Forgen

Indications

Cefepime is an injectable antibiotic used in hospital for serious bacterial infections, including:

• Pneumonia (lung infection).
• Complicated urinary tract and kidney infections.
• Serious skin and soft tissue infections.
• Complicated infections inside the abdomen, usually together with Metronidazole.
• Fever in patients with a very low white blood cell count (febrile neutropenia).
• Blood infections (septicaemia).

How It Works

Cefepime is a fourth-generation cephalosporin antibiotic. It kills bacteria by stopping them from building their cell walls. It works against a wide range of bacteria, including Pseudomonas, a germ that causes many hospital infections.

Dosage and Administration

Cefepime is given by injection into a vein (or sometimes a muscle) by a doctor or nurse. The dose, usually 1 to 2 g every 8 to 12 hours for adults, depends on the type and severity of infection and is given as prescribed. Children's doses are worked out by body weight. The dose is reduced in people with kidney problems. The length of the course is decided by the doctor.

Interactions

• Aminoglycoside antibiotics such as Gentamicin and Amikacin, and strong diuretics such as Furosemide, may increase the risk of kidney damage; kidney function is monitored.
• It can affect some laboratory tests, such as the Coombs test and some urine sugar tests.
• It may reduce the effect of the live oral typhoid vaccine.

Contraindications

• Allergy to cefepime or any other cephalosporin.
• A previous serious allergic reaction (such as anaphylaxis) to penicillins or carbapenems.

Side Effects

Common: pain or swelling where the injection is given, diarrhoea, nausea, rash, headache and changes in liver blood tests.

Tell the nurse or doctor at once, or get urgent medical help, for signs of a severe allergic reaction (swelling of the face or throat, difficulty breathing, collapse), severe or bloody diarrhoea (this can happen up to several weeks after treatment), confusion, jerking movements, fits or reduced consciousness, or a blistering or peeling skin rash.

Pregnancy and Lactation

Pregnancy: generally considered acceptable when clearly needed; the doctor will decide. Breastfeeding: small amounts pass into breast milk; it is usually considered compatible, but watch the baby for diarrhoea, thrush or rash.

Precautions and Warnings

Tell the doctor about any past allergy to penicillins or other antibiotics. Doses must be adjusted in kidney disease, because build-up of the medicine can affect the brain, causing confusion or fits, especially in older people. Long courses can lead to fungal infections such as thrush. Use with care in people with a history of bowel inflammation (colitis).

Overdose

Overdose is most likely in people with kidney problems and can cause confusion, hallucinations, fits and coma. It is treated in hospital; the medicine is stopped and dialysis can help remove it.

Therapeutic Class

Fourth-generation cephalosporin antibiotic.

Storage

Store the unopened vials below 30°C in a dry place, away from light and out of the reach of children. Once mixed, the solution is used according to the leaflet or hospital instructions.