continuous infusion	≤8/≤4	≤8/≤2	≤8/≤8	63	50	83	31	19	25	24	9	47	57	57	43	42	19	48
		sulbactam 6 g	sulbactam 3 g	sulbactam 12 g
Cefepime 6 g	bolus	≤4/≤0.5	≤4/≤0.5	≤4/≤1	47	43	53	12	12	10	5	6	6	0	43	0	15	15	17
	extended infusion	≤8/≤2	≤8/≤1	≤8/≤4	60	46	73	23	19	25	19	6	47	43	57	29	30	19	26
	continuous infusion	≤8/≤4	≤8/≤8	≤8/≤8	63	63	83	31	23	25	38	28	47	57	86	43	42	33	48
		sulbactam 8 g	sulbactam 4 g	sulbactam 16 g
Cefepime 8 g	bolus	≤8/≤1	≤8/≤0.5	≤8/≤2	53	43	73	16	15	17	9	6	47	14	43	29	21	15	27
	extended infusion	≤16/≤8	≤16/≤4	≤16/≤8	67	63	83	37	23	33	73	28	73	100	86	43	62	47	48
	continuous infusion	≤16/≤8	≤16/≤4	≤16/≤16	67	63	83	37	23	33	73	28	73	100	86	57	62	47	62

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