Cefuroxime
Cefuroxime: 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: Cefuroxime
ATX code: J01DC02
Active ingredient: cefuroxime (cefuroxime)
Manufacturer: Shijiazhuang Pharmaceutical Group Ouyi (China), Biosynthesis, JSC (Russia), BIOTEK MFPDK (Russia), KRASFARMA, JSC (Russia), DEKO Company, LLC (Russia)
Description and photo updated: 22.11.2018
Prices in pharmacies: from 101 rubles.
Buy
Cefuroxime is a drug with an antibacterial effect (II generation cephalosporin), intended for parenteral use.
Release form and composition
The dosage form of Cefuroxime is a powder for preparing a solution for intravenous (intravenous) and intramuscular (intramuscular) administration: hygroscopic, from white to yellow (in a cardboard box 1, 10, 14, 25 or 50 bottles of 250, 750 or 1500 mg).
Active ingredient in 1 bottle of powder: cefuroxime - 250, 750 or 1500 mg (in the form of cefuroxime sodium).
Pharmacological properties
Pharmacodynamics
Cefuroxime is a second generation cephalosporin antibiotic intended for parenteral use.
Violates the synthesis of the cell wall of bacteria (bactericidal effect). Possesses a wide spectrum of antimicrobial action.
Shows high activity against the following microorganisms:
- gram-negative microorganisms, including Klebsiella spp., Escherichia coli, Proteus mirabilis, Providencia spp., Proteus rettgeri, Haemophilus influenzae, including ampicillin-resistant strains;
- gram-positive microorganisms, including strains resistant to penicillins (except for strains resistant to methicillin), Staphylococcus aureus, Streptococcus pyogenes (and other beta-hemolytic streptococci), Streptococcus mitis (viridans groups), Streptococcus, group B (Streptococcus pneumoniae), Bortecoccus agal pertussis, most. Clostridium spp.;
- gram-positive / gram-negative anaerobes, including Peptostreptococcus spp., Peptococcus spp., Propionibacterium spp., Fusobacterium spp.;
- Moraxella catarrhalis, Neisseria gonorrhoeae, including strains producing and not producing penicillinase, Salmonella spp., Neisseria meningitidis, Borrelia burgdorferi;
- Haemophilus parainfluenzae, including ampicillin-resistant strains.
The following are insensitive to the action of cefuroxime: Acinetobacter calcoaceticus, Pseudomonas spp., Clostridium difficile, Campylobacter spp., Listeria monocytogenes, methicillin-resistant strains of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus epidermidis, Legionella morptocii. vulgaris, Serratia spp., Citrobacter spp., Bacteroides fragilis.
Pharmacokinetics
After i / m administration of 750 mg of cefuroxime C max (maximum concentration) is achieved after 15-60 minutes, it is 0.027 mg / ml.
After intravenous administration of 750 and 1500 mg Cmax of cefuroxime is achieved in 15 minutes and is 0.05 and 0.1 mg / ml, respectively. The time for maintaining the therapeutic concentration is 5.3 and 8 hours, respectively.
T 1/2 (half-life) with intravenous and intramuscular administration is in the range from 1.3 to 1.5 hours, in newborns this indicator is more - 2–2.5 hours. The connection with plasma proteins is 33-50%.
It is not metabolized in the liver. 85-90% of the substance is excreted unchanged by the kidneys (by tubular secretion and glomerular filtration) for 8 hours (most of the solution - in the first 6 hours, while high concentrations are created in the urine); after 24 hours it is excreted in full (in a 1: 1 ratio by tubular secretion and glomerular filtration).
Cefuroxime in a therapeutic concentration is recorded in pleural fluid, sputum, bile, myocardium, soft tissues and skin. Substance concentrations that are above the minimum inhibitory concentration for most microorganisms can be achieved in the intraocular and synovial fluids, as well as in bone tissue.
Cefuroxime crosses the blood-brain barrier in meningitis. Passes through the placenta and enters breast milk.
