CEFEPIME

Antibacterial activity

Cephalosporin, third generation (sometime refer to as fourth generation)
Effective against gram-negative 
Gram-positive coverage (
Limited anaerobic coverage 

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to cefepime, other cephalosporins or any component
Use caution if previous penicillins hypersensitivity:  10% of patient may have cross-hypersensitivity to cephalosporins
Use caution if renal dysfunction 
May cause a positive Coomb's test without hemolysis
Safety and efficacy have not been established in children up to 12 years of age
IV infusion should be given over a 30 min period

Mechanism of Action

Inhibits cell wall synthesis (bactericidal)

Pharmacodynamics

Metabolism: N/A
Half-life: 2.2 hours, changes with renal function
Elimination: excreted in urine

Dosage

Children:  

>28 days old: 
50 mg/kg IV/IM q8h

Adults:

500-2000 mg IV/IM q12h

Dose VS renal function

Cr. clearance (ml/min):
<11: 250-500 mg IM/IV q24h 11-29: 50% dose (min 500 mg) q24h 30-60: same dose, but q24h 60-80: unchanged >80: unchanged

Dialysis
Hemo: give 0.5-1 g IV/IM post dialysis
CAPD: 1-2 g IV/IM q48h