Cetyl

Cetyl is an antimicrobial drug used systemically. It belongs to the group of β-lactam antibiotics.

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Indications Cetyla

It is used to eliminate infections caused by microbes sensitive to the action of the drug:

• ENT system organs: sinusitis with pharyngitis, as well as tonsillitis and inflammation of the middle ear;
• infectious processes in the respiratory system: acute bronchitis or exacerbation of chronic bronchitis, as well as pneumonia;
• urinary tract infections: cystitis with pyelonephritis, as well as urethritis;
• infectious processes in the area of soft tissues with the skin: pyoderma and furunculosis, as well as impetigo;
• cervicitis and gonorrhea, and in addition, the acute stage of the uncomplicated gonococcal form of urethritis;
• early signs of tick-borne borreliosis, and at the same time preventing the development of late signs of this disease in adolescents from 12 years of age, as well as adults.

Release form

Released in tablets, 10 pieces in a blister. A separate pack contains 1 blister plate.

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Pharmacodynamics

Axetil cefuroxime is a bactericidal antibiotic of the cephalosporin series - cefuroxime in the form for oral administration. It is resistant to the influence of most β-lactamases, and also actively acts against a wide range of microbes (both gram-negative and gram-positive).

The bactericidal properties of the substance are due to the suppression of binding processes within the cell membrane of microbes.

Acquired antibiotic resistance varies regionally and may change over time, with some strains potentially showing significant differences. It is recommended to consult local information (if available) on antibiotic susceptibility – this is especially important when treating severe infections.

Cefuroxime has quite strong activity against the following microbes:

• Gram-negative aerobic bacteria: influenza bacilli (this also includes strains resistant to ampicillin), Moraxella catarrhalis, Haemophilus parainfluenzae, gonococci (also strains that produce penicillinase together with penicillin-producing strains), Escherichia coli, Klebsiella, Proteus mirabilis and Proteus rettgeri, as well as Providencia spp.;
• Gram-positive aerobic bacteria: Staphylococcus aureus and coagulase-negative Staphylococcus (methicillin-sensitive strains), Streptococcus pyogenes (and other β-hemolytic streptococci), pneumococcus and category B streptococci (Streptococcus agalactiae);
• anaerobic microbes: gram-positive and gram-negative cocci (including peptococci and peptostreptococci), gram-positive (including clostridia species) and gram-negative microbes (including bacteroides and fusobacteria species), as well as propionibacteria;
• other bacteria: Borrelia burgdorferi;
• cefuroxime-resistant bacteria: Clostridium difficile, Pseudomonas, Campylobacter, Acinetobacter calcoaceticus, Listeria monocytogenes, methicillin-resistant strains of Staphylococcus epidermidis and Staphylococcus aureus and Legionella;
• certain strains of bacteria resistant to the substance cefuroxime: Enterococcus faecalis, Morgan bacteria, Proteus vulgaris, Enterobacter, Citrobacter, Serratia and Bacteroides fragilis.

Pharmacokinetics

When taken orally, cefuroxime axetil is absorbed through the intestines and then hydrolyzed within the mucosa, after which it enters the circulatory system in the form of cefuroxime.

The required medicinal level of absorption is achieved immediately after eating. The peak value of the substance in the serum is observed approximately 2-3 hours after taking the tablet. The half-life is about 1-1.5 hours. The synthesis rate with protein is 33-55% (depending on the method of determination). Excretion of cefuroxime is carried out through the kidneys (unchanged) by means of tubular secretion and glomerular filtration.

Combined administration with probenecid increases the AUC of the mean serum concentration by 50%.

Serum cefuroxime levels decrease during dialysis.

Dosing and administration

Antibiotic susceptibility varies by region and time period. If necessary, local information on drug susceptibility should be consulted.

Often the course of therapy lasts 1 week. In order for the medicine to be better absorbed, it is recommended to take it after meals.

Dosage regimen for adults:

• for most infectious processes - 250 mg of the drug twice a day;
• urinary tract infections – 125 mg of the drug twice a day;
• infectious processes in the respiratory organs (moderate degree: for example, bronchitis) – 250 mg of the drug twice a day;
• more severe forms of infections in the respiratory system or suspected pneumonia – 500 mg twice a day;
• pyelonephritis – 250 mg twice a day;
• uncomplicated gonorrhea – single dose of 1 g of medication.

For tick-borne borreliosis in adolescents aged 12 years and over and adults – 500 mg of the drug twice a day for a period of 20 days.

Cefuroxime can also be produced in the form of sodium salt, which is used for parenteral administration. Thanks to this, it is possible to perform sequential treatment with one antibiotic in the case of switching from parenteral to internal administration (if there are medicinal indications).

