Cefepime

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Cefepime
Cefepime2DCSD.svg
Cefepime ball-and-stick.png
Clinical data
Pronunciation /ˈsɛfɪpm/ or /ˈkɛfɪpm/
Trade names Maxipime, Voco
AHFS/Drugs.com Monograph
MedlinePlus a698021
Pregnancy
category
  • AU: B1
  • US: B (No risk in non-human studies)
Routes of
administration
Intravenous, intramuscular
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 100% (IM)
Metabolism Hepatic 15%
Elimination half-life 2 hours
Excretion Renal 70–99%
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard 100.171.025 Edit this at Wikidata
Chemical and physical data
Formula C19H24N6O5S2
Molar mass 480.56 g/mol
3D model (JSmol)
  (verify)

Cefepime is a fourth-generation cephalosporin antibiotic. Cefepime has an extended spectrum of activity against Gram-positive and Gram-negative bacteria, with greater activity against both types of organism than third-generation agents.

A 2007 meta-analysis suggested when data of trials were combined, mortality was increased in people 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 no mortality difference.[2]

Cefepime was developed by Bristol-Myers Squibb[3][4] and marketed beginning in 1994. It is now available as a generic drug and sold under a variety of trade names worldwide.

Medical use[edit]

Cefepime is usually reserved to treat moderate to severe nosocomial pneumonia, infections caused by multiple drug-resistant microorganisms (e.g. Pseudomonas aeruginosa) and empirical treatment of febrile neutropenia.[5]

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.[citation needed]

Spectrum of bacterial susceptibility[edit]

Cefepime is a broad-spectrum cephalosporin antibiotic and has been used to treat bacteria responsible for causing pneumonia and infections of the skin and urinary tract. Some of these bacteria include Pseudomonas, Escherichia, and Streptococcus species. The following represents MIC susceptibility data for a few medically significant microorganisms:[6]

  • Escherichia coli: ≤0.007 – 128 μg/ml
  • Pseudomonas aeruginosa: 0.06 – >256 μg/ml
  • Streptococcus pneumoniae: ≤0.007 – >8 μg/ml

Chemistry[edit]

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.

Trade names[edit]

Following expiration of the Bristol-Myers Squibb patent, cefepime became available as a generic and is now marketed by numerous companies worldwide under tradenames including Neopime (Neomed), Maxipime, Cepimax, Cepimex, and Axepim.

References[edit]

  1. ^ 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. 
  2. ^ "Information for Healthcare Professionals: Cefepime (marketed as Maxipime)". Retrieved 2009-08-02. 
  3. ^ Barbhaiya RH, Forgue ST, Gleason CR, Knupp CA, Pittman KA, Weidler DJ, Martin RR (1990). "Safety, tolerance, and pharmacokinetic evaluation of cefepime after administration of single intravenous doses". Antimicrob. Agents Chemother. 34 (6): 1118–22. doi:10.1128/aac.34.6.1118. PMC 171768Freely accessible. PMID 2203303. 
  4. ^ "www.accessdata.fda.gov" (PDF). 
  5. ^ 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. doi:10.1007/bf03256641. PMID 14720024. 
  6. ^ http://www.toku-e.com/Assets/MIC/Cefepime.pdf