Cefepime Carries a Persistent Mortality Signal Versus Other Beta-Lactams
This bayesian meta-analysis of 110 randomized trials quantifies the probability that cefepime increases all-cause mortality relative to comparator beta-lactams, informing empiric selection and dosing decisions.
Cefepime use may raise mortality risks versus other β-lactams.
Cefepime is commonly used for treating gram-negative infections but has been associated with safety concerns regarding increased mortality. The analysis of 110 trials with 22,608 patients indicated a 94.4% probability that the mortality odds ratio exceeded 1 with cefepime use (OR 1.10, 95% CI 0.98-1.24). The higher mortality odds associated with cefepime suggest caution and careful consideration in therapeutic guidelines. Limitations include the potential heterogeneity of trials and study populations. Cefepime is linked to higher mortality odds compared to other β-lactams, warranting cautious use.
📊 Deep Analysis Available
Subscribers get the full breakdown: study design, outcomes, pharmacist implications, clinical pearls, GRADE evidence grade, and a downloadable PDF report.
Authors:Sohani ZN, Zhong YJ, Afshar A, Assiri BA, Gore G, Cheng MP, Lieu A, Serero J, Hamilton F, Lawandi A, Paul M, Yahav D, Albuquerque AM, Butler-Laporte G, McDonald EG, Lee TC
Citation:Sohani ZN, Zhong YJ, Afshar A, et al. Cefepime and Mortality: A Systematic Review and Bayesian Meta-Analysis. JAMA network open. 2026;9(9):e2633017. doi:10.1001/jamanetworkopen.2026.33017
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
Want the full analysis?
Subscribe to PharmD Signal for unrestricted access to every deep analysis, plus PDF reports, GRADE evidence grades, and pharmacist implications for every article we publish.