Identification

Summary

Cefepime is a fourth-generation cephalosporin antibiotic used in the treatment of infections caused by susceptible bacteria, such as pneumonia, urinary tract infections, and skin infections.

Generic Name
Cefepime
DrugBank Accession Number
DB01413
Background

Cefepime is a fourth-generation cephalosporin antibiotic developed in 1994. Cefepime is active against Gram-positive and Gram-negative bacteria, and has greater activity against both compared to third-generation antibiotics.1,4 Cefepime is normally used to treat severe nosocomial pneumonia and infections caused by multi-resistant microorganisms such as Pseudomonas aeruginosa, and is also indicated for the empirical treatment of febrile neutropenia.4 The popularity of its third-generation predecessors, its clinical efficacy, and the high prevalence of multidrug-resistant bacteria might be some of the factors leading to an increase in the use of cefepime. The activity of cefepime against Enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus aureus is due to its high stability toward beta-lactamases.4 In general, cefepime seems to be well tolerated; however, patients treated with this antibiotic, especially those with renal impairment, may develop neurotoxicity.4,5,6

Type
Small Molecule
Groups
Approved, Investigational
Structure
Weight
Average: 480.561
Monoisotopic: 480.124959288
Chemical Formula
C19H24N6O5S2
Synonyms
  • (6R,7R)-7-{[(2Z)-2-(2-amino-1,3-thiazol-4-yl)-2-(methoxyimino)acetyl]amino}-3-[(1-methylpyrrolidinium-1-yl)methyl]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate
  • Cefepima
  • Cefepime
  • Cefepimum
External IDs
  • BMY 28142
  • BMY-28142

Pharmacology

Indication

Cefepime is indicated for the treatment of pneumonia caused by susceptible bacteria, and for empiric therapy for febrile neutropenic patients. Cefepime is also indicated for the treatment of uncomplicated and complicated urinary tract infections (including pyelonephritis), uncomplicated skin and skin structure infections, and complicated intra-abdominal infections (used in combination with metronidazole) in adults caused by susceptible bacteria.5,6

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Associated Conditions
Contraindications & Blackbox Warnings
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Pharmacodynamics

Cefepime is a fourth-generation cephalosporin antibiotic.5,6 It is active against Gram-negative bacteria such as Enterobacter spp., Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa, and Gram-positive bacteria such as Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pneumoniae, Streptococcus pyogenes and Viridans group streptococci.5,6 Compared to third-generation cephalosporins, cefepime has an extended Gram-negative coverage. Whereas other cephalosporins are degraded by plasmid- and chromosome-mediated beta-lactamases, cefepime is stable and not significantly hydrolyzed by these enzymes.1,4 Cefepime is also a poor inducer of type 1 beta-lactamases and, therefore, a good alternative against bacteria resistant to third-generation cephalosporins.1

In animal models of infection, the time that the unbound plasma concentration of cefepime exceeds the minimum inhibitory concentration (MIC) of infecting organisms has been shown to correlate with treatment efficacy.5,6 It has been suggested that cefepime can cross the inflamed blood-brain barrier.5,6 This, along with its ability to inhibit γ-aminobutyric acid (GABA), could lead to the neurotoxic effects observed in some of the patients treated with cefepime.3,4

Mechanism of action

Cefepime is a bactericidal cephalosporin with a mode of action similar to other beta-lactam antibiotics.5,6 Cefepime disrupts bacterial cell walls by binding and inhibiting transpeptidases known as penicillin-binding proteins (PBPs), which are enzymes involved in the final stages of peptidoglycan layer synthesis. This results in the lysis and death of susceptible microorganisms.4 Cefepime has a broad spectrum of in vitro activity that includes both Gram-positive and Gram-negative bacteria.5,6 Cefepime has affinity for PBP-3 and PBP-1 in Escherichia coli and Pseudomonas aeruginosa, as well as PBP-2 in E. coli and Enterobacter cloacae.4

TargetActionsOrganism
APenicillin-binding protein 1A
inhibitor
Escherichia coli (strain K12)
APenicillin-binding protein 1B
inhibitor
Escherichia coli (strain K12)
APenicillin-binding protein 2
inhibitor
Escherichia coli (strain K12)
APeptidoglycan synthase FtsI
inhibitor
Escherichia coli (strain K12)
APenicillin-binding protein 1B
inhibitor
Pseudomonas aeruginosa
APenicillin-binding protein 3
inhibitor
Pseudomonas aeruginosa
UPenicillin-binding protein 2
inhibitor
Pseudomonas aeruginosa
Absorption

