Pancef, 100 mg/5 ml 32 g

Pantsef is a broad-spectrum antibacterial (bactericidal).

Pharmacodynamics

Cefixime is an oral cephalosporin antibiotic of III generation with pronounced antibacterial activity against most Gram-positive and Gram-negative microorganisms.

The mechanism of action is caused by inhibition of the synthesis of the cell membrane of the pathogen. It is resistant to beta-lactamases of both Gram-positive and Gram-negative microorganisms.

Highly active against Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis (including strains producing beta-lactamases). beta-lactamase-producing strains), Escherichia coli, Proteus mirabilis, Proteus vulgaris, Neisseria gonorrhoeae, Klebsiella pneumoniae, Klebsiella oxytoca, Pasteurella multocida, Providencia spp, Salmonella spp., Shigella spp., Citrobacter spp. (including Citrobacter diversus), Serratia marcescens.

Pseudomonas spp., Acinetobacter spp., some strains of Streptococcus, Enterococcus spp. (methicillin-resistant strains), Listeria monocytogenes, Bacteroides fragilis, most strains of Staphylococcus, Enterobacter and Clostridium are resistant to cefixime.

Pharmacokinetics

Absorption. After oral administration, cefixime absorption is 40-50% regardless of ingestion; however, serum C_max has been noted to be reached faster by 0.8 h when the drug is taken with food. When the drug is taken in tablet form at a dose of 400 mg, C_max in plasma is 3.5 µg/ml. T_max is 2-6 hours.

After taking the suspension, C_max (compared to tablets) is 25-50% higher. T_max is 2-6 h for 400 mg/5 ml suspension and 2-5 h for 200 mg/5 ml suspension. T_max in plasma is also 2-6 h.

Distribution. Binding to plasma proteins is 50-60%. V_d is 0.6-1.1 l/kg. High concentrations of the drug remain in serum, bile, urine for a long time.

Metabolism. There are no data on cefixime metabolites.

Elimation. Cefixime is excreted mainly by the kidneys by glomerular filtration in unchanged form – 50%, with bile – 10%.

T_1/2 in healthy volunteers averages 3-4 h, in some cases up to 9 h. Long T_1/2 makes single dosing possible.

In impaired renal function, in creatinine Cl 20-40 ml/min T_1/2 increases and averages 6.4 h, in creatinine Cl 5-20 ml/min T_1/2 is 11.5 h.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to cefixime:

Active ingredient

Composition

Active ingredient:

Cefixime (in the form of cefixime trihydrate);

Auxiliary substances:

sucrose;

xanthan gum;

sodium benzoate;

orange flavoring

How to take, the dosage

Ingestion. For adults and children over 12 years of age with body weight over 50 kg, the recommended daily dose is 400 mg once daily or 200 mg twice daily.

In uncomplicated gonorrhea, 400 mg once.

In children aged 6 months to 12 years with a body weight less than 50 kg, the drug is given as a suspension in a dose of 8 mg/kg once daily or 4 mg/kg every 12 hours.

Interaction

Blockers of tubular secretion (allopurinol, diuretics, etc.) delay renal excretion of cefixime, which may lead to increased toxicity.

Cefixime decreases the prothrombin index and increases the effect of indirect anticoagulants.

Antacids containing magnesium or aluminum hydroxide slow down absorption of the drug. Concomitant use of cefixime and carbamazepine increases the concentration of the latter.

Special Instructions

Patients with a history of allergic reactions to penicillins may have hypersensitivity to cephalosporin antibiotics. In case of allergic reactions the drug should be discontinued and, if necessary, appropriate measures should be taken.

As with other antibacterial drugs, prolonged use of cefixime may disrupt normal gut flora, which may lead to growth of Clostridium difficile and cause severe diarrhea and pseudomembranous colitis.

False positive direct Coombs reaction and false positive urine reaction for glucose, ketonuria are possible during treatment.

Contraindications

With caution: elderly, renal failure, colitis (history).

Side effects

Allergic reactions: urticaria, skin hyperemia, skin itching, genital itching, eosinophilia, fever, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell syndrome).

Nervous system disorders: headache, dizziness, tinnitus.

Anxiety to the genitourinary system: vaginitis.

Urinary system disorders: interstitial nephritis.

In the digestive system: nausea, vomiting, stomatitis, diarrhea, abdominal pain, constipation, pseudomembranous enterocolitis, dysbacteriosis, cholestasis; cholestatic jaundice.

Hematopoietic organs: pancytopenia, leukopenia, neutropenia, agranulocytosis, thrombocytopenia, aplastic anemia, hemolytic anemia, bleeding.

Laboratory parameters: increased hepatic transaminases and alkaline phosphatase activity, hyperbilirubinemia, increased urea nitrogen, hypercreatininemia, increased PV.

Others: candidiasis, development of hypovitaminosis B, shortness of breath.

Overdose

Symptoms: worsening manifestations of the described side effects.

Treatment: Gastric lavage, symptomatic and supportive therapy.

Hemodialysis and peritoneal dialysis are ineffective.

Similarities