Cefpivoxil 400 Ha Tay medicine for acute bronchitis (30 tablets)

Pharmacological characteristics: ACT code: J01DD16 - Cephalosporin.

cefditoren pivoxil is a semi -synthetic antibiotic cephalosporin group 3rd generation used by oral, used in the treatment of acute bacterial infections or acute batches of chronic bronchitis, acquired pneumonia in the community caused by sensitive bacteria, including: H. Influenzae, H. Parainfluenzae, Streptococcus pneumoniae sensitive with poenicllin, poenicllin, penicillin, poenicllin, penicillin, penicillin Moraxella Catgrhalis, Sore throat (Streptococcus pyogenes), Skin infection and uncomplicated subcutaneous organization (S. Aureus without multiple resistance, Streptococcus pyogenes).

Cefditoren is sustainable with many types of B-Lactamases, including penicillinases and some cephalosporinases, caused by Gram-negative and Gram-positive bacteria. Similar to the current 3rd generation cephalosporin (such as cefdinir, cefixim), cefditoren has a wider Gram -negative antibacterial spectroscopy than the 1st and 2nd generation cephalosorin. Moreover, Cefditoren works with Gram -positive bacteria better than Cephalosporin. When other 3rd generation cephalosporins are not available. The mechanism of action of cefditoren is similar to the 3rd generation cephalosporin. Cefditoren Pivoxil is a Prodrug (Prodrug) with very little antibacterial effects. Cefditoren Povixil after absorption into the body is hydrolyzed by esters to release Cefditoren into activity and pivalat into color. Cefditoren inhibits the synthesis of bacterial cell walls by connecting penicillin -mounted proteins, inhibiting the final step of transferring amino acids between peptide chains of peptidoglycan synthesis in bacterial cell walls.

bacteria are separated from the activity of acids Autolysin and Murein Hydrolase.

Dynamic pharmacokinetics

absorption

After drinking, Cefditoren Pivoxil absorbed and hydrolyzed to form Cefditoren by esterases. The peak concentration of cefditoren when hunger averages is about 1.8 ± 0.6 ng/ml after taking a single dose of 200 mg and achieved after taken from 1.5 to 3 hours.

cefditoren is not accumulated when using the regimen twice a day in patients with normal kidney function.

Absolute oral bioavailability of Cefditoren's hunger is about 14% and when eating low -fat meal is 16.15 + 3%. Food increases AUC and CMAX of Cefditoren, respectively 70% and 50%.

distribution

The distribution volume in the stable state of CEFDitoren is 9.3 ± 1.6 l.

Cefditoren is mainly connected to albumin, about 88% and this rate decreases when the amount of albumin in plasma decreases.

Water polish in the skin: The maximum concentration of cefditoren in the skin polish in the skin after drinking 4-6 hours of 400mg dose reaches an average of 1.1 ± 0.42 Ug/ml. This concentration is equivalent to 56 ± 15% of the blood concentration in the blood.

Amydan tissue: For patients with amydan cutting, in a state of hunger, the concentration of cefditoren in Amydan tissue is 0.18 ± 0.07 Ug/g after the dose of 200mg from 2-4 hours. The average concentration of the drug in Amydan is 12 ± 3% compared to blood concentration in blood.

Cerebrospinal fluid: Information about the possibility of drugs distributed into cerebrospinal fluid is currently not available

metabolism and elimination

The time for elimination of cefditoren is 1.6 ± 0.4 hours in healthy people.

The drug is almost no metabolism. After taken, the drug excreted mainly through the kidneys with glomerular filtration of about 4-5L/hour. Poor elimination drugs in patients with kidney disease.

Cefditoren Pivoxil is hydrolyzed to form an active ingredient CefDitoren accompanied by a pivalate formation. After drinking multi -dose Cefditoren Pivoxil, over 70% of the absorbed pivalate. Pivalate is mainly eliminated through the kidneys through the formation of pivalolcarnitine.

Acute renal failure, allergies, joint pain, bronchial asthma, hyperplasia blood nitrogen, reducing calcium, increasing blood clotting time, chromosomic fixation, fungal infection, hyperlem of blood glucose, interstitial pneumonia, leukopenia, hyperkalemia, hypoglyc sodium, fake colitis, Steven - Johnson syndrome, throwing blood reduction, poisoned skin necrosis.

Side reactions of cephalosporin groups:

In addition to the side effects listed above, patients treated with cefditoren may experience side effects like other drugs in the cephalosporin antibiotic group including: allergies, anaphylaxis, drug fever, Stevens-Johnson syndrome, diverse erythema, indigoic necrosis, colitis, kidney dysfunction, cholecyst dyslemen, blood-enlargement, blood-fiber anemia.

