Monday January 14, 2008
Cefepime in renal failure patients
Cefepime is dialysable. In patients on CVVHD (Continuous venovenous haemodiafiltration), no dosage adjustment for cefepime is required and the dosage regime as with normal renal function should be administered.
But in patients on HD (hemodialysis), dose of 1 gram every 24 hours is recommended. Dose of cefepime is advisable after the session on HD days as cefepime is dialysable.
Please take note of danger of not adjusting cefepime in HD patients. Cefepime-related neurotoxicity is now well documented and could be a real danger causing mild disorientation, waxing and waning mental state, generalized tonic-clonic seizures or even coma.
Reference: click to get abstract / article
1. Cefepime-related neurotoxicity in a haemodialysis patient - Nephrol Dial Transplant (1999) 14: 2265-2266