Vetdrugs 2.0Cefepime is an injectable fourth-generation cephalosporin with activity against many susceptible gram-negative bacilli and gram-positive cocci. Veterinary use centers on serious infections requiring broad parenteral coverage, particularly in dogs and foals. Its gram-negative spectrum includes some Pseudomonas aeruginosa and Enterobacter isolates that are less susceptible to earlier cephalosporins.
Group
Fourth-generation cephalosporin
Mechanism of Action
Cefepime crosses the outer membrane of susceptible gram-negative bacteria and binds penicillin-binding proteins that catalyze peptidoglycan cross-linking. Inhibition of cell-wall synthesis causes bacterial death during active growth. Its zwitterionic structure promotes gram-negative penetration, and relative stability against some beta-lactamases broadens activity. As with other beta-lactams, therapeutic effect depends on time above the organism’s inhibitory concentration.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 40 mg/kg | IM, IV | Every 6 h | |
| Antibacterial infusion — Loading | 1.4 mg/kg | IV | Once | |
| Antibacterial infusion — Maintenance | 1.1 mg/kg/hour | IV | Continuous |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 11 mg/kg | IV | Every 8 h | Foals only. |
Indications
- Parenteral treatment of serious infections caused by susceptible gram-negative or gram-positive bacteria in dogs and foals, including sepsis and severe respiratory infections.
- Treatment of selected invasive Pseudomonas aeruginosa infections when cefepime susceptibility and the infection site support its use.
- Treatment of selected complicated urinary or other systemic infections caused by susceptible Enterobacterales.
Contraindications
- Cephalosporin hypersensitivity; assess prior severe beta-lactam allergy.
- Severe renal impairment requires dose or interval adjustment.
Interactions
- Avoid mixing with other drugs in the same vial or syringe unless compatibility is established.
Adverse effects
- Hypersensitivity
- Gastrointestinal upset
- Injection-site reactions with parenteral products
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Cefepime 500 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 500 mg / vial | IV, IM |
| Cefepime 1000 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 1000 mg / vial | IV, IM |
| Cefepime 2000 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 2000 mg / vial | IV, IM |
Monitoring and Administration
Choose treatment using organism identity, infection site and susceptibility testing. Reassess clinical response and renal function where impaired clearance may increase exposure.
Food-animal authorization and withdrawal periods depend on the exact formulation, species, regimen and jurisdiction; do not transfer foreign approvals or residue intervals to another product.
Renal failure requires less frequent dosing, with 12- or 24-hour intervals described according to impairment.
Sterile water, saline or 5% dextrose are described diluents. Lidocaine-containing reconstitution is for an appropriate intramuscular product only, never IV infusion. Reconstituted solution stability is described as 24 hours at room temperature or 7 days refrigerated.
Foal experience is mainly neonatal infection where aminoglycoside kinetics are poor or a resistant organism is documented; efficacy studies remain limited.
Compatibility of cefepime with another antibiotic is concentration- and time-dependent; do not treat general compatibility lists as permission to mix arbitrary products.