Cefurozine solution powder for injection 750mg, 1pc

Composition

Cefuroxime-0,75 g

Pharmacological action

Pharmacotherapy group

Antibiotic-cephalosporin

ATX Code: J01DC02

Pharmacodynamics :

Cephalosporin antibiotic of the second generation for parenteral use. Acts bactericidal (disrupts the synthesis of the bacterial cell wall). It has a wide spectrum of antimicrobial action. Highly active against gram-positive microorganisms (Staphylococcus aureus Staphylococcus epidermidis including penicillin-resistant strains and with the exception of methicillin-resistant strains Streptococcus pyogenes, etc. beta-hemolytic streptococci Streptococcus pneumoniae Group B Streptococcus (Streptococcus agalactiae) Streptococcus mitis (viridans group) Bordetella pertussis (Clostridium spp. ), gram-negative microorganisms (Escherichia coli Klebsiella spp. Proteus mirabilis Providencia spp. Proteus rettgeri Haemophilus influenzae including ampicillin-resistant strains Haemophilus parainfluenzae including ampicillin-resistant strains Moraxella (Branhamella) catarrhalis Neisseria gonorrhoeae including penicillinase-producing and non-penicillinase-producing strains Neisseria meningitidis Salmonella spp. Bacteroides spp. Fusobacterium spp. Propionibacterium spp. Borrelia burgdorferi) of gram-positive and gram-negative anaerobes (including Peptococcus spp. and Peptostreptococcus spp. ). They are not sensitive to cefuroxime: Clostridium difficile Pseudomonas spp. Campylobacter spp. Acinetobacter calcoaceticus Listeria monocytogenes methicillin-resistant strains of Staphylococcus aureus methicillin-resistant strains of Staphylococcus epidermidis Legionella spp. Streptococcus (Enterococcus) faecalis Morganella morganii Proteus vulgaris Enterobacter spp. Citrobacter spp. Serratia spp. Bacteroides fragilis.

Pharmacokinetics:

Parenteral use: after intravenous use of 750 mg, the maximum concentration is reached in 15-60 minutes and is 27 mcg / ml. With intravenous use of 750 mg and 1.5 g, the maximum concentration after 15 minutes is 50 and 100 mcg / ml, respectively. The therapeutic concentration is maintained for 5.3 and 8 hours, respectively. The half-life of intravenous and intramuscular use – 80 min in newborns-is 3-5 times longer. Binding to plasma proteins is 33-50%. It is not metabolized in the liver. It is excreted by the kidneys by glomerular filtration and tubular secretion 85-90% unchanged for 8 hours (most of the drug is excreted during the first 6 hours creating high concentrations in the urine); after 24 hours it is completely excreted (50% – by tubular secretion 50% – by glomerular filtration). Therapeutic concentrations are recorded in pleural fluid bile sputum myocardium skin and soft tissues. Cefuroxime concentrations exceeding the minimum suppressive concentration for most common microorganisms can be achieved in bone synovial fluid and intraocular fluid. In meningitis, it penetrates the blood-brain barrier. It passes through the placenta and enters breast milk.

Indications

Bacterial infections caused by sensitive microorganisms: infectious diseases of the respiratory tract (bronchitis pneumonia lung abscess pleural empyema, etc. ) ENT organs (sinusitis tonsillitis pharyngitis, etc. ) urinary tract (pyelonephritis cystitis symptomatic bacteriuria gonorrhea, etc. ) skin and soft tissues (erysipelas pyoderma impetigo furunculosis cellulite wound infection erysipeloid, etc. ) bones and joints (osteomyelitis septic arthritis, etc. ) of the pelvic organs (in obstetrics and gynecology) septicemia meningitis prevention of infectious complications in operations on the chest abdominal cavity pelvic joints (including operations on the lungs heart esophagus in vascular surgery with a high risk of infectious complications in orthopedic operations).

Contraindications

Hypersensitivity (including to other cephalosporins penicillins and carbapenems).

With caution:

neonatal period prematurity chronic renal failure bleeding and diseases of the gastrointestinal tract (including a history of ulcerative colitis) weakened and emaciated patients pregnancy and lactation.

Side effects

Allergic reactions: chills rash pruritus urticaria rarely-erythema multiforme bronchospasm Stevens-Johnson syndrome anaphylactic shock.

From the digestive system: diarrhea nausea vomiting or constipation flatulence abdominal cramps and pain ulceration of the oral mucosa candidiasis of the oral cavity glossitis pseudomembranous enterocolitis impaired liver function (increased activity of” liver ” enzymes in plasma-aspartate aminotransferase alanine aminotransferase alkaline phosphatase lactate dehydrogenase; bilirubin) cholestasis.

From the genitourinary system: impaired renal function (decreased creatinine clearance increased creatinine and residual urea nitrogen in the blood) dysuria itching in the perineum vaginitis.

From the hematopoietic organs: decreased HB and hematocrit anemia (aplastic or hemolytic) eosinophilia neutropenia leukopenia agranulocytosis thrombocytopenia hypoprothrombinemia prolongation of prothrombin time.

