Drug information of cefepime

Mechanism of effect

Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins).Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.

Pharmacodynamic

Cefepime has an extended spectrum of activity against Gram-positive and Gram-negative bacteria, with greater activity against both Gram-negative and Gram-positive organisms than third-generation agents. Cefepime has good activity against important pathogens including Pseudomonas aeruginosa, Staphylococcus aureus, and multiple drug resistant Streptococcus pneumonia .
A particular strength is its activity against Enterobacteriaceae. Whereas other cephalosporins are degraded by many plasmid- and chromosome-mediated beta-lactamases, cefepime is stable and is a front line agent when infection with Enterobacteriaceae is known or suspected

Pharmacokinetics

Absorption : IM absorption rapid and complete
Peak plasma time : 0.5-1.5 hr (IV); 1-2 hr (IM)
Distribution : Penetrates into inflammatory fluid at concentrations ~80% of serum levels and into bronchial mucosa at concentrations ~60% of plasma levels; crosses blood-brain barrier Protein bound: 16-19%
Vd : 16-20 L (adults)
Metabolism : Minimally metabolized in liver
Elimination:Half-life : 2 hr
Excretion : Urine (85% as unchanged drug)

Drug indications

Pneumonia , Intraabdominal Infection , urinary tract infection , Pyelonephritis , Febrile Neutropenia , Skin or Soft Tissue Infection

Dosage

Cefepime injection comes as a powder to be mixed with liquid, or as a premixed product, to be injected intravenously (into a vein) over a period of 30 minutes.
Cefepime injection can also be given intramuscularly (into a muscle). It is usually given 1 to 2 g every 8 or 12 hours for 7 to 10 days.
In Pediatric : 2 months up to 16 years and up to 40 kg: 50 mg/kg IV every 8 or 12 hours for 7 to 10 days depending on the nature and severity of the infection .

Drug contraindications

hypersensitivity to drug or its components.

Side effects

nausea , Headache , decreased appetite , dizziness , vomiting , Seizures , Diarrhea , fever , Tremor , swelling , yellowing of the skin , yellowing of the eyes

Interactions

Amikacin , Gentamicin , Ampicillin+sulbactam , Amlodipine , Acetaminophen , Pantoprazole , Diclofenac , Sodium chloride , Ciprofloxacin , Furosemide , Warfarin , docusate , Combivent (Ipratropium bromide/ Salbutamol) , cholera vaccine live , Typhoid vaccine (live), oral , Florbetapir F18 , Aminohippurate Sodium

Alerts

• Long-term or repeated use of cefepime may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
• Cefepime may reduce the ability of your blood to clot. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
• Diabetes patients - Cefepime may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.
• There have been reports of nervous system problems (eg, fainting, confusion, hallucinations, coma, seizures) in some patients who take cefepime. Talk to your doctor if you develop any of these symptoms or if you have any questions or concerns.
• Use cefepime with caution in the ELDERLY; they may be more sensitive to its effects.
• Use cefepime with extreme caution in CHILDREN younger than 2 months old; safety and effectiveness in these children have not been confirmed.

Points of recommendation

• Do not use cefepime if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged .
• To clear up your infection completely, use cefepime for the full course of treatment. Keep using it even if you feel better in a few days .

Pregnancy level

B