Cefuroxime - instructions for use, reviews, analogs and forms of release (tablets Sandoz 500 mg, injections in ampoules for injection of antibiotic in solution 250 mg, 750 mg and 1500 mg) of the drug for the treatment of infections in adults, children and pregnancy
In this article, you can read the instructions for using the drug Cefuroxime. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Cefuroxime in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Cefuroxime in the presence of existing structural analogues. Use of an antibiotic for the treatment of infectious diseases and complications in adults, children, as well as during pregnancy and lactation.
Cefuroxime - a cephalosporin antibiotic of the 2nd generation of a broad spectrum of action. Has a bactericidal effect by inhibiting the synthesis of the bacterial cell wall. Cefuroxime acetylates membrane-bound transpeptidases, thereby violating the cross-linking of peptidoglycans necessary to ensure the strength and rigidity of the cell wall.
Highly active against Gram-negative bacteria: Escherichia coli (E. coli), Haemophilus influenzae, Salmonella spp. (salmonella), Shigella spp. (Shigella), Proteus mirabilis (Proteus), Neisseria gonorrhoeae, Enterobacter spp.
It is also active against gram-positive bacteria: Staphylococcus spp. (Staphylococcus aureus), Streptococcus spp. (streptococcus).
Inactive with Pseudomonas spp., Most strains of Enterococcus spp. (enterococcus), many strains of Enterobacter cloacae, methicillin-resistant strains of Staphylococcus spp. and Listeria monocytogenes (listeria).
Resistant to the action of beta-lactamases.
Composition
Cefuroxime (in the form of sodium salt) + auxiliary substances.
Pharmacokinetics
Cefuroxime is rapidly absorbed from the digestive tract. Binding to plasma proteins is 50%. Cefuroxime is distributed in tissues and body fluids. Therapeutic concentrations in the cerebrospinal fluid are reached only with meningitis. Penetrates through the placental barrier, excreted in breast milk. It is excreted unchanged in the urine.
Indications
Infectious-inflammatory diseases caused by sensitive microorganisms:
- infections of the respiratory tract (including bronchitis, pneumonia, abscess of the lungs, empyema of the pleura);
- infection of the ENT organs (including sinusitis, tonsillitis, pharyngitis, otitis media);
- urinary tract infections (including pyelonephritis, cystitis, asymptomatic bacteriuria, gonorrhea);
- infections of the skin and soft tissues (including erysipelas, pyoderma, impetigo, furunculosis, phlegmon, erysipeloid);
- wound infection;
- infection of bones and joints (including osteomyelitis, septic arthritis);
- infection of the pelvic organs (endometritis, adnexitis, cervicitis);
- sepsis;
- meningitis;
- Lyme disease (borreliosis).
Prevention of infectious complications in operations on the chest, abdominal, pelvis, joints (including operations on the lungs, heart, esophagus, vascular surgery with a high risk of infectious complications, with orthopedic operations).
Forms of release
Powder for the preparation of solution for intravenous and intramuscular administration and infusions 250 mg, 750 mg and 1500 mg.
Tablets Cefuroxime Sandoz 500 mg.
Other dosage forms, be it capsules or suspensions, did not exist in the Directory at the time of the description of the antibiotic.
Instructions for use and dosage
Ampoules
The drug is administered intravenously and intramuscularly.
Adults appoint 750 mg three times a day; with infections of severe course - the dose is increased to 1.5 g 3-4 times a day (if necessary, the interval between administrations can be reduced to 6 h). The average daily dose is 3-6 g.
Children are prescribed 30-100 mg / kg per day in 3-4 divided doses. With most infections, the optimal dose is 60 mg / kg per day. Newborns and children under 3 months are prescribed 30 mg / kg per day in 2 - 3 doses.
With gonorrhea - in / m in a dose of 1.5 mg once (or as 2 injections of 750 mg with the introduction into different areas, for example, in both gluteal muscles).
With bacterial meningitis - iv 3 g every 8 hours; children younger and older - 150-250 mg / kg per day in 3-4 doses, newborns - 100 mg / kg per day.
In surgeries on the abdominal cavity, pelvic organs and orthopedic operations - iv dose of 1.5 g with induction of anesthesia, then additionally - 750 mg at 8 and 16 h after the operation.
At operations on heart, lungs, an esophagus and vessels - in / in a dose of 1.5 g at an anesthesia induction, then - in / m on 750 mg 3 times a day during the next 24-48 hours.
When pneumonia - in / m or / in 1.5 g 2-3 times a day for 48-72 h, then go to the inside, 500 mg 2 times a day for 7-10 days.
With an exacerbation of chronic bronchitis, I / m or IV is prescribed 750 mg 2-3 times a day for 48-72 hours, then go to the oral intake of 500 mg twice a day for 5-10 days.
When the joint is completely replaced, 1.5 g of the powder is dry mixed with each polymer-methacrylate cement polymer packet before adding the liquid monomer.
In chronic renal failure, correction of the dosing regimen is necessary: with QC from 10 to 20 ml / min, 750 mg / day or 750 mg twice a day is prescribed, with CC less than 10 ml / min 750 mg once a day.
Patients on continuous hemodialysis using an arteriovenous shunt or high-velocity haemofiltration in the ICU are prescribed 750 mg twice daily; for patients on low-velocity haemofiltration, doses recommended for renal impairment are prescribed.
