What is Cefazolin for? Description of the pharmaceutical form

The recipe in Latin states that one bottle of the product contains cefazolin without any additional components.

Release form

The medicine is available in the form of a yellow-white or white powder, which dissolves to carry out intramuscular or intravenous injections . The drug is packaged in vials. This form of release as Cefazolin in tablets is not sold.

Pharmacological action

This medicine is semi-synthetic With antibacterial broad spectrum action.

Pharmacodynamics and pharmacokinetics

Pharmacological action The drug is based on blocking the biosynthesis of microbial cell walls. Antibiotic Cefazolin is active against gram-positive (Streptococcus spp., Staphylococcus spp.) and gram negative bacteria (Klebsiella spp., Escherichia coli, Treponema spp., Haemophilus influenzae, Proteus mirabilis, Neisseria gonorrhoeae, Enterobacter aerogenes).

The drug is poorly absorbed from the gastrointestinal tract when used internally, therefore it is used for intravenous And intramuscular injections . After intramuscular injections at a dosage of 0.5 g, the maximum concentration is observed after 1-2 hours. Communication with proteins – approximately 85%.

The active substance of the drug penetrates into bone tissue, as well as pleural , ascitic And synovial fluid , but is not detected in the nervous system.

The half-life of the drug is approximately 1.8 hours. The drug is excreted unchanged in the urine.

At intramuscular In injections, about 80% of the dose is eliminated after 24 hours. In case kidney dysfunction plasma half-life increases.

Indications for use of Cefazolin

Indications for use of Cefazolin are as follows:

• bile duct infections And urinary tract ;
• infectious diseases of the respiratory tract ;
• inflammation in the abdominal cavity and pelvic organs;
• infection ;
• peritonitis And sepsis ;
• skin infections after burns, surgeries and wounds;
• inflammation of the lining of the heart;
• bone infections And joints ;
• infectious skin diseases ;

For what purpose the drug will be effective in each individual case, it is necessary to consult a specialist. Only a doctor knows the exact indications for the use of Cefazolin. For example, he may recommend a drug for , skin infections or blood poisoning .

The medicine is also used in veterinary practice for cats. Injections help with infections , peritonitis , , as well as many infectious diseases .

Contraindications

The main contraindications to the use of the drug: individual intolerance and age under 1 month.

Side effects

Using the medication may cause the following side effects:

• digestive system organs: , nausea, vomiting;
• chemotherapeutic effect: , pseudomembranous ;
• : , eosinophilia , , ;
• local reactions: painful sensations in the area intramuscular introduction.

In rare cases, there is a transient increase in activity liver transaminases , , arthralgia , , leukopenia (in reversible form), thrombocytopenia , neutropenia , kidney dysfunction .

Instructions for the use of Cefazolin injections (Method and dosage)

When Cefazolin injections are prescribed, the instructions for use indicate that the dosage and duration of the course may vary depending on the disease and the individual sensitivity of the patients. Daily dosage for adults is from 1 to 6 g. Injections do 2-3 times daily. Therapy is designed for a maximum of 7-10 days.

The drug is administered i/m or IV . Depending on this, they decide how to dilute Cefazolin. At intramuscular When administered, the medicine is diluted with water or sodium chloride solution. For intravenous Injections mainly use sodium chloride. In this case, the drug is administered slowly. Administration time is approximately 5 minutes.

If the patient is given drip , antibiotic , as a rule, are diluted with glucose, and sodium chloride is used only in rare cases.

For the treatment of inflammation of the lining of the heart, joints, purulent pleurisy , bones, abdominal cavity, blood poisoning 1 g of the drug is administered 3 times every day. At kidney dysfunction the dosage should be halved.

The drug cannot be combined in the same syringe with others. antibiotics .

In addition to water and sodium chloride, the medicine is also sometimes diluted . This for topical use, which can be used to reduce pain during injection. This drug has been used in medical practice for quite a long time, so there is an established scheme for how to dilute Cefazolin Novocaine . The latter is taken at a concentration of 0.25%. Before divorcing Novocaine This medicine does not require any additional manipulations. It is enough to just inject 2-3 ml to antibiotic , and then shake well. The result is a ready-made solution for single use.

