The article will present instructions for use with Cefamed.
It is an antibiotic with a wide spectrum of action; it belongs to third generation cephalosporins. It is capable of exerting a bactericidal effect due to the inhibitory effect on bacterial cell membranes.
Release form
“Cefamed” is produced by the manufacturer in the form of a powder, which is intended for the manufacture of a solution. The solution is used for intramuscular or intravenous injection. It has two different dosages - 0.5 and 1 gram each. The kit includes a solvent - 1% lidocaine hydrochloride (2 ml, 3.5 ml, respectively).
Composition and description
According to the instructions for use with Cefamed, each vial of the drug holds 0.5 or 1 g of the main active substance - ceftriaxone sodium. Each ampoule of the supplied solvent contains 2 or 3.5 ml of the main active ingredient - lidocaine hydrochloride. Hydrochloric acid, water for injection and sodium hydroxide are used as auxiliary components in the solvent.
“Cefamed” is a crystalline powder. Has a white or yellowish color, hygroscopic. The solvent looks like a colorless, clear liquid.
Pharmacokinetics and pharmacodynamics
As indicated by the instructions for use with Cefamed, ceftriaxone, after intravenous or intramuscular administration, freely penetrates the body fluids, tissues. If intramuscular administration is carried out, the bioavailability of the active substance reaches 100%, after 3 hours the maximum concentration of the substance in the blood plasma is reached. The substance is 85-95% reversibly bound to plasma albumin. Protein binding is inversely related to blood concentration. Ceftriaxone rapidly penetrates into the interstitial fluid, in which its bactericidal effect against sensitive microorganisms lasts up to 24 hours. The substance is able to penetrate well through the blood-brain barrier.
Is Cefamed used for children? Instructions for use contain information about this.
In adults, the half-life of ceftriaxone is 8 hours, in people in old age (over 75 years) and in newborns it is elongated almost 3 times. In adults, about 60% of ceftriaxone in an unchanged form is excreted together with urine, about 40% - with bile. In newborns, about 70% of unchanged substance is excreted along with urine. The pharmacokinetics of ceftriaxone is virtually unchanged in people with impaired liver and kidney function. In some cases, only a slight increase in half-life is possible. This is due to a redistribution of functions - in case of impaired renal function, most of the substance is excreted by bile, and, conversely, with liver pathologies, most is excreted by the kidneys.
"Cefamed" is an antibiotic with a wide spectrum of action. Refers to third generation cephalosporins. It is capable of exerting a bactericidal effect by inhibiting the synthesis of bacterial cell membranes. The drug is active against most gram-negative bacteria, many gram-positive pathogens, and some anaerobes. Ceftriaxone is resistant to beta-lactamases, which bacteria produce.
Many microorganisms are sensitive to Cefamed, which multiply steadily in the presence of other antibiotics, for example, aminoglycosides, cephalosporins of 1 and 2 generations, penicillins. Clinical data indicate a good efficacy of the drug in the treatment of primary and secondary syphilis.
This confirms the instructions for use for "Cefamed".
Indications for use
"Cefamed" is effective in diseases that are caused by microorganism strains sensitive to ceftriaxone:
- Infectious pathologies of the upper as well as lower parts of the respiratory system, including pleural empyema, lung abscess, pneumonia.
- Infectious pathologies of the peritoneal organs, including empyema of the gallbladder, cholangitis.
- Inflammatory pathologies of the gastrointestinal tract, peritonitis, infectious pathologies of the biliary tract.
- Sepsis, inflammation of the meningeal membranes.
- Infected burns, wounds.
- Infectious diseases that are sexually transmitted, such as gonorrhea.
- Urinary tract infections, such as pyelonephritis.
- Infections affecting soft tissues and skin.
- Infections affecting the joints and bones.
- Prevention of complications of infectious etymology after surgery. What else does the instructions for use for Cefamed injections tell us?
Dosage and Administration
The Cefamed solution is used for intramuscular or intravenous injection or drip.
Adults and children after 12 years of age are administered up to 2 grams of ceftriaxone once a day. Between administrations, an interval of two days should be observed. The daily dose of Cefamed can be increased to 4 grams per administration if the infectious disease is provoked by moderately susceptible bacteria to ceftriaxone or has a severe course.
In accordance with the instructions for use with Cefamed for children, it is used in a dosage of up to 50 mg / kg for newborns. The introduction is carried out once a day. It is unacceptable to exceed the dosage, as newborns have an immature enzyme system.
Ceftriaxone is contraindicated in infants younger than 8 days old if they are undergoing intravenous therapy with solutions containing calcium, as well as infusion of potassium-containing drugs. This is due to the probability of the formation of precipitates of calcium salts.
