Cefotaxime 3rd generation. Cefotaxime ® recipe in Latin. "Cefotaxime" and alcohol, as well as other important information about the medicine

Cefotaxime is a drug belonging to the group of latest generation antibiotics.

Due to its composition and pharmacological action, it is used to treat a wide variety of infectious diseases.

Presented as white powder, sold in glass bottles. The powder is used to prepare a solution.

The white powder of the drug is presented in the form sodium salt and consists of anhydrous cefotaxime.

The drug is administered intramuscularly or intravenously.

pharmachologic effect

The drug acts as a bactericidal agent, since it is active against gram-positive and gram-negative microorganisms.

In addition, it has a broad spectrum antimicrobial effect. Due to its composition, it is often used in the treatment of infectious diseases of the kidneys and lungs.

Pharmacokinetics of the drug

Cefotaxime is a quickly absorbed drug. Rapid absorption is noted - within 5 minutes after application, the constituent components enter the bloodstream and increase performance.

The biological availability of the drug is 95%. Removal of the presented drug from the body occurs within 1-1.5 hours, depending on the method of administration.

Up to 40% of the constituent components are excreted from the body in the urine. The remaining part of the substances turns into metabolites.

Mechanism of action

After administration of the drug, active destruction of the cell walls of existing microorganisms occurs.

Due to the destruction of the wall, their breathing is significantly impaired, as a result of which microorganisms die and their reproduction stops.

It should also be noted that due to the destruction of cells, fewer toxins enter the human body and harmful substances which have an adverse effect on general state and further development of the disease.

Use of the product for treatment and prevention

Indications for use of Cefotaxime:

Contraindications for use

Despite its useful pharmacological actions, Cefotaxime has many contraindications.

These include:

• individual intolerance and hypersensitivity to constituent components drug – to penicillins and cephalosporins;
• cannot be used for treatment during pregnancy and lactation;
• should not be used to treat diseases in children under two years of age.

Due to its rather serious contraindications, for example, hypersensitivity to components, the drug is used to treat diseases only as prescribed by a doctor.

Assignment scheme

Before using Cefotaxime, you should carefully read the instructions for use and permissible dosages drug.

Use of injection solution

Preparation of the solution requires compliance with the rules and dosage of the drug, which differ significantly depending on the method of administration.

There are three methods of treatment using the presented medicine:

1. Intravenous injection– per 1 g of active substance there are 4 ml of special sterile water intended for preparing the solution. The prepared injection composition is injected into the vein slowly, over at least 3 minutes.
2. Intravenous infusion– use 1-2 g active substance and 50-100 ml of solvent. The composition of the solvent may vary depending on the nature and severity of the disease. A solution of sodium chloride with a percentage of 0.9%, as well as glucose 5%, can be used here. The infusion time is at least 50-60 minutes.
3. Intramuscular injection– the method of dissolving the active substance is the same as in the case of intravenous injection. A 1% lidocaine solution can also be used as a solvent.

Compliance with the proportions in preparing the solution for injection is very important. The slightest mistakes can lead to an overdose and side effects.

Details on how to dilute antibiotics:

Basic doses

The dosage of Cefotaxime may vary dramatically depending on the degree and nature of the disease.

Specialist after necessary examination will draw up a drug administration regimen and dosage.

1. Treatment of simple infections without complications carried out by injecting the solution every 8-12 hours. To prepare the solution, 1 g of the active ingredient is used.
2. Infections moderate severity require administration of the drug every 12 hours, where 1-2 g of the active substance is used for preparation.
3. Serious illnesses require administration of the drug every 4-8 hours. The solution is made using 2 g of active substance.
4. As a preventive measure no more than 1 g of substance is used in preparing the solution. The frequency of injections should not exceed 6 hours.

The severity of the disease will be determined only by the attending physician based on the data obtained from the examination. Independent use and “prescribing” the drug is strictly prohibited.

Overdose and additional instructions

If the dosage of the drug is not observed, unpleasant side effects may occur. side effects, which will only worsen the already serious condition sick.

Side effects include nausea and vomiting, headaches and dizziness, increased or decreased blood pressure, diarrhea or constipation, skin rashes.

Among the most dangerous side effects include convulsions and increased body temperature with fever. True, this is only possible in the case of a fairly serious overdose.

When using the medicine as treatment and prevention, you should remember:

1. Side effects may occur in the first 2-3 days of using the drug. In most cases, in such situations, the medication is discontinued or the dosage and regimen of use are revised.
2. Drinking alcohol during treatment is strictly contraindicated. since this combination can lead to abdominal pain and other side effects.
3. Interaction with others medicines may lead to bleeding and skin lesions . The specialist who determines the treatment regimen takes this factor into account.
4. Prohibited for use during pregnancy and lactation – active substance penetrates the placenta and enters breast milk.
5. Children can only take this product from 2.5 years of age.. IN in case of emergency prescribed to premature and newborn babies. The dosage of the drug in one injection should not exceed 50 mg/kg.

The drug is subject to careful study and careful use, since chemical composition The drug can cause many side effects and lead to deterioration of health.

This is important - the opinion of doctors and patients

In order to know how effective and safe Cefotaxime is, as well as the nuances of its use, we recommend studying reviews from patients and specialists.

