Cefepim

Strukturformel
Strukturformel von Cefepim
Allgemeines
Name Cefepim
Andere Namen

(6R,7R)-7-{[(2Z)-2-(2-Amino-1,3-thiazol-4-yl)-2-(methoxyimino)acetyl]amino}-3-[(1-methyl-1-pyrrolidiniumyl)methyl]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-2-carboxylat (IUPAC)

Summenformel C19H24N6O5S2
Externe Identifikatoren/Datenbanken
CAS-Nummer 88040-23-7
EG-Nummer (Listennummer) 643-019-5
ECHA-InfoCard 100.171.025
PubChem 5479537
ChemSpider 4586395
DrugBank DB01413
Wikidata Q2552927
Arzneistoffangaben
ATC-Code

J01DE01

Eigenschaften
Molare Masse 480,56 g·mol−1
Sicherheitshinweise
Bitte die Befreiung von der Kennzeichnungspflicht für Arzneimittel, Medizinprodukte, Kosmetika, Lebensmittel und Futtermittel beachten
GHS-Gefahrstoffkennzeichnung[1]

Gefahr

H- und P-Sätze H: 317​‐​334
P: ?
Soweit möglich und gebräuchlich, werden SI-Einheiten verwendet.
Wenn nicht anders vermerkt, gelten die angegebenen Daten bei Standardbedingungen (0 °C, 1000 hPa).

Cefepim ist ein Antibiotikum aus der Gruppe der Cephalosporine. Die bakterizide Wirkung erfolgt, wie bei anderen β-Lactam-Antibiotika, durch Hemmung der bakteriellen Zellwandsynthese. Als Cephalosporin der 4. Generation ist Cefepim auch gegen Pseudomonas aeruginosa wirksam.

Cefepim wurde von Bristol-Myers Squibb entwickelt[2] und erhielt im Januar 1996 die Zulassung in den Vereinigten Staaten für die Behandlung von mittleren bis schweren Pneumonien.[3] In Deutschland besteht die Zulassung seit 2004, Handelsname ist Maxipime, darüber hinaus existieren mittlerweile diverse Generika. Anwendungsgebiete sind Bakteriämie im Zusammenhang mit schwerer Lungenentzündung, schwerer Infektion der Harnwege oder Infektionen des Bauchraumes, einschließlich Peritonitis.

Sehr häufig kann nach Gabe von Cefepim der direkte Coombs-Test (Test zur Bestimmung von Antikörpern auf roten Blutkörperchen) falsch positiv ausfallen. Zu den möglichen Nebenwirkungen gehören gastrointestinale Beschwerden, Blutgerinnungsstörungen, Blutbildveränderungen, Kopfschmerzen, Fieber, pseudomembranöse Kolitis und allergische Reaktionen.[4]

Rote-Hand-Brief zu Maxipime® (Cefepim): Risiko schwerwiegender neurologischer Nebenwirkungen bei Patienten mit eingeschränkter Nierenfunktion[5]

Literatur

  • S. V. Burgess, V. H. Mabasa, I. Chow, M. H. Ensom: Evaluating outcomes of alternative dosing strategies for cefepime: a qualitative systematic review. In: The Annals of pharmacotherapy. Band 49, Nummer 3, März 2015, S. 311–322, doi:10.1177/1060028014564179, PMID 25575975 (Review).
  • E. E. Adderson, P. M. Flynn, J. M. Hoffman: Efficacy and safety of cefepime in pediatric patients: a systematic review and meta-analysis. In: The Journal of pediatrics. Band 157, Nummer 3, September 2010, S. 490–5, 495.e1, doi:10.1016/j.jpeds.2010.03.023, PMID 20434167 (Review).
  • Andrea Endimiani, Federico Perez, Robert A. Bonomo: Cefepime: a reappraisal in an era of increasing antimicrobial resistance. In: Expert review of anti-infective therapy. Band 6, Nummer 6, Dezember 2008, S. 805–824, doi:10.1586/14787210.6.6.805, PMID 19053894, PMC 2633657 (freier Volltext) (Review).

Einzelnachweise

  1. Vorlage:CL Inventory/nicht harmonisiertFür diesen Stoff liegt noch keine harmonisierte Einstufung vor. Wiedergegeben ist eine von einer Selbsteinstufung durch Inverkehrbringer abgeleitete Kennzeichnung von 1-[[(6R,7R)-7-[[(2Z)-2-(2-amino-4-thiazolyl)-2-(methoxyimino)acetyl]amino]-2-carboxy-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-3-yl]methyl]-1-methyl-pyrrolidinium, inner salt Vorlage:Linktext-Check/Apostroph im Classification and Labelling Inventory der Europäischen Chemikalienagentur (ECHA), abgerufen am 29. Oktober 2018.
  2. Rashmi H. Barbhaiya, S. Thomas Forgue u. a.: Safety, tolerance, and pharmacokinetic evaluation of cefepime after administration of single intravenous doses. In: Antimicrobial agents and chemotherapy. Band 34, Nummer 6, Juni 1990, S. 1118–1122, PMID 2203303, PMC 171768 (freier Volltext).
  3. Clinical Review: Cefepime. Stand 20. Januar 2009, S. 7 (PDF).
  4. Marianne Abele-Horn: Antimikrobielle Therapie. Entscheidungshilfen zur Behandlung und Prophylaxe von Infektionskrankheiten. Unter Mitarbeit von Werner Heinz, Hartwig Klinker, Johann Schurz und August Stich, 2., überarbeitete und erweiterte Auflage. Peter Wiehl, Marburg 2009, ISBN 978-3-927219-14-4, S. 340.
  5. Michael May: Rote-Hand-Brief zu Maxipime®. In: Rote-Hand-Brief. BfArM, 18. Juni 2018, abgerufen am 3. Oktober 2021.

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