Cefixim 200mg Pharimexco medicine for infection treatment (2 blisters x 10 tablets)

Dosage form Box of 2 blisters x 10 tablets
Specifications Cefixime
Ingredient Cuu Long Pharmaceutical Joint Stock Company

Ingredient

Composition information	Content
Cefixime	200mg

Uses

Indications

cefixim 200mg indicated in the treatment of infections caused by sensitive bacteria such as:

Uncontrolled urinary tract infections due to sensitive strains E. coli or Proteus Mirabilis and some cases of uncomplicated urinary tract infections due to other Gram -negative bacilli such as Citrobacter spp., Entobacter spp.

Some cases of nephritis - pyelonephritis and urinary tract infections have complications caused by sensitive enerobacteriaceae, but the treatment results are worse than in case of non -complicated urinary tract infections.

HAEMOPHYLUS INFLUENZae otitis (including beta - lactamase strains), Moraxella Catatrhalis (including beta - lactamase strains), Streptococcus pyogenes.

Sore throat and tonsils due to streptococcus pyogenes.

Acute and chronic bronchitis due to Streptococcus Pneumonia, or Haemophilus Influenzae, or Moraxella CatVrhalis.

Mild and medium -sized pneumonia.

It is also used to treat gonorrhea without complications caused by Neisseria gonorrhoeae (including beta -lactamase strains); typhoid due to salmomella typhi (including multi -resistant strains); Sensitive shigella dysentery (including ampicillin strains).

Pharmacokic

cefixim is a 3rd generation cephalosporin antibiotic, used by oral. The drug has a bactericidal effect. Cefixim's bactericidal mechanism is similar to other cephalosporins: attached to target proteins (penicillin -mounted proteins) that inhibit mucopeptide synthesis in bacterial cell walls. The bacterial Cefixim resistance mechanism is to reduce Cefixim's affinity for target protein or reduce the permeability of bacterial cell membranes for drugs.

Cefixim has high durability with the hydrolysis of beta-lactamase encoded by the gene located on plasmid and chromosom. Sustainability with beta-lactamase of Cefixim is higher than Cefaclor, Cefoxitin, Cefuroxim, Cephalexin, Cephadin.

antibacterial spectrum

Gram -positive bacteria: Gram -positive air -demands: Streptococcus pyogenes (Beta hemolytic bacterial bacteria), S. Agalactiae (Bacterial League B) and streptococcal group C, F and G; Some S. Pneumoniae strains are worse than some other oral cephalosporins (such as Cefdinir, Cefpodoxim, Cefprozil, Cefuroxim); S. pneumoniae strains of penicillin resistance are considered cefixim resistance. The majority of streptococcal group D and S. Viridans often consider Cefixim resistance. Cefixim does not have the effect of in vitro for staphylococcus aureus or no penicillinase secretion includes Staphylococcus aureus, S. Epidermidis and S. Saprophyticus, Staphylococcus resistant to methicilin. Gram -positive air -loving bacillus: Corynebacterium, Listeria monocytogenes is usually resistant to Cefixim.

Gram -negative bacteria: Cefixim works for Neisseria Meningitidis, N.Gonorrhoeae, secreted or non -secreted penicillinase. The drug also has in vitro effects on n.gonorrhoeeae resistant to penicillin through chromosomes or tetracycline resistance through plasmid intermediaries.

Cefixim has an in vitro effect on most H. Influenzae secretion or not beta-lactamase and H. parainfluenzae. Cefixim works better than Cefaclor, Cephalexin, Cefuroxim, or Amoxicilin in combination with potassium clavulanate for H. Influenzae to produce beta-lactamase, but the effect is equal to or less than Ciprofloxacin, Ceftriaxon or Co-Trimoxazol. Cefixim In vitro also works for high-quality anti-drug H. Influenzae strains (ampicillin, chloramphenicol, tetracyclin, co-trimxazol, cefaclor and/or erythromycin). However, some H. Influenzae strains do not produce beta-lactamase but ampicillin and Cephalosporin 2nd generation also reduced sensitivity to cefixim.