In case of severe and urinary system I always prescribe Cefotaxime to my patients. This drug has already proven itself as a fast-acting medicine.

In case of non-compliance with the dosage, problems are noted in the form of side effects.

Petr Valentov, urologist, Moscow

I often have exacerbations and... I dropped some medicine. I have not suffered from pain or other troubles for several months now.

Tatyana Somova, 29 years old, St. Petersburg

I work as a loader, so a slight breeze is dangerous for me. With pyelonephritis, he is immediately taken away in an ambulance. They always inject Cefotaxime. After just a couple of days, the first symptoms and pain disappear.

Now they use this remedy as a preventive measure. The doctor prescribed it. Helps.

Oleg Grishin, 41 years old, Vladivostok

From all the available reviews about treatment with this drug, we can conclude that Cefotaxime has positive impact on the body in the treatment and prevention of inflammatory and infectious diseases.

During use, it is important to follow the dosage prescribed by your doctor.

Purchase and storage

Cefotaxime is available in glass bottles, the price of one is 1 gram. active drug is no more than 25 rubles.

The shelf life of the drug is 2 years. Storage temperature should not exceed +25 degrees Celsius.

The sale of the medicine is carried out only with a prescription from a doctor.

If there is no medicine in the pharmacy

Among the most famous analogues of Cefotaxime are:

1. Ceftriaxone. This analogue has similar composition and action. However, as a side effect, bile stagnation is also noted here, which was not detected in Tsifotaxime. Therefore, the answer to the question of whether it is better to use Cefotaxime or Ceftriaxone is obvious.
2. Claforan. This analogue is no different from Tsifotaxim. But due to the fact that the drug is imported, its price is higher and lies within 120 rubles.

Cefotaxime ® is antibacterial drug, belonging to the group of cephalosporins III — th generation. The medicine has a bactericidal mechanism of action on pathogenic microorganisms and a wide range of activities. The release form is parenteral, that is, analogs of Cefotaxime ® are not produced in tablets. The antibiotic is administered exclusively intravenously or intramuscularly.

The effectiveness of the drug is determined by the fact that the active substance cefotaxime disrupts the synthesis of mucopeptides in the microbial membrane. The drug is active against gram- and gram+ pathogens resistant to other antibiotics, including strains that produce B-lactamases. The bactericidal effect extends to penicillin-, aminoglycoside- and sulfonamide-resistant bacteria.

The maximum concentration of the antibiotic in the blood plasma is achieved half an hour after intramuscular administration. When administered intravenously maximum level in plasma is achieved in five minutes. Cefotaxime ® has good binding to plasma proteins and provides an effective antibacterial concentration for twelve hours.

Also, it accumulates well in inflamed tissue and organ structures (heart muscle, bone, gallbladder, skin, subcutaneous fat). Significant therapeutic values ​​are also determined in body fluids; in particular, the antibiotic penetrates into the cerebrospinal, pericardial, pleural, peritoneal and synovial fluids.

Considering the ability of the antibiotic to overcome the placenta barrier, as well as to be excreted breast milk, Cefotaxime ® during pregnancy and breastfeeding can be prescribed only when absolutely necessary, when there is no more safe alternative. Breastfeeding must be stopped during therapy.

The drug is eliminated from the body through urine. About 20% of the excreted drug is utilized in the form of desacetylcefotaxime (a metabolite of cefotaxime ®, which also has antibacterial activity). Small part the drug is excreted with bile, and in lactating women - with breast milk.

Pharmacological group of the drug

Pharmacological group drug - antibiotics.

Cefotaxime ® is a 3rd generation parenteral cephalosporin.

Composition and release form of the drug

The active substance is cefotaxime.

The drug is used only by injection. In tablets, capsules, syrups, etc. Cefotaxime ® is not available, and there is no suspension for children either!

The solution is sold in bottles with lyophilisate (powder for making injection solution), containing five hundred, 1000 and 2000 milligrams of antibiotic in the form of Na salt. The prepared solution is administered intravenously or intramuscularly.

Photo of the packaging of Cefotaxime ® 1 bottle from PJSC BIOCHIMIC

Cefotaxime ® prescription in Latin

Rp.:Cefotaximi1.0.

D.t.d No. 12 in flac.

S. 1.0 2 times per/in

Spectrum of antimicrobial activity

Cefotaxime ® is active against bacteria resistant to aminoglycosides, penicillins, and sulfonamides.

The antibiotic is effective against staphylococci (including strains capable of producing penicillinase), streptococci, diphtheria corynebacteria, enterobacteria, Escherichia coli, acinetobacter, hemolytic bacillus (including strains resistant to ampicillin), Klebsiella, Neisseria (gonococci and meningococci), propionobacteria, protea, serrations, yersinia, bordetella, fusobacteria, bacteroides, moraxella, peptostreptococci, etc.

Compared to the first and second generation cephalosporins, Cefotaxime ® is less active against gramcocci.

Listeria, group D streptococci, and staphylococci that are resistant to methicillin are resistant to the antibiotic.

Indications and contraindications for use

The drug is successfully prescribed for infections varying degrees severity affecting:

• ENT organs;
• breath paths (upper and lower);
• urinary and reproductive system;
• organs abdominal cavity(including with the development of peritonitis);
• skin and fatty acids;
• musculoskeletal system.

