Cefuroxime

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

It exhibits bactericidal action against most gram-negative and -positive bacteria, but is resistant to β-lactamases of gram-negative microbes, which distinguishes it from cephalexin and cefazolin. At the same time, the drug affects strains that are not sensitive to amoxicillin and ampicillin. The drug is capable of inhibiting the binding of bacterial cell wall peptide glycan.

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Indications Cefuroxime

It is used in cases of infections associated with the action of microbes that demonstrate sensitivity to the drug:

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

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Release form

The pharmaceutical product is released in the form of an injection lyophilisate in vials with a capacity of 0.25, 0.75 and 1.5 g – 1 or 5 vials per pack.

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Pharmacokinetics

The Cmax values in blood plasma after intramuscular or intravenous injections are recorded after 15-45 minutes.

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

The plasma half-life of the drug is about 70 minutes. It is excreted virtually unchanged in the urine after 24 hours.

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Dosing and administration

The medicine is administered parenterally (i.m. or i.v.).

Newborns are given 30-60 mg/kg per day at 6-8 hour intervals.

Other children should be given 0.03-0.1 g/kg per day (also with 6-8 hour breaks).

Adults are often given 0.75 g (no more than 1.5 g) of the substance with 8-hour breaks. If necessary, the interval between injections can be reduced to 6 hours. In this case, the daily dose will increase to 3000-6000 mg.

Methods of drug dilution.

To prepare a liquid for intramuscular injection, add injection water or isotonic NaCl (3 ml) into the vial, then shake it until a homogeneous suspension is formed.

When preparing a liquid for intravenous injection, it is necessary to add at least 6 or 15 ml of injection water, isotonic NaCl or 5% glucose into the vial (volume 0.75 or 1.5 g). Then shake the liquid until a homogeneous suspension is formed.

The prepared liquid cannot be stored; it must be used immediately after dilution.

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Use Cefuroxime during pregnancy

There is no information regarding the embryotoxic and teratogenic effects of Cefuroxime, but it should not be prescribed to pregnant women, except in situations where the benefit from it is more likely than the risk of complications for the fetus.

The drug is excreted in breast milk, which is why it should be used with extreme caution during breastfeeding.

Contraindications

Contraindicated for use in people with personal hypersensitivity to cephalosporins or penicillins.

Side effects Cefuroxime

When using the drug, side effects are observed only occasionally; they are reversible and have a weak intensity:

• lesions of the lymph and circulatory system: leuko- or neutropenia, positive Coombs test, eosinophilia and decreased hemoglobin levels. Thrombocytopenia and hemolytic anemia are observed sporadically;
• gastrointestinal disorders: nausea, temporary increase in bilirubin levels, vomiting and diarrhea;
• problems with urinary and renal function: decreased CC levels and increased serum urea and nitrogen levels. Interstitial cystitis develops occasionally;
• disorders affecting the nervous system: dizziness or headaches. Increased excitability is noted sporadically;
• ENT-related lesions: sometimes hearing loss has been observed during treatment of meningitis in children;
• local symptoms: thrombophlebitis or phlebitis may occur after an intravenous injection. In the case of intramuscular injections, pain develops at the injection site;
• signs of allergy: anaphylactic reactions and epidermal rash.

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

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Overdose

The use of extremely large doses of cefuroxime may lead to the development of signs of increased CNS excitation, as well as seizures.

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

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Interactions with other drugs

Administration in combination with drugs that reduce platelet aggregation (NSAIDs) increases the risk of bleeding.

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

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

Combination with probenecid or phenylbuzatone may reduce the intrarenal clearance of Cefuroxime and increase its plasma values.

Administration together with diuretics increases the risk of renal failure.

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Storage conditions

Cefuroxime should be stored in a place closed to small children. Temperature indicators are in the range of 4-25°C.

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Shelf life

Cefuroxime in the form of an injection lyophilisate can be used within a 24-month period from the date of sale of the therapeutic substance. The shelf life of the injection liquid packaged in the kit is 4 years.

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Analogues

Analogues of the drug are Erythromycin, Ampiox, Cephalexin with Amoxicillin, and in addition to this Biseptol, Augmentin, Poteseptil and Ciprolet with Doxycycline. In addition, the list includes Oflobak, Tetracycline and Miramistin with Oleandomycin phosphate, Cefazolin and Sulfadimezine, Amoxiclav with Vilprafen, Zinnat and Cefotaxime.

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