***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Ninety infants and children were prospect ively r and omized to receive cefepime ( n = 43 ) or cefotaxime ( n = 47 ) for therapy of bacterial meningitis . The two treatment groups were comparable in terms of age , duration of illness before enrollment , history of seizures , clinical status on admission , and etiology . Six ( 7 % ) patients died -- two treated with cefepime and four treated with cefotaxime .  Clinical response , cerebrospinal fluid sterilization , development of complications , antibiotic toxicity , and hospital stay were similar for the two treatment regimens . Concentrations of cefepime in cerebrospinal fluid varied from 55 to 95 times greater than the maximal MIC required by the causative pathogens . Audiologic and /or neurologic sequelae were found in 16 % of the cefepime-treated patients and 15 % of the cefotaxime-treated patients examined 2 to 6 months after discharge . We conclude that cefepime is safe and therapeutically equivalent to cefotaxime for management of bacterial meningitis in infants and children OBJECTIVE To evaluate the therapeutic effects and safety of cefepime ( Maxipime ) and sulbactam/cefoperazone ( sulperazone ) on moderate and severe respiratory infection in children . METHODS Totally 100 children hospitalized for pneumonia were r and omized equally into 2 groups , namely group A with maxipime treatment at the dose of 50 mg/kg given intravenously twice daily , and group B with sulperazone treatment at 50 - 100 mg/kg given intravenously twice a day . The therapeutic effects and safety of both medications were observed . RESULTS In maxipime group , 44 of the 50 cases were cured with complete elimination of the symptoms and signs , and obvious therapeutic effect was achieved in 5 cases with significant improvement or resolution of the majority of symptoms and signs . One case failed to respond favorably to the treatment , with the overall efficacy rate of 98 % without incidence of adverse effects . In sulperazone group , 40 of the 50 cases were cured , 6 showed significant improvement , and 4 failed to respond to the treatment , with the rate of 92 % . One patient complained of rashes during  sulperazone  treatment , which disappeared the next day without sulperazone withdrawal . Significant difference was not noted between the groups ( chi(2)=2.43 , P>0.05 ) . CONCLUSIONS Both maxipime and sulperazon are effective and safe for application in children with moderate and severe respiratory infections The efficacy , safety and usefulness of cefepime ( CFPM ) , a new cephem antibiotic , in bacterial pneumonia , were evaluated in a comparative study against ceftazidime ( CAZ ) . Each drug was administered by intravenous drip infusion at a dose of 1.0 g ( nominal potency ) twice daily for 14 days , and the following results were obtained . 1 . A total of 183 cases were enrolled in this study .  Efficacy rates ( " good " or better responses ) as evaluated by the subcommittee were 90.3 % ( 65/72 ) in the CFPM group and 94.0 % ( 63/67 ) in the CAZ group , with no significant difference between the 2 groups . 2 . Efficacy rates ( " good " or better responses ) , as evaluated by attending physicians , ( in the same bacterial pneumonia cases which were subjected to evaluation by the subcommittee ) were 87.5 % ( 63/72 ) in the CFPM group and 89.6 % ( 60/67 ) in the CAZ group , with no significant difference between the 2 groups . 3 . Bacteriologically , eradication rates were 96.9 % ( 31/32 ) in the CFPM group and 96.7 % ( 29/30 ) in the CAZ group with no significant difference between the 2 groups . 4 . The incidence of side effects was 5.9 % ( 5/85 ) in the CFPM group and 4.8 % ( 4/84 ) in the CAZ group , with no significant difference between the 2 groups . No significant difference was also found between the 2 groups in the incidence of abnormal laboratory findings ; 28.4 % ( 23/81 ) of the case in the CFPM group and 34.1 % ( 28/82 ) in the CAZ group . 5 . As for overall usefulness of the drug in bacterial pneumonia cases , utility rates ( " useful " or better evaluations ) as evaluated by the subcommittee were 88.9 % ( 64/72 ) in the CFPM group and 92.5 % ( 62/67 ) in the CAZ group . The rates as evaluated by investigators ( in cases judged as evaluable by the subcommittee ) were 87.5 % ( 63/72 ) and 85.1 % ( 57/67 ) , respectively . There were no significant differences between the 2 groups . These results indicated that CFPM is very useful for the treatment of bacterial pneumonia OBJECTIVE : To compare the efficacies of cefepime and ceftazidime as empiric therapy during the management of fever in cancer patients with chemotherapy-induced neutropenia . METHODS : A prospect i ve , double-blind , r and omized study of cefepime 2 g every eight hours and ceftazidime 2 g every eight hours was performed in 276 adult neutropenic ( absolute neutrophil count < 500/mm3 ) cancer patients with fever . RESULTS : Median duration of neutropenia was five days . Sixty-one percent ( n = 188 ) of the patients were evaluable . Treatment was successful in 57 % ( 58/101 ) of cefepime-treated patients and 60 % ( 52/87 ) of ceftazidime-treated patients ( 95 % CI −18 to 12 ; p = 0.77 ) . Bacteremic clearance occurred in 71 % ( 12/17 ) of cefepime-treated patients and 40 % ( 6/15 ) of ceftazidime-treated patients ( p = 0.3 ) . Both drugs were well tolerated . CONCLUSIONS : Cefepime appears to be as effective as ceftazidime in the initial treatment of febrile episodes in adult cancer patients with chemotherapy-associated neutropenia of modest duration ABSTRACT Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and gram-positive pathogens , including drug-resistant isolates . We compared the safety and efficacy of intravenous ( i.v . ) cefepime ( 2 g administered every 12 h ) to those of i.v . ceftriaxone ( 1 g administered every 12 h ) for the empiric treatment of hospitalized patients with community-acquired pneumonia . Of the 115 patients r and omized to the study , 86 ( cefepime recipients , n = 40 ; ceftriaxone recipients , n = 46 ) were evaluated for clinical efficacy ( clinical ly evaluated patients ) . Favorable clinical outcomes ( cure or