Infants and children under 12 years of age are shown Cefamed in a dosage of 20-80 mg / kg, once a day. If the child has a body weight of more than 50 kg, the standard dosage for an adult should be used. This describes the instructions for use with Cefamed injections. Reviews about them are mostly positive.
If the dosage exceeds 50 mg / kg, the drug should be administered dropwise. Duration of administration - not less than half an hour.
The duration of the course of use of the drug depends on the severity of the disease and its nature. Continued administration is recommended at least 3 days after body temperature has returned to normal.
Indications from the instructions for use with Cefamed should be strictly observed.
When carrying out therapy of bacterial meningitis in newborn babies, 100 mg / kg is prescribed once a day. The maximum daily dosage should not exceed 4 grams. The dose can be reduced after the pathogen has been identified.
Therapy of uncomplicated gonococcal infection involves a single use of Cefamed in a dosage of 250 mg. The drug in this case should be administered intramuscularly.
Inpatient treatment of gonorrhea implies a certain tactic, which depends on the nature of the course of the disease. So, if the large vestibular and paraurethral glands are abscessed, appropriate surgical, physiotherapeutic and pathogenetic methods of therapy should be used in combination with antimicrobial agents. Therapy of complicated gonococcal infection of the pelvic organs and urinary system involves intramuscular administration every 24 hours. This is indicated in the instructions for use with Cefamed injections.
Dose reduction is not required if a patient with impaired renal function maintains normal liver function, and, conversely, if renal function is preserved, but there are impaired liver function. With severe renal failure (if creatinine clearance is less than 10 ml / min), the maximum allowable daily dosage of ceftriaxone should not exceed 2 grams per day.
If the patient simultaneously has impaired function of both the liver and kidneys, if hemodialysis is performed, the level of ceftriaxone concentration in the blood should be constantly monitored. This is stated in the instructions for use. Analogues of the drug "Cefamed" consider below.
In order to prevent infectious diseases after surgery, for 30-90 minutes before surgery, it is necessary to introduce 1-2 grams of “Cefamed” to the patient.
It is important to properly prepare the solution of “Cefamed” before its introduction. If intramuscular injection is expected, take 0.5 or 1 gram of powder and dilute it, respectively, in 2 or 3.5 ml of the attached 1% lidocaine solution. The injection is deep into the buttock muscle. In pediatrics, Lidocaine is not used to dilute Cefamed.
If intravenous administration is intended, the required amount of the drug powder (0.5 or 1 gram) in sterile distilled water (5 or 10 ml, respectively) should be diluted. The prepared solution should be injected into the vein slowly, for 3-4 minutes.
If intravenous infusion is expected, 2 grams of the drug should be diluted in 0.9% sodium chloride solution (40 ml), 5% glucose solution, 10% glucose solution, 5% fructose solution, 6% dextran solution. Intravenous infusion should be carried out for 30 minutes, at least.
It is important to use the prepared solution immediately. Storage is not allowed.
Side effects of “Cefamed”
According to the instructions for use and reviews of the drug “Cefamed”, against the background of therapy, the occurrence and development of such adverse reactions as:
- Chills and fever.
- Thrombocytopenia, agranulocytosis, hemolytic anemia, granulocytopenia, leukopenia, eosinophilia.
- Vomiting, glossitis, stomatitis, diarrhea, nausea.
- Erythema multiforme, anaphylactic shock, urticaria, itching, swelling, allergic dermatitis, exanthema.
In rare cases, dizziness, headaches, oliguria, increased activity of liver enzymes, elevated blood creatinine levels may occur.
In isolated cases, the following were noted:
- Candidiasis, dysbiosis.
- Bleeding.
- Precipitation of ceftriaxone calcium salts in the gallbladder.
- Arrhythmia (if the medicine is administered too quickly).
- Phlebitis, pain along the vein into which the drug was injected, bleeding disorders.
- Pseudomembranous colitis.
- Lyell, Stevens-Johnson syndrome, erythema multiforme.
This is described in the instructions for use with Cefamed.
Contraindications
The use of the drug is contraindicated:
- When a patient has an increased susceptibility to drugs of the penicillin and cephalosporins group.
- If there is an individual sensitivity to lidocaine used as a solvent. In this case, lidocaine can be replaced with water for injection or novocaine.
- When the patient is in the first trimester of pregnancy.
- With hyperbilirubinemia in newborns, in premature babies.
- With insufficient liver and kidney function.
- With ulcerative colitis or enteritis, due to the use of antibacterial agents.
- If there is a history of bleeding.
