Zinacef
Zinacef: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Zinacef
ATX code: J01DC02
Active ingredient: Cefuroxime (Cefuroxime)
Producer: GlaxoSmithKline Trading (Russia), GlaxoSmithKline SpA (Italy)
Description and photo update: 18.10.2018
Prices in pharmacies: from 141 rubles.
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Zinacef is a cephalosporin, a broad-spectrum antibacterial drug.
Release form and composition
The dosage form of Zinacef is a powder for preparation of a solution for injections: from light yellow to white (in a bottle, in a cardboard box 1 bottle).
1 bottle contains:
- active substance: cefuroxime (in the form of sodium cefuroxime) - 0.25 g, 0.75 g or 1.5 g;
- auxiliary component: nitrogen.
Pharmacological properties
Pharmacodynamics
Zinacef is a second generation cephalosporin, which determines the activity of cefuroxime against a wide range of bacteria, including strains producing beta-lactamase. Due to binding to the main target proteins, its action inhibits the synthesis of the bacterial cell wall.
In vitro studies have confirmed the activity of cefuroxime against the following bacteria:
- gram-negative aerobes: Haemophilus influenzae, Klebsiella spp., Escherichia coli; Proteus mirabilis, Proteus rettgeri and Neisseria gonorrhoeae (including non-penicillinase-producing and penicillinase-producing strains), Providencia spp., Neisseria meningilza catarricea spp., Neisseria meningilza catarrhal
- gram-positive: Streptococcus pneumoniae, Staphylococcus aureus, beta-hemolytic streptococci (including Streptococcus pyogenes), Group B Streptococcus (Streptococcus agalactiae), Bordetella pertussis, Streptococcus mitis (viridans group);
- anaerobes: Fusobacterium spp., Peptococcus spp., Clostridium spp., Peptostreptococcus spp., Propionibacterium spp., Bacteroides spp.;
- other microorganisms: Borrelia burgdorferi.
Infections not susceptible to cefuroxime include: Acinetobacter calcoaceticus, Pseudomonas spp., Clostridium difficile, Campylobacter spp., Legionella spp., Listeria monocytogenes, methicillin-resistant strains of Staphylococcus epidermidis, and Staphylococcus auretus.
Pharmacokinetics
After i / m administration, the maximum concentration of cefuroxime in the blood plasma (27 μg / ml) occurs approximately in 0.5-0.75 hours and remains for 5.3 hours.
The high degree of penetration of cefuroxime allows it to overcome the blood-brain barrier, placental barrier and excreted in breast milk. Its therapeutic concentrations are created in the skin, soft tissues, bones, sputum, myocardium, bile, pleural, synovial and intraocular fluids.
In bone tissue, intraocular and synovial fluids, cefuroxime can reach a concentration that exceeds the minimum inhibitory level for most microorganisms.
The binding of the drug to plasma proteins ranges from 33 to 50%.
Cefuroxime is not metabolized, its half-life (T 1/2) in adult patients is about 1.2 hours, in newborns it is 3-5 times longer.
After parenteral administration within 24 hours, 85–90% of cefuroxime is excreted in the urine, most of it within the first 6 hours. It is excreted unchanged by the kidneys, by glomerular filtration and tubular secretion.
On dialysis, serum cefuroxime levels decrease.
Indications for use
The use of Zinacef is indicated in the treatment of infectious diseases caused by bacteria susceptible to cefuroxime:
- bronchitis, infected bronchiectasis, pneumonia, lung abscess;
- infectious pathologies of the chest organs that arose after the operation;
- meningitis;
- angina, otitis media, sinusitis, pharyngitis;
- erysipelas, furunculosis, infected wounds;
- cystitis, pyelonephritis, asymptomatic bacteriuria, gonorrhea;
- osteomyelitis, septic arthritis;
- septicemia;
- infections of the pelvic organs;
- peritonitis.
In addition, Zinacef is prescribed for the prevention of infectious complications during surgery on the pelvic and abdominal organs, heart, esophagus, lungs, vessels, and orthopedic operations.
Contraindications
Do not prescribe Zinacef to patients with established hypersensitivity to penicillins, cephalosporin antibiotics and carbapenems.
Caution should be exercised in case of renal failure, ulcerative colitis and other diseases of the gastrointestinal tract (including history), concomitant therapy with aminoglycosides and "loop" diuretics, during pregnancy and lactation, if necessary, use in newborns (especially premature babies).
Instructions for using Zinacef: method and dosage
The ready-made solution of Zinacef is intended for intramuscular (i / m), intravenous (i / v) jet and drip administration.
The solution is prepared by dissolving the contents of the vial (powder) with water for injection in the following proportions:
- i / m introduction: 1 ml per 0.25 g of the drug or 3 ml per 0.75 g;
- IV injection: from 2 ml to 0.25 g, from 6 ml to 0.75 g, from 15 ml of water for injection to 1.5 g;
- short-term (up to 30 minutes) intravenous infusion: 50 ml of water for injection per 1.5 g of the drug.
After combining the components, the bottle should be gently shaken until a homogeneous suspension is formed.
