Zinatsef

Zinaceph is a systemic antibacterial medication. Included in the category of second-generation cephalosporins.

Indications of the zinacepha

It is used for the elimination of infectious diseases caused by bacteria that are hypersensitive to cefuroxime. In addition, it is used to treat those infectious pathologies in which the causative agent of the disease has not yet been determined. Among the allocated diseases:

• in the respiratory system: bronchitis in the acute or chronic stage, and in addition to this, the bronchiectasis of the infected species, viral pneumonia, pulmonary abscess, and infections in the sternum arising from surgical intervention;
• in the region of the nose and throat: tonsillitis with sinusitis, and in addition pharyngitis;
• organs of the urination system: cystitis, as well as pyelonephritis in acute or chronic stage, and besides this, the asymptomatic development of bacteriuria;
• soft tissue area: creeping erythema, cellulitis, as well as infections in the wound region;
• joints and bone structure: septic form of arthritis, as well as osteomyelitis;
• obstetric and gynecological diseases: inflammation and infection in the pelvic area. Also gonorrhea (especially when the patient can not use penicillin);
• other infections: this includes various diseases, including meningitis with septicemia.

Also, the drug is used to prevent the emergence of complications of an infectious nature after performing operations in the peritoneum and sternum, as well as in the pelvic region, as well as in operations of the vascular, orthopedic or cardiovascular type.

Often, monotherapy with the use of a drug gives a high result, but sometimes it is allowed to be used in combination with aminoglycosides or metronidazole (either in the form of candles or injections, or by oral route).

If a mixed type of disease (anaerobic and aerobic) is expected to develop, or if it is treated (with abnormalities such as pulmonary (cerebral, pelvic) abscess, peritonitis, or aspiration pneumonia), and in addition, if there is a high risk of developing such an infection (for example, as a result of gynecological surgery or surgery in the area of the large intestine) should be combined Zinatsef with the substance metronidazole.

During treatment of the exacerbated stage of chronic bronchitis, as well as pneumonia, the drug is permitted, if necessary, to be used before ingestion of Zinnata (cefuroxime axetil).

Release form

Release in powder form, ready for the injection solution, in bottles made of glass.

Pharmacodynamics

The component cefuroxime is an antibiotic of the bactericidal type that is part of the cephalosporin group. He has a wide range of activity against a variety of germs of Gram-positive, as well as Gram-negative (including strains that produce the substance β-lactamase). Cefuroxime has resistance to the effect of β-lactamases, which can affect many ampicillin or amoxicillin-resistant strains. The bactericidal effect is based on the destruction of the binding processes inside the cell walls of the microbes.

Acquired resistance to antibiotic is different in certain regions and is able to change over time, and in some strains in general can have significant differences. It is recommended to find out the local data about the sensitivity to the drug, if there is such an opportunity. This is especially important during the treatment of severe infections.

High rates of activity Zinatsef demonstrates against such bacteria: Staphylococcus aureus and coagulase-negative staphylococci (strains sensitive to the substance methicillin). In addition to the Klebsiella, pyogenic streptococcus, Pfeiffer sticks, Enterobacter, Escherichia coli, Clostridia, Streptococcus mitis (from the group of viridians), Proteus mirabilis and Proteus rettgeri. There is also a high activity regarding Salmonella typhi, intestinal salmonella and other strains of Salmonella, and in addition shigella, Neisseria (including gonococcus strains that produce β-lactamase) and Borde-Gangu bacteria.

Moderate activity is observed with respect to the vulgar proteus, the Morgan bacteria, and the bacteroid fragilis.

Bacteria that are completely resistant to cefuroxime: pseudomonas, legionella, clostridium difffile, campylobacter, Acinetobacter calcoaceticus, as well as strains of coagulase-negative staphylococci and Staphylococcus aureus, insensitive to methicillin.

Some strains of these groups showed resistance to the drug: enterococcus fecal, Morgan's bacteria, vulgar proteus, enterobacter with citrobacter, and serrations and bacteroids of fragilis.

In vitro, the drug in combination with aminoglycosides has a minimum of additive properties, in some cases with manifestations of synergism.

Pharmacokinetics

Peak serum cefuroxime is observed 30-45 minutes after the injection. The half-life of the substance after IV and IM injections is approximately 70 minutes. When combined with probenecid, the excretion of cefuroxime slows down, which causes its serum counts to increase.

With a plasma protein, the substance is synthesized by 33-50%.

During the 24 hours from the injection, the drug is almost completely (85-90%) excreted (unchanged) along with the urine, and most of it is excreted in the first 6 hours.

The component cefuroxime is not metabolized and excreted by secretion of the tubules, as well as glomerular filtration.

