cefepime hydrochloride


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Related to cefepime hydrochloride: Maxipime

cefepime hydrochloride

Maxipime

Pharmacologic class: Fourth-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity.

Availability

Powder for injection: 500-mg vial, 1-g vial, 2-g vial; 1-g and 2-g piggyback bottles

Solution for injection (premixed): 1 g (50 ml in iso-osmotic dextrose), 2 g (100 ml in iso-osmotic dextrose)

Indications and dosages

Urinary tract infections (UTIs) caused by Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis

Adults: 500 mg to 1g by I.V. infusion or I.M. q 12 hours for 7 to 10 days

Severe UTIs caused by E. coli or K. pneumoniae; moderate to severe skin infections caused by Staphylococcus aureus or Streptococcus pyogenes

Adults: 2 g by I.V. infusion q 12 hours for 10 days

Febrile neutropenia

Adults and children ages 2 months to 16 years: 2 g by I.V. infusion q 8 hours for 7 days

Complicated intra-abdominal infections caused by alpha-hemolytic streptococci, E. coli, K. pneumoniae, Pseudomonas aeruginosa, Enterobacter species, or Bacteroides fragilis

Adults: 2 g by I.V. infusion q 12 hours for 7 to 10 days (given with metronidazole)

Moderate to severe pneumonia caused by K. pneumoniae, P. aeruginosa, Enterobacter species, or Streptococcus pneumoniae

Adults: 1 to 2 g by I.V. infusion q 12 hours for 10 days

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Don't mix premixed solution with other drugs.

Don't use flexible container in series connections because of risk of air embolism.
• Obtain specimens for culture and sensitivity testing as needed before starting therapy.
• Don't mix with ampicillin (at concentrations above 40 mg/ml), metronidazole, aminoglycosides, or aminophylline if ordered concurrently. Give each drug separately.
• For I.V. infusion, use small I.V. needle and infuse into large vein over 30 to 60 minutes.
• For I.M. administration, inject deep into large muscle.

Adverse reactions

CNS: headache, lethargy, paresthesia, syncope, seizures

CV: phlebitis, hypotension, palpitations, chest pain, vasodilation, thrombophlebitis

EENT: hearing loss

GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression

Hepatic: hepatic failure, hepatomegaly

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: urticaria, maculopapular or erythematous rash, redness, swelling, induration

Other: chills, fever, superinfection, pain at I.M. site, phlebitis at I.V. site, anaphylaxis, serum sickness

Interactions

Drug-drug.Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Probenecid: decreased excretion and increased blood level of cefepime

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels
Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results

Hemoglobin, platelets, white blood cells: decreased values

Drug-herbs.Angelica, anise, arnica, asafetida, bogbean, boldo, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, horse chestnut, horseradish, licorice, meadowsweet, onion, papain, passionflower, poplar, prickly ash, quassia, red clover, turmeric, wild carrot, wild lettuce, willow: increased risk of bleeding

Patient monitoring

• Assess baseline CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.
• Monitor for inflammation at infusion site.
• Be aware that cross-sensitivity to penicillins may occur.

Patient teaching

• Instruct patient to report reduced urinary output, persistent diarrhea, bruising, petechiae, or bleeding.
• Caution patient not to take herbs without consulting prescriber.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

cefepime hydrochloride

the hydrochloride salt of cefepime, used in treatment of infections of the skin and soft tissue and of the respiratory and urinary tracts, administered intramuscularly or intravenously.
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References in periodicals archive ?
On June 18, 2007, the first generic formulation of cefepime hydrochloride was approved by the FDA.
Cefepime Hydrochloride for Injection is indicated in the treatment of the following infections: Pneumonia, Empiric Therapy for Febrile Neutropenic Patients, Urinary Tract Infections (including pyelonephritis), Skin and Skin Structure Infections, and Intra-abdominal Infections.
Forward-looking statements in this news release include statements regarding our expectations, beliefs, hopes, goals, intentions, initiatives or strategies, including statements regarding the demand, supply and distribution of cefepime hydrochloride for injection.