Formulary
Cefepime: Indications, Dosing, Side Effects and Interactions
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
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Cefepime: Indications, Dosing, Side Effects and Interactions
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
Drug action
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
Indications and dose
**Infections due to sensitive Gram-positive and Gram-negative bacteria**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion, Or By Intramuscular Injection): (body-weight up to 41 kg) 50 mg/kg every 12 hours (max. per dose 2 g), increased if necessary to 50 mg/kg every 8 hours (max. per dose 2 g), increased dose used for severe infections, intravenous route preferred in severe infections.
**Mild to moderate urinary tract infections**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion, Or By Intramuscular Injection): (body-weight 41 kg and above) 0.5-1 g every 12 hours.
**Mild to moderate infections due to sensitive Gram-positive and Gram-negative bacteria**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion, Or By Intramuscular Injection): (body-weight 41 kg and above) 1 g every 12 hours.
**Severe infections due to sensitive Gram-positive and Gram-negative bacteria**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): (body-weight 41 kg and above) 2 g every 12 hours, increased if necessary to 2 g every 8 hours, increased dose used for very severe infections.
**Infections due to sensitive Gram-positive and Gram-negative bacteria for cefepime**
- **Child 1 month** (By intravenous injection, or by intravenous infusion, or by intramuscular injection): 30 mg/kg every 8-12 hours, experience in children aged less than 2 months is limited-consult product literature; intravenous route preferred in severe infections.
- **Child 2 months-17 years (body-weight up to 41 kg)** (By intravenous injection, or by intravenous infusion, or by intramuscular injection): 50 mg/kg every 12 hours (max. per dose 2 g), increased if necessary to 50 mg/kg every 8 hours (max. per dose 2 g), increased dose used for severe infections, experience of intramuscular use is limited; intravenous route preferred in severe infections.
**Mild to moderate urinary tract infections for cefepime**
- **Child (body-weight 41 kg and above)** (By intravenous injection, or by intravenous infusion, or by intramuscular injection): 0.5-1 g every 12 hours, experience of intramuscular use is limited.
**Mild to moderate infections due to sensitive Gram-positive and Gram-negative bacteria for cefepime**
- **Child (body-weight 41 kg and above)** (By intravenous injection, or by intravenous infusion, or by intramuscular injection): 1 g every 12 hours, experience of intramuscular use is limited.
**Severe infections due to sensitive Gram-positive and Gram-negative bacteria for cefepime**
- **Child (body-weight 41 kg and above)** (By intravenous injection, or by intravenous infusion): 2 g every 12 hours, increased if necessary to 2 g every 8 hours, increased dose used for very severe infections.
Side effects
Common or very common Abdominal pain; diarrhoea; dizziness; eosinophilia; headache; leucopenia; nausea; neutropenia; pseudomembranous enterocolitis; skin reactions; thrombocytopenia; vomiting Uncommon Anaphylactic reaction; angioedema Rare or very rare Agranulocytosis; haemolytic anaemia; nephritis tubulointerstitial (reversible); severe cutaneous adverse reactions (SCARs) Side-effects For cefepime Common or very common Anaemia Uncommon Gastrointestinal disorders; increased risk of infection Rare or very rare Constipation; dyspnoea; genital pruritus; paraesthesia; seizure; taste altered; vasodilation Frequency not known Anaphylactic shock; antibiotic associated colitis; aplastic anaemia; Clostridioides difficile colitis; coma; confusion; consciousness impaired; encephalopathy; haemorrhage; hallucination; myoclonus; nephrotoxicity; renal failure
Pregnancy
Manufacturer advises caution-no data available but not known to be harmful in animal studies.
Breast feeding
Manufacturer advises caution-present in milk in very low quantities.
Renal impairment
Manufacturer advises use with caution. Dose adjustments Manufacturer advises reduce dose-consult product literature.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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