Cefangin

Cefangin is an antibacterial systemic drug from the group of first-generation cephalosporins.

Indications Cefangina

It is used to eliminate the following problems:

• pathologies affecting the respiratory system and ENT organs (such as sinusitis with bronchitis, as well as otitis media or pneumonia with tonsillitis);
• infections inside the urinary tract, soft tissues, skin, and bones and joints (such as septic arthritis or osteomyelitis).

Release form

The release occurs in capsules, in the amount of 10 pieces inside a blister pack. In a box - 2 blister plates.

Pharmacodynamics

Cefadroxil is an antibiotic from the 1st generation cephalosporin group, taken orally. It has a bactericidal effect.

The drug acts by synthesizing with penicillin-binding proteins located inside the cytoplasmic bacterial walls. As a result, the processes of peptide binding inside the cell membranes are suppressed, and then the processes of bacterial division are destroyed, causing the pathogenic organisms to die.

Cefangin has the following antibacterial activity:

• against gram-positive microorganisms: staphylococci (this list includes strains that produce b-lactamases), pneumococci and pyogenic streptococci;
• against gram-negative bacteria: Haemophilus influenzae and Escherichia coli, Proteus mirabilis, Moraxella catarrhalis, Salmonella, Shigella and Neisseria;
• relative to anaerobes: bacteroides (except bacteroides fragilis).

Pharmacokinetics

After oral administration, the active element of the drug is almost completely absorbed in the upper part of the small intestine. The bioavailability level is 95%. Protein synthesis is quite low – within 15-20%.

The substance quickly passes distribution inside fluids with tissues (peritoneal and pericardial fluids, as well as synovium). It also penetrates into bile, and along with it urine with sputum, and also into pleural effusion and soft tissues with bones. It penetrates through the placenta, and in addition it is excreted with mother's milk.

Excretion of the unchanged component occurs through the kidneys (about 93%) by glomerular filtration and tubular secretion. The half-life with normal renal function is 1.2-1.5 hours, and with renal dysfunction it reaches 20-25 hours.

Dosing and administration

Cefangin should be used regardless of food intake, 1-2 times a day.

Serving sizes of medicines prescribed to adolescents from 12 years of age (weighing over 40 kg) and adults:

• infections in the respiratory tract and ENT system (diseases such as otitis, tracheobronchitis and sinusitis with tonsillitis) - taking 0.5-1 g of the drug (2-4 capsules) twice a day;
• infectious disorders in the lower respiratory tract (pulmonary inflammation, as well as exacerbated chronic bronchitis) - use 1 g of the drug (in the amount of 4 capsules) twice a day;
• diseases affecting the urinary tract – use 500-1000 mg of the drug (in the amount of 2-4 capsules) twice a day;
• infections in the area of soft tissues with skin - use 0.5 g of the drug (2 capsules) twice a day;
• septic form of arthritis, as well as osteomyelitis – taking 1 g of the drug (in the amount of 4 capsules) twice a day.

It is allowed to take no more than 4 g of the drug per day.

Dosage sizes for children aged 6-12 years: for all the above types of diseases, it is necessary to take 0.25 g of the medicine (1 capsule) twice a day (the capsule must be swallowed whole; it is prohibited to open it).

Such therapy (both for children and adults) should last for 7-10 days. It is also necessary to continue the course for another 48-72 hours after the signs of the disease disappear.

To eliminate infections caused by the action of β-hemolytic streptococcus (from category A), therapy lasting at least 10 days is necessary. To treat severe forms of infectious diseases (such as osteomyelitis), an even longer course may be required - at least 1-1.5 months.

For people with kidney problems (with CC values less than 50 ml/minute), the dose size of the drug is changed taking into account the individual CC level:

• CC values within 25-50 ml/minute – the initial portion size is 1 g; maintenance – 0.5 g. Should be taken at intervals of 12 hours;
• CC indicators at the level of 10-25 ml/minute - the initial portion is 1 g; maintenance - 0.5 g. Use at intervals of 24 hours;
• CC level up to 10 ml/minute - the initial dose is 1000 mg; maintenance dose - 500 mg. Apply at intervals of 36 hours.