For some indications, the drug is also used in veterinary practice instead of using tablets. In this case, he is bred in or Novocaine . The dosage for cats depends on the weight of the pet, it is calculated so that 10 mg is per 1 kg. Therapy lasts 5-10 days. Before using the medicine, you should consult your veterinarian.

Often used as an analogue of the drug for humans Cefazolin Akos . It is also introduced through intramuscular And intravenous injections (stream and drip). Instructions for use Cefazolin Akos reports that the average daily dosage for adults is 1 g. They should be administered 2 times a day. The maximum dose per day should not exceed 6 g. If necessary, the frequency of use can be increased to 3-4 times a day. The average duration of therapy is 7-10 days.

The average daily dosage for children is 25-30 mg/kg, and in case of severe infections – 100 mg/kg.

At kidney dysfunction doses are adjusted.

For intramuscular injection antibiotic a dose of 500 mg is mixed with 2 ml of water, 1 g is diluted in 2.5 ml of water. For intravenous administration, the medicine is mixed with 5 ml of water and administered for 3-5 minutes.

Overdose

Administration of the drug in high doses may cause , And . In people with may appear in a chronic form neurotoxic phenomena . Convulsions are noted and vomiting.

If toxic reactions and signs of overdose, the elimination of the drug can be accelerated by using .

Interaction

When combining the drug with aminoglycosides , , noted synergism of antimicrobial action . Aminoglycosides increase the likelihood of kidney damage. The drug is incompatible with them.

It is not advisable to combine the medication with anticoagulants And diuretics .

Interaction with agents that inhibit tubular secretion , increases the level of the active substance of the drug in the blood, increases the likelihood of toxic reactions and slows down the elimination time.

Terms of sale

The medicine is sold only with a prescription from a specialist.

Storage conditions

Optimal storage conditions are a dry and dark place. Temperature no more than 5°C.

Best before date

Analogues of Cefazolin

Level 4 ATX code matches:

The following analogues of Cefazolin are known:

• Cefazex ;
• Cefazolin-Astrapharm ;
• Cefazolin Akos ;
• Reflin ;
• Cesolin ;
• Cefazolin-Pharmex ;
• Cefamezine .

All of these medications are sold in powder form. Common analogues are not available in tablets.

Cefazolin for children

Cefazolin for children is diluted only in solutions Novocaine or Lidocaine depending on individual tolerance. As a rule, a more pronounced analgesic effect has Lidocaine .

The solution is prepared immediately before use. The dosage of Cefazolin for children is calculated based on the nature of the disease and individual tolerance to the drug.

Cefazolin during pregnancy (and lactation)

When is Cefazolin used for , it has almost no negative impact on the fetus and the woman’s health. However, it should be prescribed only under the supervision of a specialist. Use Cefazolin for pregnancy And It is dangerous without medical supervision.

Cefazolin is an antibiotic with a wide spectrum of activity. The medication is prescribed for the treatment of inflammatory diseases in patients of older and younger age categories. The medicine destroys pathogenic microorganisms, inhibits their further development, and as a result, the child recovers.

Cefazolin helps fight inflammatory diseases of the respiratory, digestive, genitourinary and skeletal systems. The effect of the drug is due to the properties of the components that make up it. During treatment, it is important to follow the treatment regimen and the rules for using the injection solution.

Description of the pharmaceutical form

Cefazolin is an antibiotic that is a member of the cephalsporins. The medicine goes on sale in the form of a white powder with a yellowish tint. Before use, it is mixed with a solvent. The powder is packaged in glass bottles with a volume of 0.5, 1, 2 ml. For children, the drug is used in dosages of 0.5 and 1 ml.

The drug consists of a single component - cefazolin in the form of sodium salt.

A semi-synthetic antibiotic destroys pathogens by destroying their cell membrane. Cefazolin has a wide spectrum of activity and therefore kills different types of bacteria. The medication is the least toxic cephalsporin antibiotic.

