Cefotaxime, an antibiotic of universal action, is effective in the treatment of ailments caused by gram-positive and gram-negative bacteria. The medicine is intended for adults and children.
Antibiotics, that is, drugs that suppress activity and contribute to the destruction of the pathogenic bacterial flora, are today an indispensable participant in the therapeutic course for many diseases. These drugs are constantly being improved in order to expand the spectrum of action and reduce the possible impact on the work of internal organs.
Cefotaxime is a third generation antibiotic from the cephalosporin family.
Features of the preparation
Cephalosporins are antibiotics of the β-lactam type. They are based on 7-aminocephalosporanic acid, and the main feature in comparison with classical penicillin is resistance to β-lactamases. This enzyme produces gram-negative bacteria, it destroys substances of the penicillin class, which makes the treatment completely useless.
Cephalosporins are more resistant to enzyme effects, but not absolutely. The development of new drugs of this class is aimed at creating a drug that is insensitive to the effect of β-lactamases. Cefotaxime is a semisynthetic substance of the third generation, which has a very high resistance to the action of enzymes, and therefore both active against gram-positive and gram-negative bacteria.
In many cases, several types of bacteria are the causative agents of the disease. Specialized antibiotic affects only certain types of them, the universal has a large spectrum of action, that is, the patient is assigned not several drugs of different actions, but only one. Obviously, the side effects and the destructive effect of the drug on the natural microflora in the latter case will be much less.
Dosage forms
The drug is designed only for parenteral administration, that is, bypassing the digestive tract. It is produced only in the form of a powder intended for dissolution. The nurse prepares the solution, the dosage is calculated by the attending physician.
Cefotaxime is given intravenously - by jet or by drop, as determined by the method of treatment. Intramuscular injection with an injector is also possible.
The preparation is produced in 0.5, 1 and 2-g. Vials.
Composition of Cefotaxime
The dilution powder consists of the sodium salt of cefotaxime - sodium( 6R, 7R) -3 - [(acetyloxy) methyl] -7 - [[(Z) -2-( 2-aminothiazol-4-yl) -2-( methoxyimino) acetyl] amino] -8-oxo-5-thia-1-azabicyclo [4.2.0] oct-2-ene-2-carboxylate. This powder is white or yellow, hygroscopic, easily diluted with water.
The vial on the vial indicates the carboxylate content in terms of cefotaxime.
Price
- The cost of one bottle varies from 21 to 134 rubles.
- The package, which includes 5 bottles, costs from 93 to 97 r.
- Packing in 40 pieces costs up to 632 rubles.
Pharmacological action of
The action of antibiotics is mostly based on the destruction of any membrane protein, which causes disruption of life and cell death. Cefotaxime destroys the mechanism of formation of mucoleptide, which leads to the death of bacterial microflora.
Pharmacodynamics
- Cefotaxime is more active on gram-positive bacteria and is quite effective against gram-negative bacteria. The substance disrupts the production of membrane protein. A distinctive feature of the drug is its effectiveness against those strains of bacteria that are resistant to the effects of penicillin, aminoglycoside and sulfonamides. This quality and provides such a wide range of effects.
- The second important feature of the drug is resistance to 4 of the 5 β-lactamases, because of which the effectiveness of penicillin and previous cephalosporin derivatives was insufficient.
- The list of bacteria that can be destroyed by the drug is extensive. Firstly, these are staphylococci and streptococci, group B streptococci and beta-hemolytic group A streptococci. Second, the drug is also effective against strains resistant to ampicillin.
- The drug is less effective in relation to negative cocci than cephalosporins of previous generations.
Pharmacokinetics
Once ingested, the drug accumulates very rapidly, creating a therapeutic concentration of 11 and 21 μg / ml. With intramuscular injection, the desired level is reached after 30 minutes, with intravenous - after 5 minutes. A sufficient level of 12 hours is left from the moment of drug administration.
