Maxipime

Maxipime is the brand name for cefepime, a fourth-generation cephalosporin antibiotic. It has broad-spectrum activity against many Gram-positive cocci and Gram-negative bacilli, including Pseudomonas aeruginosa, but it does not cover MRSA and has limited anaerobic coverage. Cefepime is bactericidal and acts by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins.

The drug is active against Enterobacteriaceae (for example Escherichia coli, Klebsiella spp., Enterobacter spp.), Haemophilus influenzae, Neisseria spp., Streptococcus spp., and methicillin-susceptible Staphylococcus aureus. Activity against Enterococcus is poor. While it covers Pseudomonas in many settings, resistance can occur, and cefepime should not be relied upon for ESBL-producing organisms or many AmpC producers.

Maxipime is administered by intravenous infusion or intramuscular injection. Dosing is adjusted for renal function and infection severity. Typical pharmacokinetics include renal excretion with a half-life of about 2 hours in patients with normal renal function; the drug achieves measurable CSF levels when meninges are inflamed.

Common adverse effects include hypersensitivity reactions, rash, diarrhea, nausea, and local phlebitis at the injection site. More serious effects include seizures with high doses or reduced renal function, and antibiotic-associated colitis. Cross-sensitivity can occur in penicillin-allergic patients.

Maxipime is used for moderate to severe nosocomial and community-acquired infections, including pneumonia, complicated intra-abdominal infections, complicated urinary tract infections, febrile neutropenia, and skin and soft tissue infections caused by susceptible organisms.