Cefotaxime-norton

Cefotaxime-Norton is a semi-artificial antibiotic with a wide range of therapeutic effects. Introduced by parenteral method.

Bactericidal properties of drugs develop when slowing down the binding processes of the cell membrane of bacteria. The drug has a high rate of stability under the influence of β-lactamase. At the same time, it demonstrates the activity of a relatively large number of pathogens that are resistant to the activity of ampicillin, other cephalosporins, gentamicin and other antimicrobial drugs.

[1], [2]

Indications Cefotaxime-norton

It is used for infections of a severe nature, triggered by bacteria that demonstrate sensitivity with respect to the action of cephalosporins:

• lesions of the respiratory tract (pneumonia, which is bacterial in nature, bronchitis in the active or chronic phase, pulmonary abscess, bronchiectasis, an infectious nature and complications caused by infection after operations in the sternum);
• bacteremia or septicemia;
• meningitis (except listeriosis) and other infections affecting the central nervous system;
• infection of the joints with bones (osteomyelitis or septic arthritis);
• lesions of the subcutaneous tissue with the epidermis;
• obstetric-gynecological infections (inflammations affecting the pelvic area);
• infections in the peritoneal zone (including peritonitis);
• lesions of the urethra (cystitis, pyelonephritis in the active or chronic phase and bacteriuria occurring without the development of symptoms);
• gonorrhea

Prevention of the appearance of infections in people after gynecological or urological operations, as well as procedures in the gastrointestinal tract.

[3]

Release form

The release of the drug is in the form of an injection lyophilisate; 1 or 10 flakonchikov with powder inside the pack.

[4], [5]

Pharmacodynamics

Cefotaxime usually exhibits activity against certain bacteria in a clinical setting and in vitro tests.

Gram-positive aerobes: Staphylococcus aureus (among them are strains that produce and do not produce penicillinase), enterococci, epidermal staphylococci, pneumococci, pyogenic streptococci (β-hemolytic from subgroup A), as well as streptococcus agalactia.

Aerobic gram-negative character: Enterobacter, meningococcus, Citrobacter species, Haemophilus (including stable relative to ampicillin), Klebsiella (including Klebsiella pneumoniae), Escherichia coli, Haemophilus parainfluenzae, vulgar Proteus, gonococci (strains that produce and do not produce penicillinase) Morgan's bacteria, Proteus mirabilis, acinetobacters, Providence Rettgera and Serratia species.

Many strains of the bacteria described above that are resistant to other antibiotics (for example, cephalosporins, penicillins and aminoglycosides) are sensitive to cefotaxime Na.

Cefotaxime demonstrates the effect of relatively individual strains of Pseudomonas sutum.

Anaerobes: bacteroids (among them, some strains of bacteroids fragilis), peptococci, clostridia (most strains of clostridium differential are resistant), Fusobacterium species (this includes the Putius bacillus), as well as peptostreptoktokki.

Cefotaxime, when tested in vitro, affects such bacteria: Providences, Salmonella species (this includes S. Typhi), and Shigella, but the clinical significance of this has not yet been determined.

Cefotaxime together with aminoglycosides with in vitro has a synergistic effect on individual strains of Pseudomonas aeruginosa.

[6], [7], [8], [9]

Pharmacokinetics

The cefotaxime component passes without difficulty into the tissues with fluids, reaching indices that significantly exceed the IPC of a greater number of pathogenic microbes. With 1-time use of 1st g of cefotaxime, the average plasma values of Cmax are 23.5 mg / l after half an hour.

The term half-life of a substance is 1.2 hours. After 12 hours from the moment of using the drug, the indicators of the antibiotic are still quite high and make it possible to identify the bactericidal effect on sensitive bacteria.

The drug is excreted through the kidneys (approximately 20-36% unchanged). 15-25% is excreted in the form of the main metabolic element desacetylcefotaxim (has bactericidal activity). Another 20-25% of drugs are displayed in the form of 2 inactive metabolic components. Some of the medication is also excreted in the bile.

[10]

Dosing and administration

The method of application, the size of the dosages and the interval between applications are determined by the degree of sensitivity of the bacteria that provoked the pathology and the severity of the lesion.

The medication can be used intravenously (via infusion or bolus), as well as intramuscularly after performing a skin test for tolerability of the antibiotic.

Bolus (jet) application.

It is required to dilute 0.25, 0.5 or 1 g of lyophilisate in a sterile injectable liquid (4 ml). If you take 2 g of powder - respectively, you need 10 ml of liquid. The drug is administered by the jet method, at low speed (3-5 minutes).

The introduction of infusions in / in the way.

It is necessary to dilute 1-2 g of the drug in 0.9% NaCl or 5% glucose solution (Ringer's lactate solution or other infusion fluid, excluding Na carbonate) - 40-100 ml of fluid is required.

A short infusion (2 g of powder per 40 ml of liquid) lasts 20 minutes. A longer infusion (2 g of lyophilisate per 0.1 l of fluid) is administered within 50-60 minutes.

Intramuscular injections.

It is necessary to dilute 1 g of the drug in a sterile liquid or 1% lidocaine solution (4 ml; or 2 ml per 0.25-0.5 g of the substance). The drug is injected into the gluteus maximus, deeply.

The size of the dosage portions for various diseases.