The drug destroys harmful microorganisms that provoke infectious and inflammatory diseases. The medication is active against staphylococci, streptococci, Proteus, enterobacteria, salmonella, etc.

Thus, Cefazolin allows you to cure all diseases caused by pathogenic microflora. An antibacterial drug is used to prevent infectious diseases before and after operations on various organs.

The medication is poorly absorbed into the walls of the digestive tract when administered orally, and therefore it is injected into the muscle and vein. The antibiotic begins to act 60–120 minutes after administration. The drug is excreted unchanged through the kidneys.

Indications

As indicated in the instructions for use, Cefazolin injections are prescribed to children for the following diseases:

• Infectious lesions of the biliary tract (cholecystitis);
• Urogenital infections (inflammation of the kidneys, bladder);
• Abdominal infections (peritonitis);
• Purulent infection of tissues or organs;
• Infectious lesions of the skin and soft tissues (due to the penetration of microbes into burns, wounds, sutures after operations);
• Inflammatory disease of the joints or bones (arthritis, osteomyelitis);
• Sexual infections (gonorrhea, chlamydia);
• Inflammation of the endocardium;
• Infectious.

Before injecting Cefazolin into children, you should consult a doctor.

Application and dosage

If the child is under 1 month, the drug is used only when absolutely necessary. The dosage of the drug for children from 1 month to 15 years depends on body weight and severity of the disease. The standard daily dose is 20 to 50 mg/kg three or four times.

The drug is injected into a muscle or vein; it is prohibited to use it orally or intranasally.

The therapeutic effect appears 15 minutes after intravenous use. The drug continues to act for 2–4 hours. The active component destroys existing pathogenic microorganisms and prevents the formation of new bacteria.

After intramuscular administration, the therapeutic effect appears within an hour and lasts from 8 to 12 hours.

Solution preparation technology:

1. 5 ml of Novocaine (1%) is taken into the syringe.
2. Remove the protective foil from the neck of the bottle.
3. A cotton swab is soaked in alcohol and the cap on the bottle is wiped.
4. The Novocaine solution is injected into a bottle of powder.
5. The solution is shaken until the powder is completely dissolved.
6. The finished medicine is drawn into a syringe for injection.

The daily dose of the drug depends on the severity of the infection and the location of the inflammatory focus.

Cefazolin for children of the first year of life with infectious diseases of the respiratory organs or genitourinary system is given in the following dosage - from 25 to 50 mg/kg of total weight. This dosage is relevant for mild or moderate illnesses.

For purulent infection (for example, osteomyelitis), inflammation of the endocardium or lungs, the dose is increased - 100 ml/kg. The injection is administered at intervals of 6–8 hours.

If kidney function is impaired, the doctor independently adjusts the dosage and frequency of administration of the drug.

Rules for using the solution:

• Before administering the drug, the doctor performs a sensitivity test to cefazolin. To do this, the powder is diluted with novocaine and lidocaine.
• The inner side of the forearm is lightly scratched, and 2-3 drops of medicine are applied to the damaged skin.
• If there is no reaction after 10–25 minutes, then the antibiotic can be administered. If an allergy manifests itself in the form of redness or itching, you should discard the medication and select a suitable analogue.
• For intramuscular use, the needle is inserted as deep as possible into the muscle of the buttock or shoulder.
• For intravenous injections, the drug is slowly injected into the vein (over 3-5 minutes). Drip administration is carried out over 30 minutes.

The final dosage and treatment regimen are determined by the attending physician after diagnosis.

Special instructions

The antibacterial drug should not be used if there is hypersensitivity to cefazolin. In addition, the drug should not be used for a child under 1 month old, weakened or premature infants.

With an unreasonable increase in dosage or the presence of hypersensitivity to cefazolin, negative reactions occur:

• Allergies in the form of redness, swelling, itching of the skin, nettle fever.
• The functionality of the liver is impaired.
• Digestive disorders: diarrhea, nausea, vomiting. Long-term use disrupts the natural bacterial flora of the intestine. Due to dysbacteriosis, thrush or pseudomembranous colitis occurs.
• Inflammation of blood vessels (when injected into a vein).
• Pain at the injection site.

