Cebest 200mg Merap medicine for respiratory infections, urinary, skin infections (2 blisters x 10 tablets)

Dosage form Box of 2 blisters x 10 tablets
Specifications Cefpodoxime
Ingredient Tonsillitis, otitis media, sinusitis, urinary tract infections, skin and soft tissue, acute bronchitis, gonorrhea, chronic bronchitis

Ingredient

Composition information	Content
Cefpodoxime	200mg

Uses

Indications

Cebest is indicated to treat mild to medium infections caused by sensitive bacteria:

Infectious respiratory infections: Acute sinusitis caused by bacteria caused by the haemophilus influenzae strains (including the seminarians of beta-lacta-mase), Streptococcus pneumoniae and Moraxella catarrhalis; Sore throat and/or tonsillitis due to streptococcus pyogenes; Acute otitis median inflammation due to streptococcus pneumoniae (except for penicillin strains), Streptococcus pyogenes, Haemophilus influenzae (including the birth of beta-lactamase) or Moraxella (Branhamella) CatVrhalis (including the birth of Beta-Lactamase)

Lower respiratory infections: Exacection of chronic bronchitis caused by strains S. Pneumoniae, H. Influenzae (indicated non-born beta-lactamase) or M. Catrhalis; Pneumonia is acquired in the community caused by strains of S. Pneumoniae or H. Influenzae (including strains of Beta-Lactamase)

To treat mild and medium infections in the upper respiratory tract (sore throat, tonsillitis) due to sensitive streptococcus pyogenes, cefpodoxime is not a priority selected drug, but an alternative for amoxicillin or amoxicillin combined with potassium clavulanate used inefficiently or not used

Urinary tract infections have no complications caused by Escherichia Coli, Klebsiella Pneumoniae, Proteus Mirabilis or Staphylococcus Saprophyticus

Invalid gonorrhea and spread due to the strain N. Gonorrhea Born or not born penicillinase

Uncount infections in the skin and skin organizations caused by staphylococcus aureus (including the birth of penicillinase) or Streptococcus pyogenes.

Pharmacology

Pharmacological therapy group: Antibiotics using systemic sugar, ATC code: J01DD13.

Mechanism of action

Cefpodoxime Proxetil is a semi-synthetic beta-lactam antibiotic, belonging to the 3rd generation Cephalosporin. Cefpodoxime Proxetil is a precursor of cefpodoxime.

After drinking, Cefpodoxime Proxetil is absorbed in the digestive tract and quickly is hypothetically in the non -specific esterase into Cefpodoxime, an antibacterial antibiotic.

The mechanism of action of Cefpodoxime is to inhibit the synthesis of bacterial cell wall through the cohesion and inhibition of the activity of penicillin -mounted proteins related to the synthesis of bacterial cell walls (PBPS). The results lead to bacterial cells that are solved and dead.

Medicine resistance mechanism

Cephalosporin resistant bacteria may be by one or more of the following mechanisms:

Reduce the permeability of the external membrane in some strains of Gram-negative bacteria that limit the accessibility of the drug to Pbps. Aerobic.

Cefpodoxime has a wide antibacterial spectrum for aerobic and gram -positive gram bacteria.

In principle, Cefpodoxime has the power for Gram-positive bacteria such as streptococcus pneumoniae, streptococcus streptococcus streptococcus streptococcus streptococcus streptococcus. Cefpodoxime also works with Gram -negative bacteria, Gram -positive and gram -negative bacilli. The drug has anti -gram -negative anti -bacteria such as E. Coli, Klebsiella, Proteus Mirabilis and Citrobacter. However, in Vietnam, these bacteria are also resistant to the 3rd generation cephalosporin. Cefpodoxime sustainable for beta-lactamase caused by Haemophilus Influenzae, Moraxella Catatrhalis and Neisseria born.

Drug resistance

The drug has no anti -staphylococcus staphylococcus cansoxazoleylpenicillin staphylococcus due to changes in penicillin -mounted proteins (the resistance type of methicilin -resistant staphylococcus aureus). This MRSA antibiotic type is growing in Vietnam Cefpodoxime with little effect on Proteus Vulgaris, Encobacter, Serratia Marcescens and Clostridium Perfringens. These bacteria are sometimes resistant.

Staphylococcus anti -methicilin staphylococcion, Staphylococcus saprophyticus, Enterococcus Faecalis, Pseudomonas Aeruginosa, Pseudomonas SP Often resistant to cephalosporins.

Pharmacokinetics

absorption

Cefpodoxime Proxetil is absorbed through the gastrointestinal tract and is metabolized by non -specific esters in the intestinal wall into a metabolic cefpodoxime. The absorption rate is about 51.5% when using the tablet corresponding to 100 mg Cefpodoxime in hunger and the absorption rate increases when using the drug with food

The peak concentration of plasma (cmax) is 1.2 mg/l and 2.5 mg/l after oral the dosage corresponding to 100 mg and 200 mg Cefpodoxime respectively, the time to achieve the peak concentration (TMAX) is 2 to 3 hours. After taking the dosage corresponding to 100 mg and 200 mg of Cefpodoxime 2 times/day for 14.5 days, the plasma parameters of Cefpodoxime plasma remain unchanged.

