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Efficacy and safety of cefepime in pediatric patients: a systematic review and meta-analysis

Elisabeth E Adderson1, Patricia M Flynn, James M Hoffman

  • 1Department of Infectious Diseases, St. Jude Children's Research Hospital, Department of Pediatrics, The University of Tennessee Health Sciences Center, Memphis TN 38105, USA. elisabeth.adderson@stjude.org

The Journal of Pediatrics
|May 4, 2010
PubMed

Insights

This systematic review found no increased risk of death or treatment failure in pediatric patients receiving cefepime compared to other antibiotics. While studies had flaws, cefepime appears safe for children.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Recent reports raised concerns about cefepime's safety in pediatric patients, specifically regarding increased mortality.
  • Cefepime is a broad-spectrum cephalosporin antibiotic used for various bacterial infections.

Purpose of the Study:

  • To systematically review and synthesize evidence from clinical trials on the safety and efficacy of cefepime in pediatric populations.
  • To address concerns about cefepime's association with increased all-cause mortality rates in children.

Main Methods:

  • Systematic literature search of major databases (CENTRAL, MEDLINE, EMBASE) and other sources.
  • Inclusion of randomized clinical trials involving cefepime in patients under 19 years of age.
  • Meta-analysis of mortality, clinical failure, and adverse event rates.

Main Results:

  • Sixteen trials were included; no significant difference in 30-day all-cause mortality between cefepime and comparator groups.
  • Cefepime was not associated with increased risks of overall clinical failure or failure in microbiologically confirmed infections.
  • Adverse event rates were similar across groups, with one exception; however, all studies exhibited methodological limitations.

Conclusions:

  • Despite limitations in trial numbers and study quality, this review suggests cefepime therapy is not linked to higher adverse outcomes in pediatric patients.
  • Further high-quality research is needed to definitively establish cefepime's safety and efficacy profile in children.
Abstract

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