Cefepime

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Cefepime
Cefepime2DCSD.svg
Cefepime ball-and-stick.png
Clinical data
Pronunciation/ˈsɛfɪpm/ or /ˈkɛfɪpm/
Trade namesMaxipime, Voco
AHFS/Drugs.comMonograph
MedlinePlusa698021
Pregnancy
category
  • AU: B1
  • US: B (No risk in non-human studies)
Routes of
administration
Intravenous, intramuscular
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability100% (IM)
MetabolismHepatic 15%
Elimination half-life2 hours
ExcretionRenal 70–99%
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard100.171.025 Edit this at Wikidata
Chemical and physical data
FormulaC19H24N6O5S2
Molar mass480.56 g/mol g·mol−1
3D model (JSmol)
Melting point150 °C (302 °F) (dec.)
  (verify)

Cefepime is a fourth-generation cephalosporin antibiotic. Cefepime has an extended spectrum of activity against Gram-positive and Gram-negative bacteria, with greater activity against both types of organism than third-generation agents. A 2007 meta-analysis suggested when data of trials were combined, mortality was increased in people treated with cefepime compared with other β-lactam antibiotics.[1] In response, the U.S. Food and Drug Administration performed their own meta-analysis which found no mortality difference.[2]

Cefepime was patented in 1982 by Bristol-Myers Squibb and approved for medical use in 1994,[3] it is available as a generic drug and sold under a variety of trade names worldwide.

Medical use[edit]

Cefepime is usually reserved to treat moderate to severe nosocomial pneumonia, infections caused by multiple drug-resistant microorganisms (e.g. Pseudomonas aeruginosa) and empirical treatment of febrile neutropenia.[4]

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.[citation needed]

Spectrum of bacterial susceptibility[edit]

Cefepime is a broad-spectrum cephalosporin antibiotic and has been used to treat bacteria responsible for causing pneumonia and infections of the skin and urinary tract; some of these bacteria include Pseudomonas, Escherichia, and Streptococcus species. The following represents MIC susceptibility data for a few medically significant microorganisms:[5]

  • Escherichia coli: ≤0.007 – 128 μg/ml
  • Pseudomonas aeruginosa: 0.06 – >256 μg/ml
  • Streptococcus pneumoniae: ≤0.007 – >8 μg/ml

Chemistry[edit]

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 increase the activity of cefepime against otherwise resistant organisms including Pseudomonas aeruginosa and Staphylococcus aureus.

Trade names[edit]

Following expiration of the Bristol-Myers Squibb patent, cefepime became available as a generic and is now marketed by numerous companies worldwide under tradenames including Neopime (Neomed), Maxipime, Cepimax, Cepimex, and Axepim.

References[edit]

  1. ^ Yahav D, Paul M, Fraser A, Sarid N, Leibovici L (2007). "Efficacy and safety of cefepime: a systematic review and meta-analysis". Lancet Infect Dis. 7 (5): 338–48. doi:10.1016/S1473-3099(07)70109-3. PMID 17448937.
  2. ^ "Information for Healthcare Professionals: Cefepime (marketed as Maxipime)". Retrieved 2009-08-02.
  3. ^ Fischer, Jnos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 496. ISBN 9783527607495.
  4. ^ Chapman TM, Perry CM (2003). "Cefepime: a review of its use in the management of hospitalized patients with pneumonia". Am J Respir Med. 2 (1): 75–107. doi:10.1007/bf03256641. PMID 14720024.
  5. ^ http://www.toku-e.com/Assets/MIC/Cefepime.pdf