Also, the antibiotic is prescribed for severe septicemia, bacteremia, meningitis (with the exception of meningitis caused by Listeria) and other infections of the central nervous system.

Cefotaxime ® can be used in the treatment of:

• complicated and uncomplicated forms of gonorrhea;
• chlamydia;
• Lyme disease;
• endocarditis;
• purulent-inflammatory diseases against the background of immunodeficiency states;
• heavy gynecological infections(including septic abortions).

In surgery it is used in for preventive purposes, to prevent the development of septic complications.

The medicine is contraindicated in persons with individual intolerance to B-lactam drugs, with bleeding, if the patient has a nonspecific ulcerative colitis, severe heart failure, AV block.

Despite the fact that cephalosporins are on the list of antibiotics approved for use during pregnancy, cefotaxime ® should only be used when absolutely necessary, in the absence of a safer alternative.

Cefotaxime ® for breastfeeding not prescribed. If it is necessary to use it in lactating women, breastfeeding is stopped for the entire period of treatment.

It is also necessary to consider age restrictions. The medicine can be administered intravenously from the first days of life, however intramuscular use allowed only from 2.5 years.

Can be used with caution to treat patients with chronic renal failure (CKD).

When administered intramuscularly, an additional contraindication is an allergy to lidocaine.

Dosage of Cefotaxime ® in injections

Suitable for IV and intramuscular injection. Cefotaxime ® can be administered intravenously either as a stream or as a drip. Be sure to do this before use skin test for antibiotic sensitivity. If the drug is administered intramuscularly, an additional test for lidocaine is performed.

Intravenous Cefotaxime ® can be used from the first days of life. Intramuscular administration is allowed for children over 2.5 years old.

For adult patients and children weighing more than 50 kilograms, the antibiotic is prescribed in a standard dose of 1000 mg twice a day. The prescribed dosages are adjusted according to the severity of the patient's condition. If necessary, the drug can be administered up to 6 times a day. The maximum daily dose is twelve grams.

Patients with an uncomplicated form of gonorrhea are administered 1000 mg once, intramuscularly. For women, repeated administration is recommended after twelve hours.

For infectious and inflammatory processes localized in the urinary tract, it is necessary to prescribe 1000 mg 2-3 times a day.

For the treatment of infectious diseases with a moderate course, it is necessary to administer 1-2 grams of the drug twice a day.

Cefotaxime ® for bronchitis in children weighing more than fifty kilograms is prescribed one thousand mg twice a day.

For severe infections (for example, meningitis), the dosage of Cefotaxime ® is 2 grams, every four to eight hours. Excess daily dose 12 grams is prohibited.

The duration of treatment with Cefotaxime ® depends on the severity of the disease; the minimum duration of drug therapy is seven days (with the exception of uncomplicated gonorrhea).

If an antibiotic is used before surgery, for prophylactic purposes to prevent purulent-septic complications, then it is administered in a dose of 1000 mg when the patient is put under anesthesia. If necessary, repeated administration is carried out after six to twelve hours.

Women who are indicated for delivery by caesarean section, 1000 mg of the drug is administered intravenously at the moment when a clamp is applied to the umbilical vein. Repeated administration of 1 gram of the drug - after six to twelve hours.

Cefotaxime ® for angina is prescribed in a course lasting from a week to 10 days.

For children weighing less than fifty kilograms, the daily dose is calculated by weight. The standard dose is from 50 to one hundred milligrams per kilogram. The resulting daily dose is divided into three to four administrations.

For meningitis and other severe infections, the daily dose can be increased. In this case, the child is prescribed from 100 to 200 milligrams per kilogram. The resulting dosage is administered four to six times.

Dose of Cefotaxime ® for newborns and premature infants

Cefotaxime ® 50 mg/kg/day for a child, divided into two doses, is prescribed until the 1st week of life. The drug is also prescribed to premature babies.

From one week to a full month of life, use from fifty to one hundred mg/kg per day, divided into three administrations.

Dose for patients with renal failure

Taking into account the fact that the drug is eliminated from the body in the urine, for persons with severe renal dysfunction, the dosage is reduced in accordance with creatinine clearance.

If clearance is less than 20 milliliters per minute, it is necessary to reduce the daily dose by half.

How to dilute an antibiotic?

If Cefotaxime ® is prescribed intravenously, then one gram of lyophilisate must be diluted in eight milliliters of 0.9 sodium chloride or solution for injection. The resulting solution must be homogeneous and free of suspended matter and foreign inclusions. The medication must be administered slowly, over three to five minutes.

If the drug is prescribed by drip, then one gram of lyophilisate is diluted with fifty milliliters of saline (preferred) or five percent glucose. The duration of the infusion is about an hour.

When prescribing Cefotaxime ® for intramuscular injections, the instructions recommend dissolving 1 gram of lyophilisate with four milliliters of water for injection, or four milliliters of a 1% lidocaine solution. The resulting solution is injected deep into the gluteal muscle (upper outer quadrant).

You can also dilute 1 gram of powder with two milliliters of solution for injection and add 2 ml of lidocaine (1%).

How to dilute Cefotaxime ® with novocaine?

The use of lidocaide as an anesthetic is more preferable. It is almost four times more powerful than novocaine and lasts longer. In addition, novocaine is prohibited for use in children under 12 years of age.

