Cefurus
Cefurus: 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. Use in the elderly
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Cefurus
ATX code: J01DC02
Active ingredient: cefuroxime (Cefuroxime)
Manufacturer: JSC Sintez (Russia)
Description and photo update: 2019-05-07
Prices in pharmacies: from 79 rubles.
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Cefurus is an antibacterial agent for parenteral use.
Release form and composition
The drug is produced in the form of a powder for the preparation of a solution for intravenous (i / v) and intramuscular (i / m) administration: white with a yellow tint or white (0.75 g each in a 10 ml vial or 1.5 g in a vial a volume of 20 ml, in a cardboard box of 1, 5 or 10 bottles; for hospitals - in a cardboard box of 50 bottles; in a blister strip packaging 1 bottle with powder at a dose of 0.75 g and 2 ampoules with a solvent of 5 ml each, in a cardboard box 1 packaging and ampoule scarifier; in a cardboard box / box 1 bottle with powder at a dose of 0.75 g, 2 ampoules with solvent and an ampoule scarifier; in a blister strip 5 vials with powder at a dose of 0.75 g, in a blister strip 5 ampoules with a solvent, in a cardboard box 1 package with a preparation, 2 packages with a solvent and an ampoule scarifier;if ampoules have a fracture ring or a notch and a point, the scarifier is not inserted. Each pack also contains instructions for using Cefurus).
1 bottle contains the active substance - cefuroxime sodium (in terms of cefuroxime) at a dose of 0.75 or 1.5 g.
Solvent - water for injection (d / in.).
Pharmacological properties
Pharmacodynamics
Cefuroxime is a second generation cephalosporin antibiotic that demonstrates activity against a wide range of pathogens, including strains that produce β-lactamases. The drug has a bactericidal effect, preventing the synthesis of the bacterial cell wall.
In vitro, Cefurus is active against the following microorganisms:
- gram-negative aerobic bacteria: Haemophilus parainfluenzae (including ampicillin-resistant strains), Haemophilus influenzae (including ampicillin-resistant strains), Escherichia coli, Moraxella catarrhalis, Klebsiella spp., Providencia miracles spp., Providencia mi retria spp., Providencia mi retria spp. (including strains producing and non-producing penicillinase), Salmonella spp., Neisseria meningitidis, Bordetella pertussis;
- gram-positive aerobic bacteria: Staphylococcus aureus, Staphylococcus epidermidis (including strains resistant to penicillins, but excluding strains resistant to methicillin), Streptococcus pyogenes (and other β-hemolytic streptococci), Streptococcus molytic streptococci (Streptococcus pneumoniae groups), Streptococcus pneumoniae groups, Streptococcus pneumoniae groups, (Streptococcus agalactiae);
- anaerobic bacteria: gram-negative and gram-positive cocci (including Peptostreptococcus spp. and Peptococcus), Clostridium spp., Propionibacterium spp., Fusobacterium spp., Bacteroides spp. (except for Bacteroides fragilis);
- other microorganisms: Borrelia burgdorferi.
Microorganisms such as Campylobacter spp., Clostridium difficile, Acinetobacter calcoaceticus, Listeria monocytogenes, Pseudomonas spp., Methicillin-resistant strains Staphylococcus epidermidis, Entericus epidermidis and Staphylococcus morpp. vulgaris, Serratia spp., Citrobacter spp., Bacteroides fragilis.
Pharmacokinetics
After intramuscular injection at a dose of 0.75 g, the maximum concentration (C max) of cefuroxime is observed after 15-60 minutes and is 27 μg / ml. With intravenous infusion at doses of 0.75 and 1.5 g 15 minutes after administration, the C max of the drug is 50 and 100 μg / ml, respectively, the therapeutic concentration in the blood serum remains for 5.3 and 8 hours, respectively.
The agent binds to plasma proteins by 33-50%. With intravenous and intramuscular injections, the half-life (T ½) is 1.3–1.5 hours, in newborns - 2–2.5 hours. Therapeutic concentrations of cefuroxime are recorded in the myocardium, soft tissues, skin, pleural fluid, sputum and bile. Concentrations of the active substance in excess of the minimum inhibitory concentration (MIC) for most microorganisms can be achieved in synovial and intraocular fluids, as well as in bone tissue. The drug crosses the blood-brain barrier (BBB) in meningitis, crosses the placenta and is detected in breast milk.
