Cefaxon

Cefaxon is an antimicrobial preparation of the third generation of antibiotics from the category of cephalosporins.

[1], [2]

Indications of the cefaxon

It is used in the treatment of people with differently localized diseases of infectious origin (caused by flora, which is sensitive to cephalosporins). Among these pathologies are:

• infection in the abdominal region (among such infections in the intestinal tract and GVP, as well as peritonitis), and in addition sepsis;
• meningitis;
• infectious diseases affecting bones with joints, as well as skin and connective tissues;
• infections that develop within the lower respiratory system and in the ENT organs;
• pathologies of an infectious nature affecting the system of urination, as well as STDs (this includes gonorrhea);
• sometimes the drug is prescribed to people with low immune indicators, which is observed with different infections;
• doctors can recommend Cefaxone for use after surgery to prevent the occurrence of infections.

[3],

Release form

The release is carried out in the form of powder for parenteral administration, in vials of 0.25, 0.5 and 1 g. In the box - 1 such a bottle.

Pharmacodynamics

Cefaxon contains in its composition ceftriaxone, which has the form of Na salt. This component is designed exclusively for parenteral administration. The drug has a pronounced bactericidal effect, inhibits the binding of elements, which are the basis of bacterial cell membranes, and prevents the development and growth of pathogenic organisms.

Sensitivity to the activity of ceftriaxone has aerobic (gram-negative, and gram-positive) bacterial strains. Among them are staphylococci (such as Staphylococcus aureus and Staphylococcus aureus), streptococci from the B category (streptococcus agalactia), category A (streptococcus pyogenes), Streptococcus viridans, pneumococci, and Streptococcus bovis. In addition, the list includes Escherichia coli, Aeromonas spp., Ducrea's stick, Moraxella cataralis, Haemophilus rod, Alcaligenes spp., Haemophilus parainfluenzae, Citrobacterium, Klebsiella, Morgana bacterium, Moraxella spp. And individual strains of enterobacter. However, the drug affects gonococci, meningococci, Plesiomonas shigelloides, provinces, proteus mirabilis, vulgar proteus, salmonella, Yersinia, vibrios, shigella, and in addition individual strains of Pseudomonas aeruginosa.

The drug has an effect in diseases caused by anaerobic activity, including clostridia, bacteroides, peptostreptococci and peptococci, and in addition Fusobacterium spp.

It must be remembered that individual strains of bacteroides (those that produce β-lactamases) are resistant to the action of ceftriaxone.

[4]

Pharmacokinetics

After parenteral injection of drugs within the body, high levels of its active element are observed. The drug is concentrated inside tissues and various biological fluids (among them blood plasma, bronchial and pulmonary tissues, sputum, organs of the urogenital system, and at the same time bone and cartilage with connective tissues).

If the patient has inflammation of the brain membranes, Cefaxon forms high pharmacological concentrations inside the CSF, but in people with no disturbances in the brain envelope the substance almost does not pass through the BBB.

The active element of the drug is reversibly synthesized with a plasma protein. The effect of intestinal microflora leads to the inactivation of ceftriaxone.

Through the kidneys, about 50-60% of unchanged substance is excreted, and another 40-50% (also unchanged element) - together with bile. The half-life of ceftriaxone in adults with healthy hepatic and renal function is 8 hours.

If the patient has problems with the kidneys and liver, and also in the elderly and children, the half-life of the active element is prolonged.

[5], [6]

Dosing and administration

Powder is used to make a parenteral solution. The introduction of cefaxone is allowed exclusively at the hospital. The prepared solution can be injected in / m or in / in a method (along with it at a slow speed, jet or drip). It is necessary to comply with the same time intervals between procedures for drug administration.

Intramuscular injection should be done in the area of the upper outer quadrant of the buttock (once in one muscle can enter no more than 1 grams of medication).

Injection intravenous injection should be slow (the procedure time is within 2-4 minutes). Dropwise infusion (40 ml) is administered intravenously for a minimum of half an hour.

To prepare a solution for an intravenous injection, it is necessary to dilute the powder with 1% lidocaine solution (2 or 3.5 ml) - for dosages equal to 0.25, 0.5 or 1 g, respectively.

In jet I / O injection, it is necessary to dissolve 1 g of the drug substance in injectable water (10 ml).

To install the intravenous drip, you need to dilute 2 g of the drug in 40 ml of one of the following solvents: 0.9% solution of sodium chloride, 5% solution of levulose or glucose (a solution based on glucose can be 10%) . Do not use other solvents for Cefaxon.

The size of portions of medicines and the length of the course of treatment are selected by the doctor.