Instructions for use of Cefotaxime ® also contain information that intramuscular injections are made with lidocaine or injection solution.

As a rule, novocaine is prescribed to adults and patients over twelve years of age who have contraindications to the use of lidocaine.

In this case, use 4 milliliters of 0.5% novocaine solution per 1 gram of antibiotic. The resulting solution is also injected into the upper outer quadrant of the gluteal muscle.

It is important to remember that administering an antibiotic diluted with lidocaine or novocaine into a vein is strictly prohibited!

Side effects of Cefotaxime ®

The most common complications are gastrointestinal disorders and allergies. Other violations are rare.

Undesirable effects from antibiotic treatment can be manifested by disruption of the gastrointestinal tract (dyspeptic disorders, flatulence, abdominal pain, intestinal dysbiosis, stomatitis and glossitis rarely occur).

When treated with Cefotaxime ®, there is a risk of pseudomembranous colitis. It's hard and dangerous complication, which is accompanied long-term diarrhea(up to 20 times a day). It is associated with the activation of Clostridium difficillium in the intestine, so treatment includes immediate discontinuation of cephalosporin ® and the appointment of Vancomycin ® or Metronidazole ® (drugs are administered orally).

Women may develop thrush after treatment.

Allergic reactions may be varying degrees severity from hives or itchy skin, to angioedema, toxic epidermal necrolysis, anaphylactic reactions etc.

The hepatobiliary system can react with hepatitis, acute liver failure, stagnation of bile, jaundice, etc.

There may also be changes in blood tests. A decrease in the number of neutrophils, leukocytes, agranulocytes, and an increase in the number of eosinophils may be observed. IN biochemical analysis Hepatic transaminases may increase.

Very rarely develop hemolytic anemia and hypocoagulation.

Sometimes patients complain of headaches, increased fatigue and drowsiness. In isolated cases, convulsions and reversible encephalopathy are possible.

At the injection site, pain, redness, tissue infiltration (with intramuscular injection) or phlebitis (with intravenous injection) are possible.

Cefotaxime ® during pregnancy

That is, the drug can be prescribed to pregnant women if necessary, in cases where there is no safer alternative.

In a study in pregnant rats, the antibiotic was not found to be teratogenic or mutagenic, but there are no reliable data from controlled studies in humans.

In this regard, antibiotics can be prescribed to pregnant women, after a very careful balance of risk and benefit.

Cefotaxime ® and alcohol - compatibility

The cephalosporin group of antibiotics is not compatible with alcohol. This combination can lead to the development of disulfiram-like reactions. They can manifest as uncontrollable vomiting, tachycardia, rhythm disturbances, feelings of fear, mental disorders, tinnitus, sharp drop blood pressure (up to collapse). IN severe cases available death, due to toxic damage to the liver and nervous system.

Cefotaxime ® analogues

The product can be produced under the trade names:

• Claforan ® ;
• Clafotaxime ® ;
• Cefotaxime ® produced by Biokhimik ® Saransk;
• Razibelakta ® ;
• Cephabol ® ;
• Cefotaxime ® , Lecco ® ;
• Liforan ® ;
• Intrataxim ® ;
• Duatax ® ;
• Cefotaxime ®, Biosynthesis ®;
• Taksim®;
• Cephajet ® .

Which is better, Cefotaxime ® or Ceftriaxone ®?

Both drugs belong to the third generation of cephalosporins and have a similar mechanism of action and spectrum of antimicrobial activity.

Today, antibiotics that have wide range actions, are used by specialists for the treatment of various infectious and inflammatory ailments. Before prescribing treatment, the patient must undergo an examination so that the doctor can determine which drug will perform well during therapy specific disease. To eliminate diseases of the genitourinary and respiratory systems in children and adults, Cefotaxime is often used.

Composition and release form of the drug

The drug Cefotaxime contains active ingredient– anhydrous cefotaxime (sodium salt). Additional substances not included in the tool. The medication has the appearance of a white powder (sometimes with a yellow tint) and is used to create a solution that is injected into the gluteal muscle or intravenously.

The product is packaged in 10 ml bottles, which are sold in cardboard boxes with instructions. Each container contains 0.5, 1 or 2 g of active ingredient. The medicine is available exclusively in the form of injections - there are no suspensions or tablets of Cefotaxime.

pharmachologic effect

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The drug is a semi-synthetic antibiotic belonging to the group of cephalosporins III generation. It is effective against long list gram-negative and gram-positive bacteria, and is also used against microorganisms that are resistant to other antibiotics, including the penicillin group.

The product produces a bactericidal effect by disrupting the synthesis of bacterial cell walls. After administration of the medication maximum concentration in the body is achieved in 40–60 minutes. The bactericidal effect lasts about 12 hours. The active substance is excreted by the kidneys. The drug has several advantages:

Unlike other antibiotics, Cefotaxime combines well with many medications. In addition, the drug rarely causes side effects– gastrointestinal disorders are the most common problem.

For what diseases is Cefotaxime prescribed to a child?

Cefotaxime is used for infectious diseases, more often respiratory system:

• pneumonia;
• pleurisy;
• bronchitis;
• abscess.