Less commonly, the activity of liver transaminases (liver enzymes) increases, anaphylaxis, joint pain, and Quincke's edema occur. In addition, tests can detect a decrease in the concentration of leukocytes, platelets, and neutrophils in the blood. In some patients, kidney function is impaired as a result of taking the drug.

If too large a dose of the drug is administered intramuscularly, headaches, dizziness, and skin sensitivity are impaired (numbness, tingling).

If the child had kidney problems, then as a result of an antibiotic overdose, involuntary muscle spasms, vomiting, and increased heart rate occur.

Similar drugs

Cefazolin is a first generation cephalosporin antibacterial agent. Other representatives of this group:

• Cephalothin is also marketed in powder form for injection. Prescribed for the treatment of infections of the urinary tract, respiratory organs, cardiovascular, musculoskeletal system, etc.
• Ecocephron is an antibacterial agent based on cephalexin. Used to treat diseases of cephaloxin-sensitive microorganisms.
• Cephalexin is available in the form of powder and capsules. Used to treat infections of the genitourinary, respiratory, ENT organs, etc.

These are analogues of Cefazolin, which have a similar mechanism of action.

Thus, Cefazolin is an effective antibiotic with a wide spectrum of activity that eliminates infectious diseases of various body systems (respiratory, genitourinary, cardiovascular, digestive, etc.). The medication is used only intravenously and intramuscularly. To avoid negative reactions in the child, parents must strictly adhere to the doctor’s recommendations regarding taking the drug.

Diseases caused by various microbes and infections have become widespread nowadays. Therefore, today special medicinal drugs based on antimicrobial properties have become very popular.

Composition and release form

Such special medications include Cefazolin. Indications for the use of this drug cover a wide range of bactericidal and antimicrobial effects. Cefazolin includes cefazolin sodium, which is a first-generation semisynthetic cephalosporin antibiotic. This medicinal product is available in the form of a white powder for the preparation of a special solution for injection.

The principle of action of the drug

Cefazolin actively reacts to gram-positive and gram-negative microorganisms, is resistant to antibiotics, and does not affect rickettsia and other protozoal viruses. This drug, like the famous penicillin, easily destroys the synthesis of the bacterial cell wall. An important property of the drug Cefazolin, due to the rapid absorption of the drug, does not go unnoticed. Almost 90% of the medication taken is bound to proteins in the blood plasma.

When using Cefazolin, the indications for use of this drug indicate that after intramuscular administration, the maximum concentration of the drug is achieved within an hour, and after intravenous injection - almost immediately. Cefazolin has the ability to quite easily penetrate into tissues through the synovial membrane in the joints. The particular value of using this drug lies in the fact that the therapeutic concentration of the drug remains in the human blood for almost 8 to 12 hours.

Indications for use

Medical specialists quite often prescribe Cefazolin, the indications for use of which indicate its unique pharmacokinetic characteristics. First of all, Cefazolin is intended for the treatment of numerous infections caused by pathogenic gram-negative and gram-positive microorganisms sensitive to this drug. The main indications for the use of the drug Cefazolin are infectious diseases of the respiratory tract, such as bronchitis, infected bronchiectasis, bronchopneumonia, bacterial. This medication is used to treat postoperative chest infections, lung abscess, tonsillitis, otitis media, and other diseases of the ENT organs of a similar nature.

Cefazolin also helps remarkably with infections of the genitourinary system. Indications for the use of this drug are aimed at the effective treatment of diseases such as acute and chronic pyelonephritis, prostatitis, urethritis, cystitis. Infectious diseases of the skin and soft tissues, including cellulite, mastitis, erysipelas, infected gangrene, burns, wounds and postoperative infections are also indications for the use of Cefazolin. This medicine is used in ophthalmology for infections of eye tissue. Cefazolin is indicated for use in the treatment of infectious diseases of bones and joints, including septic arthritis and osteomyelitis.