Healthy adult male volunteers (n=9) given a single intravenous infusion of 500 mg, 1 g, and 2 g of cefepime had a corresponding Cmax of 39.1, 81.7 and 163.9 μg/mL, and a corresponding AUC of 70.8, 148.5 and 284.8 h⋅μg/mL.5,6 On the other hand, healthy adult male volunteers given a single intramuscular infusion of 500 mg, 1 g, and 2 g of cefepime had a corresponding Cmax of 13.9, 29.6 and 57.5 μg/mL, a corresponding AUC of 60, 137 and 262 h⋅μg/mL, and a corresponding Tmax of 1.4, 1.6 and 1.5 h.5

A study in healthy adult male volunteers (n=7) that received clinically relevant doses for 9 days suggests that cefepime is not accumulated in the body. Between 250 mg and 2 g, cefepime follows a linear pharmacokinetic model, and the absolute bioavailability of cefepime in pediatric patients (n=8) given an intramuscular dose of 50 mg/kg was 82.3%.5,6

Volume of distribution

The average steady-state volume of distribution of cefepime is 18.0 L. In pediatric patients, the average steady-state volume of distribution is 0.3 L/kg.5,6

Protein binding

The serum protein binding of cefepime is approximately 20%, independent of its concentration in serum.5,6

Metabolism

Less than 1% of cefepime is metabolized in the liver.3 Cefepime is metabolized to N-methylpyrrolidine (NMP), which then undergoes rapid oxidation to form NMP-N-oxide, a more stable compound.5,6 NMP-N-oxide is the predominant metabolite of cefepime, while NMP and the 7-epimer of cefepime are minor byproducts.2 It has been suggested that flavin-containing mixed-function oxygenase mediates the oxidation of NMP to NMP-N-oxide.2

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Route of elimination

Cefepime is mainly eliminated by the kidneys, and most of it is excreted unchanged. Approximately 85% of cefepime administered to normal subjects is excreted unchanged in urine. Less than 1% of the administered dose is recovered from urine as N-methylpyrrolidine (NMP), 6.8% as NMP-N-oxide, and 2.5% as an epimer.5,6 Dosage adjustments are required in patients with renal dysfunction or those undergoing hemodialysis, due to the importance of renal excretion in eliminating cefepime.5,6

Half-life

Healthy adult male volunteers (n=9) given cefepime had an average half-life of 2 hours. In patients requiring hemodialysis, the average half-life was 13.5 hours, and in patients requiring continuous peritoneal dialysis, the average half-life was 19 hours.5,6

Clearance

Cefepime has a total body clearance of 120 mL/min in healthy volunteers, and in pediatric patients, the average total body clearance is 3.3 mL/min/kg.5,6 In geriatric patients (65 years of age and older) and patients with abnormal renal function, cefepime total body clearance decreases proportionally with creatinine clearance.5,6

Adverse Effects
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Toxicity

Patients who receive a cefepime overdose should be carefully observed and given supportive treatment. In case of renal insufficiency, peritoneal dialysis should not be performed.5,6 Instead, hemodialysis is recommended to aid in the removal of cefepime from the body. Some of the symptoms of a cefepime overdose are encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, and coma), myoclonus, seizures, neuromuscular excitability and nonconvulsive status epilepticus.5,6 In vivo carcinogenicity studies for cefepime have not been performed. In chromosomal aberration studies, this antibiotic was positive for clastogenicity in primary human lymphocytes, but negative in Chinese hamster ovary cells. Cefepime does not exhibit genotoxic effects in in vitro assays, and in vivo assessments of clastogenicity are negative. In rats given up to 1000 mg/kg/day (1.6 times the recommended maximum human dose), cefepime did not have negative effects on fertility.5,6

