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Rachel V Thomas

Cefepime: Antibiotic Used For Pneumonia, UTI Linked To Higher Death Risk In Adults

A commonly used <span>antibiotic</span> for <span><a href="https://www.healthandme.com/health/pneumonia">pneumonia</a></span>, urinary tract infections (UTIs) and certain skin infections has been linked to higher odds of death in adults, according to a new study.

The <a href="https://www.healthandme.com/health-news/indias-new-antibiotic-in-30-years-offers-hope-against-antibacterial-resistant-infections-article-153007844" data-type="tilCustomLink">antibiotic, cefepime</a>, is a cephalosporin that is relatively stable against AmpC β-lactamases, enzymes produced by some bacteria that can contribute to <span>antibiotic resistance</span>.

Concerns about a possible link between <span>cefepime</span> and mortality have been raised for years. A new systematic review and Bayesian meta-analysis has now re-examined the evidence from randomized clinical trials.

The study, published in JAMA Network Open, analyzed 110 randomized clinical trials involving 22,608 patients who received either cefepime or another β-lactam antibiotic.

Researchers found a 94.4% posterior probability that cefepime was associated with higher odds of death compared with other β-lactam antibiotics. Death occurred in 6.6% of patients treated with cefepime and 6.2% of those in the comparison groups.

The mortality signal was concentrated in adults, while the analysis did not find evidence of increased mortality in children. Researchers also found higher probabilities of harm across several clinical indications and with cefepime doses of 2 grams or more every 12 hours.

The highest probability of increased mortality was seen among patients treated for febrile neutropenia, at 96.1%.

Also read: <a href="https://www.healthandme.com/health-news/98-years-after-penicillin-are-we-running-out-of-effective-antibiotics-article-156038170" data-type="tilCustomLink">98 Years After Penicillin, Are We Running Out Of Effective Antibiotics?</a> 

<h2>Why Is Cefepime Safety A Concern?</h2>

Cefepime remains an important antibiotic used to treat serious bacterial infections, including pneumonia, UTIs, skin infections and febrile neutropenia. 

Its current FDA-approved uses also include certain complicated intra-abdominal infections when used with metronidazole.

One concern with cefepime is neurotoxicity. The drug's prescribing information warns about neurological reactions, particularly in patients with kidney impairment when the dose is not appropriately adjusted. Reported reactions can include confusion, encephalopathy, myoclonus and seizures.

The question of whether mortality is directly caused by cefepime, however, remains unresolved.

An accompanying commentary in JAMA Network Open argued that the mortality findings may be related to dosing and drug exposure rather than cefepime itself.

The drug is typically administered via injection by healthcare providers in a clinical setting. Severe side effects may include confusion, decreased consciousness or seizures, especially in older patients and those with kidney problems, among many other common symptoms, according to Mayo Clinic.

<h2>Cefepime And The Earlier Mortality Debate</h2>

<strong>Read More: </strong><a href="https://www.healthandme.com/health-news/nearly-all-countries-overuse-antibiotics-60-still-use-who-discouraged-drugs-the-lancet-article-155148877" data-type="tilCustomLink">Nearly All Countries Overuse Antibiotics; 60% Still Use WHO-Discouraged Drugs: The Lancet</a>

Concerns about cefepime's safety are not new. A 2007 meta-analysis reported a 26% higher relative risk of death among patients receiving cefepime compared with other β-lactam antibiotics.

The FDA subsequently analyzed a larger set of clinical trials and reported no statistically significant difference in mortality between cefepime and comparator antibiotics.

However, the researchers have also rated the overall certainty of evidence as moderate. They downgraded it because of differences between studies and possible publication bias, including 25 unpublished trials supplied by the US Food and Drug Administration that showed results in the opposite direction from the published literature.

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A commonly used antibiotic for pneumonia, urinary tract infections (UTIs) and certain skin infections has been linked to higher odds of death in adults, according to a new study.The antibiotic, cefepime, is a cephalosporin that is relatively stable against AmpC β-lactamases, enzymes produced by some bacteria that can contribute to antibiotic resistance.Concerns about a possible link between cefepime and mortality have been raised for years. A new systematic review and Bayesian meta-analysis has now re-examined the evidence from randomized clinical trials.What Did The Study Find?The study, published in JAMA Network Open, analyzed 110 randomized clinical trials involving 22,608 patients who received either cefepime or another β-lactam antibiotic.Researchers found a 94.4% posterior probability that cefepime was associated with higher odds of death compared with other β-lactam antibiotics. Death occurred in 6.6% of patients treated with cefepime and 6.2% of those in the comparison groups.The mortality signal was concentrated in adults, while the analysis did not find evidence of increased mortality in children. Researchers also found higher probabilities of harm across several clinical indications and with cefepime doses of 2 grams or more every 12 hours.The highest probability of increased mortality was seen among patients treated for febrile neutropenia, at 96.1%.Also read: 98 Years After Penicillin, Are We Running Out Of Effective Antibiotics? Why Is Cefepime Safety A Concern?Cefepime remains an important antibiotic used to treat serious bacterial infections, including pneumonia, UTIs, skin infections and febrile neutropenia. Its current FDA-approved uses also include certain complicated intra-abdominal infections when used with metronidazole.One concern with cefepime is neurotoxicity. The drug's prescribing information warns about neurological reactions, particularly in patients with kidney impairment when the dose is not appropriately adjusted. Reported reactions can include confusion, encephalopathy, myoclonus and seizures.The question of whether mortality is directly caused by cefepime, however, remains unresolved.An accompanying commentary in JAMA Network Open argued that the mortality findings may be related to dosing and drug exposure rather than cefepime itself.The drug is typically administered via injection by healthcare providers in a clinical setting. Severe side effects may include confusion, decreased consciousness or seizures, especially in older patients and those with kidney problems, among many other common symptoms, according to Mayo Clinic.Cefepime And The Earlier Mortality DebateRead More: Nearly All Countries Overuse Antibiotics; 60% Still Use WHO-Discouraged Drugs: The LancetConcerns about cefepime's safety are not new. A 2007 meta-analysis reported a 26% higher relative risk of death among patients receiving cefepime compared with other β-lactam antibiotics.The FDA subsequently analyzed a larger set of clinical trials and reported no statistically significant difference in mortality between cefepime and comparator antibiotics.However, the researchers have also rated the overall certainty of evidence as moderate. They downgraded it because of differences between studies and possible publication bias, including 25 unpublished trials supplied by the US Food and Drug Administration that showed results in the opposite direction from the published literature.

cefepime: antibiotic used for pneumonia, uti linked to higher death risk in adults

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