Cefosin
Cefosin: 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: Cefosin
ATX code: J01DD01
Active ingredient: cefotaxime (cefotaxime)
Manufacturer: JSC "Joint-Stock Kurgan Society of Medicines and Products" Sintez "(Russia)
Description and photo updated: 22.11.2018
Prices in pharmacies: from 16 rubles.
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Cefosin is a semi-synthetic broad-spectrum antibiotic.
Release form and composition
The dosage form of Cefosin is a powder for preparation of a solution for intravenous (i / v) and intramuscular (i / m) administration: from white to white with a yellowish tint [in glass vials (10 or 20 ml), 500, 1000 or 2000 mg, in cartons of 1, 5, 10 or 50 vials (in packs containing 1 or 5 vials, 1 or 5 ampoules with "Water for Injection" solvent can be attached in the kit, respectively)].
Composition of 1 mg powder: active substance cefotaxime (in the form of cefotaxime sodium salt) - 1 mg.
Pharmacological properties
Pharmacodynamics
Cefotaxime is a III generation semi-synthetic cephalosporin antibacterial drug with a wide spectrum of action. The mechanism of its bactericidal effect is to inhibit the synthesis of the cell walls of microorganisms.
The drug is active against the following gram-positive microorganisms: Staphylococcus spp. (including Staphylococcus epidermidis, Staphylococcus aureus, including penicillinase-producing strains), Streptococcus spp. (including Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus pneumoniae), Enterococcus spp., Bacillus subtilis, Erysipelothrix insidiosa, Corynebacterium diphtheria.
Gram-negative bacteria susceptible to the action of cefotaxime: Escherichia coli, Enterobacter spp., Haemophilus influenza (including strains forming penicillinase), Citrobacter spp., Haemophilus parainfluenzae, Proteus spp. (including Proteus indole, Proteus vulgaris, Proteus mirabilis), Providencia spp. (including Providencia rettgeri), Serratia spp., Klebsiella spp. (including Klebsiella pneumoniae), Morganella morganii, Pseudomonas aeruginosa, Neisseria gonorrhoeae (including penicillinase-producing strains), Acinetobacter spp., Neisseria meningitidis.
Anaerobic microorganisms sensitive to cefotaxime: Eubacterium spp., Clostridium spp. (including Clostridium perfringens), Bacteroides spp. (including some strains of Bacteroides fragilis), Peptococcus spp., Fusobacterium spp. (including Fusobacterium nucleatum), Propionibacterium spp., Peptostreptococcus spp.
Microorganisms resistant to cefotaxime: Enterococcus spp.; Acinetobacter baumannii, Bacteroides fragilis; Gram negative anaerobes; Clostridium difficile; Listeria monocytogenes, Methi-R Staphylococcus; Stenotrophomonas maltophilia; Pseudomonas aeruginosa and Pseudomonas cepacia.
Cefotaxime is resistant to the action of beta-lactamases of gram-positive and gram-negative microorganisms, including Clostridium difficile and staphylococcal penicillinase.
Pharmacokinetics
- absorption: after a single administration of cefotaxime intravenously, at a dose of 500, 1000 and 2000 mg, the maximum concentration (C max) in the blood plasma is achieved after 5 minutes and is 39, 100 and 214 μg / ml, respectively. After i / m administration of Cefosin at a dose of 500 and 1000 mg C max is observed after 5 minutes and is 11 and 21 μg / ml, respectively;
- distribution: from 25 to 40% of the dose binds to blood plasma proteins. Cefotaxime reaches therapeutic concentrations in most tissues and body fluids: synovial, peritoneal, pleural, cerebrospinal fluid, bile, urine, sputum, bones, myocardium, gallbladder, skin, soft tissues. The volume of distribution (V d) is 0.25-0.39 l / kg. With repeated injections of cefotaxime intravenously at a dose of 1000 mg every 6 hours for two weeks, there is no accumulation of the active substance. The drug passes into breast milk;
- excretion: the half-life (T 1/2) of cefotaxime with intravenous and intramuscular administration is 1 hour. It is excreted by the kidneys: unchanged - 60-70%, in the form of metabolites - the rest (which is a deacetylated derivative, the metabolite has bactericidal activity, the other two metabolites are inactive with respect to the microflora).
