Antimicrobials
Cefepime

Cefepime

High
N/A

General Information

Administration

  • Extended-infusion protocol, infuse over 3-4 hours

Preparation

  • Reconstitute 500mg vial with 5mL, 1 and 2g vials with 10mL
  • Further dilute in compatible fluid (i.e. D5W or NS)

Compatibility

  • D5W, NS

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

Used especially nosocomial infections involving resistant organisms

Tier 2 Protected Antimicrobial

  • Broad spectrum, but 1st line for common infections, comes with a high risk of poor stewardship if initial workup and follow-up are not in place

Strategies Used:

  1. Appropriate workup initially
  2. Pharmacists audit/de-escalate
  3. Set EBM Duration

Renal function

  • Allergy (immediate & delayed)
  • Positive Coombs
  • Cytopenias
  • Non-convulsive status epilepticus

None to report

Antimicrobial class: 4th generation Cephalosporin

Pregnancy category: B

Average serum half life: 2 hours

Biliary penetration: Moderate

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic

Maxipime

Dosing per AHSM Extended Infusion/Alternative Dosing of Antibiotics Protocol

Exclusions:

  • Patients not being admitted (i.e. Emergency Department)
  • One-time pre-operative surgery dosing
  • Medication incompatibility problems upon initiation of therapy or after. A pharmacist must review these medications and determine if patient is unable to utilize protocol dosing
  • Patients < 17 y.o. and under the minimum weight
  • Pregnancy
  • Physician writes "Do Not Substitute"