Active against gram-positive bacteria – Staphylococcus aureus and Staphylococcus epidermidis (producing strains not producing penicillinase), Streptococcus pneumoniae, Streptococcus pyogenes (beta-haemolytic strain of group A), Streptococcus agalactiae (beta hemolytic strain of group B), Enterococcus faecalis, many et al. strains of beta-hemolytic Streptococcus spp .; Gram-negative organisms – Escherichia coli, Klebsiella spp. (Including Klebsiella pneumoniae), Enterobacter spp., Citrobacter spp., Haemophilus influenzae (producing strains not producing beta-lactamase), Proteus mirabilis, Proteus vulgaris, Morqanella morqanii, Providencia rettqeri (formerly Proteus rettqeri), Providencia spp., Serratia spp. (Including Serratia marcescens), Salmonella spp., Shigella spp., Many deca durabolin injection strains of Pseudomonas aeruginosa and other Pseudomonas. Species, some strains of Acinetobacter spp., Neisseria qonorrhoeae (producing strains not producing beta-lactamase), Neisseria meningitidis , Bordetella pertussis, Yersinia enterocolitica; -grampolozhitelnye anaerobes and Gram negative cocci (including Peptococcus, Peptostreptococcus and Veilloneilla spp.), and sporo- asporogenous gram positive anaerobes (Clostridium spp., Eubacterium spp., Lactobacillus spp.) and gram (including Fusobacterium spp., many strains of Bacteroides fragilis spp ., Prevotella spp., et al. representatives strains Bacteroides spp.).
It reaches therapeutic concentrations in tissues and body fluids: peritoneal, ascites fluid, and cerebrospinal fluid (meningitis), urine, bile, gallbladder wall, lung, sputum, tonsils and mucous membrane of the sinus, atrium, kidneys, ureters, prostate, testicles , uterus, fallopian tubes, bones, umbilical cord blood and amniotic fluid.
The volume of distribution 0.14-2 l / kg. The half-life (T1 / 2) – 1.6-2.4 hours, regardless of route of administration, 2.8-4.2 h hemodialysis, 2.2 ch in infants and children from 2 months – 11 years. Excreted in the bile – 70-80%, the kidneys – 20-30% in unchanged form. In patients with impaired function of the liver and biliary tract obstruction T1 / 2 – 3-7 hours, urinary excretion – 90% or more. Even under severe lesions in the liver bile therapeutic concentrations are achieved, and T1 / 2 longer only 2-4 times. In patients with renal hepatic impairment may accumulate.
Bacterial infections of the upper and lower respiratory tract, urinary tract, abdominal infections (peritonitis, cholecystitis, cholangitis, etc.), Sepsis, meningitis, skin and soft tissue infections, bone and joint infections, infectious and inflammatory diseases of the pelvic organs ( endometritis, gonorrhea and others. genital tract infection).
Prevention of infectious complications after abdominal, gynecological, cardiovascular and orthopedic surgeries.
For the treatment of severe and kraynetyazhelyh hospital and surgical infections recommended combination with aminoglycosides (amikacin), which increases the power and spectrum of antimicrobial activity against the majority of nosocomial pathogens.
Hypersensitivity to cefoperazone and other cephalosporins.
Dosage and administration . Intramuscular administration recommended the following two-step dilution of the drug: the contents of the vial is added the required amount of sterile water (see table), the vial is shaken vigorously until completely dissolved Medotsefa.Ready to use solution is kept up until the small air bubbles formed during dissolution disappears.To this was added the required amount of 2% lidocaine solution and mixed.
To prepare the starting solution for intravenous infusion add 5 ml of solvent to 1 g of cefoperazone. For the initial dilution, the following solutions: 5% glucose solution for injection, 5% glucose and 0.9% or 2% sodium chloride for injection, 10% glucose solution for injection, 0.9%) sodium chloride solution for injection, sterile water for injection. The solution was stirred as it is written in the “Intramuscular”. Next, the whole amount of the resulting solution should be diluted with one of the above (except water) solvents for intravenous infusion.
