Axef

Acef is an antiparasitic and antimicrobial drug.

Indications Accsa

It is used to prevent or treat infectious lesions, provoked by the activity of bacteria that are sensitive to cefuroxime. Among such diseases:

• lesions affecting the lower as well as the upper region of the respiratory tract: having bacterial genesis of pneumonia, bronchitis or tracheitis of a chronic or acute nature, bronchiectasis of an infected type, and in addition prevention and elimination of lesions resulting from surgical procedures in the sternum;
• infection in the ENT system: sinusitis with tonsillitis, and in addition otitis, having a bacterial origin, and pharyngitis;
• pathologies that affect the urogenital system: cystitis, gonorrhea, inflammation in the pelvic organs, and in addition pyelonephritis (also of a chronic nature);
• diseases that develop in the soft tissue and epidermis: furunculosis, infection in the wounds, erysipelas, impetigo and dermatitis of bacterial nature;
• lesions in the bones and joints: osteomyelitis or septic form of arthritis;
• the drug can be used in the development of severe stages of nosocomial infections, including peritonitis, septicemia, bacteriuria with meningitis and bacteremia;
• Prevention of the development of infections after surgical interventions.

Release form

Release of the medication is realized in tablets having a volume of 0.25 or 0.5 g, in an amount of 10 pieces inside the blister pack; 1 or 2 packs inside the pack.

In addition, it is manufactured as a lyophilizate for injection liquid, in flasks with a volume of 0.75 g; Inside the box there is 1 such bottle.

Pharmacodynamics

The active element of the drug is cefuroxime, which has a bactericidal effect against a fairly large range of bacteria. Cefuroxime is an antibiotic of the β-lactam type and is included in the category of cephalosporins.

The drug is part of the group II-th generation of cephalosporins and can be used for ingestion and parenteral injections. Cefuroxime has resistance to the influence of β-lactamases, which allows it to be used successfully for therapy in infections resulting from the activity of bacteria that produce β-lactamase. All cephalosporins have a similar principle of antimicrobial influence. The drug blocks the activity of proteins that bind penicillins (they have enzymatic activity and are required to bind biopolymers of a specific nature).

Along with this, the drug slows down the binding of peptidoglycan (a polymer element, which is the basis of the cell walls of microbes). Aksef does not have a toxic effect on the macroorganism, because peptidoglycan with penicillin-binding proteins are not contained inside the cell wall of mammals.

The drug demonstrates the bactericidal activity of a relatively wide range of anaerobes with aerobes, among which are strains resistant to amoxicillin and ampicillin.

Gram-positive aerobes:

Staphylococci (strains producing penicillinase), pneumococci, streptococcus agalactia, pyogenic streptococci, Streptococcus equisimilis, anginosa streptococcus, streptococcus mitis and Borde-Gangu bacterium.

Gram-negative aerobes:

Proteins (excluding common prostae), provints, intestinal sticks, Klebsiella, meningococci, Pfeiffer sticks, salmonella, moraxelli catarrils and gonococci (this includes strains that produce penicillinase).

Gram-negative and-positive anaerobes:

Clostridia, fusobacteria, Peptococcus niger, bacteroids (excluding phragilis bacteroids), Peptostreptococcus species and propionibacteria.

Together with this, cefuroxime exerts a bactericidal effect against the strains of Borredorfer's Borrelia.

Does not show activity for:

Campylobacter, enterococci with pseudomonad, serrations, Legionella and Citrobacterium with enterobacteria. In addition, the list of listeria monocytogenes, Acinetobacter calcoaceticus, Morgan bacteria and clostridium difficile.

The drug also does not affect methicillin-resistant strains of epidermal and golden staphylococci.

Pharmacokinetics

The medication taken orally is well absorbed inside the intestine, in the case of admission in the form of cefuroxime axetil, it undergoes a hydrolysis process inside the intestinal wall and penetrates the circulatory system in the form of cefuroxime.

The degree of drug absorption will be higher if taken immediately after eating. Plasma Cmax values are noted after 2-3 hours after taking the tablet inside. The half-life of cefuroxime is within 60-90 minutes.

