If a shortage or outage of cefepime occurs, call the MD. Cefoperazone and cefTAZidime should not be interchanged for cefepime due to cefepime having a wider spectrum of activity.
Extended Infusion Go-live 2/1/2022:
Automatic interchange of cefepime orders in adult patients only to extended-infusion dosing regimens below based on renal function with two exceptions:
Emergency department (once doses), Peri-Op/PACU, and other procedural areas.
Drug compatibility and/or medication scheduling conflicts.
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If a shortage or outage of cefepime occurs, call the MD. Cefoperazone and cefTAZidime should not be interchanged for cefepime due to cefepime having a wider spectrum of activity.
Extended Infusion Go-live 2/1/2022:
Automatic interchange of cefepime orders in adult patients only to extended-infusion dosing regimens below based on renal function with two exceptions:
Automatic renal adjustment per guidelines. See Antimicrobial Dosing Guideline and Renal Adjustment Policy (Adult) for more information. CrCl calculation policy available here.
Drug
Usual Dose
CrCl (mL/min)
Dose Adjustment
Cefepime (Extended Infusion)
Mild to Moderate Infections (IAI, UTI)
1 g x1 over 30 min* then 1 g q8h over 4 hours
11-29
<11/HD
CRRT
1 g q12h over 4 hours
1 g q24h over 4 hours, after HD
2g x1 over 30 min* then 2 g q12h over 4 hours
Severe Infections (CNS, FN, IE, OM, PNA)
2 g x1 over 30 min* then 2 g q8h over 4 hours
30-60
11-29
<11/HD
CRRT
2 g q12h over 4 hours
1 g q12h over 4 hours
1 g q24h over 4 hours, after HD
2g x1over 30 min* then 2 g q12h over 4 hour
*begin maintenance infusion 6 hours after loading dose
**NOTE: If patient receiving hemodialysis, ensure maintenance cefepime dose is scheduled to be given at 1800 after dialysis.
Reviewed: 31 January 22 (Extended-Infusion)