Study Links Cefepime Antibiotic to Increased Risk of Death in Adults

<p>A study has found a potential link between the antibiotic cefepime and a higher risk of death in adults. Cefepime is commonly used to treat bacterial infections such as pneumonia, urinary tract infections (UTIs), and skin infections, typically administered via injection in clinical settings.</p><p>According to the Mayo Clinic, severe side effects of cefepime may include confusion, decreased consciousness, or seizures, particularly in older patients and those with kidney issues.</p><p>The research, published in JAMA Network Open, reviewed 110 randomized clinical trials involving over 22,000 patients who received cefepime or another beta-lactam antibiotic, which includes penicillins and cephalosporins.</p><p>The patient population included adults and children treated for febrile neutropenia, pneumonia, severe bacterial infections, UTIs, and meningitis. Among the 11,726 patients given cefepime, 778 deaths occurred (6.6%), compared to 6.2% of patients given another antibiotic. The study evaluated deaths from any cause occurring within approximately 30 days of treatment.</p><p>Using a Bayesian meta-analysis, researchers found a 94.4% probability that cefepime was associated with higher all-cause mortality compared to other beta-lactam antibiotics. This probability increased to 98.6% when limited to 73 peer-reviewed published trials. The association appeared stronger in adults than in children, particularly among patients treated for febrile neutropenia.</p><p>Despite the findings, the researchers did not recommend discontinuing cefepime but called for further guidance and research to better understand its safety. They noted that several factors might explain the observed association, including potentially inadequate drug levels and neurotoxicity from excessive levels.</p><p>Finding the appropriate dose of cefepime can be challenging, as higher doses may enhance its effectiveness against bacteria while increasing the risk of toxic side effects. The study acknowledged several limitations, including variations in clinical trial design, patient populations, dosing strategies, and comparison antibiotics, with some studies dating back several decades. The analysis indicated an association but did not prove that cefepime itself caused the higher mortality.</p><p>Dr. Marc Siegel, a senior medical analyst at Fox News, emphasized the importance of re-evaluating older studies. He noted that febrile neutropenia is a significant cause of death in this population, complicating the determination of whether cefepime decreases or increases this risk. Siegel suggested that both underdosing and overdosing might be more closely linked to poorer outcomes and higher mortality, indicating that appropriate dosing is crucial. He also proposed that artificial intelligence could play a role in determining the correct dosage and assessing outcomes.</p>