The remedy is also used for other ailments:

Cefotaxime injections are indicated for the treatment of pneumonia in children, but they are prescribed only if other means are ineffective. Third generation antibiotics are quite toxic, so bacterial pneumonia begin treatment with penicillin group drugs. If the bacteria are resistant to them, the doctor resorts to using Cefotaxime.

Cefotaxime injections: instructions for use in children for various diseases

How many days to inject the baby with the drug depends on the complexity of the disease. The dosage of the medicine and the duration of therapy are determined by the doctor, but most often the injections are given according to the following scheme:

Disease	Required dose and frequency of administration
Uncomplicated infectious disease	Injection into the muscle 1 g every 8–12 hours
Infection medium shape gravity	Administration 1–2 g every 12 hours
Severe form infectious disease(eg meningitis)	IV 2 g every 4–8 hours
Mild gonorrhea	Injection into the muscle 1 time per day, 1 g
Complicated sore throat in a child	The drug is prescribed in a course of up to 10 days, the dose depends on age
Infectious and inflammatory disease urinary tract	1 g 2–3 times a day
Bronchitis	1000 mg twice daily (weighing more than 50 kg)
Prevention of postoperative complications	1 g before surgery and 1 g three times a day on the first day after the procedure

Therapy cannot be interrupted, as the disease may worsen, which will require the use of stronger drugs.

How to properly dilute Cefotaxime Novocaine?

Since the antibiotic is in powder form, it must be made into a solution before use. The product must be diluted in the correct proportion:

• For injections into a vein, you need to add 4 ml of sterile water to 1 g of powder. The resulting product is administered slowly (3–5 minutes).
• For intravenous infusion, 1 g of powder is mixed with 50 ml of 0.9% sodium chloride solution or 5% glucose. The infusion is carried out over an hour.

After mixing the powder with the liquid, it is recommended to shake the container so that the grains are completely dissolved. Water or solutions can be purchased at the pharmacy in ampoules.

For intramuscular administration, Cefotaxime can also be diluted with water, but the injections are painful, so it is recommended to dilute the lyophilisate with Lidocaine 1% or Novocaine 0.5%. These drugs do not react with antibiotics. To 1 g of powder you need to add 4 ml of Novocaine.

Drug dosage rules

Cefotaxime is prescribed to children from birth, but only in the form of injections and infusions. Intramuscular injections The drug is allowed from the age of 2.5 years. Product dosage:

• newborns up to 1 week - 50 mg per 1 kg of weight every 12 hours;
• babies aged 1–4 weeks - a similar dose, but every 9 hours;
• children over 2.5 years old and weighing more than 50 kg – 50–180 mg per 1 kg of weight;
• for severe infectious diseases, the dose is increased to 100–200 mg per 1 kg of body weight;
• for adolescents and adults, 1–2 g of the drug is administered every 4–12 hours.

If necessary, the daily amount of the drug can be divided into 4–6 injections. The maximum dose of medication per day is 12 g. Mixing the drug in a syringe with other medications is prohibited, as there is a risk of a chemical reaction.

What side effects can occur when using an antibiotic?

When using the drug, a child may experience various side effects:

During treatment, there is a risk of developing pseudomembranous colitis - a complication that appears against the background of the activity of the bacterium Clostridium difficile and is accompanied by frequent diarrhea. In this case, it is necessary to discontinue Cefotaxime and start taking Metronidazole or Vancomycin.

If the maximum daily dose is exceeded, the patient may experience:

• convulsions;
• trembling of individual parts of the body;
• encephalopathy;
• nervous excitability.

Analogues of the antibiotic Cefotaxime

The cost of the drug is within 160 rubles for 5 ampoules of 1 g. Today, Cefotaxime can be easily replaced, but analogues must be selected by a doctor.

A drug	Release form	Peculiarity	Price for 1 ampoule
Terzef	powder for creating a solution for injection	Contains the antibiotic ceftriaxone, has a pronounced bactericidal effect, and is effective in the treatment of infections (we recommend reading:). Approved for treatment from birth.	from 50 rubles
Claforan		Can be used for newborns. The product is used to treat patients with infections of the genital organs, respiratory system, musculoskeletal system and skin.	170 rubles
Cefantral		There are dosages of 250, 500 and 1000 mg of sodium salt, which is convenient for treating children.	from 16 rubles
Cephabol		The drug contains cefotaxime 500 or 1000 mg.	from 38 rubles
Kefotex		The product includes cefotaxime 250, 500 and 1000 mg.	about 50 rubles
Pancef (we recommend reading:)	tablets and suspension	Antibacterial activity is similar to Cefotaxime. The product is approved from 6 months.	10 tablets - 700 rubles, suspension - 450 rubles
Zinnat (we recommend reading:)		The spectrum of activity is similar to Cefotaxime. The drug can be used to treat children.	10 pills - 250 rubles, syrup - 300 rubles
Ixim Lupine	powder for making syrup	The active substance is cefixime. The product has a pleasant berry taste and can be prescribed from the age of 6 months.	about 470 rubles

The instructions for the medicine are not instructions for action. Prescription of the drug and definition required dosage is handled by the attending physician. The selection of an analogue is carried out according to indications.

