IDSA: Piperacillin-Tazobactam, Cefepime Comparable for Suspected Infection

THURSDAY, Oct. 19, 2023 (HealthDay News) -- For hospitalized patients with suspected infection for whom a clinician initiated an order for antipseudomonal antibiotics within 12 hours of presentation to the hospital, the incidence of acute kidney injury or death is comparable for those receiving cefepime and piperacillin-tazobactam, according to a study published online Oct. 14 in the Journal of the American Medical Association to coincide with the annual meeting of the Infectious Diseases Society of America (IDWeek), held from Oct. 11 to 15 in Boston.

Edward T. Qian, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues conducted a randomized trial comparing cefepime to piperacillin-tazobactam in adults for whom a clinician initiated an order for antipseudomonal antibiotics within 12 hours of presentation to the hospital in the emergency department or medical intensive care unit.

The primary analysis included 2,511 patients. The researchers observed no significant difference between the cefepime group and the piperacillin-tazobactam group in the highest stage of acute kidney injury or death (7.0 and 7.6 percent, respectively, in the cefepime group versus 7.5 and 6.0 percent, respectively, in the piperacillin-tazobactam group). At day 14, there was no difference observed between the groups in the incidence of major adverse kidney events (10.2 and 8.8 percent in the cefepime and piperacillin-tazobactam groups, respectively). Fewer days alive and free of delirium and coma within 14 days were seen for patients in the cefepime group (mean, 11.9 versus 12.2 days).

"Among adults presenting to the hospital with suspected infection in this pragmatic trial, the highest stage of acute kidney injury or death did not differ between patients randomized to cefepime or piperacillin-tazobactam," the authors write.

Several authors disclosed ties to the pharmaceutical, medical device, and medical technology industries.

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