Extended-infusion cefepime reduces mortality in patients with Pseudomonas aeruginosa infections

Antimicrob Agents Chemother. 2013 Jul;57(7):2907-12. doi: 10.1128/AAC.02365-12. Epub 2013 Apr 9.


In an era of escalating resistance and a lack of new antimicrobial discovery, stewardship programs must utilize knowledge of pharmacodynamics to achieve maximal exposure in the treatment of Pseudomonas aeruginosa infections. We evaluated the clinical and economic outcomes associated with extended-infusion cefepime in the treatment of P. aeruginosa infections. This single-center study compared inpatients who received cefepime for bacteremia and/or pneumonia admitted from 1 January 2008 through 30 June 2010 (a 30-min infusion of 2 g every 8 h) to those admitted from 1 July 2010 through 31 May 2011 (a 4-h infusion of 2 g every 8 h). The overall mortality was significantly lower in the group that received extended-infusion treatment (20% versus 3%; P = 0.03). The mean length of stay was 3.5 days less for patients who received extended infusion (P = 0.36), and for patients admitted to the intensive care unit the mean length of stay was significantly less in the extended-infusion group (18.5 days versus 8 days; P = 0.04). Hospital costs were $23,183 less per patient, favoring the extended-infusion treatment group (P = 0.13). We conclude that extended-infusion treatment with cefepime provides increased clinical and economic benefits in the treatment of invasive P. aeruginosa infections.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Cefepime
  • Cephalosporins / administration & dosage*
  • Cephalosporins / therapeutic use
  • Drug Administration Schedule
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / economics
  • Pseudomonas Infections / mortality*
  • Pseudomonas aeruginosa / drug effects*
  • Retrospective Studies


  • Anti-Bacterial Agents
  • Cephalosporins
  • Cefepime