This drug has found wide use in gynecology, in particular in obstetrics. Cefazolin injections are used for uterine infections, pelvic abscesses, and salpingitis. People cannot do without injections of this drug when treating sexually transmitted diseases - syphilis, gonorrhea. Surgeons know that preoperative administration of the drug Cefazolin helps to effectively reduce the incidence of postoperative infections. As a rule, Cefazolin injections are carried out in a jet or drip manner, intravenously or intramuscularly. The required dosage is prescribed only by the attending physician.

Contraindications

Cefazolin, although highly effective, has certain contraindications. Cefazolin is contraindicated in case of hypersensitivity to cephalosporin antibiotics, non-acceptance of other beta-lactam antibiotics, or during pregnancy. For small children under one month of age, Cefazolin is prescribed only if absolutely necessary.

The drug Cefazolin is considered to have a fairly high degree of safety. However, despite this, taking any medicine, especially an antibiotic, requires mandatory prior consultation with a qualified medical specialist. Any self-medication risks dangerous complications. Observe the principle of reasonableness, never use medications yourself. Good health to you!

Semi-synthetic antibiotic of the 1st generation cephalosporin group for parenteral use.

Mechanism of action

The mechanism of action of cefazolin is based on the suppression of the synthesis of the bacterial cell wall of the bacterium in the growth phase due to blocking penicillin-binding proteins (PBPs), such as transpeptidases. This leads to a bactericidal effect.

Relationship between pharmacokinetics and pharmacodynamics

The effectiveness of cefazolin depends essentially on the length of time drug concentrations are maintained above the minimum inhibitory concentration (MIC) for a given pathogen.

Activity spectrum:

Typically susceptible microorganisms:

Staphylococcusaureus (Methicillin-sensitive)

Staphylococcus saprophyticus

Streptococcus agalactiae

Streptococcus pneumoniae

Streptococcuspyogenes

Proteusmirabilis

Microorganisms that may develop acquired resistance:

Aerobic gram-positive microorganisms:

Staphylococcusaureus

Staphylococcus epidermidis

Staphylococcus haemolyticus

Staphylococcus hominis

Streptococcus pneumoniae (Penicillin-intermediate)

Aerobic gram-negative microorganisms:

Escherichia coli

Haemophilus influenzae

Microorganisms with natural resistance:

Aerobic gram-positive microorganisms:

Enterococcusspp.

Staphylococcus aureus (Methicillin-resistant)

Streptococcus pneumoniae (Penicillin-resistant)

Aerobic gram-negative microorganisms:

Acinetobacterbaumannii

Citrobacter freundii

Enterobacter spp.

Morganella morganii

Moraxella catarrhalis

Proteus vulgaris

Pseudomonas aeruginosa

Serratia marcescens

Stenotrophomonas maltophillia

Anaerobicmicroorganisms:

Bacteroides fragilis

Othersmicroorganisms:

Chlamydia spp.

Chlamydophila spp.

Legionella spp.

Mycoplasma spp.

Pharmacokinetics

When taken orally, the drug is destroyed in the gastrointestinal tract, so cefazolin is administered only parenterally. After intramuscular administration, it is quickly absorbed; about 90% of the administered dose is bound to blood proteins. The maximum concentration of cefazolin in the blood with intramuscular administration is observed 1 hour after injection. When administered intramuscularly in doses of 0.5 g or 1 g, C max is 37 and 64 μg/ml; after 8 hours, serum concentrations are 3 and 7 μg/ml, respectively. When administered intravenously at a dose of 1 g, C max is 185 mcg/ml, serum concentration after 8 hours is 4 mcg/ml. T1/2 from the blood is approximately 1.8 hours with IV and 2 hours after IM administration. Therapeutic concentrations remain in the blood plasma for 8-12 hours. Penetrates into the joints, tissues of the cardiovascular system, the abdominal cavity, kidneys and urinary tract, placenta, middle ear, respiratory tract, skin and soft tissues. Concentrations in gallbladder tissue and bile are significantly higher than in blood serum. Synovial fluid levels of cefazolin become comparable to serum levels approximately 4 hours after administration. Does not pass through the BBB well. Passes through the placental barrier and is found in amniotic fluid. Secreted (in small quantities) into breast milk. Volume of distribution - 0.12 l/kg.