In vitro, Cefixim works for Moraxella Catnrhalis, even when ampicillin resistance, cefaclor, cephalexin.

In vitro, Cefixim works for most important animaliaceae. In vitro, Cefixim work for many strains E. Coli, Citrobacter Freundii, K. Pneumoniae and P. Mirabilis resistant to other antibiotics (aminoglycosides, tetracyclin, ampicilin, amoxicilin, cefaclor, cephalexin), Salmonella TYPHIPIPILIPILILINI and/or co-trimoxazol).

Many strains of Cefixim resistant pseudomonas.

Anaerobic bacteria: Most of the bacteroides fragilis strains, bacteroides spp. Other, most Clostridium strains (including C. Difficile) resistance Cefixim.

Chlamydia and Mycoplasma: Chlamydia Trachomatis and Ureaplasma Urealyticum resistant Cefixim.

Spirochetes: Cefixim has a few effects on Borrelia Burgdorferi which is the cause of Lyme disease (concentration of 0.8 micrograms/ml).

Drug resistance

Cefixim high sustainable, not hydrolyzed by many beta-lactamase through plasmid and chromosomes, but the drug is hydrolyzed by some beta-lactamase of Enterobacter, Klebsiella Oxytoca, Proteus vulgaris and Pseudomonas Cepacia, Citrobacter Freundii, Enterobacter Cloahera, Enterobacter Clox,, Enterobacter Cloahera, Enterobacter Cloa Flavobacterium and bacteroides fragilis.

Staphylococcus CEFIXIM staphylococcus is caused by a weak drug for PBP2 of bacteria. Enterococcus and Listeria Monocytogenes resistant to drugs are due to poor affinity for bacterial PBPs. Citrobacter Freundii and Enterobacter resistant Cefixim are caused by factors that prevent the drug from penetrating bacteria and produce beta-lactamase. Pseudomonas and acinetobacter resistant drugs are caused by bacterial cell membranes.

Cefixim stimulates the production of beta-lactamase in some Morganella Morganii strains, but the drug still works in vitro for those strains after releasing those beta-lactamase.

Some 3rd generation cephalosporin still work with Staphylococci, Cefixim usually does not work on these bacteria. Cefixim has no in vitro active activity on staphylococci (secretive or no beta-lactamase secretion) such as Staphylococcus aureus, S.epidermidis, and S.Saprophyticus. Like other cephalosporins, cefixim has no activity on staphylococci resistant oxacilin (methicillin resistant). Most staphylococci, Enterococci and Listeria spp strains. No longer sensitive to Cefixim. Entobacter spp., Pseudomonas Aeruginosa and Bacteroides spp. has resisted cefixim. Cefixim has limited in vitro activity on anaerobic bacteria; Most Clostridia strains (including C. Difficile) are resistant to drugs.

Gram -negative bacteria such as Achromobacter xylosoxidans and flavobacterium meningosepticum are resistant to cefixim.

With Chlamydia and Mycoplasma: Cefixim is not active with Chlamydia Trachomatis and Ureaplasma Urealyticum.

Dynamic pharmacokinetics

After taking a single dose of Cefixim, only 30-50% of the dose is absorbed through the gastrointestinal tract, regardless of or taken before or after meals, although the absorption speed can be reduced when taken with meals.

The drug in the form of oral fluid is better absorbed in the form of tablets. The absorption of drugs is relatively slow. The peak concentration of plasma reaches about 2 - 3 micrograms/ml (for 200 mg dose), 3.7 - 4.6 micrograms/ml (for 400 mg dose) and reaches after taken 2 - 6 hours. Cefixim does not accumulate in serum or urine in people with normal renal function after taking many doses, drink 1-2 times/day.

