Reduced cefepime dose on par with traditional regimen for febrile neutropaenia

Clinical outcomes are comparable between cefepime 1 gram every 6 hours (1 g q6h) and the traditional Food and Drug Administration (FDA)-approved 2 grams every 8 hours (2 g q8h) regimen for the treatment of hospitalized adults with febrile neutropaenia, a recent study has found.

The authors performed a retrospective chart review of hospitalized patients who received cefepime over a 2-year period to determine if the dosing regimen of 1 g q6h amidst a cefepime shortage is an appropriate alternative for the treatment of febrile neutropaenia.

They grouped patients based on cefepime dosing strategy: 1 g q6h vs 2 g q8h. Time to defervescence after cefepime initiation was the primary outcome. Secondary ones included all-cause 30-day mortality, duration of antibiotic therapy, and inpatient length of stay.

Each group had 75 patients. No between-group differences existed in baseline age or severity of illness. Median time to defervescence was similar between the 1 g q6h and the 2 g q8h groups (69.0 vs 65.3 h; p=0.67). In addition, there were no between-group differences in all-cause 30-day mortality (10.7 vs 9.3 percent; p=0.79), duration of therapy (80.8 vs 88.0 h; p=0.34), or length of stay (9 vs 7 days; p=0.50).

“Drug shortages may negatively impact outcomes in hospitalized patients,” the authors said. “A cefepime dosing regimen of 1 g q6h has shown to provide similar exposures above target minimum inhibitory concentrations compared to the regimen of 2 g q8h approved by the FDA for febrile neutropaenia.”