For continuous / in infusion each vial is dissolved in 20-40 ml of sterile solution to a compatible I / injection and administered for 15-30 min. For continuous infusion the initial solution must be diluted to obtain a solution with a concentration of 2-25 mg / ml cefoperazone.
In / in, in / m. Adults – in the average daily dose of 2-4 g, 2 times a day. In severe infections, the dose may be increased to 12 g / day:. 2-4 g every 8 hours, or 3-6 g every 12 hours Treatment may be started before the results of the study the susceptibility of microorganisms. With no complicated gonococcal urethritis – single, w / m, 500 mg.
For antibacterial prophylaxis of postoperative complications – in / at 1 g or 2 g for 30-60 minutes prior to surgery, repeated every 12 hours (usually within less than 24 hours). In deca durabolin injection operations with an increased risk of infection (eg, operations in colorectal), or if arisen infection can cause particularly great damage (for example, open heart surgery or prosthetic joints), prophylactic use of the drug can last for 72 hours after completion of the operation.
In patients with renal hepatic failure – not more than 2 g / day. Patients with a glomerular filtration rate below 18 ml / min or creatinine above 3.5 mg / dl – is not more than 4 g / day. In isolated liver failure does not require dose reduction, if the patient does not receive the maximum dose, as compensatory increases renal excretion of the drug up to 90%> or more.
The children – daily doses of 50 to 200 mg per 1 kg / body weight; in 2 divided doses (every 12 hours) or more, if necessary. Infants (less than 8 days.) – Every 12 hours daily doses up to 300 mg / kg, applied without complications in infants and children with severe infections, including bacterial meningitis.
: Allergic reactions: rash, maculo-papular rash, fever, eosinophilia, erythema multiforme, a malignant exudative erythema (Stevens-Johnson syndrome), a positive Coombs’ test.
From the digestive system: nausea, vomiting, diarrhea, pseudomembranous colitis.
From the side of hematopoiesis and hemostasis system bleeding (vitamin K deficiency).
Laboratory findings: hypoprothrombinemia, increased prothrombin time, increased activity of “liver” transaminases and alkaline phosphatase, hypercreatininemia, anemia, neutropenia.
Local reactions: with a / in the introduction – phlebitis; when i / m administration -boleznennost at the injection site.
seizure. Treatments: sedation with diazepam.
The interaction with other drugs
Pharmaceutically compatible with aminoglycosides (when the need for combination therapy and cefoperazone aminoglycoside administered in a sequential fractional on / in the formulations using two separate I / catheter).
From ethanol – disulfiramopodobnye reaction.
Indirect anticoagulants, heparin, thrombolytics increase risk of hypoprothrombinemia, bleeding.
Aminoglycosides and “loop” diuretics can cause renal toxicity, especially in patients with renal insufficiency persons.
Drugs that reduce the tubular secretion, increase the concentration of drug in the blood and slow down its excretion.
may be used in combination therapy in conjunction with others. Antibiotics.
Patients with hypersensitivity to penicillin drug should be prescribed with great caution.
In cases of obstruction of the bile ducts, severe liver disease or concomitant deca durabolin injection renal dysfunction, it may be necessary to change the dosing regimen (see. “Dosage and Administration” section).
Long-term use can lead to the development of exciter stability.
During the period of use of the drug may be a false positive reaction for glucose in the urine with a solution of Benedict or Fehling.
During treatment should refrain from receiving ethanol – possible effects, similar to the action of disulfiram (facial flushing, abdominal cramps and in the stomach, nausea, vomiting, headache, decreased blood pressure, tachycardia, shortness of breath).
In the appointment during lactation should stop breastfeeding. Treatment during pregnancy should take place only when necessary in patients adhering to inadequate diet or with malabsorption of food (eg, cystic fibrosis), as well as patients who are in for a long time on parenteral nutrition, it may be deficient in vitamin K. Such patients should be carried out monitoring of prothrombin time, and, if necessary, it shows the assignment of exogenous vitamin K.