In the elderly, taking a dose of 400mg daily oral 1 time in 5 days, showing the peak concentration in serum is 20-26% higher and AUC is 40 - 42% higher than people 18-35 years old, but not clinical significance. Half -life in plasma is usually about 3 to 4 hours and may last for kidney failure. About 65% Cefixim in the blood is attached to plasma proteins.

Information about the distribution of Cefixim in the body's tissue and fluid is limited. After oral, the drug is distributed into bile, sputum, tonsils, sinus mucosa, middle ear pus, burn fluid, prostate epidemic.

Currently there is no adequate data on the concentration of cerebrospinal fluid.

The drug is over the placenta and can reach relatively high concentrations in bile, urine. About 50% of the absorption dose is excreted unchanged through urine for 24 hours. Up to 60% of oral doses are not passed through the kidneys. There is no evidence of metabolism but may be partly eliminated from the bile into the feces. The drug is not equal to the hemorrhage.

Before taking Cefixim 200mg Pharimexco medicine for infection treatment (2 blisters x 10 tablets)

How to use

cefixim 200mg in the form of oral film tablets. Take whole tablets with water.

Dosage

Adults: Common dose in adults 200 - 400 mg/day can be used once or divided into 2 times 12 hours apart.

To treat uncomplicated gonorrhea caused by Neisseria Gonorrhoeae (including beta-lactamase strains): Use a dose of 400 mg (single one, coordinate with an effective antibiotic for Chlamydia that is likely to be infected at the same time). Higher doses (800 mg/ time) have also been used to treat gonorrhea.

When kidney failure needs to adjust the dose accordingly.

Children:

Children> 12 years old or weight> 50 kg dose like adults.

Children> 6 months - 12 years old should use the mixed form, do not recommend using this type of tablet. The safety and effectiveness of the drug has not been verified for children under 6 months of age.

Treatment of non -complicated gonorrhea caused by Neisseria Gonorrhoeae for 8 -year -old children or older with weight or over 45kg: taking a dose of 400mg (single one), combining an effective antibiotic for Chlamydia due to being likely to be infected at the same time.

Treatment time: Depending on the type of infection, it should be extended for 48 - 72 hours after the symptoms of infections have expired. The usual treatment time for uncomplicated urinary tract infections and upper respiratory tract infections is from 5 to 10 days (if due to streptococcus group A, Beta hemolysis must treat at least 10 days to prevent heart or glomerulonephritis); Lower respiratory infections and otitis media: 10 - 14 days.

Dosage for patients with renal failure

No dose adjustment for patients with creatinine clearance> 60 ml/ min. For patients with creatinine clearance

What to do when overdose?

How to handle: Because there is no specific treatment, it is mainly symptomatic treatment. When symptoms of overdose, stop immediately and handle as follows: Gastric lavage, anti -convulsions may be used if clinical indications. Because the drug is not eliminated by hemolysis, no dialysis or peritoneal filter.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

The unwanted effects of cefixim are similar to other cephalosporins. Cefixim is often well tolerated, unwanted effects are often fleeting, light and medium. It is estimated that the unwanted effect rate may be up to 50% of patients taking the drug but only 5% of patients need to stop.

Common, ADR> 1/100

Digestive: Nausea, vomiting, diarrhea, abdominal pain, flatulence, not delicious, dry mouth. Gastrointestinal disorders usually occur in the first 1-2 days of treatment and respond to symptomatic medications, rarely stop the drug.

Nervous system: head, dizziness, restlessness, insomnia, fatigue, epilepsy.

Hypersensitivity: Red rash, urticaria, drug fever.

Other effects: increased blood amylase levels (1.5 - 5%), but there is no correlation between increased blood amylase concentration and unwanted effects in the digestive tract of patients.

Uncommon, 1/1000

Digestive: severe diarrhea caused by Clostridium difficile and fake colitis.

