Cefepima: what it is and how it acts

Cefepime is a β-lactam antibiotic belonging to the family of fourth-generation cephalosporins . Bactericide, its antimicrobial capacity is determined by the inhibition of the synthesis of the bacterial wall, which causes the destruction of the microorganism.

What do we mean by β-lactam antibiotics?

Within this category Two families of widely known drugs are included such as penicillins and cephalosporins.

Penicillins

Penicillins
Often associated with other drugs, penicillins they are the most used antibiotics since their discovery in 1928 . Its mechanism of action is to interfere with the peptidoglycan synthesis of the bacterial cell wall by binding to penicillin-binding proteins ( known vulgarly as PBPs ).

Cephalosporins

Cephalosporins are β-lactam antibiotics that were first obtained from fungi. Its mechanism of action is equal to that of penicillins and inhibit the synthesis of peptidoglycan that forms the bacterial cell wall .
The cephalosporins they have a higher activity against Gram negative bacteria than penicillins. This activity also varies within the family itself as there are several generations of cephalosporins:
  • First generation cephalosporins . With a short spectrum, its activity is restricted mainly to species of Escherichia coli Y Klebsiella , among others. They are used to treat skin infections and endocarditis.
  • Second generation cephalosporins . Its spectrum is a bit bigger than the previous ones, being useful in front of Haemophilus influenzae and species of Enterobacter , Citrobacter Y Serratia .
  • Third and fourth generation cephalosporins . In the case of these are already considered broad spectrum and it is in this category that we find the cefepima, which has activity against Gram positive cocci and Gram negative bacilli as P. aeruginosa , K. pneumoniae and many enterobacteria.

Cefepime, a very versatile cephalosporin

Cefepime, a very versatile cephalosporin

Cefepima, discovered in 1994, It is used to treat numerous infections. It is important to take into account the sensitivity of microorganisms, which can vary depending on where we are and the strain referred to.

The variation of the microbial sensitivity to cefepime is due to the presence of β-lactamases, which are one of the most important defense mechanisms currently generated by bacterial strains and are a limitation for the administration of certain antibiotics.

To avoid the appearance of resistances it is vital to use antibiotics only when needed and always under medical prescription. In addition, the prescribed dosage should always be met, not leaving the treatment half-hearted even if there is already an improvement in the patient.

The duration of treatment usually varies depending on the patient and its evolution. It is usually from one week to ten days, and a longer treatment may be necessary on certain occasions. Some of the main infections What can be treated with cefepime are the following:

  • Sepsis
  • Pneumonia and bronchitis.
  • Meningitis.
  • Infections of the urinary and biliary tract.
  • Sinusitis.
  • Abdominal infections Cefepime is usually combined with metronidazole.

It is often of intrahospital use. Its distribution in the organism is extensive, eliminating itself from the organism through the kidneys. This causes us to adjust the posology in patients with renal insufficiency.

Visit this article: Treatment of chronic renal failure

Adverse effects of cefepime

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Before the administration of cefepime hypersensitivity reactions may appear , being possible that there is cross sensitivity with penicillins. In addition to these, the appearance of the following adverse effects is common:

  • Nephrotoxicity .
  • Alcohol intolerance .
  • Diarrhea . It is often due to two causes, the damage that antibiotics do to the intestinal flora and the proliferation of Clostridium difficile, microorganism causing the so-called pseudomembranous colitis.
  • Leukopenia and thrombocytopenia. Decrease in the number of white blood cells and platelets.

On the other hand, cephalosporins do not seem to be contraindicated in pregnancy, although they do accumulate in breast milk, so its administration is not recommended during lactation.