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

Abstract Background Treatment of aspiration pneumoniais an important problem due to aging of populations worldwide. However, the effectiveness of cefepimein aspiration pneumoniahas not yet been evaluated. Aim To compare the clinical efficacy and safety of cefepimeand meropenemin patients with moderate-to-severe aspiration pneumonia. Methods In this open-label, randomized study, either cefepime1 g or meropenem0.5 g was administered intravenously every 8 h to patients with moderate-to-severe community-acquired or nursing-home acquired pneumonia at risk for aspirationfor 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 Cefepimeis as effective and safe as meropenemin the treatment of moderate-to-severe aspiration pneumonia. Clinical trials identifier UMIN000001349.