Cefepime

— THERAPEUTIC CATEGORIES —
  • Bacterial infections
PAGE CONTENTS
  • Jump to Section
  • Generic Name & Formulations
  • Indications
  • Dosage and Administration
  • Contraindications
  • Boxed Warnings
  • Warnings/Precautions
  • Pharmacokinetics
  • Interactions
  • Adverse Reactions
  • Clinical Trials
  • Note
  • Patient Counseling

    • Cefepime Generic Name & Formulations

    Legal Class

    Rx

    General Description

    Cefepime (as HCl) 1g, 2g; pwd for IV infusion or IM inj after reconstitution.

    Pharmacological Class

    Cephalosporin.

    How Supplied

    Contact supplier

    Manufacturer

    Various generic manufacturers

    Generic Availability

    YES

    Mechanism of Action

    Cefepime is a bactericidal agent that acts by inhibition of bacterial cell wall synthesis. Within bacterial cells, the molecular targets of cefepime are the penicillin binding proteins.

    Cefepime Indications

    Indications

    Susceptible infections, including moderate to severe pneumonia, uncomplicated skin and skin structure infections, complicated and uncomplicated urinary tract infections (UTIs) including pyelonephritis, complicated intraabdominal in adults (w. metronidazole). Empiric therapy in febrile neutropenia.

    Cefepime Dosage and Administration

    Adult

    When giving IV, infuse over 30mins. Pneumonia: 1–2g IV every 8–12hrs for 10 days. Skin and skin structures, severe UTIs: 2g IV every 12hrs for 10 days. Mild to moderate UTIs: 500mg–1g IV or IM every 12hrs for 7–10 days (IM only for UTIs caused by E. coli). Intraabdominal (use w. metronidazole): 2g IV every 8–12hrs for 7–10 days. Febrile neutropenia: 2g IV every 8hrs for 7 days or until neutropenia resolves. CrCl ≤60mL/min: reduce dose; see full labeling. Hemodialysis: give dose after each session. Continuous ambulatory peritoneal dialysis: give usual doses at 48hr intervals.

    Children

    <2mos: not established. Not for use in serious infection when pathogen is or may be H. influenzae type b. 2mos–16yrs (≤40kg): 50mg/kg/dose every 12hrs (every 8hrs for P. aeruginosa pneumonia); do not exceed recommended adult dose. Severe UTIs, pneumonia, skin and skin structure: give IV for 10 days. Mild to moderate UTIs: give IV or IM for 7–10 days (IM only for UTIs caused by E. coli). Febrile neutropenia: give IV every 8hrs for 7 days or until neutropenia resolves.

    Administration

    For IV or IM administration. IV: give over approx. 30mins. Solutions of cefepime should not be added to solutions of ampicillin at a concentration greater than 40mg/mL, and should not be added to metronidazole, vancomycin, gentamicin, tobramycin, netilmicin sulfate, or aminophylline because of potential interaction. However, if concurrent therapy with cefepime is indicated, each of these antibiotics can be administered separately.

    Nursing Considerations

    For IV or IM administration. IV: give over approx. 30mins. Solutions of cefepime should not be added to solutions of ampicillin at a concentration greater than 40mg/mL, and should not be added to metronidazole, vancomycin, gentamicin, tobramycin, netilmicin sulfate, or aminophylline because of potential interaction. However, if concurrent therapy with cefepime is indicated, each of these antibiotics can be administered separately. Alert patients to the potential for C. difficile-associated diarrhea or neurological adverse events; advise them to inform their providers if either occurs.

    Cefepime Contraindications

    Contraindications

    Penicillin or other β-lactam allergy.

    Cefepime Boxed Warnings

    Not Applicable

    Cefepime Warnings/Precautions

    Warnings/Precautions

    Renal impairment. Risk of neurotoxicity (esp. in renally-impaired); discontinue if occurs and treat appropriately. Renal or hepatic dysfunction, poor nutritional state, prolonged antimicrobial therapy: monitor prothrombin time. History of GI disease (esp. colitis). Pregnancy. Nursing mothers.

    Cefepime Pharmacokinetics

    Metabolism

    Hepatic.

    Elimination

    Renal (~85% unchanged).

    Cefepime Interactions

    Interactions

    Aminoglycosides may potentiate oto- or nephrotoxicity. Possible nephrotoxicity with diuretics (eg, furosemide). May cause false (+) Coomb's, Clinitest.

    Cefepime Adverse Reactions

    Adverse Reactions

    Local reactions (eg, pain, phlebitis, inflammation), rash, nausea, vomiting, diarrhea, pruritus, fever, headache, anemia, renal dysfunction; neurotoxicity, C. difficile associated diarrhea, hypersensitivity reactions.

    Cefepime Clinical Trials

    See Literature

    Cefepime Note

    Notes

    Formerly known under the brand name Maxipime.

    Cefepime Patient Counseling

    See Literature

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