Cefepime

Cefepime is a semi-synthetic, broad-spectrum, fourth-generation cephalosporin antibiotic that was patented in 1982 by Bristol-Myers Squibb. Cefepime is bactericidal against a wide range of Gram-positive and Gram-negative bacteria, disrupting bacterial cell wall synthesis. Cefepime is a zwitterion with a net neutral charge which crosses the outer membrane of Gram-negative bacilli more rapidly than other cephalosporins. It appears to be intrinsically more resistant to hydrolysis by β-lactamases and is commonly used in antimicrobial susceptibility testing.
Cefepime is sparingly soluble in water.

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Background

Like β-lactams, cephalosporins interfere with penicillin binding protein (PBP) activity involved in the final phase of peptidoglycan synthesis. PBP’s catalyze a pentaglycine crosslink between alanine and lysine residues providing additional strength to the cell wall. Without a pentaglycine crosslink, the integrity of the cell wall is severely compromised and ultimately leads to cell lysis and death. Resistance to cephalosporins is commonly due to cells containing plasmid-encoded β-lactamases. Interestingly, cefepime is resistant to various β-lactamases encoded by otherwise resistant β-lactam bacteria strains.