- In plasma of 25-40%, cefotaxime binds to a protein.
- The substance penetrates into tissues and liquids - bone tissue, myocardium, gall bladder, synovial fluid, creating a sufficient concentration. Cefotaxime is found in the placenta and breast milk: pregnant women and young mothers should take this factor into account.
- The substance with urine is excreted - 90%, with 60% in unchanged form and 20-30% in the form of metabolites. The half-life is 1 hour with intravenous injection and 1.5 hours after the injection.
- In newborns, the duration of the period reaches 0.8-1.5 hours, in preterm - up to 6.5 hours, in elderly patients - up to 2.5 hours.
Cefotaxime does not affect liver function and does not displace bilirubin, as it does when using other antibiotics. Due to this quality, the drug is allowed to be used for the treatment of small children and newborns.
Indications
Bacterial activity causes a variety of ailments of very different nature. In the treatment, it is not so much the localization of the inflammatory focus or the nature of the injured organ as the type of pathogenic microflora. It is the type of bacteria that determines the choice of antibiotic.
Cefotaxime is effective against all ailments caused by the above bacteria and their strains:
- infections of the lower respiratory tract - bronchitis, pleurisy, pneumonitis;
- lesions of the urinary system of an infectious nature;
- infections of the ear, nose and throat - otitis, angina, if the latter are provoked not by enterococci;
- infectious kidney disease;
- diseases of bones, abdominal cavity, soft tissues;
- Lyme disease;
- endocarditis - inflammation of the heart membrane;
- sepsis;
- gynecological infections - gonorrhea, chlamydia.
In addition, the drug is used to prevent complications after surgery.
Instruction for use
The drug is administered intravenously or intramuscularly as a solution. The composition of the latter is determined by the ailment, the method of administration and the age of the patient.
Adults
The standard doses are designed for patients over 12 years of age and weighing more than 50 kg.
- For intramuscular injections, 0.5-1 g of powder is dissolved in 2-5 ml of sterile water for injections and injected into the muscle.
- When intravenously administered, 0.5-1 g is dissolved in 2-4 ml of sterile water, and then the lidocaine is diluted with a solvent, for example, to a volume of 10 ml. The drug is administered slowly - at least 3-5 minutes.
- With a drop by drop method, 2 g is dissolved in 100 ml of an isotonic solution - sodium chloride, or in 100 ml of a 5% solution of glucose. The procedure takes 50-60 minutes.
The usual dosage dose reaches 1 g for 12 hours, in severe cases the dosage is increased to 2 g. The maximum allowable per day dose is 12 g.
The mode of administration and dosage are determined by the type and severity of the disease. In this case, you must also take into account the limitations: for example, with renal failure, the daily dose can not exceed 6 g.
- Uncomplicated infections, as well as diseases of the urinary tract - intramuscularly or intravenously at 1 g every 8-12 hours.
- For moderate ailments, the dose is increased to 2 g. The medication is administered every 12 hours.
- In severe infections - meningitis, for example, the dose is increased to 2 g, the drug is injected after 4-8 hours, not exceeding the permissible daily dose.
- To prevent complications, cefotaxime is administered once with anesthesia. If there is a need, the administration of the medicine is repeated after 6-12 hours.
- Acute gonorrhea - intramuscularly 1 g. The medicine is administered once.
- Cefotaxime is used in cesarean section: intravenously 1 g when applying clamps to the umbilical vein. After 6-12 hours, the input is repeated.
Children, newborns
Cefotaxime is allowed to be used to treat newborns and premature infants.
- Babies up to 1 week of the drug is injected into the vein at a rate of 50 mg per kg of body weight after 12 hours.
- For infants up to 4 weeks - intravenously every 8 hours at the same dosage.
- Children over 2.5 years of age are prescribed 50-180 mg / kg - 4-6 injections. In severe forms of infection, the dose is increased to 100-200 mg / kg. The maximum daily intake is 12 g.
