Cefepime
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| Systematic (IUPAC) name | |
| (6R,7R,Z)- 7-(2-(2-aminothiazol-4-yl)-2-(methoxyimino)acetamido)- 3-((1-methylpyrrolidinium-1-yl)methyl)-8-oxo-5-thia- 1-aza-bicyclo[4.2.0]oct-2-ene-2-carboxylate |
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| Clinical data | |
| Trade names | Maxipime |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a698021 |
| Pregnancy cat. | B1 (Au) |
| Legal status | S4 (Au) |
| Routes | Intravenous, intramuscular |
| Pharmacokinetic data | |
| Bioavailability | 100% (IM) |
| Metabolism | Hepatic 15% |
| Half-life | 2 hours |
| Excretion | Renal 70–99% |
| Identifiers | |
| CAS number | 88040-23-7  |
| ATC code | J01DE01 |
| PubChem | CID 5479537 |
| DrugBank | DB01413 |
| ChemSpider | 4586395 |
| UNII | 807PW4VQE3 |
| KEGG | D02376 |
| ChEBI | CHEBI:478164 |
| ChEMBL | CHEMBL186 |
| Chemical data | |
| Formula | C19H24N6O5S2 |
| Mol. mass | 480.56 g/mol |
| SMILES | eMolecules & PubChem |
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Cefepime (INN) (
/ˈsɛfɨpiːm/ or /ˈkɛfɨpiːm/) is a fourth-generation cephalosporin antibiotic developed in 1994. Cefepime has an extended spectrum of activity against Gram-positive and Gram-negative bacteria, with greater activity against both Gram-negative and Gram-positive organisms than third-generation agents. Cefepime hydrochloride was first marketed in 1994 and is currently marketed under various trade names including Neopime(Neomed)Maxipime, Maxcef, Cepimax, Cepimex, and Axepim. A 2007 meta-analysis suggested that when data of trials were combined, mortality was increased in patients treated with cefepime compared with other β-lactam antibiotics.[1] In response, the U.S. Food and Drug Administration performed their own meta-analysis which found that there was no mortality difference.[2]
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[edit] Clinical use
Cefepime is usually reserved to treat moderate-severe nosocomial pneumonia, infections caused by multi-resistant microorganisms (e.g. Pseudomonas aeruginosa) and empirical treatment of febrile neutropenia.[3]
Cefepime has good activity against important pathogens including Pseudomonas aeruginosa, Staphylococcus aureus, and multiple drug resistant Streptococcus pneumoniae. A particular strength is its activity against Enterobacteriaceae. Whereas other cephalosporins are degraded by many plasmid- and chromosome-mediated beta-lactamases, cefepime is stable and is a front line agent when infection with Enterobacteriaceae is known or suspected.
[edit] Chemistry
The combination of the syn-configuration of the methoxyimino moiety and the aminothiazolyl moiety confers extra stability to β-lactamase enzymes produced by many bacteria. The N-methylpyrrolidine moiety increases penetration into Gram-negative bacteria. These factors increases the activity of cefepime against otherwise resistant organisms including Pseudomonas aeruginosa and Staphylococcus aureus.
[edit] References
- ^ Yahav D, Paul M, Fraser A, Sarid N, Leibovici L (2007). "Efficacy and safety of cefepime: a systematic review and meta-analysis". Lancet Infect Dis 7 (5): 338–48. doi:10.1016/S1473-3099(07)70109-3. PMID 17448937.
- ^ "Information for Healthcare Professionals: Cefepime (marketed as Maxipime)". http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm167254.htm. Retrieved 2009-08-02.
- ^ Chapman TM, Perry CM (2003). "Cefepime: a review of its use in the management of hospitalized patients with pneumonia". Am J Respir Med 2 (1): 75–107. PMID 14720024.
[edit] External links
- Maxipime fact sheet – Elan Pharmaceuticals
- [1]- "POTENTOX" A unique combination of CEFEPIME AND AMIKACIN for resistant pathogen - Venus Remedies Limited,#51/52,Industrial Area,Phase -1,Panchkula,Haryana - INDIA [2]
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