Cefepime, a fourth-generation cephalosporin antibiotic, is widely used to treat serious bacterial infections due to its broad-spectrum activity and resistance to many β-lactamases. Its rapid bactericidal action and favorable safety profile make it a cornerstone in hospital settings.
What is Cefepime?
Cefepime is a semi-synthetic bactericidal antibiotic classified as a fourth-generation cephalosporin. It exhibits an extended spectrum of activity against both Gram-positive and Gram-negative bacteria, with greater effectiveness against both types compared to third-generation cephalosporins.
Approved by the FDA in 1996, cefepime is administered through injection into muscles or veins under medical supervision. Cefepime is available under various brand names, with Maxipime being the most common in the United States.
Following the expiration of Bristol-Myers Squibb's patent, it became available as a generic medication and is marketed by numerous companies worldwide under names including Neopime, Cepimax, Cepimex, and Axepim
What are the Uses of Cefepime?
Cefepime is highly effective against a wide range of bacterial infections due to its broad-spectrum activity. Its ability to combat various pathogens makes it a crucial treatment option in medical settings.
Primary Uses of Cefepime Injection
Cefepime injection is commonly prescribed for the treatment of the following serious infections:
Pneumonia (both hospital-acquired and community-acquired)
Complicated intra-abdominal infections (usually combined with metronidazole)
Febrile neutropenia - used as empiric therapy in patients with low white blood cell counts due to chemotherapy or other causes
These infections often require immediate and aggressive treatment, making cefepime an ideal choice for intravenous or intramuscular use in clinical settings.
Secondary Uses of Cefepime
Additionally, cefepime is sometimes used to treat:
Endocarditis (infection of the heart lining and valves)
Meningitis (infection of the membranes covering the brain and spine)
Sepsis and bloodstream infections (bacteremia) - where rapid broad-spectrum coverage is required
How Does Cefepime Work?
Cefepime works by inhibiting bacterial cell wall synthesis. It covalently binds to enzymes responsible for the final step in transpeptidation during peptidoglycan wall synthesis. This binding causes defects in the bacterial cell wall, leading to autolysis and subsequent death of the organism.
Compared to older cephalosporins, cefepime is more stable against beta-lactamases, which are enzymes produced by bacteria that can break down and inactivate antibiotics. This enhanced stability makes cefepime effective against many resistant bacterial strains.
How to Use Cefepime
Follow your doctor's instructions carefully. Cefepime is typically administered via injection into a muscle or vein. Ensure thorough understanding of preparation and usage instructions.
Key Instructions for Use:
Thaw frozen pre-mixed solutions properly before use.
Check for particles or discoloration before administration.
Shake thawed solutions vigorously and check for leaks.
Use at regular intervals to maintain effectiveness.
Cefepime Dosage
Cefepime is administered via injection into a muscle or vein as directed by a healthcare professional. The dosage is based on the patient's medical condition, renal function, and response to treatment. In children, the dosage is also based on weight.
Typical Dosage Instructions
For adults:
Pneumonia: 1-2 g every 12 hours for 7-10 days
Urinary tract infections (moderate to severe): 0.5-2 g every 12 hours for 7-10 days
Skin and soft tissue infections: 2 g every 12 hours for 10 days
Febrile neutropenia: 2 g every 8 hours for 7 days or until resolution
Intra-abdominal infections: 2 g every 8-12 hours plus metronidazole
For children (2 months and older):
Children weighing less than 40 kg: 50 mg/kg every 8-12 hours for 7-10 days
Children weighing more than 40 kg: Same as adult dose
What Should I Do If I Miss a Dose?
If you miss a dose, take it as soon as you remember. However, if it's almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed one.
While cefepime is generally well-tolerated, it can cause various side effects. Most side effects are mild and resolve without intervention, but some can be serious.
Respiratory symptoms like difficulty breathing or swallowing
Precautions While Taking Cefepime
Cefepime Tablet and injection require caution in certain populations:
Who Should Avoid This Medicine
Cefepime should be avoided by:
People with known allergies to cefepime, other cephalosporins, or any components of the formulation
Those who have had severe allergic reactions to penicillin antibiotics (use with caution)
Conditions Where Caution Is Needed
Caution is advised in patients with:
Kidney disease (dosage adjustment may be necessary)
History of seizures or brain disorders
History of gastrointestinal disease, especially colitis
Renal impairment (creatinine clearance less than or equal to 60 mL/min)
Are There Any Age Restrictions for Using Cefepime?
Cefepime is approved for use in patients 2 months of age and older. The safety and efficacy in infants younger than 2 months have not been established.
Alcohol or Food Interactions
There are no specific food restrictions with cefepime. However, alcohol consumption should be avoided while taking antibiotics as it can reduce their effectiveness and increase the risk of side effects.
