Cefepime

Cefepime is an antibiotic that fights bacteria. It is used to treat severe bacterial infections of the skin, lungs, stomach, urinary tract, and blood. It works by killing the bacteria that cause these problems. However, it will not treat a viral infection. Cefepime is commonly used to treat critically ill patients admitted to the hospital. This medicine is given by drip or by direct injection into a vein, under the supervision of a healthcare professional. The dose depends on what type of infection you have, where it is in the body and how serious it is. You should have your injections at the same time each day to get the most benefit and you should keep on taking this medicine for as long as you are prescribed it, even if your symptoms quickly improve. If you stop taking it too early the infection may return or worsen. Some people may develop side effects like rash, itching, nausea, vomiting, headache, fever, diarrhea or local redness and swelling at the site of injection. These side effects are usually temporary and go away during treatment as your body adjusts to the medicine. Consult your doctor if these side effects bother you or do not go away. Before starting treatment with this medicine, you should tell your doctor if you have any liver or kidney problems or if you are allergic to any antibiotic. While using it, your doctor may advise blood tests to monitor your kidney function. This medicine is generally regarded as safe to use in pregnancy and breastfeeding if prescribed by your doctor.

Cefepime is an antibiotic. It kills bacteria by preventing them from forming the bacterial protective covering (cell wall) which is needed for them to survive.

• Moderate to Severe Pneumonia
• Febrile Neutropenia
• Uncomplicated and Complicated Urinary Tract Infections (including pyelonephritis)
• Uncomplicated Skin and Skin Structure Infections
• Complicated Intra-abdominal Infections (used in combination with metronidazole)

Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins). Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin binding proteins (PBPs).

Cefepime is a 4th generation cephalosporin which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs).

Adult Dose (IV):

Pediatric Dose (2 months-16 years):

Renal Dose Adjustment:

Your doctor or nurse will give you this medicine. Kindly do not self administer. It should be administered intravenously over approximately 30 minutes.

If you miss a dose of Cefepime, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Rash
• Itching
• Nausea
• Vomiting
• Headache
• Fever
• Diarrhea
• Abdominal pain

• [CONSULT YOUR DOCTOR] It is not known whether Cefepime alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react.
• Your doctor has prescribed Cefepime to cure your infection and improve your symptoms. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early may make the infection to come back and harder to treat.
• Discontinue Cefepime and inform your doctor immediately if you get a rash, itchy skin, swelling of face and mouth, or have difficulty in breathing.
• Diarrhea may occur as a side effect but should stop when your course is complete. Inform your doctor if it doesn't stop or if you find blood in your stools.
• Avoid consuming alcohol while taking Cefepime as it may cause increased side effects.
• Prescribing Cefepime in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
• As with other antimicrobials, prolonged use of Cefepime may result in overgrowth of non susceptible microorganisms. Repeated evaluation of the patient's condition is essential.
• Many cephalosporins, including cefepime, have been associated with a fall in prothrombin activity. Those at risk include patients with renal or hepatic impairment, or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy. Prothrombin time should be monitored in patients at risk.
• Cefepime should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.

• Hypersensitivity to cefepime or other cephalosporins.
• Hypersensitivity to penicillin or other beta-lactam antibiotics.

Increased potential for nephrotoxicity and ototoxicity of aminoglycosides. Increased risk of nephrotoxicity with potent diuretics (e.g. furosemide).

Renal function should be monitored carefully if high doses of aminoglycosides are to be administered with Cefepime because of the increased potential of nephrotoxicity and ototoxicity of aminoglycoside antibiotics. Nephrotoxicity has been reported following concomitant administration of other cephalosporins with potent diuretics such as furosemide.

[SAFE] Consuming alcohol with Cefepime does not cause any harmful side effects.

[SAFE IF PRESCRIBED] Cefepime is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies. Pregnancy Category B. There are no adequate and well-controlled studies of cefepime use in pregnant women. This drug should be used during pregnancy only if clearly needed.

[SAFE IF PRESCRIBED] Cefepime is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby. Cefepime is excreted in human breast milk in very low concentrations (0.5 pg/ml). Caution should be exercised when cefepime is administered to a nursing woman. Avoid prolonged use of Cefepime, since it may have possible effects such as rash and diarrhea.

Use of Cefepime is not recommended for pediatric patients less than 2 months of age. The maximum dose for pediatric patients should not exceed the recommended adult dose. The usual recommended dosage in pediatric patients up to 40 kg is 50 mg/kg/dose, administered every 12 hours (50 mg/kg/dose, every 8 hours for febrile neutropenic patients).

Serious adverse events have occurred in geriatric patients with renal insufficiency given unadjusted doses of cefepime, including encephalopathy, myoclonus, and seizures. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and renal function should be monitored.

[CAUTION] Cefepime should be used with caution in patients with kidney disease. Dose adjustment of Cefepime may be needed. Please consult your doctor. In patients with impaired renal function (creatinine clearance <60 ml/min), the dose of Cefepime should be adjusted to compensate for the slower rate of renal elimination.

[SAFE IF PRESCRIBED] Cefepime is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment of Cefepime may not be needed in these patients. Please consult your doctor. No adjustment is necessary for patients with impaired hepatic function.

Patients who receive an overdose should be carefully observed and given supportive treatment. In the presence of renal insufficiency, hemodialysis, not peritoneal dialysis, is recommended to aid the removal of cefepime from the body. Accidental overdosing has occurred when large doses were given to patients with impaired renal function. Symptoms of overdose include encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, and coma), myoclonus, seizures, and neuromuscular excitability.

Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician. Keep below 25°C temperature, away from light & moisture.

Cefepime Hydrochloride