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirCefepime may decrease the excretion rate of Abacavir which could result in a higher serum level.
AbciximabThe therapeutic efficacy of Abciximab can be decreased when used in combination with Cefepime.
AceclofenacThe risk or severity of nephrotoxicity can be increased when Cefepime is combined with Aceclofenac.
AcemetacinThe risk or severity of nephrotoxicity can be increased when Cefepime is combined with Acemetacin.
AcenocoumarolThe risk or severity of bleeding can be increased when Cefepime is combined with Acenocoumarol.
AcetaminophenCefepime may decrease the excretion rate of Acetaminophen which could result in a higher serum level.
Acetylsalicylic acidThe risk or severity of nephrotoxicity can be increased when Acetylsalicylic acid is combined with Cefepime.
AclidiniumCefepime may decrease the excretion rate of Aclidinium which could result in a higher serum level.
AcrivastineCefepime may decrease the excretion rate of Acrivastine which could result in a higher serum level.
AcyclovirThe risk or severity of nephrotoxicity can be increased when Acyclovir is combined with Cefepime.
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Food Interactions
No interactions found.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Cefepime hydrochlorideI8X1O0607P123171-59-5LRAJHPGSGBRUJN-OMIVUECESA-N
International/Other Brands
Axepim / Cepimax / Cepimex / Maxipime
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
CefepimeInjection, solution1 g/50mLIntravenousBaxter Healthcare Corporation2008-08-05Not applicableUS flag
Cefepime for InjectionPowder, for solution1 g / vialIntramuscular; IntravenousApotex CorporationNot applicableNot applicableCanada flag
Cefepime for InjectionPowder, for solution2 g / vialIntravenousApotex Corporation2009-03-19Not applicableCanada flag
Cefepime for Injection USPPowder, for solution2 g / vialIntravenousHikma Canada Limited2021-07-09Not applicableCanada flag
Cefepime for Injection USPPowder, for solution1 g / vialIntramuscular; IntravenousHikma Canada LimitedNot applicableNot applicableCanada flag
Cefepime for Injection, USPPowder, for solution1 g / vialIntramuscular; IntravenousQilu Pharmaceutical Co. LtdNot applicableNot applicableCanada flag
Cefepime for Injection, USPPowder, for solution2 g / vialIntravenousQilu Pharmaceutical Co. LtdNot applicableNot applicableCanada flag
Cefepime Hydrochloride and DextroseInjection, solution2 g/50mLIntravenousB. Braun Medical Inc.2010-05-06Not applicableUS flag
Cefepime Hydrochloride and DextroseInjection, solution1 g/50mLIntravenousB. Braun Medical Inc.2010-05-06Not applicableUS flag
MaxipimeInjection, powder, for solution1 g/1Intramuscular; IntravenousElan Pharmaceuticals2009-06-012013-05-31US flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Apo-cefepimePowder, for solution2 g / vialIntravenousApotex Corporation2018-05-14Not applicableCanada flag
Apo-cefepimePowder, for solution1 g / vialIntramuscular; IntravenousApotex Corporation2018-05-14Not applicableCanada flag
CefepimeInjection, powder, for solution1 g/1Intramuscular; IntravenousApotex Corporation2007-06-182019-01-31US flag
CefepimeInjection, powder, for solution1 g/1Intramuscular; IntravenousApotex Corp.2022-09-01Not applicableUS flag
CefepimeInjection, powder, for solution1 g/1Intramuscular; IntravenousApotex Corp.2017-03-30Not applicableUS flag
CefepimeInjection, powder, for solution1 g/1Intramuscular; IntravenousApotex Corporation2007-06-182019-01-31US flag
CefepimeInjection, powder, for solution1 g/1Intramuscular; IntravenousQilu Pharmaceutical Co., Ltd.2016-02-01Not applicableUS flag
CefepimeInjection, powder, for solution1 g/20mLIntramuscular; IntravenousWG Critical Care, LLC2021-03-31Not applicableUS flag
CefepimeInjection, powder, for solution2 g/1IntravenousHospira, Inc.2012-07-302012-07-30US flag
CefepimeInjection, powder, for solution2 g/1IntravenousMeitheal Pharmaceuticals Inc.2018-12-17Not applicableUS flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
ROXIPIME 1 GR IM/IV ENJEKTABL TOZ ICEREN FLAKON, 1 ADETCefepime (1 gr)InjectionIntramuscular; IntravenousWorld Medicine Ilac San. Ve Tic. a.s.2020-08-14Not applicableTurkey flag

