Cefepime Brand Name– Maxipime
What is Cefepime
Cefepime is a parenteral cephalosporin with pharmacokinetics and spectrum of activity similar to ceftazidime, a ‘third-generation’ cephalosporin.
Because cefepime may be active against some organisms resistant to ceftazidime, some consider cefepime a ‘fourth-generation’ cephalosporin.
Cefepime is comparable to ceftazidime in its coverage of Pseudomonas aeruginosa, and it may be more active than ceftazidime against Enterobacter sp. due to enhanced stability against beta-lactamases. Clinical uses of cefepime are similar to those of the third-generation cephalosporins.
Cefepime was approved in January 1996. It was approved for the treatment of febrile neutropenia in June 1997 and for complicated intra-abdominal infections in January 1998. In early 2007, the safety of cefepime relative to other beta-lactam antibiotics was questioned.
A meta-analysis evaluating the efficacy and safety of cefepime reported a higher all-cause mortality in patients treated with cefepime compared to other beta-lactams.
The FDA has conducted additional analyses and determined that the data do not indicate a higher rate of death in cefepime-treated patients.
While the FDA has concluded that cefepime remains an appropriate therapy for its approved indications, they will continue to review its safety.
Indications
- Acinetobacter calcoaceticus
- Acinetobacter lwoffii
- Aeromonas hydrophila
- bacteremia
- biliary tract infections
- cholangitis
- cholecystitis
- Citrobacter diversus
- Citrobacter freundii
- community-acquired pneumonia
- diabetic foot ulcer
- endocarditis
- Enterobacter sp.
- Escherichia coli
- febrile neutropenia
- Gardnerella vaginalis
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- Hafnia alvei
- intraabdominal infections
- Klebsiella oxytoca
- Klebsiella pneumoniae
- meningitis
- Moraxella catarrhalis
- Morganella morganii
- Neisseria gonorrhoeae
- Neisseria meningitidis
- nosocomial pneumonia
- Pantoea agglomerans
- peritonitis
- pleural empyema
- pneumonia
- Proteus mirabilis
- Proteus vulgaris
- Providencia rettgeri
- Providencia stuartii
- Pseudomonas aeruginosa
- pyelonephritis
- Salmonella sp.
- sepsis
- Serratia liquefaciens
- Serratia marcescens
- Shigella sp.
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Staphylococcus saprophyticus
- Streptococcus agalactiae (group B streptococci)
- Streptococcus bovis
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- urinary tract infection (UTI)
- Viridans streptococci
- Yersinia enterocolitica
Side Effects
- agranulocytosis
- anaphylactic shock
- anaphylactoid reactions
- anemia
- aphasia
- aplastic anemia
- azotemia
- bleeding
- candidiasis
- cholestasis
- colitis
- coma
- confusion
- diarrhea
- elevated hepatic enzymes
- encephalopathy
- eosinophilia
- erythema
- erythema multiforme
- fever
- hallucinations
- headache
- hemolytic anemia
- hypercalcemia
- hyperkalemia
- hyperphosphatemia
- hypocalcemia
- hypophosphatemia
- hypoprothrombinemia
- injection site reaction
- leukopenia
- nausea
- neutropenia
- pancytopenia
- phlebitis
- pruritus
- pseudomembranous colitis
- rash
- seizures
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vaginitis
- vomiting
Monitoring Parameters
- prothrombin time (PT)
- serum creatinine/BUN
Contraindications
- breast-feeding
- cephalosporin hypersensitivity
- coagulopathy
- diarrhea
- geriatric
- penicillin hypersensitivity
- pregnancy
- pseudomembranous colitis
- renal failure
- renal impairment
- vitamin K deficiency
Interactions
- Amikacin
- Aminoglycosides
- Gentamicin
- Kanamycin
- Loop diuretics
- Oral Contraceptives
- Paromomycin
- Plazomicin
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Streptomycin
- Tobramycin
- Warfarin
