Training session

Training session 7

Spizef

Category :

SPIZEF contains cefuroxime axetil
Cefuroxime is a 2nd generation cephalosporin antibiotic with a broad spectrum of activity.
The drug is available for both oral and parenteral use
The oral drug is available as the axetil ester. (Cefuroxime Axetil)

Mechanism of action :

SPIZEF is a betalactam antibiotic. It inhibits the cell wall synthesis of the bacteria, thus killing the bacteria in the process. It has activity against certain beta lactamase producing strains of bacteria.: Detailed mechanism of action

Absorption :

After oral administration, SPIZEF is absorbed from the gastrointestinal tract.

Certain enzymes called as non-specific esterases break down Cefuroxime axetil into Cefuroxime and axetil.

Cefuroxime is distributed throughout the extracellular fluids. The axetil group is metabolized into acetaldehyde and acetic acid for excretion.

Absorption of cefuroxime is greater when taken along with food. The actual amount of drug available (bioavailability) will increase from 37% to 52%.

Does this mean that cefuroxime axetil should always be administered along with food? No.
This is because studies have clearly indicated that despite this large difference in absorption, the clinical and bacteriologic responses were same if taken with food or without food.

Excretion :

Cefuroxime is excreted unchanged in the urine

Microbiology :

CEFUROXIME HAS BACTERICIDIAL ACTIVITY AGAINST A WIDE RANGE OF COMMON PATHOGENS, INCLUDING BETA LACTAMASE PRODUCING STRAINS.

AEROBIC, GRAM POSITIVE	Staphylococcus aureus	Including betalactamase producing strains
	Streptococcus pneumoniae
	Streptococcus pyogenes
AEROBIC, GRAM NEGATIVE	Escherichia coli
	Haemophilus influenzae	Including beta lactamase producing strains
	Klebsiella pneumoniae
	Moraxella ( Branhamella) catarrhalis	Including beta lactamase producing strains
	Neisseria gonorrhoae	Including beta lactamase producing strains
SPIROCHAETES	Borrelia burgdorferi
AEROBIC GRAM POSITIVE	Staphylococcus epidermidis
	Streptococcus agalactiae
AEROBIC GRAM NEGATIVE	Proteus mirabilis
	Providencia rettgeri

Indication and usage :

Pharyngitis and Tonsillitis

Acute Otitis Media

Acute Sinusitis

Acute exacerbations of Chronic Bronchitis

Skin and Skin Structure Infections

Urinary Tract Infections

Uncomplicated Gonorrhoea

Lyme Disease

Contraindications:

Known allergy to Cephalosporins.

Warnings :

In an individual who is allergic to beta lactam antibiotics, the probability of allergy manifestation to Cefuroxime is as high as 10%.

Subsequent to the administration of Cefuroxime, patients who present with diarrhoea should be considered for diagnosis of pseudomembranous colitis.

Precautions :

1. Super infection - prolonged use of Cefuroxime may result in the overgrowth of nonsusceptible organisms.

2. Pregnancy and Lactation - Safety of Cefuroxime for use in humans in not established. Cefuroxime should be used during pregnancy only of clearly needed.

3. Cephalosporins should be given with caution in patients receiving potent diuretics because these drugs are suspected of affecting the renal function.

Adverse reactions :

1. Gastrointestinal - The most frequent side effect has been diarrhoea. Nausea and vomiting are reported rarely.

2. Haematologic - Haemolytic anaemia, leukopenia, pancytopenia and thrombocytopenia.

3. The following hypersensitive reactions have been reported .

Anaphylaxis , Angioedema , Pruritus .

4. Skin - erythema multiforme, Steven-Johnson syndrome.

5. Urologic - Renal dysfunction.

Dosage:

General dosing guidelines.

Adults: The adult dose ranges from 250mg to 500mg for 5 to 10 days depending upon the severity of the infection.

For uncomplicated gonorrhoea the recommended dose is 1000mg as a single dose.

Paediatrics: (3 month onwards)

For pharyngitis and tonsillitis - 20mg/ kg/ day ( divided into 2doses, bid) for 10 days.

For acute otitis media, acute bacterial maxillary sinusitis and impetigo - 20mg/kg/ day(divided into 2doses,bid)for 10 days.

Product formulation :

SPIZEF is available as 125mg,250mg and 500mg tablets.

Benefits :

As a second-generation cephalosporin, Cefuroxime is useful in the management of day to day infections of the respiratory tract, urinary tract and skin & soft tissue caused by beta lactamase producing susceptible pathogens.

Cefuroxime is the ideal choice, especially where first generation cephalosporins are not effective.

Competition :

Brand	Company
CEFTUM	GLAXO
ALTACEF	GLENMARK
CETIL	LUPIN
ZOCEF	ALKEM