{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:43:51Z","timestamp":1786999431206,"version":"build-2736575974"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"unspecified","delay-in-days":190,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2023]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Extended infusion cefepime (1 gram every 6 hours administered over 3 hours) achieves pharmacodynamic efficacy against bacteria with a MIC of \u22648 mg\/L in Monte Carlo simulations. This regimen has not been evaluated in clinical practice.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n Compare clinical and economic outcomes for cefepime by intermittent infusion and by extended infusion in the acute-care setting.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Single-center, retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Tertiary-care academic medical center.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n Hospitalized adults who received cefepime between August 2016 and July 2018 with a diagnosis of sepsis or pneumonia.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Clinical and economic outcomes were compared for patients who received empiric cefepime via intermittent infusion (30-minute infusion of 2 g every 8 hours) or extended infusion (3-hour infusion of 1 g every 6 hours). Clinical outcomes analyses were carried out using appropriate statistical methods.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Overall, 111 patients received intermittent infusion and 93 patients received extended infusion. Approximately half of the included patients had a positive culture for a bacterial pathogen (intermittent infusion 45.9% vs extended infusion 47.3%). Median hospital length of stay (intermittent infusion 6 days vs extended infusion 6 days;\n P<\/jats:italic>\n = .67) and 90-day readmission rates (intermittent infusion 61.3% vs extended infusion 67.7%;\n P<\/jats:italic>\n = .34) did not differ between the groups. Mortality was infrequent in both groups (intermittent infusion 2.9% vs extended infusion 1.5%;\n P<\/jats:italic>\n = .45). Cefepime cost per patient was lower with cefepime by extended infusion: average total daily cost $86.06 for intermittent infusion versus $43.39 for extended infusion.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Cefepime via extended infusion (4 grams\/day) did not differ in clinical outcomes compared to intermittent infusion (6 grams\/day) but reduced drug expenditure. Prospective, multicenter, high-quality studies should be conducted to evaluate a mortality difference between these regimens.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ash.2023.179","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T06:25:59Z","timestamp":1688970359000},"source":"Crossref","is-referenced-by-count":6,"title":["Cefepime extended infusion versus intermittent infusion: Clinical and cost evaluation"],"prefix":"10.1017","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4817-4814","authenticated-orcid":false,"given":"Aalok V.","family":"Khole","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Dionne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Zitek-Morrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Campion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"S2732494X23001791_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2019.06.005"},{"key":"S2732494X23001791_ref3","unstructured":"3. Antibiotic resistance threats in the United States. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/drugresistance\/biggest-threats.html. Published 2019. 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All-Patient Refined Diagnosis-Related Groups (APR-DRGs) version 20.0: methodology overview. Agency for Healthcare Research and Quality website. https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nis\/APR-DRGsV20MethodologyOverviewandBibliography.pdf. Published 2003. 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