The discovery of the first antibiotic (known to all today as penicillin) in the mid-twentieth century was a real breakthrough in medicine. During the Great Patriotic War, this medicine saved the lives of thousands of defenders of the motherland.
Since then, biochemistry and the pharmaceutical industry have developed rapidly and offered consumers more and more antibacterial drugs. One of the most modern and widely used in various fields of medicine is Maxipim, reviews of which regulate this drug as very, very effective in various bacterial infections.
Composition and form of release
The main active ingredient of this drug is cefepimadihydrochloride monohydrate. Release Thomas - a whitish-yellowish powder for the preparation of a solution for subsequent intramuscular or intravenous administration. In several dosages, the manufacturer offers its customers the Maxipim product to consumers. An antibiotic can be purchased in 500 mg and 1 g vials.
The composition prepared for administration can be stored at room temperature for a day. In the refrigerator, the shelf life of the finished solution increases to 1 week. In powder form and in a sealed vial, the drug can be stored for 3 years. Necessary conditions - temperature up to + 30 ° and a place protected from light. A change in the color of the solution does not affect the activity of the drug.
Pharmacological effect
"Maksipim" application instruction positions as an antibacterial substance belonging to the group of cephalosporins 4 generations. The principle of exposure is the destruction of the cell wall of bacteria, strains. The drug has an extensive spectrum of influence in relation to a number of gram-positive and gram-negative microorganisms, characterized by their resistance to aminoglycosides and antibacterial agents of the 3rd generation cephalosporin group.
“Maksipima” is characterized by resistance to beta-lactamases and activity against a large number of gram-positive and gram-negative aerobes (for a detailed list, see the instructions for use). But the medication is not active against methicillin-resistant staphylococci, penicillin-resistant pneumococci.
After administration, the Maxipim antibiotic (instructions for use includes such information) is completely absorbed. Therapeutically significant concentrations of the main active ingredient are found in urine, bile, bronchial secretion, in the prostate gland and peritoneal fluid.
The half-life is approximately two hours. For comparison, we can say that, for example, in adult patients who received 2 g of the drug intravenously for 9 days with a time interval between procedures of at least 8 hours, no accumulation of cefepime was detected in the body. The greatest volume is excreted in the urine (up to 85% of the dosage initially received by the patient in the form of unchanged cefepime is observed).
Indications for use
The antibacterial agent "Maksipim" recommends that it is prescribed for use in various types of pathology of an infectious-inflammatory nature. Good results will be obtained in the treatment of infections of the lower respiratory tract (pneumonia and bronchitis including) and urinary ducts (both uncomplicated and complicated, including pyelonephritis). Positive dynamics are observed in the treatment of various intra-abdominal infectious lesions (not excluding biliary tract infections and peritonitis).
Also, Maksipim is widely used by paramedics to treat gynecological infections, infections of the skin and soft tissues, and septicemia (sepsis). In the treatment of patients with febrile neutropenia, Maxipim recommends using the instructions as empirical therapy.
Another area of influence of the drug is bacterial meningitis in children. Here, this antibiotic has also proven itself.
For preventive purposes, the drug is used to prevent infections in the process of abdominal surgery.
In general, we can say that "Maxipim" can be used for any infectious diseases, the development of which is provoked by bacteria and strains sensitive to it. To identify the pathogen microorganism and determine its (or their) sensitivity to this antibiotic, tests are supposed to be done. However, Maksipim affects such a wide range of bacteria and strains that it can be taken as monotherapy even before the identification of the pathogen. If there is a risk of developing a mixed infection (aerobic-anaerobic), then before conducting tests to identify pathogenic bacteria, you can start treatment with Maxipim in tandem with a drug that affects anaerobes.
Methods of use and dosage regimens
The dosage and type of administration (in / in or / m) is determined depending on the sensitivity of the bacteria, the severity of the disease and the condition of the patient's kidneys. Moreover, the on / off path is usually preferred in cases where the infection is severe and really threatens the patient's life.
