Cefepime vs. Piperacillin-Tazobactam for Infection? The ACORN Trial

Critical Care Perspectives in Emergency Medicine

Timely and appropriate administration of empiric broad-spectrum antibiotics for adult patients with sepsis is critical. Current guidelines recommend an antipseudomonal antibiotic for those at risk of a resistant gram-negative organism. The two most common antipseudomonal antibiotics prescribed in this setting are cefepime and piperacillin-tazobactam. In recent years, observational studies have reported an association with cefepime and neurotoxicity, whereas piperacillin-tazobactam has been associated with AKI especially when given with vancomycin. In this podcast, we discuss the recently published ACORN Trial, a randomized trial that evaluated cefepime and piperacillin-tazobactam for adult patients with suspected infection.