Does not undergo metabolic transformation in the liver. Approximately 85–90% of the administered dose is excreted by the kidneys through glomerular filtration and tubular secretion unchanged over 8 hours (most of the active substance is excreted within the first 6 hours, forming a high degree of concentration in the urine). The agent is completely eliminated after 24 hours (one half by tubular secretion, the other by glomerular filtration).
Indications for use
Cefurus is recommended for the treatment of bacterial infections caused by microorganisms sensitive to the drug:
- pharyngitis, tonsillitis, sinusitis, otitis media (infections of the ENT organs);
- bronchitis, lung abscess, pneumonia, pleural empyema (respiratory tract infections);
- asymptomatic bacteriuria, cystitis, pyelonephritis (urinary tract infections);
- septic arthritis, osteomyelitis (infections of bones and joints);
- furunculosis, impetigo, pyoderma, wound infection, erysipelas, phlegmon, erysipeloid (skin and soft tissue infections);
- cervicitis, adnexitis, endometritis (infections of the pelvic organs);
- meningitis;
- sepsis;
- gonorrhea;
- Lyme disease (borreliosis).
In addition, Cefurus is indicated for the prevention of infectious complications during operations on the organs of the abdominal cavity, chest, pelvis and joints (including operations on the heart, lungs, esophagus, orthopedic operations and operations in vascular surgery in the presence of a high risk of infectious complications).
Contraindications
The use of the antibiotic Cefurus is contraindicated in case of hypersensitivity to cefuroxime, as well as to other cephalosporins, carbapenems and penicillins.
An antibacterial agent should be used with extreme caution for the following diseases / conditions:
- bleeding and diseases of the digestive tract (including ulcerative colitis), including indications in the anamnesis;
- chronic renal failure (CRF);
- neonatal period (including prematurity);
- pregnancy and lactation;
- combined use with loop diuretics, aminoglycosides.
Also, with caution, drug therapy should be carried out in emaciated and debilitated patients.
Cefurus, instructions for use: method and dosage
Cefurus is injected intramuscularly or intravenously by jet or drip.
Adults are prescribed the drug intramuscularly or intravenously 3 times a day, 0.75 g each, in case of severe infection, the dose may be increased to 3-4 injections of 1.5 g per day (if necessary, the time interval between injections can be reduced up to 6 hours). The average daily dose usually ranges from 3 to 6 g.
Recommended dosing regimen for Cefurus for adults:
- bacterial meningitis: IV every 8 hours, 3 g;
- exacerbation of chronic bronchitis: intramuscularly or intravenously 2-3 times a day, 0.75 g for 48-72 hours, then it is recommended to switch to taking the oral form of cefuroxime - 2 times a day, 0.5 g in a course of 5– 10 days;
- pneumonia: intramuscular or intravenous 2–3 times a day, 1.5 g for 48–72 hours, followed by the use of an oral form of cefuroxime 2 times a day, 0.5 g for 7–10 days;
- gonorrhea: IM 1 injection at a dose of 1.5 g or 2 injections at a dose of 0.75 g in different areas (for example, in both gluteal muscles);
- postoperative complications (for prophylaxis): surgical interventions on the lungs, heart, vessels and esophagus - intravenously 0.5-1 hour before the operation, 1.5 g each, and for long-term operations intravenously or intramuscularly each 8 hours within the next 24–48 hours, 0.75 g each (for open heart surgery, the total dose should not exceed 6 g); orthopedic surgery and operations on the pelvic organs, abdominal cavity - i.v. with induction of anesthesia, 1.5 g each, then additionally 8 and 16 hours after the completion of the operation i / m, 0.75 g each; complete joint replacement - powder in dry form is mixed in a dose of 1.5 g with each package of methyl methacrylate cement polymer before adding liquid monomer.
The drug must be used with extreme caution in the treatment of newborns (including premature babies).
Cefurus for children over the age of 3 months is prescribed intravenously or intramuscularly in a daily dose of 30-100 mg / kg in 3-4 injections. In the treatment of most infectious diseases, the optimal daily dose is 60 mg / kg. Newborns and children under 3 months of age are prescribed 30 mg / kg per day in 2-3 injections.
