Data suggest that up to 15% of icu patients treated with cefepime may experience these adverse. It is 16 to 19% proteinbound and is primarily renally eliminated. The clinical success rate for patients with communityacquired pneumonia, the most frequent infection, was 86% for both treatment groups. Mechanism of action of cefepime cefepime is a 3rd generation cephalosporin which exerts its bactericidal action by inhibiting bacterial cell wall synthesis. Johns hopkins guide app for ios, iphone, ipad, and android included. Concepts in clinical pharmacokinetics has helped thousands of students and practitioners through five editions by simplifying a.
Elimination is prolonged in patients with compromised renal function. Pharmacodynamic parameters of two different doses of cefepime the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Clinical pharmacokinetics and pharmacodynamics print. Cefepime is a new parenteral cephalosporin with antimicrobial activity similar to thirdgeneration cephalosporins. Available on pc, apis is an attractive and useful tool for clinical and experimental pharmacokinetics. Treatment of uncomplicated skin and skin structure infections. Cefepime exceptions 1g q12h dose only appropriate for communityacquired pneumonia not due to p. Pharmacokinetics of cefepime in patients with cancer and. Zid had a very broad and potent in vitro spectrum of activity, and was highly active against many mdr isolates of enterobacterales. The pharmacokinetics of cefepime in 31 young, healthy volunteers were assessed after the administration of single and multiple 250, 500, 1,000, or 2,000mg intravenous doses. Cefepime is a broadspectrum fourthgeneration cephalosporin with in vitro activity similar to that of cefotaxime or ceftriaxone against the common meningeal pathogens h. Pharmacokinetics and dosage regimen of cefepime following. Despite its extensive use, its presence in multiple clinical guidelines, and numerous indications for its use 1, 16, 20, 26, a recent metaanalysis found treatment with cefepime to be associated with an increase in the patient. Cefepime definition of cefepime by medical dictionary.
Dec 28, 2009 cefepime is a commonly used broadspectrum cephalosporin with potent activity against a wide variety of gramnegative bacteria, including pseudomonas aeruginosa. Cefepime fda prescribing information, side effects and uses. Clinical experience suggests the utility of cefepime for the treatment of septic arthritis goldenberg 2019. Reference guide for pharmaceutical calculations krisman. If the pharmacy thats willing to deliver medicines to your home doesnt have cefepime in stock, you can ask for one of the branded alternatives for cefepime. Pharmacodynamic parameters of two different doses of cefepime. Jul 15, 2015 evaluation of safety, pharmacokinetics and efficacy of ceftazidime and avibactam cazavi compared with cefepime in children from 3 months to less than 18 years of age with complicated urinary tract infections cutis full text view. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and. Maxipime cefepime dosing, indications, interactions.
The average plasma concentrations of cefepime observed in healthy adult male volunteers. The pharmacokinetics of cefepime in goats following single. A software for identification, simulation and dosage regimen calculations in clinical and experimental pharmacokinetics. This edition has been retitled clinical pharmacokinetics and pharmacodynamics. Cefepime is a topic covered in the johns hopkins abx guide. Cefepime is an antibacterial agent belonging to the cephalosporin class of antibacterials with. Sep 07, 2018 data in pediatric patients with impaired renal function are not available. Casebook in clinical pharmacokinetics and drug dosing. Listing a study does not mean it has been evaluated by the u. Severe utis due to escherichia coli or klebsiella pneumoniae. Pediatric pharmacotherapy university of virginia school of. A 2007 metaanalysis suggested when data of trials were combined, mortality was increased in people treated with cefepime compared with other. Cefepime is a generic medicine name and there are several brands available for it. Cefepime concentrations in plasma, urine, and hemodialysate were assayed using reverse.
Pharmacokineticpharmacodynamic rationale for cefepime dosing. Evaluation of safety, pharmacokinetics and efficacy of. Activity of cefepimezidebactam against multidrugresistant. Concepts and applications to reflect the increasing body of knowledge linking the two concepts that explain the relationship between drug administration and drug response and also reflects the expansion in our understanding at the molecular and mechanistic levels of. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to. If 1g q12h is ordered for any other indication, dose will be interchanged to 1g q6h. We delineated the dose and timedependent retinal toxicity of cefepime bmy28142, a new third generation cephalosporin, using electroretinography in pigmented rabbit eyes. Peak serum concentrations of roughly 150 to 160 mcgml are achieved after a 2 g iv dose of cefepime to healthy adult males. Contraindications patients with known immediate hypersensitivity reactions to cefepime or other cephalosporins, penicillins or other betalactam antibacterial drugs. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and cefotaxime. It is a resourceful practice guide for preparation of the naplex, fpgee, ptcb and california pharmacy board exams. Oct 02, 2018 the pharmacokinetics of cefepime were unaltered in patients with hepatic impairment who received a single 1 g dose n11.
Cefepime has a broad spectrum of in vitro activity that encompasses a wide range of. Cefepime hydrochloride pharmacokinetics absorption bioavailability. Treatment of complicated intraabdominal infections. Cefepime about cefepime fourth generation cephalosporin antibiotic. Peak serum concentrations of cefepime are 2 to 3 times greater following an intravenous iv dose than an intramuscular im dose. Pharmacokinetics of cefepime in patients with cancer and febrile neutropenia in the setting of hematologic malignancies or hematopoeitic cell transplantation laura whited, meagan grove, dusten rose, nathaniel j.
