Cefepime

Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.

Maxipime (Bristol-Myers Squibb)
500 mg in 15 mL vials
1 g in 15 mL vials
2 g in 77 mL vials

Indication: specified infections

Cefepime is an injectable cephalosporin with a broad spectrum of activity. Bacteria sensitive to cefepime include staphylococci, streptococci, Escherichiacoli, Klebsiella pneumoniae, Haemophilus influenzae and Proteus mirabilis.Its efficacy against Pseudomonas aeruginosa is similar to that of ceftazidime.

The drug can be used to treat septicaemia and intra-abdominal infections such as peritonitis. It can also be used to treat gynaecological infections and infections in the urinary tract, lower respiratory tract or the skin. Cefepime can also be considered as part of a regimen for the empirical treatment of febrile neutropenia. The drug has not been approved for use in children under 12 years old.

Cefepime is injected every 12 hours. The drug is eliminated by renal clearance and has a half-life of two hours. If the creatinine clearance is less than 30 mL/minute, the dose should be reduced. The usual duration of treatment is 7-10 days, but this may be extended for more severe infections.

The most common adverse effects of cefepime are diarrhoea, headache, rash, nausea and vomiting. Some cases of diarrhoea may be due to Clostridiumdifficile.

Although cefepime has many potential uses, it should probably be reserved as an option for infections where ceftazidime would currently be considered.1

References

  1. Turnidge J. The choice of cephalosporins [editorial].Aust Prescr 1992;15:26-8.