Cefepime effectiveness in Gram-negative bloodstream infections

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Medicine

Background:

• Gram-negative bloodstream infections (BSI) pose significant mortality risks.
• Evaluating the comparative efficacy of different beta-lactam antibiotics for Gram-negative BSI is crucial for treatment guidelines.

Purpose of the Study:

• To compare 28-day all-cause mortality in adult patients with Gram-negative BSI treated with cefepime versus other beta-lactam antibiotics.
• To assess the safety and effectiveness of cefepime in a real-world clinical setting for Gram-negative BSI.

Main Methods:

• Retrospective cohort study of 398 adult patients with monomicrobial Gram-negative BSI.
• Propensity score adjustment and multivariable Cox proportional hazard regression were used to analyze 28-day mortality.
• Data collected from Mayo Clinic hospitals between January 2001 and October 2006.

Main Results:

• Patients receiving cefepime were more likely to have cancer and immunocompromising conditions.
• Cefepime-treated patients had a lower likelihood of community-acquired infections and urinary source of BSI.
• After adjustment, cefepime therapy showed no association with increased 28-day all-cause mortality (HR 0.99, 95% CI 0.53-1.79).

Conclusions:

• Cefepime therapy is a safe and effective option for adult patients with monomicrobial Gram-negative BSI.
• No increased mortality was observed when comparing cefepime to other beta-lactam antibiotics in this patient population.