Pharmacological group: antibiotics
Systematic (IUPAC) name: (6R,7R,Z)-3-(acetoxymethyl)-7-(2-(2-aminothiazol-4-yl)-2-(methoxyimino)acetamido)-8-oxo-5-thia -1-azabicyclooct-2-ene-2-carboxylic acid
Trade names Claforan; Cefatam (LGls)
Legal status: Available by prescription only
Application: intravenous
Metabolism: liver
Half-life: 0.8-1.4 hours
Elimination: 50-85% renal
Formula: C 16 H 17 N 5 O 7 S 2
Mol. mass: 455.47 g/mol

Cefotaxime is a third generation cephalosporin antibiotic. Like other third generation cephalosporins, it has a broad spectrum active action against gram-positive and gram-negative bacteria. In most cases, the drug is considered equivalent to Ceftriaxone in terms of safety and effectiveness.

Mechanism of action

Cefotaxime inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs). This inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus preventing cell wall biosynthesis. The bacteria are eventually lysed due to the continued activity of autolytic cell wall enzymes (autolysins and murein hydrolases) while cell wall formation is delayed. Cefotaxime, like other β-lactam antibiotics, not only blocks the division of bacteria, including cyanobacteria, but also blocks the division of cyanella, the photosynthetic organelles of Glaucophytes, and the division of bryophyte chloroplasts. However, the drug does not have any effect on the plastids of highly developed vascular plants. This supports the endosymbiotic theory and points to the evolution of plastid partitioning in land plants.

Bacterial sensitivity spectrum

Cifotaxime is used to treat a wide range of diseases associated with bacterial activity, causing infections bones, central nervous system, skin and lower respiratory tract. Known species include Streptococcus, Staphylococcus, Enterococcus and Escherichia. The susceptibility data for several microorganisms of medical importance are presented below.

Haemophilus influenzae infection: ≤ 0.007 µg/ml - 0.5 µg/ml Staphylococcus aureus: 0.781 µg/ml - 172 µg/ml Pneumococcus: ≤ 0.007 µg/ml - 8 µg/ml

Clinical Application

Cefotaxime is used for infections of the respiratory tract, skin, bones, joints, genitourinary system, meninges and blood. It generally has a broad spectrum of activity against most gram-negative bacteria, with the exception of Pseudomonas. It is also effective against most gram-positive cocci, except enterococcus. He has moderate activity against the anaerobic organism Bacteroides fragilis. For meningitis, Cefotaxime crosses the blood-brain barrier better than Cefuroxime.

Cefotaxime: instructions for use

Lower respiratory tract infections, including pneumonia caused by Streptococcus pneumoniae (with decreased sensitivity to penicillin), E. coli, Klebsiella spp., H. influenzae (including ampicillin-resistant strains), P. mirabilis, S. marcescens and Enterobacter spp. Urinary tract infections caused in particular by Citrobacter SPP, Enterobacter SPP, E. coli, Klebsiella SPP, P. mirabilis, Proteus vulgaris, M. morganii, Providencia rettgeri and S. marcescens.. Cases of gonorrhea without complications, including those caused strains of gonococci producing penicillinase. Infections in the pelvic area, including those caused by E.coli, P. Mirabilis, anaerobic cocci - Peptostreptococcus spp. and Peptococcus spp., as well as some strains of Bacteroides spp, including B. fragilis, Clostridium spp. Sepsis and/or bacteremia caused, in particular, by strains of E. coli, Klebsiella spp, S. marcescens. Skin and soft tissue infections caused by E.coli, Enterobacter SPP, Klebsiella SPP, P. Mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Pseudomonas SPP, S. marcescens, Bacteroides spp. and anaerobic cocci - Peptostreptococcus spp. i Peptococcus spp. Intra-abdominal infections, including peritonitis caused by E.coli, Klebsiella spp., Bacteroides spp., Peptostreptococcus spp. and Peptococcus spp. Infections of bones and joints, including those caused by strains of H. influenzae, Streptococcus spp., P. mirabilis. CNS infections, including meningitis caused by N. meningitidis, H. influenzae, S. pneumoniae, K. pneumoniae and E. coli. Prevention of infections in postoperative period, numerous studies have shown that its effectiveness does not exceed the effectiveness of prophylaxis using first-generation cephalosporins.

Contraindications

Hypersensitivity to cephalosporins. Caution should be used in patients allergic to penicillin, due to the possibility of developing a cross-reaction. gastrointestinal diseases(especially with colitis), elderly patients or patients with renal failure. Cefotaxime should be used with caution in patients concurrently taking aminoglycoside antibiotics or potent diuretics. For children under 2 months of age, the drug is administered intravenously only.

Drug interactions

Cefotaxime exhibits a synergistic effect with aminoglycoside antibiotics, vancomycin, and anticoagulants (coumarin derivatives). Probenecid, azlocillin and mezlocillin significantly lengthen the time of its action. For infections involving anaerobes, it must be used in combination with metronidazole or clindamycin. Do not mix with aminoglycoside antibiotics, metronidazole, sodium bicarbonate due to incompatibility. Solutions of cefotaxime should not be mixed (for example, in the same syringe) with solutions of aminoglycosides, and if used simultaneously, injections of these drugs must be administered intravenously. different places. During the use of cefotaxime, it is possible false positive results reduction tests for the presence of glucose in urine. In serological tests, the Coombs test result may be false positive.

