Cefepime

Oral Antibiotics

Drug class: Fourth-Generation Cephalosporin Antibiotic; beta-lactam antibiotics class, specifically categorized as a Fourth-generation cephalosporin.

Cefepime (Maxipime) (中文：頭孢吡肟)

Common Strengths

Cefepime injections available in the following strengths:

• 1 g per vial

Trade Name

Maxipime

Drug Usage

Cefepime is a fourth-generation cephalosporin antibiotic that belongs to the beta-lactam class. It is used to treat a variety of bacterial infections, particularly those caused by gram-positive and gram-negative organisms.

Cefepime is indicated for:

• Pneumonia
• Complicated and uncomplicated urinary tract infections
• Skin and soft tissue infections
• Complicated intra-abdominal infections (in combination with metronidazole)
• Empiric treatment for febrile neutropenia

Mechanism of Action

Cefepime disrupts bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation, which leads to cell lysis and death of the bacteria.

Route of Administration

Intravenous (IV) injection

Dosages

Normal Adults:

• Typical dosing is 2 g IV every 8 hours for severe infections or every 12 hours for moderate infections.

Renal Impairment: Dosage adjustments are necessary based on creatinine clearance (CrCl):

• CrCl >60 mL/min: 2 g IV every 8 hours
• CrCl 30-60 mL/min: 2 g IV every 12 hours
• CrCl 10-29 mL/min: 1 g IV every 24 hours
• CrCl <10 mL/min: 500 mg IV every 24 hours

Side Effects

Frequency	Adverse reactions
Common Side Effects	Diarrhea
	Nausea
	Rash
	Injection site reactions
Serious Side Effects	Neurotoxicity (e.g. seizures)
	Allergic reactions (e.g. anaphylaxis)
	Clostridium difficile-associated diarrhea

Pharmacokinetics

• Cefepime has a half-life of approximately 2 hours in patients with normal renal function.
• Onset Time: Rapid onset after IV administration.
• Duration of Action: Generally lasts for about 8 to 12 hours.

Drug Precautions

Pregnancy

Use with caution; benefits should outweigh risks.

Breastfeeding

Minimal risk to infants; use under medical advice.

Children and Elderly

Safety in children under two months is not established; the elderly may require dose adjustments due to renal function decline.

Monitoring Items

• Renal function (creatinine clearance)
• Signs of neurotoxicity
• Efficacy of treatment (resolution of infection)

Drug Interactions

• Aminoglycosides (e.g. gentamicin): Increased risk of nephrotoxicity.
• Frusemide: Concurrent use can lead to an increased risk of nephrotoxicity.
• Warfarin: Cefepime may elevate INR, increasing bleeding risk, particularly in patients with renal dysfunction.
• BCG vaccine (live): Concurrent use is not recommended as it may adversely affect treatment outcomes.
• Cholera and Typhoid vaccines: Th efficacy of these live vaccines may be reduced when administered with cefepime.

FAQ

How Should I Take the Cefepime?

Cefepime is administered via injection.

What Should I Avoid during Treatment?

Avoid alcohol, as it may increase side effects. Consult your doctor about other medications you are taking to avoid interactions.