4th generation cephalosporins in tablets. Group of cephalosporins. Resistant strains of bacteria

Cephalosporins in tablets belong to the group of antibiotic drugs. Submitted medicines They are used mainly to combat diseases of a bacterial nature. Let's take a closer look pharmacological effects, indications and features of the use of this type of medicine.

Cephalosporins are antibiotic drugs, characterized high degree efficiency. These drugs were discovered in the mid-20th century. To date, there are 5 generations of cephalosporins. At the same time, 3rd generation antibiotics are especially popular.

The pharmacological effect of these drugs lies in the ability of their main active ingredients to damage bacterial cell membranes, which leads to the death of pathogens.

Cephalosporins (especially 4th generation) are extremely effective in the fight against infectious diseases, the occurrence and development of which is associated with the pathological activity of so-called gram-negative bacteria.

4th generation cephalosporins give positive results even in cases where antibiotic drugs belonging to the penicillin group turned out to be completely ineffective.

Indications for use

Cephalosporins in tablet form are prescribed to patients suffering from certain infectious diseases of a bacterial nature, and also as a means of preventing the development of infectious complications at surgical intervention. Experts identify the following indications for the use of the presented drugs:

Cystitis.
Furunculosis.
Urethritis.
Otitis media
Gonorrhea.
Bronchitis in acute or chronic form.
Pyelonephritis.
Streptococcal tonsillitis.
Sinusitis.
Shigellosis.
Infectious lesions of the upper respiratory tract.

It is worth noting that the spectrum of action and scope of application of cephalosporins largely depend on the generation to which the antibiotic drug belongs. Let's look at this issue in more detail:

1st generation cephalosporins are used to combat uncomplicated infections affecting the skin, bones and joints.
Indications for the use of 2nd generation cephalosporins include diseases such as tonsillitis, pneumonia, chronic bronchitis, pharyngitis, lesions urinary tract, which are bacterial in nature.
3rd generation cephalosporins are prescribed for diseases such as bronchitis and infectious lesions urinary system, shigellosis, gonorrhea, impetigo, Lyme disease.
4th generation cephalosporins may be indicated for sepsis, joint damage, pulmonary abscesses, pneumonia, pleural empyema. It is worth emphasizing that the 4th generation cephalosporin group of drugs is not available in tablet form due to its specific molecular structure.

These antibiotic drugs are contraindicated only in cases of individual sensitivity and allergic reactions to the main active ingredient - cephalosporin, as well as in patients under 3 years of age.

Side effects

In some cases, when using cephalosporins, it is possible to develop side effects. The most common adverse reactions include the following:

Nausea.
Attacks of vomiting.
Diarrhea.
Stomach upset.
Headaches similar in nature to the symptoms of migraine.
Allergic reactions.
Pain in the abdominal area.
Impaired kidney function.
Liver disorders.
Dysbacteriosis.
Dizziness.
Urticaria and the appearance of a rash on the skin.
Blood clotting disorder.
Eosinophilia.
Leukopenia.

In most cases, the occurrence of the above side effects is associated with prolonged and uncontrolled use cephalosporins.

The choice of drug, determination of the dosage and duration of the therapeutic course should be carried out exclusively by the attending physician, taking into account the diagnosis, severity of the disease, age and general condition patient's health. In addition, in order to avoid the occurrence of unwanted reactions, it is necessary to strictly follow the instructions for use of the drug and take medications that prevent the development of dysbacteriosis.

What are the advantages of tableted cephalosporins?

Cephalosporins in tablet form are especially in demand and popular. The fact is that this form antibiotic drugs have certain advantages. These include the following factors:

Pronounced bacterial effect.
Increased resistance to a specific enzyme called beta-lactamase.
Simple and convenient use.
Possibility of carrying out the therapeutic process on an outpatient basis.
Cost-effectiveness due to the absence of the need to purchase syringes and solutions necessary for injecting the drug.
Absence inflammatory reactions local localization characteristic of injections.

Features of application

Cephalosporin tablets are prescribed to adult patients by a doctor in the appropriate dosage. The duration of the therapeutic course ranges from a week to 10 days, depending on the severity of the disease. For patients childhood the medicine is given 2-3 times a day, the dosage is calculated individually taking into account the child’s weight.

It is recommended to take cephalosporins after meals, which facilitates their better absorption by the body. In addition, according to the instructions for use, along with the drugs of this group, it is necessary to take antifungal medications and agents that prevent the development of dysbacteriosis.