Cefotaxime: side effects

Local reactions: phlebitis after intravenous administration, pain at the injection site, induration and soreness after intramuscular injection; increased sensitivity: rash, itching, urticaria, bronchospasm, fever; gastrointestinal disorders: diarrhea, sometimes nausea and vomiting, very rarely pseudomembranous colitis; temporary increase in the activity of liver transaminases and alkaline phosphatase; temporary increase in serum creatinine levels; changes in blood composition: granulocytopenia, leukopenia, eosinophilia, neutropenia, hemolytic anemia, thrombocytopenia; headache; superinfection caused by Candida (inflammation of the vaginal mucosa). In case of overdose, especially in patients with renal failure, there is a risk of developing reversible encephalopathy. Symptomatic treatment. Hemodialysis or peritoneal dialysis can be used.

Cefotaxime: dosage

Intramuscular or intravenous Adults and children aged 12 years: 2 g per day in 2 doses, moderate and severe infections 3-6 g per day in 3 doses, for severe infections requiring higher doses, for example, sepsis 6-8 g per day in 3-4 intravenous injections, with life-threatening infections intravenously 12 g per day in 6 injections. For gonorrhea, a single dose of 1 g intramuscularly. The maximum dose is 12 g per day. Children. Premature children and infants under 7 days of age - iv 50-100 mg/kg body weight per day in 2 injections. Infants aged 7 days to 1 month - IV 75-150 mg/kg body weight per day in 3 injections. Infants over 2 months and children under 12 years of age: children weighing less than 50 kg intramuscularly or intravenously 50-180 mg/kg body weight per day in 4-6 injections. More high doses should be used for severe infections, including meningitis; in children weighing more than 50 kg, the same dose is usually used as in adults. The maximum dose is 12 g per day. Children under 2.5 years of age should not be administered solutions of the drug with lidocaine. As a prophylaxis, 1 g 30-90 minutes before surgery. Depending on the indications, the dose can be re-administered after 6 and 12 hours. In individuals with a creatinine clearance of 5-20 ml/min, it is recommended to reduce the dose by half; at clearance<5 мл / мин вводить 0,5 г через каждые 12 часов.

Availability:

Cefotaxime is used to treat severe bacterial infections caused by sensitive microorganisms: central nervous system infections (meningitis); infections of the respiratory tract and ENT organs; urinary tract; bone and joint infections; skin and soft tissue infections; pelvic organ infections; chlamydia; gonorrhea; infected wounds and burns; peritonitis; sepsis; abdominal infections; endocarditis; Lyme disease (borreliosis); salmonellosis; infections due to immunodeficiency. The drug is also used to prevent infections after surgical operations (including urological, obstetric-gynecological, and gastrointestinal). The drug is available with a prescription.

Notes

It is recommended to monitor renal function in seriously ill patients receiving high doses of antibiotics. In patients taking cefotaxime for more than 10 days, blood morphology should be monitored.

The page contains instructions for use Cefotaxime. It is available in various dosage forms of the drug (injections in ampoules for injections of 500 mg and 1 g), and also has a number of analogues. This abstract has been verified by experts. Leave your feedback on the use of Cefotaxime, which will help other site visitors. The drug is used for various diseases (pneumonia, endocarditis, sepsis and other infectious diseases). The product has a number of side effects and interactions with other substances. Doses of the drug differ for adults and children. There are restrictions on the use of the medicine during pregnancy and breastfeeding. Treatment with Cefotaxime should only be prescribed by a qualified physician. The duration of therapy may vary and depends on the specific disease. Methods for diluting the antibiotic (in water or novocaine) and the effect of the drug.

Instructions for use and dosage

The drug is administered intravenously (stream or drip (in a dropper) and intramuscularly.

The drug is prescribed to adults and children over 12 years of age (with body weight ≥50 kg)

For uncomplicated infections, as well as for urinary tract infections - 1 g IM or IV every 8-12 hours.

For uncomplicated acute gonorrhea - intramuscularly in a dose of 1 g once.

For moderate infections - 1-2 g intramuscularly or intravenously every 12 hours.

For severe infections, for example, meningitis - 2 g IV every 4-8 hours, maximum daily dose -12 g. The duration of treatment is determined individually.

In order to prevent the development of infections before surgery, it is administered during induction of anesthesia in a single dose of 1 g. If necessary, the administration is repeated after 6-12 hours.

For caesarean section - at the moment of applying clamps to the umbilical vein - intravenously at a dose of 1 g, then 6 and 12 hours after the first dose - an additional 1 g.

Premature and newborns under 1 week of age - IV at a dose of 50 mg/kg every 12 hours; at the age of 1-4 weeks - IV at a dose of 50 mg/kg every 8 hours. Children weighing ≤50 kg - IV or IM (children over 2.5 years old) 50-180 mg/kg IV 4-6 injections.

In case of severe infections (including meningitis), the daily dose when prescribed to children is increased to 100-200 mg/kg, IM or IV for 4-6 injections, the maximum daily dose is 12 g.

Rules for preparing injection solutions (how to dilute Cefotaxime)

For intravenous injection: 1 g of the drug is diluted in 4 ml of sterile water for injection; the drug is administered slowly over 3-5 minutes.

