Pharmacokinetics of cefepime in patients with cancer and. To view the entire topic, please sign in or purchase a subscription. Six clinically healthy hubbard chickens of four weeks of age weighting about 1500. We examined clinical outcomes of patients undergoing cefepime tdm in an initial. Cefepime is a topic covered in the johns hopkins abx guide. Cefepime is an antibacterial agent belonging to the cephalosporin class of antibacterials with. Cefepime is a fourthgeneration cephalosporin antibiotic developed in 1994. Nicholas odonnell, jessica neeb, kelli thoele, david r. Clinical pharmacodynamics of cefepime in patients infected. Hardin, pharmd college of pharmacy, the university of texas at austin, austin, and department of pharmacology, the university of texas health science center at san antonio, san antonio.
If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus. Pharmacokinetics of cefepime following a single 30 or 50 mgkg dose the pharmacokinetics of cefepime were observed in seven and two patients between the ages of 2 and 12 years following a single dose of 30 or 50 mgkg, respectively. Pharmacokinetic and pharmacodynamic profiles of antibiotics are important in. Elimination is prolonged in patients with compromised renal function. May 09, 2018 cefepime induced neurotoxicity is a relatively common complication, and may be widely underrecognised in the icu, where patients can have multiple risk factors for altered mental status. Cefepime concentrations in plasma, urine, and hemodialysate were assayed using reverse. The pharmacokinetics of cefepime were unaltered in patients with hepatic impairment who received a single 1 g dose n11. Peak serum concentrations of cefepime are 2 to 3 times greater following an intravenous iv dose than an intramuscular im dose. Cefepime is a new parenteral cephalosporin with antimicrobial activity similar to thirdgeneration cephalosporins. Casebook in clinical pharmacokinetics and drug dosing.
Evaluation of safety, pharmacokinetics and efficacy of. Pharmacokinetics and spectrum of activity similar to ceftazidime. Cefepime pharmacokinetics have been investigated in elderly 65 years of age and older men n12 and women n12 whose mean sd creatinine clearance was 74 15 mlmin. Pharmacokinetics of cefepime after single intravenous and. If 1g q12h is ordered for any other indication, dose will be interchanged to 1g q6h. Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the bloodbrain barrier and exhibit concentrationdependent. Seda27, 245, and clinical reports 25 r, 26 c and experimental reports 27 r concerning this and other betalactams continue to appear. Pharmacokinetic and pharmacodynamic properties of meropenem. Limarogel et al 40 compared their own results on the pharmacokinetics of cefepime in neonates with those of capparelli et al 38 and reed et al. Cefepime maxipime side effects, dosage, interactions. Cefepime can cause neurotoxic and neuropsychiatric symptoms seda26, 264. Pharmacokinetics and pharmacodynamics of cefepime in patients.
Jul 15, 2015 evaluation of safety, pharmacokinetics and efficacy of ceftazidime and avibactam cazavi compared with cefepime in children from 3 months to less than 18 years of age with complicated urinary tract infections cutis full text view. This study assessed the pharmacokinetics and pharmacodynamics of cefepime administered by intermittent and continuous infusion against clinical isolates of pseudomonas aeruginosa, enterobacter cloacae, and staphylococcus aureus. Cefepime plasma concentrations and clinical toxicity. Dailymed cefepime cefepime hydrochloride injection, powder. Additional clinical uses of meropenem have regulatory approval in.
Oct 02, 2018 the pharmacokinetics of cefepime were unaltered in patients with hepatic impairment who received a single 1 g dose n11. Plasma, urine and skin pharmacokinetics of cefepime in burns. Pdf pharmacokinetics of cefepime in subjects with renal. Data are insufficient to support the efficacy of cefepime monotherapy in patients at high risk for severe. Review of the pharmacokinetics of cefepime in children. From a clinical viewpoint, cefepime levels may not be readily available to guide management of a patient with deteriorating mental status. Uptodate, electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine, allergy and immunology, cardiovascular medicine, emergency medicine, endocrinology and diabetes, family medicine, gastroenterology and hepatology, hematology, infectious diseases, nephrology and.
Pharmacokineticpharmacodynamic rationale for cefepime dosing. Cefepime is usually reserved to treat severe nosocomial pneumonia. Cefepime pharmacokinetics are linear over the range 250 mg to 2 g iv. However, modification of the dosing regimen based on renal impairment should also take into consideration pharmacodynamic parameters predicting clinical.
