Cefepime hydrochloride
Cefepime hydrochloride (Maxipime)
Cefepime hydrochloride
( SEF-eh-pim)
Pregnancy Category: B Maxipime (Rx)

Classification: Cephalosporin, third-generation

See Also: See also Cephalosporins .

Action/Kinetics: Antibacterial activity against both gram-negative and gram-positive pathogens, including those resistant to other ß-lactam antibiotics. High affinity for the multiple penicillin-binding proteins that are essential for cell wall synthesis. Peak serum levels, after IV: 78 mcg/mL. t 1/2, terminal: 2 hr. About 85% of the drug is excreted unchanged in the urine.

Uses: Adults: (1) Uncomplicated and complicated UTIs (including pyelonephritis) caused by Escherichia coli or Klebsiella pneumoniae; when the infection is severe or caused by E. coli, K. pneumoniae, or Proteus mirabilis; when the infection is mild to moderate, including infections associated with concurrent bacteremia with these microorganisms. (2) Uncomplicated skin and skin structure infections caused by Staphylococcus aureus (methicillin-susceptible strains only) or Streptococcus pyogenes. (3) Moderate to severe pneumonia due to Streptococcus pneumoniae including cases associated with concurrent bacteremia, Pseudomonas aeruginosa, K. pneumoniae, or Enterobacter species. (4) Monotherapy for empiric treatment of febrile neutropenia. (5) Complicated intra-abdominal infections due to E. coli viridans group streptococci, P. aeruginosa, K. pneumoniae, Enterobacter species, or Bacteroides fragilis.
Children, 2 months to 16 years: Treatment of complicated and uncomplicated UTIs incluidng pyrelonephritis, uncomplicated skin and skin structure infections, pneumonia, and as empiric therapy for febrile neutropenic clients.

Contraindications: Use in those who have had an immediate hypersensitivity reaction to cefepime, cephalosporins, pencillins, or any other ß-lactam antibiotics.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been determined in children less than 12 years of age.

Side Effects: See Cephalosporins. The most common side effects include rash, phlebitis, pain, and/or inflammation.

Laboratory Test Alterations: ALT, AST, alkaline phosphatase, BUN, creatinine, potassium, total bilirubin. Hematocrit, neutrophils, platelets, WBCs. or Calcium, phosphorus. Positive Coombs' test. Abnormal PTT, PT.

Drug Interactions: Aminoglycosides / Risk of nephrotoxicity and ototoxicity Furosemide / Risk of nephrotoxicity

How Supplied: Powder for injection: 500 mg, 1 g, 2 g

Dosage
?IM, IV Mild to moderate uncomplicated or complicated UTIs, including pyelonephritis, due to E. coli, K. pneumoniae or P. mirabilis.
Adults: 0.5-1 g IV or IM (for E. coli infections) q 12 hr for 7-10 days.
Severe uncomplicated or complicated UTIs, including pyelonephritis, due to E. coli or K. pneumoniae.
Adults: 2 g IV q 12 hr for 10 days.
Moderate to severe pneumonia due to S. pneumoniae, P. aeruginosa, K. pneumoniae or Enterobacter species.
Adults: 1-2 g IV q 12 hr for 10 days.
Moderate to severe uncomplicated skin and skin structure infections due to S. aureus or S. pyogenes.
Adults: 2 g IV q 12 hr for 10 days.
Febrile neutropenia.
2 g IV q 8 hr for 7 days, or until resolution of neutropenia.
Complicated intra-abdominal infections due to E. coli, P. aeruginosa, K. pneumoniae, B. fragilis, Enterobacter species, or viridans group streptococci.
Adults: 2 g IV q 12 hr for 7-10 days.
Infections in children 2 months to 16 years.
Up to 40 kg: 50 mg/kg b.i.d. (q 8 hr for febrile neutropenia) for 7-10 days, depending on the type and severity of infection. Do not exceed the adult dose.