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Indications & Uses
Cefa-4 is indicated for:
Pharmacology
Cefepime Hydrochloride is a cephalosporin, and cephalosporins kill bacteria (they are bactericidal). They work in the same way as other beta-lactam antibiotics, such as the penicillins. They interfere with the making of the peptidoglycan layer in the bacterial cell wall. This layer keeps the cell wall strong and intact, and that matters most in Gram-positive organisms. The last step in building peptidoglycan is called transpeptidation, and it is carried out by enzymes known as penicillin binding proteins (PBPs), which are transpeptidases.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Cefepime should be given intravenously over about 30 minutes.
For moderate to severe pneumonia due to S. pneumoniae, P. aeruginosa, K. pneumoniae or Enterobacter species, the dose is 1 to 2 gm IV 12 hourly for 10 days. For empiric therapy in febrile neutropenic patients, give 2 gm IV 8 hourly for 7 days, or until the neutropenia resolves.
For mild to moderate uncomplicated or complicated urinary tract infections, including pyelonephritis, due to E. coli, K. pneumoniae or P. mirabilis, the dose is 0.5 to 1 gm IV/IM 12 hourly for 7 to 10 days. For severe uncomplicated or complicated urinary tract infections, including pyelonephritis, due to E. coli or K. pneumoniae, give 2 gm IV 12 hourly for 10 days.
For moderate to severe uncomplicated skin and skin structure infections due to S. aureus or S. pyogenes, the dose is 2 gm IV 12 hourly for 10 days. For complicated intra-abdominal infections caused by E. coli, viridans group streptococci, P. aeruginosa, K. pneumoniae, Enterobacter species or B. fragilis, give 2 gm IV 12 hourly for 7 to 10 days, and use it in combination with metronidazole.
A few notes go with these doses. The pneumonia and urinary tract infection doses also cover cases with concurrent bacteremia. If a patient's fever settles but the neutropenia continues for more than 7 days, the need for continued antimicrobial therapy should be re-evaluated frequently. The IM route is indicated only for mild to moderate, uncomplicated or complicated UTls due to E. coli, and only when IM is considered the more appropriate route of giving the drug.
Side Effects
Upset stomach is one of the commonest side effects of Cefepime Hydrochloride. Some people get nausea, vomiting, diarrhea or abdominal pain. These symptoms are usually mild and pass quickly, though they can be troublesome for some people. Taking the medicine with food may help reduce them.
Cautions & Contraindications
Warnings & Precautions
Giving Cefepime Hydrochloride when there is no proven or strongly suspected bacterial infection, and no preventive reason to use it, is unlikely to help the patient. It also raises the risk that drug-resistant bacteria will develop. As with other antimicrobials, using Cefepime Hydrochloride for a long time may allow non susceptible microorganisms to overgrow. The patient's condition needs to be checked again and again during treatment. Many cephalosporins, cefepime included, have been linked with a fall in prothrombin activity. Patients at risk are those with renal or hepatic impairment, those in a poor nutritional state, and those on a protracted course of antimicrobial therapy. Prothrombin time should be monitored in these patients. Cefepime Hydrochloride should be prescribed with caution in people who have a history of gastrointestinal disease, particularly colitis. Arginine has been shown to alter glucose metabolism and to raise serum potassium for a short time when given at 33 times the amount supplied by the maximum recommended human dose of Cefepime Hydrochloride. The effect of lower doses is not known at present.
Contraindications
Cefepime shouldn't be given to anyone who has had an immediate hypersensitivity reaction to cefepime itself. The same applies to people who have had such a reaction to other cephalosporin antibiotics, to penicillin, or to any other betalactum antibiotic.
Pregnancy & Breastfeeding
Cefepime is listed as Pregnancy Category B. Even so, there are no adequate and well-controlled studies of cefepime in pregnant women. Animal reproduction studies don't always predict how a human will respond, so the medicine should be used during pregnancy only if it is clearly needed.
Cefepime passes into human breast milk in very low concentrations (0.5 pg/ml). Caution should still be taken when cefepime is given to a nursing woman.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Pediatric use (2 months up to 16 years)
For children, the maximum dose of Cefepime Hydrochloride should not go above the recommended adult dose. The usual dose for children weighing up to 40 kg is 50 mg/kg/dose, given every 12 hours. This applies to uncomplicated and complicated urinary tract infections (including pyelonephritis), uncomplicated skin and skin structure infections, and pneumonia. For febrile neutropenic patients the dose is 50 mg/kg/dose, given every 8 hours. The durations are the same as given above.
Geriatric use
Serious adverse events have occurred in elderly patients with renal insufficiency who were given unadjusted doses of cefepime. Some of these were life-threatening or fatal: encephalopathy, myoclonus and seizures. Cefepime Hydrochloride is known to be substantially excreted by the kidney, so the risk of toxic reactions may be greater in patients with impaired renal function. Elderly patients are more likely to have decreased renal function, so care should be taken in choosing the dose, and renal function should be monitored.
Impaired hepatic function
No adjustment is necessary for patients with impaired hepatic function.
Impaired renal function
In patients with impaired renal function (creatinine clearance <60 ml/min), the dose of Cefepime Hydrochloride should be adjusted to make up for the slower rate of renal elimination.
Overdose
Anyone who receives an overdose of cefepime should be watched closely and given supportive treatment. If the patient has renal insufficiency, hemodialysis is recommended to help remove cefepime from the body. Peritoneal dialysis is not recommended for this. Accidental overdose has happened when large doses were given to patients with impaired renal function.
The symptoms of overdose include encephalopathy (a disturbance of consciousness, including confusion, hallucinations, stupor and coma), myoclonus, seizures and neuromuscular excitability.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Don't use Cefepime Hydrochloride after the expiry date. Keep it, like all medicines, out of the reach of children. It should be dispensed only on the prescription of a registered physician.
Drug Interactions
Common questions about Cefa-4 2 gm
What is Cefa-4 2 gm IV Injection?
Cefa-4 2 gm IV Injection is a medicine that contains Cefepime Hydrochloride. It is made by Popular Pharmaceuticals PLC. It belongs to the Fourth generation cephalosporins group of medicines.
What is Cefa-4 used for?
Cefa-4 is used for: Pneumonia, Skin and Soft Tissue Infection.
What are the side effects of Cefa-4?
Upset stomach is one of the commonest side effects of Cefepime Hydrochloride. Some people get nausea, vomiting, diarrhea or abdominal pain.
Can I take Cefa-4 during pregnancy or while breastfeeding?
Cefepime is listed as Pregnancy Category B. Even so, there are no adequate and well-controlled studies of cefepime in pregnant women. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Cefa-4?
Anyone who receives an overdose of cefepime should be watched closely and given supportive treatment. If the patient has renal insufficiency, hemodialysis is recommended to help remove cefepime from the body. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Cefa-4?
Don't use Cefepime Hydrochloride after the expiry date. Keep it, like all medicines, out of the reach of children.
Can I take other medicines with Cefa-4?
Some medicines can interact with Cefepime Hydrochloride, for example: Furosemide. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Cefa-4?
Cefa-4 is a prescription (Rx) medicine. Take it as your doctor advises.