Each specific drug is accompanied by a corresponding annotation, which must be carefully studied before starting the course of treatment and then strictly followed the instructions presented in the instructions.

Brief characteristics of the drugs

There are various tablet preparations of cephalosporins, each of which has certain characteristics and clinical properties. Let's look at them in more detail:

Cephalexin belongs to the group of 1st generation cephalosporins. The presented drug is highly effective in the fight against streptococci and staphylococci. Cephalexin is prescribed for infectious and inflammatory diseases. Side effects include the possible development of allergic reactions in case of intolerance to penicillin.
Cefixime is a 3rd generation cephalosporin. This drug has a pronounced antibacterial effect, suppressing the activity of almost all known pathogens. Cefixime is characterized by the presence of pharmacokinetic properties and good penetration into tissues. Medication is characterized by an increased degree of effectiveness in the fight against Pseudomonas aeruginosa and enterobacteria.
Ceftibuten. Medicine belongs to the 3rd generation cephalosporins. The drug is available in the form of tablets and suspensions. Ceftibuten is characterized by a high degree of resistance to the effects of specific substances secreted for protective purposes by pathogens.
Cefuroxime acetyl belongs to the group of 2nd generation cephalosporins. The presented drug is very effective in the fight against pathogens such as enterobacteriaceae, moraxella and hemophilus. Cefuroxime acetyl is taken several times a day. The dosage is determined depending on the form and severity of the disease, age category patient. At long-term use Possible side effects such as diarrhea, nausea, vomiting, changes clinical picture blood.
Zinnat is one of the most common drugs belonging to the group of 2nd generation cephalosporins. This drug is used to treat furunculosis, pyelonephritis, pneumonia, infections of the upper and lower respiratory tract and other diseases caused by the pathological activity of pathogens that are sensitive to cefuroxime.

Cephalosporins are highly effective and efficient antibiotic drugs used in the field of modern medicine to combat infectious diseases. The tablet form of medicines is particularly widespread, characterized by a minimal range of contraindications and side effects.

Cephalosporins are classified as beta-lactam drugs. They represent one of the largest classes of antibacterial medications.

General information

4th generation cephalosporins are considered relatively new. Oral forms not in this group. The remaining three are represented by drugs for oral and parenteral use. Cephalosporins have high effectiveness and relatively low toxicity. Thanks to this, they occupy one of the leading positions in terms of frequency of use in clinical practice of all antibacterial agents.

Indications for use for each generation of cephalosporins depend on their pharmacokinetic properties and antibacterial activity. The medications are structurally similar to penicillins. This predetermines a single mechanism of antimicrobial action, as well as in a number of patients.

Activity spectrum

Cephalosporins have a bactericidal effect. It is associated with disruption of the formation of bacterial cell walls. In the series from the first to the third generation, there is a tendency towards a significant expansion of the spectrum of action and increased antimicrobial activity on gram-negative microbes with a slight decrease in the effect on gram-positive microorganisms. A property common to all products includes the absence of a significant effect on enterococci and some other microbes.

Many patients are interested in why 4th generation cephalosporins are not available in tablets? The fact is that these medications have a special molecular structure. This does not allow the active components to penetrate the cell structures of the intestinal mucosa. Therefore, 4th generation cephalosporins are not available in tablets. All medications in this group are intended for parenteral administration. 4th generation cephalosporins are produced in ampoules with a solvent.

4th generation cephalosporins

Drugs in this group are prescribed exclusively by specialists. This is a relatively new category of medications. 3rd and 4th generation cephalosporins have a similar spectrum of effects. The difference is in fewer side effects in the second group. The drug "Cefepime", for example, is close in a number of parameters to third-generation medications. But due to some features in the chemical structure, it has the ability to penetrate the outer wall of gram-negative microorganisms. At the same time, Cefepime is relatively resistant to hydrolysis by C-class beta-lactamases (chromosomal). Therefore, in addition to the characteristics characteristic of 3rd generation cephalosporins (Ceftriaxone, Cefotaxime), the drug exhibits such features as:

influence on microbes that are hyperproducers of C-class beta-lactamases (chromosomal);
high activity relative to non-fermenting microorganisms;
higher resistance to hydrolysis of extended-spectrum beta-lactamases (the significance of this feature is not entirely clear).