Categories

ATC Codes
J01DE01 — CefepimeJ01RA06 — Cefepime and amikacin
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as 3'-quaternary ammonium cephalosporins. These are cephalosporins that are substituted at the 3'-position by a quaternary ammonium group.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Lactams
Sub Class
Beta lactams
Direct Parent
3'-quaternary ammonium cephalosporins
Alternative Parents
N-acyl-alpha amino acids and derivatives / 2,4-disubstituted thiazoles / 1,3-thiazines / 2-amino-1,3-thiazoles / N-alkylpyrrolidines / Heteroaromatic compounds / Tetraalkylammonium salts / Tertiary carboxylic acid amides / Carboxylic acid salts / Azetidines
show 14 more
Substituents
1,3-thiazol-2-amine / 2,4-disubstituted 1,3-thiazole / 3'-quaternary ammonium cephalosporin / Alpha-amino acid or derivatives / Amine / Amino acid / Amino acid or derivatives / Aromatic heteropolycyclic compound / Azacycle / Azetidine
show 30 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
cephalosporin, oxime O-ether (CHEBI:478164)
Affected organisms
  • Enteric bacteria and other eubacteria

Chemical Identifiers

UNII
807PW4VQE3
CAS number
88040-23-7
InChI Key
HVFLCNVBZFFHBT-ZKDACBOMSA-N
InChI
InChI=1S/C19H24N6O5S2/c1-25(5-3-4-6-25)7-10-8-31-17-13(16(27)24(17)14(10)18(28)29)22-15(26)12(23-30-2)11-9-32-19(20)21-11/h9,13,17H,3-8H2,1-2H3,(H3-,20,21,22,26,28,29)/b23-12-/t13-,17-/m1/s1
IUPAC Name
1-{[(6R,7R)-7-[(2Z)-2-(2-amino-1,3-thiazol-4-yl)-2-(methoxyimino)acetamido]-2-carboxylato-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-3-yl]methyl}-1-methylpyrrolidin-1-ium
SMILES
CO\N=C(/C(=O)N[C@@H]1C(=O)N2[C@]1([H])SCC(C[N+]1(C)CCCC1)=C2C([O-])=O)C1=CSC(N)=N1

References

Synthesis Reference

Kaplan, MA., et al. (1990). Cefepime cephalosporin salts (U.S. Patent No. 4,910,301). U.S. Patent and Trademark Office. https://patentimages.storage.googleapis.com/43/8a/fa/0010ba48b44ce5/US4910301.pdf

US20050043531
General References
  1. Chapman TM, Perry CM: Cefepime: a review of its use in the management of hospitalized patients with pneumonia. Am J Respir Med. 2003;2(1):75-107. [Article]
  2. Barbhaiya RH, Knupp CA, Forgue ST, Matzke GR, Halstenson CE, Opsahl JA, Pittman KA: Disposition of the cephalosporin cefepime in normal and renally impaired subjects. Drug Metab Dispos. 1991 Jan-Feb;19(1):68-73. [Article]
  3. Ortega AJ, Ghafouri SR, Vu L, Edwards B, Nickel N: Cefepime-Induced Encephalopathy in a High-Risk Patient With Renal Insufficiency and Cirrhosis. Cureus. 2021 Oct 14;13(10):e18767. doi: 10.7759/cureus.18767. eCollection 2021 Oct. [Article]
  4. Drago L, De Vecchi E: The safety of cefepime in the treatment of infection. Expert Opin Drug Saf. 2008 Jul;7(4):377-87. doi: 10.1517/14740338.7.4.377. [Article]
  5. FDA Approved Drug Products: MAXIPIME (cefepime hydrochloride) injection for intravenous or intramuscular use [Link]
  6. FDA Approved Drug Products: Cefepime and dextrose injection, for intravenous use [Link]
  7. Hospira: Cefepime hydrochloride SDS [Link]
Human Metabolome Database
HMDB0015483
KEGG Drug
D02376
KEGG Compound
C08111
PubChem Compound
5479537
PubChem Substance
46507919
ChemSpider
4586395
BindingDB
50350470
RxNav
20481
ChEBI
478164
ChEMBL
CHEMBL186
Therapeutic Targets Database
DAP000455
PharmGKB
PA164754876
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Cefepime

