#124 – Dosing Consult: Cefepime

#124 – Dosing Consult: Cefepime

Author: Society of Infectious Diseases Pharmacists October 10, 2025 Duration: 1:16:08

Drs. Erin Barreto (@erin_barreto) and Jeffrey Lipman join Dr. Whitney Buckel for a conversation on ideal dosing of cefepime. Hear from the experts on the differences between package insert and “high-dose” regimens, adjustments for renal impairment/augmented renal clearance, and the role of cefepime therapeutic drug monitoring.

References:

  1. Barreto EF, et al. Setting the Beta-Lactam Therapeutic Range for Critically Ill Patients: Is There a Floor or Even a Ceiling? Crit Care Explor. 2021 Jun 11;3(6):e0446.PMID: https://pubmed.ncbi.nlm.nih.gov/34136822/
  2. Barreto EF, et al. Adequacy of cefepime concentrations in the early phase of critical illness: A case for precision pharmacotherapy. Pharmacotherapy. 2023 Nov;43(11):1112-1120. https://pubmed.ncbi.nlm.nih.gov/36648390/
  3. ** **Udy AA, et al. Augmented renal clearance: implications for antibacterial dosing in the critically ill. Clin Pharmacokinet. 2010;49(1):1-16. https://pubmed.ncbi.nlm.nih.gov/20000886/
  4. Lipman J, Wallis SC, Boots RJ. Cefepime versus cefpirome: the importance of creatinine clearance.   Anesth Analg. 2003 Oct;97(4):1149-1154. doi: 10.1213/01.ANE.0000077077.54084.B0.PMID: 14500173
  5. Roberts JA, Ulldemolins M, Roberts MS, McWhinney B, Ungerer J, Paterson DL, Lipman J. Therapeutic drug monitoring of beta-lactams in critically ill patients: proof of concept.  Int J Antimicrob Agents. 2010 Oct;36(4):332-9. doi: 10.1016/j.ijantimicag.2010.06.008. Epub 2010 Aug 3.PMID: 20685085

Hosted by the Society of Infectious Diseases Pharmacists, Breakpoints is a podcast dedicated to the intricate and ever-evolving world of antimicrobial therapy. Each episode delves into the practical challenges and scientific nuances faced by pharmacists on the front lines of patient care, from interpreting susceptibility data and optimizing dosing strategies to navigating the complexities of antimicrobial stewardship. The conversations in this podcast bridge the gap between groundbreaking infectious diseases research and its direct application in clinical settings, offering insights that are both academically rigorous and immediately useful. You’ll hear expert discussions on new resistance patterns, evolving treatment guidelines, and the real-world implementation of life-saving protocols. Designed for healthcare professionals committed to precision medicine, Breakpoints provides a deeper understanding of how to effectively manage infections and improve patient outcomes. Tune in for thoughtful analysis and forward-thinking dialogue that defines the critical role of specialized pharmacists in public health.
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