Cephalosporins類抗生素 (四代)

Pneumonia: moderate to severe pneumonia caused by susceptible strains of Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae, or Enterobacter species
Febrile Neutropenic: Injection as monotherapy for empiric treatment
Urinary Tract Infections (including pyelonephritis): uncomplicated and complicated UTI caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis
Uncomplicated Skin and Skin Structure Infections: Infections caused by Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes
Complicated Intra-abdominal Infections: used in combination with metronidazole in adults caused by susceptible isolates of Escherichia coli, viridans group streptococci, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter species, or Bacteroides fragilis

Antibiotic, Cephalosporin (Fourth Generation)

Absorption
Intramuscular (IM) administration: completely absorbed
Distribution
1. Volume of distribution: 18 (±2) L
2. Serum protein binding: 20% (independent of its concentration in serum)
3. Excreted in human milk at a concentration of 0.5 mcg/mL
Metabolism
Metabolized to N-methylpyrrolidine (NMP) which is rapidly converted to the N-oxide(NMP-N-oxide)
Excretion
1. Urinary recovery of unchanged cefepime accounts for approximately 85% of the administered dose.
2. Renal dysfunction/hemodialysis patients require dosage adjustment

Immediate hypersensitivity reactions to cefepime or the cephalosporin class of antibiotics, penicillins or other beta-lactam antibiotics.

B
There are no adequate and well-controlled studies of cefepime use in pregnant women.

Cefepime is excreted in human breast milk. Caution should be exercised when cefepime is administered to a breastfeeding woman.

Hypersensitivity Reactions, Neurotoxicity, Clostridium difficile Associated Diarrhea

Usual dosage:
1. Traditional infusion method: (IV) 1-2 g Q8-12H over 30 minutes; cover serious Pseudomonas aeruginosa infections: 2 g Q8H
2. Extended-infusion method (off-label): (IV) 2 g Q8H infused over 3 or 4 hours, may consider giving first dose over 30 minutes.
3. Continuous infusion method (off-label method): (IV) 4-6 g infused over 24 hours; may give first dose of 2 g over 30 minutes, especially when rapid attainment of therapeutic drug concentrations (eg, sepsis) is desired

General dosage:
1. Non-Pseudomonas spp. infections: (IV, IM) 50 mg/kg/dose Q12H; Max 2,000 mg/dose
2. Pseudomonas spp. infections: (IV, IM) 50 mg/kg/dose Q8H; Max 2,000 mg/dose

No dosage adjustment necessary.

Protect from light. Retain in carton until time of use. Discard unused portion.