Cefepime

Cephalosporin · Cephalosporin

Indications

Infections due to susceptible organisms in patients over 12 years of age. Febrile neutropaenia.

Dosage

Lower Respiratory Infection: Adults: Moderate-Severe: 1-2 gm IV every 12 hr for 10 days. Children: 2 mth-16 yr: < 40 kg: 50 mg/kg IV every 12 hr. Max: Do not exceed adult dose. Urinary Tract Infection: Adults: Mild-Moderate: 0.5-1 gm IM/IV every 12 hr for 7-10 days. Severe: 2 gm IV every 12 hr for 10 days. Children: 2 mth-16 yr: <40 kg: 50 mg/kg IV every 12 hr. Max: Do not exceed adult dose. Skin Infection: Adults: Moderate-Severe: 2 gm IV every 12 hr for 10 days. Children: 2 mth-16 yr: <40 kg: 50 mg/kg IV every 12 hr. Max: Do not exceed adult dose. Febrile neutropaenia: Adults: 2 gm IV every 8 hrs.

Administration

IM: Inject deep IM large muscle mass. IV: Inject direct IV over 5 min. Infuse intermittent infusion over 30-60 min. IV Detail: pH 4-6. Reconstitution: IV: Reconstitute using manufacturer’s guidelines. IM: Reconstitute 500 mg vial of drug with 1.3 mL of diluent, such as SWFI (or 1 gm vial with 2.4 mL of diluent). Compatibility: Stable in D5LR, D5NS, D5W, D10W, NS, bacteriostatic water, SWFI. Y-site administration: Drug to Drug IV Compatibility: Amikacin, aztreonam, bumetanide, calcium gluconate, dexamethasone, fluconazole, furosemide, heparin, hydrocortisone, hydromorphone, imipenem, insulin regular, levofloxacin, linezolid, lorazepam, methylprednisolone, metronidazole, milrinone, piperacillin/tazobactam, ranitidine. Drug to Drug IV Incompatibility: Acyclovir, amphotericin B, amphotericin B cholesteryl sulphate complex, chlordiazepoxide, chlorpromazine, cimetidine, ciprofloxacin,…

Adverse Effects

Pseudomembranous colitis; superinfection; neutropenia; injection site reaction (IV); GI upset; headache, rash.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Precautions: GI disease (especially colitis); prolonged use; renal impairment; children under 12 years of age.

Interactions

Aminoglycosides; potent diuretics.

Advice to Patient

Take with or without meals. Contact prescriber if there is burning/swelling/redness or pain at infusion or injection site or if there is itching, hives, difficulty in breathing or swallowing, severe unrelieved diarrhoea, vaginal itching, vaginal drainage, mouth sores, bloody stool, bloody urine, unusual chills or fever. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber.

Pharmacokinetics

Absorption: IM: Rapid and complete. Metabolism: Minimally hepatic. Half-life elimination: Neonates: 4-5 hrs. Children 2 mth-6 yrs: 1.77-1.96 hrs. Adults: 2 hrs. Haemodialysis: 13.5 hrs. Continuous peritoneal dialysis: 19 hrs. Time to peak: IM: 1-2 hrs. IV: 0.5 hrs. Excretion: Urine.

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Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.