Cefotaxime - instructions for use, analogs, reviews and release forms (injections in ampoules for injection 500 mg and 1 g) drugs to treat infections in adults, children and in pregnancy. Breeding (on water or novocaine) and the action of an antibiotic
In this article, you can read the instructions for using the drug Cefotaxime. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Cefotaxime in their practice. 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 Cefotaxime in the presence of existing structural analogues.Use to treat infectious and inflammatory diseases in adults, children, as well as during pregnancy and lactation. Breeding (on water or novocaine) and the action of an antibiotic.
Cefotaxime - 3-generation cephalosporin antibiotic of a broad spectrum of action. Has a bactericidal effect by inhibiting the synthesis of the bacterial cell wall. The mechanism of action is due to the acetylation of membrane-bound transpeptidases and the cross-linking of peptidoglycans, which is necessary to ensure the strength and rigidity of the cell wall.
Highly active against Gram-negative bacteria (resistant to other antibiotics): Escherichia coli (E. coli), Citrobacter spp., Proteus mirabilis (Proteus), Providencia spp., Klebsiella spp. (Klebsiella), Serratia spp., Certain strains of Pseudomonas spp., Haemophilus influenzae.
Less active against Streptococcus spp. (including Streptococcus pneumoniae) (streptococcus), Staphylococcus spp. (Staphylococcus aureus), Neisseria meningitidis, Neisseria gonorrhoeae, Bacteroides spp.
Resistant to the action of most beta-lactamases.
Pharmacokinetics
Quickly absorbed from the injection site. The binding with plasma proteins is 40%. Widely distributed in tissues and body fluids. Achieves therapeutic concentrations in the cerebrospinal fluid, especially with meningitis. Penetrates through the placental barrier, excreted in breast milk in low concentrations.40-60% of the dose is excreted unchanged in 24 hours, 20% in the form of metabolites.
Indications
Infectious-inflammatory diseases caused by sensitive microorganisms, including:
- CNS infections (meningitis);
- respiratory tract infection and ENT organs;
- urinary tract infections;
- infection of bones and joints;
- infections of the skin and soft tissues;
- infections of the pelvic organs;
- abdominal infections;
- peritonitis;
- sepsis;
- endocarditis;
- gonorrhea;
- infected wounds and burns;
- salmonellosis;
- Lyme disease;
- infection against the background of immunodeficiency;
- prevention of infections after surgical operations (including urological, obstetric-gynecological, on the organs of the digestive tract).
Forms of release
Powder for the preparation of solution for intravenous and intramuscular injection (injections in ampoules for injection) 250 mg, 500 mg and 1 gram of powder for reconstitution in water for injection or novocaine.
Instructions for use and dosage
The drug is administered intravenously (either jet or drip (in a dropper) and intramuscularly.
With uncomplicated infections, as well as with infections of the urinary tract - in / m or / in 1 g every 8-12 hours.
In uncomplicated acute gonorrhea - in / m in a dose of 1 g once.
For infections of moderate severity - in / m or / in 1-2 g every 12 h.
In severe infections, for example, with meningitis - iv every 2 to 8 hours, the maximum daily dose is 12 g. The duration of treatment is set individually.
In order to prevent the development of infections before the surgical operation is introduced during the initial anesthesia once in a dose of 1 g. If necessary, the administration is repeated after 6-12 hours.
At caesarean section - at the time of application of the clamps to the umbilical vein - iv in a dose of 1 g, then 6 and 12 hours after the first dose - in addition to 1 g.
Premature and newborns under the age of 1 week-in / in a dose of 50 mg / kg every 12 hours; at the age of 1-4 weeks - in / in the dose of 50 mg / kg every 8 hours. Children with body weight ≤50 kg - in / in or / m (children over the age of 2.5 years) 50-180 mg / kg in 4-6 introductions.
In severe infections (including meningitis), the daily dose for prescribing to children is increased to 100-200 mg / kg, IM or IV for 4-6 injections, the maximum daily dose is 12 g.
