Cefurus

Cefurus is a bactericidal cephalosporin; it has a powerful effect on a relatively large range of gram-negative and -positive microbes, including strains that produce β-lactamases.

The drug is resistant to the influence of β-lactamases, in accordance with which it demonstrates the effect in relation to many amoxicillin- or ampicillin-resistant strains. The main mechanism of the bactericidal activity of the drug is a violation of the binding of the membranes of microbial cells.[1]

Indications Cefurus

It is used for diseases of an infectious and inflammatory type that develop due to the influence of microflora that is sensitive to the drug:

• ENT pathology (sinusitis with tonsillitis, otitis media, pharyngitis and  sinusitis );
• respiratory diseases ( empyema , pneumonia or bronchitis);
• pathologies affecting the urogenital system (cystitis, endometritis, pyelonephritis, adnexitis and gonorrhea);
• systemic lesions of ODA (osteomyelitis, bursitis and arthritis);
• infection of subcutaneous tissues and epidermis ( impetigo , pyoderma, furunculosis, erysipelas and streptoderma);
• diseases in the gastrointestinal tract and gastrointestinal tract;
• infections of an infectious and inflammatory nature that develop after the operation.

Release form

The release of the drug substance is made in the form of a powder - inside vials with a volume of 0.75 or 1.5 g; inside the box - 1, 5 or 50 such bottles.

Pharmacodynamics

The drug is highly effective against coagulase-negative and Staphylococcus aureus (strains insensitive to methicillin), Klebsiella, pyogenic streptococci, Haemophilus influenzae with enterobacteria, Clostridia and Escherichia coli. In addition, the list includes Shigella, streptococci mitis (group viridians), Rettger's proteas, Proteus mirabilis, Neisseria (among them strains of gonococci that produce β-lactamase), Salmonella typhimurium with Salmonella typhi and other Salmonella strains, as well as pertussis.

The medicine has a moderate effect on Morgan bacteria, common proteas and Fragilis bacteroids. [2]

Among bacteria resistant to Cefuroxime: pseudomonas, legionella, clostridia dificile, campylobacter, Acinetobacter calcoaceticus, and in addition, methicillin-resistant strains of epidermal, cogulase-negative and Staphylococcus aureus.

Separate strains of these species are also resistant to the drug: Morgan bacteria, citrobacters, common proteas, bacteroids fragilis, serrations and fecal streptococci.

In vitro, the drug in combination with aminoglycosides has a minimum additive effect, sometimes with manifestations of synergy.

Pharmacokinetics

Indicators of serum Cmax of Cefurus are noted after 30-45 minutes from the moment of the intramuscular injection. The half-life of the drug after intravenous and intramuscular injections is approximately 70 minutes. When used together with probenecid, the rate of excretion of cefuroxime is reduced, which increases its serum values.

Intraserum protein synthesis is in the range of 33-50%.

For a period of 24 hours from the moment of application, the drug is almost completely (by 85-90%) excreted unchanged in the urine; most of it is excreted in the first 6 hours.

The drug does not participate in metabolic processes and is excreted through tubular secretion and glomerular filtration.

When dialysis is performed, the serum values of Cefurus decrease.

Drug levels in excess of the MIC values for most common pathogenic bacteria are observed inside the synovium, bone tissue, and intraocular fluid. Cefurus overcomes the BBB in case of inflammation of the meninges.

Use Cefurus during pregnancy

There is no information regarding the embryotoxic effect of the drug, which is why it should not be prescribed to pregnant women; use is allowed only with a careful assessment of all the risks and benefits of drugs.

The medication is excreted in breast milk, and therefore, if it is necessary to use it, it is necessary to stop breastfeeding.

Contraindications

It is contraindicated to prescribe the drug in case of increased intolerance to cephalosporins and penicillins.

Side effects Cefurus

Single-sided effects are noted when using the medication, but with its personal intolerance, vomiting or nausea, phlebitis, dizziness, signs of allergies, headaches and hearing impairment may occur.

In addition, with prolonged use of drugs inside the patient's body, an intensive growth of pathogenic flora that is resistant to Cefurus can occur. This significantly complicates the therapy of the underlying pathology.

Dosing and administration

It is necessary to use Cefurus through intravenous or intramuscular injections.

For newborns and infants, the drug is administered in portions of 30-60 mg / kg (at 6-8-hour intervals), and for children over 1 year old - at a dosage of 30-100 mg / kg (at 6-8-hour intervals). Adults need to inject 0.75-1.5 g of the substance with 8-hour breaks.

If necessary, the interval between procedures can be reduced to 6 hours; the maximum portion per day is no more than 6 g.

Overdose

The use of large dosages of the medication can provoke headaches, emotional arousal and seizures.

When signs of poisoning appear, the patient undergoes peritoneal or hemodialysis.

Interactions with other drugs

Cefurus, like other antibiotics, is able to change the intestinal flora, due to which estrogen reabsorption decreases and the effect of combined oral contraception is weakened.

The drug is excreted through tubular secretion and glomerular filtration. It is forbidden to use it together with probenecid, since it prolongs the excretion of the antibiotic and increases its serum Cmax values.

When using Cefurus, plasma and blood sugar values should be determined using the hexose kinase or glucose oxidase method.

The drug may slightly change the indications of methods that are based on copper recovery processes (Fehling's or Benedict's tests, as well as Clinitest), but does not cause false positive data, as with some other cephalosporins.

The combination of the drug and oral anticoagulants can increase the INR values.

Storage conditions

Cefurus must be kept out of the reach of children, moisture and sunlight.

Shelf life

Cefurus is allowed to be used within a 2-year term from the date of manufacture of the therapeutic substance.

Analogs

Analogs of the drug are medicines Cedrohexal, Cefurabol, Abipim with Partsef, and in addition, Tsepodem, Totacef with Cefamezin, Medotsef and Ceftrax. In addition, the list includes Blicef, Cefoperabol and Maxicef, Zinnat and Sporidex, as well as Lendacin with Cefabol.