Common Antibiotic Cefepime Linked to Higher Mortality Risk, Study Finds

A widely used antibiotic, cefepime, has been associated with a higher risk of death in adults, according to a new global study published in JAMA Network Open. Cefepime is an injectable beta-lactam antibiotic commonly prescribed to treat bacterial infections such as pneumonia, urinary tract infections (UTIs), and meningitis.

The research reviewed 110 randomized clinical trials involving more than 22,000 patients. These patients received either cefepime or another type of beta-lactam antibiotic. The study found that 6.6% of patients treated with cefepime (778 deaths out of 11,726) died from any cause within approximately 30 days of treatment, compared to 6.2% of patients who received other beta-lactam antibiotics.

Using a Bayesian meta-analysis, researchers determined a 94.4% probability that cefepime was linked to higher all-cause mortality when compared with other beta-lactam antibiotics. This probability rose to 98.6% when the analysis was restricted to 73 peer-reviewed published trials. The association appeared more pronounced in adults than in children, and was particularly notable in patients treated for febrile neutropenia, a condition involving fever and critically low white blood cell counts.

Despite these findings, the researchers did not recommend discontinuing the use of cefepime. They emphasized the need for further guidance and research to fully understand its safety profile. The study acknowledges that it identified an association, not definitive proof that cefepime caused the increased mortality.

Several factors could potentially explain the observed link. Researchers suggested that issues with drug levels, either too low to effectively treat the infection or too high leading to neurotoxicity, might play a role. Finding the optimal dosage can be challenging, as higher doses increase bacterial killing power but also elevate the risk of toxic side effects. The study also noted limitations, including the combination of trials with varying designs, patient groups, and dosing strategies, some dating back decades.

Dr. Marc Siegel, Fox News senior medical analyst, commented that the study highlights the importance of re-evaluating existing research. He suggested that appropriate dosing, rather than the drug itself, may be the key factor influencing patient outcomes. Siegel also proposed that artificial intelligence could potentially assist in determining the precise dosage and assessing treatment results.