Cephalosporin antibiotic II generation of cephamycins group for parenteral administration. The bactericidal action is due to the blocking of bacterial transpeptidase, which leads to disruption of the closing stages of the cell walls of microorganisms synthesis. It has a broad antimicrobial spectrum against both aerobic and anaerobic bacteria. The unique molecular structure tsefoksitina determines its high resistance to bacterial beta-lactamases. It is active against gram-positive aerobes – of Staphylococcus aureus and of Staphylococcus epidermidis (including producing and producing no penicillinase-producing strains), beta-hemolytic group A streptococci ( of Streptococcus pyogenes ), beta-hemolytic streptococci group In ( Streptococcus agalactiae ), Streptococcus pneumoniae ; aerobic Gram – Escherichia coli, Haemophilus influenzae, Eikenella corrodens (not beta-lactamase producing strains),K. pneumoniae, of Neisseria gonorrhoeae (including producing and producing no penicillinase strains), Morganella morganii, the Proteus mirabilis, the Proteus vulgaris, Providencia spp. (including Providencia rettgeri), Salmonella spp, Shigella spp,.. as well as clinically significant anaerobes – of Actinomyces spp,. Clostridium spp. (except Clostridium difficile), Peptococcus niger, Peptostreptococcus spp. , microaerophilic Streptococcus, Bacteroides distasonis, Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides spp., Prevotella bivia. anadrol reviews activity against metitsillinoustoychivyh Staphylococcus spp., enterococcus, Listeria monocytogenes, Enterobacter cloacae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Mycobacterium spp., Rickettsia spp., Chlamydia spp., Mycoplasma spp., Ureaplasma spp.
After 5 min after bolus intravenous (i / v) administration of 1 g and 2 g anadrol reviews maximum serum concentration (Cmax) is 110 and 244 mg / l, respectively. After 4 hours after intravenous administration at a dose of 1 g serum concentrations less than 1 mg / l. Following intramuscular (i / m) administration of 1 g of anadrol reviews Cmax observed and after 20 minutes is 30 mg / liter.
It penetrates into fluids and tissues of the body: the pleural, ascites and synovial fluid; bactericidal concentrations determined in bile. The volume of distribution – 0.16 l / kg. Relationship to plasma proteins – 70-80%. Excreted in breast milk in low concentrations.
Excreted mainly by the kidneys in unchanged form (85% by glomerular filtration, 6% – tubular secretion), while in urine are high concentrations of the drug. In the form of inactive metabolites derived only 0.2-5% of the administered dose. The half-life (T ½ ) when administered intravenously is from 41 to 59 minutes, in the elderly – from 51 to 90 minutes.
Infections caused by susceptible microorganisms:
- lower respiratory infections, including pneumonia, empyema pleura, lung abscess;
- abdominal infections, including peritonitis, abdominal abscess;
- infectious and inflammatory diseases of the pelvic organs, including endometritis, pelvioperitonit, salpingo;
- Urinary tract infections (pyelitis, pyelonephritis);
- Skin and soft tissue infections,
- infections of bones and joints;
- uncomplicated gonorrhea;
Prevention of postoperative infectious complications.
Hypersensitivity to anadrol reviews and other cephalosporin antibiotics.
In patients with allergic reactions to penicillin in history as possible cross-allergy between penicillins and cephalosporins; When specifying a history of ulcerative colitis; renal insufficiency.
Pregnancy and lactation
Application Anaerotsefa ® in pregnant women is possible in cases where the expected benefit to the mother outweighs the potential risk to the fetus and should be administered under the supervision of a specialist. During treatment anadrol reviews should stop breastfeeding.
Dosing and Administration
Depending on the dose and the severity of the infection, Anaerotsef ® can be administered in / in (jet or / drip) or / m.
For adults sredneterapevticheskih dosage is 1-2 g every 6-8 hours.
In uncomplicated urinary tract infections – in / m 2 to 1 g twice daily. In uncomplicated gonorrhea, including penicillinase-producing strains caused by Neisseria gonorrhoeae , administered once / m at a dose of 2 g; at the same time (or 1 hour later) is taken orally 1 g probenecid.
In severe infections in / route of administration is preferred; appoint 2 g every 4 hours or 3 g every 6 hours. The daily dose should not exceed ’12
Tsefoksitin excreted from the body mainly by the kidneys, so patients with kidney failure require correction of the mode of administration depending on creatinine clearance values (see. table ):
Dosing Anaerotsefa ® in patients with renal insufficiency
ml / min
|Dose, g||The interval between
Patients, located on hemodialysis, it is recommended after each hemodialysis additionally administered 1-2 g Anaerotsefa ® . Children older than 1 month. Anaerotsef ® is administered at the rate of 30-40 mg / kg every 6-8 hours (maximum daily dose should not exceed 12 g). In mild and moderate infections may intramuscular injection, in severe infections preferably by intravenous injection or infusion of the drug. Children up to 3 months. Anaerotsef ® is administered only intravenously. Newborn and first week of life in preterm infants weighing more than 1500 g is administered intravenously at a dose of 30-40 mg / kg every 12 hours; newborn 1-4 weeks. . lives of 30-40 mg / kg intravenously every eight hours for adults for the prevention of postoperative infectious complications introduced into / in a dose of 2 grams per 30 minutes prior to surgery; if indicated, in the first postoperative day 2 g every 6 hours. During the cesarean section 2 g Anaerotsefa ® is administered in / in immediately after cord clamping.Babies and children up to 12 years, Anaerotsef ® is administered in / in 30 minutes before the operation at a dose of 30-40 mg / kg. As indicated, in the first postoperative day the drug further administered 30-40 mg / kg every 6-8 hours (neonatal – 08.12 h).
