Cephalosporins

Bacterial infection

Sterile powder for preparation of injectable suspension

Cephalosporins bind to PBPS on the bacterial cell membrane to inhibit cell wall construction by a mechanism similar to penicillins.

This drug combines the gram-positive activity of the first-generation agents with a wider gram-negative coverage than the third-generation cephalosporins.

This drug is classified as a group B in terms of the classification of drugs for use during pregnancy. Although no teratogenic or miscarriage effects have been observed in studies related to the use of this drug in normal doses in pregnant laboratory animals, there have not yet been controlled and sufficient studies on the use of this drug during human pregnancy. Therefore, it can only be used during pregnancy for absolutely necessary situations. This drug is secreted in low concentrations in human milk, so caution should be taken to use it during breastfeeding.

Before taking this medicine, consult your doctor in the following cases:

• Having a possible history of allergy to Cefepime or other cephalosporins, penicillins, or other pharmaceutical substances. Pseudomembral colitis, which occurs with most antibiotics. It has also been observed with the consumption of Cefepime. Therefore, in patients who suffer from diarrhea following the use of antibiotics, this issue should be considered.
• A history of renal failure (in patients with creatinine less than or equal to 60 ml per minute), in which case it is necessary to adjust the dose of the drug.
• The presence of a history of encephalopathy (or symptoms such as impaired consciousness, mangia, hallucinations, coma) of myoclonic contractions and seizures in the patient.
• History of hepatic renal failure or blood coagulation disorders related to prothrombin activity (many cephalosporins reduce prothrombin activity).
• Concomitant use of this drug with other drugs, especially aminoglycosides and strong diuretics such as furosemide (which increases the risk of nephrotoxicity and ototoxicity).
• Before performing a blood glucose (glucose) test by a method other than enzymatic glucose oxidase.
• During pregnancy and lactation.

Before taking this drug, the patient should be asked about the history of immediate allergic reactions to this drug or other cephalosporins and penicillins or other drugs. In case of a positive response, the possibility of a cross-sensitivity reaction should be taken into account, and in case of immediate sensitivity to this drug, its use should be stopped and other emergency measures such as the use of oxygen, epinephrine, corticosteroids, intravenous fluids, intravenous antihistamines, blood pressure-increasing amines and retention ducts Breathing, according to the conditions.

With the use of this drug, antibiotic pseudomembranous colitis may occur with different severities from moderate to dangerous. Therefore, this should be considered in patients who develop diarrhea after taking antibiotics. By the way, from consumption you should avoid arbitrarily taking anti-diarrhea drugs in such cases and consult your doctor.

As with other cephalosporins, with the use of this drug, the symptoms of encephalopathy may be impaired consciousness and cause hallucinations. Insanity, coma, myoclonic contractions, convulsions, or renal failure may occur, especially in patients with kidney problems, where even with normal therapeutic doses, the aforementioned side effects may occur, but by stopping the drug or performing hemodialysis, the symptoms Neurotoxicity is eliminated. In patients With kidney disorders and insufficiency, the dosage of this drug should be adjusted according to the condition of the patient.

The prepared vial or prepared solution of Cefepime should not be used in injection solutions containing ampicillin drugs with a concentration higher than 40 mg/ml, metronidazole, vancomycin, gentamicin, tobramycin and aminophylline should be poured and consumed. But use them as there is no obstacle separately or consecutively.

Drug Poisoning:

With the dosage recommended for this drug, symptoms such as the side effects mentioned above may be seen. However, with the consumption of higher doses and doses, especially in patients with renal failure, symptoms of toxicity with this drug may appear, which include:

Encephalopathy (impaired consciousness, hallucinations, confusion, lethargy, apathy, coma), myoclonic muscle contractions, seizures of nervous and muscular irritability. However, patients who take high doses of this drug, especially those with kidney problems, should be closely monitored and cared for in case of symptoms of poisoning. Symptomatic treatment is recommended. In addition to removing the drug from the blood, especially in the presence of renal failure, hemodialysis (Not peritoneal dialysis) is appropriate.

Any drug, in parallel with the desired therapeutic effect, may cause unwanted side effects. Although all these side effects are not seen in one person or at every time of use, and with the use of recommended therapeutic doses of this drug, cases of death with permanent disability due to the toxicity of this drug have not been reported.

