Cefuroxime

When ATH:
J01DC02

Characteristic.

Semisynthetic cephalosporin antibiotic II generation.

In medical practice, use of cefuroxime sodium (for parenteral application) and cefuroxime axetil (orally).

Cefuroxime sodium: white solid, easily soluble in water and buffer solutions, Soluble in methanol, very slightly soluble in ethyl acetate, diethyl ether, octanol, benzene and chloroform; растворимость в воде — 500 mg / 2.5 ml; solutions are stable at room temperature for 13 no; solutions have color from pale yellow to amber depending on the concentration of the solution and the solvent used. pH of a freshly prepared solution of 6 to 8,5. Molecular weight 446,38.

Cefuroxime axetil: molecular weight 510,48.

Pharmacological action.
Broad-spectrum antibacterial, bactericide.

Application.

Bacterial infections, caused by susceptible microorganisms: diseases of the upper and lower respiratory tract (and acute exacerbation of chronic bronchitis, infected bronchiectasis, pneumonia, lung abscess, empyema), ear, nose and throat (incl. acute otitis media, pharyngitis, tonsillitis, sinusitis, epiglottiditis), urinary tract (uretrit, acute and chronic pyelonephritis, cystitis, asymptomatic bacteriuria), gonorrhea (Acute gonococcal urethritis and cervicitis), skin and soft tissue (incl. mug, cellulitis, pyoderma, impetigo, furunculosis, flegmona, wound infection, erysipeloid), bone and joints (incl. osteomyelitis, septicheskiy arthritis), pelvic (incl. endometritis, adnexitis, cervicitis) and abdomen, biliary tract and gastrointestinal tract, sepsis, bakterialynaya septicemia, peritonitis, meningitis, Lyme disease (ʙorrelioz); prevention of infectious complications in surgery of the chest, abdomen, clean, joints (incl. in lung surgery, heart, esophagus, in vascular surgery at high risk of infectious complications, orthopedic surgery).

Contraindications.

Hypersensitivity, incl. to other cephalosporins.

Restrictions apply.

The neonatal period, prematurity, chronic renal failure, bleeding and gastrointestinal diseases in history, incl. nespetsificheskiy yazvennыy colitis; weak and malnourished patients.

Pregnancy and breast-feeding.

Be wary of pregnancy (especially in the early stages of) and during lactation.

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, drowsiness, hearing loss.

Cardio-vascular system and blood (hematopoiesis, hemostasis): decrease in hemoglobin and hematocrit, transient eosinophilia, transient neutropenia and leukopenia, aplastic and hemolytic anemia, thrombocytopenia, agranulocytosis, gipoprotrombinemii, prolonged prothrombin time.

From the digestive tract: diarrhea, nausea, vomiting, constipation, flatulence, cramping and abdominal pain, dyspepsia, oral ulcers, anorexia, thirst, glossitis, psevdomembranoznыy colitis, transient increase in transaminases, Alkaline phosphatase, LDH and bilirubin, liver dysfunction, cholestasis.

With the genitourinary system: impairment of renal function, increase of creatinine and / or urea nitrogen in blood serum, a decrease in creatinine clearance, dizurija, itching in the perineum, vaginitis.

Allergic reactions: rash, itch, hives, drug fever or chills, serum sickness, bronchospasm, erythema multiforme, interstitial nephritis, Stevens-Johnson syndrome, anaphylactic shock.

Other: chest pain, shortness of breath, dysbiosis, superimposed infection, candidiasis, incl. oral candidiasis, convulsions (in renal failure), Coombs test positive; local reaction is pain or infiltration at the injection site, thrombophlebitis after the on / in the.

Cooperation.

Diuretics and nephrotoxic antibiotics increase the risk of kidney damage, NPVS-bleeding. Probenecid reduces the tubular secretion, reduces renal clearance (about 40%), increases C_max (about 30%), T_1/2 serum (about 30%) and toxicity. Preparations, lowering gastric acidity, reduce the absorption and bioavailability of cefuroxime.

Overdose.

Symptoms: CNS excitation, convulsions.

Treatment: appointment of anticonvulsants, monitoring and maintenance of vital functions, e pyeritonyealinyi dialysis and hemodialysis.

Dosing and Administration.

Cefuroxime sodium administered / m and I /. Adults-to 750-1500 mg 3-4 times a day, with meningitis — in/in to 3 g every 8 no. To prevent postoperative complications-in/ 1,5 g for 0.5-1 hours before the operation and 750 mg in/in or/m every 8 h during long operations (with operations in the open-heart total dose up to 6 g). Babies, including infants, daily dose is 30-100 mg/kg 3-4 introduction; infants and children up to 3 Months - 30 mg/kg/day in 2-3 injection.

Cefuroxime axetil - Inside: adults-500 mg-125 on 2 once a day, in gonoree- 1 g once; children-125-250 mg 2 once a day (the suspension is up to 1000 mg per day). The course of treatment is 5-10 days or more.

Precautions.

With prolonged use it is recommended to monitor renal function (especially when using high doses of) and to carry out preventive maintenance of dysbiosis. In patients with impaired renal function the dose reduced (It takes into account the severity of renal failure and the sensitivity of the pathogen).

Before / m administration is carried aspirate. Patients, with hypersensitivity to penicillins, possible cross-allergic reaction cephalosporin antibiotic.

After the disappearance of the clinical signs of the disease should be appointed for a further 2-3 days. In the case of infections, caused Streptococcus pyogenes, treatment for at least 7-10 days.

In the transition from parenteral to receive inward to consider the severity of infection, the sensitivity of micro-organisms and the general condition of the patient. If after 72 h after administration of cefuroxime into no improvement, We need to continue parenteral administration.

There may be a false positive reaction to the sugar in the urine.

Cooperation