Does not biotransform. It is excreted mainly by the kidneys unchanged: during the first 6 hours - approximately 60%, after 24 hours - 70-80%. After intramuscular administration in doses of 0.5 g and 1.0 g, the maximum concentration in urine is 2400 mcg/ml and 4000 mcg/ml, respectively. A small amount of the drug is excreted in the bile.

Indications for use

Cefazolin injection is indicated for the treatment of the following infections caused by susceptible microorganisms:

Respiratory tract infections: caused by S.pneumoniae,S.aureus(including beta-lactamase producing strains) and S.pyogenes.

Injectable benzathine penicillin is considered the drug of choice in the treatment and prevention of streptococcal infections, including the prevention of rheumatism.

Cefazolin is effective in eliminating streptococcus from the nasopharynx, but there is no data on the effectiveness of cefazolin in the subsequent prevention of rheumatism.

Urinary tract infections: caused by E.coliP.mirabilis.

Infections of the skin and its structures: caused by S.aureus S.pyogenes and other strains of streptococci.

Biliary tract infections: caused by E.coli various strains of streptococci, P.mirabilis And S.aureus.

Bone and joint infections: caused by S.aureus.

Genital infections (including prostatitis, epididymitis): caused by E.coliP.mirabilis.

Septicemia: caused by S.pneumoniae,S.aureus(including strains producing beta-lactamases), P.mirabilis,E.coli

Endocarditis: caused S.pyogenes(including strains producing beta-lactamases) . Appropriate culture and susceptibility studies should be performed to determine the susceptibility of the pathogen to cefazolin.

Perioperative prevention: Prophylactic administration of cefazolin preoperatively, intraoperatively, and postoperatively may reduce the incidence of some postoperative infections in patients undergoing surgical procedures that are classified as contaminated or potentially contaminated (eg, vaginal hysterectomy and cholecystectomy in high-risk patients: age older 70 years old, concomitant acute cholecystitis, obstructive jaundice or the presence of gallstones).

Perioperative use of cefazolin may also be effective in surgical patients in whom infection at the surgical site would be a serious concern (eg, during open-heart surgery and joint replacement).

Prophylactic administration of cefazolin should usually be discontinued within a 24-hour period following the surgical procedure. In surgery, where the occurrence of infection can be particularly devastating (for example, during open-heart surgery and joint replacement), prophylactic administration of cefazolin can be continued for 3 to 5 days after completion of surgery.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of cefazolin and other antibacterial drugs, cefazolin should be used only for the treatment or prevention of infections with a proven or suspected susceptible organism. When culture and susceptibility information is available, consideration should be given to the selection or modification of antibiotic therapy. In the absence of such data, knowledge of local epidemiology and susceptibility may guide empirical treatment decisions.

Contraindications

Hypersensitivity to cephalosporin antibiotics; pregnancy. The drug is not prescribed to premature babies and children in the first month of life.

With caution: renal failure, intestinal diseases (including a history of colitis).

Pregnancy and lactation

During breastfeeding, the drug is used with caution, stopping breastfeeding for the period of treatment. Use during pregnancy is allowed only for health reasons.

Directions for use and doses

The drug is administered intramuscularly and intravenously (stream or drip). The dosage regimen is set individually, taking into account the severity of the disease, the type of pathogen and its sensitivity to cefazolin.

Preparation of solutions for injections and infusions

For intramuscular administration, the contents of a bottle of 0.5 g of the drug are dissolved in 2 ml, 1 g in 4 ml of isotonic sodium chloride solution or sterile water for injection, shaking thoroughly until completely dissolved. The resulting solution is injected deep into the muscle.

For intravenous jet administration, a single dose of the drug is diluted in 10 ml of isotonic sodium chloride solution or sterile water for injection and administered slowly over 3-5 minutes. For intravenous drip administration, the drug 0.5 g or 1 g is diluted in 50-100 ml of water for injection or isotonic sodium chloride solution or 5% dextrose solution and administered over 20-30 minutes (the rate of administration is 60-80 drops per minute ).

Only clear, freshly prepared solutions of the drug are suitable for use.