Indications for use
According to the instructions, Cefuroxime is prescribed for infectious and inflammatory diseases caused by microorganisms sensitive to its action:
- respiratory tract infections (including pneumonia, bronchitis, lung abscess, pleural empyema, etc.), ENT organs (including otitis media, tonsillitis, sinusitis, pharyngitis, etc.), skin and soft tissues (including pyoderma, erysipelas, impetigo, phlegmon, furunculosis, wound infections, erysipeloid, etc.), urinary tract (including cystitis, pyelonephritis, bacteriuria, asymptomatic gonorrhea, etc.), pelvic organs (including adnexitis, endometritis, cervicitis), joints and bones (including septic arthritis, osteomyelitis and etc.), meningitis, sepsis, Lyme borreliosis;
- operations on the organs of the abdominal cavity, chest, pelvis, joints, including operations on the esophagus, heart, lungs, in vascular surgery, orthopedic operations (for prophylactic purposes with a high risk of developing infectious complications).
Contraindications
An absolute contraindication to the use of Cefuroxime is the presence of individual intolerance to its components, including other cephalosporins, carbapenems and penicillins.
Relative contraindications (Cefuroxime is prescribed under medical supervision):
- weakened / exhausted state;
- chronic renal failure;
- diseases of the gastrointestinal tract, including a burdened history of ulcerative colitis;
- bleeding;
- neonatal period, prematurity;
- pregnancy and the period of breastfeeding.
Instructions for the use of Cefuroxime: method and dosage
Mode of administration of Cefuroxime: intravenous and intramuscular.
Recommended therapy regimen:
- adults: 750 mg 3 times a day; in cases of a severe course of the infectious process, a single dose can be doubled, the frequency of administration - up to 4 times a day (with intervals of 6 hours). The average dose is 3000-6000 mg per day;
- children: 30–100 mg / kg per day, divided into 3–4 injections. In most cases, the optimal daily dose is 60 mg / kg, newborns and children under 3 months are prescribed 30 mg / kg per day in 2-3 doses.
Application of Cefuroxime, depending on the indications:
- gonorrhea: single intramuscular injection at a dose of 1500 mg, or 2 injections of 750 mg each with administration in different areas (for example, in two gluteal muscles);
- bacterial meningitis: 3000 mg IV every 8 hours; children of younger and older age are prescribed 150-250 mg / kg per day, divided into 3-4 injections, for newborns - 100 mg / kg per day;
- exacerbation of chronic bronchitis: i / v or i / m 2-3 times a day, 750 mg for 48-72 hours, then the patient is transferred to oral cefuroxime (2 times a day, 500 mg for a course of 5 to 10 days);
- operations on the lungs, heart, vessels and esophagus: 1500 mg intravenously with induction of anesthesia, additionally 750 mg intramuscularly 3 times a day for 24–48 hours;
- operations on the abdominal cavity, pelvic organs, orthopedic operations: i.v. 1500 mg with induction of anesthesia, then additionally i / m at 750 mg 8 and 16 hours after the operation;
- pneumonia: intravenous or intramuscularly 2–3 times a day, 1500 mg for 48–72 hours, then the patient is transferred to oral administration (2 times a day, 500 mg for a course of 7 to 10 days);
- total joint replacement: Before adding liquid monomer, 1500 mg of dry powder should be mixed with each bag of methyl methacrylate cement polymer.
Patients with chronic renal failure require dosage adjustment (depending on creatinine clearance):
- 10–20 ml / min: i / v or i / m 2 times a day, 750 mg;
- less than 10 ml / min: i / v or i / m once a day, 750 mg.
Patients who are on continuous hemodialysis using an arteriovenous shunt or in intensive care units with high-speed hemofiltration are prescribed Cefuroxime 2 times a day, 750 mg; for patients on low speed hemofiltration, the drug is prescribed in doses recommended for impaired renal function.
Method of preparation of injection solution:
- solution for intramuscular injection: add 3 ml of water for injection to 750 mg of powder and shake gently until a suspension is formed. Cefuroxime is compatible with aqueous solutions containing up to 1% lidocaine hydrochloride;
- solution for intravenous injection: dissolve 750 mg of powder in 6 or more ml of water for injection; the required volume of water for injection for 1500 mg of the drug - from 15 ml;
- solution for short-term intravenous infusion (up to 30 minutes): 1500 mg of powder is dissolved in 50 ml of water for injection. The solutions can be injected into an infusion tube or directly into a vein.
