Antimicrobials
Cefepime

Cefepime

High
N/A
See below under General Info

Spectrum of Activity

Dosing

General Information

Hospital Formulary Status Yes (parenteral inj)

In-Hospital Cost will be updated

PharmaCare Formulary Status No

Special Authority None

PharmaCare Coverage None

Outpatient Cost 1g powder for soln/inj - $18.24-20.06/vial 2g powder for soln/inj - $36.45-40.10/vial

Broad spectrum antimicrobial with gram positive and gram negative coverage including Pseudomonas.

Nosocomial infections involving resistant organisms.

Acute liver injury (IV)

  • rare and self-limiting
  • involves cholestatic hepatitis and elevations in ALT, AST and alkaline phosphatase
  • latency period: 1-3 weeks after exposure, may occur after stopping drug
  • sx: itching, jaundice, nausea, fever, and rash
  • liver failure is rare

Neutropenia (IV)

  • associated with immune-mediated destruction of polymorphonuclear leukocytes
  • sx: abrupt onset of fever, rash, and eosinophilia

Thrombocytopenia (IV)

  • acute immune-mediated
  • usually platelet count normalizes within 2 weeks after discontinuation

Allergic interstitial nephritis (IV)

  • sx: acute and often severe renal failure, with active urinary sediment (hematuria, proteinuria, and pyuria) but no red cell casts
  • usually signs of hypersensitivity are present (fever, peripheral eosinophilia, eosinophiluria and rash)
  • several cases of cross-sensitivity between beta-lactam antibiotics

Pulmonary infiltrate with eosinophilia (PIE) syndrome (IV)

  • sx: abrupt onset of fever, chills, dyspnea, pulmonary infiltrates and peripheral eosinophilia

CNS toxicity (IV)

  • sx: nonconvulsive status epilepticus
  • has similar evidence of epileptogenesis to ceftriaxone and ceftazidime, but less than penicillin

Allergic reaction (IV)

  • IgE-mediated
  • sx: pruritus, flushing, urticaria, angioedema, wheezing, laryngeal edema, hypotension, and/or anaphylaxis
  • sx usually appear within 4 hrs of administration but may begin within mins

Serum sickness (IV)

  • late allergic reaction
  • sx: fever, rash, adenopathy, arthritis and glomerulonephritis
  • associated with circulating immune complexes

Rash (IV)

  • includes morbilliform rash, erythema multiforme, SJS, exfoliative dermatitis, toxic epidermal necrolysis and vasculitis
  • sx: photosensitivity, skin lesions, mucosal membrane ulceration, erythema, scaling, palpable purpura and/or positive Nikolsky's sign

Note: EBV-related rash - not an allergy

  • morbilliform rash, occurring 48 hrs to weeks after initial amoxicillin exposure in patients with Epstein Barr Virus, does not appear to be a true drug allergy

Antimicrobial class: 4th Generation Cephalosporin

Pregnancy category: B

Average serum half life: 2.0 hr

Biliary penetration: Moderate

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic