Cefepime
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Cefepime
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| Systematic (IUPAC) name | |
| (6R,7R,Z)- 7-(2-(2-aminothiazol-4-yl)-2-(methoxyimino)acetamido)- 3-((1-methylpyrrolidinium-1-yl)methyl)-8-oxo-5-thia- 1-aza-bicyclo[4.2.0]oct-2-ene-2-carboxylate |
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| Identifiers | |
| CAS number | |
| ATC code | J01 |
| PubChem | |
| Chemical data | |
| Formula | C19H24N6O5S2 |
| Mol. mass | 480.56 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 100% (IM) |
| Metabolism | Hepatic 15% |
| Half life | 2 hours |
| Excretion | Renal 70–99% |
| Therapeutic considerations | |
| Pregnancy cat. |
B1 (Au) |
| Legal status |
S4 (Au) |
| Routes | Intravenous, intramuscular |
Cefepime (INN) (IPA: [ˈkɛfəpim, ˈsɛfə-]) is a fourth-generation cephalosporin antibiotic developed in 1994. Cefepime has an extended spectrum of activity against Gram-positive and Gram-negative bacteria, with greater activity against both Gram-negative and Gram-positive organisms than third-generation agents. Cefepime hydrochloride was first marketed in 1994 and is currently marketed under various trade names including Maxipime (Elan Pharma), Maxcef, Cepimax, Cepimex, and Axepim.
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[edit] Clinical use
Cefepime is usually reserved to treat severe nosocomial pneumonia, infections caused by multi-resistant microorganisms (e.g. Pseudomonas aeruginosa) and empirical treatment of febrile neutropenia.
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.
[edit] Chemistry
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 increases the activity of cefepime against otherwise resistant organisms including Pseudomonas aeruginosa and Staphylococcus aureus.
[edit] References
↑ Chapman TM, Perry CM. Cefepime: a review of its use in the management of hospitalized patients with pneumonia. Am J Respir Med. 2003;2(1):75-107. PMID 14720024
[edit] See also
[edit] External links
| Cephalosporin Antibiotics (J01D) | |
|---|---|
| First Generation | Cefacetrile, Cefadroxil, Cefalexin, Cefaloglycin, Cefalonium, Cefaloridine, Cefalotin, Cefapirin, Cefatrizine, Cefazaflur, Cefazedone, Cefazolin, Cefradine, Cefroxadine, Ceftezole |
| Second Generation | Cefaclor, Cefamandole, Cefonicid, Ceforanide, Cefotiam, Cefprozil, Cefuroxime, Cefuzonam |
| Third Generation | Cefcapene, Cefdaloxime, Cefdinir, Cefditoren, Cefetamet, Cefixime, Cefmenoxime, Cefodizime, Cefoperazone, Cefotaxime, Cefpimizole, Cefpiramide, Cefpodoxime, Cefsulodin, Ceftazidime, Cefteram, Ceftibuten, Ceftiofur, Ceftiolene, Ceftizoxime, Ceftriaxone, Latamoxef |
| Fourth Generation | Cefclidine, Cefepime, Cefetecol,Cefluprenam, Cefoselis, Cefozopran, Cefpirome, Cefquinome |
