Home Drug Guide Cefepime Hydrochloride

Drug Guide

Generic Name

Cefepime Hydrochloride

Brand Names Maxipime, Cefepime In Plastic Container, Cefepime And Dextrose In Duplex Container, Cefepime Hydrochloride In Plastic Container

Classification

Therapeutic: Antibiotic, Broad-spectrum cephalosporin

Pharmacological: Beta-lactam antibiotic

FDA Approved Indications

Treatment of severe bacterial infections caused by susceptible organisms, including pneumonia, febrile neutropenia, urinary tract infections, skin and soft tissue infections, intra-abdominal infections, and meningitis.

Mechanism of Action

Cefepime inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell lysis and death. It is resistant to many beta-lactamases, providing broad-spectrum activity.

Dosage and Administration

Adult: Typically 1-2 g every 8-12 hours intravenously, dosage adjusted based on infection severity and renal function.

Pediatric: Dosing varies; generally 50-100 mg/kg/day divided every 8-12 hours, adjusted for renal function.

Geriatric: Use with caution; start at lower doses due to decreased renal function.

Renal Impairment: Dose adjustments required, based on creatinine clearance.

Hepatic Impairment: No specific adjustment necessary.

Pharmacokinetics

Absorption: Administered IV; not absorbed orally.

Distribution: Widely distributed, including cerebrospinal fluid (CSF).

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.

Excretion: Renal excretion via glomerular filtration and tubular secretion.

Half Life: Approximately 2 hours in patients with normal renal function.

Contraindications

Known hypersensitivity to cefepime or other cephalosporins.

Precautions

Use cautiously in patients with allergies to penicillin or other beta-lactam antibiotics.

Adverse Reactions - Common

Pain at injection site (Common)
Rash (Common)
Headache (Common)

Adverse Reactions - Serious

Anaphylaxis (Rare)
Seizures (Rare, increased risk in renal impairment)
Clostridioides difficile-associated diarrhea (Rare)

Drug-Drug Interactions

Probenecid (may increase cefepime levels).
Aminoglycosides (potential nephrotoxicity).

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal function, electrolyte balance, and for allergic reactions.

Diagnoses:

Risk for allergic reaction
Risk for infection related to antibiotic therapy
Impaired skin integrity at injection site

Implementation: Administer IV as prescribed; monitor for adverse reactions; adjust dose in renal impairment.

Evaluation: Assess infection resolution, monitor labs, and watch for side effects.

Patient/Family Teaching

Complete full course of therapy.
Report any signs of allergic reaction or unusual side effects.
Inform about possible diarrhea and to seek medical attention if severe or persistent.

Special Considerations

Black Box Warnings:

Risk of hypersensitivity reactions, including anaphylaxis.

Genetic Factors: None specified.

Lab Test Interference: May cause false elevations in urine glucose testing with some methods.

Overdose Management

Signs/Symptoms: Neurotoxicity including seizures, confusion, and coma in severe overdose.

Treatment: Supportive care; no specific antidote; consider dialysis in severe cases.

Storage and Handling

Storage: Store at room temperature 20-25°C (68-77°F). Protect from light.

Stability: Stable under recommended storage conditions; discard after expiration.