Cefurus

Cefurus is a bactericidal cephalosporin; it has a potent effect on a relatively wide range of Gram-negative and -positive microbes, including strains producing β-lactamases.

The drug is resistant to the effects of β-lactamases, accordingly demonstrating an effect on many amoxicillin- or ampicillin-resistant strains. The main mechanism of the drug's bactericidal activity is the disruption of the binding of microbial cell membranes. [ 1 ]

Indications Cefurus

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

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

Release form

The medicinal substance is released in the form of powder - inside vials of 0.75 or 1.5 g; inside a box - 1, 5 or 50 such vials.

Pharmacodynamics

The drug is highly effective against coagulase-negative and Staphylococcus aureus (methicillin-resistant strains), Klebsiella, pyogenic Streptococci, Haemophilus influenzae with Enterobacter, Clostridia and Escherichia coli. In addition, the list includes Shigella, Streptococcus mitis (viridians group), Proteus Rettgeri, Proteus mirabilis, Neisseria (including gonococcus strains producing β-lactamase), Salmonella typhimurium with Salmonella typhi and other Salmonella strains, as well as whooping cough.

The drug has a moderate effect on Morgan's bacteria, common Proteus and Bacteroides fragilis. [ 2 ]

Among the bacteria resistant to Cefuroxime are: pseudomonads, legionella, clostridia difficile, campylobacter, Acinetobacter calcoaceticus, and in addition, methicillin-resistant strains of epidermal, coagulase-negative and golden staphylococci.

Some strains of the above species are also resistant to the drug: Morgan bacteria, Citrobacter, Proteus, Bacteroides fragilis, Serratia and faecal streptococci.

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

Pharmacokinetics

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

Intra-serum protein synthesis ranges from 33-50%.

Over a period of 24 hours from the moment of administration, the drug is almost completely (85-90%) excreted unchanged in the urine; its main part 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, serum levels of Cefurus decrease.

The drug level, exceeding the MIC values for most common pathogenic bacteria, is observed in synovium, bone tissue and intraocular fluid. Cefurus overcomes the BBB in case of inflammation of the meninges.

Dosing and administration

Cefurus must be used via intravenous or intramuscular injections.

Newborns and infants are given the drug in doses of 30-60 mg/kg (at 6-8 hour intervals), and children over 1 year old are given 30-100 mg/kg (at 6-8 hour intervals). Adults should be given 0.75-1.5 g of the substance at 8-hour intervals.

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

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 permitted only with a thorough assessment of all the risks and benefits of the drug.

The medication is excreted in breast milk, therefore, if it is necessary to use it, breastfeeding should be discontinued.

Contraindications

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

Side effects Cefurus

Side effects are occasionally observed when using the medication, but in case of personal intolerance, vomiting or nausea, phlebitis, dizziness, signs of allergy, headaches and hearing loss may be observed.

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

Overdose

Using large doses of the drug can cause headaches, emotional agitation and convulsions.

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

Interactions with other drugs

Cefurus, like other antibiotics, is capable of changing the intestinal flora, which reduces estrogen reabsorption and weakens the effect of combined oral contraception.

The drug is excreted via tubular secretion and glomerular filtration. It is prohibited 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 results of methods based on copper reduction processes (Fehling's or Benedict's tests, as well as Clintest), but does not cause false positive data, as with the use of some other cephalosporins.

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

Storage conditions

Cefurus must be stored in a place out of reach of children, moisture and sunlight.

Shelf life

Cefurus is permitted to be used within a 2-year period from the date of production of the therapeutic substance.

Analogues

Analogues of the drug are the medications Cedrogexal, Cefurabol, Abipim with Partsef, and in addition to this, Tsepodem, Totacef with Cefamezin, Medocef and Ceftrax. In addition, the list includes Blitsef, Cefoperabol and Maxicef, Zinnat and Sporidex, as well as Lendacin with Cefabol.