An injected cephalosporin antibiotic for serious infections
Cefepime
A strong cephalosporin antibiotic given by injection in hospital to treat serious bacterial infections.
What is Cefepime?
Cefepime is a powerful cephalosporin antibiotic given by injection or drip, usually in hospital, to treat serious bacterial infections such as severe chest, urine, skin and blood infections, including in people with weakened immunity. It works by killing a wide range of bacteria. Because it is related to penicillin, people with a serious penicillin or cephalosporin allergy may react to it. Like other broad antibiotics it can upset the gut and, less commonly, lead to a serious bowel infection called C. difficile. An important point is that it can cause confusion or seizures, particularly in people with reduced kidney function, so the dose is adjusted and patients are watched.
Education and reference only. This is a plain-language guide to Cefepime — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Cefepime is a broad-spectrum cephalosporin antibiotic, a relative of penicillin, used to treat serious bacterial infections. It is given by injection into a vein or muscle, almost always in hospital, because it is reserved for more serious or harder-to-treat infections such as severe pneumonia, complicated urine infections, skin and soft-tissue infections, and infections in people whose immune system is weakened. It is described as fourth-generation, meaning it works against a particularly wide range of bacteria. It is used under specialist guidance, with the dose tailored to the infection and to the person's kidney function.
How it works
Cefepime kills bacteria by stopping them from building their cell walls, which they need to survive. Without a working wall the bacteria break apart and die, which clears the infection. Being a broad-spectrum, fourth-generation cephalosporin, it is active against a wide range of bacteria, which is why it is used for serious infections where the exact germ may not yet be known or where resistance is a concern. Because the kidneys clear it from the body, the dose has to be reduced when kidney function is poor; otherwise it can build up and affect the brain, causing confusion or seizures.
Company & origin
Originated / developed by: Various manufacturers.
A hospital antibiotic given by injection or drip for serious bacterial infections, used under specialist guidance.
Practical use
How to take Cefepime
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by injection or drip by a healthcare professional, usually in hospital.
- Tell the team about any allergy to penicillin or other antibiotics before it is given.
- Report any new confusion, agitation, twitching or unusual movements straight away.
- Report severe or watery diarrhoea during or after treatment, as it can signal a bowel infection.
- Make sure the team knows about any kidney problems, as the dose may need adjusting.
Weighing it up
Advantages & disadvantages of Cefepime
Advantages
- Works against a wide range of bacteria, making it useful for serious infections.
- Can be used when the exact germ is not yet known or when resistance is a concern.
- An option for infections in people with weakened immune systems.
Disadvantages
- Given only by injection or drip, usually requiring hospital care.
- Can cause confusion or seizures, especially when kidney function is reduced.
- Can upset the gut and, less commonly, lead to a serious C. difficile bowel infection.
Practical use
Good to know
The first thing to mention is allergy: cefepime is related to penicillin, so anyone with a serious allergy to penicillin or other cephalosporins should make sure the team knows, as a reaction is possible. Like all broad antibiotics, it can upset the balance of bacteria in the gut and, less commonly, cause a serious bowel infection called C. difficile, so any severe or persistent diarrhoea during or after treatment should be reported. A particularly important safety point is that cefepime can cause confusion, agitation, jerking movements or seizures, especially in people whose kidneys are not working well or when the dose is too high for their kidney function; for this reason the dose is carefully adjusted and patients are monitored. It is a hospital medicine given by injection, used for serious infections, so it is always managed by the medical team.
Who should not take it / use with caution
- People who have had a serious allergic reaction to cefepime or other cephalosporins should not receive it.
- It is used with great caution in people with a serious penicillin allergy, because of possible cross-reaction.
- The dose must be reduced in people with reduced kidney function to avoid brain side effects.
Monitoring
- Checking kidney function and adjusting the dose accordingly.
- Watching for confusion, twitching or seizures, especially in older people or those with kidney problems.
- Reviewing the response to treatment and watching for diarrhoea or allergic reactions.
Side effects
- Reactions where the injection or drip is given, such as redness or soreness.
- Diarrhoea, nausea or rash, as with many antibiotics.
- Confusion, agitation, twitching or seizures, particularly with poor kidney function.
- Rarely, serious allergic reactions or a serious C. difficile bowel infection.
Key interactions
- Tell the team about all medicines you take, as some can affect the kidneys alongside it.
- It is used carefully with other medicines that lower the seizure threshold.
- Other antibiotics that affect the kidneys may add to the risk, so the team reviews this.
Available as: A powder made up into a solution for injection into a vein or muscle.
Answers
Cefepime: frequently asked questions
What is cefepime used for?
It is a strong cephalosporin antibiotic given by injection in hospital for serious bacterial infections, including severe chest, urine, skin and blood infections.
I am allergic to penicillin — can I have it?
Cefepime is related to penicillin, so a reaction is possible; tell the team about any penicillin or antibiotic allergy so they can decide whether it is safe.
Why might it cause confusion?
Cefepime can affect the brain, causing confusion or seizures, especially if the kidneys are not working well, so the dose is adjusted and you are monitored.
Should I worry about diarrhoea afterwards?
Report severe or watery diarrhoea during or after treatment, as broad antibiotics can occasionally cause a serious bowel infection called C. difficile.
Can I take it as a tablet at home?
No. Cefepime is given by injection or drip, almost always in hospital, because it is used for serious infections.
The wider class
About Fourth-generation cephalosporin antibiotic (injection)
Cefepime belongs to the fourth-generation cephalosporin antibiotic (injection) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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