Distribution

The average distribution of Cefpodoxime is 32.3 liters. Cefpodoxime protein bonds range from 22% to 33% in serum and from 21% to 29% in plasma.

Cefpodoxime levels are measured higher than the minimum inhibitory concentration (MIC) of sensitive bacteria that can be achieved in lung parenchyma, bronchial mucosa, pleural fluid, tonsils, interstitial fluid and prostate tissue.

Metabolism and elimination

After absorption, the main metabolites are Cefpodoxime, the product of hydrolysis Cefpodoxime Proxetil.

The main elimination line of Cefpodoxime is kidney. About 80% of Cefpodoxime absorbs excreted in urine in the form of unchanged. The average selling time for cefpodoxime is 2.4 hours.

Cefpodoxime is excreted by the kidneys with high concentrations (this concentration is higher than the mic90 for bacteria that often cause urinary tract infections). The distribution of Cefpodoxime in the kidney tissue, with a concentration greater than the mic90 for bacteria that often cause urinary tract infections, 3-12 hours after using a single dose of 200 mg (1.6-3.1 PG/G)

Special patients

Elderly

Unsurtable dose adjustment in elderly patients with normal renal function.

Children

Safety and efficiency in children who are less than 2 months old have not been established.

kidney failure

Extraction of cefpodoxime decreases in patients with medium to severe renal failure (CLCR

Hepatic failure

Absorbed and excreted absorption does not change in cirrhosis patients. The average selling time and clearance of Cefpodoxime in patients with liver failure are similar to healthy people. No dose adjustment in patients with impaired liver function.

Mobile pharmacokinetic/pharmacokinetic correlation

As cephalosporin antibiotics, the most important pharmacokinetics and pharmacokinetics index with in vivo is recorded as the percentage of the time between the two giving drugs (%T), the concentration of free drugs is higher than the minimum inhibitory concentration (MIC) of Cefpodoxime with each specific bacteria strain (%T> MIC).

Before taking Cebest 200mg Merap medicine for respiratory infections, urinary, skin infections (2 blisters x 10 tablets)

How to use

Cebest tablets should be taken with food to increase the absorption of the drug through the gastrointestinal tract

Treatment time:

For effective treatment, this antibiotic must be taken regularly at the dose and during the time the doctor prescribes.

The disappearance of fever or any other symptom does not mean completely recovered. Feeling tired is not due to antibiotic treatment but due to infection itself. Reducing the dose or suspension of treatment will have no effect on these feelings and only make gonorrhea recover.

Dosage

Common dose:

Adults and children over 12 years: Take 100 - 400 mg 2 times/day, 12 hours apart.

The acute period of chronic bronchitis or mild pneumonia to the community: 200 mg x 2 times/day, 12 hours apart, for 10 or 14 days, corresponding to the above disease. Just complicated: 400 mg x 2 times/day, 12 hours apart, for 7-14 days. Chlamydia. There is no need to adjust the dose in elderly patients with normal kidney function.

Children from 2 months old to 12 years old: take 10 mg/kg/day, divided into 2 times, 12 hours apart (maximum dose of 400 mg/day). Children from 2 months old to 6 years old: Can use the form of Cebest oral phase nuggets or as directed by the doctor.

Acute otitis media: 5 mg/kg (to 200 mg) x 2 times/day, 12 hours apart, for 5 days. 12 hours, for 10 days.

kidney failure:

If creatinine clearance is greater than 40 ml/min, no change of dosage Cefpodoxime. More than this value, dynamic pharmacokinetics shows half -life elimination and peak concentration in plasma of cefpodoxime increases, so the dosage should be adjusted appropriately according to the following table:

Creatinin (ml/minute) Dosage )))

Patients with hemolysis The only dose used after each dialysis
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

Side Effects

The harmful reactions of the drug are listed below by the organ system and frequency. The defined frequency is: Very common (≥ 1/10), common (≥ 1/100 to

Blood and lymphatic disorders

Rare: Hemorrhage disorders such as hemoglobin, thrombocytopenia, thrombocytopenia, leukopenia and EOSIN leukemia.

Very rare: hemolytic anemia.

Nervous system disorders.

Less: headache, abnormal feeling, dizziness.

abnormalities in the ears and hearing disorders

Uncommon: tinnitus

Gastrointestinal disorders

Common: increased stomach pressure, nausea, vomiting, abdominal pain, flatulence, diarrhea.

Desarization of bleeding may occur as a symptom of bowelitis. The likelihood of fake colitis should be considered if diarrhea is severe or prolonged during or after treatment.