IV solutions can be injected into the infusion tube or directly into a vein.
The ready-made solution is suitable for use at storage temperatures up to 25 ° C for 5 hours or 4 ° C - 48 hours.
The recommended dosage regimen has age restrictions:
- adults: i / m or i / v - 0.75 g 2-3 times a day, in severe forms of infectious diseases - 1.5 g 2-4 times a day. The daily dose is 3–6 g. With the frequency of application of Zinacef 2 times a day, the subsequent appointment of Zinnat's intake is effective;
- children: the dose is prescribed taking into account the weight of the child - 0.03–0.1 g per 1 kg per day, the frequency of administration is 3-4 times. The optimal daily dose for most infections is 0.06 g per 1 kg;
- newborns: 0.03–0.1 g per 1 kg per day, divided into 2-3 injections.
Recommended dosage of Zinacef for specific diseases:
- gonorrhea: i / m - 0.75 g in each of the gluteal muscles once;
- meningitis: IV, adults - 3 g every 8 hours; children - 0.15-0.25 g per 1 kg of child's weight per day every 6-8 hours; newborns - 0.1 g per 1 kg per day;
- prevention of infectious complications during surgery on the organs of the abdominal cavity, pelvis and orthopedic operations: during induction anesthesia IV - 1.5 g, additionally after the operation, IM administration of 0.75 g can be prescribed after 8 and 16 hours;
- prevention of infectious complications during operations on the lungs, heart, esophagus, blood vessels: during induction anesthesia intravenously - 1.5 g, intramuscularly (after surgery within 24-48 hours) - 0.75 g 3 times a day …
In total joint replacement surgeries, 1.5 g of cefuroxime powder can be mixed with a polymer bag of methyl methacrylate cement before adding the liquid polymer.
Step therapy of the following infectious pathologies:
- pneumonia: within 48–72 hours intravenous or intramuscular injection of Zinacef, 1.5 g every 8–12 hours, then the patient is transferred to oral administration of Zinnat, 0.5 g every 12 hours for 7–10 days;
- exacerbation of chronic bronchitis: within 48–72 hours intravenous or intramuscular injection of the drug at a dose of 0.75 g every 8–12 hours, then Zinnat is administered orally at a dose of 0.5 g every 12 hours for 5 -10 days.
The period of parenteral and oral therapy is determined individually, taking into account the clinical indications and the patient's condition.
In renal failure with creatinine clearance (CC) more than 20 ml / min, no adjustment of the standard dose of the drug is required.
The recommended dose reduction of Zinacef in adult patients with CC less than 20 ml / min:
- CC 10–20 ml / min: 0.75 g 2 times a day;
- CC less than 10 ml / min: 0.75 g once.
With hemodialysis, it is necessary to additionally administer 0.75 g of Zinacef after each hemodialysis session.
In intensive therapy on continuous hemodialysis using an arteriovenous shunt or high-speed hemofiltration, patients should receive the drug 0.75 g 2 times a day. In the case of using hemofiltration at a low rate - apply doses of Zinacef, as in the treatment of renal failure.
Side effects
- from the hematopoietic system: leukopenia, neutropenia, eosinophilia, thrombocytopenia, hemolytic anemia, agranulocytosis;
- from the digestive system: pain and cramps in the abdominal cavity, nausea, vomiting, oral candidiasis, pseudomembranous colitis, diarrhea, hyperbilirubinemia, increased activity of liver enzymes - alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase;
- on the part of the senses and the nervous system: hearing loss, convulsions;
- allergic reactions: pruritus, rash (including urticaria), drug fever, exudative erythema multiforme (including Stevens-Johnson syndrome), bronchospasm, toxic epidermal necrolysis (Lyell's syndrome), serum sickness; very rarely - anaphylactic shock;
- on the part of the reproductive and urinary system: with the development of candidiasis - vaginitis, itching in the perineum, impaired renal function, increased levels of urea nitrogen and / or creatinine, decreased CC;
- local reactions: at the place of intramuscular injection - pain, irritation, infiltration; at the intravenous injection site - phlebitis, thrombophlebitis;
- laboratory indicators: the result of the Coombs' test is false positive;
- others: against the background of prolonged use of Zinacef - excessive growth of fungi of the genus Candida and other microorganisms insensitive to the drug, development of oral candidiasis, vaginal candidiasis
Overdose
Symptoms: the development of seizures against the background of increased excitability of the cerebral cortex.
Treatment: symptomatic therapy with hemodialysis and peritoneal dialysis.
special instructions
With great caution, Zinacef should be prescribed to patients with a history of anaphylactic reaction to beta-lactam antibiotics.
If there is no clinical effect after 72 hours of parenteral treatment, the course should be continued. The transition to taking an antibiotic inside with stepwise therapy is carried out taking into account the patient's clinical condition, the severity of the infection and the sensitivity of the pathogen.
If it is necessary to switch from parenteral to oral therapy, Zinnat should be prescribed, which is an analogue of the drug in the form of tablets.
