Maxipime

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Cefepime

Treatment option: Bacterial Meningitis, Bacterial Meningitis In Children, Bacteremia, Bronchitis, Hypotension, Infection, Infection,Urinary Tract, Meningitis, Neutropenia, Peritonitis

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Maxipime

What is Maxipime? The Cefepime Identity and Class

Property	Description
Active Ingredient	Cefepime (as Cefepime hydrochloride)
Form	Sterile dry powder for injection
Pharmacological Class	Fourth-Generation Cephalosporin Antibiotic
Prescription Status	Prescription-only (Rx)
Origin	Semi-synthetic compound

Maxipime is the original brand name for the active ingredient Cefepime (specifically Cefepime hydrochloride), an injectable, semi-synthetic beta-lactam antibiotic. Cefepime is a fourth-generation cephalosporin, distinguishing it from earlier compounds by its enhanced activity and structural resilience. This advanced classification grants Cefepime a naturally broad-spectrum capability, making it a critical choice for treating serious bacterial infections. The medication is clinically recognized for its ability to target both Gram-positive and Gram-negative bacteria, including certain strains that have developed resistance to preceding antibiotic classes.

Composition and Pharmaceutical Form of Maxipime

The product Maxipime is supplied exclusively as a sterile, dry powder for injection; it is not manufactured as an oral tablet or capsule, necessitating professional administration. The composition is a single active ingredient product, consisting of Cefepime hydrochloride alongside an excipient, typically L-arginine. The L-arginine is added to the mixture to control the pH and ensure the powder is properly dissolved when reconstituted into a liquid solution. Due to this specialized formulation, the medication must be administered via the parenteral route (intravenously or intramuscularly) to guarantee the complete and controlled dose rapidly reaches the bloodstream.

Why is Cefepime Classified as a Bactericidal Agent?

Cefepime's primary therapeutic action is bactericidal, meaning its fundamental purpose is to directly kill susceptible bacteria rather than simply inhibiting their reproduction. The drug achieves this by interfering with the structural integrity of the bacterial cell. Specifically, Cefepime targets and inhibits the enzymes essential for building the rigid bacterial cell wall. This direct interference leads to the fatal structural failure and death of the bacterial organism, providing a definitive approach to clearing the bacterial proliferation, which is why it is often chosen for severe bacterial disease scenarios.

Regulatory References

What side effects are possible with Maxipime?

Maxipime: Possible Side Effects and Safety Information

Maxipime (Cefepime) safety data is classified based on the reported frequency and the affected physiological system, following standards set by regulatory authorities.

Officially Documented Adverse Reactions

Adverse reactions are grouped into several System-Organ Classes (SOC) as listed in government-approved prescribing information:

Gastrointestinal Disorders: Diarrhea is the most commonly reported effect. Nausea and vomiting are classified as uncommon reactions.
Nervous System Disorders: The label lists headache as common, but also highlights serious, potentially reversible neurological effects, including seizures, encephalopathy, myoclonus, and non-convulsive status epilepticus.
Skin and Hypersensitivity Reactions: Common reactions include rash. Less common effects are pruritus and urticaria. Rare but severe reactions include anaphylaxis, Stevens-Johnson syndrome (SJS), and Toxic Epidermal Necrolysis (TEN).
Blood and Laboratory Changes: Eosinophilia is common. Uncommon effects include increases in serum creatinine and blood urea nitrogen (BUN), and potential changes in blood cell counts such as neutropenia and thrombocytopenia.
Administration Site Conditions: Phlebitis and local pain at the injection site are reported as uncommon reactions.

Serious Safety Considerations

The most significant safety consideration is the risk of neurotoxicity. This risk is explicitly stated to be greater in patients with underlying renal impairment and older adults due to reduced clearance and accumulation of the drug. Additionally, Maxipime is associated with the rare risk of developing Clostridioides difficile-associated diarrhea (CDAD), which may occur during or after treatment is complete. The medication is contraindicated in individuals with a known history of hypersensitivity to Cefepime, any cephalosporin, or any other beta-lactam antibiotic.

