Use: Labeled Indications Intra-abdominal infection: Treatment, in combination with metronidazole, of complicated intra-abdominal infections caused by Escherichia coli, viridans group streptococci, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter species, or Bacteroides fragilis. Neutropenic fever: Empiric treatment of febrile neutropenic patients. Pneumonia moderate to severe : Treatment of moderate to peritoneal cancer alternative treatment pneumonia caused by Streptococcus pneumoniae, including cases associated with concurrent bacteremia, P.
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Skin and soft tissue infection: Treatment of moderate to severe skin and soft tissue infections caused by Staphylococcus aureus methicillin-susceptible isolates only or Streptococcus pyogenes. Urinary tract infection, including pyelonephritis: Treatment of urinary tract infections, including pyelonephritis, caused by E.
Off Label Uses Bloodstream infection gram-negative bacteremia Data from peritoneal cancer alternative treatment prospective, randomized, open-comparison study support the use of cefepime in the treatment of gram-negative bacteremia [Schrank ].
Based on the Infectious Diseases Society of America IDSA clinical practice guidelines for the diagnosis and management of intravascular catheter-related infectioncefepime is effective and recommended for the treatment of intravascular catheter-related infection caused by Pseudomonas aeruginosa. Cystic fibrosis, exacerbation Based on the Cystic Fibrosis Foundation's cystic fibrosis pulmonary guidelinescefepime, as part of an appropriate combination regimen which should include an additional antipseudomonal agentis effective and recommended for the treatment of P.
Diabetic foot infection, moderate to severe Based on the IDSA guidelines for the diagnosis and treatment of diabetic foot infectionscefepime, in combination with other appropriate agents, is an effective and recommended treatment option for diabetic foot infections. Intracranial abscess brain abscess, intracranial epidural abscess and spinal epidural peritoneal cancer alternative treatment Clinical experience suggests the utility of cefepime in the management of brain abscess, intracranial epidural abscess, and spinal epidural abscess [Bond ], [Sexton a], [Sexton b], [Southwick ].
Meningitis, bacterial Based on the IDSA guidelines for the management of bacterial meningitis and healthcare-associated ventriculitis and meningitiscefepime is effective and recommended for the treatment of bacterial meningitis caused by P.
Neutropenic enterocolitis typhlitis Based on the IDSA clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancercefepime, in combination with metronidazole, is effective and recommended for the management of neutropenic enterocolitis typhlitis.
Osteomyelitis Data from a limited number of patients suggest that cefepime may be beneficial for the treatment of osteomyelitis [Jauregui ]. Based on the IDSA guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adultscefepime is an effective and recommended agent for the treatment of native vertebral osteomyelitis due to P.
Prosthetic joint infection Based on the IDSA guidelines for the diagnosis and management of prosthetic joint infectioncefepime is an effective and recommended agent for the treatment of prosthetic joint infection due to P. Sepsis and septic shock Based peritoneal cancer alternative treatment the Society of Critical Care Medicine international guidelines for management of sepsis and septic shockcefepime, in combination with other appropriate agents, is effective and recommended for broad-spectrum antibacterial coverage including P.
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Septic arthritis Clinical experience suggests the utility of cefepime peritoneal cancer alternative treatment the treatment of septic arthritis [Goldenberg ]. Contraindications Hypersensitivity to cefepime, other cephalosporins, penicillins, other beta-lactam antibiotics, or any component of the formulation Dosing: Adult Usual dosage range: Traditional intermittent infusion method over 30 minutes : IV: 1 to 2 g every 8 to 12 hours.
For coverage of serious Pseudomonas aeruginosa infections: 2 g every 8 hours Crandon ; Koomanachai ; Su Extended-infusion method off label : IV: 2 g every 8 hours infused over 3 or 4 hours Arnold ; Bauer ; Koomanachai ; Nicasio ; Wrenn ; may consider giving first dose over 30 minutes Wrenn Extended-infusion method is supported by data suggesting equal or better attainment of pharmacokinetic targets and theoretical clinical benefit in patients peritoneal cancer alternative treatment critical illness or altered pharmacokinetics MacVane ; Moehring a and possible clinical benefit among patients infected with P.
Bloodstream infection gram-negative bacteremia off-label use : Community-acquired infection, without sepsis or septic shock immunocompetent host and no infections with P.
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Health care-associated infection including catheter-related infection, infection in immunocompromised hosts, patients with sepsis or septic shock, or for coverage of P.
Note: For empiric therapy of gram-negative bloodstream infection in patients with sepsis or septic shock and for empiric therapy of P.
