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Cefepime

CEFEPIME

Manufacturer: WG Critical Care, LLC

Score: 141.0

Quick Summary

Cefepime is a cephalosporin antibacterial used for treating various infections, including pneumonia, febrile neutropenia, urinary tract infections, skin and skin structure infections, and intra-abdominal infections. It is administered intravenously or intramuscularly, with dosing recommendations varying based on the type and severity of the infection, as well as patient factors such as renal function and age. Important safety considerations include hypersensitivity reactions, neurotoxicity, and potential interactions with other medications. Special population considerations include use in pregnancy, nursing mothers, pediatric patients, and geriatric patients, with careful attention to dosing and potential adverse effects.

Key Clinical Findings and Indications

  • Treatment of pneumonia, febrile neutropenia, urinary tract infections, skin and skin structure infections, and intra-abdominal infections
  • Effective against a broad range of Gram-positive and Gram-negative bacteria
  • Administered intravenously or intramuscularly

Important Safety Information

Warning

Hypersensitivity reactions, including anaphylaxis, can occur with cefepime use

Contraindications

  • Known hypersensitivity to cefepime or other cephalosporins
  • Penicillin or other beta-lactam allergy

Adverse Reactions

  • Local reactions, positive Coombs' test, decreased phosphorus, increased ALT and AST, increased PT and PTT, and rash
  • Neurotoxicity, including encephalopathy, myoclonus, and seizures, particularly in patients with renal impairment

Dosing Recommendations

General Guidance

Dose adjustments recommended for patients with renal impairment, with careful attention to creatinine clearance and potential need for hemodialysis

Moderate to severe pneumonia

Adult Dose

1-2 g IV every 8-12 hours

Pediatric Dose

50 mg/kg IV every 8-12 hours

Febrile neutropenia

Adult Dose

2 g IV every 8 hours

Pediatric Dose

50 mg/kg IV every 8 hours

Special Population Considerations

Pregnancy

  • Category B; use during pregnancy only if clearly needed
  • No adequate and well-controlled studies in pregnant women

Nursing Mothers

  • Cefepime is excreted in human breast milk; caution recommended
  • Monitor infant for potential adverse effects

Pediatric Use

  • Safety and effectiveness established for patients 2 months to 16 years
  • Use in pediatric patients below 2 months not established

Geriatric Use

  • Careful attention to dosing and potential adverse effects recommended
  • Increased risk of neurotoxicity and other adverse effects in patients with renal impairment