Cefepime vs. Piperacillin-Tazobactam for Sepsis: The Debate Continues

A retrospective study suggests that PTZ for initial empirical management of undifferentiated sepsis is associated with higher mortality.

Observational data suggest that cefepime might be associated with fewer adverse outcomes than is piperacillin-tazobactam (PTZ), but a recent randomized trial showed no difference in 14-day mortality or renal outcomes between the two drugs when they were used to treat patients with sepsis or suspected serious infection (NEJM JW Gen Med Nov 15 2023 and JAMA 2023; 330:1557). Because only half of patients in that study had sepsis and <10% were critically ill, Michigan investigators performed a retrospective cohort study of 7500 patients who were admitted to the emergency department from 2014 through 2018 with undifferentiated suspected sepsis (all had organ dysfunction within 24 hours; mean SOFA score, 5). Patients who received PTZ were compare…

Reviewing Author

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Cefepime vs. Piperacillin-Tazobactam for Sepsis: The Debate Continues

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Reviewing Author