Zocef

Zotsef is an antimicrobial drug from a subcategory of the 2nd generation of cephalosporins. Contains cefuroxime, which has a bactericidal effect on a relatively wide range of different microbes (gram-negative and positive), including strains that help produce β-lactamase.

The active element of the drug is resistant to exposure to β-lactamase, because of which relatively large amounts of amoxicillin or ampicillin-resistant strains are affected. Its bactericidal properties are manifested by the breakdown of membrane binding processes of microbial cells.

Indications Zocefa

It is used for a variety of infections caused by bacteria that are sensitive to cefuroxime (or used until the bacteria that cause the infection is identified):

• lesions of the respiratory system: bronchitis in the active or chronic stage, pulmonary abscess, postoperative infection of the organs of the sternum, infected bronchiectasis and pneumonia of a bacterial nature;
• infections in the throat, ears, or nose: tonsillitis with sinusitis, otitis media, and pharyngitis besides;
• lesions of the urethra: cystitis, pyelonephritis in the active or chronic phase, bacteriuria, occurring without symptoms;
• soft tissue infections: erysipelas, cellulitis, or infections that appear in wounds;
• diseases affecting the joints with bones: osteomyelitis or arthritis of a septic variety;
• gynecological pathology: inflammation in the pelvic area;
• treatment of gonorrhea (especially when it is impossible to use penicillin);
• infections, including peritonitis with septicemia and meningitis.

Prevention of infections in case of increased likelihood of complications after operations in the area of the peritoneum and sternum, affecting the pelvis, as well as after performing orthopedic or cardiovascular procedures.

The use of Zocef alone for therapy is generally sufficient to obtain the desired effect, but if necessary it can be combined with aminoglycosides or metronidazole (via injections, suppositories, or inwards), especially as a preventive substance in gynecological or gastrointestinal operations.

[1]

Release form

The release of the medicinal substance is realized in the form of an injection lyophilisate - inside glass bottles, whose volume is 0.75 or 1.5 g. Inside a separate box - 1 bottle.

[2],

Pharmacodynamics

Cefuroxime in vitro testing has demonstrated effects on the following bacteria:

• Gram-negative Aerobes: Klebsiels with Providence, Escherichia Colonel (with ampicillin-resistant strains), meninghy, anesthesia, abdominal pains (with ampicillin-resistant)
• Gram-positive aerobes: pneumococci with staphylococcus aureus, and in addition streptococcus tumors (subcategory viridans) with epidermal types of staphylococcus (with strains that help produce penicillinase, and without methicillin-resistant strains), streptococci of subgroup B (streptchkov, and methicillin-resistant strains), streptococci of subgroup B (streptchkov, and methicillin-resistant strains), streptococci of subgroup B (streptchkov, and methicillin-resistant strains), streptococci of subgroup B (streptchkov, and methicillin-resistant strains), streptococci of subgroup B (streptchkov, and methicillin-resistant strains), streptococci of subgroup B (streptchkov, and methicillin-resistant strains), streptococci of subgroup B (streptchkov), and methicillin-resistant strains without streptococci of subgroup B (streptok) streptococcus β-hemolytic form) and pertussis;
• anaerobes: this includes gram-negative as well as positive cocci, including peptococci and the Peptostreptococcus species;
• Gram-positive microbes (most of them are clostridia) and of the gram-negative type (fusobacteria with bacteroids), as well as propionibacteria;
• Other: Burgdorfer Borrelia.

Bacteria exhibiting resistance to cefuroxime: pseudomonads, listeria monocytogenes, legionella with clostridium differential, campylobacter, methicillin strains of staphylococcus (golden with epidermal), and Acinetobacter calcoaceticus.

Certain bacterial strains resistant to the drug: vulgar proteus, serration, fecal enterococci, fragilis bacteroids, citrobacter with enterobacteria and morgan bacteria.

In vitro testing revealed that the compound of the drug and aminoglycosides showed a noticeable additive effect; sometimes synergism also develops.