In the treatment of bacterial meningitis in children, the drug is injected intravenously: for younger and older age, the recommended daily dose is 150-250 mg / kg in 3-4 injections, for newborns - 100 mg / kg in 2-3 injections. With therapy for meningitis, children may experience hearing loss.
Patients with chronic renal failure require a change in the dosage regimen. With CC (creatinine clearance) 10–20 ml / min in adults, Cefurus is used intravenously or intramuscularly 2 times a day, 0.75 g each, with CC below 10 ml / min - once a day, 0.75 g In children with chronic renal failure, the dosage regimen should be adjusted in accordance with recommendations for adults.
Patients who are on continuous hemodialysis using an arteriovenous shunt or high speed hemofiltration in intensive care units are recommended to use Cefurus 2 times a day for 0.75 g. If patients are on low speed hemofiltration, it is necessary to follow the dosing regimens prescribed in case of violation activity of the kidneys.
To prepare a suspension for intramuscular administration to the powder at a dose of 0.75 g (contents of a 10 ml vial), add a solvent - water for injection. in an amount of 3 ml, to a powder in a dose of 1.5 g (contents of a 20 ml bottle) - in an amount of 6 ml. The mixture must be gently shaken until a suspension forms.
To obtain a solution for intravenous jet injection, the powder at a dose of 0.75 g should be diluted with water for injection. in a volume of 9 ml, in a dose of 1.5 g - in a volume of 14 ml.
To prepare a solution for intravenous infusion, for example, for intravenous infusions lasting up to 30 minutes, the powder at a dose of 1.5 g is dissolved in water for injection. volume of 50 ml. The prepared solution can be infused directly into a vein or into a dropper tube for parenteral fluid administration.
Side effects
- digestive system: flatulence, diarrhea, nausea, constipation, vomiting, abdominal pain and cramps, glossitis, oral candidiasis, ulceration of the oral mucosa, cholestasis, pseudomembranous colitis (the risk of the latter must be taken into account in patients with severe diarrhea that develops during the course treatment or after its completion);
- nervous system: convulsions;
- urinary system: dysuria, interstitial nephritis, impaired renal function - a decrease in CC, an increase in the level of creatinine and / or urea nitrogen in the blood;
- reproductive system: vaginitis, itching in the perineum;
- hematopoietic organs: leukopenia, eosinophilia, neutropenia, hemolytic anemia, thrombocytopenia, decreased hemoglobin and hematocrit levels, agranulocytosis, prolongation of prothrombin time, hypoprothrombinemia;
- sense organs: hearing loss;
- allergic reactions: rash, chills, itching, urticaria; rarely - drug fever, toxic epidermal necrolysis (Lyell's syndrome), exudative erythema multiforme (including Stevens-Johnson syndrome), bronchospasm, cutaneous vasculitis, anaphylactic shock, serum sickness;
- laboratory parameters: hyperbilirubinemia, false positive Coombs' test, increased activity of liver enzymes - aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP);
- local reactions: with intramuscular injection - irritation, pain and infiltration at the injection site; with intravenous administration - thrombophlebitis, phlebitis.
Overdose
Overdose symptoms may include central nervous system agitation and seizures. Treatment is symptomatic, hemodialysis and peritoneal dialysis are effective.
special instructions
During therapy with Cefurus, it is necessary to monitor renal function, especially in patients with a history of kidney disease, patients using an antibiotic in high doses, in the elderly, when combined with loop diuretics and aminoglycosides.
If there is a history of allergic reactions to penicillins, hypersensitivity to cephalosporin antibiotics is possible.
After removing the symptoms, you should continue using Cefurus for another 48-72 hours, in the treatment of infections caused by Streptococcus pyogenes, the course should be at least 7-10 days.
Against the background of therapy, a false-positive urine reaction to glucose and a false-positive direct antiglobulin test (direct Coombs' reaction) may be noted. When establishing blood glucose levels in patients receiving cefuroxime, it is recommended to use glucose oxidase / hexokinase tests.
During the period of treatment, the use of ethanol is prohibited.
When transferring a patient from parenteral administration of Cefurus to taking an oral form of cefuroxime, it is necessary to take into account the severity of the infection, the sensitivity of the pathogen and the general condition of the patient. If within 72 hours after the start of treatment it is not possible to achieve a clinical effect, parenteral administration of the drug should be continued.
