Cefotaxime (indications for use, the rules for calculating the optimal dosage, as well as the most popular analogues will be given below) is a modern semi-synthetic antibiotic. It is resistant to beta-lactamases and is active against both gram-positive and gram-negative microflora. The mechanism of the biochemical reaction is due to the ability of the components to suppress the natural processes that occur in the cell membrane of pathogens.
The drug, entering the body, purposefully destroys the cruciate linkages of peptidoglycans, which are so necessary for bacteria to ensure the natural stability of the walls. And, as you know, for antibodies and inhibitor ingredients, an elastic aggressor cell is a fairly easy target.
Release form
The medicine “Cefotaxime” (the instructions for injections and infusion presents as the only possible delivery schemes for the active substance) enters the pharmaceutical market in the form of a white or yellow powder, which serves as the basis for the preparation of the solution. We are talking about the so-called injection ampoules.
Original 10 ml bottles are made of transparent glass. The actual weight of the reagent present in one product unit depends on the packing matrix (0.5, 1.0 or 2.0 grams).
Pharmacokinetic scenario
It should be noted right away that not every analogue of Cefotaxime has the same pharmacokinetic properties as the original. In particular, if we talk about the rate of absorption of the components from the injection site, then the assimilation of the described drug, judging by the comments of many practicing doctors, is much faster than the initial absorption of the same Duatax or Cetax. The reason for the "phenomenon" lies in the structured molecule of the original sample. Experts in their reviews emphasize that the above Indian generics contain “pharmaceutical impurities” in the form of complex cephalosporin derivatives, which significantly slow down the metabolism of other ingredients.
It was found that Cefotaxime (the indications enshrined in the official guide to this medicine exclude the possibility of prescribing it in case of bleeding) shows a relatively high level of binding to plasma proteins, while the duration of the bactericidal effect varies between 11-12 hours. After starting the transformation, the reagent is evenly distributed throughout the tissues, including bone (the maximum concentration is also observed in the myocardium and gall bladder).
The main ingredient successfully overcomes the placental barrier and becomes an integral part of the pericardial and cerebrospinal fluid. On average, the half-life with intravenous drip does not exceed one hour, with an intramuscular injection - eighty-one hundred minutes. No transcendental accumulation of the substance is noted - some of the components are excreted along with bile, the other (about 90%) - with urine. In the latter case, the proportion of active metabolites is limited to 20-30% of the administered dose, that is, about 70% of the solution leaves the body without undergoing structural modifications.
Indications for appointment
The described drug has proven itself as a blocker of infectious and inflammatory processes triggered by microorganisms that are particularly sensitive to cefotaxime. Moreover, not only clinical studies testify to this - a similar conclusion can also be drawn after familiarizing yourself with the many positive reviews published on sites whose topic is an effective drug fight against pathogens. The front of the pharmacological action of this medicine is quite wide, but most often chronic or acute disorders of the kidneys and urinary tract, as well as ENT diseases, fall under the “eye”.
I must say that, even with the absolute identity of the composition, the analogue of “Cefotaxime”, whether “Cefasin” or “Cetax”, cannot be prescribed for use on the basis of the above conditions. The fact is that for many generics, only a “relative copying” of the biochemical model of behavior of the initial sample is characteristic, and therefore an experienced specialist must calculate the exact drug chart, taking into account the schedule of administration and dosage of the “double”,.
The original product is recommended for use if:
- the patient is diagnosed with a pathology of the respiratory system in the form of pneumonia, abscess or bronchitis, and other antibiotics do not bring the desired result;
- the patient's condition is aggravated by progressive bacterial meningitis;
- analyzes confirmed the presence of endocarditis;
- in the postoperative period, it was not possible to avoid complications in the form of focal destruction of the skin and / or membrane of vital organs;
- pathogens of infection are firmly established in bone tissues, and intramuscular injections with the use of synonymous drugs do not have a proper effect on them;
- gram-negative or gram-positive flora penetrated into burn wounds and provoked large-scale infections (up to sepsis);
- there was a need for preventive measures.
Independent experts are inclined to believe that today there is little analogue of “Cefotaxime” that can demonstrate clearly pronounced positive dynamics in Lyme disease. It is worth recalling that the described original, subject to regular use, copes with the task perfectly (comments on the nuances of the therapeutic course, patients post on the forums).
Application and dosage
“Cefotaxime” instructions (injections, according to some doctors and patients, are not as effective as a dropper) is positioned as a selective antibiotic focused on combating severe bacterial infections. As already mentioned, three reagent delivery schemes are provided: by drip or jet infusion, as well as by intramuscular injection. There is no single rule for the preparation of working fluid, so it is extremely important to determine in advance the method of administration of the drug.
