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Zefogram
Last reviewed: 23.04.2024
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Cefogram is cephalosporin from the 3rd generation of antibiotics. Has a large range of drug activity.
Indications Cefograma
It is used for the treatment of various pathologies that have an infectious and inflammatory origin, and are provoked by the action of bacteria sensitive to ceftriaxone:
- sepsis with meningitis, and in addition cholangitis with peritonitis;
- pulmonary abscess or pneumonia;
- empyema affecting the gallbladder, or pyothorax;
- dysentery;
- carriers of salmonellosis;
- pyelonephritis ;
- burns or wound lesions, infected with infection;
- infections developing in the genital area, joints and bones with soft tissues;
- prevention of infections after surgical interventions.
Release form
The release is realized in the form of a liquid for injection procedures, in glass bottles with a capacity of 0.25, 0.5 or 1 g. Inside a separate pack - 1 such a bottle.
Pharmacodynamics
Cefogram is used for parenteral administration. It has a bactericidal effect that develops by slowing the binding of mucopeptides to bacterial membrane cells at the mitosis stage.
The medicament has a wide range of therapeutic effects - it shows activity both for gram-positive microbes and for gram-negative bacterial strains. Together with this, it is resistant to many β-lactamases.
Among Gram-positive microorganisms undergoing medical treatment are streptococci that are included in categories A and B, and in addition C and G, streptococcus agalactia, pyogenic streptococci, pneumococci and Streptococcus viridans, and with it epidermal or golden staphylococci.
Among gram-negative bacteria: hydrophilic aeromonada, hay bacillus, borrelia Burgdorfer and Morgan bacteria. In addition to this, Citrobacter diversus, clostridia perforings, diphtheria corynebacterium, meningococcus and gonococcus. It also includes strains of Haemophilus and enterobacter, intestinal rods, moraxelly catarials, Klebsiella pneumonia, vulgar proteins, mirabilis proteins, shigella, eubacteria, salmonella, Yersinia, shigella, and so on.
Pharmacokinetics
In a drug, non-linear pharmacokinetic indices-all properties that are based on common medicament values (free ceftriaxone or protein-synthesized element), apart from the half-life, depend on the size of the dose.
Absorption.
Peak plasma values when using 1000 mg of the drug are 81 mg / l, the achievement of which takes 2-3 hours. Single intravenous infusions (1000 or 2000 mg) after half an hour form concentrations that are, respectively, 168.1 ± 28.2, as well as 256.9 ± 16.8 mg / l. The level of bioavailability of the medication after the / m shot is 100%.
Distribution processes.
Indicators of the distribution volume of drugs - about 7-12 liters. After injection, the substance at high speed passes into the interstitial fluid, where its bactericidal level of relatively sensitive bacteria persists for 24 hours.
When using portions of 1000-2000 mg, the medicine passes well into various liquids and tissues. In the period exceeding 24 hours, its values reach a level many times higher than the minimal oppressive parameters for many microbial pathogens of infections within 60+ tissue fluids (this includes the heart, liver, ZHVP with the lungs, bones, nasal mucosa, middle ear , the secret of the prostate, and besides this, synovia, cerebrospinal fluid and pleural fluid).
Ceftriaxone demonstrates reverse synthesis with albumin (the synthesis index decreases according to the increase in drug values - for example, it decreases from 95% (plasma level below 0.1 g / l) to 85% (plasma level 0.3 g / l)). Low albumin values inside liquids with tissues lead to the formation of higher free energy indices than inside the blood plasma.
The medication passes through the inflamed membranes of the brain in the child (in this group and newborns). The level of Cmax inside the CSF is noted after 4 hours from the moment of drug administration and on average is about 18 mg / l (if the dosage is 0.05-0.1 g / kg). In the case of a bacterial form of meningitis, the mean values of ceftriaxone within the CSF are 17% of the plasma index; with aseptic form of the disease - 4%. After 24 hours from the moment of drug use in a portion of 0.05-0.1 g / kg, the ceftriaxone value within the CSF is more than 1.4 mg / L.
