Reflin

Reflin is an antibacterial drug for systemic administration. It belongs to the cephalosporin subgroup.

The component cefazolin is an antibiotic with a wide range of bactericidal antimicrobial action (1st generation). Similar to penicillins, it inhibits the binding of the bacterial cell membrane. The drug destroys bacteria due to its ability to suppress the production of cell membrane elements. [ 1 ]

The substance ceftriaxone is active against gram-negative and -positive microbes.

Indications Reflin

It is used in case of such violations:

• respiratory tract infections;
• lesions in the ENT organs;
• infection of the urinary tract or kidneys;
• diseases affecting the genitals (including gonorrhea);
• epidermal infections or soft tissue infections;
• lesions of the peritoneum (for example, peritonitis );
• infectious pathologies associated with bones and joints;
• wound infections;
• sepsis (systemic infection of the body) or mastitis;
• endocarditis and meningitis;
• disseminated form of tick-borne borreliosis.

Release form

The release of the medicinal product is realized in the form of a lyophilisate for the preparation of a medicinal solution (inside vials with a volume of 1 g).

Pharmacodynamics

The drug demonstrates activity against the following elements:

• gram-positive bacteria from the staphylococcus group (producing or not producing penicillinase), many strains of streptococci, including pneumococci, as well as diphtheria corynebacterium;
• gram-negative microbes, including Escherichia coli, Shigella, Klebsiella with Salmonella, Enterobacter aerogenes, Proteus mirabilis with Haemophilus influenzae, and gonococci.

It has no effect on indol-positive strains of Proteus (Proteus vulgaris, Morgan's bacterium and Providence Rettger) and Pseudomonas aeruginosa. In addition, it does not affect viruses with protozoa, fungi and rickettsia.

Pharmacokinetics

After administration, the drug is absorbed at a rapid rate. About 90% of the used dosage is synthesized with protein. The blood Cmax indicator is noted after 1 hour from the moment of injection. Bactericidal values in the blood are maintained for 8-12 hours.

After an intravenous injection, a high blood level of the drug is formed, but it is secreted faster (the half-life is approximately 2 hours).

Cefazolin passes into many fluids with tissues. The substance is almost not involved in metabolic processes; most of the applied portion is excreted unchanged with urine (approximately 90%); excretion with bile is insignificant.

The drug crosses the placenta and enters the umbilical cord blood with amniotic fluid. Low levels of the drug are observed in mother's milk. The drug passes well into the joint cavities through the inflamed synovial membrane.

Dosing and administration

The drug is administered intravenously or intramuscularly. Before starting therapy, the risk of developing an allergy should be excluded by performing an epidermal test.

For an adult, the usual dosage is 0.5-1 g, administered at 12-hour intervals.

In case of severe infection or low effectiveness of the medication, the daily dose may be increased to 4 g.

The use of antibiotics continues for another 48-72 hours from the moment the temperature and tests stabilize.

• Application for children

It is prohibited to prescribe to newborns under 1 month of age.

Use Reflin during pregnancy

Reflin can cross the placenta, which is why it is not used during pregnancy.

The active element of the drug is excreted in small concentrations in breast milk, and therefore breastfeeding should be discontinued during therapy.

Contraindications

Contraindicated for use in patients with intolerance to cephalosporins (if there is an allergy to penicillins, the possibility of developing a cross-reaction must be taken into account).

Caution is required when prescribing to individuals with renal insufficiency or intestinal pathologies (colitis).

Side effects Reflin

Main side effects:

• lesions associated with the lymph and blood system: leukopenia, thrombocyto- or granulocytopenia, anemia of the hemolytic form, eosinophilia, increased creatinine levels and increased PT values, agranulocytosis and disorders of coagulation processes;
• digestive disorders: glossitis, biliary obstruction, diarrhea, stomatitis, pancreatitis and nausea. Occasionally, pseudomembranous enterocolitis (intestinal inflammation associated with the action of Clostridium difficile) may develop;
• problems with the hepatobiliary system: a curable form of cholelithiasis, deposits of Ca salts inside the gallbladder and an increase in the values of liver enzymes in the blood (ALT, AST or ALP);
• infectious infections: lesions associated with the activity of resistant microbes, mycosis in the genital area and secondary fungal infections;
• lesions of the subcutaneous layer or epidermis: urticaria, exanthema, rash, TEN, swelling, allergic dermatitis, itching and erythema multiforme;
• disorders associated with urinary processes: formation of renal stones, glucosuria, renal failure, oliguria or hematuria;
• systemic disorders: headaches, anaphylactoid or anaphylactic symptoms, dizziness, chills and fever.

Overdose

In case of poisoning with Reflin, symptomatic actions must be taken.

Interactions with other drugs

Probenecid is able to weaken the processes of excretion of cephalosporins by the renal tubules, due to which the rate and duration of blood circulation of the latter increases.

Data obtained from experimental tests involving animals administered cephalosporins indicate that use together with potent diuretics (ethacrynic acid or furosemide) may increase the likelihood of nephrotoxicity.

A false positive response may be observed when determining sugar levels in urine by introducing Fehling's or Benedict's reagents, as well as Cu sulfate test tablets.

It is possible that false-positive (indirect and direct) antiglobulin Coombs tests may develop in newborns (in cases where their mothers were given cephalosporins during pregnancy).

Storage conditions

Reflin must be stored in a dry place at temperatures no higher than 25°C.

Shelf life

Reflin can be used within a 36-month period from the date of manufacture of the therapeutic substance.

Analogues

The analogs of the drug are Zolin, Orpin, Ifizol with Ancef, Cefazolin and Cefezol with Nacef. In addition, the list includes Cefaprim, Totacef, Cefopride and Intrazolin, Cefamezin, Kefzol, Cezolin with Lizolin and Cephasex.