From the Guidelines
The oral equivalent of 2 grams of Cefepime can be approximated with a combination of oral antibiotics such as ciprofloxacin 400 mg every 12 hours 1 and amoxicillin-clavulanate, however the exact dosage of amoxicillin-clavulanate is not specified in the provided evidence. Alternatively, levofloxacin 750 mg every 24 hours 1 and metronidazole 500 mg every 8-12 hours 1 can be used.
- The dose and duration of oral antibiotics may vary based on the severity of the infection, patient comorbidities, and renal function.
- It is essential to note that Cefepime is a fourth-generation cephalosporin with a broad spectrum of activity, and the chosen oral antibiotics should be selected based on the suspected or confirmed pathogens and their susceptibility patterns.
- The provided evidence does not offer a direct oral equivalent for Cefepime, but rather lists various antibiotic dosages for the treatment of complicated intra-abdominal infections 1.
- In clinical practice, the selection of oral antibiotics should be guided by the severity of the infection, patient factors, and local antimicrobial resistance patterns.
From the Research
Cefepime Dosage
- The oral equivalent of 2 grams of Cefepime is not directly stated in the provided studies, as Cefepime is typically administered intravenously 2, 3, 4, 5, 6.
- However, the studies provide information on the intravenous dosing of Cefepime, which can be used as a reference point.
- For example, one study recommends a fixed dose of Cefepime of 1 g before every 48-h interval and of 1.5 g before every 72-h interval in patients infected by highly susceptible pathogens 3.
- Another study uses Cefepime at a dose of 2 grams every 12 hours 4.
- It is essential to note that Cefepime is not typically administered orally, and its pharmacokinetics and pharmacodynamics are well-established for intravenous administration 2.
Pharmacokinetics and Pharmacodynamics
- Cefepime is a broad-spectrum fourth-generation cephalosporin with activity against Gram-positive and Gram-negative pathogens 2.
- It is widely distributed in biological fluids and tissues with an average volume of distribution of ~ 0.2 L/kg in healthy adults with normal renal function 2.
- Protein binding is relatively low (20%), and elimination is mainly renal, with about 85% of the dose excreted unchanged in the urine 2.
- The elimination half-life of Cefepime is 2-2.3 h, and therapeutic drug monitoring may be beneficial in certain patients, including those who are critically ill or have life-threatening infections 2.