Recommended serving sizes for teens from 12 years, and also adults:

• on the average for a day it is required to enter 1-2 g of a medicinal substance (the required portion is administered once a day);
• for elimination of infections in a severe degree it is allowed to increase the daily dosage to 4 g of the drug;
• adults for the treatment of gonorrhea should be injected once in / m by the method of 0.25 g of the drug;
• to prevent the development of infection after surgery, you should enter a single standard dose of LS for 0.5-1.5 hours before the procedure.

The sizes of the recommended portions to children till 12-year-old age:

• Newborns are required to administer the drug on average 20-50 mg / kg of weight per day;
• for the treatment of meningitis in children, administration of drugs in a dosage of 100 mg / kg of weight is allowed, but not more than 4 g / day.

Children under 12 years of age are usually given Cefaxon in a dosage of 20-50 mg / kg of weight, but with a maximum of 2 g per day. When treating severe stages of infection, it is allowed to increase the portion size to 75 mg / kg of weight, but at the most 3 g / day. Dosages exceeding 50 mg / kg are allowed to be injected exclusively by intravenous drip for a minimum of half an hour.

For children weighing more than 50 kg, a drug, regardless of age, is prescribed in portions recommended for adults.

Taking into account the pathogen type, the duration of treatment can vary within 4-14 days.

Recommended dose sizes for people with kidney problems.

It should be borne in mind that the maximum allowable recommended portion per day for people whose QC level is less than 10 ml / minute is equal to 2 g of ceftriaxone.

If long-term drug use is expected, it is required to monitor the patient's blood counts.

[7], [8]

Use of the cefaxon during pregnancy

The use of Cefaxon is completely prohibited from use on the 1st trimester. The doctor should exclude the possibility of pregnancy before prescribing this medicine. At the 2nd and 3rd trimesters, the doctor's appointment determines the appropriateness of prescribing.

Breastfeeding mothers should refrain from breastfeeding before starting to use the medication.

Contraindications

Among the contraindications - the presence of hypersensitivity to ceftriaxone, and in addition to other antimicrobial drugs from the category of cephalosporins, as well as in relation to penicillins.

They are used with caution in persons with hyperbilirubinemia, and in addition (in particular) in newborn infants.

Side effects of the cefaxon

When treating with Cefaxone, patients may sometimes experience the following side effects:

• disturbances in the function of the NA: the appearance of headaches or dizziness, the development of asthenia;
• disorders of the gastrointestinal tract: the emergence of vomiting or stool disorders, the development of stomatitis or glossitis, an increase in the activity of liver enzymes. The appearance of a pseudomembranous form of colitis is noted singly;
• symptoms from the hematopoietic system: development of leuko-, thrombocyto- or granulocytopenia, and in addition hemolytic form of anemia and eosinophilia. Disorientation of processes of blood uptake is observed;
• allergy symptoms: development of urticaria, angioedema, exanthema, allergic form of dermatitis, and in addition anaphylaxis and polyiform erythema;
• other: the development of oliguria, chills, pain in the right hypochondrium, and in addition hypercreatininaemia and thrush.

In addition, parenteral administration of drugs can cause the appearance of local signs, among which the sensation of pain (after intramuscular injection) and phlebitis (after intravenous injection).

Sedimentation occurs on the walls inside the gallbladder - they can be detected during ultrasound. This symptom usually occurs after withdrawal of use of drugs. If a patient has pain syndrome, it is required to switch to conservative treatment.

Overdose

Due to intoxication with ceftriaxone in patients, the severity of side symptoms may be potentiated.

The medicine does not have a special antidote. In case of an overdose, symptomatic interventions are required. In this case, it must be taken into account that the procedures for hemodialysis or peritoneal dialysis will be ineffective in such cases.

Interactions with other drugs

When eliminating infections of a serious nature, combination of Cefaxon with aminoglycoside drugs (they mutually reinforce each other's medicinal properties) is considered appropriate. But they need to be introduced separately, because they are incompatible for parenteral injections.

Ready-to-administer Cefaxon solution does not have compatibility with other parenteral substances (except for solutions indicated in the manual as recommended for the manufacture of infusion).

[9], [10], [11], [12]

Storage conditions

Cefaxone when stored under standard conditions at a temperature within 15-25 ° C can be used for 3 years from the date of manufacture of the drug.

The ready-made medicinal solution has therapeutic properties for 6 hours in case of storage at 25 ° C, and also for 24 hours if the temperature is not more than 5 ° C.

[13]

Shelf life

3 years.

Reviews

Cefaxon is considered to be a sufficiently effective means - its qualitative and effective impact is noted in the reviews of many patients. Among its shortcomings are allocated a fairly high cost of the drug, as well as the presence of a large number of adverse symptoms.