Cefepime extended infusion versus intermittent infusion: Clinical and cost evaluation

Abstract Background: Extended infusion cefepime (1 gram every 6 hours administered over 3 hours) achieves pharmacodynamic efficacy against bacteria with a MIC of ≤8 mg/L in Monte Carlo simulations. This regimen has not been evaluated clinical practice. Objective: Compare and economic outcomes for by intermittent extended the acute-care setting. Design: Single-center, retrospective cohort study. Setting: Tertiary-care academic medical center. Patients: Hospitalized adults who received between August 2016 July 2018 diagnosis sepsis or pneumonia. Methods: Clinical were compared patients empiric via (30-minute 2 g 8 (3-hour 1 hours). analyses carried out using appropriate statistical methods. Results: Overall, 111 93 infusion. Approximately half included had positive culture bacterial pathogen (intermittent 45.9% vs 47.3%). Median hospital length stay days days; P = .67) 90-day readmission rates 61.3% 67.7%; .34) did differ groups. Mortality was infrequent both groups 2.9% 1.5%; .45). Cefepime cost per patient lower infusion: average total daily $86.06 versus $43.39 Conclusions: (4 grams/day) to (6 but reduced drug expenditure. Prospective, multicenter, high-quality studies should be conducted evaluate mortality difference these regimens.