Possible Interactions with Other Medications
Cefepime may interact with various medications, potentially affecting their efficacy or increasing the risk of side effects.
Notable interactions include:
Aminoglycosides (gentamicin, tobramycin): Increased risk of kidney toxicity
Warfarin: Cefepime may decrease prothrombin activity, potentially increasing bleeding risk
Live bacterial vaccines: Cefepime may reduce vaccine effectiveness
Immune checkpoint inhibitors (dostarlimab, durvalumab, toripalimab): Cefepime may interfere with their therapeutic effects
Always inform your healthcare provider about all medications, supplements, and herbal products you are taking before starting cefepime treatment.
How Should Cefepime Be Stored?
Proper storage of cefepime is essential to maintain its potency and effectiveness. Follow the storage guidelines provided by your healthcare provider or pharmacist.
Recommended Storage Temperature for Cefepime
Cefepime should be stored away from heat, light, and moisture to maintain its potency. Specific storage requirements may vary by formulation:
Unopened vials: Store at controlled room temperature (20-25°C or 68-77°F)
Reconstituted solutions: Stability varies by diluent and concentration; follow specific product guidelines
What Happens If Cefepime Is Not Stored Properly?
Improper storage can lead to degradation of the medication, potentially reducing its effectiveness or increasing the risk of side effects. Always check for particles or discoloration before administration, and do not use if either is present.
Keep cefepime and all medications out of reach of children. Properly discard unused or expired medication according to local regulations or guidelines provided by your healthcare provider.
Cefepime vs Ceftriaxone
Cefepime
Ceftriaxone
Cefepime is a cephalosporin antibiotic of the fourth generation. Cefepime has a broad spectrum of activity against Gram-positive and Gram-negative bacteria.
Ceftriaxone, also known as Rocephin, is an antibiotic that is used to treat a variety of bacterial infections.
Cefepime is an antibiotic that is used to treat a wide range of bacterial infections. This medication is a cephalosporin antibiotic, which is a type of antibiotic.
Used to treat bacterial infections that are serious or life-threatening, such as E. coli, pneumonia, or meningitis. Ceftriaxone is also used to prevent infection in patients undergoing specific types of surgery.
It works by preventing bacterial growth.
It works by interfering with the cell wall formation of bacteria. Ceftriaxone weakens the bonds that hold the bacterial cell wall together, allowing holes to form. This kills the bacteria that are causing the infection.
Cefdinir is used to treat bacterial infections such as bronchitis (inflammation of the airway tubes leading to the lungs), pneumonia, and infections of the skin, ears, sinuses, throat, and tonsils. It belongs to a class of medications known as cephalosporin antibiotics.
Cefdinir is a cephalosporin antibiotic effective against mild-to-moderate infections caused by susceptible gram-positive and gram-negative bacteria. Most side effects are mild and occur infrequently.
Cefdinir and amoxicillin are both antibiotics used to treat bacterial infections, but they belong to different classes. Cefdinir is a cephalosporin antibiotic, while amoxicillin is a penicillin-type antibiotic. Cefdinir is typically available only in its generic form.
Cefdinir treats bacterial infections in various parts of the body by either killing the bacteria or preventing their growth. It is a cephalosporin antibiotic and is not effective against viral infections such as colds or the flu.
Avoid taking antacids or mineral supplements that contain aluminum, magnesium, or iron within two hours of taking cefdinir, as these can interfere with its absorption. This caution does not apply to iron-fortified baby formula.
Common side effects of cefdinir 300 mg include nausea, vomiting, stomach pain, diarrhea, headache, and rash.
Cefdinir is available in oral capsule and suspension forms and should be taken once or twice daily as prescribed. Taking it with food or milk can help reduce the chance of stomach upset.
When used appropriately to treat bacterial pneumonia, cefdinir typically begins to improve symptoms within three to seven days. It’s important to remember that antibiotics do not treat viral infections.
No, Cefepime (brand name Maxipime) is not available in an oral form. It is only administered as an injection, either intravenously or intramuscularly. Currently, there is no oral antibiotic on the market considered to be an equivalent substitute for Cefepime.
In individuals with healthy kidney function, most of Cefepime is eliminated from the body within approximately 10 hours after a dose. This is based on the medication’s half-life—the time it takes for half of the drug to be cleared from the body. Since Cefepime is primarily excreted through the kidneys, people with impaired kidney function may take longer to clear the drug, sometimes up to 3 days.
Disclaimer: The information provided is accurate and up-to-date to the best of our knowledge. However, it should not be considered a substitute for medical advice or consultation. We do not guarantee its completeness or accuracy. The absence of specific warnings does not mean a medicine is safe for all users. We are not responsible for any outcomes based on this information and strongly recommend consulting a doctor for any medical concerns or questions.
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