In the case of dialysis, a decrease in cefuroxime within the serum is observed.

The substance reaches values that exceed MIC values for most of the common pathogenic bacteria, inside synovia, bone tissue, and also intraocular fluid. In addition, cefuroxime passes through the BBB in the event that inflammation of the membranes of the brain is observed.

Dosing and administration

You can enter the drug solution solely by w / m or IV injection.

Because cefuroxime, among other things, exists as a drug for internal use - cefuroxime aksetil (Zinnat drug), it is allowed from the parenteral type of treatment, with the help of Zinatsef, to consistently switch to the internal intake of the active substance (but only if there is appropriate clinical expediency).

With the help of a single injection of an i / m method, a maximum of 750 mg of the substance is allowed to enter into one body region.

Treatment regimen and dose sizes for adults.

In the treatment of most infections, it is required to inject the solution iv / in or / m way - 750 mg 3 times per day. If an infection of a more severe type is observed, it is required to increase the dose to a 3-fold injection of 1.5 g. If necessary, it is allowed to increase the frequency of injections to 4 procedures per day (with an interval of 6 hours). At the same time, the total daily dose will increase to 3-6 g.

If necessary, individual diseases can be treated according to the following scheme: administration of 750 mg or 1.5 g of solution twice a day (in / m or / in), and then take Zinnat medicine inside.

Children (this includes also babies).

For a day it is required to administer 30-100 mg / kg (divide by 3-4 injections). In most diseases, it is sufficient to administer 60 mg / kg of medication per day.

Newborns.

Introduction for the day 30-100 mg / kg (divide this dose into 2-3 injections). It is also necessary to take into account that the half-life of the active drug component in the first weeks of life of an infant may exceed the adult values by 3-5 times.

Treatment of gonorrhea.

Enter in / m way 1,5 g (1 injection) or 750 mg (2 injections in both buttocks) medication.

Treatment of meningitis.

With the drug-susceptible strains of bacterial-type meningitis, Zinaceph is used as a monotherapeutic agent.

Daily dosage:

• for adults: enter 3 g at intervals of 8 hours;
• for children (also infants): 200-240 mg / kg (divide by 3-4 injections). This dose can be reduced to 100 mg / kg after 3 days of treatment or when symptoms of improvement appear;
• for newborns: the size of the initial dosage is 100 mg / kg. If improvement is observed, dosage can be reduced to 50 mg / kg.

With prophylaxis.

The standard dosage is 1.5 g at the stage of anesthesia in preparation for surgery in the orthopedic, pelvic and abdominal area. It can be supplemented by injection of 750 mg of medication in the / m way after 8 and 16 hours.

In the case of operations on the esophagus, heart, vessels, and lungs, the size of the standard dose is 1.5 g. It is administered during the call for anesthesia, after which an additional 750 mg of the drug is injected intravenously three times a day over the next 24-48 hours.

During the full replacement of the joint, it is required to mix cefuroxime powder (1.5 g) with methyl methacrylate cement polymer (1 pack) before adding the liquid monomer.

With sequential treatment.

Pneumonia: iv or / m injection of 1.5 g of solution 2-3 times per day in the interval of 48-72 hours, after which the transition to internal application - Zinnata in the amount of 0.5 g twice a day for 7-10 days.

Chronic form of bronchitis at the stage of exacerbation: administer 2-3 times per day 750 mg of medication (IM or IV) in the period of 48-72 hours, and then start oral intake of Zinnat - 0.5 g twice for day for 7 days.

Duration of oral, and in addition parenteral course is determined taking into account the health status of the patient, and in addition to this severity of the disease.

Functional renal impairment.

Because cefuroxime is excreted through the kidneys, individuals who have problems with their work, it is necessary to reduce the dosage of the medication to compensate for its slower elimination. The usual dosage is not required to be reduced (three times daily 750-1500 mg LS) with QC values of more than 20 ml / minute. For adults with severe functional renal impairment (CC level within 10-20 ml / minute), the dose should be 750 mg twice daily. If the disorder is even more severe (CC level is less than 10 ml / minute), 750 mg of solution should be administered once per day.

During the procedure of hemodialysis, it is required to inject intravenously or intravenously an injection of LS (750 mg) at the end of each such session. Parenteral injection of the substance is allowed to be added to the liquid for peritoneal dialysis (250 mg of Zinatsef per every 2 liters of liquid). Persons undergoing intensive care and undergoing programmed hemodialysis or high-flow haemofiltration, need to administer 750 mg of solution twice a day. Individuals who undergo low-flow haemofiltration need to prescribe dosages that are used by people with disorders in kidney function.