Local reactions: irritation, infiltration and pain at the injection site, phlebitis.

Interaction

Concomitant oral use of loop diuretics slows down channel secretion reduces renal clearance increases plasma concentrations and increases the half-life of cefuroxime. Concomitant use with aminoglycosides and diuretics increases the risk of nephrotoxic effects. Drugs that reduce the acidity of gastric juice reduce the absorption of cefuroxime and its bioavailability Pharmacologically compatible with metronidazole azlocillin xylitol with aqueous solutions containing up to 1% lidocaine hydrochloride 0.9% sodium chloride solution 5% dextrose solution 0.18% sodium chloride solution and 4% dextrose solution 5% dextrose solution and 0.9% sodium chloride solution 5% dextrose solution and 0.45% sodium chloride solution 5% dextrose solution and 0.225% sodium chloride solution 10% dextrose solution; 10% inverted sugar in water for injection Ringer’s solution sodium lactate solution Hartmann’s solution 0.9% sodium chloride solution 5% dextrose solution and hydrocortisone heparin (10 u/ml and 50 u/ml) in 0.9% sodium chloride solution potassium chloride (10 mEk/l and 40 mEk/L) in 0.9% sodium chloride solution Pharmacologically incompatible with aminoglycosides with 2.74% sodium bicarbonate solution.

How to take, course of use and dosage

V/m v/V. IV and iv adults are prescribed 750 mg 3 times a day; for severe infections, the dose is increased to 1500 mg 3-4 times a day (if necessary, the interval between injections can be reduced to 6 hours). The average daily dose is 3000-6000 mg.

Children are prescribed 30-100 mg / kg / day in 3-4 doses. For most infections, the optimal dose is 60 mg / kg / day. Newborns and children under 3 months are prescribed 30 mg / kg / day in 2-3 doses.

With gonorrhea – in / m 1500 mg once (or in the form of 2 injections of 750 mg with introduction in different areas, for example, in both gluteal muscles).

For bacterial meningitis-intravenous 3000 mg every 8 hours; for younger and older children-150-250 mg / kg/day in 3-4 doses for newborns-100 mg / kg/day.

For operations on the abdominal cavity of the pelvic organs and orthopedic operations-IV 1500 mg with induction of anesthesia, then additionally-iv 750 mg 8 and 16 hours after the operation.

For operations on the heart lungs esophagus and blood vessels-IV 1500 mg with induction of anesthesia, then – iv 750 mg 3 times a day for the next 24-48 hours.

When the joint is completely replaced,1500 mg of powder is mixed in dry form with each package of methyl methacrylate cement polymer before adding a liquid monomer.

For pneumonia – IV or iv 1500 mg 2-3 times a day for 48-72 hours, then switch to oral use (use dosage forms for oral use) 500 mg 2 times a day for 7-10 days.

In case of exacerbation of chronic bronchitis, they are prescribed IV or iv 750 mg 2-3 times a day for 48-72 hours, then they switch to oral use (use dosage forms for oral use) 500 mg 2 times a day for 5-10 days.

In case of chronic renal failure, the dosage regimen should be adjusted: with a creatinine clearance of 10-20 ml/min,750 mg 2 times a day is prescribed intravenously or intramuscularly, with a creatinine clearance of less than 10 ml/min – 750 mg 1 time a day.

Patients on continuous hemodialysis using an arteriovenous shunt or on high-speed hemofiltration in intensive care units are prescribed 750 mg 2 times a day; for patients on low-speed hemofiltration, the recommended doses for impaired renal function are prescribed.

Overdose

Symptoms: excitement of the central nervous system convulsions. Treatment: prescribing anticonvulsants providing ventilation and perfusion monitoring and maintaining vital body functions hemodialysis and peritoneal dialysis.

Special instructions

Patients with a history of allergic reactions to penicillins may be hypersensitive to cephalosporin antibiotics. During treatment, monitoring of renal function is necessary, especially in patients receiving the drug in high doses. Treatment is recommended to continue for 48-72 hours after symptoms disappear in the case of Streptococcus pyogenes infections, it is recommended to continue treatment for at least 10 days.

During treatment, a false positive direct Coombs reaction and a false positive urine glucose reaction are possible.

After dilution, it can be stored at room temperature for 7 hours in the refrigerator for 48 hours. It is allowed to use a solution that has turned yellow during storage.

Do not use ethanol during treatment.

In patients receiving cefuroxime, the use of glucose oxidase or hexokinase tests is recommended when determining blood glucose levels.

During the treatment of meningitis in children, hearing loss may occur.

When switching from parenteral use to oral use, the severity of the infection, the sensitivity of microorganisms and the general condition of the patient should be taken into account. If no clinical improvement is observed 72 hours after oral use of cefuroxime, parenteral use should be continued.

Form of production

Powder for preparing a solution for injection in vials of 750 mg.

Storage conditions

In a place protected from light and inaccessible to children at a temperature not exceeding 25° C.

Shelf

life is 3 years. Do not use after the expiration date indicated on the package.

Active ingredient

Cefuroxime

Conditions of release from pharmacies

By prescription

Dosage form

solution for injection