[3], [4]

Pharmacokinetics

Serum indicators of Cmax cefuroxime are determined after a 30-45-minute period from the time of use. The term half-life of the component after the intramuscular injection or intravenous injection is approximately 70 minutes. The introduction of combined with probenecid inhibits the excretion of cefuroxime and leads to an increase in its serum level.

Intlasma protein synthesis - in the range of 33-50%.

Within 24 hours from the moment of use, the drug is removed almost all (85-90%), unchanged - with urine (the main part of the drug is excreted in the first 6 hours). Cefuroxime is not exposed to metabolic processes, being secreted through the secretion of tubules and KF.

Serum drug values can be reduced through dialysis.

Indicators of cefuroxime, which have a higher level of MIC (BMD) in the main part of the common pathogenic bacteria, are noted inside the synovia, along with bone tissue and ophthalmic fluid. The component overcomes the BBB if the patient has inflammation that affects the brain sheath.

[5], [6]

Dosing and administration

It is allowed to enter Zotsef only in the intramuscular or intravenous way.

General instructions.

For most infections, an adult can use standard intravenous or intramuscular administration of 0.75 g of the substance, in 3 single quantities per day. If the infection is severe in nature, the portion increases to 3 times the use of 1.5 g of drugs per day. If necessary, you can increase the frequency of application of Zocef to the 6-hour period, and the total dosage per day will increase to 3-6 g. Individual infections can be treated according to this regimen: 0.75 or 1.5 g 2 times per day. (v / m or v / v) with the further transition to the use inside.

Children per day need 0.03-0.1 g / kg (divided into 3-4 injections). For most lesions, a dosage of 0.06 g / kg per day can be used.

A newborn is prescribed to use 0.03-0.1 g / kg per day (2-3 injections). It is necessary to take into account that the term half-life of a substance during the first weeks after birth may be three to five times higher than those found in adults.

For gonorrhea, use 1.5 g of drug after 1 injection or 2 injections (one per each buttock) in a 0.75 g serving.

Assigned to monotherapy in the case of meningitis, having a bacterial origin, (developed under the influence of sensitive microbial strains). An adult should use 3 g of the drug over 8-hour breaks. Children are usually administered per day at 0.15-0.25 g / kg (divide the indicated dosage into 3-4 doses). Newborn - intravenous 0.1 g / kg per day.

Prevention.

Adults are usually given 1.5 g of medication at the same time as anesthesia during procedures in the pelvic or abdominal area, as well as orthopedic. It can be supplemented with a / m injection of 0.75 g of the component after an 8-hour and 16-hour length.

In the case of operations involving the lungs, heart or vessels, and also the esophagus, the dosage is usually also equal to 1.5 g (combined with anesthesia). Additionally, one day is injected into the drug by the method of 0.75 g of drug, 3 times, for 1-2 days.

When a joint is completely replaced by a patient, you need to mix 1.5 g of a medical lyophilisate with a methyl methacrylate cement polymer (the volume of the 1st package is required), and then add the monomer in a liquid form.

Sequential treatment procedures.

During the day, with pneumonia, 2-3 times you need to use (w / w or v / m injections) 1.5 g of Zotsef (for a segment in the range of 48-72 hours). Next, the patient is transferred to the daily intake of tablets - 0.5 g 2 times, for a period of 7-10 days.

With chronic bronchitis in the acute phase of the intramuscular or intravenous or intravenous route, 2-3 times a day, 0.75 g of drug is injected (for an interval of 48-72 hours), and then tablets are prescribed - 5-10 days to take 0.5 g of the drug 2 times a day.

The duration of these therapeutic cycles is selected taking into account the clinical picture and the degree of intensity of infection.

Disorders of renal activity.

Cefuroxime is excreted through the kidneys. Therefore, people with disabilities in their work need to reduce the amount of medication to compensate for its delayed elimination. You do not need to reduce the standard portion (0.75-1.5 g 3 times a day), while QC indicators range from 20 ml per minute. With a strong violation of the renal work (QC - in the range of 10-20 ml per minute), you must enter 0.75 g 2 times per day; with KK values less than 10 ml per minute - 0.75 g per day, 1 time.

