Risk Factor: BM
Class: Anti-infectives/ Cephalosporins
Fetal Risk Summary
Cefepime is a parenteral, semisynthetic cephalosporin antibiotic. No adverse effects on fertility or reproduction, including embryo toxicity and teratogenicity, were observed in mice, rats, and rabbits dosed at one to four times the recommended maximum human daily dose on a mg/m2/day basis (1).
No reports describing the use of cefepime in human pregnancy have been located. Cephalosporins are usually considered safe to use during pregnancy (see other cephalosporins for published human experience).
Breast Feeding Summary
Cefepime is excreted in human milk. The manufacturer reports that very low concentrations (0.5 g/mL) were measured in milk, but the maternal dose was not provided (1). In spite of these low levels, three potential problems exist for the nursing infant exposed to cefepime in milk: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. Although not specifically listing cefepime, the American Academy of Pediatrics classifies other cephalosporin antibiotics as compatible with breast feeding (2).
- Product information. Maxipime. Bristol-Myers Squibb Company, 1997.
- Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.