Study links common antibiotic cefepime to increased overall mortality risk

Researchers examined 110 randomized clinical trials covering more than 22,000 patients who received the broad-spectrum cephalosporin cefepime or another beta-lactam antibiotic for serious infections. Across the studies, 778 of the 11,726 cefepime recipients (6.6 %) died within roughly 30 days, compared with a 6.2 % death rate among those given other agents, leading to a 94.4 % Bayesian probability that cefepime is linked to higher all-cause mortality; the figure rose to 98.6 % when only peer-reviewed trials were considered.

The excess risk appeared most pronounced in adult patients and those treated for febrile neutropenia. While cefepime remains widely used, the authors did not advise abandoning it, instead urging more research on optimal dosing and safety. Possible explanations include sub-therapeutic levels that fail to clear infection or neurotoxic effects from excessive concentrations. Experts highlighted the need for better dose-finding, potentially aided by artificial-intelligence tools.