Cephritis

Cefort is an antibacterial drug for systemic use.

Indications Cologne

It is used in the treatment of infections, the activation of which occurs under the action of microbes that are sensitive to ceftriaxone. Among those:

• respiratory ducts - pneumonia or inflammation in the region of the upper respiratory tract;
• Ears - acute stages of otitis media;
• peritoneum - typhoid fever or peritonitis and so on;
• urethra and kidneys - infections of urogenital nature;
• genitalia - syphilis or gonorrhea and so on;
• bones or soft tissues - infections appearing in the area of wounds;
• people who have weakened immunity;
• sepsis, meningitis or tick-borne borreliosis of disseminated nature (2nd or 3rd stage).

It can be used to prevent the appearance of infections after surgical procedures.

In the case of ceftriaxone, the existing official guidelines for the prevention of antibiotic resistance should be observed. Chlamydia and mycobacteria with mycoplasma are resistant to cephalosporins.

[1], [2]

Release form

The release of the drug is in the form of a lyophilisate, in bottles of 1 g. Inside the box - 1 bottle.

[3]

Pharmacodynamics

The active drug element, ceftriaxone, is a third-generation antibiotic from the cephalosporin group. Parenterally administered, has a prolonged type of drug effect.

The bactericidal effect of drugs develops due to the ability to suppress the binding of cell walls, due to which lysis of bacterial cells occurs with its subsequent death. Actively affects a large number of gram-negative and positive microbes.

In addition, ceftriaxone is highly resistant to relatively large amounts of β-lactamase.

[4], [5], [6], [7], [8], [9]

Pharmacokinetics

After parenteral injection, ceftriaxone passes perfectly inside fluids with tissues. The values of the bioavailability of the component after administration are 100%. When i / m injections Cmax indicators are observed after 2-3 hours. In case of inflammation of the meningeal membranes, the substance passes well inside the cerebrospinal fluid. After the administration of drugs in 50 mg / kg portions, the values inside the blood plasma are 216 μg / ml, and inside the cerebrospinal fluid - 5.6 μg / ml. In an adult, after 2-24 hours after the injection of 50 mg / kg of drugs, its performance inside the cerebrospinal fluid repeatedly exceeds the minimum inhibitory concentrations in the most common microbes that cause meningitis.

Protein synthesis of the drug inside the plasma is 85%. Distribution volume indicator - within 5,78-13,5 l. Half-life is in the range of 5.8-8.7 hours. Values of total clearance - in the range of 0.58-1.45 l / h; renal - 0.32-0.73 l / h.

At 50-60% of the drug in the active state is excreted in the urine (for 48 hours), and another part - with bile. In a newborn child, about 70% of the applied portion is excreted through the kidneys.

In infants within 8 days of age, as well as elderly patients (more than 75 years old), the half-life is approximately doubled. In case of failure of the renal work excretion slows down.

[10], [11], [12], [13], [14], [15], [16], [17],

Dosing and administration

It is necessary to use the medication by parenteral method, through intravenous infusion or intramuscular injections or injections. It is forbidden to mix inside one bottle or syringe with other drugs.

Adolescents from 12 years of age or adults should be given an average of 1-2 g of drugs (often 1 time per day). In a day it is allowed to use no more than 4 g of substance.

In case of treatment of severe stages of infections or due to low sensitivity to ceftriaxone, the daily dose of drugs can be increased to 2-4 g (neutropenic fever, infections of bacterial origin, and also meningitis or endocarditis of a bacterial nature).

The duration of therapy is at least 1 day (gonorrhea), a maximum of 21 days (complicated infections; for example, tick-borne borreliosis, disseminated). The exact size of the portion, the duration of treatment and the method of administration are selected by the doctor, taking into account the severity of the pathology, as well as the individual characteristics of the patient.

Production of liquid for i / m injection: 1 g of lyophilisate diluted in 1% lidocaine solution (3.5 ml).

