Cefepime: Difference between revisions
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==Special Populations== | ==Special Populations== | ||
*Pregnancy: | *Pregnancy: B | ||
*Lactation: | *Lactation: Probably safe | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: CrCl 30-60: give q24h; CrCl 11-29: give usual dose x1, then 0.5-1 g q24h; CrCl <11: give usual dose x1, then 250-500 mg q24h; HD: 1 g x1, then 500 mg q24h, give after dialysis; PD: give usual dose q48h | ||
**Pediatric | **Pediatric: CrCl 30-60: 50 mg/kg q24h; CrCl 11-29: 50 mg/kg x1, then 25-50 mg/kg q24h; CrCl <11: 50 mg/kg x1, then 12.5-25 mg/kg q24h; HD: 50 mg/kg x1, then 25 mg/kg q24h, give after dialysis; PD: 50 mg/kg q48h | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: No adjustment | ||
**Pediatric | **Pediatric: No adjustement | ||
==Contraindications== | ==Contraindications== | ||
Revision as of 00:53, 17 May 2014
General
- Type: Fourth generation cephalosporin
- Dosage Forms: IV, IM
- Common Trade Names: Maxipime
Adult Dosing
Bacterial Infections
- 1-2 g IV q12H (Max: 6 g/24h; dose, duration varies with infection type, severity)
Febrile Neutropenia
- 2g IV q8H
UTI, mild-moderate
- 0.5-1g IV/IM q12H x7-10 days (IM only for UTI due to E. coli)
UTI, severe
- 2g IV q12H x10 days
Renal dosing
- Febrile Neutropenia: CrCl 30-60: 2 g q12H; CrCl 11-29: 2 g q24H; CrCL <11: 2gx1, then 1g q24H; HD: 1g q24H, give after dialysis; PD: 2g q48H
- All other infections: CrCl 30-60: give q24h; CrCl 11-29: give usual dose x1, then 0.5-1 g q24h; CrCl <11: give usual dose x1, then 250-500 mg q24h; HD: 1 g x1, then 500 mg q24h, give after dialysis; PD: give usual dose q48h
Hepatic Doseing
- no adjustment
Pediatric Dosing
Bacterial Infections
- >2 mo: Dose: 50 mg/kg IV/IM q12h; Max: 2 g/dose; Info: duration varies w/ infection type, severity; IM only for mild-mod. UTI due to E. coli
Febrile Neutropenia
- >2 mo: Dose: 50 mg/kg IV q8h; Max: 2 g/dose
Respiratory Infections, cystic fibrosis pts
- >2 mo: Dose: 50 mg/kg IV q8h x2wk; Max: 2 g/dose
Renal Dosing
- Febrile Neutropenia, cystic fibrosis: CrCl 30-60: 50 mg/kg q12h; CrCl 11-29: 50 mg/kg q24h; CrCl <11: 50 mg/kg x1, then 25 mg/kg q24h; HD: 25 mg/kg q24h, give after dialysis; PD: 50 mg/kg q48h
- all other infections: CrCl 30-60: 50 mg/kg q24h; CrCl 11-29: 50 mg/kg x1, then 25-50 mg/kg q24h; CrCl <11: 50 mg/kg x1, then 12.5-25 mg/kg q24h; HD: 50 mg/kg x1, then 25 mg/kg q24h, give after dialysis; PD: 50 mg/kg q48h
Hepatic Dosing
- No Adjustment
Special Populations
- Pregnancy: B
- Lactation: Probably safe
- Renal Dosing
- Adult: CrCl 30-60: give q24h; CrCl 11-29: give usual dose x1, then 0.5-1 g q24h; CrCl <11: give usual dose x1, then 250-500 mg q24h; HD: 1 g x1, then 500 mg q24h, give after dialysis; PD: give usual dose q48h
- Pediatric: CrCl 30-60: 50 mg/kg q24h; CrCl 11-29: 50 mg/kg x1, then 25-50 mg/kg q24h; CrCl <11: 50 mg/kg x1, then 12.5-25 mg/kg q24h; HD: 50 mg/kg x1, then 25 mg/kg q24h, give after dialysis; PD: 50 mg/kg q48h
- Hepatic Dosing
- Adult: No adjustment
- Pediatric: No adjustement
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life: 2 hours, 13.5 hours (HD), 19 hours (CAPD)
- Metabolism: minimal, site unknown; CYP450: unknown
- Excretion: urine primarily (85% unchanged)
- Mechanism of Action: bactericidal; inhibits cell wall mucopeptide synthesis
See Also
Source
- Epocrates