cefepime + ciprofloxacin

Cefepime + ciprofloxacin is a combination of two antibiotics used together for the treatment of severe bacterial infections, particularly those caused by multidrug-resistant Gram-negative organisms. Cefepime is a fourth-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell lysis and death. Ciprofloxacin is a second-generation fluoroquinolone that inhibits DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for bacterial DNA replication, transcription, repair, and recombination. The combination has demonstrated synergistic effects in vitro and in vivo against pathogens such as Vibrio vulnificus and Pseudomonas aeruginosa, especially in biofilm-associated or severe systemic infections. This regimen may be considered empirically when resistant Gram-negative coverage is needed pending microbiological diagnosis[1][4][8].