Cefepime
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.