Inhibitor-protected medications

This group includes one drug, Cefoperazone/Sulbactam. Compared to a single drug, a combined medication has an expanded spectrum of activity. It has an effect on anaerobic microorganisms, most strains of enterobacteria capable of producing beta-lactamases.

Pharmacokinetics

Parenteral cephalosporins 3 and 4 generations are very well absorbed when injected into the muscle. Oral medications are characterized by high absorption in the gastrointestinal tract. Bioavailability will depend on the specific medication. It ranges from 40-50% (for the drug Cefixime, for example) to 95% (for the drugs Cefaclor, Cefadroxil, Cephalexin). The absorption of some oral medications may be slowed by food intake. But a medicine such as “Cefuroxime ascetil” undergoes hydrolysis during absorption. Faster release active component food contributes to this.

4th generation cephalosporins are well distributed throughout many tissues and organs (except the prostate), as well as secretions. IN high concentrations drugs are found in peritoneal and synovial, pericardial and pleural fluids, bones and skin, soft tissues, liver, muscles, kidneys and lungs. The ability to pass the BBB and form therapeutic concentrations in the cerebrospinal fluid is more pronounced in third-generation drugs such as Ceftazidime, Ceftriaxone, and Cefotaxime, and the representative of the fourth - Cefepime.

Metabolism and excretion

For the most part, cephalosporins do not degrade. An exception is the drug Cefotaxime. It is biotransformed with the subsequent formation of the active product. 4th generation cephalosporins, like other representatives, are excreted primarily by the kidneys. When excreted in urine, fairly high concentrations are found.

The medications "Cefoperazone" and "Ceftriaxone" differ in their dual elimination route - liver and kidneys. For most cephalosporins, the half-life is within one to two hours. A longer time is required for Ceftibuten, Cefixime (3-4 hours), and Ceftriaxone (up to 8.5 hours). This makes it possible to prescribe them once a day. On the background renal failure the dosage of medications requires adjustment.

Side effects

Antibiotics - 4th generation cephalosporins - cause a number of negative consequences, in particular:

Allergies. Patients may experience erythema multiforme, rash, urticaria, and eosinophilia. Side effects in this category also include anaphylactic shock and fever, Quincke's edema, bronchospasm.
Hematological reactions. Among them it is worth highlighting positive leukopenia, eosinophilia (rarely), hemolytic anemia, neutropenia.
Nervous disorders. When using higher doses in patients with renal dysfunction, seizures are observed.
From the liver: increased activity of transaminases.
Digestive disorders. Among the negative consequences, diarrhea, vomiting and nausea, and abdominal pain are quite common. If loose stool with blood fragments, the drug is discontinued.
Local reactions. These include infiltration and pain at the site of intramuscular injection and phlebitis during intravenous injection.
Other consequences are expressed in the form of candidiasis of the vagina and mouth.

Indications and contraindications

4th generation cephalosporins are prescribed for severe, predominantly low-grade infections caused by multidrug-resistant microflora. These include an abscess in the lung, pneumonia, sepsis, damage to joints and bones. 4th generation cephalosporins are indicated for complicated infections in the urinary tract, against the background of neutropenia and other immunodeficiency conditions. Medicines are not prescribed for individual intolerance.

Precautionary measures

When used, cross-type allergies are noted. Patients with penicillin intolerance have a similar reaction to first-generation cephalosporins. Cross allergy when using the second or third categories, it is observed less frequently (in 1-3% of cases). If there is a history of reactions immediate type(for example, or urticaria), first generation drugs are prescribed with caution. Drugs in the following categories (especially the fourth) are safer.

Lactation and pregnancy

Cephalosporins are prescribed in the prenatal period without any special restrictions. However, adequate controlled drug safety studies have not been conducted. IN low concentrations Cephalosporins can pass into milk. When using the medication during lactation, changes in intestinal microflora, candidiasis, skin rash, child sensitization.

Pediatrics and Geriatrics

When used in newborns, the half-life is likely to increase due to slow renal excretion. Elderly patients experience a change renal function, and therefore the elimination of medications is likely to slow down. This may require adjustments to the dosage and administration regimen.

Kidney dysfunction

Since the elimination of most cephalosporins occurs through the renal system primarily in active form, the dosage regimen should be adjusted taking into account the characteristics of the body. When using high doses, especially in combination with loop diuretics or aminoglycosides, a nephrotoxic effect is likely to occur.