Preparation of solutions, methods of administration Intramuscular For the / m of sterile powder Anaerotsefa ® dissolved in sterile water for injection, 0.5% or 1% lidocaine hydrochloride solution. The following minimum amount of solvent is added directly into a vial of dry powder of the antibiotic:
|The vial containing 0.5 g Anaerotsefa ®||1 ml|
|The vial containing 1.0 g Anaerotsefa ®||2 ml|
The resulting solution is injected deep intramuscularly in the areas of the body with pronounced muscular layer (the upper-outer quadrant of the buttock or the lateral surface of the thigh). It is recommended to conduct a test on the aspiration to avoid unwanted introduction of the solution into a blood vessel. Intravenous For in / bolus Anaerotsef ® dissolved in sterile water for injection. The following minimum amount of solvent is added directly into a vial of dry powder of the antibiotic:
|The vial containing 0.5 g Anaerotsefa ®||5 ml|
|The vial containing 1.0 g Anaerotsefa ®||10 ml|
The resulting solution was introduced into / in slowly, over 3-5 minutes; . can be introduced through a special node or port injection system for the on / in infusion if the patient receives parenteral fluid
For in / drip in a 0.5 g Anaerotsefa ® is dissolved in 5 ml, 1 g – 10 ml of sterile water for injection. The resulting solution was added to the vial containing 50-400 ml compatible infusion fluid: 0.9% NaCl solution, 5% dextrose solution, an aqueous solution containing 5% dextrose and 0.9% sodium chloride; intravenously administered using intravenous infusion system.
Do not use solutions containing preservatives (e.g. benzyl alcohol in bacteriostatic water for injection) for the preparation of solutions Anaerotsefa ® , used in infants.
Side effects: Allergic reactions : rash, exfoliative dermatitis, toxic epidermal necrolysis (Lyell’s syndrome), eosinophilia, fever, shortness of breath, rarely – anaphylactic reactions, angioedema. Local reactions : thrombophlebitis after intravenous injection; pain, induration in places in / m injections From the urinary system : increased serum creatinine, interstitial nephritis, renal failure. From the digestive system : nausea, vomiting, dry mouth, decreased appetite, diarrhea, pseudomembranous enterocolitis. On the part of the system blood: leukopenia, granulocytopenia, neutropenia, anemia, thrombocytopenia, bone marrow suppression, hemolytic anemia. cardio-vascular system: arterial hypotension. Laboratory findings: patients with azotemia possible false positive Coombs’ test, increased activity of “liver” enzymes. Other: worsening trends myastenia gravis.
Interaction with other medicinal products
In an application with aminoglycosides observed synergy of antimicrobial activity, mainly in respect of the Enterobacteriaceae .
Solutions Anaerotsefa ® is compatible with 0.9% sodium chloride solution, 5% dextrose; solution for infusion containing 0.45% NaCl and 5% dextrose; solution for infusion containing 0.9% sodium chloride and 5% dextrose; 5% dextrose in Lactated Ringer’s solution, lactated Ringer’s solution, 2.5%, 5% and 10% solution of mannitol, M / 6 sodium lactate solution.
It should not be mixed in the same syringe or a fluid medium solutions Anaerotsefa ® and aminoglycosides .
Drugs that block tubular secretion, increase in blood drug concentration and duration of action.
The concurrent use of other cephalosporins, aminoglycosides and increases the risk of nephrotoxicity.
Anaerotsef ® is used as a single antibiotic (monotherapy) for the treatment of mixed aerobic-anaerobic infections a wide variety of locations, including those caused by bacterial strains that are resistant to penicillins, other cephalosporins, lincosamides and aminoglycosides.
Patients who had a history of allergic reactions to penicillins, may be sensitive to cephalosporin antibiotics.
should be used solvent without preservatives for the treatment of newborns. The use of high doses in children is accompanied by an increase in the frequency of eosinophilia and increased activity asparaginamino-transferases.
Anaerotsef ® is not recommended for the treatment of bacterial meningitis.
When using the method of Jaffe may falsely inflated the concentration of creatinine in serum, it is not recommended to take blood samples for determination of creatinine for 2 anadrol reviews hours after administration.