With IV injection, plasma Cmax values are noted after 30-45 minutes. The half-life of the substance in this case is 60-70 minutes. Indices of protein synthesis of drugs inside the plasma - 50%.

During the first 6 hours most of the drug is excreted; after a lapse of 24 hours from the time of administration, a maximum of 10% of the used portion of the drug remains within the blood.

The medicine is not exposed to metabolic processes inside the body, excreted through the kidneys in the unmodified state.

At high drug concentrations, its active element is found in the intraocular fluid, as well as in synovia. In people with meningitis, Axef passes through the BBB.

Hemodialysis significantly lowers cefuroxime.

Dosing and administration

Select the dosage regimen and the duration of the treatment cycle, taking into account the individual nature of the pathology and characteristics of the patient's body. Often, the therapeutic course lasts a minimum of 1 week. Use tablets should be after taking food, because it increases the intestinal absorption of drugs.

Schemes of drug use in tablets.

In the case of the defeat of the urethra, 125 mg of the substance are taken 2 times a day.

For the treatment of respiratory infections, taking place without complications, you need to use 0.25 grams of LS 2 times a day.

To eliminate infections in the respiratory tract, having a severe nature, take 0.5 g of substance 2 times a day.

In the case of treatment of pyelonephritis (chronic or acute), 0.25 g of the drug is used 2 times a day.

For therapeutic use in gonorrhea, occurring without complications, 1-time application of 1000 mg of substance is required.

For adolescents over 12 years of age and adults with tick-borne borreliosis, 0.5 g of the drug is often used 2 times a day. This disease requires a 20-day treatment cycle.

Children over 3 years of age need to use 125 mg of LS 2 times a day, and in severe stages of pathology, the portion is doubled. For a day for children, a maximum of 0.5 g of the drug is allowed.

Sometimes it is required to start treatment with Axef in the form of an injection liquid, and then continue it, taking the pills. This scheme is assigned in the following cases.

In the case of pneumonia, adults are given medication in / m or iv in a method, in an amount of 1.5 mg, 2-3 times per day for 2-3 days. Then the medication is administered inside - 0.5 g 2 times a day for 8-10 days.

With the development of recurrence of bronchitis (chronic), an adult needs parenteral administration of 0.75 g of substance 2-3 times per day in a 2-3-day period. At the end of this interval, the drug is taken orally - 2 times a day in a 0.5 g portion, over a 5-7-day cycle.

Schemes of injection of lyophilizate.

Injection liquid is allowed to use exclusively in / m or / in the method.

With the / m injections, a solvent (3 ml) is added to the vial of powder and then gently shaken to obtain a suspension. The solvent in this case is injection water.

To make the liquid for intravenous injections, you need to dilute 0.75 g of the substance in 6 ml of solvent (1500 ml of the substance requires 15 ml of this solvent). For infusions of 1500 mg of cefuroxime, 50-100 ml of a liquid-solvent are required. As a solvent, injection water is used in this case.

Entering a medication through infusion is required for a minimum of half an hour. Injection fluid is injected directly into the vein or through the dropper tube.

For adults, the portion size of the drug is 0.75-1.5 g, with a 2-3-fold application per day (administered intramuscularly or intravenously), taking into account the severity of the disease.

With the stable development of the positive dynamics of the symptoms of the pathology, a transition to treatment with Axef in tablets takes place.

For the treatment of gonorrhea requires 1-time administration of 1500 mg of substance or 2-fold injection of 0.75 g of LS (in each of the buttocks).

In case of meningitis, it is necessary to use a drug for monotherapy, injecting it iv in a way with an 8-hour interval in a dose of 3000 mg. For children with meningitis, the dosage should be 0.15-0.25 g / kg per day; it is divided into several separate injections, after which it is injected in / in the method. For newborns, the daily dosage is 0.1 g / kg.

In case of infections, children should use 30-100 mg / kg of the drug per day, dividing this dose into 3-4 injections.

Newborns often need to inject 30-100 mg / kg of substance per day, dividing this dosage by 2-3 parts. If cefuroxime is used in neonates, remember that they have a half-life of several times longer than an adult.

