From the FDA Drug Label
At least 90 percent of the following bacteria exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for cefepime. ... Gram-positive bacteria ... NOTE: Most isolates of enterococci, e.g., Enterococcus faecalis, and methicillin-resistant staphylococci are resistant to cefepime.
Table 5: Acceptable Quality Control Ranges for Cefepime QC StrainMinimum InhibitoryConcentrations(mcg/mL)Disk Diffusion(zone diameters in mm) ... Staphylococcus aureus ATCC 29213 1 to 4 -
Staphylococcus aureus ATCC 25923 - 23 to 29
The FDA drug label does not provide sufficient direct information to confirm that Maxipime (Cefepime) covers Staphylococcus aureus. Although it mentions Staphylococcus aureus in the context of quality control ranges, it notes that most isolates of methicillin-resistant staphylococci are resistant to cefepime, and it does not explicitly state that cefepime is effective against Staphylococcus aureus in the clinical infections context 1.
From the Research
Maxipime (cefepime) does cover many strains of Staphylococcus aureus, particularly methicillin-sensitive Staphylococcus aureus (MSSA). Cefepime is a fourth-generation cephalosporin antibiotic that has good activity against many gram-positive bacteria, including MSSA, as well as excellent coverage of gram-negative organisms. However, it's essential to note that Maxpime is not effective against methicillin-resistant Staphylococcus aureus (MRSA), which requires different antimicrobial agents such as vancomycin, linezolid, or daptomycin 2. When treating a suspected or confirmed staph infection, it's crucial to know the susceptibility pattern of the specific strain, as resistance patterns can vary. If MRSA is a concern or has been identified, Maxpime would not be an appropriate choice for therapy. Typical dosing of cefepime for serious infections is 1-2 grams every 8-12 hours intravenously, adjusted based on renal function, with duration depending on the site and severity of infection.
Some key points to consider:
- Cefepime has been shown to be effective against MSSA in various studies, including a study published in 1993 that demonstrated its efficacy in a rat model of endocarditis caused by a methicillin-susceptible strain of S. aureus 3.
- The combination of cefepime with other antimicrobials, such as aminoglycosides, has been shown to have an enhanced effect against MRSA in some studies 2.
- Cefepime is generally well tolerated, with a tolerability profile similar to that of other parenteral cephalosporins, and adverse events are primarily gastrointestinal in nature 4, 5.
In terms of morbidity, mortality, and quality of life, the use of cefepime as a treatment option for MSSA infections can lead to improved outcomes, including reduced morbidity and mortality, and improved quality of life for patients. However, it's essential to use cefepime judiciously and in accordance with local resistance patterns and susceptibility testing to minimize the risk of resistance development and ensure optimal treatment outcomes. The most recent and highest quality study available, published in 2005, suggests that cefepime in combination with other antimicrobials may be a viable treatment option for MRSA infections, but further studies are needed to confirm these findings 2.