Biofuroxime

Biofuroxime is a systemic antibacterial drug from the cephalosporin subgroup. Contains the active component cefuroxime.

Cefuroxime is a semi-artificial cephalosporin of the 2nd generation, which has a broad spectrum of bactericidal activity. It is effective against gram-positive and -negative microbes, including strains that produce β-lactamase and are often resistant to the action of amoxicillin and ampicillin. [ 1 ]

The bactericidal effect of the drug develops through the inhibition of the processes of binding of microbial membranes.

Indications Biofuroxime

It is used for the following disorders:

• infections of the respiratory tract (pulmonary abscess, bronchitis or bronchiectasis of the infected type, infections of the sternum organs associated with operations, 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);
• subcutaneous lesions (erysipeloid, cellulitis and wound-related infections);
• problems with joints or bones (osteomyelitis or septic arthritis);
• infections of an obstetric-gynecological nature (gonorrhea or lesions of the pelvic organs);
• other infections (meningitis or septicemia);
• prevention of complications after performing orthopedic, abdominal, proctological, vascular, as well as thoracic or gynecological surgeries.

Release form

The drug is released in the form of a lyophilisate for the preparation of injection liquid - inside glass vials with a capacity of 17 or 26 ml (containing 0.75 g or 1.5 g of lyophilisate). There is 1 such vial inside the pack.

Pharmacodynamics

The following microorganisms are sensitive to cefuroxime:

• gram-negative - Proteus mirabilis, Klebsiella (including Klebsiella pneumoniae), Haemophilus influenzae and Escherichia coli, Shigella with Moraxella catarrhalis, Salmonella and gonococci with Providencia, as well as Providencia Rettgerii, meningococci (including strains that produce penicillinase) and Haemophilus parainfluenzae (this includes strains that demonstrate resistance to ampicillin);
• gram-positive - pyogenic streptococci, epidermal staphylococci (among them are bacteria that produce penicillinase - methicillin-resistant staphylococci are not sensitive to cefuroxime), Staphylococcus aureus and pneumococci;
• anaerobes - from gram-positive elements: peptostreptococci with peptococci, as well as most strains of clostridia; from gram-negative: fusobacteria and individual bacteroids.

Cefuroxime does not show any effect on the following microorganisms: Clostridium difficile, Legionella with Enterococcus, Campylobacter and Mycoplasma, as well as Acinetobacter, Listeria monocytogenes, Chlamydia with Bacteroides fragilis and Pseudomonas aeruginosa. [ 2 ]

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

Pharmacokinetics

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

In infants in the first 3 weeks of life, the half-life of the drug from serum can be three to five times longer than in an adult. Among infants under 2 weeks of age, blood values of the drug are on average higher in low-weight individuals, and its half-life is inversely proportional to age. For example, it is 5.6 hours in a 1-day-old newborn and 4 hours in a 2-week-old child.

Unchanged cefuroxime is excreted via the kidneys (over 90% of the dose is excreted in the urine within 6 hours). When using a single dose of 0.75 g, the values of the drug in the urine for the first 8 hours average 1300 mcg/ml, and when using doses of 0.75 and 1.5 g – 1150 and 2500 mcg/ml.

The drug achieves therapeutic values within 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 prepared medicinal liquid is used intravenously or intramuscularly. Before starting the treatment course, it is necessary to test the patient for allergies by performing an epidermal test.

For children over 12 years of age (or weighing more than 50 kg) and adults, a dose of 0.75 g is used 2-3 times a day. If the infection is severe, or the effect of the medicine is insufficient, the daily dosage may be increased to 4 times the administration of 0.75 g per day.

For newborns (born on time or prematurely), use 0.03-0.1 g/kg per day (the dose is divided into several administrations).

Use Biofuroxime during pregnancy

Biofuroxime can cross the placenta, but its safety during pregnancy has been little studied.

Small amounts of the active ingredient of the drug are excreted in breast milk, which is why breastfeeding must be discontinued during therapy.

Contraindications

Contraindicated in case of allergy to cephalosporins (if there is an allergy to penicillins, the possibility of cross-influence should be taken into account).

Side effects Biofuroxime

Main side effects:

• infections: mycosis affecting the reproductive system, infections associated with resistant bacteria, and secondary fungal infections;
• disorders associated with the blood and lymphatic system: hemolytic anemia, leukopenia, thrombocyto- or granulocytopenia, agranulocytosis, eosinophilia, coagulation disorders, increased creatinine levels or PT values;
• problems with digestive function: nausea, obstruction of the biliary tract, stomatitis, diarrhea, pancreatitis and glossitis. Pseudomembranous enterocolitis is occasionally observed;
• lesions of the hepatobiliary system: curable formation of stones inside the gallbladder (cholelithiasis), deposition of Ca salts inside the gallbladder and an increase in the values of liver enzymes in the blood (AST, ALP and ALT);
• problems associated with subcutaneous tissues and epidermis: exanthema, urticaria, rash and dermatitis of allergic origin, as well as itching, TEN, erythema multiforme and edema;
• urinary disorders: hematuria, oliguria, renal failure, glucosuria and formation of renal stones;
• systemic disorders: headache, chills, phlebitis, fever, dizziness and anaphylactic or anaphylactoid symptoms;
• changes in laboratory diagnostic data: false positive results in 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 measures.

Interactions with other drugs

Administration together with nephrotoxic elements (potent diuretic drugs or aminoglycosides) leads to potentiation of their toxic activity in relation to renal function.

Use of cefuroxime may cause false-positive results in urine sugar reduction tests. False-positive Coombs tests may be observed in serologic tests.

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

During the use of cefuroxime, plasma and blood sugar levels should be determined using hexose kinase or glucose oxidase methods.

The drug has a weak effect on the results of methods that are carried out using copper reduction (Fehling's or Benedict's tests, as well as Clintest), but does not cause the appearance of false positive data, as happens 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 can be used for a period of 24 months from the date of sale of the medicinal substance.

Analogues

The analogs of the drug are Zinnat, Cefoktam, Aksef and Baktil with Abitsef Farmunion, 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, Zocef, Cefumax and Kimacef with Cetyl and Cefutil, and in addition, Yokel, Enfeksia and Furexa with Cefurox.