What Is Cefepime?

Cefepime is a fourth-generation cephalosporin antibiotic given intravenously (IV) or intramuscularly (IM) to treat serious bacterial infections including pneumonia, urinary tract infections, and febrile neutropenia.

Originally sold under the brand name Maxipime by Bristol-Myers Squibb, Cefepime is now available almost exclusively as a generic. It belongs to the beta-lactam class of antibiotics and is particularly effective against gram-negative bacteria, including Pseudomonas aeruginosa — a notoriously difficult-to-treat pathogen.

Multiple manufacturers produce generic Cefepime, including Apotex, Hospira/Pfizer, Sagent, BBraun, Baxter, and Eugia/Dr. Reddy's. It is not a controlled substance and does not have a DEA schedule.

What Is Cefepime Used For?

Cefepime is FDA-approved for treating several types of serious infections:

FDA-Approved Uses

• Pneumonia — Moderate to severe cases, including hospital-acquired pneumonia
• Urinary tract infections (UTIs) — Both complicated and uncomplicated, including pyelonephritis (kidney infection)
• Skin and skin-structure infections — Uncomplicated cases caused by susceptible bacteria
• Complicated intra-abdominal infections — Used in combination with Metronidazole
• Febrile neutropenia — Empiric therapy for cancer patients with fever and dangerously low white blood cell counts

Off-Label Uses

Doctors also prescribe Cefepime for conditions not on its official label, based on clinical evidence and guidelines:

• Bacterial meningitis
• Hospital-acquired or ventilator-associated pneumonia
• Sepsis and bacteremia (bloodstream infections)
• Osteomyelitis (bone infections)
• Cystitis caused by AmpC beta-lactamase-producing bacteria (supported by IDSA guidelines)

How Is Cefepime Taken?

Cefepime is not available as a pill or liquid you take by mouth. It must be given by a healthcare professional through one of two routes:

• Intravenous (IV) infusion — The most common method, typically infused over 30 minutes
• Intramuscular (IM) injection — Less common, used for certain infections

You'll receive Cefepime in one of these settings:

• Hospital — Most patients receive it during a hospital stay
• Infusion center — For patients who don't need to be hospitalized
• Home IV therapy (OPAT) — Some patients can receive IV antibiotics at home through outpatient parenteral antibiotic therapy programs, with nursing support

Available Forms

• Powder for reconstitution: 500 mg, 1 g, and 2 g vials
• Pre-mixed IV solutions: 1 g/50 mL and 2 g/100 mL in dextrose

Typical Dosing

The standard dose ranges from 1 to 2 g every 8-12 hours, depending on the type and severity of infection:

• Mild to moderate infections: 1-2 g IV every 12 hours
• Severe infections or Pseudomonas: 2 g IV every 8 hours
• Febrile neutropenia: 2 g IV every 8 hours
• Children (2 months+): 50 mg/kg/dose every 8-12 hours, up to 2 g maximum per dose

Kidney function matters: If your creatinine clearance is below 60 mL/min, your dose must be reduced. Cefepime is removed by hemodialysis, so patients on dialysis need supplemental doses after each session.

Who Should Not Take Cefepime?

Cefepime should not be used if you have:

• Known allergy to Cefepime or other cephalosporins
• History of severe allergic reaction (anaphylaxis) to penicillins or other beta-lactam antibiotics — though the cross-reactivity risk is low at about 1-2%, severe reactions warrant caution
• History of Cefepime-induced encephalopathy — a previous episode of brain dysfunction caused by Cefepime

Special caution is needed for:

• Elderly patients — Higher risk of neurotoxicity from age-related kidney function decline
• Patients with kidney disease — Dose adjustments are essential
• Pregnant women — Category B; discuss risks and benefits with your doctor
• Breastfeeding mothers — Passes into breast milk in low amounts; generally considered low risk

For more on risks, see our detailed guide on Cefepime side effects.

How Much Does Cefepime Cost?

Because Cefepime is a generic injectable antibiotic, pricing varies by setting:

• Hospital setting: Cefepime is included in your facility charges — you typically don't pay for it separately.
• Without insurance (cash price): Approximately $50-$400+ per course depending on dose and duration. A common course of 9 vials (2 g each) runs around $363 at full cash price.
• With discount coupons: Generic Cefepime can be found for approximately $93-$150 per course of 9 vials (2 g each). Individual vials range from $5-$40 depending on strength.
• Insurance: Covered by most commercial plans and Medicare/Medicaid as a generic injectable. For OPAT (home IV therapy), some insurers may require prior authorization.

There are no manufacturer copay cards or savings programs since Maxipime is largely discontinued and Cefepime is only available as a generic. However, hospital financial assistance programs and patient assistance through organizations like NeedyMeds and RxAssist may help qualifying patients.

Final Thoughts

Cefepime is a critical antibiotic for treating some of the most serious bacterial infections, from hospital-acquired pneumonia to neutropenic fever in cancer patients. While it's only available as an injection — meaning it requires a healthcare setting or home IV setup — it remains one of the most effective tools against resistant gram-negative bacteria.

If you've been prescribed Cefepime and are having difficulty finding it due to the current shortage, use Medfinder to check availability near you, or talk to your doctor about alternative options.