But consult your doctor if any of the following side effects occur: Rash, pain and inflammation at the site of injection, phlebitis, Colitis, Diarrhea, Fever, headache, Vomiting, Oral Moneliase, vaginitis.

Dosage of medication

Children and infants the safety and efficacy of this medicine has not been confirmed for use in children younger than 2 months, but for ages between 2 months and 16 years old, it is taken as an intravenous infusion for 30 minutes.

In moderate to severe uncomplicated skin infections, moderate uncomplicated and complicated urinary tract infections for the ages of 2 months to 16 years, up to 40 kg of body weight, 50 mg per kg of body weight intravenously every 12 hours for 10 days (7 to 10 days for urinary tract infection).

In severe complicated or uncomplicated urinary tract infections for ages 2 months to 16 years old up to 40 kg weight 50 mg per kilogram of body weight every 12 hours for 7 to 10 days intramuscularly or intravenously.

The maximum dose for children should not exceed the recommended dose for adults.

Adults use and dosage of this medicine in adults is as follows. In moderate to severe pneumonia due to Streptococcus pneumonia, Pseudomonas, Klebsiella pneumonias aeruginosa, or Enterobacteriaceae species.

1-2 grams intravenously every 12 hours for 10 days

In mild to moderate simple or complex urinary tract infections and pyelonephritis due to Escherichia coli, Klebsiella pneumonia and Pseudomonas mirabilis 0.5-1 g intravenously or intramuscularly every 12 hours for 7-10 days .

In patients with febrile neutropenia, 2 grams intravenously every 8 hours for 7 days.

In severe simple or complex urinary tract infections and pyelonephritis due to Escherichia coli, Klebsiella pneumonia: 2 grams intravenously every 12 hours for 10 days .

In uncomplicated skin and skin appendage infections due to Staphylococcus aureus and Staphylococcus pyogenes: 2 grams intravenously every 12 hours for 10 days.

In complicated intra-abdominal infections due to Escherichia coli, viridans streptococci, Pseudomonas aeruginosa, Klebsiella pneumonia, Enterobacteriaceae and Brucella fragilis: 2 grams intravenously every 12 hours for 7-10 days along with Metronidazole.

Deep intramuscular injection method for this product only for mild to moderate simple or complicated urinary tract infections due to Escherichia coli is considered.

The correct way to prepare medicine for use for deep intramuscular injection, the appropriate volume according to the following table of suitable solvents, sterile injectable solutions Add 0.9% sodium chloride injection or 5% dextrose to the vial and shake well until the medicinal powder is completely dissolved.

The 2 gram vial of this product cannot be used for intramuscular injection.

For intravenous infusion, the appropriate volume according to the following table of compatible injectable solutions of (sodium chloride 0.9% dextrose 5% or 10% or dextrose 5% containing 0.9% sodium chloride) to the vial and shake well until the medicinal powder is completely dissolved. Then dilute the desired dose of the drug with 50-100 ml of the same injectable solutions.

The resulting infusion solutions should be infused within 30 minutes.

The contents of the vial 500 mg, 1 gram ,2 grams Volume of injectable solutions compatible with reconstitution of vial contents 5 ml ,10 ml ,10 ml The volume of suitable solvents to dissolve the contents of the vial 1.3 ml 2.4 ml.

After adding appropriate solvents or injectable solutions to the vial and shaking it takes about a minute to powder the drug should be completely dissolved and a clear solution with a colorless to amber color would be obtained.

If you see any foreign particles in any of the solutions, do not inject.

It is recommended that the solutions prepared for deep intramuscular injection or intravenous infusion immediately after preparation be consumed and after one injection, throw them away and avoid storing them.

The dissolved vial or prepared solution of Cefemax® should not be poured and consumed in injection solutions containing ampicillin with a concentration higher than 40 mg/ml, metronidazole, vancomycin, gentamicin, tobramycin, and aminophylline. But the use of They do not interfere separately or consecutively.

• Keep the medicine out of the reach of children. Avoid storing and using expired medicines.
• Vials containing the powder of this drug should be kept at a temperature of less than 25 degrees Celsius in closed containers and away from light and moisture.