In an adult with meningitis, using a portion of 0.05 g / kg after 2-24 hours within the CSF, there are indices much higher than the minimum retarding values for the most common microbes that cause the development of meningitis.
Ceftriaxone is able to pass through the placenta, and in addition, in small amounts falls into the mother's milk (about 3-4% of the plasma parameters in the mother after 4-6 hours).
Exchange processes.
The drug is not subjected to a general metabolism, transforming into inactive decay products under the influence of the intestinal microflora.
Excretion.
The total values of drug clearance are approximately 10-22 ml / minute. The index of renal clearance is 5-12 ml / minute. Approximately 50-60% of unchanged substance is excreted by the kidneys, and another 40-50% - with bile. The half-life of ceftriaxone in an adult is approximately 8 hours.
Dosing and administration
The scheme of using the medication is selected individually. Usually it is suggested to administer 1000-2000 mg of the drug (intravenously or intramuscularly) at intervals of 24 hours or 500-1000 mg at intervals of 12 hours.
In view of the nature of the disease, single application in a dose of 0.25 g (intramuscular) may be prescribed.
Size of daily dose of Cefogram:
- newborns - 0,02-0,05 g / kg;
- children older than 2 months and up to 12 years of age - to 0.02-0.1 g / kg, with a single injection per day.
The duration of the therapy cycle is selected separately for each patient.
People with problems in the work of the kidneys should choose the dosage, taking into account the QC indices.
The maximum allowable dose for a day is 4000 mg (adult) and 2000 mg (child).
[2]
Use Cefograma during pregnancy
Adequately controlled appropriate tests regarding the safety of use of Cefogram during pregnancy were not performed. Experimental tests with animals did not reveal embryotoxic or teratogenic effects in ceftriaxone.
Use medicament during lactation or pregnancy is allowed only in situations where the likely benefits for women are more likely than the risk of the fetus having negative consequences.
Contraindications
The main contraindication is the presence of hypersensitivity to ceftriaxone or other cephalosporins. With intolerance to penicillins, allergy symptoms may develop.
Caution is required when using in people with problems in the work of the kidneys, which have a pronounced shape.
Side effects Cefograma
Use of the drug may cause the emergence of certain side-effects:
- problems with digestive activity: the appearance of nausea, diarrhea or vomiting, the development of hepatitis, a cholestatic form of jaundice or a pseudomembranous form of colitis, as well as a transient increase in the activity of liver transaminases;
- manifestations of allergy: itching or eruptions on the epidermis, as well as eosinophilia. Occasionally angioedema is noted;
- disorders of the hemopoietic function: prolonged use in large portions can lead to a change in the values of peripheral blood (development of thrombocyte-, leuko- or neutropenia, as well as hemolytic form of anemia);
- violations of blood uptake: development of hypoprothrombinemia;
- problems with urinary function: the emergence of tubulointerstitial nephritis;
- Symptoms provoked by chemotherapeutic effects: development of candidiasis;
- local signs: the appearance of phlebitis (intravenous injection) or pain at the site of the procedure (intramuscular injection).
[1]
Overdose
Signs of poisoning: the appearance of seizures, paresthesias, headaches and dizziness.
The medicine does not have an antidote, therefore, symptomatic procedures are prescribed.
Storage conditions
Cefogram should be kept in a dark and dry place, inaccessible to young children. The temperature should not exceed 25 ° C.
Shelf life
Cefogram can be used for 36 months after the release of the therapeutic agent.
Application for children
Newborns with hyperbilirubinemia (especially if they are premature) the drug can be administered exclusively under strict medical supervision.
Analogues
The analogues of the medication are Lendacin, and in addition Ceftriaxone and Rocefin.
Attention!
To simplify the perception of information, this instruction for use of the drug "Zefogram" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.