Influence on the ability to drive vehicles and complex mechanisms
When treating with Cefurus, patients who drive vehicles or other complex and potentially dangerous equipment need to be careful.
Application during pregnancy and lactation
During pregnancy and lactation, antibiotic therapy with Cefurus is possible only if the intended benefit to the woman significantly outweighs the possible threat to the health of the fetus / child.
Pediatric use
The drug must be used with extreme caution in the treatment of newborns (including premature babies).
Cefurus for children over the age of 3 months is prescribed intravenously or intramuscularly in a daily dose of 30-100 mg / kg in 3-4 injections. In the treatment of most infectious diseases, the optimal daily dose is 60 mg / kg. Newborns and children under 3 months of age are prescribed 30 mg / kg per day in 2-3 injections.
In the treatment of bacterial meningitis, Cefurus is injected intravenously, for younger and older age the recommended daily dose is 150-250 mg / kg in 3-4 injections, for newborns - 100 mg / kg in 2-3 injections. With therapy for meningitis, children may experience hearing loss.
With impaired renal function
In the presence of chronic renal failure, Cefurus therapy is carried out with extreme caution.
Patients with chronic renal failure require a change in the dosage regimen. When CC is 10-20 ml / min in adults, Cefurus is used intravenously or intramuscularly 2 times a day, 0.75 g each, with CC below 10 ml / min - 0.75 g once a day. CRF dosage regimen should be adjusted in accordance with recommendations for adults.
Patients who are on continuous hemodialysis using an arteriovenous shunt or high speed hemofiltration in intensive care units are recommended to use Cefurus 2 times a day for 0.75 g. If patients are on low speed hemofiltration, it is necessary to follow the dosing regimens prescribed in case of violation activity of the kidneys.
Use in the elderly
During therapy in elderly patients, it is necessary to monitor renal function.
Drug interactions
- aminoglycosides and diuretics: the threat of nephrotoxic effects is aggravated;
- loop diuretics: tubular secretion slows down, renal clearance decreases, plasma levels and T ½ of cefuroxime increase;
- sodium bicarbonate solution 2.74%, aminoglycosides: there is a pharmaceutical incompatibility of these agents with cefuroxime;
- sodium chloride solution 0.9%, aqueous solutions containing up to 1% lidocaine hydrochloride, dextrose solutions 5 and 10%, dextrose solution 5% and sodium chloride solution 0.9%, sodium chloride solution 0.18% and dextrose solution 4%, Hartman's solution, Ringer's solution, sodium lactate solution, heparin (10 U / ml and 50 U / ml) in 0.9% sodium chloride solution: the pharmaceutical compatibility of these drugs with cefuroxime was recorded.
Analogs
The analogs of Cefurus are: Antibioxime, Super, Zinacef, Cefroxim J, Zinnat, Cetyl Lupine, Cefuroxime, Acenoveriz, Cefurabol, Axosef, etc.
Terms and conditions of storage
Store out of the reach of children, protected from moisture and light, at a temperature not exceeding 25 ° C.
Shelf life is 2 years.
The solution prepared from the powder can be stored for 7 hours at room temperature and for 48 hours in the refrigerator. The solution that turns yellow during storage is usable.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cefurus
The few reviews about Cefurus indicate the effectiveness of drug therapy in adults and children of infectious diseases caused by microorganisms that are sensitive to it. Cefurus exhibits bactericidal activity against a wide range of pathogens and, according to reviews, is successfully used to prevent the development of infectious complications during surgical interventions.
The disadvantages of this antibiotic include a large number of side effects, pain in intramuscular injections and a rather high cost of the drug required for a full course of therapy.
Price for Cefurus in pharmacies
The price of Cefurus, a powder for preparing a solution for intravenous and intramuscular administration, can be 65–70 rubles. for 1 bottle containing 0.75 g; 100-130 rubles. for 1 bottle containing 1.5 g.
Cefurus: prices in online pharmacies
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Drug name Price Pharmacy |
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Cefurus powder for prig solution for intravenous and intramuscular injection. 750mg 79 RUB Buy |
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Cefurus 750 mg powder for preparation of a solution for intravenous and intramuscular administration 1 pc. 79 RUB Buy |
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Cefurus 1.5 g powder for preparation of solution for intravenous and intramuscular administration 1 pc. 140 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!
