Indication

Moderate to severe Pneumonia caused by Pseudomonas aeruginosa, Klebsielia pneumoniae, Streptococcus pneumoniae and other gram negative organisms. Empiric monotherapy for Febrile Neutropenia; Treatment of uncomplicated and complicated Urinary tract infections, including pyelonephritis caused by typical urinary tract pathogens (Escherichia coli, Klebsielia pneumoniae, Proteus mirabilis). Uncomplicated skin and skin structure infections caused by Staphylococcus aureus or Streptococcus pyogenes. It is also used for Intra-abdominal infections with metronidazole and also active against methicillin-susceptible staphylococci and many other gram-negative bacilli.


Dosage & Administration

Children Febrile neutropenia: 50 mg/kg every 8 hours for 7-10 days. Uncomplicated skin/soft tissue infections, pneumonia and complicated/uncomplicated UTI: 50 mg/kg twice daily. Adults Most infections: 1-2 gm every 12 hours for 5-10 days; higher doses or more frequent administration may be required in Pseudomonal infections. Dosing adjustment in renal impairment Adults Recommended maintenance schedule based on creatinine clearance (mL/minute), compared to normal dosing schedule. Hemodialysis Removed by dialysis; administer supplemental dose of 250 mg after each dialysis session. Peritoneal dialysis Removed to a lesser extent than hemodialysis; administer 250 mg every 48 hours. Continuous arteriovenous or venovenous hemofiltration Dose as normal Clcr (eg, >30 mL/minute) Recommended Dosage schedule for Cefa-4TM

Site and Type of InfectionDoseFrequencyDuration(Days)
Moderate to Severe Pneumonia due
to S.Pneumoniae,P.aeruginosa, K.
Pneumoniae, or Enterobacter species
1-2 g IVq 12 h10
Emperic therapy for febrile
neutropenic Patients
2 g IVq 8 h7
Mild to Moderate Uncomplicated or
complicated UTI, including
pyelonephritis, due to E.coli, K.
Pneumoniae, or P.mirabilis
500 mg-1 gq 12 h7-10
Severe Uncomplicated or
complicated UTI, including
pyelonephritis, due to E.coli, K.
Pneumoniae,
2 g IVq 12 h10
Moderate to Severe Uncomplicated
Skin and Skin Structure Infections
due to S.aureus or S.pyogenes
2 g IVq 12 h10
Complicated Intra-abdominal
Infections (used in combination with
metronidazole) caused by E.coli,
virindans group streptococci, P.
aeruginosa, K.pneumoniae,
Enterobacter species or B.fragilis.
2 g IVq 12 h7-10

Reonstitution:

Single Dose VialsAmmount of diluents to be added (ml)
500 mg IV5.0
500 mg IM1.3
1 g IV10.0
1 g IM2.4
2 g IV10.0
Cefa-4 is compatible at concentrations between 1 and 40 mg/ml with the following IV infusion fluids : 1) 0.9% Sodium Chloride 2) 5% and 10% Dextrose


Precautions

As like other antimicrobials, prolonged use of cefepime may result in overgrowth of nonsusceptible microorganisms. Repeated evaluation of the patient\'s condition is essential.


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