In patients with impaired renal function and in elderly patients, there is a twofold increase in T 1/2.
In newborns, T 1/2 varies from 0.75 to 1.5 hours, in premature newborns, it lengthens to 4.6 hours.
Indications for use
According to the instructions, Cefosin is indicated for use in the following infectious and inflammatory diseases caused by microorganisms sensitive to cefotaxime:
- bacterial infections of the upper and lower respiratory tract;
- ENT infections;
- infectious diseases of the genitourinary system;
- sepsis;
- joint and bone infections;
- abdominal infections (including peritonitis);
- infections of the skin and soft tissues;
- gonorrhea;
- infectious and inflammatory diseases of the pelvic organs;
- endocarditis;
- central nervous system infections (including meningitis);
- chlamydia;
- Lyme disease;
- salmonellosis;
- infected burns and wounds;
- infectious diseases in patients with immunodeficiency.
In addition, Cefosin is used for the prevention of infectious complications after traumatological, gynecological, urological and abdominal surgical interventions.
Contraindications
Absolute:
- children's age up to 2.5 years (for intramuscular injection);
- increased individual sensitivity to cephalosporins, other β-lactam antibiotics and penicillins.
Cefosin should be used with caution in newborns, patients with chronic renal impairment, ulcerative colitis (including a history of), as well as during pregnancy and lactation.
Instructions for the use of Cefosin: method and dosage
Cefosin solution is administered intramuscularly or intravenously (drip or stream).
To prepare a solution intended for intramuscular injection, 500 mg of powder is diluted in 2 ml (1000 mg of powder - in 4 ml, respectively) of sterile water for injection. When administered intramuscularly, 1% lidocaine solution can be used as a solvent in the same proportions.
A solution for jet intravenous administration is prepared as follows: 500–1000 mg of Cefosin is dissolved in 10 ml of sterile water for injection. It should be introduced slowly, over 3-5 minutes.
For drip IV injection, 2000 mg of powder is diluted in 100 ml of isotonic sodium chloride solution or 5% glucose solution (dextrose). It should be administered within 50-60 minutes.
Recommended dosage regimens for Cefosin:
- adults and children over 12 years of age: Usually 1000 mg every 12 hours. In severe cases - 3000-4000 mg per day (1000 mg is administered 3-4 times a day). The maximum daily dose is 12,000 mg;
- newborns and children under 12 years of age: 50–100 mg / kg of body weight every 6–12 hours;
- premature infants: 50 mg / kg body weight.
Patients with impaired renal function require a dose adjustment of Cefosin downward. With a creatinine clearance below 10 ml / min, the daily dose of the drug is halved.
Side effects
Possible side reactions from systems and organs:
- digestive system: nausea, vomiting, constipation, diarrhea, flatulence, pain in the epigastric region, dysbiosis, liver dysfunction (increased plasma aminotransferase and alkaline phosphatase activity, hyperbilirubinemia, hypercreatininemia); rarely - glossitis, stomatitis, pseudomembranous colitis;
- hematopoietic system: neutropenia, leukopenia, thrombocytopenia, granulocytopenia, hypocoagulation, hemolytic anemia;
- urinary system: anuria, oliguria, azotemia, increased concentration of urea in the blood, interstitial nephritis;
- central nervous system: dizziness, headache;
- cardiovascular system: in the case of a quick bolus injection into the central vein - the development of potentially dangerous arrhythmias;
- allergic reactions: itching, rash, chills, urticaria, fever; rarely - eosinophilia, bronchospasm, Stevens-Johnson syndrome (malignant exudative erythema), toxic epidermal necrolysis (Lyell's syndrome), angioedema, anaphylaxis;
- local reactions: with intravenous administration - soreness along the vein, phlebitis; with i / m administration - pain and infiltration;
- organism as a whole: false positive Coombs' test, superinfection (including candidal vaginitis).
