|Systematic (IUPAC) name|
|Pregnancy cat.||B1 (Au)|
|Legal status||S4 (Au)|
|Mol. mass||480.56 g/mol|
| (what is this?)
Cefepime (INN) (// or //) 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. In response, the U.S. Food and Drug Administration performed their own meta-analysis which found that there was no mortality difference.
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.
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.
Spectrum of bacterial susceptibility and resistance
Aeromonas spp., Citrobacter koseri, Enterobacter agglomerans and Shigella sonnei are generally susceptible to Cefepime, while Bacillus cereus and Enterococcus faecalis are resistant to Cefepime. Burkholderia cepacia, Citrobacter amalonaticus, Enterobacter cloacae and Haemophilus influenzae have developed resistance to Cefepime to varying degrees. For detailed minimum inhibition concentration information, please refer to Cefepime Susceptibility and Resistance Data sheet.
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 increase the activity of cefepime against otherwise resistant organisms including Pseudomonas aeruginosa and Staphylococcus aureus.
- 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)". 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.
- "Cefepime Susceptibility and Resistance Data". Retrieved 22 July 2013.