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| Pronunciation | /ˈsɛfɪpiːm/ or/ˈkɛfɪpiːm/ |
| Trade names | Maxipime, Voco |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a698021 |
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| Routes of administration | Intravenous,intramuscular |
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| Bioavailability | 100% (IM) |
| Metabolism | Hepatic 15% |
| Eliminationhalf-life | 2 hours |
| Excretion | Renal 70–99% |
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| ECHA InfoCard | 100.171.025 |
| Chemical and physical data | |
| Formula | C19H24N6O5S2 |
| Molar mass | 480.56 g·mol−1 |
| 3D model (JSmol) | |
| Melting point | 150 °C (302 °F) (dec.) |
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Cefepime is a fourth-generationcephalosporinantibiotic. Cefepime has an extended spectrum of activity againstGram-positive andGram-negativebacteria, with greater activity against both types of organism than third-generation agents. A 2007meta-analysis suggested when data of trials were combined,mortality was increased in people treated with cefepime compared with otherβ-lactam antibiotics.[1] In response, the U.S.Food and Drug Administration (FDA) performed their own meta-analysis which found no mortality difference.[2]
Cefepime was patented in 1982 byBristol-Myers Squibb and approved for medical use in 1994.[3] It is available as ageneric drug and sold under a variety of trade names worldwide.[citation needed][4]
It was removed from theWorld Health Organization's List of Essential Medicines in 2019.[5]
Cefepime is usually reserved to treat moderate to severenosocomialpneumonia, infections caused by multiple drug-resistant microorganisms (e.g.Pseudomonas aeruginosa) andempirical treatment offebrileneutropenia.[6]
Cefepime has good activity against important pathogens includingPseudomonas aeruginosa,Staphylococcus aureus, and multiple drug-resistantStreptococcus pneumoniae. A particular strength is its activity againstEnterobacteriaceae. Whereas other cephalosporins are degraded by manyplasmid- andchromosome-mediatedbeta-lactamases, cefepime is stable and is a front-line agent when infection with Enterobacteriaceae is known or suspected.[medical citation needed]
Cefepime is a broad-spectrum cephalosporin antibiotic and has been used to treat bacteria responsible for causing pneumonia and infections of the skin and urinary tract. Some of these bacteria includePseudomonas,Escherichia, andStreptococcus species. The following representsMIC susceptibility data for a few medically significant microorganisms:[7]
Cefepime crosses theblood brain barrier and exhibits a concentration-dependentϒ-aminobutyric acid (GABA)antagonist effect, which can cause neurological symptoms in susceptible individuals, particularly those with renal dysfunction.[8][9] Up to 15% of ICU patients treated with cefepime will experience cefepime induced neurotoxicity.[9] Symptoms typically begin within 2-6 days[10] of cefepime administration and include diminished level of consciousness, disorientation,aphasia,myoclonus,seizures, andnonconvulsive status epilepticus.[11] Symptoms typically resolve within 1-3 days of discontinuing cefepime.[10]
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The combination of thesyn-configuration of themethoxyiminomoiety and the aminothiazole moiety confers extra stability toβ-lactamase enzymes produced by many bacteria. TheN-methylpyrrolidine moiety increases penetration into Gram-negative bacteria. These factors increase the activity of cefepime against otherwise resistant organisms includingPseudomonas aeruginosa andStaphylococcus aureus.
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Following expiration of the Bristol-Myers Squibb patent,[when?] cefepime became available as a generic and is now[when?] marketed by numerous companies worldwide under tradenames including Neopime (Neomed), Maxipime, Cepimax, Cepimex, and Axepim.
