Cefepime: a reappraisal in an era of increasing antimicrobial resistance

Andrea Endimiani*a, Federico Perezb & Robert A Bonomoca Department of Medicine, Section of Infectious Diseases, Case Western Reserve University, School of Medicine, Cleveland, OH, USA and Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH 44106, USA. b Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, Cleveland, OH, USAc Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA and Departments of Pharmacology and Molecular Biology and Microbiology, Case Western Reserve University, School of Medicine, Cleveland, OH, USA† Author for correspondenceCefepime is a ‘fourth-generation’ cephalosporin with an in vitro extended-spectrum of activity against Gram-negative and Gram-positive pathogens. Cefepime is approved for the treatment of moderate-to-severe infections, such as pneumonia, uncomplicated and complicated urinary tract infections, skin and soft-tissue infections, intra-abdominal infections and febrile neutropenia. In this article, we provide a critical review of pharmacodynamics, clinical management, pharmacokinetics, metabolism, pharmacodynamic target analyses, clinical efficacy, safety and tolerability of cefepime after more than a decade of clinical use.