NR 293 Pharmacology for Nursing Practice

NR 293 Pharmacology for Nursing Practice

Cephalosporin for Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are a common health issue affecting millions worldwide. They can cause discomfort, pain, and inconvenience for those affected. Fortunately, effective treatment options are available, such as using cephalosporins like cefepime (Maxipime). Cefepime belongs to the fourth generation of cephalosporins. It is known for destroying bacterial cell walls, making it an essential weapon against UTIs, skin infections, and pneumonia.

UTIs are often caused by certain types of bacteria, with Escherichia coli (E. coli) and Klebsiella pneumonia being the most common culprits. These bacteria are gram-negative, meaning they have a specific cell structure that makes them resistant to certain antibiotics. UTIs caused by E. coli are more prevalent in women due to the anatomical proximity of the urethra to the vagina and anus and the shorter length of the female urethra. Improper wiping technique after a bowel movement, specifically wiping from back to front, can introduce E. coli bacteria into the urethra, increasing the risk of UTIs.

NR 293 Pharmacology for Nursing Practice

Cefepime is available only in injection form and can be administered intravenously (IV) or intramuscularly (IM). Once cefepime enters the bloodstream, it exhibits its therapeutic effects by interfering with the synthesis of bacterial cell walls. It specifically inhibits the cross-linking of peptidoglycan, a crucial cell wall component. By disrupting this process, cefepime causes defects in the cell wall structure, rendering the bacteria unable to survive and ultimately leading to death.

Before initiating cefepime therapy, it is essential to consider certain precautions. Patients with a history of hypersensitivity reactions to cefepime, cephalosporins, or penicillin should be cautious and discuss their allergies with their healthcare provider. Patients with impaired renal function also require close monitoring to ensure appropriate dosage adjustments and avoid potential complications. Neurotoxicity and C. difficile-associated diarrhea are also potential concerns that should be considered. Careful monitoring of renal function is necessary when patients take aminoglycosides alongside cephalosporins, as there is an increased risk of nephrotoxicity and ototoxicity. Another drug that may interact with cephalosporins is furosemide, a diuretic medication commonly used to manage fluid retention. Close monitoring and proper dosage adjustments are necessary when these drugs are used together to minimize potential adverse effects.

NR 293 Pharmacology for Nursing Practice

Patients undergoing cefepime treatment can expect to experience therapeutic effects as their UTI symptoms diminish. Common symptoms such as pain, burning sensation during urination, urgency, and frequency should decrease with successful treatment. Patients must adhere to the entire course of antibiotics as their healthcare provider prescribes. Skipping doses or not completing the whole treatment regimen can lead to the recurrence of UTIs and contribute to developing antibiotic resistance. By completing the prescribed course, patients maximize the effectiveness of the treatment and minimize the risk of recurrent infections. In addition to adequately using antibiotics, patient education plays a vital role in preventing UTIs.

Patients should be educated on various preventive measures to reduce the risk of developing UTIs in the first place. Drinking plenty of water helps to flush out bacteria from the urinary system and maintain proper hydration. Proper wiping technique after using the bathroom is essential, emphasizing the importance of wiping from front to back to avoid introducing bacteria from the anal area into the urethra. Individuals must listen to their bodies. Cefepime (Maxipime) is a fourth-generation cephalosporin antibiotic that destroys bacterial cell walls, similar to penicillin.

NR 293 Pharmacology for Nursing Practice

Cephalosporins are broad-spectrum bactericidal drugs that treat urinary tract infections (UTIs), skin infections, and pneumonia.UTIs are commonly caused by gram-negative bacteria such as Escherichia coli and Klebsiella pneumonia. UTIs caused by E. coli are more frequent in women due to the shorter length of their urethra and its proximity to the vagina and anus. Improper wiping from back to front after a bowel movement can introduce E. coli into the urethra. Cefepime, available only as an injection administered intravenously (IV) or intramuscularly (IM), enters the bloodstream and disrupts bacterial cell wall synthesis by inhibiting the cross-linking of peptidoglycan. This leads to defects in the cell wall, eventually causing the death of the microorganism.

Before starting cefepime therapy, precautions should be taken for patients with a history of hypersensitivity reactions to cefepime, cephalosporins, or penicillins. Renal function should be monitored, and caution exercised for neurotoxicity and C. difficile-associated diarrhea. Patients taking aminoglycosides should have their renal function monitored due to the increased risk of nephrotoxicity and ototoxicity. The diuretic medication furosemide may also interact with cephalosporins. The therapeutic effects of cefepime treatment can be observed through decreased symptoms such as pain, burning sensation during urination, urgency, and frequency. To ensure effective treatment, patients should complete the entire course of antibiotics as prescribed. Skipping doses or not finishing the therapy can lead to UTI recurrence and the development of antibiotic resistance. Patient education is crucial in preventing UTIs, including the importance of drinking plenty of water, properly wiping from front to back, and promptly addressing the urge to urinate.


Lilley, L. L., Collins, S. R., & Snyder, J. S. (2020). 38. In Pharmacology and the nursing process (p. 1887). essay, Elsevier.Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2021). 45 Urinary Elimination. In Fundamentals of Nursing. Essay, Elsevier. U.S. National Library of Medicine. (n.d.). Cefepime Injection: MedlinePlus Drug Information. MedlinePlus. Retrieved September 12, 2021, from

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