Overdose and Emergency Response

Overdose and when to seek help

Overdose with the antibiotic Cefepime (Maxipime) is primarily associated with the occurrence of severe neurological toxicity. If an overdose is suspected or if overt signs of intoxication are observed, immediate medical attention must be sought.

Documented Overdose Manifestations

The officially documented manifestations of Maxipime overdose predominantly involve the Central Nervous System (CNS). These signs, listed in regulatory documents, include encephalopathy, confusion, aphasia (speech difficulty), hallucinations, myoclonus (muscle twitching), and seizures. The most severe, life-threatening outcomes reported are coma and nonconvulsive status epilepticus, which necessitate urgent medical care.

Risk and Management

Regulatory information emphasizes that the risk of severe neurotoxicity is significantly higher in patients with impaired renal function and in elderly patients who receive the medication without appropriate dosage adjustments. Upon recognition of a severe reaction or overdose, regulatory guidance mandates the immediate discontinuation of drug therapy.

No specific antidote is known to reverse the effects of Cefepime overdose. Therefore, clinical intervention is restricted to providing symptomatic and supportive treatment. Haemodialysis is described in regulatory documents as an effective procedure to accelerate the removal of the drug from the body during overdose management.

Therapeutic Uses of Maxipime

What Maxipime Treats: Main Uses and Benefits

Maxipime injection is generally used to address serious bacterial infections and conditions characterized by periods of heightened symptoms across various sites, including the lungs, urinary tract, and abdomen. Its primary therapeutic use is in complex scenarios such as moderate-to-severe pneumonia, complicated urinary tract infections like pyelonephritis, and febrile neutropenia—a high-risk state where fever occurs with severely low white blood cell counts.

The medication is applied in clinical settings that involve acute or unstable symptom patterns where support for bacterial management is needed. It helps address symptom clusters that may become intense or disruptive, such as high fever, chills, and organ-specific discomfort. In these situations, the goal is to support the patient by managing the bacterial cause.

“Maxipime is considered relevant for managing symptoms that create noticeable physiological strain when severe infection is present.”

It is considered a relevant therapeutic option that provides support that helps ease the overall symptom burden by offering assistance with bacterial management in complex scenarios, thus assisting with maintaining functional stability during the acute phase.

Quick Fact: Relief for Systemic Discomfort

Maxipime is commonly used to help manage the severe, widespread symptoms of infection, such as high fever and chills, which are symptomatic of significant systemic discomfort.

Regulatory References

NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Who Can and Cannot Use Maxipime?

The population eligibility for Maxipime (Cefepime) is strictly defined by regulatory documents, focusing on patient age, allergic history, and organ function status.

Primary Eligibility and Non-Eligibility

Status	Population Requirement
Contraindicated	Individuals with a known history of immediate hypersensitivity reaction to Cefepime or any antibiotic in the cephalosporin class.
Allowed	Adults and pediatric patients who are 2 months of age and older.

Conditional Use and Restrictions

Use is not established in infants younger than two months of age. The medicine must be used under restricted conditions for patients with impaired renal function (Creatinine Clearance le 60 mL/min), requiring specific management due to the risk of serious adverse reactions. This required caution also applies to older adults with existing renal insufficiency.

Additional caution is mandated for patients with a history of gastrointestinal disease, such as colitis, and those with pre-existing seizure disorders or brain disease. For pregnant or breastfeeding individuals, use is typically permitted only if clearly needed and requires caution, as the drug is known to pass into human milk.

What should I know about interactions with other medicines?

The official interaction profile for Maxipime (Cefepime) is defined by its primary elimination pathway through the kidneys. Co-administration with certain medicinal products results in pharmacokinetic or pharmacodynamic interactions that affect drug exposure or increase specific safety risks, as noted in government regulatory labeling.

A clinically significant pharmacokinetic interaction is documented with Probenecid, a substance known to inhibit renal tubular secretion. The co-use of Probenecid officially reduces Cefepime's renal clearance, which results in a measurable increase in the medicine's plasma concentration and a prolonged elimination half-life. This pattern is based on the drug's metabolism-free renal route.

