From the FDA Drug Label
Cefepime Injection is a cephalosporin antibacterial indicated in the treatment of the following infections caused by susceptible isolates of the designated microorganisms: pneumonia (1.1) The FDA drug label does not answer the question.
From the Research
Cefepime is an appropriate treatment option for Haemophilus influenzae pneumonia, typically administered at 1-2 grams intravenously every 8-12 hours for 7-14 days depending on severity. This recommendation is based on the most recent and highest quality study available, which suggests that cefepime has good activity against Gram-negative organisms, including Haemophilus influenzae 1.
Key Considerations
- Cefepime should be part of a comprehensive treatment approach, including supportive care such as oxygen therapy, hydration, and respiratory support as needed.
- For hospitalized patients with H. influenzae pneumonia, initial empiric therapy often includes cefepime while awaiting culture results, especially in areas with high beta-lactamase producing strains.
- Once susceptibility is confirmed, therapy may be narrowed to a more targeted agent like a third-generation cephalosporin (ceftriaxone or cefotaxime) or ampicillin (if the strain is susceptible).
- For outpatients with less severe disease, oral options like amoxicillin-clavulanate may be appropriate.
Rationale
Cefepime is effective against H. influenzae because it penetrates well into lung tissue and maintains activity against beta-lactamase producing strains 2. The dosing of cefepime has been optimized to 2g every 8 hours for serious infections, which is preferred to optimize pharmacokinetic/pharmacodynamic considerations 1.
Additional Factors
- Treatment duration should be individualized based on clinical response, with patients typically showing improvement within 48-72 hours.
- Cefepime is generally well tolerated, with a tolerability profile similar to those of other parenteral cephalosporins 2.
- The emergence of resistant organisms is a concern, and cefepime should be used prudently to prevent this 2.