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedTreatmentAntibiotic Reaction / Febrile Neutropenia / Leukemias / Pediatrics Cancer1
4CompletedTreatmentBacteremia / Sepsis1
4CompletedTreatmentDiabetes Mellitus1
4CompletedTreatmentPeritoneal Dialysis Associated Peritonitis1
4CompletedTreatmentPneumonia1
4Enrolling by InvitationTreatmentEndocarditis1
4RecruitingPreventionAspiration / Aspiration Pneumonia1
4RecruitingTreatmentFebrile Neutropenia2
4RecruitingTreatmentPneumonia1
4Unknown StatusTreatmentCystic Fibrosis (CF)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
  • Antibioticos Ltd.
  • Apotex Inc.
  • APP Pharmaceuticals
  • B. Braun Melsungen AG
  • Baxter International Inc.
  • Bristol-Myers Squibb Co.
  • Cardinal Health
  • Elan Pharmaceuticals Inc.
  • GC Hanford Manufacturing Co.
  • Orchid Healthcare
  • Patheon Inc.
  • Sagent Pharmaceuticals
  • Sandoz
Dosage Forms
FormRouteStrength
Injection, powder, for solution
InjectionParenteral
Injection, powder, for solutionParenteral0.5 g
Injection, powder, for solutionParenteral
Injection, powder, for solutionParenteral1 g
Injection, powder, for solutionParenteral2 g
InjectionIntramuscular; Intravenous1 g/1
InjectionIntramuscular; Intravenous500 mg/1
InjectionIntravenous2 g/1
Injection, powder, for solutionIntramuscular; Intravenous1 g/20mL
Injection, powder, for solutionIntramuscular; Intravenous2 g/1
Injection, powder, for solutionIntravenous1 g/1
Injection, powder, for solutionIntravenous100 g/1
Injection, powder, for solutionIntravenous2 g/20mL
PowderNot applicable1 g/1g
Injection, powder, for solutionIntramuscular; Intravenous1 g
Powder, for solutionIntravenous2 g / vial
Injection, solutionIntravenous1 g/50mL
Injection, solutionIntravenous2 g/50mL
Injection, powder, for solutionIntravenous1000 mg
Injection, powder, for solution1 G
Injection, powder, for solution2 G
Injection, powder, for solutionIntramuscular; Intravenous1 g/vial
Injection, powder, for solutionIntramuscular; Intravenous2 g
Injection, powder, lyophilized, for solutionIntramuscular; Intravenous1000 MG
Injection, powder, for solutionIntravenous2000 mg
InjectionIntramuscular
InjectionIntramuscular; Intravenous
Injection, powder, for solutionParenteral1 G/3ML
Injection, powder, for solutionParenteral2 G/10ML
Injection, powder, for solutionParenteral500 MG/1.5ML
Injection, powder, for solutionParenteral1000 MG/3ML
Injection, powder, for solutionParenteral2000 MG/10ML
Injection
Injection, powder, for solutionParenteral1000 mg
Injection, powder, for solutionIntramuscular; Intravenous1 g/1
Injection, powder, for solutionIntramuscular; Intravenous500 mg/1
Injection, powder, for solutionIntravenous2 g/1
Injection, powder, for solutionIntramuscular; Intravenous
Powder, for solutionIntramuscular; Intravenous1 g / vial
Injection, powder, for solutionIntravenous
Injection, powder, for solutionIntravenous2 g/vial
InjectionIntravenous1 G
InjectionIntravenous500 MG
Powder500 mg/1vial
Prices
Unit descriptionCostUnit
Maxipime 2 gram vial43.04USD vial
Cefepime hcl 2 gram vial40.36USD vial
Maxipime 1 gm piggyback vial23.24USD vial
Maxipime 1 gram vial21.7USD vial
Cefepime hcl 1 gm vial20.33USD vial
Cefepime 2 gm injection0.51USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)150ºCPrabhakar et al. Pharmacology in Clinical Neurosciences: A Quick Guide. 2020, Springer Nature. p 321.
water solubility0.017 g/LPrabhakar et al. Pharmacology in Clinical Neurosciences: A Quick Guide. 2020, Springer Nature. p 321.
Predicted Properties
PropertyValueSource
Water Solubility0.0173 mg/mLALOGPS
logP-0.37ALOGPS
logP-4.2Chemaxon
logS-4.5ALOGPS
pKa (Strongest Acidic)2.82Chemaxon
pKa (Strongest Basic)3.62Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count8Chemaxon
Hydrogen Donor Count2Chemaxon
Polar Surface Area150.04 Å2Chemaxon
Rotatable Bond Count7Chemaxon
Refractivity141.98 m3·mol-1Chemaxon
Polarizability47.53 Å3Chemaxon
Number of Rings4Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleYesChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption-0.9819
Blood Brain Barrier-0.9332
Caco-2 permeable-0.6669
P-glycoprotein substrateSubstrate0.9066
P-glycoprotein inhibitor INon-inhibitor0.7965
P-glycoprotein inhibitor IINon-inhibitor0.5353
Renal organic cation transporterNon-inhibitor0.7455
CYP450 2C9 substrateNon-substrate0.8806
CYP450 2D6 substrateNon-substrate0.8068
CYP450 3A4 substrateSubstrate0.6023
CYP450 1A2 substrateNon-inhibitor0.7233
CYP450 2C9 inhibitorNon-inhibitor0.736
CYP450 2D6 inhibitorNon-inhibitor0.8741
CYP450 2C19 inhibitorNon-inhibitor0.6986
CYP450 3A4 inhibitorNon-inhibitor0.8378
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.8854
Ames testNon AMES toxic0.6625
CarcinogenicityNon-carcinogens0.9051
BiodegradationNot ready biodegradable0.6571
Rat acute toxicity2.3513 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9015
hERG inhibition (predictor II)Non-inhibitor0.734
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Targets