Systemic: Anaphylaxis, angioedema, Stevens-Johnson syndrome, diverse roses, poisoned epidermal necrosis.

Hematology: reducing platelets, leukocytes, white blood cells; Reduce hemoglobin and hematocrit concentrations.

liver: hepatitis and jaundice; Temporarily increased AST, ALT, alkaline phosphatase, bilirubin and LDH.

Kidney: Acute renal failure, hypercogen nitrogen nitrogen and temporary plasma creatinine levels.

Other cases: Vaginal infection and infection.

Rare, ADR

Hematology: Prothrombin time

Body: convulsions

How to handle : If hypersensitivity occurs, should stop the drug, in case of severe hypersensitivity, need supportive treatment (use epinephrin, oxygen breathing, antihistamine, corticosteroid).

If there is convulsions, stop cefixim and take anti -convulsions.

When diarrhea is caused by C. vares and fake colitis, if mild just stop the drug. In medium and severe cases, electrolytes, protein supplements and metronidazol treatment.

Warnings

Contraindicated

cefixim 200mg Contraindicated in the following case: The patient has a history of hypersensitivity to Cefixim or other antibiotics of Cephalosporin group, people with a history of anaphylaxis due to penicilline or allergies to other ingredients of the drug preparation.

Caution when using

Before starting cefixim treatment, the patient's allergic history should be carefully investigated in penicillin and other cephalosporins due to the hypersensitivity between beta-lactam antibiotics, including: penicillin, cephalospherin and cephamycin.

Be careful when using Cefixim in people with a history of gastrointestinal diseases and colitis, especially when used for prolonged use, because there may be excessive risk of developing anti -drug bacteria, especially Clostridium difficile in the intestine, severe diarrhea, need to stop drugs and treat other antibiotics (metronidazol, vancomycin ...). In addition, diarrhea for 1-2 days is mainly due to the drug, if mild does not need to stop the drug. Cefixim also changes the bacteria in the intestine.

Like other antibiotics, using long -term cefixim can cause excessive breeding bacteria to reproduce, leading to superinfection or infection seriously. Gram -positive bacteria have occurred in patients using Cefixim to treat otitis media or urinary tract infections. Therefore, careful monitoring of patients using Cefixim to promptly treat appropriate if superinfection occurs.

Dosage or number of drugs need to be reduced in patients with renal impairment, including patients who are dialysis in the kidneys due to plasma cefixim concentrations in patients with higher renal impairment and longer than patients with normal kidney function. (See also: Dosage for kidney failure).

For children under 6 months of age, so far there is no data on the safety and effectiveness of Cefixim.

For the elderly: In general, there is no need to adjust the dose, unless there is impaired renal function (creatinine clearance

The ability to drive and operate machinery

Because the drug can cause dizziness, headache, Cefixim users should not drive and operate machinery.

Pregnancy

so far, there is no complete research data on the use of Cefixim in pregnant women, during labor and delivery. Therefore, only use Cefixim for these cases when really necessary.

The period of breastfeeding

Currently, it has not yet been confirmed that CEFIXIM is distributed into milk in breastfeeding women. Cefixim should be used for women to breastfeed carefully and can suspend breastfeeding during medication.

Drug interaction

Probenecid increases the peak and AUC concentration of Cefixim, reducing the clearance of the kidneys and the distribution of the drug.

anticoagulants like warfarin when used with cefixim increase prothrombin time, with or without bleeding.

Carbamazepin taken with cefixim increases carbamazepine levels in plasma.

nifedipin when taken with cefixim increases the bioavailability of cefixim, manifests itself by increasing peak concentration and AUC.

CEFIXIM's activity may increase when used together with ureteric acidic agents.

Cefixim can reduce the activity of typhoid vaccine.

Testing interaction:

A positive reaction to glucose in urine may occur with Benedict or Fehling solution but not based on the oxidase glucose reaction.

The drug can positive for direct test cops.

Storage

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

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