For people with healthy kidneys and a body weight of more than 40 kg, injections are done at intervals of 12 hours at the doses prescribed by the doctor. Urinary tract lesions of mild to moderate severity, other infections that occur with the same intensity, are treated with dosages of 0.5-1 g, administered intramuscularly or intravenously (as the doctor decides). To combat severe infections, it is practiced to administer 2 g of the substance intravenously (the same frequency - 12 hours). For very serious infections that endanger the patient’s life, the required dosage is also 2 g, but the frequency is every 8 hours.
The antibiotic Maxipim is used for influenza only in cases when a bacterial infection is also connected during the course of the viral infection.
During surgical interventions (1 hour before the start) for preventive purposes, 2 g of Maxipima are administered intravenously for half an hour, after which 500 mg of metronidazole is additionally infused. Both substances should not be administered simultaneously.
The average volume of the drug for patients with a body weight under 40 kg in the treatment of urinary tract infections (complicated and not complicated), soft tissue and skin lesions (not complicated), pneumonia and empirical therapy of neutropenic fever is 50 mg per kilogram of weight. Injections are done at intervals of 12 hours. In bacterial meningitis and neutropenic fever, the same 50 mg / kg is recommended to be administered at intervals of 8 hours between treatments.
For patients suffering from abnormalities in the functioning of the kidneys, it is necessary to adjust the maintenance dose. The Maxipim antibiotic description of the drug (the dosage depending on the type of pathogen and the severity of the infection will be selected by the attending physician) recommends that the initial volume of the medication be taken as for people with healthy kidneys, and the maintenance dosage should be selected depending on the creatine clearance values.
Those patients who take Maxipim and undergo hemodialysis are recommended to re-introduce a new antibiotic dose equal to the initial dose at the end of the procedure. This is necessary, because in 3 hours of hemodialysis, up to 68% of the total amount of Maxipim will be removed from the body (the instruction contains this information).
Contraindications for taking Mexipima
Despite the extremely wide range of effects of this antibacterial drug, it does not have a large list of contraindications. "Maxipim" instructions for use prohibits taking people with individual hypersensitivity with cefepime and L-arginine. It is also unacceptable to prescribe it to patients with immediate hypersensitivity reactions to penicillins, to other beta-lactam drugs, cephalosporin type antibacterial drugs.
Pregnant women and nursing mothers, people suffering from diseases of the digestive tract should be attentive to their well-being during the treatment with Maksipim, especially with regard to ailments such as ulcerative or antibiotic-associated colitis, regional enteritis.
As for the effect on reproductive function, it must be said that during clinical trials on animals, no negative effects on the body of the mother and fetus were detected. However, well-controlled studies on the effect on the body of a woman have not been made. Therefore, it is permissible for pregnant women to take Maxipim only under the supervision of a doctor. In breast milk, the drug is excreted in very small quantities, but it is not worth the risk. During lactation, take the medication with caution.
In addition, the Maxipim antibiotic instruction recommends use with great caution to those who suffer from severe forms of chronic renal failure. Studies have shown that in patients with chronic renal failure, the elimination half-life of the substance increases. At the same time, people with impaired liver function or cystic fibrosis do not feel any pharmacokinetic changes associated with absorption and excretion of cefepime from the body.
Side effects, excess dose
In general, we can say that "Maxipim" is well tolerated by patients, and the incidence of adverse events is not high. Of all the recorded cases, most often it was about disorders of the digestive tract (dyspepsia, diarrhea, constipation, nausea, vomiting) and hypersensitivity reactions (rash, skin itching, fever).
In addition, the information available on such a drug as the Maxipim antibiotic - a description of the drug, instructions for its use - indicates the possibility of reactions from the cardiovascular system in the form of tachycardia (heart palpitations) and chest pain. Respiratory organs can make themselves known as sore throats, shortness of breath, and coughing. The most likely reactions from the central nervous system will be insomnia, headaches, dizziness, anxiety, confusion, paresthesia are possible. Of the other manifestations, we can talk about asthenia, vaginitis, sweating, pain in the back, peripheral edema. Also, as side effects, medical specialists talk about a possible change in laboratory parameters.
