Intravenously (IV) infusion (for at least 30 minutes) or intramuscularly (IM) (only with complicated or uncomplicated urinary tract infections of mild and moderate severity caused by E. coli).
Pneumonia (moderate to severe) caused by Streptococcus pneumoniae (including with concomitant bacteremia), 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.
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., Bacteroides fragilis: in / in 2 g every 12 hours for 7-10 days.
To prevent infection during surgical interventions on the abdominal organs: 60 minutes before the start of the surgical operation, 2 g of the drug is injected 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 with followed by administration of 500 mg of metronidazole.
In children from 2 months and with body weight up to 40 kg recommended dosing regimen for all indications (excluding febrile neutropenia) - 50 mg / kg every 12 h in / in; with febrile neutropenia - 50 mg / kg every 8 h. Duration of treatment as in adults. The maximum dose for children should not exceed the recommended dose for adults.
Have patients with impaired renal function (creatinine clearance [CK] <30 ml / min), the dose of the drug should be adjusted. The initial dose of cefepime should be the same as for patients with normal renal function. The recommended maintenance doses of the drug are shown in the table.
| Creatinine clearance (CK) (ml / min) | Recommended maintenance doses |
|
| >50 | 2 g every 8 hours (usual dose, | 2 g every 12 hours (usual dose, | 1 g every 12 hours (usual dose, | 500 mg every 12 hours (normal |
|
|
| adjustment is not required) | adjustment is not required) | adjustment is not required) | dose, adjustment is not required) |
| 30-50 | 2 g every 8 hours | 2 g every 12 h | 1 g every 12 h | 500 mg every 12 hours |
| 11-29 | 1 g every 12 h | 1 g every 24 h | 500 mg every 24 hours | 500 mg every 24 hours |
| <10 | 1 g every 24 h | 500 mg every 24 hours | 250 mg every 24 hours | 250 mg every 24 hours |
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Patients on hemodialysis, on the 1st day, 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 (CRF) However, given the similarity of pharmacokinetics in children and adults, the dosage regimen (dose reduction or increase in the interval between administrations) in children with CRF is similar to the dosing regimen in adults.
To prepare a solution for intravenous administration the preparation is dissolved in 10 ml (1.0 g) of sterile water for injection, 5% dextrose solution or 0.9% sodium chloride solution. Intravenously injected intravenously 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 lactate solution and 5% dextrose solution, maximum concentration 40 mg / ml) and injected within less than 30 minutes.
For the preparation of solution for the / m introduction the drug is dissolved in sterile water for injection, 0.9% solution of sodium chloride, bacteriostatic water for injection with paraben or benzyl alcohol, in 0.5% and 1% solution of lidocaine hydrochloride (1.0 g in 2.4 ml).