Metabolic and nutrition disorders

Common: Delicious food

immune system disorders

Very rare: anaphylactic reaction, bronchospasm, bleeding and angioed.

Kidney and urinary disorders

Very rare: Sleek to blood urea and creatinin.

Liver-dysfunction

Rare: increasing the transient liver enzyme of Asat, alat and alkaline phosphatase and/or bilirubin. The abnormalities in the test can be explained by the infection, can rarely exceed the upper limit of the enzymes above and evoke a model of liver damage, usually bile stasis and most asymptomatic.

Very rare: liver damage.

Skin and subcutaneous tissue disorders

Less: hypersensitivity to skin and mucous reactions, rash, urticaria, itching.

Very rare: Johnson Stevens, epidermal necrosis due to poisoning and diverse roses.

Infections and parasites

As with other antibiotics, the prolonged use of Cefpodoxime can lead to excessive growth of non -sensitive organisms (Candida and Clostridium difficile).

General disorder

Less: weakness or discomfort.

Notice immediately to the doctor or pharmacist the harmful reactions encountered when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Sensitive people with cefpodoxime, other cephalosporins or any ingredients of the drug.

Patients with hypersensitivity to penicillin or other beta-lactam antibiotics.

Be cautious when using

cefpodoxime is not a priority antibiotic to treat staphylococcus aureus pneumonia and should not be used in the treatment of pneumonia is not typical caused by bacteria such as Legionella, Mycoplasma and Chlamydia. Cefpodoxime is not recommended for the treatment of pneumes caused by S. Pneumoniae (see the pharmacological part).

Serious hypersensitivity reactions and sometimes death have been reported. In the case of severe hypersensitivity reactions, immediately stop treatment with cefpodoxime and have appropriate emergency measures.

Before starting treatment, careful investigation of the patient's allergic history with cefpodoxime, cephalosporin, penicillin or other beta-lactam. Precautions when used if Cefpodoxime is used for patients with a history of hypersensitivity, not serious with other beta-lactam.

In case of severe renal failure, it may be necessary to reduce the dosage depending on creatinine clearance (see the dose part).

Fake colitis and fake colitis are seen in most antibiotics including cefpodoxime and can fluctuate in mild to life -threatening levels. So consider this diagnosis in diarrhea patients during or after using Cefpodoxime is very important. Discontinue treatment with cefpodoxime and specific treatment for Clostridium difficile should be considered. Do not use intestinal inhibitors.

Be cautious when using Cefpodoxime in patients with a history of gastrointestinal diseases, especially colitis.

As with all beta-lactam antibiotics, leukemia and rarely grain leukemia can develop especially during prolonged treatment. In case of treatment lasting more than 10 days, blood formula should be monitored and stopped if there is leukopenia.

Cephalosporin can be absorbed on the surface of the red blood cell membrane and reacts with antibodies directly against the drug. This can create positive Coombs test and rarely hemolytic anemia. Cross reactions can occur with penicillin for this reaction.

Changes in renal function have been observed with cephalosporin antibiotics, especially when used simultaneously with drugs that can poison the kidneys such as aminoglycosides and/or drugs that are likely to diuretic. In such a case, kidney function should be monitored.

The prolonged use of Cefpodoxime can lead to excessive development of non -sensitive organisms (Candida and Clostridium difficile), which may require stopping treatment.

Safety and effectiveness of drugs have not been determined for children under 2 months of age.

A false positive reaction with glucose in the urine can occur with copper reduction tests (tested with Benedict solution, fehling) but will not have false positive when testing with enzymes.

The use of Cefpodoxime is related to positive Coombs tests that can affect diagonal blood reactions.

The effect of the drug on the ability to drive and operate machinery

If you feel dizzy, headache after taking this medication, do not drive or operate machinery.

Use drugs for women during pregnancy and lactation

pregnancy

There is no data on drug use in pregnant women, only drugs should be used if the benefits are superior to the risk. If you find pregnancy during treatment, consult your doctor to see if you should continue treatment.

Breastfeeding period

cefpodoxime is excreted into breast milk with low concentrations. Can breastfeeding in case of this medication. However, if your baby has digestive disorders (diarrhea, candidiasis) or skin rash, stop breastfeeding or stop taking this medication and quickly consult your doctor.

Always consult a doctor or pharmacist before taking any drug during pregnancy or breastfeeding.

Interactive drug

antihistamine H2 and antacids that reduce the bioavailability of cefpodoxime, so these drugs should be taken after using Cefpodoxime 2-3 hours.

Probenecid reduces Cefpodoxime excretion.

cefpodoxime can reduce the activity of typhoid vaccine.

cephalosporin has the ability to enhance the anticoagulant effect of cooumarin and reduce the contraceptive effect of the estrogen.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

To be out of reach of children, read the user manual carefully before use.

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