cefepime
Cefepime (also known by its brand name, Maxipime) is an antibiotic that treats a wide range of bacterial infections, including pneumonia, skin infections, stomach infections, and urinary tract infections (UTIs). It belongs to the cephalosporin drug class (fourth generation). Cefepime (Maxipime) is typically given as an injection through the veins (intravenous or IV). It can also be given as an injection into the muscle for certain UTIs. Your provider will decide on the dose depending on the type and severity of the infection and your kidney health. Some side effects include reactions at the injection site, like pain and inflammation.
What is Cefepime (Maxipime)?
What is Cefepime (Maxipime) used for?
Pneumonia
Skin infections (e.g., cellulitis)
Stomach infections - add-on therapy to metronidazole (Flagyl)
Treatment of possible infections in people with febrile neutropenia
How Cefepime (Maxipime) works
Cefepime (Maxipime) is a cephalosporin antibiotic. It kills bacteria by preventing them from making a covering around themselves for protection.
Drug Facts
What are the side effects of Cefepime (Maxipime)?
Common Side Effects
- Side effects aren't common. See Other Side Effects.
Other Side Effects
- Inflammation at or near the injection site
- Pain at injection site
- Rash
- Itching
- Hives
- Nausea
- Diarrhea
- Headache
- Fever
Serious Side Effects
- Serious allergic reaction: hives, rash, blisters, skin reddening, swelling of the lips or tongue, difficulty breathing
- Nervous system side effects: hallucinations (seeing or hearing things that aren't real), seizures, sudden and brief involuntary movements or twitching, not able to speak, confusion
- C. difficile-related diarrhea: foul-smelling diarrhea, frequent bowel movements (up to 15 times per day), fever, stomach pain or cramps
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Abdominal or stomach cramps
back, leg, or stomach pains
bleeding gums, nosebleeds
confusion
convulsions
dark urine
difficulty with breathing
fever, chills
general body swelling
headache
irregular heartbeats
loss of appetite
mood or mental changes
muscle cramps in the hands, arms, feet, legs, or face
nausea or vomiting
numbness and tingling around the mouth, fingertips, or feet
yellowing of the eyes or skin
Incidence not known
Agitation
blistering, peeling, or loosening of the skin
bloody or cloudy urine
bloody, black, or tarry stools
blurred vision
change in consciousness
cough or hoarseness
difficult or painful urination
difficulty with swallowing
dizziness
fast heartbeat
general feeling of tiredness or weakness
muscle twitching or jerking
paralysis
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
rhythmic movement of the muscles
seeing, hearing, or feeling things that are not there
seizures
severe sleepiness
stiff neck
sudden decrease in the amount of urine
swollen or painful glands
unpleasant breath odor
unusual bleeding or bruising
vomiting of blood
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Cefepime (Maxipime)
Pros
Covers many types of bacteria
Can treat some infections caused by certain resistant bacteria
Gets into the body quickly to start treating infections
Can use in children as young as 2 months of age
Cons
Must be given as an injection into the veins (or into the muscle for certain UTIs)
Might need to be given as often as every 8 hours
Can cause nervous system side effects
Might not be the best choice if you've had an allergic reaction to penicillins or other cephalosporin antibiotics
Pharmacist tips for Cefepime (Maxipime)
Make sure your provider know about all the medications you take (especially water pills or diuretics) before starting cefepime (Maxipime). You might need to have your kidney function monitored more closely. Taking cefepime (Maxipime) and diuretics at the same time might harm your kidney.
Cefepime (Maxipime) can cause diarrhea. In general, it should go away when you stop taking the antibiotic. But get medical help as soon as possible if you start having watery or bloody diarrhea, fever, fatigue, or stomach cramps anytime during treatment or after stopping cefepime (Maxipime). These can be signs of infectious diarrhea that can be serious and needs to be treated right away.
Seek medical help right away if you or your loved ones notice any changes in your behavior, such as confusion, hallucinations (seeing things that are not real), and trouble speaking. These could be signs of nervous system side effects from cefepime (Maxipime).
Contact your provider if you develop other symptoms of an illness or if your symptoms become worse. Cefepime (Maxipime) can only treat infections caused by bacteria, so it won't help if you have an infection caused by a virus or fungus.
Tips for using cefepime (Maxipime) at home (if instructed by your provider):
If you need treatment with cefepime (Maxipime) for a long time, it's possible that your provider might let you take the medication at home. If so, make sure to follow your provider's instructions carefully so you use cefepime (Maxipime) properly and safely. Your provider might instruct you to use vials of the medication that need to be mixed and prepared or premixed bags that are ready to use.
If you're using cefepime (Maxipime) at home for long-term treatment, make sure to set a reminder of when your doses are due. It's important to get all of your doses of cefepime (Maxipime) and finish your treatment course, even if you feel better. Otherwise, your infection might get worse or become harder to treat.
Mark your scheduled provider visits and blood work appointments on your calendar. This will help your provider make sure that cefepime (Maxipime) is treating your infection and that it's as safe as possible for you.
Frequently asked questions about Cefepime (Maxipime)
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What are the risks and warnings for Cefepime (Maxipime)?
Cefepime (Maxipime) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reactions
Risk factors: Allergy to penicillins or other cephalosporin antibiotics
Allergic reactions to cefepime (Maxipime) are possible. These can include life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Let your provider know if you have an allergy to antibiotics. If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after treatment with cefepime (Maxipime), get medical attention right away.
