IV infusion, (for at least 30 minutes) or IM (only with complicated or uncomplicated urinary tract infections of mild and moderate severity caused by E. coli).
Doses and the route of administration of the drug vary depending on the sensitivity of the microorganisms of the pathogens, the severity of the infection, and the state of kidney function in the patient.
Pneumonia (medically severe and severe), caused by Streptococcus pneumoniae (incl. cases of association with concomitant bacteraemia), Pseudomonas aeruginosa, Klebsiella pneumoniae or Enterobacter spp.: in / in 1-2 g every 12 hours for 10 days.
Febrile neutropenia (empirical therapy): iv 2 g every 8 hours for 7 days or until neutropenia is resolved.
Complicated or uncomplicated urinary tract infections of mild and moderate severity, caused by E. coli, Klebsiella pneumoniae, Proteus mirabilis: in / in or in / m (only for infections caused by E. coli) for 0.5-1 g every 12 hours for 7-10 days.
Severe complicated or uncomplicated urinary tract infections (including pyelonephritis) caused by E. coli or Klebsiella pneumoniae: in / in 2 g every 12 hours for 10 days.
Moderately severe and severe infections of the skin and soft tissues, caused by Staphylococcus aureus (only methicillin-sensitive strains), Streptococcus pyogenes: in / in 2 g every 12 hours for 10 days.
Complicated, intra-abdominal infections (in combination with metronidazole),
caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter spp.: in / in 2 g every 12 hours for 7-10 days.
For the prevention of infections in the conduct of cavitary surgery: 60 minutes before the start of the surgery, 2 g intravenously for 30 minutes. At the end of the infusion, add an additional 500 mg of metronidazole intravenously. Metronidazole solutions should not be administered concomitantly with cefepime. Infusion system before the introduction of metronidazole should be washed. During long (more than 12 hours) surgical operations 12 hours after the first dose, it is recommended to re-administer 2 g of the drug intravenously for 30 minutes, followed by the administration of 500 mg of metronidazole.
Children (over 2 months) and body weight up to 40 kg. the recommended dosing regimen for all indications (excluding ferro-neutropenia) is 50 mg / kg every 12 hours IV. For febrile neutropenia, 50 mg / kg every 8 hours. The maximum dose should not exceed the recommended dose for adults.Duration of treatment is 7-10 days. In chronic renal failure, the dose is prescribed depending on the severity of the infection and the clearance of creatinine (CC): more than 60 ml / min - 0.5-1-2 g every 12 hours or 2 g every 8 hours, KK 30-60 ml / min - 0.5, 1 g or 2 g every 24 hours or 2 g every 12 hours, with KK 11-29 ml / micron - 0.5-1-2 every 24 hours, less than 11 ml / min - 0.25-0 , 5-1 g every 24 hours.
Permanent ambulatory peritoneal dialysis - 0.5-1-2 g every 48 hours. Patients on hemodialysis on day 1 are given 1 g, then 0.5 g every 24 hours for all infections and 1 g every 24 hours for the treatment of febrile neutropenia . On the day of hemodialysis, the drug is administered after the end of the hemodialysis session; it is desirable to enter cefepime every day at the same time.
Data on the use of the drug in children with concomitant chronic renal failure are not available, however, given the similar pharmacokinetics in children and adults, the dosing regimen (dose reduction or increase in the interval between administrations) in children with chronic renal failure is similar to the dosing regimen in adults.
For intravenous administration, the drug is dissolved in 10 ml (1.0 g) of sterile water for injection, 5% dextrose solution or 0.9% solution of sodium chloride,injected for 3-5 minutes; for intravenous infusion, the prepared solution is combined with other solutions for intravenous infusions (0.9% sodium chloride solution, 5% or 10% dextrose solution, Ringer's solution with lactate and 5% dextrose solution, maximum concentration 40 mg / ml) and administered for not less than 30 minutes;
For intravenous administration, the drug is dissolved in sterile water for injection, 0.9% solution of sodium chloride, bacteriostatic water for injection with paraben or benzene alcohol, in 0.5% and 1% solution of lidocaine hydrochloride (0.5 g in 1, 3 ml, 1.0 g in 2.4 ml).