Tupime (Cefepime) is a fourth generation cephalosporin, acts by inhibition of bacterial cell wall synthesis and is active against a wide range of gram-positive and gram-negative aerobic organisms. Against gram-positive cocci, its activity is similar to that of cefotaxime and includes staphylococci (but not methicillin-resistant Staphylococcus aureus) and streptococci. Against Enterobacteriaceae, it has a broader spectrum of activity than other cephalosporins, including activity against organisms producing chromosomally mediated beta-lactamases such as Enterobacter species and Proteus vulgaris.