Adults

For mild to moderate urinary tract infections: 500 mg - 1 g IV/IM every 12 hours. For severe infections: 1-2 g IV/IM every 8-12 hours. Note: 250 mg is generally not an adult therapeutic dose; higher doses would be achieved by using multiple 250 mg vials or higher strength vials. For pediatric use or very specific mild infections, 250 mg may be a component of the regimen.

Elderly

Dosage adjustment is necessary based on renal function and creatinine clearance.

Renal_impairment

Significant dosage reduction and/or extended dosing interval are required based on creatinine clearance. For CrCl 30-60 mL/min: 500 mg - 1 g every 24 hours. For CrCl 11-29 mL/min: 250-500 mg every 24 hours.

Onset

Rapid, typically within minutes after IV administration.

Excretion

Primarily excreted by the kidneys via glomerular filtration. Approximately 85% of the dose is recovered unchanged in the urine.

Half life

Approximately 2 hours in individuals with normal renal function.

Absorption

Rapid and complete absorption after intramuscular (IM) or intravenous (IV) administration.

Metabolism

Minimally metabolized; less than 7% of the administered dose is metabolized.

Aminoglycosides

Concurrent administration may increase the risk of nephrotoxicity and ototoxicity.

Chloramphenicol

Antagonistic effect observed in vitro, avoid concurrent use.

Loop Diuretics (e.g., Furosemide)

May increase the serum levels of cefepime, especially in patients with impaired renal function.

Live Bacterial Vaccines (e.g., Typhoid)

Antibiotics may reduce the therapeutic effect of these vaccines; vaccination should be deferred.