Summary
The ACORN randomised clinical trial compared cefepime and piperacillin-tazobactam in 2511 hospitalised adults to evaluate their comparative safety profiles, specifically addressing longstanding concerns that piperacillin-tazobactam causes acute kidney injury whilst cefepime causes neurological dysfunction. The trial found no significant difference in the highest stage of acute kidney injury or death between the two antibiotic groups by day 14, suggesting comparable safety profiles in empirical treatment of suspected pseudomonal infection.
UK applicability
The findings are directly applicable to UK clinical practice, as cefepime and piperacillin-tazobactam are similarly used in National Health Service hospitals for empirical treatment of hospital-acquired infections. These results may inform UK antimicrobial stewardship guidelines and empirical prescribing protocols in emergency departments and intensive care units.
Key measures
Primary outcome: highest stage of acute kidney injury or death (5-level ordinal scale) by day 14. Secondary outcomes: incidence of major adverse kidney events at day 14; days alive and free of delirium and coma within 14 days.
Outcomes reported
The study measured the highest stage of acute kidney injury or death by day 14 on a 5-level ordinal scale, major adverse kidney events at day 14, and days alive and free of delirium and coma within 14 days. No significant difference was found in acute kidney injury outcomes between the two antibiotic groups.
Topic tags
Dig deeper with Pulse AI.
Pulse AI has read the whole catalogue. Ask about this record, its theme, or how the findings apply to UK farming and policy — every answer cites the underlying studies.