To prevent the occurrence of infection after surgical procedures, often 1500 mg of medication is used intravenously (at the stage of induction of anesthesia). Such preventive measures are taken in the case of operations in the sternum or peritoneum, and in addition with pelvic, and with it abdominal or orthopedic procedures.

In orthopedic or pelvic surgical procedures, the drug is used in a dose of 0.75 g - after 8 and 16 hours after the end of the procedure.

In operations in the peritoneum or sternum, it is required to administer the drug in a dose of 0.75 g, 3 times a day for a 1-2-day cycle.

Persons with impaired renal activity and those who are on hemodialysis need to adjust the dosage of the drug.

Use Accsa during pregnancy

The drug does not have mutagenic and teratogenic effects, as well as embryotoxic effects, but in pregnancy it can be used only in situations where it is considered that the benefits for women will be more anticipated than the risk of developing negative consequences for the fetus.

Cefuroxime is able to pass into the mother's milk, because of what, if there is a need for its use during lactation, temporarily stop breastfeeding.

Contraindications

It is contraindicated to use the drug when intolerant with regard to elements of the drug or cephalosporins.

Caution is required when used in people with a history of severe sensitivity to β-lactam antibiotics. It is also very cautious to apply the medication in disorders of renal activity.

Side effects Accsa

The medicine is often transferred without complications, but with prolonged use or intolerance of the patient, urticaria, rashes and itching can develop. Only anaphylaxis, febrile condition and tubulointerstitial nephritis were recorded alone. Negative symptoms are often mild and go away after drug withdrawal.

Single injection of the drug led to the emergence of multiform erythema, Stevens-Johnson syndrome or TEN.

Disorders affecting the operation of the digestive tract - vomiting, pseudomembranous colitis, nausea and diarrhea.

Violations of the function of the hematopoietic system - neutro-, leuko- or thrombocytopenia, and in addition eosinophilia and a decrease in the values of hemoglobin.

Although Axef has no direct toxic effect on the liver, in some patients hyperbilirubinemia or an increase in the activity of liver enzymes is observed.

People who use cefuroxime may have a change in laboratory data, such as a false positive response from Coombs, or an increase in urea nitrogen along with creatinine.

Injections of the drug may lead to the appearance of local side effects. In the case of a / m injections there are painful sensations in the zone of drug administration. With intravenous injection, thrombophlebitis develops.

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Overdose

When Aksef is poisoned, the patient develops tremors, a sense of overexcitation and convulsions. These manifestations are due to the fact that cefuroxime has an irritant effect on the brain.

The drug has no antidote. In case of intoxication, symptomatic measures are taken. To reduce the plasma indices of cefuroxime, peritoneal dialysis and hemodialysis can be performed.

Interactions with other drugs

Combined use together with antacids weakens the absorption of cefuroxime (if the drug is used in tablet form).

Combined application with probenecid leads to an increase in the blood values of cefuroxime, as well as to a decrease in its renal excretion.

The medication can be combined with solutions of azlocillin or metronidazole, and in addition with xylitol injection and 1% lidocaine solution. In addition, the properties of drugs do not change for 24 hours when combined with such substances:

• sodium lactate 6M;
• isotonic liquid NaCl;
• 5% glucose;
• 0.18% NaCl together with 4% glucose;
• 5% glucose with 0.9%, 0.45%, and 0.25% NaCl;
• 10% glucose;
• Ringer-lactate or Ringer;
• Hartman.

It is prohibited to mix medication inside one syringe with aminoglycosides.

Aksef can not be mixed with the injection solution of sodium bicarbonate, because such mixing causes a strong change in the shade of the solution of cefuroxime.

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Storage conditions

Aksef must contain in a dark and dry place at a temperature in the range 15-25 values ^of C.

Shelf life

Acef can be used within 24 months of the manufacture of the therapeutic agent. Shelf life of the finished injection liquid is a maximum of 24 hours.

Analogues

Analogues of the drug are medicines Zinnat, Proxim with Zinatsefom, Cetil with Cefutil and Aksetinom, and in addition Cefuroxime, Bactyl and Cefumax.