“…The low permeability shown by the outer membrane of Gram-negative bacteria, as well as the active efflux systems in the inner membrane generated by the pathogens to protect their intracellular functions, are known. However, the zwitterionic character of cefepime eases passage through the protein channels of the outer membrane, showing a broad spectrum against Gram-negative bacteria [3,4,5], and also good activity versus Gram-positive micro-organisms [6]. Alone, combined, or in a rotatory treatment, cefepime seems to be efficient against several bactericidal infections [7,8,9,10].…”