Cefepime

Cefepime is a fourth-generation cephalosporin antibiotic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Treatment of moderate to severe pneumonia caused by susceptible bacteria.
• Complicated and uncomplicated urinary tract infections, including pyelonephritis, caused by susceptible bacteria.
• Uncomplicated skin and skin-structure infections caused by susceptible bacteria.
• Complicated intra-abdominal infections, usually used with metronidazole when anaerobic bacterial coverage is needed.
• Empirical treatment of febrile neutropenia when a doctor judges broad-spectrum injectable antibiotic treatment is required.
• Bloodstream infection or sepsis may be treated with Cefepime when the suspected or confirmed bacteria are susceptible, according to specialist advice.

Adult dosing depends on the infection site, severity, kidney function, and culture results. Common adult regimens are given by IV infusion or IM injection, often 1–2 g every 8–12 hours, with lower or adjusted dosing in renal impairment. The exact dose, route, infusion time, and duration must be decided by the prescribing doctor.

• Common: pain or inflammation at the injection site, rash, itching, nausea, vomiting, diarrhoea, headache, and fever.
• Laboratory changes may include raised liver enzymes, changes in blood counts, or positive Coombs test.
• Serious: severe allergic reaction or anaphylaxis, severe skin reactions, Clostridioides difficile-associated diarrhoea, seizures, confusion, encephalopathy, or abnormal movements, especially in kidney impairment or overdose.

Use with caution in people with previous allergy to penicillins, cephalosporins, or other beta-lactam antibiotics; kidney disease; seizure disorder; gastrointestinal disease such as colitis; or in elderly or critically ill patients. Kidney function may need checking and the dose may need adjustment. Prolonged use can encourage overgrowth of non-susceptible organisms, including fungi. Use Cefepime only under the guidance of a registered doctor or pharmacist.

• Aminoglycoside antibiotics or other nephrotoxic medicines may increase the need for kidney monitoring.
• Loop diuretics such as furosemide may add to kidney-related risk in vulnerable patients.
• Warfarin or other anticoagulants may require closer INR or bleeding monitoring during antibiotic therapy.
• Live bacterial vaccines, such as oral typhoid vaccine, may be less effective during antibiotic treatment.
• Some urine glucose tests and other laboratory tests may be affected; inform the laboratory and doctor that Cefepime is being used.

• Known serious hypersensitivity to cefepime.
• Known serious hypersensitivity to cephalosporin antibiotics.
• History of immediate severe allergic reaction to penicillins or other beta-lactam antibiotics, unless a specialist determines it is safe.

During pregnancy, Cefepime should be used only when clearly needed and prescribed by a doctor. It passes into breast milk in small amounts; breastfeeding is usually possible when clinically necessary, but the infant should be observed for diarrhoea, thrush, rash, or feeding problems.

Store unopened vials as directed on the product label, generally in a cool, dry place protected from light and out of the reach of children. After reconstitution or dilution, use promptly or store only for the time and temperature recommended by the manufacturer or hospital pharmacy. Do not use if the solution is cloudy, contains particles, or the container is damaged.