During hemodialysis, at the end of each of the sessions, it is necessary to inject 0.75 g of the substance intravenously or intramuscularly. In addition to parenteral injections, the drug can be added to the dialysis fluid (0.25 g / 2 l of fluid is required).

People undergoing prolonged hemodialysis (arteries) or rapid hemofiltration in intensive care should be administered 0,75 g of drugs 2 times a day. If hemofiltration is performed at low speed, the regimen required for therapy for renal disorders is observed.

Specific use of the drug.

Before the introduction of the drug, 0.25 g of the substance is diluted with an injection liquid (1 ml). For a portion of 0.75 g, 3 ml of liquid is required. The container with this mixture should be shaken until a suspension having an opaque shape is formed.

For intravenous injection, 0.25 g of drug is required to be diluted in at least 2 ml of liquid; 0.75 g - at least 6 ml of liquid; 1.5 g - in 15 ml. With infusions lasting no longer than half an hour, 1.5 g of the drug is diluted in 50-100 ml of a special injection liquid. These substances are used either in / in the method, or using a dropper for infusion.

Diluted solutions during storage can change the saturation of their color.

[9]

Use Zocefa during pregnancy

Although preclinical tests did not detect the teratogenic or mutagenic effects of Zocef, it cannot be used during pregnancy (especially in the first trimester) without strict indications.

For the period of therapy, breastfeeding should be abandoned.

Contraindications

It is contraindicated to appoint people with severe intolerance regarding cephalosporins.

[7],

Side effects Zocefa

Among the adverse events:

• invasions or infections: rarely there is an excessive increase in the growth of resistant bacteria (for example, candida);
• impaired blood function: eosinophilia or neutropenia is often observed. Sometimes leukopenia, a positive Coombs test or hemoglobin index decreases. Thrombocytopenia rarely develops. Cephalosporins are able to be absorbed through the surface of the walls of erythrocytes and exhibit interaction with antibodies, leading to a positive Coombs reaction, which may affect the blood grouping procedure or (single) lead to anemia of hemolytic form;
• immune lesions: sometimes there is urticaria or epidermal rashes and itching. Occasionally, medical fever develops. Single - anaphylaxis, and in addition tubulointerstitial nephritis or epidermal vasculitis;
• digestive disorders: occasionally note discomfort in the gastrointestinal tract; single - colitis pseudomembranous form;
• problems associated with the hepatobiliary system: a transient increase in intrahepatic enzyme values usually occurs; sometimes bilirubin levels increase temporarily. These abnormalities usually occur in individuals with existing liver disease, there is no information about the negative effects on the liver;
• lesions of the subcutaneous layers and the epidermis: TEN or SSD, as well as erythema multiforme;
• disorders associated with the urethra: serum creatinine or blood urea nitrogen increases individually, and the CC is reduced;
• systemic and local manifestations: disorders in the injection area are often observed, including thrombophlebitis and pain. The appearance of pain in the injection area is more likely when using large dosages, but this is not a reason to cancel the drug.

[8]

Overdose

Cephalosporins poisoning can cause signs of cerebral irritation, leading to seizures.

Cefuroxime values can be decreased through peritoneal or hemodialysis sessions. Symptomatic events are also carried out.

[10], [11], [12]

Interactions with other drugs

Zotsef can affect the intestinal flora, which significantly reduces estrogen reabsorption and reduces the effectiveness of complex oral contraception.

During drug use, plasma and blood sugar values should be determined using hexozokinase or glucose oxidase tests.

[13]

Storage conditions

Zotsef is required to be kept in a place inaccessible for the penetration of children. Temperature values - not more than 25 ° С. The finished liquid at this temperature can contain a maximum of 6 hours, and at rates up to 6 ° C - a maximum of 24 hours.

[14]

Shelf life

Zotsef can be used for a 24-month term from the date the drug was manufactured.

Analogs

Analogues of drugs are drugs Axsef, Cefutil, Zinnat and Auroksetil with Cefumax, and in addition, Euromax, Tsetil and Zinatsef with Cefohctam, Microx and Kimacef with Cefuroxime.

[15], [16]