Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Cefepime

Restricted
Restricted

C. diff Risk

High

Oral Bioavailability

NA

Approximate Cost

$$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Pediatric

50 mg/kg, IV, q8hr. Infuse over 30 minutes. Max dose = 2000mg.

Neonatal

Renal

CRRT50 mg/kg, q12hr

Hemodialysis/Peritoneal dialysis50 mg/kg, q24hr

<10 mL/minute/1.73 m250 mg/kg, q24hr

10 to 50 mL/minute/1.73 m250 mg/kg, q12hr

General Information

Acceptable Uses

Acceptable Uses

  • Pneumonia

  • Skin and soft tissue Infections

  • Pyelonephritis

  • Febrile neutropenia

  • Intra-abdominal infections, in combination with metronidazole

  • Peritonitis associated with peritoneal dialysis

  • CF exacerbation

  • Pseudomonas high risk

Unacceptable Uses

Unacceptable Uses

  • MRSA

  • Enterococci

  • b. fragilis

Drug Monitoring

Drug Monitoring

With prolonged therapy, monitor renal and hepatic function periodically, CBC with diff

First Line Indications

First Line Indications

  • Febrile neutropenia

  • CF exacerbation

  • Sepsis and high risk for pseudomonas

Adverse Effects

Adverse Effects

  • Hypersensitivity, rash

  • Can cause positive Coombs

  • Cytopenias

Pharmacology

Pharmacology

Antimicrobial class: 4th generation Cephalosporin

Pregnancy category: B

Average serum half life:

  • Neonates: 4-5hours

  • Children and adults: 2 hours

Biliary penetration: Good

CSF penetration: Good (10%)

Lung penetration: Good (60%)

Urine penetration: Excellent (85% unchanged)

Route of Elimination: At least 85% eliminated as unchanged drug in urine

Metabolism: minimally hepatic