Cefepime
- Atc Codes:J01DE01
- CAS Codes:123171-59-5
- PHARMGKB ID:123171-59-5
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Inhibits
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Cefepim, Maxipime; Belgium: Maxipime; Bulgaria: Maxipime; Czech Republic: Maxipime; Estonia: Maxipime; Finland: Maxipime; France: Axepim, Cefepime; Germany: Maxipime; Greece: Verapime; Hungary: Maxipime; Italy: Cepim, Cepimex, Maxipime; Latvia: Forpar, Maxipime; Lithuania: Maxipime; Luxembourg: Maxipime; Poland: Maxipime; Portugal: Maxipime; Slovakia: Maxipime; Slovenia: Maxipime; Spain: Maxipime; Sweden: Maxipime.
North America
Canada: Cefepime, Maxipime; USA: Cefepime, Maxipime.
Latin America
Argentina: Cefepime, Cefimen-K, Maxcef; Brazil: Cefepim, Cefepima, Clocef, Maxcef; Mexico: Maxef, Maxipime.
Asia
Japan: Maxipime.
Drug combinations
Chemistry
Cefepime Hydrochloride: C~19~H~25~ClN~6~O~5~S~2~ HCl H~2~O. Mw: 571.50. (1) Pyrrolidinium, 1-[[7-[[(2-amino-4-thiazolyl)(methoxyimino)acetyl]amino]-2-carboxy-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-3-yl]methyl]-1-methyl-, chloride, monohydrochloride, monohydrate, [6R-[6α,7β(Z)]]-; (2) 1-[[(6R,7R)-7-[2-(2-Amino-4-thiazolyl)glyoxylamido]-2-carboxy-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-3-yl]methyl]-1-methylpyrrolidinium chloride, 7^2^-(Z)-(O-methyloxime), monohydrochloride, monohydrate. CAS-123171-59-5 (1993).
Pharmacologic Category
Antibacterials; Fourth Generation Cephalosporins. (ATC-Code: J01DE01).
Mechanism of action
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins. Usually bactericidal. Active in vitro and in clinical infections against Gram-positive aerobic bacteria, such as S. aureus, S. pneumoniae, S. pyogenes (group A β-hemolytic streptococci), and viridans streptococci. Also active in vitro against S. epidermidis (oxacillin-susceptible (methicillin-susceptible) strains only), S. saprophyticus, and S. agalactiae (group B streptococci). Enterococci (e.g. Enterococcus faecalis), oxacillin-resistant (methicillin-resistant) staphylococci, and Listeria monocytogenes are resistant. It is active in vitro and in clinical infections against Gram-negative aerobic bacteria such as Enterobacter, E. coli, K. pneumoniae, P. mirabilis, and Ps. aeruginosa. Also active in vitro against Acinetobacter calcoaceticus, Citrobacter diversus, C. freundii, E. agglomerans, H. influenzae (including β-lactamase-producing strains), Havnia alvei, K. oxytoca, Moraxella catarrhalis (including β-lactamase-producing strains), Morganella morganii, P. vulgaris, Providencia rettgeri, P. stuartii, and Serratia marcescens. Inactive against Stenotrophomonas. Inactive against fungi and viruses.
Therapeutic use
Urinary tract infections, including pyelonephritis caused by typical urinary tract pathogens. Monotherapy for febrile neutropenia. Uncomplicated skin and skin structure infections caused by Streptococcus pyogenes. Moderate-to-severe pneumonia caused by pneumococcus, Pseudomonas aeruginosa, and other Gram-negative organisms. Complicated intra-abdominal infections (in combination with metronidazole).
Pregnancy and lactiation implications
Teratogenic effects not observed in animal studies. It is not known if cefepime crosses the human placenta. Enters breast milk.
Unlabeled use
Contraindications
Hypersensitivity to cefepime, any component of the formulation, or other cephalosporins.
Warnings and precautions
May be associated with increased INR, especially in nutritionally-deficient patients, prolonged treatment, hepatic or renal disease. Use with caution in history of penicillin allergy, especially IgE-mediated reactions (e.g. anaphylaxis, angioedema, urticaria). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in renal impairment. Use with caution in history of seizure disorder (high levels may increase risk of seizures). Positive direct Coombs’, false-positive urinary glucose test using cupric sulfate, false-positive serum or urine creatinine with Jaffé reaction, false-positive urinary proteins and steroids. Use of cefepime not recommended in pediatric patients for treatment of serious infections due to Haemophilus influenzae type b, for suspected meningitis, or for meningeal seeding from a distant infection site. May be a valuable alternative for treating bacterial meningitis in children in conjunction with other agents like vancomycin in areas with cephalosporin nonsusceptible pneumococci.