The manufacturer, in particular, recommends adhering to such an algorithm:
- for i / m injections: 1 gram of powder should be dissolved in 4 milliliters of water, lidocaine or novocaine;
- for intravenous injection: 1 gram of the substance must be diluted in sterile water (4 ml);
- for iv infusion: in a vial with two grams of cefotaxime, you need to add 100 ml of NaCl (0.9%) or the same amount of five percent glucose.
Reagent Delivery Time:
- with a / m injections: 5-10 s;
- with iv injection: 3-5 minutes;
- when setting the dropper: 50-60 minutes
The calculation of the balanced dose and the construction of the optimal schedule of admission is carried out individually. The patient's age and body weight, as well as the type of infection and the stage of its development, are taken into account. In addition, therapeutic amendments are made for the anamnesis.
Nevertheless, the instructions nevertheless provide information on the weighted average rates of use of the drug “Cefotaxime”. Injections (how to dilute the powder, described in detail above, but, interestingly, almost all reviews are dominated by the idea that the injection is a very painful and unpleasant procedure, even if all the manufacturer's recommendations are followed), in particular, it is prescribed for uncomplicated situations, with a break of 4-12 hours and a single dose of 1-2 grams. For critical and precritical scenarios, an intravenous administration is relevant (based on 2 g every 4 hours, but not more than 12 g / day).
When choosing a treatment regimen, pediatricians are guided by the body weight of the young patient and the general reaction of the body ("standard" - from two to six jet injections; 50-180 mg / kg).
Side effects
When prescribing the drug “Cefotaxime” (injections reviews are not as flattering as drip infusion, since i / m administration is often accompanied by pain; for this reason, novocaine or lidocaine usually acts as a “solvent”), the atypical effects of the components on the systems cannot be ruled out and patient organs.
Allowed:
- allergic "answers" in the form of large-scale urticaria, candidiasis or Quincke's edema;
- gastrointestinal problems (vomiting, nausea; very rarely - cholestatic jaundice);
- violations in the composition of the blood (drop in platelet count, hemolytic anemia, etc.).
Consequences of an overdose
An excessive increase in the daily norm is fraught with dysbiosis and encephalopathy; visualization of skin irritations is also likely.
The primary task is to stop the reagent from entering the body. Further, measures are needed to stabilize the condition with the mandatory use of desensitizing pharmacological products (under the supervision of a doctor).
Contraindications declared by the manufacturer
According to the information given in the official instructions, “Cefotaxime” (injections are usually given to children after 30 months of age; before that, they resort to iv infusions) should not be used:
- during pregnancy;
- with increased sensitivity to ingredients;
- with open and closed bleeding;
- if a history of enterocolitis is already presented.
Drug interaction
The original guide focuses on the fact that other solutions should under no circumstances be administered together (from the same medical device) with the cefotaxime antibiotic.
Injections (use through a dropper, in terms of pharmacological interaction with the components of other drugs, is no different from IM injections), in particular, can provoke kidney damage if some aminoglycoside or loop diuretic acts as an “ally” of the described drug. In turn, tubular secretion blockers greatly inhibit the withdrawal of this reagent and stimulate an increase in its concentration.
Combination with antiplatelet agents is also undesirable due to the risk of bleeding.
Special Provisions
“Cefotaxime” (tablet counterparts, judging by the reviews and comments, are less effective) sometimes provokes false tests of Kumbus and “fakes” urinalysis for true glucose content.
With prolonged therapy, the measurement of the component composition of the blood should be carried out at least 1 time in 10 days.
In the early days of treatment, severe diarrhea is not ruled out. Moreover, which is typical, such an analogue of “Cefotaxime” (for children under 12 years of age the mentioned “understudy” is not recommended), as “Fagotsef”, causes a similar clinical picture much less often.
The use of alcohol during therapy based on the specified reagent is strictly prohibited.
Which analog of Cefotaxim is recommended for use by independent experts?
Comments on Sephotac and Cephanthral as synonyms for the described pharmacological product are ambiguous. Judging by the reviews, their appointment by doctors is practiced much more often than writing out prescription directions for the purchase of the same “Cefabol” or “Tax-o-bid”. However, some patients are inclined to believe that the therapeutic effect of the use of these samples is weak, and the likelihood of developing atypical reactions is disproportionately high.
When on the forums the question arises of how to inject Cefotaxim so that it doesn’t hurt, many doctors advise:
- check if discomfort is a reaction to a specific ingredient (if the syndrome recurs with a novocaine dilution of the powder, then there is reason to believe that the discomfort is a result of an allergy, and not a direct effect of the substance);
- look for a decent alternative.
The analysis of opinions shows that the most “respect” among synonyms was awarded to “Loraxim”. However, before replacing one reagent with another, you must always consult with a specialist.