Research article single dose pharmacokinetics of cefepime. Cefepime pharmacokinetics have been investigated in elderly 65 years of age and older men n12 and women n12 whose mean sd creatinine clearance was 74 15 mlmin. Cefepime is cleared primarily by urinary excretion 85%. Microbiology cefepime is a bactericidal agent that acts by inhibition of bacterial cell wall synthesis. Typical chromatogram of calf serum containing cefepime. Plasma, urine and skin pharmacokinetics of cefepime in. Each subject received a single dose of cefepime via a 30min intravenous infusion on day 1 of the study.
Casebook in clinical pharmacokinetics and drug dosing henry cohen a casebased approach to learning how to design accurate dosing regimens authored by the editorinchief of the journal of pharmacy practice, casebook in pharmokinetics uses reallife cases to teach you how to apply clinical pharmokinetics to formulate proper dosing regimens. Evaluation of safety, pharmacokinetics and efficacy of ceftazidime and avibactam cazavi compared with cefepime in children from 3 months to less than 18 years of age with complicated urinary tract infections cutis full text view. Cefepime pharmacokinetics are linear over the range 250 mg to 2 g iv. Pharmacokinetics of cefepime in subjects with renal.
Some of the brands for cefepime might be better known than cefepime itself. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine. Hypersensitivity to cefepime, other cephalosporins, penicillins, other betalactam antibiotics, or any component of the formulation. Despite the great potential for clinical use of cefepime in veterinary medicine, the data on its pharmacokinetics in goats are limited. Data suggest that up to 15% of icu patients treated with cefepime may experience these. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus. Clinical pharmacokinetics sixth edition pdf download. This study assessed the pharmacokinetics and pharmacodynamics of cefepime administered by intermittent and continuous infusion against clinical isolates of pseudomonas aeruginosa, enterobacter cloacae, and staphylococcus aureus.
It acts against the enterobacteriaceae family, and pseudomonas aeruginosa, but maintains grampositive activity similar to that of first or secondgeneration cephalosporins. Clinical pharmacodynamics of cefepime in patients infected. A multicenter comparative study of cefepime versus broad. Maxipime cefepime hydrochloride dose, indications, adverse.
Plasma, urine and skin pharmacokinetics of cefepime in burns. Farina 2 1 commission of scientific research of the province of buenos aires, argentina. Nicholas odonnell, jessica neeb, kelli thoele, david r. A significant correlation between serum and gall bladder tissue concentrations of cefepime with the sampling interval was observed r 2 0. The results demonstrated doserelated increases in maximum concentration cmax and area under the curve auc. If the pharmacy thats willing to deliver medicines to your home doesnt have cefepime in stock, you can ask for.
The results suggest that cefepime was a potential bactericidal agent for more than 7 h by both administration routes, and that it might be very useful in the treatment of various infections in goats at 10 mgkg of body weight administered i. Cefepime maxipime side effects, dosage, interactions drugs. Review of the pharmacokinetics of cefepime in children. Cefepime is the generic form of the brandname drug maxipime, which is used to treat bacterial infections such as urinary tract infections, pneumonia, and skin infections the prescription. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and cefotaxime, is. Casebook in clinical pharmacokinetics and drug dosing henry. Application of antimicrobial pharmacodynamic concepts into clinical practice. Toxicity and pharmacokinetics of cefepime bmy28142. To view the entire topic, please sign in or purchase a subscription. The pharmacokinetics of intravenously administered cefepime mg over 30 minutes were studied in 5 healthy volunteers and 20 patients with various degrees of renal impairment. Pdf pharmacokinetics of cefepime in subjects with renal. Cefepime has an extended spectrum of activity against grampositive and gramnegative bacteria, with greater activity against both types of organism than thirdgeneration agents. Clinical pharmacokinetics sixth edition pdf author dr. Toxicity was evaluated following intravitreal doses ranging from 0.
The pharmacokinetics of cefepime have been well described in adults with normal and impaired renal function. Cefepime hydrochloride monograph for professionals. The pharmacokinetics of cefepime were unaltered in patients with impaired hepatic function who received a single 1 g dose n11. Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the bloodbrain barrier and exhibit concentrationdependent. Cefepime is a commonly used broadspectrum cephalosporin with potent activity against a wide variety of gramnegative bacteria, including pseudomonas aeruginosa. Pharmacokinetics of cefepime after single and multiple. The pharmacokinetics of cefepime in burns patients is not well documented. Administered intravenously or intramuscularly as the hydrochloride salt. Pharmacokinetics of cefepime in bile and gall bladder tissue. Cefepime pharmacokinetics have been evaluated in pediatric patients from 2 months to 11 years of age following single and multiple doses on every 8 hours n29 and every 12 hours n schedules.
Cefepime for injection is a sterile powder of cefepime in vials for reconstitution, available in the following strengths. Following a single intravenous dose, total body clearance and the steadystate volume of distribution averaged 3. Pharmacokinetics and evaluation of the safety of cefepime. The comparative disposition of cefepime following single dose intravenous administration in cow calves was plotted on semi logarithmic scale fig 2. Cefepime concentrations were determined by the agar microbiological diffusion method.
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