Use Cefangina during pregnancy

It is prohibited to prescribe Cefangin to pregnant women. Also, breastfeeding should be discontinued during therapy, because the component cefadroxil is excreted in breast milk.

Contraindications

Main contraindications: intolerance to cephalosporin antibiotics, as well as children under 6 years of age.

Side effects Cefangina

The use of the drug may cause the occurrence of certain side effects:

• infectious or invasive disorders: growth of opportunistic bacteria (fungi) that cause the development of thrush, candidal stomatitis, and vaginal mycosis;
• disorders of hematopoiesis and lymph: leuko-, thrombocyto- or neutropenia, as well as eosinophilia or agranulocytosis (in case of prolonged use) occasionally occur. If treatment is discontinued, these disorders can be eliminated. Hemolytic anemia (due to immune disorders) is observed occasionally;
• immune damage: the appearance of rashes, itching, Quincke's edema, hyperthermia or urticaria. In addition, Stevens-Johnson syndrome or erythema multiforme, as well as serum sickness, sometimes develop. Anaphylaxis is observed sporadically;
• problems of a neurological nature: a feeling of nervousness, excitement or drowsiness is occasionally noted, as well as insomnia or dizziness with headaches;
• problems with the gastrointestinal tract: dyspeptic symptoms, as well as nausea, glossitis, diarrhea, vomiting, signs of colitis of a pseudomembranous nature (the appearance of severe stomach cramps and pain, an increase in temperature, and at the same time diarrhea of a watery nature; diarrhea with blood may also be observed);
• disorders in the area of hepatobiliary function: occasionally cholestasis or liver failure (due to idiosyncrasy) develops, as well as a moderate increase in the activity of liver transaminases (AST levels, as well as ALT) and alkaline phosphatase;
• manifestations from the musculoskeletal system: arthralgia occasionally develops;
• problems with the urinary system: occasionally an intermediate stage of nephritis is observed;
• systemic lesions: fever of drug origin is occasionally observed. A feeling of fatigue occurs occasionally;
• laboratory test results: false positive results of the direct and indirect Coombs tests are occasionally observed.

Overdose

Signs of intoxication: the appearance of hallucinations, nausea, extrapyramidal hyperreflexia disorders, a feeling of confusion, and in addition, the development of renal dysfunction and a state of coma.

To eliminate an overdose, vomiting should be induced or gastric lavage should be performed. If necessary, hemodialysis and correction of water-salt balance should be performed. It is also necessary to carefully monitor kidney function.

Interactions with other drugs

Cefangin is prohibited to be combined with bacteriostatic antibiotics (such as erythromycin or tetracycline, as well as chloramphenicol or sulfonamides), because this can cause the development of antagonistic manifestations.

It is necessary to avoid using the drug in combination with aminoglycosides, colistin, as well as polymyxin type B or with large doses of loop diuretics, due to the fact that these combinations can lead to the appearance of nephrotoxic symptoms.

In case of combined long-term use of the drug with anticoagulants or drugs that slow down platelet aggregation, in order to avoid the development of complications (bleeding), it is necessary to constantly monitor blood clotting indicators.

Taking it together with probenecid can lead to a persistent increase in cefadroxil levels in bile and blood serum.

The use of strong diuretic drugs may cause a decrease in cefadroxil levels in the blood.

Cefangin can reduce the effects of oral contraception.

The drug is synthesized with cholestyramine, which may reduce its bioavailability.

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Storage conditions

Cefangin must be kept in a place that is closed to small children. The temperature mark in this case is a maximum of 25°C.

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Shelf life

Cefangin can be used for 3 years from the date of manufacture of the drug.