Cefuroxime - instructions for use, dose, side effects, contraindications

Has bactericidal action due to inhibition of bacterial cell wall synthesis. Violates the synthesis of the biopolymer peptidoglikana - the main component of the cell wall of bacteria. It inhibits the peptidoglycan transpeptidase, inhibits the activity of the endogenous inhibitor, which leads to activation of murein hydrolase, which cleaves peptidoglycan. Effective against fissile bacteria, in the walls of which the synthesis of peptidoglycan occurs.

Highly active against gram-negative bacteria: Escherichia coli, Proteus mirabilis, Salmonella spp., Haemophilus influenzae, Neisseria gonorrhoeae, Shigella spp., Enterobacter spp.; Gram-positive bacteria: Staphylococcus spp., Streptococcus spp.

Inactive for Pseudomonas spp., methicillin-resistant strains Staphylococcus spp. and Listeria monocytogenes, most strains Enterococcus spp., many strains Enterobacter cloacae.

Resistant to the action of β-lactamases.

Pharmacokinetics:

After oral administration, the maximum concentration in the blood plasma is achieved after 2-3 hours, 45 minutes after intramuscular injection, after 30 minutes after intravenous administration. The connection with plasma proteins is 50%.

Not exposed to metabolism. It is distributed in tissues and body fluids. Therapeutic concentrations in the cerebrospinal fluid are reached only with meningitis. Penetrates through the placental barrier, excreted in breast milk.

The half-life is 70 minutes. Elimination of the kidneys unchanged.

Indications:

It is used for the treatment of infectious and inflammatory diseases caused by microorganisms susceptible to cefuroxime:

- infections of the respiratory tract - acute and chronic bronchitis, empyema of the pleura, bronchoectatic disease, abscess of the lung, bacterial pneumonia, postoperative infections of the thoracic organs;

- infections of the ear, throat, nose - sinusitis, tonsillitis, pharyngitis;

- Urinary tract infections - acute and chronic pyelonephritis, cystitis, asymptomatic bacteriuria;

- infections of soft tissues - cellulitis, erysipelas, wound infections;

- infections of bones and joints: osteomyelitis, septic arthritis;

- infections in gynecology and obstetrics (inflammatory diseases of the pelvic organs);

- gonorrhea (especially if hypersensitivity to antibacterial agents of the penicillin series);

- other infections, including peritonitis, septicemia and meningitis.

It is used as a preventive agent for operations on the abdominal organs, pelvic organs, orthopedic operations, operations on the heart, lungs, esophagus and vessels, with an increased risk of infection.

ICD-10

I.A30-A49.A39 Meningococcal infection

I.A30-A49.A40 Streptococcal septicemia

I.A30-A49.A41 Other septicemia

VI.G00-G09.G00 Bacterial meningitis, not elsewhere classified

IX.I30-I52.I33 Acute and subacute endocarditis

X.J00-J06.J00 Acute nasopharyngitis (runny nose)

X.J30-J39.J31.1 Chronic nasopharyngitis

X.J30-J39.J31 Chronic rhinitis, nasopharyngitis and pharyngitis

X.J00-J06.J01 Acute Sinusitis

X.J30-J39.J32 Chronic Sinusitis

X.J30-J39.J31.2 Chronic pharyngitis

X.J00-J06.J02 Acute pharyngitis

X.J00-J06.J03 Acute tonsillitis

X.J30-J39.J35.0 Chronic tonsillitis

X.J00-J06.J04 Acute laryngitis and tracheitis

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

X.J20-J22.J20 Acute bronchitis

X.J40-J47.J42 Chronic bronchitis, unspecified

XI.K65-K67.K65.0 Acute peritonitis

XI.K80-K87.K81.1 Chronic cholecystitis

XI.K80-K87.K81.0 Acute cholecystitis

XI.K80-K87.K83.0 Cholangitis

XII.L00-L08.L01 Impetigo

XII.L00-L08.L02 Abscess of skin, boil and carbuncle

XII.L00-L08.L03 Phlegmon

XII.L00-L08.L08.0 Pyoderma

XIII.M00-M03.M00 Pyogenic arthritis

XIII.M86-M90.M86 Osteomyelitis

XIV.N10-N16.N11 Chronic tubulointerstitial nephritis

XIV.N10-N16.N10 Acute tubulointerstitial nephritis

XIV.N30-N39.N30 Cystitis

XIV.N30-N39.N34 Urethritis and urethral syndrome

XIV.N40-N51.N41 Inflammatory diseases of the prostate

XIV.N70-N77.N70 Salpingitis and oophoritis

XIV.N70-N77.N71.0 Acute inflammatory disease of the uterus

XIV.N70-N77.N72 Inflammatory disease of the cervix

XIV.N70-N77.N73.0 Acute parametritis and pelvic cellulite

XXI.Z20-Z29.Z29.2 Another type of preventive chemotherapy

Contraindications:

Individual intolerance to β-lactam antibiotics: penicillins and cephalosporins.

Carefully:

Imbalance of electrolytes or fluids, severe liver damage, neonatal period.

Pregnancy and lactation:

Recommendations for FDA - Category B. It is used in pregnancy and lactation.

Dosing and Administration:

Use in children

Inside, to 0,125 g 2 times a day. When otitis, children older than 2 years are given orally 0.25 g 2 times a day.

Intramuscularly and intravenously: 30-100 mg / kg per day for 2-3 injections.

Adults

Inside, 0.25 g 2 times a day, with severe disease - 0.5 g 2 times a day.

Intravenous and intramuscular, 750 mg 3 times a day. In severe disease, the interval between injections is reduced to 6 hours, the daily dose is 3-6 g.

With uncomplicated gonorrhea - 1.5 g intramuscularly once or 750 mg in both buttocks.

With a preventive purpose, an average dose of 1.5 g intravenously before the introduction of anesthesia with abdominal, urological and orthopedic operations.

The highest daily dose: inside - 1 g; parenterally - up to 6 g.

The highest single dose: inside - 0.5 g; parenterally - 1.5 g.

Side effects:

Central and peripheral nervous system: rarely - convulsions.

Hemopoietic system: thrombocytopenia, eosinophilia, leukopenia, an increase in prothrombin index and coagulation time.

Digestive system: nausea, vomiting, diarrhea, increased activity of hepatic enzymes, hepatic or cholestatic jaundice, intestinal dysbacteriosis.

Dermatological reactions: local reactions - compaction at the injection site, candidiasis dermatitis, vulvovaginitis.

urinary system: rarely - the development of hypokalemia.

Allergic reactions.

Overdose:

Nausea, vomiting, diarrhea, neuromuscular excitability, convulsive attacks.

Treatment is symptomatic, hemodialysis.

Interaction:

Simultaneous application with probenecid slows the renal excretion of cefuroxime.

"Loop diuretics" block the tubular secretion of cefuroxime.

Special instructions:

Simultaneous use with ethanol can cause a disulfiram-like reaction.

In patients receiving cefuroxime, to determine the level of glucose in the blood is recommended to use enzymatic methods (using glucokinase or hexokinase).

Instructions

Cefuroxime (Cefuroximum)