Following a single intravenous dose, total body clearance and the steadystate volume of distribution averaged 3. Cefepime is a new parenteral cephalosporin with antimicrobial activity similar to thirdgeneration cephalosporins. Pharmacokinetics of cefepime in patients with cancer and. 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. Cefepime pharmacokinetics are linear over the range 250 mg to 2 g iv. Cefepime is a generic medicine name and there are several brands available for it. Pharmacokinetics of cefepime has been determined for rats and monkey 4, men 5, foals and dogs 6, horses 7, calves 8, and ewes 9. Clinical experience suggests the utility of cefepime for the treatment of septic arthritis goldenberg 2019. Cefepime for injection is a sterile powder of cefepime in vials for reconstitution, available in the following strengths. 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.
Cefepime is a commonly used broadspectrum cephalosporin with potent activity against a wide variety of gramnegative bacteria, including pseudomonas aeruginosa. Available on pc, apis is an attractive and useful tool for clinical and experimental pharmacokinetics. 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. The results demonstrated doserelated increases in maximum concentration cmax and area under the curve auc. Clinical pharmacokinetics sixth edition pdf download. 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. 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. A software for identification, simulation and dosage regimen calculations in clinical and experimental pharmacokinetics. Various pharmacokinetic parameters calculated from serum config 1. Cefepime about cefepime fourth generation cephalosporin antibiotic. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and cefotaxime, is.
Listing a study does not mean it has been evaluated by the u. 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. Casebook in clinical pharmacokinetics and drug dosing. It is 16 to 19% proteinbound and is primarily renally eliminated.
Data suggest that up to 15% of icu patients treated with cefepime may experience these adverse. This edition has been retitled clinical pharmacokinetics and pharmacodynamics. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and. 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. Mechanism of action of cefepime cefepime is a 3rd generation cephalosporin which exerts its bactericidal action by inhibiting bacterial cell wall synthesis. It is a resourceful practice guide for preparation of the naplex, fpgee, ptcb and california pharmacy board exams.
Elimination is prolonged in patients with compromised renal function. Cefepime concentrations were determined by the agar microbiological diffusion method. Clinical pharmacokinetics and pharmacodynamics print. Cefepime fda prescribing information, side effects and uses. Johns hopkins guide app for ios, iphone, ipad, and android included. 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. Each subject received a single dose of cefepime via a 30min intravenous infusion on day 1 of the study. Treatment of complicated intraabdominal infections.
Pharmacokinetics and dosage regimen of cefepime following. Microbiology cefepime is a bactericidal agent that acts by inhibition of bacterial cell wall synthesis. Severe utis due to escherichia coli or klebsiella pneumoniae. Concepts in clinical pharmacokinetics has helped thousands of students and practitioners through five editions by simplifying a. Administered intravenously or intramuscularly as the hydrochloride salt. Plasma, urine and skin pharmacokinetics of cefepime in. We delineated the dose and timedependent retinal toxicity of cefepime bmy28142, a new third generation cephalosporin, using electroretinography in pigmented rabbit eyes. Activity of cefepimezidebactam against multidrugresistant. The pharmacokinetics of cefepime have been well described in adults with normal and impaired renal function. Despite the great potential for clinical use of cefepime in veterinary medicine, the data on its pharmacokinetics in goats are limited. Cefepime has a broad spectrum of in vitro activity that encompasses a wide range of. Pediatric pharmacotherapy university of virginia school of.
Contraindications patients with known immediate hypersensitivity reactions to cefepime or other cephalosporins, penicillins or other betalactam antibacterial drugs. Pharmacokinetics of cefepime in subjects with renal. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and cefotaxime. Treatment of uncomplicated skin and skin structure infections. Cefepime is a topic covered in the johns hopkins abx guide. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. 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. Cefepime is cleared primarily by urinary excretion 85%. 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 concentrations in plasma, urine, and hemodialysate were assayed using reverse. Research article single dose pharmacokinetics of cefepime. 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 exceptions 1g q12h dose only appropriate for communityacquired pneumonia not due to p.