Axetil cefuroxime acts effectively during sequential therapy of pulmonary inflammation, and along with this, exacerbations of chronic bronchitis in cases where parenteral administration of sodium cefuroxime was performed before.

Sequential treatment:

• in case of pulmonary inflammation: 2-3 times a day, administer intramuscular or intravenous injections of cefuroxime in the amount of 1.5 g over a period of 48-72 hours. Then take Cetyl in the amount of 500 mg twice a day during the first week;
• in case of exacerbation of chronic bronchitis: 2-3 times a day, administer cefuroxime intramuscularly or intravenously - in the amount of 750 mg for 48-72 hours. Then use the oral form of the drug - 500 mg twice a day for 5-7 days.

The duration of oral and parenteral therapy is prescribed taking into account the patient's health status, as well as the severity of the infectious process.

Children.

The standard dose is 125 mg or 10 mg/kg twice a day (no more than 250 mg of the medicine can be taken per day). When eliminating inflammation of the middle ear in a child under 2 years old, the drug should be taken in the amount of 125 mg or 10 mg/kg twice a day (maximum 250 mg per day). A child over 2 years old - 250 mg or 15 mg/kg twice a day (the daily dose is no more than 500 mg).

For children under 2 years of age, it is necessary to use axetil cefuroxime in the form of a medicinal suspension.

People with kidney failure.

Excretion of cefuroxime occurs through the kidneys, therefore people suffering from severe renal dysfunction need to reduce the dosage of the drug to compensate for its slow excretion:

• CC level ≥30 ml/minute (half-life 1.4-2.4 hours) – you can take the standard dosage of 125-500 mg twice a day;
• CC level 10-29 ml/minute (half-life 4.6 hours) – an individual standard dosage is prescribed every 24 hours;
• CC level <10 ml/minute (half-life 16.8 hours) – the standard dose is determined individually over a period of 48 hours;
• during hemodialysis (half-life 2-4 hours) – after each procedure it is necessary to take an additional standard dose of the drug.

Use Cetyla during pregnancy

There is no experimental evidence to suggest that Cetyl is teratogenic or embryopathic, but it should be used with caution in early pregnancy.

The medicine passes into breast milk, so caution is required when using it during lactation.

Contraindications

Contraindicated in case of hypersensitivity to cephalosporin antibiotics.

For children under 2 years old, it is recommended to use the medicine in the form of a suspension. There is no data on the use of the drug in infants under 3 months.

Side effects Cetyla

The use of the drug may provoke the development of certain side effects:

• invasions with infectious processes: increased growth of Candida fungi;
• hematopoietic system: development of hemolytic anemia, eosinophilia, and also leukopenia (in some cases - deep) and thrombocytopenia, as well as a positive Coombs reaction. Substances from the cephalosporin category are capable of being absorbed through the surface of erythrocyte membranes, as well as interacting with antibodies. As a result, the likelihood of developing hemolytic anemia, as well as a positive Coombs reaction, increases;
• immune reactions: hypersensitivity (this includes urticaria with itching and rashes, as well as anaphylaxis, drug fever and serum sickness);
• NS reactions: dizziness with headaches;
• Gastrointestinal tract: gastrointestinal disorders, including abdominal pain, nausea, diarrhea, vomiting, and pseudomembranous colitis;
• reactions of the hepatobiliary system: development of hepatitis or jaundice (mainly cholestatic), as well as a transient increase in liver enzyme levels (ALT, LDH and AST);
• subcutaneous layers and skin: Lyell's or Stevens-Johnson syndromes, as well as erythema multiforme.

Overdose

An overdose may result in irritation in the brain, causing seizures.

Serum cefuroxime levels can be reduced using peritoneal dialysis or hemodialysis.

Interactions with other drugs

Medicines that reduce the pH level of gastric juice can reduce the bioavailability of cefuroxime axetil, and can also eliminate the effect of increased absorption of the drug after meals.

Similar to other antibiotics, Cetyl is able to affect the intestinal flora, resulting in a decrease in estrogen reabsorption and a weakening of the effectiveness of combined oral contraception.

Because the ferrocyanide assay may give false-negative results for plasma and blood sugar levels in people treated with cefuroxime axetil, the hexokinase or glucose oxidase assay should be used. Cefuroxime does not interfere with the alkali picrate test for creatinine levels.

Combined administration with probenecid increases serum AUC values by 50%. Serum cefuroxime levels can be reduced by dialysis.

Positive Coombs tests have been reported during treatment with cephalosporins. This may interfere with cross-matching.

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Storage conditions

Cetyl should be kept in a place inaccessible to small children. Temperature values - no more than 25°C.

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Shelf life

Cetyl can be used for a period of 3 years from the date of manufacture of the drug.