For adults single dose of cefazolin for infections caused by gram-positive microorganisms, is 0.25-0.5 g every 8 hours. For moderate respiratory tract infections caused by pneumococci or urinary tract infections For adults, the drug is prescribed at a dose of 0.5-1 g every 12 hours. For diseases caused by gram-negative microorganisms, the drug is prescribed in a dose of 0.5-1 g every 6-8 hours.

For severe infections (sepsis, endocarditis, peritonitis, destructive pneumonia, acute osteomyelitis, complicated urological infections) The daily dose of the drug for adults can be increased to a maximum of 6 g/day, with an interval between doses of 6-8 hours.

To prevent postoperative infection– IV, 1 g 0.5-1 hour before surgery, 0.5-1 g – during surgery and 0.5-1 g – every 8 hours during the first day after surgery.

For children over 1 month, the drug is prescribed in a daily dose of 20-50 mg/kg body weight (in 3-4 doses); for severe infections – 90-100 mg/kg. The maximum daily dose for children is 100 mg/kg.

The average duration of treatment is 7-10 days.

When prescribing cefazolin patients with impaired renal function correction of the dosage regimen is necessary. In adults, the dose of the drug is reduced and the interval between its administrations is increased. The initial dose of the drug, regardless of the degree of renal impairment, is 0.5 g. The following dosage regimens for cefazolin are further recommended in adult patients with impaired renal function:

- with creatinine clearance 55 ml/min. and more the full dose can be administered;

- with creatinine clearance 35-54 ml/min. the full dose can be administered, but the intervals between administrations must be increased to 8 hours;

- with creatinine clearance less than 11-34 ml/min.½ dose is administered with an interval between administrations of 12 hours;

- with creatinine clearance 10 ml/min. or less½ dose is administered with an interval between administrations of 18-24 hours.

If renal function is impaired in children, the usual single dose of the drug is first administered, subsequent doses are adjusted taking into account the degree of renal failure:

- with creatinine clearance 70-40 ml/min. the drug is administered in a daily dose of 12-30 mg/kg, divided into 2 injections with an interval of 12 hours;

- with creatinine clearance 40-20 ml/min. the drug is administered in a daily dose of 5-12.5 mg/kg, divided into 2 injections with an interval of 12 hours;

-with creatinine clearance less than 5-20 ml/min. the drug is administered in a daily dose of 2-5 mg/kg, divided into 2 injections with an interval of 24 hours.

Side effect

From the immune system: skin rash, itching, redness, dermatitis, urticaria, hyperthermia, angioedema, anaphylactic shock, exudative erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome), eosinophilia, arthralgia, serum sickness, bronchospasm.

From the blood and lymphatic system: cases of leukopenia, agranulocytosis, neutropenia have been reported; lymphopenia, hemolytic anemia, aplastic anemia, thrombocytopenia/thrombocytosis, hypoprothrombinemia, decreased hematocrit, increased prothrombin time, pancytopenia.

From the gastrointestinal tract: anorexia, nausea, vomiting, abdominal pain, diarrhea, flatulence, symptoms of pseudomembranous colitis, which may appear during or after treatment; with long-term use, dysbacteriosis, candidiasis of the gastrointestinal tract (including candidal stomatitis) may develop. In isolated cases, an increase in the level of ALT and AST and alkaline phosphatase was observed, extremely rarely - transient hepatitis and cholestatic jaundice, hyperbilirubinemia.

From the urinary system: impaired renal function (increased levels of urea nitrogen in the blood, hypercreatininemia); in such cases, the dose of the drug is reduced, and treatment is carried out under the control of the dynamics of these indicators. Interstitial nephritis and other renal dysfunction (nephropathy, renal papillary necrosis, renal failure) have been rarely reported.

Neurological disorders: headache, dizziness, paresthesia, anxiety, agitation, hyperactivity, convulsions.

Reactions at the injection site: pain, compaction, swelling at the injection site, cases of phlebitis have been reported during intravenous administration.

