Cefuroxime

Cefuroxime is a semi-artificial antibiotic from the category of cephalosporins (2nd generation).

Demonstrates bactericidal effect on most of the gram-negative as well as positive bacteria, but at the same time it is resistant against β-lactamase microbes of the gram-negative type, which differs from cefalexin with cefazolin. Along with this, the drug affects strains that are not sensitive to amoxicillin with ampicillin. The drug is able to inhibit the binding of the bacterial cell wall peptidoglycan.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

Indications Cefuroxime

It is used in case of infections associated with the action of microbes, demonstrating sensitivity to the drug:

• lesions of the upper respiratory tract area ( pneumonia, bronchitis or empyema);
• ENT pathology (pharyngitis with sinusitis, tonsillitis, antritis and otitis media);
• diseases associated with the urogenital system (pyelonephritis, endometritis with adnexitis, cystitis and gonorrhea);
• lesions of the joints along with bones (bursitis, tendovaginitis and osteomyelitis with arthritis);
• infections in the subcutaneous layer and epidermis (furunculosis, erysipeloid, pyoderma or streptoderma, as well as impetigo and erysipelas);
• pathologies arising in the area of the gastrointestinal tract, gallstone and peritoneum;
• prevent the development of infections during operations.

[11], [12], [13]

Release form

The release of the pharmaceutical product is made in the form of an injection lyophilisate inside the vials with a capacity of 0.25, 0.75 and 1.5 g - 1 or 5 vials inside the pack.

[14], [15], [16], [17]

Pharmacokinetics

The Cmax values inside the blood plasma at i / m or in / in injections are recorded after 15-45 minutes.

The therapeutic level of the drug is noted inside the bone and soft tissues, myocardium with sputum, epidermis, pleural fluid and cerebrospinal fluid. It overcomes the placenta and can be excreted with breast milk.

The term plasma elimination half-life of a drug is about 70 minutes. Excreted almost unchanged with urine - after 24 hours.

[18], [19], [20], [21], [22], [23], [24], [25]

Dosing and administration

The drug is injected parenterally (in / m or / in).

Newborns per day injected at 30-60 mg / kg with 6-8-hour intervals.

The rest of the children should be applied at 0.03-0.1 g / kg per day (also with 6-8 hour breaks).

Adults often use 0.75 g (not more than 1.5 g) of the substance with 8-hour breaks. If necessary, you can reduce the interval between injections to 6 hours. In this case, the daily portion will increase to 3000-6000 mg.

Methods of dilution drugs.

In order to make a liquid for i / m injection, inject vial or isotonic NaCl (3 ml) into the vial, then shake it until a homogeneous suspension is formed.

In the manufacture of liquid for intravenous injection, it is necessary to add a minimum of 6 or 15 ml of injection water, isotonic NaCl or 5% glucose into the bottle (volume 0.75 or 1.5 g). Next, the liquid is shaken until a suspension having a uniform character is formed.

Ready liquid can not be stored, it is necessary to use it immediately after dilution.

[27], [28], [29]

Use Cefuroxime during pregnancy

Information on the embryotoxic and teratogenic effect of Cefuroxime is absent, but it should not be prescribed to pregnant women, except in situations where its benefits are more likely than the risk of complications for the fetus.

The drug is excreted with the mother's milk, because of which it must be used very carefully when breastfeeding.

Contraindications

It is contraindicated to appoint people with personal hypersensitivity to cephalosporins or penicillins.

Side effects Cefuroxime

When using drugs side effects are observed only occasionally; they are reversible and have weak intensity:

• lesions of the lymph and circulatory system: leukopenia or neutropenia, a positive Coombs test, eosinophilia and a decrease in hemoglobin values. Thrombocytopenia and anemia of the hemolytic type are singled out individually;
• disorders of the digestive tract: nausea, a temporary increase in the values of bilirubin, vomiting and diarrhea;
• problems with urinary and renal function: a decrease in the level of QC and an increase in serum values of urea and nitrogen. Interstitial cystitis is uncommonly developed;
• disorders affecting NS: dizziness or headaches. A single marked increased excitability;
• lesions associated with the ENT system: sometimes in the treatment of meningitis in children there has been a deterioration in hearing;
• local symptoms: after i / v injection, thrombophlebitis or phlebitis may appear. In the case of IM injection, pain develops at the site of administration;
• signs of allergy: anaphylactic manifestations and epidermal rash.

Prolonged use of the drug can lead to increased growth of bacteria resistant to cefuroxime (for example, from the Candida family), which will require appropriate treatment.

[26]

Overdose

The use of extremely large portions of cefuroxime can lead to the development of signs of enhanced excitation of the central nervous system, as well as seizures.

If such manifestations occur, peritoneal or hemodialysis should be performed.

[30], [31], [32], [33]

Interactions with other drugs

Introduction in combination with drugs that weaken platelet aggregation (NSAIDs), increases the likelihood of bleeding.

The combination with erythromycin causes a weakening of the therapeutic effect of both antibiotics.

The use together with aminoglycosides leads to an increase in their toxic activity.

Combining with probenecid or phenylbuzaton can reduce the intrarenal clearance of Cefuroxime and increase its plasma values.

Administration with diuretic substances increases the likelihood of kidney failure.

[34], [35], [36]

Storage conditions

Cefuroxime must be kept in a place that is protected from the entry of small children. Temperature indicators - in the range of marks 4-25 ° C.

[37], [38], [39]

Shelf life

Cefuroxime as an injection lyophilisate can be used within a 24-month term from the time the therapeutic substance is realized. The expiration date of the injection liquid packaged in a set makes 4 years.

[40], [41]

Analogs

Analogs of drugs are drugs Erythromycin, Ampioks, Cefalexin with Amoxicillin, and in addition, Biseptol, Augmentin, Potesetil and Tsiprolet with Doxycycline. In addition, Oflobak, Tetracycline and Miramistin with oleandomycin phosphate, Cefazolin and Sulfadimezin, Amoxiclav with Vilprafen, Zinnat and Cefotaxime are on the list.

[42], [43], [44], [45], [46], [47], [48]