Cefepime Hydrochloride (7 brand names, 2 dosage forms, 2 routes)
Available dosage forms: POWDER, INJECTABLE.
Routes of administration: INTRAVENOUS, INJECTION.
Brand Names
- CEFEPIME AND DEXTROSE IN DUPLEX CONTAINER
- CEFEPIME HYDROCHLORIDE
- CEFEPIME HYDROCHLORIDE IN PLASTIC CONTAINER
- CEFEPIME IN PLASTIC CONTAINER
- EXBLIFEP
- MAXIPIME
- ZAYNICH
Indications and Usage
Cefepime for injection is indicated in the treatment of pneumonia (moderate to severe) caused by susceptible strains of Streptococcus pneumoniae, including cases associated with concurrent bacteremia, Pseudomonas aeruginosa, Klebsiella pneumoniae, or Enterobacter species.
Dosage and Administration
The recommended adult dosages and routes of administration are outlined in Table 1 below for patients with creatinine clearance greater than 60 mL/min. Administer cefepime for injection intravenously over approximately 30 minutes. Table 1: Recommended Dosage Schedule for Cefepime for Injection in Adult Patients with Creatinine Clearance (CrCL) Greater Than 60mL/min Site and Type of Infection Dose Frequency Duration (days) Adults Intravenous (IV)/ Intramuscular (IM) Moderate to Severe Pneumonia§ 1 to 2 g IV Every 8 to 12hours 10 Empiric therapy for febrile neutropenic patients 2 g IV Every 8 hours 7* Mild to Moderate Uncomplicated or Complicated Urinary Tract Infections, including pyelonephritis 0.5 to 1 g IV/IM** Every 12 hours 7 to 10 Severe Uncomplicated or Complicated Urinary Tract Infections, including pyelonephritis 2 g IV Every 12 hours 10 Moderate to Severe Uncomplicated Skin and Skin Structure Infections 2 g IV Every 12 hours 10 Complicated Intra-abdominal Infections§ (used in combination with metronidazole) 2 g IV Every 8 to 12hours 7 to 10 *or until resolution of neutropenia. In patients whose fever resolves but who remain neutropenic for more than 7 days, the need for continued antimicrobial therapy should be re-evaluated frequently. **Intramuscular route of administration is indicated only for mild to moderate, uncomplicated or complicated UTIs due toE. coli. §ForP. aeruginosa, use 2 g IV every 8 hours.
Contraindications
Cefepime for injection is contraindicated in patients who have shown immediate hypersensitivity reactions to cefepime or the cephalosporin class of antibacterial drugs, penicillins or other beta-lactam antibacterial drugs.
Warnings and Precautions
Before therapy with cefepime for injection is instituted, careful inquiry should be made to determine whether the patient has had previous immediate hypersensitivity reactions to cefepime, cephalosporins, penicillins, or other beta-lactams. Exercise caution if this product is to be given to penicillin-sensitive patients because cross-hypersensitivity among beta-lactam antibacterial drugs has been clearly documented and may occur in up to 10% of patients with a history of penicillin allergy. If an allergic reaction to cefepime for injection occurs, discontinue the drug and institute appropriate supportive measures.
Adverse Reactions
The following adverse reactions are discussed in the Warnings and Precautions section and below: Hypersensitivity Reactions [see Warnings and Precautions (5.1)] Neurotoxicity [see Warnings and Precautions (5.2) ] Clostridioides difficile-Associated Diarrhea [see Warnings and Precautions (5.3)]
Drug Interactions
The administration of cefepime may result in a false-positive reaction for glucose in the urine with certain methods. It is recommended that glucose tests based on enzymatic glucose oxidase reactions be used.
Mechanism of Action
Cefepime is a cephalosporin antibacterial drug [See Microbiology (12.4) ].
Overdosage
Patients who receive an overdose should be carefully observed and given supportive treatment. In the presence of renal insufficiency, hemodialysis, not peritoneal dialysis, is recommended to aid in the removal of cefepime from the body. Symptoms of overdose include encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, and coma), myoclonus, seizures, neuromuscular excitability and nonconvulsive status epilepticus [see Warnings and Precautions (5.2), Adverse Reactions (6.2), Dosage and Administration (2.3)].