Association of white blood cell count with treatment response to cefepime versus piperacillin-tazobactam.
Am J Respir Crit Care MedOct 1, 2026
Daniel I Rzewnicki, Rishi Chanderraj, Edward T Qian et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized controlled trial analyzed the impact of white blood cell (WBC) count on the effectiveness of cefepime versus piperacillin-tazobactam in treating sepsis. The study found that higher WBC counts significantly modified the effect of antibiotic choice on 28-day mortality, with an odds ratio of 0.95 for both cohorts, indicating a potential predictive role for WBC in treatment outcomes.
Key findings
- WBC count significantly interacted with treatment group in predicting 28-day mortality (OR, 0.95).
- In the ACORN cohort, patients with WBC ≥16 had lower odds of mortality with piperacillin-tazobactam compared to cefepime (OR, 0.51).
- Likelihood ratio testing showed better model fit with the inclusion of the WBC interaction term (F = 8.17, P <.01).
Why it matters
Understanding how WBC count influences antibiotic efficacy can guide clinicians in selecting appropriate treatments for sepsis, potentially improving patient outcomes. This insight may also inform future clinical trial designs.