Features of the mortar.

Before the injection, 750 ml of powder should be added to 3 ml of the injection liquid, and then shake the bottle to form a suspension of opaque shade.

Also, a powder of 750 mg can be dissolved in a minimum of 6 ml of injection liquid.

Infusion solutions, which should be administered for a maximum of half an hour, are made as follows - in 50-100 ml of injection liquid 1.5 g of powder is dissolved.

Ready solutions are required to be administered immediately intravenously or through the dropper tube (when performing the infusion treatment).

During the storage of ready-made solutions, their color saturation can vary.

[3]

Use of the zinacepha during pregnancy

There is no information about the teratogenic and embryotoxic effects of cefuroxime, but in the early stages of pregnancy it should be administered very carefully.

Since the substance is excreted in the mother's milk, it is necessary to stop breastfeeding for the period of treatment.

Contraindications

The main contraindications:

• intolerance to cefuroxime or other elements of the drug, as well as to cephalosporins;
• a history of high sensitivity in severe form (for example, anaphylactic manifestations) with respect to other β-lactam type antibiotics (such as monobactams, penicillins, and carbapenems).

[1], [2]

Side effects of the zinacepha

The use of the solution may cause some side effects:

• pathology of infectious or invasive nature: occasionally there is an increased growth of resistant microbes (such as Candida);
• manifestations of the systemic blood flow, as well as lymph: often develops eosinophilia or neutropenia. Sometimes there is leukopenia, and in addition there is a positive result of Coombs test or a decrease in hemoglobin. Occasionally thrombocytopenia appears. Single - hemolytic anemia;
• immune disorders: manifestations of hypersensitivity - sometimes itching, rashes or urticaria. Occasionally, drug fever. Single - vasculitis on the skin, anaphylaxis and tubulointerstitial nephritis;
• disorders of the gastrointestinal tract: sometimes there is discomfort in the gastrointestinal tract. The pseudomembranous form of colitis is observed sporadically;
• manifestations in the field of the hepatobiliary system: there is often a transient increase in the parameters of liver enzymes. Sometimes - a temporary increase in bilirubin. In general, such disorders developed in persons who already have hepatic disease, but there is no information on the negative effect on the liver;
• skin disorders and disorders from the subcutaneous layer: there is a single-occurrence of erythema multiforme, TEN or Stevens-Johnson syndrome;
• manifestations of the urination system: there is a single increase in serum creatinine, as well as urea nitrogen, and in addition, a decrease in QC values;
• reactions at the site of injection and systemic disorders: often there are violations in the field of injection (among them thrombophlebitis and pain).

Overdose

As a result of intoxication with cephalosporins, signs of irritation in the brain area may appear, which can cause the development of seizures.

The indicators of the substance in the body can be reduced by means of peritoneal dialysis or hemodialysis sessions.

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

Interactions with other drugs

Since Zinacef is an antibiotic, it is capable of altering the intestinal flora, which is why estrogen reabsorption is reduced, and the effect of combined oral contraception is weakened.

During treatment with Zinatsef it is required to determine plasma, as well as blood, sugar values with the help of hexose-kinase or glucose oxidase methods.

The drug has no effect on the effectiveness of enzymatic methods for detecting glucosuria.

The effect of drugs on the effectiveness of methods based on copper recovery processes (such as Clintest, as well as Felling or Benedict's test) is insignificant. It does not cause the appearance of false positive data, as when using other cephalosporins.

Cefuroxime does not affect the test data for creatinine measurements using alkaline picrates.

[10], [11]

Storage conditions

Zinatsef in the form of powder is recommended to be kept in a place closed from children's access, at a temperature of maximum 25 ° C. The diluted and ready-to-use solution should remain in the refrigerator (at a maximum temperature of 4 ° C).

[12]

Special instructions

Reviews

Zinatsef is considered one of the most effective antibiotics, as a result of which it is often used to treat various diseases. The medicine has a large number of positive reviews.

It is often prescribed for both children and adults - to eliminate pathologies of infectious origin. Most often, situations are described where a medicine is used to eliminate diseases in the respiratory system (such as pneumonia or bronchitis, etc.). The drug course does not last long - about 10 days. During a given period of time, a good tolerability of drugs is observed.

But in this case, sometimes there are cases of the appearance of signs of hypersensitivity to the drug. Among the acute symptoms is a worsening of hearing. As a result, I had to cancel the treatment, although it gave the result.

Shelf life

Zinacef is allowed to be used in the period of 2 years from the date of release of the medicine. Diluted agent at room temperature can keep its properties no more than 5 hours, and in the refrigerator it is allowed to keep a maximum of 48 hours.