Some subclinical changes such as: prolonging prothrombin; false positive with direct Coombs test, urinary test; alkaline phosphatase increase; increase bilirubin; platelet reduction.

Be cautious when used

Be careful when indicating cefpivoxil for patients with a history of allergies to cephalosporins, penicillin or other drugs. For patients with penicillin allergies, it is necessary to closely monitor when indicated by cefditoren because the patient may be crossed allergies.

Fake colitis has been reported in most antibiotics, including Cefditoren. Therefore, it is important to pay attention to this diagnosis when taking medication for patients with diarrhea due to antibiotic use.

Antibiotic treatment changes the intestinal bacteria and can help harmful bacteria grow. Studies show that the toxin produced by Clostridium difficile is the main cause of antibiotic colitis.

Cefpivoxil is not recommended in the regimens that need long -term antibiotic treatment because other drugs contain Pivalate when used for more than 1 month, causing carnitine deficiency. When used short -term or repeated in a short time, the drug does not cause this phenomenon. The effect of cefditoren pivoxil on carnitine concentration when short -term use is not known.

Patients with community pneumonia are subjected to cefditoren 200mg twice a day in 14 days, carnitine concentration in blood decreases by about 30%. When using a dose of 400mg twice a day in 14 days, Carnitine concentration decreased by about 46%. Carnitine concentration returns to normal levels within 7 days of stopping the drug.

Studies with patients with community pneumonia have shown no side effects due to reduced carnitine levels. However, for other groups of patients (such as patients with renal impairment or reduced muscle mass), this risk increases when using Cefditoren Pivoxil. Moreover, the dose adjustment for patients with end -stage renal failure has not been established.

As with other antibiotics, prolonged use can increase the risk of drug resistance. Cephalosporins can cause a decrease in prothrombin activity, especially in patients with kidney or liver or poor nutrition and patients who have previously needed treatment with anticoagulant regimen. Prothrombin should be monitored and may need to be indicated for vitamin K if necessary. In clinical studies, there is no difference between cefditoren and cephalosporins comparison with the risk of prolonging prothrombin time.

Need to take Cefpivoxil after eating to increase bioavailability. The drug can be used simultaneously with oral contraceptive pills. Unable to simultaneously use Cefpivoxil with anti -juice drugs.

Use drugs for pregnant and lactating women

cefditoren pivoxil does not cause teratogen in rabbits and mice research at a dose of 1000mg/kg/day, equivalent to about 24 times the dose of 200mg 2 times a day in people equivalent to mg/m/day. In rabbits, the highest dose is studied as 90mg/kg/day, 4 times the dose of 200mg, 2 times a day in people calculated by mg/m2/day.

At this dose, the drug is toxic to the mother rabbit and leads to premature birth.

In mouse postpartum research, Cefditoren Pivoxil does not cause any side effects to survive, develop behavior and physical and fertility of the mouse when it comes to the stage of sexual development with a dose of up to 750mg/kg/day, 18 times the dose of 200mg twice a day in the person equivalent to mg/m/kg.

However, there is currently no full research on humans, so if it is really necessary, CEFDITOREN for women during pregnancy.

cefditoren is excreted in milk when studying on mice. Because many drugs are excreted in milk, it is necessary to be careful when using cefditoren for nursing women.

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

There is currently no research on the effect of the drug on driving or operating the machine. However, some side effects are recorded (dizziness, sleep, headache) may affect the ability to drive or operate the machine. Patients should be recommended for this side effect when using the drug.

Interactive drug

Oral contraceptive pills: Cefditoren Pivoxil multi -dose non -impact on the kineticness of ethinyl estradiol.

Antibiotic drugs: Concentrated with aluminum -containing anti -juice drugs and Magnesi Hydroxide reduces the absorption of Cefditoren after eating, namely a 11% and 14% reducing AUC. Although the clinical impact is significantly not known, it is not recommended to use these two drugs simultaneously.

H2 anti -H2: Use single dose of famotidine injection and reduce the absorption of cefditoren 400mg single doses after eating, shown by reducing AUC 22% and 27% CMAX. These two drugs also do not recommend simultaneously use even though the clinical impact is not known.

Probenecid: Like B-Lactam antibiotics, simultaneous use with Probenecid increases CMAX of CEFDitoren 49% and AUC 122% and extends the sale time of up to 53%.

Testing interactions: Can cause direct positive Coombs' reaction, fake Ferricyanid test, pseudo -urinary testing test when using clinitest.

Interaction with food: Food increases the absorption of cefditoren. Fat meals increase the bioavailability of the drug.