CEFEPIME

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CEFEPIME
CALCUTIONS AREA
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Infant Data

Results

MEDICAL INFORMATIONS

INDICATIONS

    • Treatment of serious infections: Caused by susceptible gram-negative organisms (eg, E coli, H influenzae, Enterobacter, Klebsiella,Morganella, Neisseria, Serratia, and Proteus species), especially Pseudomonas aeruginosa that are resistant to 3rd generation cephalosporins.
    • Treatment of serious infections: Caused by susceptible Gram-positive organisms (eg, Strep pneumoniae, Strep. pyogenes, Strep. agalactiae, and Staph. aureus).

A positive clinical response was observed in 26 of the 32 (81.3%) evaluable neonates treated with cefepime (mean dose 36 mg/kg/dose IV every 12 hours) in a retrospective, singlecenter study (n=74; mean postmenstrual age at initiation, 33 weeks). Concomitant antibiotics were used during all courses; most common infections were late-onset sepsis (42%), early-onset sepsis (17.6%), and multiple indications (16.2%)

  • Infective Endocarditis: The following recommendations are based on a consensus of experts . The full pediatric guidelines can be found here:

ADVERSE EFFECTS

Safety has been documented to be the same as commonly used second- and thirdgeneration cephalosporins. Reported adverse effects are uncommon, but include rash, diarrhea, elevated hepatic transaminases, eosinophilia, and positive Coomb’s test. In a retrospective, single-center study of 74 neonates (mean postmenstrual age at initiation was 33 weeks) treated with cefepime (mean dose 36 mg/kg/dose IV every 12 hours), acute kidney injury (16.2%), hypophosphatemia (12.2%), seizures (0.03%), and hyponatremia (0.01%) were reported. Concomitant nephrotoxic agents (i.e., vancomycin and gentamicin) were used in all neonates.

ADMINISTRATION

Give as an IV infusion in a compatible solution over 30 minutes at a concentration of 1 to 100 mg/mL. A large healthcare system selected 40 mg/mL and 100 mg/mL (IV push) as standard concentrations for cefepime. May be given by IM injection at a concentration of 280 mg/mL. To reduce pain at IM injection site, cefepime may be mixed with 1% lidocaine without epinephrine.

MONITORING

Measuring serum concentration is not usually necessary.

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