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Physicochemical findings on active ingredients
common name
Ceftizoxime sodium, Ceftizoxime Sodium (JAN)
Chemical name
Monosodium (6R, 7R) -7-[(Z) -2- (2-aminothiazol-4-yl) -2- (methoxyimino) acetylamino] -8-oxo-5-thia-1-azabicyclo [4.2.0] oct-2-ene-2-carboxylate
Molecular formula
C13H12N5NaO5S2
Molecular weight
405.38
Properties
It is a white to pale yellow crystalline or crystalline powder.
Very soluble in water, poorly soluble in methanol, and practically insoluble in ethanol (95).
Drug class name
Synthetic cephalosporin preparation
Sales name
Eposerin suppository 125/250
composition
Ingredients and contents (in one piece)
Japan Bureau ceftizoxim sodium 125 mg / 250 (titer)
Additive
Sodium caprate, hard fat
Contraindication
Patients who have a history of shock due to the ingredients of this drug
Effect or effect
Adapted bacterial species
Streptococcus species sensitive to ceftizoxime, Streptococcus pneumoniae, Escherichia coli, Citrobacter, Klebsiella, Enterobacter, Serratia, Proteus, Morganella morgani, Providencia, H. influenzae, Peptostreptococcus, Bacteroides, Prevotella. Melaninogenica
Indication
Acute bronchitis, pneumonia, secondary infection of chronic respiratory disease, cystitis, pyelonephritis
In children, usually 20 to 70 mg (titer) of ceftizoxim / kg body weight / day is divided into 3-4 times and inserted into the anus.
The dosage may be adjusted according to the age and symptoms.
In principle, in order to prevent the development of resistant bacteria etc., the sensitivity of the drug should be confirmed, and the administration should be for a minimum period necessary for the treatment of the disease.
In patients with severe renal impairment, blood levels will be maintained, so the dosage should be reduced according to the degree of renal impairment and used at intervals.
Careful administration
Patients with a history of hypersensitivity to penicillin antibiotics
Patients who are prone to cause allergic symptoms such as bronchial asthma, rash, urticaria etc.
Patients with severe renal impairment (see "Usage and Dose Related Usage Notes" section)
Patients with poor oral intake or patients with parenteral nutrition or with poor general condition [Because symptoms of vitamin K deficiency may occur, make sure that observation is sufficient. ]
Serious side effects
shock
As shock (less than 0.1%) may occur, observation should be carried out sufficiently. If discomfort, feeling of mouth abnormality, wheezing, dizziness, palpitation, palpitation, tinnitus, sweating etc. occur, discontinue administration and take appropriate measures. To do.
Anaphylactic symptoms
Anaphylaxis-like symptoms (respiratory distress, general flushing, angioedema, urticaria etc.) (less than 0.1%) may occur. Therefore, observe carefully and if any abnormalities are observed, discontinue administration and appropriate. Performing the treatment.
Blood disorder
Pancytopenia (less than 0.1%), agranulocytosis (less than 0.1%, initial symptoms: fever, sore throat, headache, fatigue etc), hemolytic anemia (less than 0.1%, initial symptoms: fever, hemoglobinuria, anemia Symptoms etc.), thrombocytopenia (less than 0.1%, initial symptoms: petechiae, purpura, etc.) may occur. Therefore, conduct regular examinations such as periodical examination, and if abnormalities are observed, administration Stop and take appropriate action.
Liver disorder
As jaundice (less than 0.1%), AST (GOT), ALT (GPT), Al-P increase (each less than 0.1 to 5%) may appear, etc. If any abnormalities are observed, discontinue administration and take appropriate measures.
Kidney disorder
Serious renal failure such as acute renal failure (less than 0.1%) may occur. Therefore, conduct regular observation such as periodical examination, and if any abnormality is found, stop administration and appropriate. Performing the treatment.
Colitis
Serious colitis (less than 0.1%) with bloody stools such as pseudomembranous colitis may occur. If abdominal pain or frequent diarrhea occurs, stop administration immediately and take appropriate measures.
Interstitial pneumonia, PIE syndrome
Interstitial pneumonia with fever, cough, dyspnea, chest x-ray abnormality, eosinophilia etc., PIE syndrome (less than 0.1% each) etc. may appear, so when such symptoms appear Discontinue administration and take appropriate measures such as administration of corticosteroids.
Pharmacology
Antibacterial action
The antibacterial spectrum covers a wide range of gram-positive bacteria and gram-negative bacteria, and in particular gram-positive cocci, Streptococcus, pneumococci, gram-negative bacilli, Escherichia coli, Klebsiella, Proteus, Morganella morganii, Providencia, influenzae etc. In addition to its strong antibacterial activity, it also exhibits excellent antibacterial activity against anaerobic bacteria including Citrobacter, Enterobacter, Serratia, Peptostreptococcus, Bacteroides and Prevotella melaninogenica. The mode of action is bactericidal 6) -9).
It is stable to β-lactamase produced by various bacteria and exhibits excellent antibacterial activity against β-lactamase-producing bacteria 6) 10) 11).
Mechanism of action
The mechanism of action is inhibition of bacterial cell wall synthesis, with the highest affinity for penicillin binding protein (PBP) 1b, followed by 1a, 3. Also, the outer membrane permeability of gram negative bacteria is good12) -14).
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