Cefepim

Definition
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β-Lactamase-resistant broad spectrum cephalosporin of the 4th generation. Cefepim is the most stable cephalosporin compared to β-lactamases.

Half-life
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2 h

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Spectrum of action
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Acinetobacter spp., Citrobacter spp., Enterobacter spp., E. coli, Hafnia alvei, Haemophilus spp., Klebsiella spp., Moraxella catarrhalis, Morganella morganii, Neisseria spp, Proteus spp., Providencia spp., Pseudomonas spp., Salmonella spp., Serratia spp., Shigella spp., Staphylococcus spp., Streptococcus spp.

Indication
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Severe, life-threatening respiratory and bile duct infections.

Dosage and method of use
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2 times/day 2 g slowly i.v. or as a short infusion, in immunocompromised patients 3 times 2 g/day. Treatment duration: 7-10 days, max. 14 days.

Undesirable effects
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Neurotoxicity (Payne LE et al. 2017)

Preparations
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Maxipime®

Literature
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Payne LE et al (2017) Cefepime-induced neurotoxicity: a systematic review. Crit Care 21:276.
Lacroix C et al (2019) Serious central nervous system side effects of cephalosporins: A national analysis of serious reports registered in the French Pharmacovigilance Database.J Neurol Sci 398:196-201.
Mullins BP et al (2018) Comparison of the Nephrotoxicity of Vancomycin in Combination With Cefepime, Meropenem, or Piperacillin/Tazobactam: A Prospective, Multicenter Study. Ann Pharmacother 52:639-644.