Cefotaxime (When ATH J01DA10)

When ATH:
J01DA10

Characteristic.

Semisynthetic antibiotic cephalosporin III generation for parenteral use.

Used in the form of sodium salt, solutions have a color from pale yellow to pale amber (depending on the concentration and the solvent used). Molecular weight 477,46.

Pharmacological action.
Broad-spectrum antibacterial, bactericide.

Application.

Severe bacterial infections, caused by susceptible microorganisms: respiratory tract infections and otolaryngology (except enterococcal), skin and soft tissue (including infected wounds and burns), bone and joints, urinary tract, pelvic, obstetric and gynecological (incl. Chlamydia, gonorrhea, incl. caused by microorganisms, allocating penicillinase), bacteraemia, septicemia, peritonitis, intra-abdominal infections, bacterial meningitis (except listerioznogo), endokardit, Lyme disease, typhoid fever, infection are immunocompromised; prevention of infection after surgery, incl. gastrointestinal.

Contraindications.

Hypersensitivity (incl. penicillin, other cephalosporins, carbapenems), pregnancy, lactation (It passes into breast milk), Children age - up 2,5 years (for the / m).

Restrictions apply.

The neonatal period, a history enterocolitis (particularly ulcerative colitis), chronic renal failure.

Pregnancy and breast-feeding.

When pregnancy is possible only in cases, the potential benefit to the mother outweighs the risk to the fetus. There are no adequate and well-controlled studies in pregnant women have not held.

In studies of the reproduction at / in at dosages up to 1200 mg / kg / day (0,4 MRDC, in mg / m²) Pregnant female mice or in / at dosages up to 1200 mg / kg / day (0,8 MRDC, in mg / m²) pregnant female rats revealed no evidence of embryotoxicity or teratogenicity.

In studies of prenatal and postnatal development in rats has been shown, at a dosage 1200 mg / kg / day body weight of pups at birth was much smaller and had less than, than in the control group, during 21 day feeding.

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

Side effects.

From the nervous system and sensory organs: headache, dizziness.

Cardio-vascular system and blood (hematopoiesis, hemostasis): cardiac arrhythmias (with the rapid introduction of the jet), neutropenia, transient leukopenia, granulocytopenia, eozinofilija, thrombocytopenia, agranulocytosis, gipoprotrombinemii, autoimmunnaya gemoliticheskaya anemia.

From the digestive tract: nausea, vomiting, abdominal pain, diarrhea / constipation, flatulence, dysbiosis, transient increase in liver transaminases, LDH, Alkaline phosphatase and bilirubin in blood plasma; rarely - pseudomembranous colitis, stomatitis, glossitis.

With the genitourinary system: increasing the concentration of urea nitrogen and creatinine in blood plasma, interstitial nephritis, impairment of renal function, oligurija.

Allergic reactions: rash, hyperemia, hives, eozinofilija, erythema multiforme exudative, Syndrome Stevens - Johnson, toxic epidermal necrolysis, chills / fever, angioedema, anaphylactic shock.

Other: superimposed infection, vaginal and oral candidiasis; injection site reactions: when i / m administration - pain, sealing and tissue inflammation at the injection site; with a / in the introduction - phlebitis.

Cooperation.

When concomitantly with aminoglycosides, polymyxin B and loop diuretics enhanced nephrotoxicity. It increases the risk of bleeding when combined with antiplatelet (incl. NSAIDs). Probenecid slows excretion, increases the concentration in plasma and T_1/2 (It increases the likelihood of adverse events).

Pharmaceutical incompatible with solutions of other antibiotics in the same syringe or an infusion solution.

Overdose.

Symptoms: improving neuromuscular excitability, convulsions, tremor, encephalopathy (especially in patients with renal insufficiency).

Treatment: symptomatic, maintaining vital functions. The specific antidote is absent.

Dosing and Administration.

B / (bolus or infusion) and / m. The dosage regimen and duration of treatment are determined individually, depending on the indication and the severity of infection. Adults usually 1-2 g every 8-12 hours, The maximum daily dose - 12 g (3-4 administration); children - depending on age and body weight. In renal failure dose adjustment is necessary.

Precautions.

Anaphylactic reactions. The appointment requires the collection of cephalosporins allergic history (allyergichyeskii diatyez, hypersensitivity reactions to beta-lactam antibiotics). If the patient developed a hypersensitivity reaction, treatment should be discontinued. Use of cefotaxime is strictly contraindicated in patients with a history of an indication of immediate hypersensitivity reactions to cephalosporins. In case of any doubt, the presence of a doctor at the first administration of the drug is required to view a possible anaphylactic reaction. Known cross-allergy between cephalosporins and penicillins, which occurs in 5-10% of. People, a history which there are indications of allergy to penicillin, the drug is used with extreme caution.

Psevdomembranoznыy colitis. In the first weeks of treatment may occur pseudomembranous colitis, manifesting severe, prolonged diarrhea. The diagnosis is confirmed by colonoscopy and / or histological examination. This complication is regarded as very serious: immediately stop administering the drug and prescribe appropriate therapy, including oral vancomycin or metronidazole.

The combination with nephrotoxic drugs require monitoring of renal function, the use of more 10 days - the control of cellular blood. Elderly or debilitated patients should be assigned to vitamin K (Prevention hypocoagulation).

During treatment with cefotaxime possible false-positive and false-positive Coombs reaction of urine glucose (It recommends the use of glucose oxidase methods for determining glucose in blood).

Cooperation