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Kind
Protein
Organism
Escherichia coli (strain K12)
Pharmacological action
Yes
Actions
Inhibitor
General Function
Serine-type d-ala-d-ala carboxypeptidase activity
Specific Function
Cell wall formation. Synthesis of cross-linked peptidoglycan from the lipid intermediates. The enzyme has a penicillin-insensitive transglycosylase N-terminal domain (formation of linear glycan str...
Gene Name
mrcA
Uniprot ID
P02918
Uniprot Name
Penicillin-binding protein 1A
Molecular Weight
93635.545 Da
References
  1. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]
Kind
Protein
Organism
Escherichia coli (strain K12)
Pharmacological action
Yes
Actions
Inhibitor
General Function
Serine-type d-ala-d-ala carboxypeptidase activity
Specific Function
Cell wall formation. Synthesis of cross-linked peptidoglycan from the lipid intermediates. The enzyme has a penicillin-insensitive transglycosylase N-terminal domain (formation of linear glycan str...
Gene Name
mrcB
Uniprot ID
P02919
Uniprot Name
Penicillin-binding protein 1B
Molecular Weight
94291.875 Da
References
  1. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]
Kind
Protein
Organism
Escherichia coli (strain K12)
Pharmacological action
Yes
Actions
Inhibitor
General Function
Serine-type d-ala-d-ala carboxypeptidase activity
Specific Function
Cell wall formation; PBP-2 is responsible for the determination of the rod shape of the cell. It synthesizes cross-linked peptidoglycan from lipid intermediates.
Gene Name
mrdA
Uniprot ID
P0AD65
Uniprot Name
Penicillin-binding protein 2
Molecular Weight
70856.1 Da
References
  1. Grassi GG, Grassi C: Cefepime: overview of activity in vitro and in vivo. J Antimicrob Chemother. 1993 Nov;32 Suppl B:87-94. [Article]
  2. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]
Kind
Protein
Organism
Escherichia coli (strain K12)
Pharmacological action
Yes
Actions
Inhibitor
General Function
Peptidoglycan glycosyltransferase activity
Specific Function
Essential cell division protein that is required for the synthesis of peptidoglycan at the division septum (PubMed:1103132, PubMed:9614966). Catalyzes the synthesis of cross-linked peptidoglycan fr...
Gene Name
ftsI
Uniprot ID
P0AD68
Uniprot Name
Peptidoglycan synthase FtsI
Molecular Weight
63876.925 Da
References
  1. Grassi GG, Grassi C: Cefepime: overview of activity in vitro and in vivo. J Antimicrob Chemother. 1993 Nov;32 Suppl B:87-94. [Article]
  2. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]
Kind
Protein
Organism
Pseudomonas aeruginosa
Pharmacological action
Yes
Actions
Inhibitor
General Function
Peptidoglycan glycosyltransferase activity
Specific Function
Cell wall formation. Synthesis of cross-linked peptidoglycan from the lipid intermediates. The enzyme has a penicillin-insensitive transglycosylase N-terminal domain (formation of linear glycan str...
Gene Name
ponB
Uniprot ID
Q9X6W0
Uniprot Name
Penicillin-binding protein 1B
Molecular Weight
85486.615 Da
References
  1. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]
Kind
Protein
Organism
Pseudomonas aeruginosa
Pharmacological action
Yes
Actions
Inhibitor
General Function
Peptidoglycan glycosyltransferase activity
Specific Function
Not Available
Gene Name
pbpB
Uniprot ID
Q51504
Uniprot Name
Cell division protein
Molecular Weight
62855.78 Da
References
  1. Grassi GG, Grassi C: Cefepime: overview of activity in vitro and in vivo. J Antimicrob Chemother. 1993 Nov;32 Suppl B:87-94. [Article]
