Cefepim - instructions for use, analogs, reviews and release forms (injections in ampoules for injections of antibiotic for 1 gram, tablets) drugs for the treatment of bronchitis, pneumonia, cystitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Cefepim. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of antibiotic Cefepime in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Cefepime in the presence of existing structural analogues. Use for the treatment of bronchitis, pneumonia,cystitis and other infectious diseases in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Cefepim - a cephalosporin antibiotic from the 4-generation group for parenteral use. It has a bactericidal effect, disrupting the synthesis of the cell wall of microorganisms.

It is active against most Gram-negative bacteria, incl. producing beta-lactamases, including Pseudomonas aeruginosa. More active than cephalosporins of the 3rd generation, with respect to Gram-positive cocci.

Not active against Enterococcus spp. (enterococcus), Listeria spp. (Listeria), Legionella spp. (Legionella), some anaerobic bacteria (Bacteroides fragilis, Clostridium difficile).

Cefepime is characterized by high stability in relation to various plasmid and chromosomal beta-lactamases.

Composition

Cefepime hydrochloride + excipients.

Pharmacokinetics

The binding to plasma proteins is less than 19% and does not depend on the concentration of cefepime in serum. Therapeutic concentrations of cefepime are found in urine, bile, peritoneal fluid, blister exudate, bronchial mucus secretion, sputum, prostate tissue, appendix and gallbladder, cerebrospinal fluid with meningitis.In healthy people with intravenous cefepime in a dose of 2 g with an interval of 8 hours for 9 days there was no cumulation in the body. Cefepime is excreted by the kidneys, mainly by glomerular filtration (the average renal clearance is 110 ml / min). In urine, approximately 85% of the injected cefepime is found in unchanged form. In patients age 65 or older with normal renal function, the magnitude of renal clearance is less than in young patients. The pharmacokinetics of cefepime in patients with impaired liver function, cystic fibrosis is not changed.

Indications

Treatment of infectious-inflammatory diseases caused by microorganisms sensitive to cefepime:

• infections of the lower respiratory tract (including pneumonia and bronchitis);
• urinary tract infections (both complicated and uncomplicated);
• infections of the skin and soft tissues;
• intra-abdominal infections (including peritonitis and biliary tract infections);
• gynecological infections;
• septicemia;
• neutropenic fever (as an empirical therapy);
• bacterial meningitis in children.

Prevention of infections in the conduct of cavitary surgery.

Forms of release

Powder for the preparation of solution for intravenous and intramuscular injection 1 gram (injections in ampoules for injection).

Other dosage forms, be it tablets or capsules, do not exist.

Instructions for use and dosage

Individual, depending on the sensitivity of the pathogen, the severity of the infection, as well as the state of kidney function.

An intravenous route of administration is preferred for patients with severe or life-threatening infections, especially when there is a threat of shock.

When administered intramuscularly or intravenously to adults and children weighing more than 40 kg with normal kidney function, a single dose is 0.5-1 g, the interval between administrations is 12 hours. In severe infections, intravenously administered at a dose of 2 g every 12 hours.

In order to prevent infections in the conduct of cavitary surgery are used in combination with Metronidazole according to the scheme.

For children aged 2 months, the maximum dose should not exceed the recommended dose for adults. The average dose for children weighing up to 40 kg with complicated or uncomplicated urinary tract infections (including pyelonephritis), uncomplicated infections of the skin and soft tissues, pneumonia, the empirical treatment of neutropenic fever is 50 mg / kg every 12 hours.

Patients with neutropenic fever and bacterial meningitis - 50 mg / kg every 8 hours.

The average duration of therapy is 7-10 days. In severe infections, longer treatment may be required.

For violations of kidney function (KK less than 30 ml / min), correction of the dosing regimen is necessary. The initial dose of cefepime should be the same as for patients with normal renal function. Supportive doses are determined depending on the values ​​of CK or the serum creatinine concentration.

With hemodialysis, approximately 68% of the total amount of cefepime is removed from the body within 3 hours. At the conclusion of each session, a repeat dose equal to the initial dose should be given. In patients who are on continuous ambulatory peritoneal dialysis, cefepime can be used in average recommended doses, i.e. 500 mg, 1 g or 2 g, depending on the severity of the infection, with an interval between single dose administration of 48 hours.

Children with impaired renal function are recommended the same changes in the dosing regimen as adults, since the pharmacokinetics of cefepime in adults and children is similar.