Pharmacokinetics and pharmacodynamics of extendedinfusion. The pharmacokinetics of cefepime in burns patients is not well documented. Data suggest that up to 15% of icu patients treated with cefepime may experience these adverse. The clinical success rate was 88% for patients in both the cefepime and ceftazidime. Cefepime is a broadspectrum cephalosporin antibiotic and has been used to treat bacteria responsible for causing pneumonia and infections of the skin and urinary tract.
They decrease ergosterol synthesis by interfering with the lanosterol14. Costeffectiveness comparison of cefepime and ceftazidime using. Maxipime cefepime dosing, indications, interactions. Cefepime exceptions 1g q12h dose only appropriate for communityacquired pneumonia not due to p. Mediakit reprints and eprints sponsored supplements branded books. Despite its extensive use, its presence in multiple clinical guidelines, and numerous indications for its use 1, 16, 20, 26, a recent metaanalysis found treatment with cefepime to be associated with an increase in the patient. The following two case reports can be taken as brief reminders. It is 16 to 19% proteinbound and is primarily renally eliminated.
Sep 07, 2018 data in pediatric patients with impaired renal function are not available. The population pharmacokinetics of cefepime were described by a. Aug 20, 2012 some pharmacodynamic effects of cefepime, a new injectable semisynthetic cephalosporin, were studied in laboratory animals and the following results were obtained. The pharmacokinetics of cefepime have been well described in adults with normal and impaired renal function. Seda27, 245, and clinical reports 25r, 26c and experimental reports 27r. Cefepime has an extended spectrum of activity against grampositive and gramnegative bacteria, with greater activity against both gramnegative and grampositive organisms than thirdgeneration agents. Activity of cefepimezidebactam against multidrugresistant. Pdf pharmacokinetics of intraperitoneal cefepime in automated.
Official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine. Unspecified error evidencebased clinical decision support. Developmental population pharmacokinetics and dosing. Jul 24, 2018 the pharmacokinetics of cefepime were unaltered in patients with hepatic impairment who received a single 1 g dose n11. Pharmacokinetics of cefepime in subjects with renal. Cefepime is cleared primarily by urinary excretion 85%. Freshly constituted solutions of maxipime will range in color from colorless to amber. Cefepime maximally stimulated isolated guinea pigs ileum, rats colon 80. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Pharmacokinetics of cefepime in subjects with renal insufficiency. Cefpirome, which is not available in the united states, has a pharmacokinetic profile very similar to that of cefepime.
Cefepime was not associated with adverse developmental outcomes in rats, mice, or rabbits when administered parenterally during period of organogenesis. Zid had a very broad and potent in vitro spectrum of activity, and was highly active against many mdr isolates of enterobacterales. Voriconazole and posaconazole are broadspectrum triazole antifungal agents. It acts against the enterobacteriaceae family, and pseudomonas aeruginosa, but maintains grampositive activity similar to that of first or secondgeneration cephalosporins. Johns hopkins guide app for ios, iphone, ipad, and android included. Pediatric pharmacotherapy university of virginia school of. Following a single intravenous dose, total body clearance and the steadystate volume of distribution averaged 3. Clinical pharmacology pharmacokinetics the average plasma concentrations of cefepime observed in healthy adult male. Cefepime is a broadspectrum fourthgeneration cephalosporin with in vitro activity. Maxipime cefepime hydrochloride dose, indications, adverse. Cefepime is the generic form of the brandname drug maxipime, which is used to treat bacterial infections such as urinary tract infections, pneumonia, and skin infections the prescription. This prospective, multicenter study aims to determine the pharmacokinetics and pharmacodynamics of extendedinfusion cefepime in crrt.
The average plasma concentrations of cefepime observed in healthy adult male volunteers. Cefepime has in vitro activity against many bacterial isolates resistant to ceftazidime and cefotaxime, is. This study determined the pharmacokinetics of intraperitoneal ip cefepime in automated peritoneal. Cefepime maxipime side effects, dosage, interactions drugs. Cefepime pharmacokinetics have been evaluated in pediatric patients from 2 months to 11 years of age following single and multiple doses on every 8 hours n29 and every 12 hours n schedules. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to. Peak serum concentrations of roughly 150 to 160 mcgml are achieved after a 2 g iv dose of cefepime to healthy adult males. Clinical uses are similar to those of the thirdgeneration cephalosporins. The results demonstrated doserelated increases in maximum concentration cmax and area under the curve auc.
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