Intravenously struined for 3-5 minutes or infuzionno for at least 30 minutes; intramuscularly (only with complicated or uncomplicated urinary tract infections of mild and moderate severity caused by Escherichia coli). The dose and route of administration vary depending on the sensitivity of the microorganisms, the type and severity of the infection, and the state of kidney function in the patient.
Pneumonia (medium and heavy) caused by Streptococcus pneumoniae (including cases of association with concomitant bacteremia), Pseudomonas aeruginosathe Klebsiella pneumoniae or Enterobacter spp:. intravenously 1-2 g every 12 h for 10 days.
Febrile neutropenia (empirical therapy): intravenously 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 Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis; intravenously or intramuscularly (only for infections caused by Escherichia coli) for 0.5-1 g every 12 hours for 7-10 days.
Severe complicated or uncomplicated urinary tract infections
(including pyelonephritis) caused by Escherichia coli or Klebsiella pneumoniae: intravenously 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: intravenously 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: intravenously 2 g every 12 h for 7-10 days.
In children from 2 months to 16 years and with a body weight of up to 40 kg the recommended dosage regimen for all indications (excluding febrile neutropenia) is 50 mg / kg every 12 hours intravenously; with febrile neutropenia - 50 mg / kg every 8 hours intravenously. Duration of treatment - as in adults.The maximum dose should not exceed the recommended dose for adults.
In chronic renal failure (CRF), the dose is prescribed depending on the severity of infection and the clearance of creatinine (CC). Recommended doses of cefepime and the intervals of administration are given in the table:
| Creatinine clearance ml / min | Recommended doses and intervals of administration |
| >60 | 2 g every 8 hours | 2 g every 12 h | 1 g every 12 h | 500 mg every 12 hours |
| 30-60 | 2 g every 12 h | 2 g every 24 h | 1 g every 24 h | 500 mg every 24 hours |
| 11-29 | 2 g every 24 h | 1 g every 24 h | 500 mg every 24 hours | 500 mg every 24 hours |
| <11 | 1 g every 24 h | 500 mg every 24 hours | 250 mg every 24 hours | 250 mg every 24 hours |
In patients who are on permanent ambulatory peritoneal dialysis, cefepime can be used at the usual recommended doses, i.e. 500 mg, 1 g or 2. g, depending on the severity of the infection, the interval between injections is 48 hours.
Patients who are on hemodialysis, in the 1 st day is administered 1 g, followed by 0.5 g every 24 hours for the treatment of 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 (cefepime it is advisable to enter every day at the same time).
Data on the use of the drug in children with concomitant renal failure are not available, however, given the similarity of pharmacokinetics in children and adults,dosing regimen (dose reduction or increase in the interval between injections) in children with CRF is similar to the dosing regimen in adults.
For intravenous administration cefepime are dissolved in 10 ml of sterile water for injection, 5% dextrose solution or 0.9% sodium chloride solution as indicated in the table below and administered for 3-5 minutes.
When infusion through the system, the prepared solution is combined with other solutions for intravenous infusions and injected for 30 minutes. Drug solutions Cefepim in a concentration of 1 to 40 mg / ml are compatible with the following solutions for parenteral administration:
- 0.9% solution of sodium chloride for injection,
- 5% or 10% dextrose solution for infusion,
- Ringer's solution with sodium lactate for injection.
For intramuscular injection cefepime are dissolved in sterile water for injection with paraben or benzyl alcohol, in a 1% solution of lidocaine hydrochloride, as indicated in the table below.
Preparation of Cefepime solution for parenteral administration:
| The dose of cefepime | The volume of the solution for | Approximate | Approximate |
| | dilution (ml) | the volume of | concentration |
| | | solution (ml) | cefepime (mg / ml) |
| Intravenous administration |
| 1 g | 10 | 11,3 | 100 |
| Intramuscular injection |
| 1 g | 2,4 | 3,6 | 280 |