Overdose
In case of an overdose of cefotaxime, seizures, encephalopathy (with the introduction of high doses, especially in patients with impaired renal function), hyperexcitability, tremor are possible.
In such cases, symptomatic treatment is recommended.
special instructions
Before using Cefosin, it is necessary to find out the patient's allergic history, especially in relation to β-lactam antibiotics. It should be borne in mind that cross-allergy may develop between cephalosporin antibiotics and penicillins. For patients with a history of hypersensitivity reactions to penicillin, Cefosin is prescribed with caution, given the likelihood of developing severe anaphylactic reactions, up to and including death.
In the case of prolonged therapy (more than 10 days), it is necessary to control the picture of peripheral blood.
During the first weeks of using cefotaxime, it is possible to develop pseudomembranous colitis, manifested by severe diarrhea. In such cases, cefosin should be discontinued and appropriate treatment should be carried out, including oral metronidazole and vancomycin.
During the period of treatment with Cefosin, when performing analyzes with a non-enzymatic method (using Fehling's or Benedict's solutions), a false-positive reaction to glucose in the urine is likely.
Application during pregnancy and lactation
Cefosin can be used in pregnant women only when the intended benefit to the mother outweighs the potential risks to the fetus.
Since cefotaxime tends to be excreted in breast milk, it is recommended to stop breastfeeding if necessary to use the drug during lactation.
Pediatric use
For children under 2.5 years of age, intramuscular administration of Cefosin is contraindicated.
Prescribe the drug to newborns with caution.
With impaired renal function
The use of Cefosin in patients with chronic renal failure requires caution. For such patients, the dose of the drug is reduced. When creatinine clearance is less than 10 ml / min, the daily dose of cefotaxime is recommended to be halved.
Drug interactions
The use of cefotaxime simultaneously with some drugs can lead to the development of the following effects:
- aminoglycoside antibiotics, loop diuretics, polymyxin B and other nephrotoxic drugs: enhancement of their nephrotoxic effect. With simultaneous use with cefotaxime, control of renal function is necessary;
- antiplatelet agents, non-steroidal anti-inflammatory drugs: increased risk of bleeding;
- drugs that block tubular secretion: an increase in plasma concentrations of cefotaxime and a slowdown in its excretion;
- ethyl alcohol: with simultaneous use with cefotaxime, the development of disulfiram-like reactions is not noted.
Cefotaxime solution is incompatible in one syringe or dropper with solutions of other antibiotics.
Analogs
Analogues of Cefosin are: Intrataxim, Kefotex, Claforan, Liforan, Oritax, Oritaxim, Talcef, Cefotaxime, Cefotaxime-Vial and others.
Terms and conditions of storage
Store in a dry place protected from light, at a temperature not exceeding 25 ° C.
Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cefosin
In reviews of Cefosin, in almost every case, pain is noted with the introduction of this drug. Quite often, users complain of side reactions: swelling of the lips, throat, difficulty breathing, pain under the ribs, skin rash, itching, as well as dysfunction of the gastrointestinal tract.
Price for Cefosin in pharmacies
The price for Cefosin per package is approximately: 1 bottle (1000 mg) - 20 rubles, 50 bottles (1000 mg) - 1022 rubles.
Cefosin: prices in online pharmacies
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Drug name Price Pharmacy |
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Cefosin 1 g powder for preparation of a solution for intravenous and intramuscular administration 1 pc. RUB 16 Buy |
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Cefosin 2 g powder for preparation of solution for intravenous and intramuscular administration 1 pc. 42 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
