Abstract:Background: Third generation cephalosporins are still most commonly used antibiotics empirically in our setup leading to emergence of resistance in this group. In this environment of increasing resistance, empirical use of this group of antibiotics would be a futile effort. Therefore, this study was conducted to evaluate the in vitro efficacy of fourth generation cephalosporin cefepime against multi-drug resistant isolates of Pseudomonas aeruginosa from various clinical specimens in our setup. Methodology: All the clinical specimens giving growth of Pseudomonas aeruginosa were included in the study. Modified Kirby-Bauer disk diffusion method was used for sensitivity testing. Isolates resistant to three or more than three groups of antibiotics were included in the final results. Place and Duration of Results:A total of 100 multi-drug resistant Pseudomonas aeruginosa isolates were cultured from various clinical specimens. Out of 100 isolates, 71% were resistant to cefepime while resistance rate of amikacin, gentamicin, ceftazidime, tazobactem/piperacillin, sulbactam/piperacillin, imipenem and polymyxin were 61%, 83%, 72%, 10%, 2%, 45% and 2% respectively. Conclusion:Drug resistance in Pseudomonas aeruginosa is alarming as it is now increasing even in newer generation of drugs. It is the need of hour to follow strict hospital infection control and antibiotic policies to halt the spread of this resistance.