Biofuroxime

Biofuroxime is a systemic antibacterial drug from the subgroup of cephalosporins. Contains the active ingredient cefuroxime.

Cefuroxime is a second generation semi-artificial cephalosporin with a broad spectrum of bactericidal activity. It acts against gram-positive as well as -negative microbes, including strains that produce β-lactamase, and are often resistant to the action of amoxicillin with ampicillin. [1]

The bactericidal effect of the drug develops when the processes of binding of microbial membranes are inhibited.

Indications Biofuroxime

It is used for such disorders:

• infection of the respiratory ducts (pulmonary abscess , bronchitis or bronchiectasis of the infected type associated with operations of infection of the sternum organs, as well as pneumonia of bacterial etiology);
• lesions of the nose or throat ( tonsillitis , sinusitis or pansinusitis, as well as pharyngitis);
• infections affecting the urinary tract (cystitis or pyelonephritis, as well as asymptomatic bacteriuria);
• lesions of the subcutaneous layer (erysipeloid, cellulitis and wound-related infections);
• joint or bone problems (osteomyelitis or septic-type arthritis);
• infections that have an obstetric and gynecological nature (gonorrhea or pelvic organ damage);
• other infections (meningitis or septicemia);
• prevention of the development of complications after performing operations of an orthopedic, abdominal, proctological, vascular, as well as thoracic or gynecological nature.

Release form

The release of the medication is made in the form of a lyophilisate for the manufacture of injection liquid - inside glass vials with a capacity of 17 or 26 ml (contain 0.75 g or 1.5 g of lyophilisate). Inside the pack - 1 such bottle.

Pharmacodynamics

The following microorganisms are sensitive to cefuroxime:

• gram-negative - Proteus mirabilis, Klebsiella (among them Klebsiella pneumonia), Haemophilus influenzae and Escherichia coli, Shigella with moraxella catarrhalis, Salmonella and Gonococcus with providence, and besides this, Rettger's provinces, meningococci (among them, the strains that produce the production of paraenicilinus and Haemilinus parasinus) this includes strains that show resistance to ampicillin);
• gram-positive - pyogenic streptococci, epidermal staphylococci (among them bacteria that produce pencillinase - methicillin-resistant staphylococci have no sensitivity to cefuroxime), staphylococcus aureus and pneumococci;
• anaerobes - from gram-positive elements: peptostreptococci with peptococci, as well as most of the strains of Clostridia; of gram-negative: fusobacteria and individual bacteroids.

Cefuroxime does not show any effect with respect to such microorganisms: Clostridia Dificile, Legionella with Enterococci, Campylobacter and Mycoplasma, and besides this, Acinetobacters, Listeria monocytogenes, Chlamydia with Fragilis bacteroids and Pseudomonas aeruginosa. [2]

Penicillin-resistant pneumococci are resistant to cefuroxime, and in addition, strains of gram-negative hospital sticks from the Enterobacteriaceae subgroup, which produce β-lactamases with a wider substrate range.

Pharmacokinetics

With i / m injections, the blood counts of the Cmax of the antibiotic are noted after 0.5-1 hour. The therapeutic level of drugs inside the serum, equal to 2+ μg / ml, remains in this range for 5.5-8 hours. The synthesis of the drug with protein is 33%, and the half-life from blood in an adult is approximately 80 minutes.

In infants in the first 3 weeks of life, the serum half-life of a drug can be three / five times longer than that of an adult. Among infants up to 2 weeks of age, the blood values of drugs are on average higher in persons with low birth weight, and the term of its half-life has an inverse proportion with respect to age. For example, it equals 5.6 hours for a 1-day-old newborn and 4 hours for a 2-week-old baby.

Unchanged cefuroxime is excreted through the kidneys (over 90% of the dosage is excreted in the urine within 6 hours). When using a 1-fold portion of 0.75 g, the drug values inside the urine for the first 8 hours are on average 1300 μg / ml, and when dosages of 0.75 and 1.5 g are used, 1150 and 2500 μg / ml.

