ReviewAntibiotics (Basel, Switzerland)2022
Continuous Infusion of High Doses of Cefepime in Intensive Care Unit: Assessment of Steady-State Plasma Level and Incidence on Neurotoxicity.
Review in Antibiotics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Real-world validation of a reduced-dose continuous infusion cefepime regimen: pharmacodynamic target attainment, efficacy and neurotoxicity.The Journal of antimicrobial chemotherapy · 2026Observational
- Safety concerns associated with high-dose continuous infusion of cefepime among critically ill patients with mild renal impairment to augmented renal clearance at a level 1 trauma center: CEFTOX study.Antimicrobial agents and chemotherapy · 2026Article
- Encephalopathy in mechanically ventilated adult patients in the intensive care unit: the role of β-Lactam overdosing.Scientific reports · 2026Article
- Impact of High-Dose Cefepime During the Initial 48 h on Intensive Care Unit Survival in Sepsis: A Retrospective Observational Study.Antibiotics (Basel, Switzerland) · 2026Article
- Relationship between antibiotic use and short-term risk of mortality in patients with sepsis-associated encephalopathy: a study based on the medical information mart for intensive care database.BMC infectious diseases · 2025Observational
- Case Report: Cefepime Induced Neurotoxicity Following a Change in Infusion Time.Hospital pharmacy · 2024Article
- Efficacy of Continuous vs. Intermittent Administration of Cefepime in Adult ICU Patients with Gram-Negative Bacilli Bacteremia: A Randomized Double-Blind Clinical Study.Antibiotics (Basel, Switzerland) · 2024Article
- Beta-Lactam Probability of Target Attainment Success: Cefepime as a Case Study.Antibiotics (Basel, Switzerland) · 2023Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Continuous infusion (CI) with high doses of cefepime is recommended in the empirical antimicrobial regimen of critically ill patients with suspected Gram-negative sepsis. This study aimed to determine factors associated with cefepime overdosing and the incidence of cefepime-induced neurotoxicity (CIN) in these patients. We performed a retrospective study including all patients receiving cefepime treatment between January 2019 and May 2022. The plasma level of cefepime defining overdosing was over 35 mg/L. Neurotoxicity was defined according to strict criteria and correlated with concomitant steady-state concentration of cefepime. Seventy-eight courses of cefepime treatment were analyzed. The mean cefepime plasma level at steady state was 59.8 ± 29.3 mg/L, and overdosing occurred in 80% of patients. Renal failure and a daily dose > 5 g were independently associated with overdosing. CIN was present in 30% of patients. In multivariate analysis, factors associated with CIN were chronic renal failure and a cefepime plasma concentration ≥ 60 mg/L. CIN was not associated with mortality. Overdosing is frequent in patients receiving high doses of cefepime by CI. Steady-state levels are higher than targeted therapeutic pharmacokinetic/pharmacodynamic objectives. The risk of CIN is important when the plasma concentration is ≥60 mg/L.
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