improvement ) were comparable among clinical ly evaluated patients in the cefepime and ceftriaxone treatment arms ( 95.0 versus 97.8 % , respectively ; 95 % confidence interval for treatment difference [ data for ceftriaxone group minus data for cefepime group ] , −5.1 to + 10.8 % ) . The most common bacteria isolated from patients in both treatment groups were Streptococcus pneumoniae , Haemophilus influenzae , and Staphylococcus aureus . In clinical ly evaluated patients with a microbiologic response , all ( 100 % ) of the 32 pathogens from cefepime-treated patients and 97.4 % ( 38 of 39 ) of the pathogens from ceftriaxone-treated patients were eradicated ( documented or presumed eradication ) . The one persistent infection in the ceftriaxone group was caused by Pseudomonas fluorescens . Both treatments were well tolerated . Our data thus suggest that cefepime and ceftriaxone have comparable safety and efficacy for the treatment of pneumonia in hospitalized patients BACKGROUND With the availability of new broad-spectrum antibiotics , initial therapy with a single agent has become an alternative to classic combinations , especially beta-lactam antibiotics plus aminoglycosides , in the management of febrile neutropenic cancer patients . PROCEDURE Since January 1994 , monotherapy has been used for empiric initial treatment at our center . The aim of this prospect i ve r and omized study is to compare the efficacy of cefepime ( CFP ) , a new fourth-generation cephalosporin , and ceftazidime ( CFZ ) as empirical monotherapy of febrile neutropenic patients with solid tumors . From January 1998 to November 1998 , 63 episodes of fever and neutropenia occurring in 33 children with solid tumors including lymphomas , were r and omized to receive treatment with either CFP or CFZ . The patients were analyzed for leukocyte count and absolute neutrophil count ( ANC ) at entry , days in fever , neutropenia and hospitalization , and side effects of drugs . Success with or without modifications of the initial antibiotic was defined as survival through neutropenia ; failure was death due to infection . RESULTS In our study group , with a median age of 7 [ (1/12)-14 ] years , CFP was administered in 32 , and CFZ in 31 episodes . An infection was documented microbiologically in eight episodes ( 25 % ) in the CFP arm and in nine episodes ( 29 % ) in the CFZ arm . The success rate with initial empiric monotherapy was 62.5 % in the CFP arm and 61.3 % in the CFZ arm respectively ( P > 0.05 ) . The total success rate ( success with or without modification ) was 100 % in both arms . No major adverse effects were observed in either groups . CONCLUSION CFP is as effective and safe as CFZ for the empirical treatment of febrile episodes in neutropenic patients with solid tumors A prospect i ve , open-label , r and omized , comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients . Febrile episodes were classified as microbiologically documented infection , clinical documented infection , or fever of unknown origin . Clinical response to therapy was classified as success or failure . In this period 37 children with solid tumors including lymphoma , 25 males , 12 females , had neutropenia on 65 occasions . Microbiologically documented infections occurred in 21 episodes ( 32.31 % ) . Frequency of positive bacteria isolated was higher than gram-negative bacteria . There was no infection-related death . There were no statistical differences between the cefepime and meropenem groups for duration of fever or neutropenia , response rate , and necessity for modification . Cefepime appears to be as effective and safe as meropenem for empiric treatment of febrile episodes in neutropenic pediatric cancer patients Cephalosporins are one of the mainstays of antibiotic therapy , and third-generation cephalosporins are first-line agents for the treatment of many types of serious infections , including those of nosocomial origin . Gaps in activity of currently available third-generation cephalosporins such as cefotaxime , cefoperazone , ceftriaxone , and ceftazidime , and increasing reports of gram-negative bacilli resistance to some of these agents , especially Klebsiella pneumoniae , Pseudomonas aeruginosa , and Enterobacter spp . , make it necessary to investigate new compounds . Cefepime , a fourth-generation cephalosporin with a wide range of activity against gram-positive and gram-negative bacteria , including multi-resistant strains of Enterobacteriaceae , was evaluated in comparison with ceftazidime for the treatment of serious infections in hospitalized patients .  Ceftazidime is a commonly prescribed third-generation cephalosporin used for empiric treatment of serious infections such as pneumonia , urinary tract infection , and skin and skin-structure infection . This investigation was an open , r and omized comparative study involving 882 patients in North America .  Cefepime 2 g every 12 hours demonstrated similar efficacy to that of ceftazidime 2 g every 8 hours for the treatment of pneumonia and urinary tract infection ( including cases associated with concurrent bacteremia ) , and skin and skin-structure infections . The bacteriologic responses were generally > 85 % . The most common pathogens isolated were Escherichia coll , Streptococcus pneumoniae , P. aeruginosa , K. pneumoniae , Haemophilus influenzae , Staphylococcus aureus , and Streptococcus , group B. Overall , approximately 94 % of pathogens isolated in pretreatment cultures were susceptible to cefepime and ceftazidime . Cefepime and ceftazidime were well tolerated ; only 3 % of patients in each group discontinued therapy because of an adverse event . The most common adverse events were headache , diarrhea , nausea , vomiting , pruritus , and rash . The results of this study indicate that cefepime is a promising , effective , and safe single-agent therapy for serious infections in hospitalized patients ABSTRACT In a r and omized , evaluator-blind , multicenter trial , we compared cefepime ( 2 g three times a day ) with imipenem-cilastatin ( 500 mg 
    Output:
    
No significant differences between groups in treatment failure , superinfection , or adverse events were found .