Clinical outcomes of cefepime extended infusions

Cefepime, a fourth-generation cephalosporin, has traditionally been administered via 30-minute standard infusions. However, an extended infusion of cefepime, administered over 3-4 h, has demonstrated improved pharmacodynamic target attainment. This narrative review evaluates the clinical impact of extended infusion cefepime across diverse infections and patient populations. While retrospective studies suggest improved outcomes, such as reduced mortality and faster defervescence in patients with Pseudomonas aeruginosa infections or febrile neutropenia, prospective trials have not consistently shown significant benefits, particularly in mortality reduction. Potential risks of extended infusions, including neurotoxicity and complications from increased IV access, remain under-researched, especially in adult populations. Overall, the extended infusion is non-inferior to the standard infusion length and may be superior to the standard infusion in certain contexts. Further prospective, controlled studies are warranted to determine the clinical efficacy and safety of EI cefepime in comparison to standard infusion in various patient populations.