Table 7.
Summary of results of a systematic review and meta-analysis of 57 clinical trials evaluating efficacy and safety of cefepime
| Outcome index | Statistical comparison (number of clinical trials) | Cefepime (n/N patients) | Comparator (n/N patients) | RR (95% CI) | p-value |
|---|---|---|---|---|---|
| All-cause mortality by comparator drug | Total (n = 41) | 309/3931 | 220/3457 | 1.26 (1.08-1.49) | 0.005 |
| Cefepime vs ceftazidime (n = 23) | 167/2006 | 116/1625 | 1.20 (0.96-1.50) | 0.11 | |
| Cefepime vs piperacillin-tazobactam (n = 3) | 30/398 | 15/416 | 2.14 (1.17-3.89) | 0.01 | |
| Cefepime vs imipenem or meropenem (n = 6) | 73/808 | 62/802 | 1.20 (0.88-1.63) | 0.24 | |
| Cefepime vs ceftriaxone or cefotaxime (n = 9) | 39/719 | 27/614 | 1.24 (0.77-1.99) | 0.38 | |
| All-cause mortality by comparator infection | Total (n = 41) | 309/3931 | 220/3457 | 1.26 (1.08-1.49) | 0.005 |
| Neutropenic fever (n = 19) | 130/2043 | 87/1928 | 1.42 (1.09-1.84) | 0.009 | |
| Pneumonia (n = 10) | 110/953 | 84/767 | 1.15 (1.89-1.48) | 0.29 | |
| Urinary tract/gynecological infections (n = 2) | 0/308 | 0/222 | NE | NA | |
| Other infections (n = 10) | 69/627 | 49/540 | 1.20 (0.85-1.69) | 0.3 | |
| Clinical failure by comparator infection | Total (n = 55) | 1715/4656 | 1628/4215 | 0.98 (0.93-1.03) | 0.37 |
| Neutropenic fever (n = 20) | 1258/2258 | 1178/2152 | 1.00 (0.96-1.05) | 0.88 | |
| Community-acquired pneumonia (n = 15) | 107/829 | 105/658 | 0.78 (0.61-1.00) | 0.05 | |
| Hospital-acquired pneumonia (n = 3) | 132/294 | 142/292 | 0.92 (0.77-1.09) | 0.34 | |
| Urinary tract/gynecological infections (n = 5) | 41/397 | 22/276 | 1.12 (0.69-1.81) | 0.66 | |
| Meningitis (n = 2) | 34/146 | 37/152 | 0.96 (0.64-1.44) | 0.85 | |
| Other infections (n = 10) | 143/732 | 144/685 | 0.97 (0.79-1.19) | 0.77 |
CI: Confidence interval; NA: Not applicable; NE: Not estimable; RR: Relative risk.
Data from [97].