As for exceeding the allowable doses of the Maxipim antibiotic, the instructions for use report the effectiveness in such cases of hemodialysis.
What you should pay attention to?
A lot of different unusual situations can develop during the period when the antibiotic Maxipim is prescribed. How to apply it in such cases? If pseudomembranous colitis with prolonged diarrhea develops against the background of “Maksipima”, they generally stop taking it and prescribe vancomycin or metronidazole.
If the patient suffers from combined severe hepatic and renal insufficiency, the medical staff should constantly monitor the concentration of the drug in the blood plasma and, depending on the indicators, adjust the dosage.
If an antibiotic has been used for a long period of time, it is important to regularly monitor the composition of peripheral blood and the functional parameters of the kidneys and liver.
In cases when a patient from a remote infectious focus has a meningeal dissemination (spread of the pathogen both within the focus and throughout the body), there is a suspicion of meningitis or such a diagnosis has already been established, you should refuse treatment with Maxipim and prescribe some or an alternative antibacterial agent with efficacy confirmed for this diagnosis.
There is a chance of detecting a positive reaction to the Coombs test, false positive - to the presence of glucose in the urine.
"Maksipim" with the flu and colds (ie, with viral infections) will not be effective.
Interaction with other substances
If the patient is assigned to receive Maxipim, the use of other drugs in parallel should be under the supervision of a doctor. This antibiotic is not pharmaceutically compatible with other antimicrobial drugs and heparin.
The tubular secretion of cefepime will be significantly reduced when combined with diuretics, aminoglycosides, and polymyxin B. The same tandem of drugs will increase the concentration of Maxiprim in the blood serum, and will increase nephrotoxicity up to the development of nephronecrosis. In addition, the half-life will increase.
The combination of Maxiprim with NSAIDs (non-steroidal anti-inflammatory drugs) will inhibit the elimination of cephalosporins from the body and may cause bleeding.
The use in combination with other bactericidal antibiotics (aminoglycosides) will lead to the manifestation of synergism, with bacteriostatic - antagonism.
Analog medicines
Analogous medicines are selected on the basis of the international non-proprietary name (INN), the name of the main active ingredient (for “Maksipima” this is cefepime). The most popular analogues of the antibacterial agent “Maxipim” are reviews of specialists called such drugs as “Cepepim-Alpa”, “Cepepim”, “Movizar”, “Maxicef”, “Cefepim sterile”.
This is not a complete list, and as for the name “Cepepim”, here, in addition to the above, there are also Cepepim-Vial, Cepepim-Agio, Cepepim-Jodas, Cepepim-Alkem, Cepepima hydrochloride ".
Also, for different types of bacterial infections, health workers prescribe Ladef, Efipim, Kefsepim, Cefomax, and Tsepim drugs.
As for analog medicines, they may not always be as effective as a licensed drug.
The opinion of patients and health workers
Since the drug has a wide range of uses for a wide variety of microbial infections, there are also positive and negative opinions about “Maksipima”. Most people taking the antibiotic were satisfied with the results. Improving the state of health even in severe forms of bacterial infections occurred 2-3 days after the start of therapy. According to health professionals, the drug has also proven itself in a wide variety of clinical situations. And the cost of the medicine is not so high (there are medicines cheaper, but at the same time there are much more expensive than Maxipim).
However, there are not such encouraging opinions about this medicine. Basically, those patients who have side effects during treatment have responded negatively. In addition, a negative opinion was expressed by a separate group of people who took the Maxipim antibiotic for colds. Although in this case, the result, so to speak, is expected. Any cold has a viral nature, and Maksipim is a bactericidal drug whose principle of action is based on the destruction of the bacterial cell membrane.
You can buy a medicine only with a prescription from your doctor. And this is right: a physician with special knowledge and experience will thus select an antibacterial drug and calculate the minimum effective dose, that all risks of developing side effects will be minimized, and the positive effect on the body will be maximized.