Cefepime is NOT Available in Oral Form
Cefepime is only available for intravenous (IV) or intramuscular (IM) administration—there is no oral tablet or capsule formulation of this antibiotic. 1
Administration Routes
- Cefepime must be administered parenterally, either by IV infusion (typically over 30 minutes) or by IM injection 1
- The FDA-approved formulations include single-dose containers for IV use containing 1g in 50mL or 2g in 100mL 1
- Subcutaneous administration has been studied as an alternative route in geriatric patients with comparable effectiveness to IV administration, though this remains off-label 2
Why This Matters Clinically
The lack of oral bioavailability is a fundamental limitation of cefepime's chemical structure. Unlike some other antibiotics, cefepime cannot be absorbed through the gastrointestinal tract in therapeutically meaningful amounts 3.
Oral Alternatives for Similar Coverage
If oral therapy is needed for gram-negative infections (including Pseudomonas), consider these alternatives:
Fluoroquinolones provide comparable gram-negative coverage with oral bioavailability:
Third-generation oral cephalosporins offer partial alternatives (though with less Pseudomonas activity):
Sequential IV-to-Oral Strategies
For patients requiring initial parenteral therapy who can transition to oral treatment:
- Start with IV ceftriaxone or cefepime, then switch to oral fluoroquinolones once clinically stable 5, 4
- This approach has been validated in pyelonephritis, where initial IV ceftriaxone followed by oral cefixime showed comparable outcomes to continued parenteral therapy 6
Common Pitfall
Do not confuse cefepime with oral cephalosporins like cefixime or cefpodoxime—these are entirely different drugs with different spectra of activity and cannot substitute for cefepime's broader coverage against resistant gram-negative organisms 5, 3.