Side effects
- central nervous system: convulsions;
- genitourinary system: vaginitis, dysuria, impaired renal function, itching in the perineum;
- digestive and hepatobiliary system: nausea, diarrhea, vomiting, flatulence, constipation, abdominal cramps / pains, pseudomembranous enterocolitis, ulceration of the oral mucosa, glossitis, oral candidiasis, cholestasis, hepatic dysfunction;
- sense organs: hearing loss;
- hematopoietic organs: prolongation of prothrombin time, decrease in hemoglobin and hematocrit concentration, hemolytic / aplastic anemia, neutropenia, eosinophilia, hypoprothrombinemia, leukopenia, thrombocytopenia, agranulocytosis;
- allergic reactions: urticaria, chills, itching, rash; rarely - bronchospasm, exudative erythema multiforme, malignant exudative erythema, anaphylactic shock;
- reactions at the injection site: irritation, phlebitis, infiltration / pain at the injection site.
Overdose
The main symptoms: convulsions, agitation of the central nervous system.
Therapy: antiepileptic drugs, maintenance and control of vital body functions, peritoneal dialysis and hemodialysis.
special instructions
With a burdened history of allergic reactions to penicillins, hypersensitivity to Cefuroxime cannot be ruled out.
After the symptoms disappear, treatment should be continued for 48–72 hours. The course of therapy in case of infections caused by Streptococcus pyogenes is at least 7-10 days.
During the period of therapy, monitoring of renal function is required, especially in patients receiving high doses of Cefuroxime.
It should be borne in mind that during treatment, there may be a false positive urine reaction to glucose and a false positive direct Coombs' reaction. When determining the concentration of glucose in the blood, the use of tests with hexokinase or glucose oxidase is recommended.
The prepared solution can be stored for 7 hours at room temperature; when stored in a refrigerator, this period increases to 48 hours. The use of a solution that has turned yellow during storage is permissible.
When transferring a patient from parenteral administration to oral administration, the general condition, the severity of the infection and the sensitivity of microorganisms should be taken into account. If, 72 hours after taking cefuroxime inside, there is no improvement in the condition, you should return to the injection of the drug. If symptoms of pseudomembranous colitis appear, therapy is canceled.
Influence on the ability to drive vehicles and complex mechanisms
During therapy with Cefuroxime when driving a motor vehicle, patients should be careful, which is associated with a high risk of adverse reactions from the nervous system.
Application during pregnancy and lactation
Cefuroxime therapy for pregnant women should be carried out under medical supervision, the drug is prescribed after assessing the benefit / risk ratio. If it is necessary to carry out therapy during lactation, it is necessary to consider the issue of stopping breastfeeding.
Pediatric use
The neonatal period and prematurity are relative contraindications to the use of Cefuroxime. Treatment should be carried out under medical supervision.
With impaired renal function
Chronic renal failure is a relative contraindication to the use of Cefuroxime. Treatment should be carried out under medical supervision.
Drug interactions
Cefuroxime is pharmaceutically compatible with the following drugs / solutions: metronidazole, azlocillin, xylitol, 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% invert sugar in water for injection, Ringer's solution, sodium lactate solution, Hartman's solution, 5% dextrose solution 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 0.9% sodium chloride solution.
Cefuroxime is pharmaceutically incompatible with the following drugs / solutions: aminoglycosides, 2.74% sodium bicarbonate solution.
Other possible interactions:
- loop diuretics (oral): tubular secretion of cefuroxime slows down, its renal clearance decreases, plasma concentration increases, T 1/2 increases;
- aminoglycosides, diuretics: the likelihood of nephrotoxic effects increases.
Analogs
Analogues of Cefuroxime are: Cetyl Lupine, Antibioxime, Xorim, ACENOVERIZ, Cefurotek, Zinacef, Cefurabol, Cefurus, Aksetin, Cefurosin, Zinnat, Axosef, Super.
Terms and conditions of storage
Store in a place protected from light at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cefuroxime
According to reviews, Cefuroxime is an effective antibacterial drug with a wide spectrum of action. Improvement usually comes quickly. Of the shortcomings, they indicate the development of side effects.
Price for Cefuroxime in pharmacies
The approximate price for Cefuroxime (1 bottle of 750 mg) is 153 rubles.
Cefuroxime: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Cefuroxime powder for prig solution for intravenous and intramuscular injection. 750mg RUB 101 Buy |
|
Cefuroxime 750 mg powder for preparation of solution for intravenous and intramuscular administration 1 pc. RUB 101 Buy |
|
Cefuroxime Kabi 750 mg powder for preparation of solution for intravenous and intramuscular administration 10 pcs. 1250 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!
