Cefepime vs. meropenem for moderate-to-severe pneumonia in patients at risk for aspiration: An open-label, randomized study

Abstract

Background: Treatment of aspiration pneumonia is an important problem due to aging of populations worldwide. However, the effectiveness of cefepime in aspiration pneumonia has not yet been evaluated.

Aim: To compare the clinical efficacy and safety of cefepime and meropenem in patients with moderate-to-severe aspiration pneumonia.

Methods: In this open-label, randomized study, either cefepime 1 g or meropenem 0.5 g was administered intravenously every 8 h to patients with moderate-to-severe community-acquired or nursing-home acquired pneumonia at risk for aspiration for an average of 10.5 days. The primary outcome was the clinical response rate at the end of treatment (EOT) in the validated per-protocol (VPP)-population. Secondary outcomes were clinical response during treatment (days 4 and 7) and at the end of study (EOS) in the VPP-population, and survival at day 30 in the modified intention-to-treat (MITT)-population.

Results: There was no difference between the groups in the primary or secondary outcomes or safety. Significant improvement was observed in each group on day 4.

Conclusion: Cefepime is as effective and safe as meropenem in the treatment of moderate-to-severe aspiration pneumonia.

Clinical trials identifier: UMIN000001349.

Keywords: Aspiration pneumonia; Cefepime (CFPM); Meropenem (MEPM); Moderate-to-severe pneumonia; Open-label randomized study.