cefepime, a fourth-generation cephalosporin. ▪ INDICATIONS: It is used to treat infections caused by gram-negative bacilli, including Escherichiacoli, Proteus, and Klebsiella; gram-positive organisms, including Streptococcus pneumoniae, S. pyogenes, and Staphylococcus aureus; and infections of the lower respiratory tract, urinary tract, skin, and bone. ▪ CONTRAINDICATIONS: Known hypersensitivity to cephalosporins prohibits its use. It also should not be used in infants less than one month old. ▪ ADVERSE EFFECTS: Life-threatening effects include nephrotoxicity, renal failure, leukopenia, thrombocytopenia, agranulocytosis, neutropenia, lymphocytosis, eosinophilia, pancytopenia, hemolytic anemia (rare), and anaphylaxis. Other serious effects include GI bleeding; increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, lactic dehydrogenase, and alkaline phosphatase; proteinuria, candidiasis, increased blood urea nitrogen, and thrombophlebitis. Common side effects include nausea, vomiting, diarrhea, and anorexia.