Side effect

• diarrhea, constipation;
• nausea, vomiting;
• Colitis (including pseudomembranous colitis);
• stomach ache;
• change in taste;
• rash;
• itching;
• hives;
• anaphylactic reactions;
• headache;
• dizziness;
• paresthesia;
• convulsions;
• redness of the skin;
• anemia;
• increased activity of ALT, AST, APF;
• increase in total bilirubin;
• eosinophilia, transient thrombocytopenia, transient leukopenia and neutropenia;
• increased prothrombin time;
• positive Coombs test without hemolysis;
• increased body temperature;
• vaginitis;
• erythema;
• genital itching;
• nonspecific candidiasis;
• phlebitis (with intravenous administration);
• with intramuscular injection, inflammation or pain at the injection site is possible.

Contraindications

• hypersensitivity to cefepime or L-arginine, as well as to cephalosporin antibiotics, penicillins or other beta-lactam antibiotics.

Application in pregnancy and lactation

Adequate and strictly controlled studies of the safety of the use of Cefepime in pregnancy are not conducted; The application is only possible under the supervision of a physician.

Cefepime is excreted in breast milk in very low concentrations. Use with caution during lactation.

In experimental studies, there was no effect on the reproductive function and fetotoxic effect of Cefepime.

Use in children

Safety and efficacy of cefepime in children under 2 months of age have not been established. For children older than 2 months (including infants), the application is possible according to the dosing regimen. Children with impaired renal function are recommended the same changes in the dosing regimen as adults, since the pharmacokinetics of cefepime in adults and children is similar.

special instructions

When used in patients who are at high risk of infection due to mixed aerobic / anaerobic microflora (including in cases where Bacteroides fragilis is one of the pathogens), it is recommended to prescribe simultaneously with Cefepim a drug active against anaerobes.

Use with caution in patients at risk of developing allergic reactions, especially on drugs.

With the development of allergic reactions, Cefepime should be discontinued.

Serious reactions of immediate type hypersensitivity may require the use of epinephrine (adrenaline) and other forms of maintenance treatment.

When diarrhea appears on the background of treatment, the possibility of developing pseudomembranous colitis should be considered. In such cases, Cefepime should be immediately discontinued and, if necessary, appropriate treatment.

With the development of superinfection, Cefepime should be immediately discontinued and appropriate treatment should be prescribed.

With the use of other antibiotics of the cephalosporin group, urticaria, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, colitis, renal dysfunction, toxic nephropathy, aplastic anemia, hemolytic anemia, hemorrhage, convulsions, impaired liver function including cholestasis, false positive test results on glucose of urine.

With particular caution apply Cefepime together with aminoglycosides and looped diuretics.

Drug Interactions

With the simultaneous administration of Cefepime solution with solutions of metronidazole, vancomycin, gentamicin, tobramycin sulfate and netilmicin sulfate, a pharmaceutical interaction is possible.

Analogues of the drug Cefepime

Structural analogs for the active substance:

• Cefepime;
• Ladef;
• Maksipim;
• Maksitsef;
• Movizar;
• We chain;
• Cefepime with arginine;
• Cefepim Agio;
• Cefepim Alkem;
• Cefepim Vial;
• Cephepim Jodas;
• Cefepime hydrochloride;
• Cefomax;
• Etipim.

Analogues on the pharmacological group (antibiotics of cephalosporins):

• Azaran;
• Aksetin;
• Axon;
• Alfacet;
• Anceph;
• Biotrakson;
• Witsef;
• Duracif;
• Zefter;
• Zinnat;
• Zolin;
• Intrazoline;
• Iphizol;
• Ketoceph;
• Kefadim;
• Kefzol;
• Claforan;
• Lysolin;
• Longacef;
• Maksipim;
• Maksitsef;
• Medaxone;
• Nacef;
• Opexin;
• Panzef;
• Rocefin;
• Soleksin;
• Sulperazone;
• Supraks;
• Tertsef;
• Triacsone;
• Forcef;
• Tzedek;
• Cefazolin;
• Cephalexin;
• Cefamandol;
• Cefaprim;
• Cephezole;
• Cefoxytin;
• Cefoperazone;
• Ceforal Solutab;
• Cefosin;
• Cefotaxime;
• Cefpar;
• Ceftazidime;
• Ceftriabal;
• Ceftriaxone;
• Cefurabol;
• Cefuroxime;
• Etipim.

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