Production of liquid for on / in the introduction: 1 g of the substance is diluted in injection water (10 ml). Injection should be performed at a slow speed for 4-5 minutes.

The manufacture of drugs for IV injection through an IV: 2 g of the drug is diluted in one of the following solvents (40 ml): 0.9% NaCl, 0.45% NaCl + 2.5% glucose, 5% - either 10% glucose, 6% dextran in 5% glucose or 10% hydroxyethyl starch.

Children are recommended to enter the following dosages of the drug:

• newborns younger than 14 days - calculate the dose in the ratio of 20-50 mg / kg (the drug must be administered for at least 1 hour);
• children from 15 days of age and up to 12 years - to calculate the dose in the proportion of 20-80 mg / kg.

In severe stages of the disease, a dose of 80 mg / kg is used. Children who weigh more than 50 kg should take the medicine in dosages calculated for adults.

Dosages over 50 mg / kg should be administered for at least half an hour. A maximum of 80 mg / kg of medication is allowed. The only exception is therapy for meningitis in children under the age of 12 years - in this case, a dose of 100 mg / kg is used.

[26], [27], [28], [29],

Use Cologne during pregnancy

There is no information regarding the safety of the drug when used in pregnant women, which is why it is not recommended to be administered to such patients.

Due to the fact that ceftriaxone is able to pass through the placenta, in case of its use it is required to suspend breastfeeding.

Contraindications

Main contraindications:

• the presence of intolerance towards cephalosporins or medication used as a solvent. If a person is hypersensitive to monobactams, penicillins or carbapenems, the risk of cross-allergy to ceftriaxone should be taken into account;
• It is forbidden to use with enteritis, ulcerative form of colitis or colitis associated with antibiotics;
• acidosis or jaundice;
• You can not combine the drug with solutions, which include calcium. They can be used only after a minimum of 48 hours from the time of using Ceftriaxone. This is due to the increased probability of the formation of precipitates of Ca ceftriaxone salts.

[18], [19], [20], [21], [22]

Side effects Cologne

Ceftriaxone is often tolerated without complications, but sometimes some side effects may occur:

• fungal infections;
• thrombocyto-or leukopenia, and in addition eosinophilia or hemolytic form of anemia. It is also possible to increase the values of the PTV;
• nausea, pancreatitis, diarrhea, bile stasis, stomatitis or vomiting;
• the appearance of precipitates of Ca ceftriaxone salts inside the gallbladder;
• itching, rash, swelling, or urticaria;
• hematuria or oliguria, as well as the formation of calculi in the kidneys;
• fever, headaches, signs of anaphylaxis.

Phlebitis was occasionally noted, due to which it was necessary to inject the medicine at low speed. To relieve an injection, the drug should be dissolved in lidocaine (only with a / m injection).

[23], [24], [25]

Overdose

Overdosing leads to the potentiation of negative signs of the drug - vomiting with nausea, as well as headaches.

To eliminate these disorders, symptomatic procedures are performed. Peritoneal dialysis or hemodialysis is not necessary, as they will have no effect. The antidote is missing.

[30], [31]

Interactions with other drugs

Cephort mutually potentiates the effect of aminoglycosides in relation to a variety of gram-negative bacteria.

NSAIDs, as well as other drugs that slow down platelet aggregation, increase the risk of bleeding, and nephrotoxic drugs and diuretic drugs - renal disorders.

Does not possess pharmaceutical compatibility with other antimicrobial medicines.

[32], [33], [34], [35], [36]

Storage conditions

Cephort must be kept in a dark and forbidden place. The temperature values are within 25 ° С.

Shelf life

Cephort can be used within 24 months from the date of manufacture of the pharmaceutical agent.

Application for children

It is forbidden to prescribe to premature babies (born before week 41), as well as to premature babies or newborns with hyperbilirubinemia.

[37],

Analogs

Analogues of the medication are the drugs Tercef, Rocefin, Lendacin with Ceftriaxone, and in addition, Xon, Emesef and Ceftriaxone-CMP.

[38],