Cefepime and mortality: a real issue?

Abstract

The fourth-generation cephalosporin, cefepime, has an antimicrobial spectrum that makes it a valuable antibiotic for empirical treatment of neutropenic fever. Randomized trials have proven the efficacy and safety of cefepime in neutropenic fever. However, 2 recent meta-analyses have shown an increased all-cause mortality for cefepime. Since then, many clinicians have been left in doubt about the use of cefepime for this indication. In this paper, we put in perspective some of the methodological and clinical issues and call for further clinical analyses.

Acknowledgements

The authors wish to thank Dr S. Deferme (PharmaXL, Belgium) for his assistance in writing and editing this manuscript.

Statement of conflict of interest: The authors have no personal conflicts of interest to declare, for clarity they declare that Antwerp University Hospital was in receipt of a research grant from Bristol-Myers Squibb until 2008. Virga Jesse Hospital received a research grant and sponsorship for scientific symposia until 2007 and in 2008–09 received partial sponsorship for symposia from Bristol-Myers Squibb.