Concomitant therapy with aminoglycosides and diuretics increases the risk of developing nephrotoxic effects, especially with a high dose of the drug, impaired renal function and in elderly patients. Therefore, if necessary, this combination should monitor renal function.
The use of Zinacef for the treatment of meningitis in children can cause mild to moderate hearing loss, the appearance in the cerebrospinal fluid after 18–36 hours of therapy with positive cultures of Haemophilus influenzae.
Consideration should be given to the possibility of pseudomembranous colitis in severe diarrhea that occurs during or after antibiotic treatment.
Zinacef does not affect the results of studies when determining the level of glucose in urine using enzymatic methods. Interaction that does not lead to false positive results is possible when using the Fehling, Benedict, KliniTest method. While using the drug to determine the level of glucose in blood or plasma, it is recommended to use the method with hexokinase or glucose oxidase.
Cefuroxime does not affect the determination of creatinine levels by the alkaline-picrate method.
Influence on the ability to drive vehicles and complex mechanisms
Not installed.
Application during pregnancy and lactation
According to the instructions, Zinacef belongs to category B drugs, therefore, it should be prescribed with caution during pregnancy and during breastfeeding.
There is no information about the embryotoxic or teratogenic effects of cefuroxime.
Pediatric use
It is permissible to use in children according to clinical indications; when prescribing a dose of Zinacef, the age of the patient must be taken into account.
With impaired renal function
The recommended dosage for renal failure, taking into account the level of CC:
- CC more than 20 ml / min: standard dose - 750-1500 mg 3 times a day;
- CC 10–20 ml / min: Zinacef 750 mg 2 times a day;
- CC less than 10 ml / min: Zinacef 750 mg 1 time per day.
After each hemodialysis procedure, patients on hemodialysis require an additional administration of 0.75 g of cefuroxime.
With continuous hemodialysis using an arteriovenous shunt or high-speed hemofiltration, patients are prescribed 0.75 g 2 times a day, with a low hemofiltration rate, the dose is applied, as in renal failure.
Drug interactions
With the simultaneous use of Zinacef aminoglycosides, "loop" diuretics (furosemide) slow down tubular secretion, cause a decrease in renal clearance, an increased risk of nephrotoxic effects against the background of an increase in the level of cefuroxime in plasma and an increase in its half-life, synergism of action with aminoglycosides is possible.
Pharmaceutical interaction of cefuroxime solution:
- metronidazole at a dose of 0.5 g per 100 ml and 1.5 g of the drug in 15 ml of water for injection, when mixed, retain their activity for no more than 24 hours at temperatures up to 25 ° C;
- Azlocillin (1 g in 15 ml and 5 g in 50 ml) is compatible with a solution of 1.5 g of the drug, the activity of the components remains up to 24 hours at a temperature of 4 ° C or up to 6 hours at a temperature of up to 25 ° C;
- 5% or 10% xylitol solution when mixed with Zinacef solution at a concentration of 5 mg per 1 ml remains active for up to 24 hours at temperatures up to 25 ° C;
- aqueous solutions containing up to 1% lidocaine hydrochloride and solutions most widely used for infusion are compatible with the drug.
At room temperature, the drug remains stable for 24 hours when mixed with the following solutions:
- 0.9% sodium chloride solution;
- 5% or 10% dextrose solution for injection;
- 4% dextrose injection and 0.18% sodium chloride solution;
- 0.9% sodium chloride solution and 5% dextrose solution;
- 5% dextrose solution and 0.225% sodium chloride solution;
- 5% dextrose solution and 0.45% sodium chloride solution;
- Ringer's solution or Ringer's lactate solution;
- Hartmann's solution.
The properties of cefuroxime are not impaired in 5% dextrose solution and 0.9% sodium chloride solution in the presence of sodium hydrocortisone phosphate.
Compatible with heparin at a dose of 10 or 50 U (units of action) in 1 ml in 0.9% sodium chloride solution and remains stable for 24 hours at room temperature.
Do not mix aminoglycoside antibiotics and cefuroxime in one syringe.
The acidity index of sodium bicarbonate solution 2.74% has a significant effect on the color of the cefuroxime solution, therefore it is not recommended to use it to dilute Zinacef. But you can use the tube of the infusion system, through which the patient is injected with sodium bicarbonate solution.
Analogs
Zinacef's analogs are: Axosef, Antibioxime, Aksetin, Zinnat, Ketocef, Zinoximor, Xorim, Cefuroxime sodium, Cefuroxime, Cefurus.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C in a dark place.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Zinacef
Reviews of Zinacef indicate the high therapeutic efficacy of the drug, especially in the treatment of infectious diseases of the upper and lower respiratory tract.
Price for Zinacef in pharmacies
The price of a bottle of Zinacef 0.75 g is from 145 rubles, 1.5 g - 150–250 rubles.
Zinacef: prices in online pharmacies
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Drug name Price Pharmacy |
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Zinacef 1500 mg powder for solution for injection 1 pc. 141 r Buy |
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Zinacef 750 mg powder for solution for injection 1 pc. RUB 150 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