Liver dysfunction

Some drugs are excreted in the bile, and therefore the dosage should be reduced for patients with severe liver pathologies. Such patients have a high predisposition to bleeding and hypoprothrombinemia when using Cefoperazone. IN for preventive purposes Vitamin K recommended.

Due to the fact that the majority antibacterial drugs can be purchased without a doctor's prescription, their uncontrolled use is increasing. This entails the development of resistance of microorganisms to medications of this group and the ineffectiveness of standard therapy. Therefore, 4th generation cephalosporins were developed, which remain active against almost all bacteria resistant to earlier versions of antibiotics.

1st and 4th generation cephalosporins

The main difference between the drugs in question and their predecessors is that 4th generation cephalosporins act on a larger number of microorganisms, both gram-positive and gram-negative. In addition, they are effective against cocci, bacilli and entrobacteria, which are completely resistant to 3rd generation antibiotics.

Due to the listed features and advantages, cephalosporins of the described type are used in complex chemical therapy of acute and chronic inflammatory diseases skin, digestive, genitourinary system, pelvic organs, joints and bones.

Despite the relative safety of these antibiotics, they produce many side effects, among which allergic reactions, digestive disorders, and decreased activity are quite common. immune system. Therefore, 4th generation cephalosporins are rarely prescribed to women with hormonal disorders, including pregnant women, with dysbacteriosis, and autoimmune problems. Taking the described antibiotic drugs can only aggravate the course of the disease.

List of 4th generation cephalosporins

To date, about 10 varieties are known similar drugs, but most of them are still in the research stage, and only 2 types are allowed for mass production: cefpirome and cefepime. These antibiotics are active ingredients in many medicines.

Names of 4th generation cephalosporins:

Izodepom;
Kefsepim;
Maxipim;
Cefanorm;
Ladef;
Movisar;
Cefepime;
Maxicef;
Cefomax;
We chain;
Cefepime Alchem;
Cefepime Jodas;
Cefepime Agio;
Ephipim.

It should be noted that 4th generation cephalosporin antibiotics are produced in ampoules with a solvent, included with the powder for preparing a medicinal suspension. The fact is that drugs only work when intramuscular injection, being maximally absorbed into the blood and lymph. 4th generation cephalosporins are not available in tablets, because their molecular structure does not allow the active substances to penetrate the cellular structures of the intestinal mucosa and digestive tract, antibiotics are destroyed even when they enter the stomach due to high

An important achievement in the production of the cephalosporins discussed is that they can be stored long time even after diluting the powder with a solvent. The resulting liquid sometimes darkens due to contact with air and ultraviolet radiation, but does not lose its therapeutic properties.

For a pronounced and sustainable treatment result, it is important to follow correct scheme– administer the suspension every 12 hours (intramuscularly), preferably at the same specific time. You should also not exceed the recommended course duration, which is usually from 7 to 10 days. Otherwise, intoxication of the body with antibiotics, hepatological damage to the liver and kidney pathologies are possible.

Content

Antibacterial drugs by mechanism of action and active substance are divided into several groups. One of them is cephalosporins, which are classified according to generations: from the first to the fifth. The third is more effective against gram-negative bacteria, including streptococci, gonococci, Pseudomonas aeruginosa, etc. This generation includes cephalosporins for both internal and parenteral use. They are chemically similar to penicillins and can replace them if you are allergic to such antibiotics.

Classification of cephalosporins

This concept describes a group of semi-synthetic beta-lactam antibiotics that are produced from “cephalosporin C”. It is produced by the fungi Cephalosporium Acremonium. They secrete a special substance that inhibits the growth and reproduction of various gram-negative and gram-positive bacteria. Inside the cephalosporin molecule there is a common core consisting of bicyclic compounds in the form of dihydrothiazine and beta-lactam rings. All cephalosporins for children and adults are divided into 5 generations depending on the date of discovery and the spectrum of antimicrobial activity:

First. The most common parenteral cephalosporin in this group is Cefazolin, and the most common oral cephalosporin is Cephalexin. Used when inflammatory processes skin and soft tissues, often to prevent postoperative complications.
Second. These include the drugs Cefuroxime, Cefamandole, Cefaclor, Ceforanide. They have increased activity against gram-positive bacteria compared to 1st generation cephalosporins. Effective for pneumonia, combined with macrolides.
Third. This generation includes antibiotics Cefixime, Cefotaxime, Ceftriaxone, Ceftizoxime, Ceftibuten. They are highly effective against diseases caused by gram-negative bacteria. Used for infections of the lower respiratory tract, intestines, inflammation of the biliary tract, bacterial meningitis, gonorrhea.
Fourth. Representatives of this generation are the antibiotics Cefepime and Cefpirom. Can affect enterobacteria that are resistant to 1st generation cephalosporins.
Fifth. They have the spectrum of activity of 4th generation cephalosporin antibiotics. They act on flora resistant to penicillins and aminoglycosides. Effective antibiotics in this group are Ceftobiprole and Zefter.

