Properties
What is it?
Zinnat International name - cefuroxime axetil ATC classification code - J01DA06 Clinical-pharmacological group - Beta-lactam antibiotics (penicillins and cephalosporins); second-generation cephalosporins Composition and dosage form Film-coated tablets 125 mg: 10 pcs. Film-coated tablets 250 mg: 10 pcs. Granules for oral suspension 125 mg /5ml: 50 ml bottle Film-coated tablets: In a pack of 10 pcs. 1 tab. Cefuroxime axetil . . . . 125 mg Film-coated tablets: In a pack of 10 pcs. 1 tab. Cefuroxime axetil . . . . 250 mg Granules for oral suspension: In a 50 ml bottle 5 ml. Cefuroxime (as cefuroxime axetil). . . 125 mg Excipients: Povidone 30, stearic acid, sucrose, flavoring. See blog: Zinnat — an effective antibiotic for fighting various infections Pharmacological properties Zinnat is a broad-spectrum antibiotic of the II generation cephalosporins group for oral use. Zinnat's bactericidal action is due to the inhibition of microorganism cell wall synthesis. It is resistant to most beta-lactamases. In vitro, cefuroxime is active against Gram-positive and Gram-negative microorganisms: Staphylococcus aureus, Staphylococcus epidermidis (including penicillin-resistant strains, except for rare strains resistant to methicillin); Haemophilus influenzae (including ampicillin-resistant strains), Klebsiella spp., Enterobacter spp., Streptococcus pyogenes, Escherichia coli, Streptococcus mitis (jgufi viridans), Clostridium spp., Proteus mirabilis, Proteus rettgeri, Salmonella typhi, S. typhimurium and other types of Salmonella spp., Shigella spp., Neisseria spp. (including beta-lactamase-producing N. gonorrhoeae strains) and Bordetella pertusis. The preparation is also active against Pr. Vulgaris, Pr. morganii strains. Most strains of Bacteroides fragilis are not sensitive to the preparation. It is not active against Pseudomonas, Campilobacter, Acinobacter calcoaceticus and Serratia, most strains of Clostridium difficile. In vitro studies have shown that when cefuroxime is combined with aminoglycoside antibiotics, an additive effect is observed, and in some cases – synergism. Pharmacokinetics Absorption: Upon oral administration of Zinnat, cefuroxime axetil is well absorbed from the gastrointestinal tract and rapidly hydrolyzed by the intestinal mucosa and in the blood, releasing cefuroxime into the systemic circulation. Its maximum concentration in blood plasma is observed 2-3 hours after administration. Food intake accelerates the absorption process. Distribution: The protein binding of the preparation ranges from 33% to 50%. Metabolism and excretion: Zinnat does not undergo biotransformation in the body; it is excreted unchanged via the urinary tract. The half-life of the preparation is 1-1.5 hours. Indications Zinnat is used for the treatment of infectious-inflammatory diseases caused by microorganisms sensitive to the preparation: - Respiratory tract infections (including acute and chronic bronchitis, infected bronchiectasis, bacterial pneumonia, lung abscess, postoperative infections of thoracic organs); - Ear, nose, and throat infections (sinusitis, tonsillitis, pharyngitis); - Genitourinary tract infections (including acute and chronic pyelonephritis, cystitis, urethritis, asymptomatic bacteriuria, inflammatory diseases of the pelvic organs); - Soft tissue infections (including furunculosis, pyoderma, impetigo); - Bone and joint infections (including osteomyelitis, septic arthritis); - Gonorrhea (including acute uncomplicated gonococcal urethritis and cervicitis); - Treatment of Lyme disease in the early stages and prevention of late symptoms of the disease in adults and children up to 12 years of age. Dosage and administration For most infections in adults, the single dose of the preparation is 250 mg, 2 times a day. Mild to moderate lower respiratory tract infections – 250 mg 2 times a day. Severe lower respiratory tract infections (e.g., pneumonia) – 500 mg 2 times a day. Urinary tract infections – 125 mg 2 times a day, for pyelonephritis – 250 mg 2 times a day. For uncomplicated gonorrhea – 1 g once a day. For Lyme disease in adults and children over 12 years of age – 500 mg 2 times a day for 20 days. For children under 2 years of age, for most infections, an average of 125 mg (one 125 mg tablet or 5 ml of suspension) is prescribed 2 times a day. For children over 2 years of age and for otitis media, 250 mg is prescribed 2 times a day. For mild and moderate infections, the single dose is 10 mg/kg. Age | Body weight (kg) | Single dose (mg) twice daily 2-6 months | 4-6 | 40-60 6 months - 2 years | 6-12 | 60-120 2-12 years | 12->20 | 125 For otitis media and severe infections, 15 mg/kg is prescribed 2 times a day. Age | Body weight (kg) | Single dose (mg) twice daily 3-6 months | 4-6 | 60-90 6 months - 2 years | 6-12 | 90-180 2-12 years | 12->20 | 180-250 The maximum daily dose is 500 mg. Patients with renal insufficiency undergoing hemodialysis are prescribed 1 g per day. The duration of treatment is an average of 7 days (5-10 days). Zinnat is recommended to be taken after meals. Side effects Gastrointestinal tract: nausea, vomiting, diarrhea, possible transient increase in liver transaminase activity, jaundice, cases of pseudomembranous colitis have been described. Hematopoietic system: hemolytic anemia, eosinophilia, leukopenia, neutropenia, thrombocytopenia. Allergic reactions: skin rash, itching, urticaria, fever, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, serum sickness. Rarely - anaphylactic shock. CNS: headache. Other side effects: A positive Coombs test is observed in some patients. Contraindications Hypersensitivity to cephalosporin antibiotics. Pregnancy and lactation Zinnat, like other antibiotics, is prescribed with caution during the first trimester of pregnancy and during lactation. Embryotoxic and teratogenic effects of the preparation have not been established in experimental studies. Special instructions The preparation is prescribed with caution to patients with hypersensitivity to penicillin antibiotics. With prolonged use of Zinnat, increased growth of microorganisms resistant to the preparation (Candida, Enterococci, Clostridium difficile) is possible, which may necessitate discontinuation of treatment with the preparation. Development of pseudomembranous colitis is suspected in case of diarrhea developing against the background of antibiotic intake (including Zinnat). In rare cases, Jarisch-Herxheimer reaction is observed during the treatment of Lyme disease with Zinnat. This reaction is a direct consequence of Zinnat's bactericidal action against the spirochete Borrelia burgdorferi, the causative agent of the disease, which is a common and frequent occurrence and usually resolves on its own shortly. For determining blood glucose levels against the background of Zinnat, it is recommended to use glucokinase or hexokinase. The preparation does not affect the results of the creatinine determination test with alkaline picrate. Mixing granules for oral suspension or already prepared suspension with hot liquids is not recommended. Overdose Symptoms: CNS changes - excitability, convulsions. Treatment: symptomatic. Zinnat is eliminated from the body by hemodialysis and peritoneal dialysis. Drug interactions When Zinnat is used in combination with probenecid, the cefuroxime "concentration-time" curve area increases by 50%. Antacids reduce the bioavailability of Zinnat suspension. Storage conditions and shelf life Tablets should be stored in a dry, protected from light and children place at a temperature not exceeding 25°C. Shelf life - 3 years. Granules for oral suspension should be stored at a temperature not exceeding 25°C. Shelf life - 2 years. Prepared suspension should be stored for no more than 10 days at a temperature not exceeding 25°C or in the refrigerator.