- If a newborn child under the age of 1 month is already undergoing therapy using calcium-containing solutions, or he is given calcium-containing infusions (including through parenteral nutrition).
Interaction of “Cefamed” with other medicines
As we are told by the instructions for use for the drug “Cefamed”, there is no interaction with loop diuretics, for example, with “Furosemide”. Aminoglycosides and Cefamed have synergies with many gram-negative bacteria. Such a combination of drugs is allowed in the treatment of severe infections and infections that threaten the patient's life.
It is unacceptable to mix in one syringe "Cefamed" and other medicines, including antibiotics.
The bactericidal effect of the drug is reduced if it is simultaneously used with bacteriostatic antibiotics.
Pharmaceutically, “Cefamed” is incompatible with aminoglycosides, fluconazole, vancomycin, amsacrine.
This will be confirmed by the instructions for use. Reviews about "Cefamed" are in large numbers.
Special instructions when using the drug
It is important to consider the likelihood of anaphylactic reactions in patients receiving Cefamed. It is important to exercise caution when prescribing it, if there is a history of allergic reactions to penicillins. If the drug is used for a long period, it is necessary to regularly monitor the condition of peripheral blood.
If the treatment used doses of “Cefamed” in excess of the standard recommended, then with ultrasound of the gallbladder can be detected shadows, often mistaken for stones. These shadows are precipitates of ceftriaxone calcium salts. After discontinuation of therapy using Cefamed, they disappear. These changes in the gallbladder only in rare cases give any symptoms. If it does appear, the patient is shown exclusively conservative treatment, and the decision to cancel the medication is made by the doctor who oversees the treatment. The development of pancreatitis is not ruled out.
In rare cases, the development of agranulocytosis has been noted. It occurs most often if the course of treatment with Cefamed exceeds 10 days, and the total doses exceed 20 grams of ceftriaxone. Sometimes, against the background of therapy, such serious allergic reactions as Stevens-Johnson syndrome, epidermal necrolysis (Lyell syndrome), erythema multiforme develop.
This is reported to us by the instructions for use for injections "Cefamed". Reviews on this subject are available.
In less than 0.01% of cases, the patient develops pseudomembranous colitis, there is a violation of blood coagulation, and kidney stones form. Such negative reactions occur, most often, if the minimum recommended dosage of the drug is significantly exceeded. Kidney calculi usually do not show any symptoms, as a result of which the development of renal failure can be triggered.
Pregnancy Use
Many are interested in reviews and analogues of this drug.
Instructions for use with Cefamed injections indicate that the use of ceftriaxone in pregnant women is allowed when the expected benefit to the mother is higher than the potential risk to the fetus (since ceftriaxone is able to penetrate the placental barrier). If there is a need to administer the drug during lactation, breastfeeding for the period of therapy should be suspended, since ceftriaxone is able to penetrate into breast milk.
Drug overdose
An overdose of the drug manifests itself by enhancing side effects. In this case, symptomatic treatment is necessary. A specific antidote to medicine is not currently known, peritoneal dialysis and hemodialysis are ineffective.
So tells us the instructions for use with "Cefamed". Analogs and reviews are presented below.
Analogs of this drug
Due to the fact that “Cefamed” is an antibiotic with a wide spectrum of action, it has a lot of analogues in terms of therapeutic effect. Among them are Ceftriaxone-bhfz, Ceficar, Cefaxon, Rosin, Trixotsef, Medaxon, Biotrakson, Ceftriaxon.
Thus, the patient can choose a drug that will be cheaper than Cefamed or that will be more effective. It is important to understand that any replacement of the drug should be done with the consent of the attending physician. Self-medication with antibiotics is unacceptable.
Detailed instructions for use with Cefamed's analogues will not be considered.
The use of "Cefamed" in veterinary medicine
Sometimes there is evidence of the possibility of treating viral infections and pets with Cefamed. In this case, the antibiotic and its dosage should be prescribed by a veterinarian who will first establish the causative agent of the animal’s disease.
Reviews about "Cefamed"
As with any drug, there are conflicting reviews about Cefamed. Many doctors have a positive attitude towards Cefamed because of its effectiveness in relation to a number of infectious pathogens, as well as the possibility of its use in children from birth. in patients with impaired liver or kidney function. Patients undergoing therapy using this medication also report its high effectiveness, however, they often report a high risk of developing negative effects. Another part of the negative reviews is related to the cost of the drug. Many patients prefer to coordinate with the attending physician the replacement of the drug with a cheaper drug based on ceftriaxone.
We reviewed the instructions for use with Cefamed, including in veterinary medicine, as well as reviews and analogues.