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Cefepime



Cefepime
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
Identifiers
CAS number 88040-23-7
ATC code J01DE01
PubChem 68606
Chemical data
Formula C19H24N6O5S2 
Mol. mass 480.56 g/mol
Pharmacokinetic data
Bioavailability 100% (IM)
Metabolism Hepatic 15%
Half life 2 hours
Excretion Renal 70–99%
Therapeutic considerations
Pregnancy cat.

B1 (Au)

Legal status

S4 (Au)

Routes Intravenous, intramuscular

Cefepime (INN) (pronounced /ˈsɛfəpiːm/, /ˈkɛfəpiːm/) 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 Maxipime (Elan Pharma), Maxcef, Cepimax, Cepimex, and Axepim. A FDA MedWatch early communication reports an increased risk of death per an article in the May 2007 issue of The Lancet Infectious Diseases (Efficacy and safety of cefepime: a systematic review and meta-analysis).

Additional recommended knowledge

Contents

Clinical use

Cefepime is usually reserved to treat severe nosocomial pneumonia, infections caused by multi-resistant microorganisms (e.g. Pseudomonas aeruginosa) and empirical treatment of febrile neutropenia.[1] The use of cefepime might become less common, since it has been associated to an increase mortality when used for different types of infections.

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.

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.

References

^  Chapman TM, Perry CM. Cefepime: a review of its use in the management of hospitalized patients with pneumonia. Am JRespir Med. 2003;2(1):75-107. PMID 14720024 ^  Yahav, D et al. Efficacy and safety of cefepime: a systematic review and meta-analysis. Lancet 2007; 7:338-348.

See also

 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Cefepime". A list of authors is available in Wikipedia.
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