cefepime cefepime cefepime is a fourth-generation cephalosporin antibiotic. cefepime has an extended spectrum of activity against gram-positive and gram-negative bacteria, with greater activity against both types of organism than third-generation agents. a 2007 meta-analysis suggested when data of trials were combined, mortality was increased in people treated with cefepime compared with other β-lactam antibiotics. in response, the u.s. food and drug administration (fda) performed their own meta-analysis which found no mortality difference. cefepimeclinical datapronunciation/ˈsɛfɪpiːm/ or /ˈkɛfɪpiːm/ trade namesmaxipime, vocoahfs/drugs.commonographmedlineplusa698021pregnancycategory au: b1 routes ofadministrationintravenous, intramuscularatc codej01de01 (who) legal statuslegal status au: s4 (prescription only) ca: ℞-only uk: pom (prescription only) us: ℞-only pharmacokinetic databioavailability100% (im)metabolismhepatic 15%elimination half-life2 hoursexcretionrenal 70–99%identifiers iupac name (6r,7r,z)-7-(2-(2-aminothiazol-4-yl)-2-(methoxyimino)acetamido)-3-((1-methylpyrrolidinium-1-yl)methyl)-8-oxo-5-thia-1-aza-bicyclooct-2-ene-2-carboxylate cas number88040-23-7 ypubchem cid5479537drugbankdb01413 ychemspider4586395 yunii807pw4vqe3keggd02376 ychebichebi:478164 ychemblchembl186 ycomptox dashboard (epa)dtxsid70873208 echa infocard100.171.025 chemical and physical dataformulac19h24n6o5s2molar mass480.56 g·mol−13d model (jsmol)interactive imagemelting point150 °c (302 °f) (dec.) smiles o=c2n1/c(=c(\cs12nc(=o)c(=n\oc)/c3nc(sc3)n)c4(c)cccc4)c()=o inchi inchi=1s/c19h24n6o5s2/c1-25(5-3-4-6-25)7-10-8-31-17-13(16(27)24(17)14(10)18(28)29)22-15(26)12(23-30-2)11-9-32-19(20)21-11/h9,13,17h,3-8h2,1-2h3,(h3-,20,21,22,26,28,29)/b23-12-/t13-,17-/m1/s1 ykey:hvflcnvbzffhbt-zkdacbomsa-n y (verify) cefepime was patented in 1982 by bristol-myers squibb and approved for medical use in 1994. it is available as a generic drug and sold under a variety of trade names worldwide. it was removed from the world health organization's list of essential medicines in 2019. medical use cefepime is usually reserved to treat moderate to severe nosocomial pneumonia, infections caused by multiple drug-resistant microorganisms (e.g. pseudomonas aeruginosa) and empirical treatment of febrile neutropenia. cefepime has good activity against important pathogens including pseudomonas aeruginosa, staphylococcus aureus, and multiple drug-resistant streptococcus pneumoniae. a particular strength is its activity against enterobacteriaceae. whereas other cephalosporins are degraded by many plasmid- and chromosome-mediated beta-lactamases, cefepime is stable and is a front-line agent when infection with enterobacteriaceae is known or suspected. spectrum of bacterial susceptibility cefepime is a broad-spectrum cephalosporin antibiotic and has been used to treat bacteria responsible for causing pneumonia and infections of the skin and urinary tract. some of these bacteria include pseudomonas, escherichia, and streptococcus species. the following represents mic susceptibility data for a few medically significant microorganisms: escherichia coli: ≤0.007 – 128 μg/ml pseudomonas aeruginosa: 0.06 – >256 μg/ml streptococcus pneumoniae: ≤0.007 – >8 μg/ml chemistry the combination of the syn-configuration of the methoxy imino moiety and the aminothiazole moiety confers extra stability to β-lactamase enzymes produced by many bacteria. the n-methyl pyrrolidine moiety increases penetration into gram-negative bacteria. these factors increase the activity of cefepime against otherwise resistant organisms including pseudomonas aeruginosa and staphylococcus aureus. trade names following expiration of the bristol-myers squibb patent, cefepime became available as a generic and is now marketed by numerous companies worldwide under tradenames including neopime (neomed), maxipime, cepimax, cepimex, and axepim.