A pharmacodynamic interaction is noted with other nephrotoxic agents, such as Aminoglycosides and potent loop diuretics. Co-administering Cefepime with these substances may increase the risk of developing nephrotoxicity. This risk of accumulation and potential neurotoxicity is officially heightened for patients with underlying renal impairment, especially when used concurrently with other medicinal products that may compromise kidney function. No interactions with food, alcohol, herbal products, or supplements are explicitly specified in the official regulatory documentation.

Mechanism of Action

Covalent Inhibition of Bacterial Cell Wall Assembly

Cefepime exerts a bactericidal effect by irreversibly inhibiting the final steps of bacterial cell wall synthesis. The drug's beta-lactam ring forms a covalent bond with essential bacterial enzymes known as Penicillin-Binding Proteins (PBPs), particularly PBP-3, which are responsible for peptidoglycan cross-linking . This permanent deactivation prevents the formation of a rigid cell wall, leading to the rapid cell lysis of the bacterial organism due to osmotic instability.

Enhanced Molecular Access and Stability

The molecule is structurally unique, possessing a zwitterionic charge that facilitates rapid penetration through the porin channels of the Gram-negative bacterial outer membrane, speeding access to its PBP targets. This structure also confers an enhanced resilience against degradation by many common beta-lactamase enzymes, a structural feature that contributes to the compound's range of activity against susceptible organisms.

Understanding Mechanistic Limitations

The drug’s core mechanism is constrained in the presence of certain bacterial defenses, such as the activity of specific beta-lactamase classes or the overexpression of efflux pumps that actively expel the molecule from the bacterial cell. Furthermore, Cefepime has a secondary, non-therapeutic mechanism involving antagonism of GABA A receptors in the host's central nervous system, which involves the modulation of GABA A receptor signaling within the host's central nervous system.

Dosage and Administration Information

How to Use Maxipime (Cefepime)

Maxipime is an injectable antibiotic whose administration must strictly follow approved prescribing information to ensure proper use. It is intended for use by or under the direction of a qualified healthcare professional.

Administration Routes and Formulations

Maxipime is available as a powder for injection and may also be supplied in premixed solutions. The approved methods of delivery are:

Intravenous (IV) Infusion: The primary route for most infections. The medication must be infused slowly over approximately 30 minutes.
Intramuscular (IM) Injection: This route is approved only for mild to moderate uncomplicated or complicated urinary tract infections (UTIs).

Standard Dosing and Schedule

Dosing is standardized and depends on the type of infection being addressed. For adults with normal kidney function, the dose typically ranges from 0.5 g to 2 g and is administered every 8 hours (q8 h) or every 12 hours (q12 h).

Patient Group	Frequency and Schedule	Typical Dose Range
Adults (Normal Renal Function)	q8 h or q12 h	0.5 g to 2 g per dose
Pediatrics (2 months to 16 years)	q8 h or q12 h	50 mg/kg per dose

Dose Adjustments and Preparation

Renal Adjustment: The dosing frequency and amount must be reduced in patients with decreased kidney function (creatinine clearance le 60 mL/min) as specified in the official labeling.

Preparation: The Maxipime powder must first be reconstituted with specific approved solutions (e.g., Sterile Water for Injection, 0.9% Sodium Chloride) before being diluted for the IV infusion. The final solution must not be physically mixed with metronidazole or vancomycin.

Recent Clinical Evidence

Maxipime: Recent Clinical Evidence

Evidence for Approved Indications

Pneumonia (Moderate to Severe)

Randomized Controlled Trials (RCTs) primarily studied Maxipime's profile for pneumonia, examining clinical outcomes and microbiological clearance in adult and pediatric groups. Studies monitored how symptom parameters evolved, and subsequent regulatory data reviews synthesized findings regarding survival endpoints, an area that led to scientific debate in early analyses.

