Intravenous, intramuscular (only with complicated or uncomplicated urinary tract infections of mild and moderate severity caused by Escherichia coli).
Doses and the route of administration of the drug vary depending on the sensitivity of the microorganisms, the severity of the infection, and the state of kidney function in the patient.
Pneumonia (moderate to severe), caused by Streptococcus pneumoniae (including cases of association 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 to moderate severitycaused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis: in / in or / m (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: in / in 2 g every 12 hours for 10 days.
Severe and severe skin and soft tissue infectionscaused 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.
To prevent infection during surgical interventions on the abdominal organs: 60 minutes before the start of surgery, 2 g of the drug intravenously administered 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.
In children older than 2 months. and with a body weight of up to 40 kg, the recommended dosing regimen for all indications (excluding febrile neutropenia) is 50 mg / kg every 12 hours IV; with 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 patients with impaired renal function, the dose of the drug should be adjusted. The initial dose of cefepime should be the same as for patients with normal renal function.
| Clearance creatinine (ml / min) | Recommended maintenance doses |
| more than 60 | 500 mg every 12h | 1 g every 12 h | 2 g every 12 h | 2 g every 8 hours |
| 30-60 | 500 mg every 24 hours | 1 g every 24 h | 2 g every 24 h | 2 g every 12 h |
| 11-29 | 500 mg every 24 hours | 500 mg every 24 hours | 1 g every 24 h | 2 g every 24 h |
| less than 11 | 250 mg every 24 hours | 250 mg every 24 hours | 500 mg every 24 hours | 1 g every 24 h |
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 insufficiency are not available, however, given the similar pharmacokinetics in children and adults, the dosage 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% sodium chloride solution, 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 benzyl alcohol, in 0.5% and 1% lidocaine hydrochloride solution (1.0 g - 2.4 ml).