For intravenous infusion: 1-2 g of the drug is diluted in 50-100 ml of solvent. The solvent used is 0.9% sodium chloride solution or 5% dextrose (glucose) solution. Duration of infusion - 50 - 60 minutes.

For intramuscular administration: 1 g is dissolved in 4 ml of solvent. Water for injection or a 1% solution of lidocaine (novocaine) is used as a solvent.

Release forms

Powder for the preparation of a solution for intravenous and intramuscular administration (injections in ampoules for injection) 250 mg, 500 mg and 1 gram of powder for dilution in water for injection or novocaine.

Cefotaxime- cephalosporin antibiotic of the 3rd generation with a wide spectrum of action. It has a bactericidal effect by inhibiting the synthesis of bacterial cell walls. The mechanism of action is due to acetylation of membrane-bound transpeptidases and disruption of peptidoglycan cross-linking, which is necessary to ensure the strength and rigidity of the cell wall.

Highly active against gram-negative bacteria (resistant to other antibiotics): Escherichia coli (Escherichia coli), Citrobacter spp., Proteus mirabilis, Providencia spp., Klebsiella spp., Serratia spp., some strains of Pseudomonas spp., Haemophilus influenzae.

Less active against Streptococcus spp. (including Streptococcus pneumoniae), Staphylococcus spp., Neisseria meningitidis, Neisseria gonorrhoeae, Bacteroides spp.

Resistant to most beta-lactamases.

Pharmacokinetics

Rapidly absorbed from the injection site. Plasma protein binding is 40%. Widely distributed in tissues and body fluids. Reaches therapeutic concentrations in the cerebrospinal fluid, especially in meningitis. Penetrates the placental barrier and is excreted in breast milk in low concentrations. 40-60% of the dose is excreted unchanged in the urine after 24 hours, 20% in the form of metabolites.

Indications

Infectious and inflammatory diseases caused by sensitive microorganisms, including:

• central nervous system infections (meningitis);
• infections of the respiratory tract and ENT organs;
• urinary tract infections;
• bone and joint infections;
• skin and soft tissue infections;
• pelvic organ infections;
• abdominal infections;
• peritonitis;
• sepsis;
• endocarditis;
• gonorrhea;
• infected wounds and burns;
• salmonellosis;
• Lyme disease;
• infections due to immunodeficiency;
• prevention of infections after surgical operations (including urological, obstetric and gynecological, on the gastrointestinal tract).

Contraindications

• pregnancy;
• children up to 2.5 years of age (for intramuscular administration);
• hypersensitivity (including to penicillins, other cephalosporins, carbapenems).

special instructions

In the first weeks of treatment, pseudomembranous colitis may occur, manifested by severe, prolonged diarrhea. In this case, stop taking the drug and prescribe adequate therapy, including vancomycin or metronidazole.

Patients with a history of allergic reactions to penicillins may have increased sensitivity to cephalosporin antibiotics.

When treating with the drug for more than 10 days, monitoring of the peripheral blood picture is necessary.

During treatment with cefotaxime, it is possible to obtain a false-positive Coombs test and a false-positive urine test for glucose.

During treatment, you should not drink alcohol, since effects similar to those of disulfiram are possible (facial hyperemia, spasms in the abdomen and stomach, nausea, vomiting, headache, decreased blood pressure, tachycardia, shortness of breath).

Side effect

• headache;
• dizziness;
• renal dysfunction;
• oliguria;
• nausea, vomiting;
• diarrhea or constipation;
• flatulence;
• abdominal pain;
• dysbacteriosis;
• stomatitis;
• glossitis;
• pseudomembranous enterocolitis;
• hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia, agranulocytosis;
• potentially life-threatening arrhythmias following rapid central venous bolus administration;
• increased concentration of urea in the blood;
• positive Coombs reaction;
• phlebitis;
• pain along the vein;
• pain and infiltration at the site of intramuscular injection;
• hives;
• chills or fever;
• rash;
• skin itching;
• bronchospasm;
• eosinophilia;
• anaphylactic shock;
• superinfection (vaginal and oral candidiasis).

Drug interactions

Cefotaxime increases the risk of bleeding when combined with antiplatelet agents and nonsteroidal anti-inflammatory drugs.

The risk of kidney damage increases with concomitant use of aminoglycosides, polymyxin B and loop diuretics.

Drugs that block tubular secretion increase plasma concentrations of cefotaxime and slow down its elimination.

Pharmaceutical interactions

Pharmaceutically incompatible with solutions of other antibiotics in the same syringe or dropper.

Analogues of the drug Cefotaxime

Structural analogues of the active substance:

• Intrataxim;
• Kefotex;
• Clafobrine;
• Claforan;
• Clafotaxime;
• Liforan;
• Oritax;
• Oritaxim;
• Resibelacta;
• Spirosine;
• Tax o bid;
• Talcephus;
• Tarcefoxime;
• Tirotax;
• Cetax;
• Cephabol;
• Cefantral;
• Cefosin;
• Cefotaxime Lek;
• Cefotaxime sodium;
• Cefotaxime Sandoz;
• Cefotaxime Vial;
• Cefotaxime sodium salt.

Use in children

Contraindicated in children under 2.5 years of age (for intramuscular administration).

Use during pregnancy and breastfeeding

Cefotaxime is contraindicated for use during pregnancy.

If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.