Some experts also prefer the extended-infusion method in critical illness or if treating a susceptible organism with an elevated minimum inhibitory concentration MIC Moehring a; SCCM [Rhodes ]. Duration of therapy: Usual duration is 7 to 14 days; individualize duration depending on source and extent of infection as well as clinical response.
A 7-day duration is recommended for patients with uncomplicated Enterobacteriaceae infection who respond appropriately peritoneal cancer alternative treatment antibiotic therapy Moehring b; Yahav For P. Cystic fibrosis, severe acute pulmonary exacerbation or failure of oral therapy, for coverage of P.
Note: Most often given as part of a combination regimen, which should include an additional antipseudomonal agent Flume ; Simon The optimal duration is not well defined and should be individualized based on clinical response Flume ; duration is usually 10 days to 3 weeks or longer Simon Diabetic virusi za kompijuter infection, moderate to severe off-label use : IV: 2 g every 8 to 12 hours in combination with other appropriate agents; for P.
Note: Empiric P.
Duration of therapy: Duration which may include peritoneal cancer alternative treatment step-down therapy is usually 2 to 4 weeks in the absence of osteomyelitis but varies based on patient-specific factors, including clinical response IDSA [Lipsky ]; Weintrob Intra-abdominal infection, health care-associated or high-risk community-acquired infection: IV: 2 g every 8 to 12 hours in combination with metronidazole, and, when appropriate, other agents; if P.
Duration of therapy may be limited to 4 to 7 days in patients with adequate source control IDSA [Solomkin ]; SIS [Mazuski ] ; a longer peritoneal cancer alternative treatment of therapy may be necessary in certain situations eg, source control is suboptimal, the patient is managed nonoperatively Barshak Intracranial abscess brain abscess, intracranial epidural abscess and spinal epidural abscess off-label use : As a component of empiric therapy in patients at risk for P.
The appropriate duration depends on cultured pathogen s and patient-specific factors, including peritoneal cancer alternative treatment response Bodilsen ; Sexton a; Sexton b; Southwick Meningitis, bacterial off-label use : Note: As a component of empiric therapy for health care-associated infections or infections in immunocompromised patients, or as pathogen-specific therapy eg, gram-negative bacteria, including P.
In patients who have clinical resolution following neutropenia and who did not have signs of severe disease at the time of diagnosis, the duration of antibiotics is 14 days following recovery peritoneal cancer alternative treatment neutropenia; many patients can be switched to an appropriate oral antibiotic regimen once neutropenia has resolved Wong Kee Song Some experts prefer the extended infusion method, particularly in those who are critically ill Moehring a; SCCM [Rhodes ]; Wingard Pneumonia: Community-acquired pneumonia, as a component of empiric therapy for inpatients at risk of infection with a resistant gram-negative pathogen sincluding P.
Total duration which may include oral step-down therapy is a minimum of 5 days and varies based on disease severity and response to therapy; a longer course may be required for severe or complicated infection or for P. Hospital-acquired pneumonia or ventilator-associated cancer plamani cauze, as empiric therapy or pathogen-specific therapy for resistant gram-negative bacilli eg, P. Note: Some experts prefer the extended-infusion method, particularly in those who are critically ill or to optimize exposure if treating a susceptible organism with an elevated MIC Klompas ; Moehring a; SCCM [Rhodes ].
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Prosthetic joint infection, pathogen-specific therapy for gram-negative bacilli off-label use : IV: 2 g every 8 to 12 hours Berbari ; IDSA [Osmon ]. Sepsis and septic shock broad-spectrum coverage, including P. Initiate therapy as soon as possible and preferably within 1 hour of recognition of sepsis or septic shock. Septic arthritis, without prosthetic material off-label use : As a component of empiric therapy or pathogen-specific therapy for gram-negative pathogens including P.
Total treatment duration is 3 to 4 weeks in the absence of osteomyelitisincluding oral step-down therapy Goldenberg Skin and soft tissue infections, moderate to severe: IV: 2 g every 12 hours. Usual duration of treatment is 5 to 14 days and is individualized based on peritoneal cancer alternative treatment to therapy Kanj a; Spelman Urinary tract infection, complicated including pyelonephritis : IV: 1 to 2 g every 12 hours; some peritoneal cancer alternative treatment prefer 2 g every 8 hours if P.
Switch to an appropriate oral regimen once patient has improvement in symptoms, if culture and susceptibility results allow.
Duration of therapy depends on the antimicrobial chosen to complete the regimen peritoneal cancer alternative treatment ranges from 5 to 14 days Hooton ; IDSA [Gupta ].