Rules for the preparation of injection solutions
For intravenous injection: 1 g of the drug is diluted in 4 ml of sterile water for injection; the drug is injected slowly for 3-5 minutes.
For intravenous infusion: 1-2 g of the drug is diluted in 50-100 ml of the solvent.As a solvent, use 0.9% solution of sodium chloride or 5% solution of Dextrose (glucose). The duration of the infusion is 50-60 min.
For the / m introduction: 1 g is dissolved in 4 ml of the solvent. As a solvent, water for injection or 1% solution of Lidocaine (novocain) is used.
Side effect
- headache;
- dizziness;
- impaired renal function;
- oliguria;
- nausea, vomiting;
- diarrhea or constipation;
- flatulence;
- abdominal pain;
- dysbiosis;
- stomatitis;
- glossitis;
- pseudomembranous enterocolitis;
- hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia, agranulocytosis;
- potentially life-threatening arrhythmias after a rapid bolus injection into the central vein;
- increased urea concentration in the blood;
- a positive Coombs reaction;
- phlebitis;
- soreness along the veins;
- morbidity and infiltration at the site of intramuscular injection;
- hives;
- chills or fever;
- rash;
- itching;
- bronchospasm;
- eosinophilia;
- anaphylactic shock;
- Superinfection (vaginal and oral candidiasis).
Contraindications
- pregnancy;
- children's age to 2.5 years (for intramuscular injection), with caution in newborns;
- increased sensitivity (incl.to penicillins, other cephalosporins, carbapenems).
Application in pregnancy and lactation
The use of cefotaxime in the first trimester of pregnancy is not recommended.
Application in the 2nd and 3rd trimester of pregnancy and lactation is possible only in cases where the intended benefit to the mother exceeds the potential risk to the fetus or infant.
It should be borne in mind that after intravenous administration of cefotaxime at a dose of 1 g in 2-3 hours the maximum concentration of the active substance in breast milk averages 0.32 μg / ml. With such concentration, a negative effect on the oropharyngeal flora of the child is possible.
In experimental animal studies, teratogenic and embryotoxic effects of cefotaxime were not detected.
Use in children
With caution apply cefotaxime in newborns.
special instructions
In the first weeks of treatment, pseudomembranous colitis can occur, which is manifested by severe prolonged diarrhea. At the same time, stop taking the drug and prescribe adequate therapy, including Vancomycin or metronidazole.
Patients who had a history of allergic reactions to penicillins, may have increased sensitivity to cephalosporin antibiotics.
When treating the drug for more than 10 days, monitoring of the peripheral blood pattern is necessary.
During treatment with cefotaxime, it is possible to obtain a false positive sample of Coombs and a false positive urine reaction to glucose.
During treatment, alcohol can not be consumed, since effects similar to that of Disulfiram (facial hyperemia, stomach and stomach spasms, nausea, vomiting, headache, decreased blood pressure, tachycardia, dyspnea) are possible.
Drug Interactions
Cefotaxime increases the risk of bleeding when combined with antiaggregants, non-steroidal anti-inflammatory drugs.
The risk of kidney damage increases with the simultaneous administration of aminoglycosides, polymyxin B and "loop" diuretics.
Drugs that block tubular secretion, increase plasma concentrations of cefotaxime and slow its elimination.
Pharmaceutical interaction
Pharmaceutically incompatible with solutions of other antibiotics in one syringe or dropper.
Analogues of the drug Cefotaxime
Structural analogs for the active substance:
- Intrataxime;
- Kefotex;
- Clafhorn;
- Claforan;
- Clafotaxime;
- Liphoran;
- Oritax;
- Ortaxime;
- Resibelact;
- Spirozin;
- Tax-o-bid;
- Taltsef;
- Tarcephoxime;
- Tirotax;
- Cetax;
- Cefabol;
- Cefanthral;
- Cefosin;
- Cefotaxime Lek;
- Cefotaxime sodium;
- Cefotaxime Sandoz;
- Cefotaxime Vial;
- Cefotaxime sodium salt.