From the FDA Drug Label
Cefepime Injection should be administered intravenously over approximately 30 minutes Intermittent intravenous infusion with a Y-type administration set can be accomplished with compatible solutions. However, during infusion of Cefepime Injection, it is desirable to discontinue the other solution
To administer Cefepime (Maxipime) 2Gm via a saline lock, it should be done through intermittent intravenous infusion. The recommended administration is over approximately 30 minutes. It is desirable to discontinue any other solution during the infusion of Cefepime Injection. 1
From the Research
To administer Cefepime (Maxipime) 2Gm via a saline lock, it is recommended to reconstitute the medication with 10 mL of sterile water for injection, then further dilute with 50-100 mL of normal saline, and administer as an intermittent infusion over 30 minutes, as supported by the most recent and highest quality study 2. The administration process should start by reconstituting the 2Gm vial of Cefepime with 10 mL of sterile water for injection or a compatible diluent, resulting in a concentration of approximately 160 mg/mL.
- Then, further dilute this solution with 50-100 mL of normal saline or another compatible IV fluid.
- Before administration, flush the saline lock with 5-10 mL of normal saline to ensure patency.
- Administer the diluted Cefepime as an intermittent infusion over 30 minutes, as rapid administration can increase the risk of neurotoxicity and seizures, while proper dilution helps reduce vein irritation, as noted in 3.
- After completion, flush the saline lock again with 5-10 mL of normal saline to ensure the entire dose is delivered and to maintain patency of the line. It is crucial to check for compatibility with other medications if the patient is receiving multiple drugs through the same line, as Cefepime may be incompatible with certain medications like aminoglycosides, highlighting the importance of careful management and monitoring, especially in patients with renal impairment, as discussed in 4 and 5. The goal is to achieve a balance between effective antibiotic treatment and minimizing the risk of adverse effects, particularly neurotoxicity, which is a concern with Cefepime, especially in patients with reduced renal function, as emphasized in 6.