Febrile Neutropenia

RCTs and systematic reviews examined high-level outcomes like all-cause mortality and the overall achievement of study-defined outcomes in patients with physiological imbalance. The scientific literature indicates continuing discussion and variability when Maxipime was evaluated against specific other strong antibiotic classes.

Complicated and Skin Infections

For complicated urinary tract infections (cUTI), research monitored the achievement of study-defined outcomes (clinical success and bacterial clearance) in adult populations. For complicated intra-abdominal infections (cIAI), evidence is specific to the study of Maxipime in combination with metronidazole, meaning there is limited information regarding its use as a single agent. Clinical trials also explored Maxipime's role in uncomplicated skin infections, with findings based on susceptible Gram-positive organisms.

Research Limitations and Unanswered Questions

Evidence in Special Populations Research has included pediatric patients (over two months of age) and older adults, though data for certain groups remain insufficient. Studies in patients with kidney (renal) impairment focused mainly on pharmacokinetic outcomes to characterize drug monitoring strategies.

Scientific Uncertainty and Follow-up In most primary efficacy trials, follow-up durations were limited to the short term. Long-term effects are not fully established by the existing data. Research exploring complex dosing strategies in the critically ill relies on studies where sample sizes were modest, meaning certainty remains low in these findings. Overall, there is limited information for long-term outcomes.

Key Studies & References

Frequently Asked Questions (FAQ)

Common questions about Maxipime (FAQ)

Q: What is the half-life of cefepime and how long does it stay in the body?

According to the official product information on pharmacokinetics, the average half-life of cefepime in healthy individuals is about 2 hours. This is the time it takes for the concentration of the medicine in the body to be reduced by half. Regulatory documents indicate that the medicine is primarily eliminated from the body via the kidneys.

Q: Does cefepime affect the results of any laboratory tests, such as blood or urine tests?

Official labeling for Maxipime includes precautions about laboratory test interference. Specifically, the medicine may cause false-positive results when certain tests are used to check for glucose (sugar) in the urine. This potential is noted in the official prescribing information for healthcare providers.

Q: Can people with a corn allergy receive cefepime injections?

Official drug information addresses the use of certain diluents with Maxipime. Some prepared solutions containing dextrose, which is sometimes made from corn products, may be contraindicated in patients with a known allergy or hypersensitivity to corn or corn-derived products. Regulatory materials indicate that the selection of the specific formulation and diluent should account for known allergies.

Q: Is cefepime effective against Pseudomonas aeruginosa?

Regulatory documents indicate that cefepime is approved for treating certain infections caused by susceptible strains of the bacterium Pseudomonas aeruginosa. Official use is based on the organism being confirmed as susceptible to the medicine.

Q: What is the typical length of a course of cefepime treatment?

The length of treatment is not standardized and depends on the type and severity of the infection being treated. Regulatory guidance specifies different durations, such as 7 days for certain cases of febrile neutropenia, or 7 to 10 days for some complicated urinary tract infections. The precise duration is determined by a qualified healthcare professional according to the specific infection's requirements.

Q: Does cefepime cross the blood-brain barrier?

Official warnings for Maxipime highlight the risk of neurotoxicity, which includes serious effects like encephalopathy (brain disease) and seizures. The occurrence of these central nervous system effects is reported to be associated with high and prolonged concentrations of the drug.

How should Maxipime be stored and disposed of?

How to Store and Dispose of Maxipime

The storage of Maxipime (cefepime hydrochloride) for Injection is governed by specific regulatory conditions. The unreconstituted powder must be stored at Controlled Room Temperature, 20 C to 25 C (68 F to 77 F), and must be protected from light by keeping it in the original carton.

Stability and Handling

Storage State	Temperature Range	Maximum Stability Period
Reconstituted Solution	Room Temperature (20 C to 25 C)	24 hours
Reconstituted Solution	Refrigerated (2 C to 8 C)	7 days

All Maxipime must be stored out of reach of children. Thawed solutions must not be refrozen. Any unused portion or waste materials must be disposed of in compliance with local requirements for pharmaceutical waste.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.