A commonly used antibiotic, cefepime, has been linked to a higher risk of death in adults, according to a new global study published in JAMA Network Open.
The study reviewed 110 randomized clinical trials involving over 22,000 patients who received cefepime or another beta-lactam antibiotic. The patients included adults and children treated for a range of conditions, including pneumonia, severe bacterial infections, urinary tract infections, and meningitis.
The researchers found that 778 deaths occurred among 11,726 patients given cefepime, compared to 6.2% of patients given another antibiotic. Using a Bayesian meta-analysis, the researchers found a 94.4% probability that cefepime was associated with higher all-cause mortality compared with other beta-lactam antibiotics.
The association between cefepime and higher mortality appeared stronger in adults than in children, and was most pronounced among patients treated for febrile neutropenia, a medical emergency involving fever and dangerously low infection-fighting white blood cells.
The researchers did not recommend discontinuing cefepime, but called for additional guidance and research to better understand its safety. They suggested that finding the right dose of cefepime can be challenging, as higher doses may improve its ability to kill bacteria while also increasing the risk of toxic side effects.
The study had several limitations, including combining clinical trials that differed in design, patient populations, dosing strategies, and comparison antibiotics.
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