Adult

Cefepime with enmetazobactam (Exblifep®)

General Information

A cephalosporin and beta-lactamase inhibitor.

Do NOT use if patient has a history of severe penicillin allergy.  If in doubt, discuss with Micro/ID.

Restricted formulary antimicrobial: For details see OUH netFormulary

AWaRe antibiotic classification: All indications to be discussed with Micro/ID. Has not been classified in 2025 UK modified AWaRe list.

For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).

Standard dose

  Intravenous dose
Standard dose

2.5g (2g cefepime/0.5g enmetazobactam)

TDS
  • Each vial contains 2g cefepime + 0.5g enmetazobactam
  • Standard dose of 2.5g (2 g cefepime + 0.5g enmetazobactam) is 1 vial

Note: The duration of infusion varies with indication, see SPC.

Renal and hepatic impairment

Renal impairment  

 

Creatinine Clearance  (mL/min)*

Dose 

Frequency

60 or over

Where creatinine clearance is over 150 ml/minute (augmented renal clearance), give infusion over 4 hours.

 Dose as in normal renal function

30-59

1.25 g

 

(1g cefepime/ 250 mg enmetazobactam)

 

TDS

15-29

1.25 g

 

(1g cefepime/ 250 mg enmetazobactam)

 

BD

Less than 15

1.25 g

 

(1g cefepime/ 250 mg enmetazobactam)

 

OD

HD/HDF/High flux/PD

Discuss with pharmacy

*Dose ranges use creatinine clearance, rather than eGFR

 

Hepatic impairment

No dose adjustment required


References

  • ADVANZ Pharma. EXBLIFEP 2 g/0.5 g powder for concentrate for solution for infusion summary of product characteristics. Electronic Medicines Compendium. Last revision of the text: 4/4/24 Available at  https://www.medicines.org.uk/emc Accessed: 2/3/26
  • British National Formulary. Cefepime-Enmetazobactam. Accessed via: BNF online accessed via www.medicinescomplete.com. Accessed 2/3/26
  • Sanford Guide [online]. Cefepime-Enmetazobactam. Last updated 31/10/25. Accessed 2/3/26
  • The Renal Drug Database. EXBLIFEP (cefepime hydrochloride and enmetazobactam). Last reviewed: 19/06/25. Available at: https://www.renaldrugdatabase.com Accessed 2/3/26

Editorial Information

Last reviewed: 04 Mar 2026

Next review date: 01 Mar 2029

Author(s): AMST.