Unraveling the safety concerns about cefepime

Unexpectedly poor outcomes in patients on cefepime have been noted previously although the mechanisms were unclear. Investigators in Switzerland monitored PK and PD parameters in a group of ICU patients receiving cefepime. The results suggested treatment failure due to inability to attain PD target in infections with MICs in the upper part of the sensitive range, as well as neurotoxicity in patients with creatinine clearances below 50. Authors suggested measuring plasma levels in patients with creatinine clearances below 50 or with infections by organisms with MICs above 4.