  2. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]
Kind
Protein
Organism
Pseudomonas aeruginosa
Pharmacological action
Unknown
Actions
Inhibitor
Curator comments
Cefepime shows low affinity for PBP-2 of P. aeruginosa.
General Function
Penicillin binding
Specific Function
Not Available
Gene Name
pbpA
Uniprot ID
Q9X6V3
Uniprot Name
Penicillin-binding protein 2
Molecular Weight
72212.855 Da
References
  1. Grassi GG, Grassi C: Cefepime: overview of activity in vitro and in vivo. J Antimicrob Chemother. 1993 Nov;32 Suppl B:87-94. [Article]
  2. Pucci MJ, Boice-Sowek J, Kessler RE, Dougherty TJ: Comparison of cefepime, cefpirome, and cefaclidine binding affinities for penicillin-binding proteins in Escherichia coli K-12 and Pseudomonas aeruginosa SC8329. Antimicrob Agents Chemother. 1991 Nov;35(11):2312-7. doi: 10.1128/AAC.35.11.2312. [Article]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Symporter activity
Specific Function
Sodium-ion dependent, high affinity carnitine transporter. Involved in the active cellular uptake of carnitine. Transports one sodium ion with one molecule of carnitine. Also transports organic cat...
Gene Name
SLC22A5
Uniprot ID
O76082
Uniprot Name
Solute carrier family 22 member 5
Molecular Weight
62751.08 Da
References
  1. Ganapathy ME, Huang W, Rajan DP, Carter AL, Sugawara M, Iseki K, Leibach FH, Ganapathy V: beta-lactam antibiotics as substrates for OCTN2, an organic cation/carnitine transporter. J Biol Chem. 2000 Jan 21;275(3):1699-707. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
Curator comments
Cefepime has a low affinity for solute carrier family 15 member 1 (PEPT1, Ki>30 mM)
General Function
Proton-dependent oligopeptide secondary active transmembrane transporter activity
Specific Function
Proton-coupled intake of oligopeptides of 2 to 4 amino acids with a preference for dipeptides. May constitute a major route for the absorption of protein digestion end-products.
Gene Name
SLC15A1
Uniprot ID
P46059
Uniprot Name
Solute carrier family 15 member 1
Molecular Weight
78805.265 Da
References
  1. Ganapathy ME, Huang W, Rajan DP, Carter AL, Sugawara M, Iseki K, Leibach FH, Ganapathy V: beta-lactam antibiotics as substrates for OCTN2, an organic cation/carnitine transporter. J Biol Chem. 2000 Jan 21;275(3):1699-707. [Article]
  2. Luckner P, Brandsch M: Interaction of 31 beta-lactam antibiotics with the H+/peptide symporter PEPT2: analysis of affinity constants and comparison with PEPT1. Eur J Pharm Biopharm. 2005 Jan;59(1):17-24. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
Curator comments
Cefepime has a low affinity for solute carrier family 15 member 2 (PEPT2, Ki=11.4 mM)
General Function
Peptide:proton symporter activity
Specific Function
Proton-coupled intake of oligopeptides of 2 to 4 amino acids with a preference for dipeptides.
Gene Name
SLC15A2
Uniprot ID
Q16348
Uniprot Name
Solute carrier family 15 member 2
Molecular Weight
81782.77 Da
References
  1. Ganapathy ME, Huang W, Rajan DP, Carter AL, Sugawara M, Iseki K, Leibach FH, Ganapathy V: beta-lactam antibiotics as substrates for OCTN2, an organic cation/carnitine transporter. J Biol Chem. 2000 Jan 21;275(3):1699-707. [Article]
  2. Luckner P, Brandsch M: Interaction of 31 beta-lactam antibiotics with the H+/peptide symporter PEPT2: analysis of affinity constants and comparison with PEPT1. Eur J Pharm Biopharm. 2005 Jan;59(1):17-24. [Article]

Drug created at July 19, 2007 15:47 / Updated at December 04, 2022 18:48