The drug reaches therapeutic values inside fluids and bone tissues: sputum, bile and urine, synovium, pleural fluid and cerebrospinal fluid (only in the presence of inflammation), as well as aqueous humor.

Dosing and administration

The finished medicinal liquid is used intravenously or intramuscularly. Before starting a treatment course, it is required to test the patient for allergies by performing an epidermal test.

For children over 12 years old (or weighing more than 50 kg) and adults, a portion of 0.75 g is used 2-3 times a day. If the infection is severe, or the effect of the drug is not enough, the daily dosage is allowed to be increased up to 4 times the introduction of 0.75 g per day.

For newborns (born on time or premature), apply 0.03-0.1 g / kg per day per day (the portion is divided into several injections).

Use Biofuroxime during pregnancy

Biofuroxime can cross the placenta, but the safety of its use during pregnancy has hardly been studied.

Small volumes of the active drug element are excreted in the mother's milk, which is why it is necessary to cancel hepatitis B during therapy.

Contraindications

It is contraindicated to prescribe in case of allergy to cephalosporins (if there is an allergy to penicillins, one must bear in mind the likelihood of cross-effects).

Side effects Biofuroxime

The main side symptoms:

• infections: mycosis affecting the reproductive system, infections associated with resistant bacteria, and fungal infections of a secondary nature;
• disorders associated with the blood system and lymph: hemolytic anemia, leuko-, thrombocyto- or granulocytopenia, agranulocytosis, eosinophilia, coagulation disorders, an increase in creatinine or PTT values;
• problems with digestive function: nausea, obstruction of the gastrointestinal tract, stomatitis, diarrhea, pancreatitis and glossitis. Occasionally, enterocolitis of the pseudomembranous type is observed;
• lesions of the hepatobiliary system: the curable formation of calculi inside the gallbladder (cholelithiasis), the deposition of Ca salts inside the gallbladder and an increase in the values of liver enzymes inside the blood (AST, ALP and ALT);
• problems associated with subcutaneous tissues and epidermis: exanthema, urticaria, rash and dermatitis of allergic genesis, as well as itching, TEN, erythema polyform and swelling;
• violations of urinary activity: hematuria, oliguria, failure of the kidneys, glucosuria and the formation of renal calculi;
• systemic disorders: headaches, chills, phlebitis, fever, dizziness and anaphylactic or anaphylactoid symptoms;
• changes in laboratory diagnostic data: false positive indications during Coombs' tests and tests for glucosuria or galactosemia.

Overdose

In case of poisoning with this antibiotic, signs of cerebral irritation may appear, including convulsions.

Hemo- or peritoneal dialysis procedures are performed, as well as the required symptomatic actions.

Interactions with other drugs

The introduction together with nephrotoxic elements (with a powerful effect of diuretic drugs or aminoglycosides) leads to the potentiation of their toxic activity relative to renal activity.

Cefuroxime use can cause a false positive response in urinary sugar reduction tests. Serologic testing may show false positive Coombs test data.

Like other antibiotics, Biofuroxime affects the intestinal microflora, causing a weakening of estrogenic reabsorption in combined oral contraception.

During the use of cefuroxime, plasma and blood sugar parameters should be determined using hexosekinase or glucose oxidase methods.

The drug has a weak effect on the indications of methods that are carried out using copper reduction (Fehling's or Benedict's tests, as well as Clinitest), but it does not cause false positive data, as is the case with the use of some other cephalosporins.

Storage conditions

Biofuroxime can be stored at temperatures within the range of 15-25 ° C.

Shelf life

Biofuroxime is allowed to be used for a 24-month period from the date of sale of the drug substance.

Analogs

Analogues of drugs are the drugs Zinnat, Cefoctam, Aksef and Baktil with Abicef Pharmunion, and in addition to this Mikrex, Aksetin, Cefunort and Spizef with Auroxetil, Cefur and Euroxim with Furocef and Zinacef. Also on the list are Cefuroxime, Zotsef, Cefumax and Kimacef with Cetil and Cefutil, and in addition Yokel, Enfexia and Furex with Cefurox.