Nervous system side effects
Risk factors: Not adjusting the cefepime (Maxipime) dose in people with kidney problems
Although rare, some people treated with cefepime (Maxipime) reported serious nervous system side effects, such as hallucinations (seeing or hearing things that aren't real), seizures, sudden and brief involuntary movements or twitching, trouble speaking, and confusion. While these side effects can happen to anyone, people with kidney problems are at higher risk, especially if their cefepime (Maxipime) dose isn't appropriately adjusted. Call 911 or call the nurse if you or your loved ones notice any of these side effects. They usually go away after stopping the medication.
Diarrhea from Clostridioides difficile infection
Antibiotics, including cefepime (Maxipime), raise your risk of getting infected with a bacteria called Clostridioides difficile (C. diff). This infection can cause diarrhea that can sometimes be life-threatening. Antibiotics change the amount of normal bacteria in your stomach and intestines. This can cause C. diff to overgrow in your gut and lead to an infection. This type of infectious diarrhea is different than diarrhea as a possible side effect of cefepime (Maxipime). C. diff-related diarrhea can cause rapid heart rate, foul-smelling diarrhea, fever, nausea, frequent bowel movements (even up to 15 times per day), or bloody stools and is an emergency. If you experience any of these symptoms, get medical attention right away so you can be tested for C. diff infection and receive treatment.
Development of drug-resistant bacteria
Your provider will monitor your treatment with cefepime (Maxipime) to make sure you're taking the antibiotic for the appropriate infection and amount of time. Using cefepime (Maxipime) for any shorter or longer periods of time or taking the antibiotic for other illnesses can raise your risk for developing infections caused by drug-resistant bacteria. This raises your risk for severe and life-threatening infections that might be difficult to treat.
Cefepime (Maxipime) dosage forms
Typical dosing for Cefepime (Maxipime)
The dose and length of treatment depends on what type of infection you have, how serious it is, and whether you have kidney problems. Your provider will determine the right dose and length of treatment for you.
Cefepime (Maxipime) is typically given as an injection into the veins (intravenous or IV) by a provider in a healthcare setting (e.g., hospital, office, nursing home). It can also be given as an injection into the muscle for mild-to-moderate UTIs.
Age 16 years and older who weigh at least 40 kg (88 lbs): The typical dose ranges from 0.5 to 2 grams every 8 to 12 hours for 7 to 10 days.
Age 2 months to under 16 years who weigh less than 40 kg (88 lbs): The typical dose is 50 mg/kg of body weight every 8 to 12 hours for 7 to 10 days.
Interactions between Cefepime (Maxipime) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Cefepime (Maxipime) contraindications
Allergy to penicillins or cephalosporin antibiotics
What are alternatives to Cefepime (Maxipime)?
Pneumonia
Skin infections (e.g., cellulitis)
Stomach infections - add-on therapy to metronidazole (Flagyl)
Treatment of possible infections in people with febrile neutropenia
Serious skin infections
Serious stomach infections
Meningitis in children
Stomach infection in people ages 2 months and older
Pneumonia in people ages 2 months and older
Skin infection (e.g., cellulitis, foot infection due to diabetes) in adults
Pelvic infection in adult females
Cefepime (Maxipime) images
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References
Best studies we foundApotex Corp. (2021). Cefepime- cefepime injection, powder, for solution [package insert]. DailyMed.
Apotex Corp. (2023). Cefepime injection, powder, for solution [package insert]. DailyMed.
B. Braun Medical Inc. (2022). Cefepime hydrochloride and dextrose- cefepime hydrochloride injection, solution [package insert]. DailyMed.
Bush, L. M. (2022). Overview of Gram-negative bacteria. Merck Manual Consumer Version.
Bush, L. M. (2022). Pseudomonas infections. Merck Manual Consumer Version.
Bush, L. M. (2023). Overview of Gram-positive bacteria. Merck Manual Consumer Version.
Bush, L. M., et al. (2023). Overview of anaerobic bacteria. Merck Manual Professional Version.
Centers for Disease Control and Prevention. (2010). Klebsiella pneumoniae in healthcare settings.
Centers for Disease Control and Prevention. (2019). Pseudomonas aeruginosa in healthcare settings.
Centers for Disease Control and Prevention. (2022). Streptococcus pneumoniae.
Centers for Disease Control and Prevention. (2024). E. coli (Escherichia coli).
Chaudhry, S. B., et al. (2019). Cephalosporins: A focus on side chains and β-lactam cross-reactivity. Pharmacy.
Infectious Diseases Society of America. (2023). IDSA 2023 guidance on the treatment of antimicrobial resistant gram-negative infections.
Lopez, N., et al. (2011). A comprehensive review of abdominal infections. World Journal of Emergency Surgery.
Norris, A. H., et al. (2018). 2018 Infectious Diseases Society of America clinical practice guideline for the management of outpatient parenteral antimicrobial therapy. Clinical Infectious Diseases.
Pais, G. M., et al. (2022). Clinical pharmacokinetics and pharmacodynamics of cefepime. Clinical Pharmacokinetics.
Patel, K., et al. (2017). Febrile neutropenia. Journal of the American Medical Association Oncology.
Payne, L. E., et al. (2017). Cefepime-induced neurotoxicity: A systematic review. Critical Care.
Saini, T., et al. (2021). Cefepime-induced neurotoxicity. Cureus.
Tam, V. H., et al. (2003). Pharmacokinetics and pharmacodynamics of cefepime in patients with various degrees of renal function. Antimicrobial Agents and Chemotherapy.
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