Preparation of injection solution (dilution of powder for injection)
Solution for IM injections: add 3 ml of water for injection to 750 mg of the drug. Gently shake until a slurry forms. Cefuroxime is compatible with aqueous solutions containing up to 1% Lidocaine hydrochloride.
Solution for intravenous injections: dissolve 750 mg of the drug in 6 or more ml of water for injection, and 1.5 g in 15 or more ml of water for injection.
For short-term intravenous infusions (up to 30 minutes): 1.5 g of the drug is dissolved in 50 ml of water for injection. These solutions can be injected directly into the vein or into the tube of the infusion system.
Pills
Usually the duration of treatment is 7 days. For better absorption, the drug is recommended after eating.
Recommended dosage regimen for Cefuroxime Sandoz tablets in adult patients:
- Most infections are 250 mg twice a day.
- Urinary tract infections - 125 mg 2 times a day.
- Infections of the upper respiratory tract of medium severity - 250 mg 2 times a day.
- Infections of the respiratory tract of medium severity (bronchitis) - 250 mg 2 times a day.
- Respiratory infections severe or suspected pneumonia - 500 mg 2 times a day.
- Pyelonephritis - 250 mg 2 times a day.
- Uncomplicated gonorrhea - 1000 mg once.
- Lyme disease in adults and children from 12 years - 500 mg 2 times a day for 20 days.
Side effect
- chills;
- rash;
- itching;
- hives;
- multiforme exudative erythema;
- bronchospasm;
- malignant exudative erythema (Stevens-Johnson syndrome);
- anaphylactic shock;
- diarrhea, constipation;
- nausea, vomiting;
- flatulence;
- spasms and abdominal pain;
- ulceration of the oral mucosa;
- Candidiasis of the oral cavity;
- glossitis;
- pseudomembranous enterocolitis;
- violation of liver function (increased activity of AST, ALT, APF, LDH, bilirubin);
- cholestasis;
- dysuria;
- itching in the perineum;
- vaginitis;
- convulsions;
- hearing loss;
- reduction of hemoglobin and hematocrit;
- anemia (aplastic or hemolytic), eosinophilia, neutropenia, leukopenia, agranulocytosis, thrombocytopenia, hypoprothrombinemia;
- irritation, infiltration and pain at the injection site;
- phlebitis.
Contraindications
- hypersensitivity to the drug and other cephalosporins, penicillins and carbapenems.
Application in pregnancy and lactation
The use of the drug in pregnancy is possible only in those cases when the intended use for the mother exceeds the potential risk to the fetus.
If you need to use cefuroxime during lactation, you should decide whether to stop breastfeeding.
Use in children
The use of cefuroxime in children is possible according to the dosing regimen.
special instructions
Patients who had a history of allergic reactions to penicillins, may have a hypersensitivity to cephalosporin antibiotics.
In the process of treatment, control of kidney function is necessary, especially in patients receiving the drug in high doses.
Treatment continues for 48-72 hours after the disappearance of the symptoms; In the case of infections caused by Streptococcus pyogenes, the course of treatment is at least 7-10 days.
During treatment, a false positive Coombs reaction and a false positive urine reaction to glucose are possible.
The ready-to-use solution can be stored at room temperature for 7 hours, in the refrigerator for 48 hours. It is allowed to use a yellow solution during storage.
In patients receiving cefuroxime, glucose oxidase or hexokinase tests are recommended when determining blood glucose concentrations.
When switching from parenteral to ingestion, the severity of the infection, the sensitivity of the microorganisms and the general condition of the patient should be considered. If 72 hours after taking cefuroxime inside, there is no improvement, it is necessary to continue parenteral administration.
Drug Interactions
Simultaneous oral administration of "loop" diuretics slows tubular secretion, reduces renal clearance, increases plasma concentration and increases the half-life of cefuroxime.
When used simultaneously with aminoglycosides and diuretics, the risk of nephrotoxic effects increases.
Pharmaceutical interaction
Pharmaceutically compatible with aminoglycosides, sodium bicarbonate 2.74% solution, and metronidazole, azlocillin, xylitol, aqueous solutions containing 1% lidocaine hydrochloride, 0.9% sodium chloride solution, 5% dextrose, 0.18% sodium chloride and 4% solution dextrose, 5% Dextrose and 0.9% sodium chloride, 5% dextrose and 0.45% sodium chloride, 5% dextrose, and 0.225% sodium chloride solution, 10% dextrose solution; 10% inverted sugar in water for injection, Ringer's solution, sodium lactate solution, sodium Hartman, 0.9% sodium chloride, 5% dextrose and hydrocortisone, Heparin (10 U / ml and 50 U / ml) in 0.9% sodium chloride solution , potassium chloride (10 meq / L and 40 meq / L) in a 0.9% solution of sodium chloride.
Analogues of the drug Cefuroxime
Structural analogs for the active substance:
- Aksetin;
- Axosafe;
- Antibioksim;
- Acenoveis;
- Zinatsef;
- Zinnat;
- Zinoxymor;
- Ketoceph;
- Ksorim;
- Proxim;
- Super;
- Cetil Lupine;
- Cefroxime J;
- Cefurabol;
- Cefuroxime sodium;
- Cefuroxime Sandoz;
- Cefuroxime axetil;
- Cephus.
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