Other side effects: general weakness, pale skin, tachycardia, hemorrhages. In rare cases, anogenital itching, genital candidiasis and vaginitis may occur. Positive Coombs test. With long-term use, superinfection caused by pathogens resistant to the drug may develop.

Overdose

Parenteral administration of unreasonably high doses of the drug can cause dizziness, paresthesia and headache. With an overdose of cefazolin or its accumulation in patients with chronic renal failure, neurotoxic phenomena may occur, with increased convulsive readiness, generalized clonic-tonic convulsions, vomiting, and tachycardia.

Treatment: stop using the drug, if necessary, carry out anticonvulsant and desensitizing therapy. In case of severe overdose, supportive care and monitoring of hematological, renal, hepatic and coagulation functions are recommended until the patient's condition is stabilized. The drug is removed from the body during hemodialysis; peritoneal dialysis is less effective.

Interaction with other drugs

It is not recommended to use simultaneously with anticoagulants and diuretics, incl. furosemide, ethacrynic acid (when used simultaneously with loop diuretics, tubular secretion of cefazolin is blocked).

There is a synergistic antibacterial effect when combined with aminoglycoside antibiotics. Aminoglycosides increase the risk of developing kidney damage. Pharmaceutically incompatible with aminoglycosides (mutual inactivation). The drug cannot be mixed in the same infusion bottle with other antibiotics (chemical incompatibility).

Excretion of the drug is reduced when administered simultaneously with probenecid. Drugs that block tubular secretion slow down excretion, increase blood concentrations and increase the risk of toxic reactions.

Cephazolin is incompatible with drugs containing amikacin, sodium amobarbital, Bleomycin sulfate, calcium glintate, calcium gluconate, cimetidine hydrochloride, sodium coli, erythromycin, cannamicine sulfate, hydrochloride oxetraticyloris, pentarbitis on Triya, polymixin in sulfate and tetracycline hydrochloride.

When used simultaneously with ethanol, disulfiram-like reactions are possible.

Cross-reactivity may occur between cefazolin and drugs of the penicillin group.

Cefazolin may reduce the therapeutic effect of the BCG vaccine and typhoid vaccine, so this combination is not recommended.

Precautions

Patients with a history of allergic reactions to penicillins and carbapenems may have increased sensitivity to cephalosporin antibiotics, so one should be aware of the possibility of developing cross-allergic reactions.

During treatment with cefazolin, it is possible to obtain positive (direct and indirect) Coombs tests and a false-positive urine reaction to glucose. The drug does not affect the results of glucosuric tests performed using enzymatic methods. When prescribing the drug, exacerbation of gastrointestinal diseases, especially colitis, is possible.

Treatment with antibacterial drugs, especially for severe diseases in the elderly, as well as in weakened patients and children, can lead to antibiotic-associated diarrhea, colitis, including pseudomembranous colitis. Therefore, if diarrhea occurs during or after treatment with cefazolin, it is necessary to exclude these diagnoses, including pseudomembranous colitis. The use of cefazolin should be discontinued in case of severe and/or bloody diarrhea and appropriate therapy should be instituted. In the absence of necessary treatment, toxic megacolon, peritonitis, and shock may develop.

No dose adjustment is required for geriatric patients with normal renal function.

Cefazolin should not be administered intrathecally due to the possibility of developing severe toxic reactions from the central nervous system, including seizures.

Patients with impaired synthesis or deficiency of vitamin K (for example, chronic liver disease, kidney disease, old age, malnutrition, long-term antibiotic therapy), with long-term anticoagulant therapy prior to the administration of cefazolin, should monitor prothrombin time.

With intravenous administration of hypotonic solutions using water for injection as a solvent, hemolysis may develop.

One bottle of Cefazolin-Belmed 500 mg contains 1.05 mmol (24.1 mg) sodium. One bottle of Cefazolin-Belmed 1000 mg contains 2.1 mmol (48.2 mg) sodium. This should be taken into account in people monitoring their sodium intake (on a low sodium diet).

Storage conditions

In a place protected from moisture and light at a temperature not exceeding 25°C.

Keep out of the reach of children.

Best before date

3 years. Do not use after the expiration date stated on the package.