Cefepime, a widely used antibiotic, may be linked to a small increase in the risk of death compared with other beta-lactam antibiotics, according to a study published in JAMA Network Open. Researchers reached the conclusion after analyzing more than 100 randomized trials involving 22,600 patients.
What the study found
Among patients who received cefepime, 6.6 percent died, compared with 6.2 percent in groups treated with other antibiotics, the researchers found. Statistical analysis showed a 94.4 percent probability that the risk of death was indeed higher with cefepime, according to the study.
The researchers calculated that for every 227 patients given cefepime instead of another antibiotic, there could be one additional death.
Who is affected
The link was found only in adults, not in children, according to the study. The probability of increased risk was especially high in patients treated for febrile neutropenia, a dangerous condition marked by high fever alongside a sharp drop in certain immune cells.
Why it happens
The researchers said a possible explanation lies in problems with dosing. A dose that is too low may fail to fight the infection effectively, while a dose that is too high can cause toxic effects on the nervous system, particularly in patients with impaired kidney function.
Background on cefepime
Cefepime is a fourth-generation antibiotic used to treat severe bacterial infections, including those caused by microorganisms resistant to other drugs. Beta-lactam antibiotics, the broader class cefepime belongs to, work by disrupting the formation of bacterial cell walls and include well-known drugs such as penicillin and other cephalosporins.
What comes next
The study's authors stressed that the findings do not mean cefepime should be abandoned. The drug remains an important treatment for severe infections, they said, but the potential risk should be factored into decisions about which antibiotic and dosage to use.
Earlier research found that shorter courses of antibiotics can be more effective than standard-length courses, according to the article.
