2010/06/14

Cefoperazone

International name:
Cefoperazone (Cefoperazone)

Group Affiliation:
Antibiotic, cephalosporin

Description of the active substance (INN):
Cefoperazone

Dosage form:
powder for solution for intravenous and intramuscular

Mode of action:
Cephalosporin antibiotic III generation for parenteral administration. Effective bactericidal, disrupting the synthesis of cell walls of microorganisms. It has a wide spectrum of action. It is active against Gram-positive microorganisms - Staphylococcus aureus and Staphylococcus epidermidis (strains producing and penicillinase-producing), Streptococcus pneumoniae, Streptococcus pyogenes (beta-hemolytic group A strains), Streptococcus agalactiae (beta-hemolytic group B strain) , Enterococcus faecalis, many other strains of beta-hemolytic Streptococcus spp.; Gram-negative microorganisms - Escherichia coli, Klebsiella spp. (Including Klebsiella pneumoniae), Enterobacter spp., Citrobacter spp., Haemophilus influenzae (strains producing and not producing beta-lactamases), Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri (formerly Proteus rettgeri), Providencia spp., Serratia spp. (Including Serratia marcescens), Salmonella spp., Shigella spp., Many strains of Pseudomonas aeruginosa and Pseudomonas species, etc., some strains of Acinetobacter spp., Neisseria gonorrhoeae (strains producing and not producing beta-lactamases), Neisseria meningitidis , Bordetella pertussis, Yersinia enterocolitica; anaerobic bacteria - Gram-positive and Gram-negative cocci (including Peptococcus, Peptostreptococcus and Veillonella spp.), Gram-positive spore-and asporogenous anaerobes (Clostridium spp., Eubacter spp., Lactobacillus spp.) and gram (including Fusobacterium spp ., many strains of Bacteroides fragilis spp., Prevotella spp. and other representatives of the strains of Bacteroides spp.). is stable with respect to the plasmid beta-lactamases broad spectrum (TEM-1-2, SHV-1), but collapses under the influence of enzymes, extended spectrum (TEM-3-2, SHV-2-5). It teturamopodobny effect.

Indications:
Bacterial infections of the upper and lower respiratory tract, urinary tract infections, abdominal infections (peritonitis, cholecystitis, cholangitis, etc.), sepsis, meningitis, infections of the skin and soft tissue, bone and joint infections, infectious and inflammatory diseases of the pelvic organs (endometritis, gonorrhea and other reproductive tract infections). Prevention of infectious complications after abdominal, gynecological and orthopedic surgery, as well as in cardiovascular surgery.

Contraindications:
Hypersensitivity (including beta-lactam antibiotics). C care. Renal-hepatic insufficiency, pregnancy, lactation, history of colitis

Adverse effects:
Allergic reactions: urticaria, maculopapular rash, fever, eosinophilia, erythema multiforme exudative (including Stevens-Johnson syndrome), a positive reaction to Coombs. On the part of the digestive system: nausea, vomiting, diarrhea, pseudomembranous colitis. From the blood and organs of hemostasis: bleeding (vitamin K). Laboratory indicators: gipoprotrombinemii, increased prothrombin time, increased activity of "liver" transaminase and alkaline phosphatase, hypercreatininemia, anemia, neutropenia. Local reaction: if i / in the introduction - phlebitis, with the / m introduction - pain at the site vvedeniya.Peredozirovka. Symptoms: an epileptic seizure. Treatment: sedative therapy with diazepam.

Dosage and administration:
B / c, a / m. Adults - the average daily dose of 2-4 g divided into 2 admission. In severe infections the dose may be increased to 12 g / day: 2-4 g every 8 h or 6.3 g every 12 h. The treatment can be started pending the results of sensitivity study of microorganisms. For uncomplicated gonococcal urethritis - singly, in / m, 500 mg. Antimicrobial prophylaxis for postoperative complications - a / c, 1 g or 2 g for 30-60 min before surgery, repeated every 12 hours (in most cases within not more than 24 h). In operations with an increased risk of infection (such as operations in the field of colon and rectum) or if the infection can cause arose particularly great harm (such as open heart surgery or prosthetic joints), prophylactic use of the drug may continue for 72 hours after the operation. In patients with kidney-liver failure - no more than 2 g / day. Patients with glomerular filtration rate below 18 ml / min or creatinine concentration above 3.5 mg / dl - no more than 4 g / day. In isolated liver failure does not require dose reduction, if the patient does not receive the maximum dose, because compensatory increases excretion of the drug by the kidneys (up to 90% or more). The children - daily doses of 50 to 200 mg per 1 kg of body weight, in 2 divided doses (every 12 hours) or longer if necessary. Newborn babies (less than 8 days) - every 12 hours daily doses up to 300 mg / kg applied without complications in infants and children suffering from severe infections, including bacterial meningitis.

Cautions:
Can be used in combination therapy in combination with other antibiotics. Patients with hypersensitivity to penicillin drug should be prescribed with great caution. In cases of obstruction of bile ducts, severe liver disease or concomitant renal dysfunction may become necessary to change the dosing regimen. Prolonged use may lead to the development of pathogen resistance. During the period of the drug may be false-positive response to glucose in the urine with Benedict's solution or Fehling. At the time of treatment should refrain from receiving ethanol - possible effects, similar to the action of disulfiram (hyperemia of the face, stomach cramps and in the stomach, nausea, vomiting, headache, lower blood pressure, tachycardia, dyspnea). If necessary, the appointment during lactation should stop breastfeeding. Patients who adhere to a diet deficient or have malabsorption of food (eg suffering from cystic fibrosis), and patients in a long time on parenteral nutrition, it may be a deficiency of vitamin K. In these patients should be monitored prothrombin time, and if necessary, he shows vitamin K. The stability of prepared solutions depends on their concentration and nature of the solvent. Storage time should not exceed 24 hours at room temperature, 5 days - if stored in a refrigerator at a temperature of from 2 to 8 град.С and 3 weeks - at a temperature of 10-20 grad.S. Solutions must be stored in glass or plastic syringes, glass or plastic bottles for storage solutions for parenteral administration. Thawing a frozen product should take place at room temperature. The solution can not be re-frozen. After thawing unused solution of the drug to be destroyed.

Interaction:
Pharmaceutical incompatible with aminoglycosides (with the need for combination therapy cefoperazone and aminoglycoside administered in the form of a sequence of fractional / v administration of drugs using two separate in / catheters). At a joint appointment with ethanol may develop disulfiramopodobnyh reactions. Indirect anticoagulant, heparin, thrombolytics increase risk gipoprotrombinemii, bleeding. Aminoglycosides and "loop" diuretics increase risk of nephrotoxicity, particularly in patients with renal insufficiency. drugs that reduce tubular secretion, increase the concentration of drug in the blood and slows its removal.