For adults:

• gonorrhea in the active phase without complications - 1-fold intramuscular injection of 1 g of drugs;
• infections of the urethra and uncomplicated lesions - jet intravenous injection or intramuscular injection of 1 g of the substance at 12-hour intervals;
• lesions with moderate severity: intramuscularly or intravenously intravenously applied to 1-2 g of drugs with 12-hour breaks;
• very severe forms of infections (for example, meningitis): intravenous administration of 2 g of medication with 6-8 hour intervals;
• for the prevention of infectious complications after operations: together with the introduction into anesthesia, 1 g of intravenous use of 1 g of the drug. If necessary, after 6-12 hours, repeated injection can be performed.

A day is allowed to apply no more than 12 g of Cefotaxime-Norton.

Children over the age of 1 month and up to the 12th anniversary (weight less than 50 kg): 0.1-0.15 g / kg of the substance is administered intramuscularly or intravenously a day (only for children over 2.5 years old). This portion is divided into 3-4 injections (with a 6-8 hour interval), taking into account the degree of intensity of infection. In the case of severe lesion stages, daily portions of 0.2 g / kg can be used.

Children weighing over 50 kg are prescribed standard adult dosages with a maximum per day equal to 12 g.

Infants aged 1-4 weeks and premature babies: 50 mg / kg intravenous injection per day (for 3–4 injections, with 6–8-hour intervals) is allowed per day. In the case of severe violations per day, it is allowed to inject 0.15-0.2 g / kg of the drug.

Infants up to 7 days of age and premature babies: intravenous injection of 50 mg / kg per day, which is divided into 2 injections in equal portions (12-hour intervals).

The duration of the treatment cycle is selected personally.

In case of problems with the work of the kidneys, the portion size is selected, taking into account the severity of the renal disorder. During the initial phase of anuria (the level of QA is less than 10 ml per minute), the standard dose of drugs is halved, without changing the interval between uses.

[14], [15]

Use Cefotaxime-norton during pregnancy

Cefotaxime-Norton is prohibited from prescribing to pregnant women, especially in the 1st trimester. Exceptions are only situations with the use of strict indications. This is due to the fact that there is no confirmed data regarding the safety of the drug for pregnant women.

A small amount of the drug is excreted in the mother's milk, therefore, if the component needs to be administered with HB, it is necessary to refuse breastfeeding for the duration of therapy.

Contraindications

Among contraindications: severe intolerance regarding the effect of cephalosporin antibiotics.

In cases where the fluid injected contains lidocaine:

• personal intolerance against lidocaine;
• intracardiac blockages in persons without a pacemaker;
• having severe severity of HF;
• intravenous injection.

[11], [12]

Side effects Cefotaxime-norton

Main adverse symptoms:

• allergy symptoms: rash, bronchospasm, urticaria, pruritus and angioedema. Occasionally, SSD, IEE, anaphylaxis, eosinophilia, TEN, and fever are noted;
• damage to the liver and digestive system: rarely vomiting, diarrhea, loss of appetite, pain in the abdominal area and nausea, and in addition, an increase in transaminase or bilirubin, alkaline phosphatase and LDH. When using Cefotaxime-Norton or after the end of therapy, colitis of a pseudomembranous nature may appear, provoked by the action of clostridium differential;
• disorders of hematopoietic processes: thrombocyto-, neutro- or leukopenia, hemolytic anemia, agranulocytosis and eosinophilia;
• urination disorders: tubulointerstitial nephritis;
• problems with the work of the central nervous system: headaches or curable encephalopathy (when using large portions, especially in people with kidney failure);
• negative effects caused by biological effects: prolonged therapy can lead to candidiasis, dysbiosis or superinfection caused by drug-resistant strains;
• other: candidiasis that affects the mucous membranes, and an increase in temperature. An excessively high rate of fluid injection may cause arrhythmia;
• local symptoms: pain in the injection area, as well as phlebitis, arising in the case of intravenous injection.

[13]

Overdose

Possible signs of poisoning include thrombocyte or leukopenia, fever, dyspnea, anemia of a hemolytic nature in the active phase, anorexia, symptoms of the gastrointestinal tract or epidermis, as well as the liver, and in addition stomatitis, loss of spatial orientation, insufficiency of the renal function, transient loss hearing and encephalopathy (especially in case of failure of renal activity).

The drug has no antidote. The required symptomatic measures supporting the vital functions of the body are carried out.

[16], [17]

Interactions with other drugs

The combined use of the drug with aminoglycosides caused an increase in the nephrotoxic effect. Diuretic substances - derivatives of ethacrynic acid with pyretadine and other diuretic drugs (for example, furosemide) have a similar effect.

Combination with nifedipine increases cefotaxime bioavailability by 70%.

When using probenecid, the release of cefotaxime through the tubules occurs, and the term of its half-life is also prolonged.

Administration with NSAIDs (such as diclofenac, aspirin or indomethacin) increases the likelihood of bleeding (also inside the digestive system).

[18], [19], [20], [21]

Storage conditions

Cefotaxime-Norton should be kept in a dark place, closed from small children. Temperature indicators - no more than 25 ° C. The finished solution maintains stability for 24 hours, subject to temperature values of 2-8 ° C.

[22]

Shelf life

Cefotaxime-Norton can be used for a 24-month term from the time a drug is sold.

[23], [24]

Application for children

Infants aged 1-12 months can be given the drug only if there are strict indications. Also, you can not use the drug intramuscularly children under 2.5 years.

[25], [26]

Analogs

Analogs of drugs are the means Loraxim, Cefotaxime with Taxtam, and in addition Sefotak, Cefantral and Fagotsef with Tax-O-Bidom.

[27]