In pregnancy and lactation,
- The drug is found in the placenta and is extracted by breast milk. Cefotaxime in pregnancy is used only for life indications.
- During the course of breastfeeding it is best to stop.
This video shows how to prick yourself an antibiotic:
Contraindications
Despite the relative safety of cephalosporins, their use has a number of limitations:
- pregnancy and lactation - the drug is only allowed if absolutely necessary;
- intolerance to cephalosporin and penicillin;
- open or closed bleeding;
- enterocolitis - inflammation of the colon and small intestine.
The use of the drug requires caution in the treatment of patients with renal impairment. In this case, appoint reduced doses and necessarily observe the response of the body.
Side effects of
Taking medication can have side effects:
- from the hematopoietic system - leukopenia, anemia, thrombocytopenia. This is due to the fact that the biochemical parameters of the peripheral blood change under the influence of the medicine;
- from the digestive tract - nausea before vomiting, diarrhea, dysbacteriosis, hepatitis, cholestatic jaundice;
- from the side of the urinary system - interstitial nephritis is possible, that is, inflammation in the tubular kidney apparatus;
- with rapid administration of arrhythmia, headache, encephalopathy - reversible;
- allergic reactions - rashes, accompanied by itching, eosinophilia. With high sensitivity, Quincke's edema is possible.
Also, when the drug is administered, some patients note pain at the injection site.
Special instructions
Cefotaxime is an effective antibacterial agent, but it is because of its effectiveness that it should be administered cautiously, taking into account the patient's medical history.
- Thus, in case of renal failure or other organ damage, half doses are used. If the treatment is not effective, the appointment should be reviewed.
- Extreme caution requires the simultaneous use of nephrotoxic drugs and cefotaxime, since in this case the burden on the kidneys is very high. With this appointment, it is important to control the composition of peripheral blood, and it is carried out not only during therapy, but also for the next 10 days.
- Although the introduction of the drug is allowed even for newborns, it is better to avoid pregnancy during pregnancy.
- An overdose of the medication causes the allergic reactions described above.
- Cefotaxime, like any antibiotic, suppresses the intestinal microflora, but also reduces the production of vitamin K. Elderly patients are prescribed additional vitamin K preparations for the duration of treatment.
Interaction with other medications
Cefotaxime reacts in a certain way to medications of other classes that needtake into account when appointing.
- The drug can not be administered with substances that reduce platelet aggregation, otherwise the risk of bleeding is very high.
- Cefotaxime should not be combined with any anticoagulants, including non-steroidal anti-inflammatory drugs, as it significantly enhances the effect of the latter.
- Simultaneously with cefotaxime, do not prescribe a probenecid or its analogue, as the drug reduces calcium secretion, resulting in cefotaxime poorly excreted.
- Nephrotoxic drugs - loop diuretics, polymyxin B, aminoglycosides and others, together with cefotaxime, have too severe effects on the kidneys.
- In addition, it is impossible to mix the drug with any other substance in one syringe because of the danger of a chemical reaction.
Reviews
Cefatoxime is used to treat a variety of ailments, because it is active not only against gram-positive, but also gram-negative bacteria. This allows the doctor to reduce the amount and dose of antibiotics, thereby minimizing side effects.
If there are no allergic reactions and irritations, the course of therapy, including cektotaksim, does not affect the state of health of the patient. However, the prescription of the medicine involves a stay in the hospital. This is due to the need to observe the action of cefotaxime and to prevent its reaction with other drugs.
Analogues
Analogues of cefotaxime are preparations with another non-patented name or having the same active substance. To those include:
- cephalos;
- Claforan;
- cefanthral;
- Loraxim.
Cefotaxime is a semisynthetic antibiotic that suppresses reproduction and destroys a number of gram-positive and gram-negative bacteria. It is an antibiotic universal and is prescribed even for infants.
On cefotaxime in lactation, the video will be described below:
https: //www.youtube.com/ watch? V = lcTi8CuNK5g