Indications
Xemimax IV/IM Injection is used for:
Skin and skin structure infections, Urinary tract infection, Nosocomial pneumonia, Multiple drug resistant pneumonia, Neutropenia
Adult Dose
Adult: IV UTI 0.5-1 g 12 hrly for 7-10 days.
Empirical therapy for febrile neutropenia 2 g 8 hrly for 7 days or until resolution of neutropenia.
Moderate to severe pneumonia 1-2 g 12 hrly for 10 days.
Complicated intra-abdominal infections 2 g 12 hrly for 7-10 days.
Uncomplicated skin and skin structure infections 2 g 12 hrly for 10 days.
Child Dose
Child: IV, IM 100 mg/kg/day q12h
150 mg/kg/day empiric therapy of fever with neutropenia q8h
2 mth - 16 yr: >40 kg: 50 mg/kg every 12 hr for 7-10 days for Uncomplicated and Complicated Urinary Tract Infections (including pyelonephritis),
Uncomplicated Skin and Skin Structure Infections and Pneumonia.. May be given via direct inj over 5 minutes or infuse over 30 minutes.
For empiric therapy for febrile neutropenic patients 2 mth - 16 yr: <40 kg: 50 mg/kg every 8 hr for 7 days or until neutropenia resolves.
Renal Dose
Renal impairment:
Haemodialysis: 1 g on the 1st day of treatment, followed by 0.5 g 24 hrly; dose should be given after haemodialysis on dialysis days and preferably at the same time each day.
CAPD: Adult dose 48 hrly.
CrCl (ml/min)
<10 0.25-0.5 g 24 hrly.
11-29 0.5-1 g 24 hrly.
30-60 0.5-2 g 24 hrly.
Administration
Reconstitution: IV infusion: Add 5 mL, 10 mL, or 10 mL of a compatible IV soln to a vial labeled as containing 500 mg, 1 g, or 2 g, respectively, to provide soln containing approx 100 mg/mL, 100 mg/mL, or 160 mg/mL of the drug, respectively. The appropriate dose of the drug should then be added to a compatible IV soln. IM inj: Add 1.3 mL or 2.4 mL of an appropriate diluent (e.g. sterile water for inj, NaCl 0.9%) to a vial labeled as containing 500 mg or 1 g respectively, to provide a soln containing approx 280 mg/mL.
IV Administration
Infuse intermittently over 30 minutes
IM Administration
Inject deeply
Give IM only in mild-to-moderate UTI due to E coli
Contra Indications
Hypersensitivity to cefepime or other cephalosporins.
Precautions
Renal impairment; history of penicillin or cephalosporin allergy; lactation, pregnancy. Caution when used in patients with history of GI diseases, especially colitis. May decrease prothrombin activity; monitor prothrombin time in patients with poor nutritional state, renal or hepatic impairment and those on prolonged treatment. Prolonged treatment may result in overgrowth of nonsusceptible organisms, resulting in superinfection. Consider the possibility of Clostridium difficile associated diarrhoea in patients who present with diarrhoea after treatment. Caution when used in patients with a history of seizures.
Lactation: Drug enters breast milk; use with caution
Pregnancy-Lactation
Pregnancy category: B
Lactation: Drug enters breast milk; use with caution
Interactions
Increased potential for nephrotoxicity and ototoxicity of aminoglycosides. Increased risk of nephrotoxicity w/ potent diuretics (e.g. furosemide).
Side Effects
Side effects of Cefepime :
>10%
Positive Coombs test result without hemolysis (16%)
1-10%
Rash (1-4%), Elevated alanine aminotransferase (3%), Hypophosphatemia (3%), Diarrhea (<3%), Eosinophilia (2%), Erythema at injection site (2%), Normal partial thromboplastin time (PTT) (2%), Nausea or vomiting (<2%), Fever (1%), Headache (1%), Pain (1%), Pruritus (1%)
<1%
Agranulocytosis, Anaphylactic shock, Anaphylaxis, Coma, Encephalopathy, Hallucinations, Leukopenia, Myoclonus, Neuromuscular excitability, Neutropenia, Seizures, Thrombocytopenia
Mode of Action
Cefepime is a 4th generation cephalosporin which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs).
Note
Xemimax 500 mg/vial IV/IM Injection generic name is Cefepime. Xemimax 500 mg/vial IV/IM Injection is manufactured by Pharmasia Ltd.Xemimax is availble in all over Bangladesh.
Mes BD drug index information on Xemimax IV/IM Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.