Pharmacokineticpharmacodynamic rationale for cefepime dosing. The pharmacokinetics of cefepime were unaltered in patients with impaired hepatic function who received a single 1 g dose n11. Application of antimicrobial pharmacodynamic concepts into clinical practice. Pharmacokinetics and evaluation of the safety of cefepime. Peak serum concentrations of cefepime are 2 to 3 times greater following an intravenous iv dose than an intramuscular im dose. Data suggest that up to 15% of icu patients treated with cefepime may experience these. Sep 07, 2018 data in pediatric patients with impaired renal function are not available. The clinical success rate for patients with communityacquired pneumonia, the most frequent infection, was 86% for both treatment groups. Plasma, urine and skin pharmacokinetics of cefepime in burns. A multicenter comparative study of cefepime versus broad. To view the entire topic, please sign in or purchase a subscription. 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. Toxicity and pharmacokinetics of cefepime bmy28142. Official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine.
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. Cefepime maxipime side effects, dosage, interactions drugs. Typical chromatogram of calf serum containing cefepime. Evaluation of safety, pharmacokinetics and efficacy of. Cefepime definition of cefepime by medical dictionary. A significant correlation between serum and gall bladder tissue concentrations of cefepime with the sampling interval was observed r 2 0. 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. 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. It acts against the enterobacteriaceae family, and pseudomonas aeruginosa, but maintains grampositive activity similar to that of first or secondgeneration cephalosporins. Zid had a very broad and potent in vitro spectrum of activity, and was highly active against many mdr isolates of enterobacterales. Pharmacokinetics of cefepime in bile and gall bladder tissue. Maxipime cefepime hydrochloride dose, indications, adverse. The pharmacokinetics of cefepime in burns patients is not well documented. Reference guide for pharmaceutical calculations krisman.
Some of the brands for cefepime might be better known than cefepime itself. Farina 2 1 commission of scientific research of the province of buenos aires, argentina. Review of the pharmacokinetics of cefepime in children. Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the bloodbrain barrier and exhibit concentrationdependent. Clinical pharmacodynamics of cefepime in patients infected. Casebook in clinical pharmacokinetics and drug dosing henry. 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. Nicholas odonnell, jessica neeb, kelli thoele, david r. The comparative disposition of cefepime following single dose intravenous administration in cow calves was plotted on semi logarithmic scale fig 2. The average plasma concentrations of cefepime observed in healthy adult male volunteers. Cefepime is a broadspectrum fourthgeneration cephalosporin with in vitro activity similar to that of cefotaxime or ceftriaxone against the common meningeal pathogens h. If the pharmacy thats willing to deliver medicines to your home doesnt have cefepime in stock, you can ask for. Peak serum concentrations of roughly 150 to 160 mcgml are achieved after a 2 g iv dose of cefepime to healthy adult males. Hypersensitivity to cefepime, other cephalosporins, penicillins, other betalactam antibiotics, or any component of the formulation.
Pharmacodynamic parameters of two different doses of cefepime. A 2007 metaanalysis suggested when data of trials were combined, mortality was increased in people treated with cefepime compared with other. Maxipime cefepime dosing, indications, interactions. Cefepime hydrochloride pharmacokinetics absorption bioavailability. Dec 28, 2009 cefepime is a commonly used broadspectrum cephalosporin with potent activity against a wide variety of gramnegative bacteria, including pseudomonas aeruginosa. Toxicity was evaluated following intravitreal doses ranging from 0. Cefepime has an extended spectrum of activity against grampositive and gramnegative bacteria, with greater activity against both types of organism than thirdgeneration agents. Oct 02, 2018 the pharmacokinetics of cefepime were unaltered in patients with hepatic impairment who received a single 1 g dose n11. The pharmacokinetics of cefepime were unaltered in patients with hepatic impairment who received a single 1 g dose n11. The pharmacokinetics of cefepime in goats following single. Cefepime is an antibacterial agent belonging to the cephalosporin class of antibacterials with. Pharmacokinetics of cefepime after single and multiple. Cefepime hydrochloride monograph for professionals. Pdf pharmacokinetics of cefepime in subjects with renal.
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