Skip to content

Cefepime

    Brands

    DEA Class; Rx

    Common Brand Names; Maxipime

    • Cephalosporins, Other

    Parenteral fourth-generation cephalosporin. Pharmacokinetics and spectrum of activity similar to ceftazidime. Clinical uses are similar to those of the third-generation cephalosporins.

    Indicated for Treatment of moderate-to-severe pneumonia.

    Empiric therapy in febrile neutropenic patients.

    Treatment of uncomplicated and complicated urinary tract infections (UTIs), including pyelonephritis.

    Treatment of uncomplicated skin and skin structure infections

    Treatment of complicated intra-abdominal infections; use in combination with metronidazole

    Documented hypersensitivity to cefepime, penicillins, or other beta-lactam antibiotics

    • Positive Coombs test result without hemolysis (16%)
    • Rash (1-4%)
    • Elevated alanine aminotransferase (3%)
    • Hypophosphatemia (3%)
    • Diarrhea (<3%)
    • Eosinophilia (2%)
    • Erythema at injection site (2%)
    • Normal partial thromboplastin time (PTT) (2%)
    • Nausea or vomiting (<2%)
    • Fever (1%)
    • Headache (1%)
    • Pain (1%)
    • Pruritus (1%)
    • Agranulocytosis
    • Anaphylactic shock
    • Anaphylaxis
    • Coma
    • Encephalopathy
    • Hallucinations
    • Leukopenia
    • Myoclonus
    • Neuromuscular excitability
    • Neutropenia
    • Seizures
    • Thrombocytopenia

    IM recommended only for mild-to-moderate complicated or uncomplicated UTI due to E coli

    Prescribing drug in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria

    Prolonged use may cause superinfection

    May increase international normalized ratio (INR) with prolonged treatment, especially in nutritionally deficient patients

    Caution warranted with history of previous immediate hypersensitivity reactions to cefepime, cephalosporins, penicillins, or other drugs; exercise caution if product is to be given to penicillin-sensitive patients; cross-hypersensitivity among beta-lactam antibacterials documented to occur up to 10% of patients with history of penicillin allergy; if allergic reaction to this drug occurs, discontinue drug and institute appropriate supportive measures

    Use with caution in patients with GI disease, particularly colitis

    If CrCl <60 mL/min, adjust dosage to compensate for slower renal elimination rate

    There are no cases of drug exposure during pregnancy reported from postmarketing experience or from clinical trials; available data from published observational studies and case reports over several decades with cephalosporin use in pregnant women have not established drug-associated risks of major birth defects, miscarriage or adverse maternal or fetal outcomes

    Drug is present in human milk at low concentration (0.5 mcg/mL); a nursing infant consuming approximately 1000 mL of human milk per day would receive approximately 0.5 mg of cefepime per day

    Adults

    6 g/day IV or 2 g/day IM.

    Geriatric

    6 g/day IV or 2 g/day IM.

    Adolescents

    150 mg/kg/day IV (Max: 6 g/day) or 100 mg/kg/day IM (Max: 2 g/day).

    Children

    150 mg/kg/day IV (Max: 6 g/day) or 100 mg/kg/day IM (Max: 2 g/day).

    Infants

    2 to 11 months: 150 mg/kg/day IV or 100 mg/kg/day IM.
    1 month: Safety and efficacy have not been established; however, doses up to 150 mg/kg/day IV or 100 mg/kg/day IM have been used off-label.

    Neonates

    Neonates 36 weeks gestation and older: Safety and efficacy have not been established; however, doses up to 100 mg/kg/day IV have been used off-label.
    Neonates less than 36 weeks gestation: Safety and efficacy have not been established; however, doses up to 60 mg/kg/day IV have been used off-label.

    Cefepime

    infusion solution

    • 1g/50mL
    • 2g/100mL

    powder for injection

    • 1g
    • 2g