The bactericidal effect of such antibiotics is due to inhibition (inhibition) of the synthesis of peptidoglycan, which is the structural main wall of bacteria. Among common features cephalosporins, the following can be noted:

good tolerability due to minimal side effects compared to other antibiotics;
high synergy with aminoglycosides (in combination with them they have a greater effect than individually);
manifestation of cross allergic reaction with other beta-lactam drugs;
minimal impact on intestinal microflora (bifidobacteria and lactobacilli).

3rd generation cephalosporins

This group of cephalosporins, unlike the previous two generations, differs more wide range actions. Another feature is a longer half-life, due to which the medicine can be taken only once a day. The advantages include the ability of third-generation cephalosporins to cross the blood-brain barrier. Thanks to this, they are effective against bacterial and inflammatory lesions nervous system. The list of indications for the use of third generation cephalosporins includes the following diseases:

meningitis of bacterial nature;
intestinal infections;
gonorrhea;
cystitis, pyelonephritis, pyelitis;
bronchitis, pneumonia and other lower respiratory tract infections;
inflammation of the biliary tract;
shigillosis;
typhoid fever;
cholera;
otitis.

3rd generation cephalosporins in tablets

Oral forms of antibiotics are convenient to use and can be used for complex therapy infections at home bacterial etiology. Oral cephalosporins are often prescribed in a stepped therapy regimen. In this case, antibiotics are first administered parenterally and then switched to forms that are taken orally. Thus, oral cephalosporins in tablets are represented by the following drugs:

Cefodox;
Pantsef;
Tsedex;
Suprax.

The active ingredient in this drug is cefixime trihydrate. The antibiotic is presented in the form of capsules with a dosage of 200 mg and 400 mg, suspensions with a dosage of 100 mg. The price of the first is 350 rubles, the second is 100-200 rubles. Cefixime is used for diseases of an infectious-inflammatory nature caused by pneumococci and streptococci pyrrolidonyl peptidase:

acute bronchitis;
acute intestinal infections;
acute pneumonia;
otitis media;
relapses of bronchitis chronic form;
pharyngitis, sinusitis, tonsillitis;
urinary tract infections that occur without complications.

Cefixime capsules are taken with meals. They are allowed for patients over 12 years of age. They are prescribed a dosage of 400 mg of Cefixime daily. Treatment depends on the infection and its severity. Children from six months to 12 years are prescribed Cefixime in the form of a suspension: 8 mg/kg body weight 1 time or 4 mg/kg 2 times a day. Regardless of the form of release, Cefix is prohibited if you are allergic to cephalosporin antibiotics. After taking the drug, the following adverse reactions may develop:

diarrhea;
flatulence;
dyspepsia;
nausea;
stomach ache;
rash;
hives;
itching;
headache;
dizziness;
leukopenia;
thrombocytopenia.

Cefodox

The bactericidal effect of this antibiotic is due to the cefpodoxime in its composition. Release forms this drug– tablets and powder. Suspensions are prepared from the latter. Regardless of the form of release, Cefodox is used to treat:

pyelonephritis, mild or moderate cystitis;
tonsillitis, pharyngitis, laryngitis, sinusitis, otitis;
pneumonia, bronchitis;
urethritis, proctitis, cervicitis of gonococcal origin;
infectious lesions of the skin, joints, bone and soft tissues.

The use of Cefodox is not practiced in people with increased sensitivity to the composition of the drug. In tablet form, the antibiotic is not prescribed to children under 12 years of age, in the form of a suspension - under the age of 5 months, with galactose intolerance, malabsorption syndrome, lactase deficiency. The dosage of Cefodox is determined as follows:

200-400 mg per day – for patients over 12 years of age (average dose);
200 mg – for infectious diseases of the respiratory and genitourinary systems;
400 mg – for bronchitis or pneumonia.

The course of therapy continues as prescribed by the doctor. Its average duration depends on the course of the disease and is determined by a specialist. The price of the drug is about 350-400 rubles. The list of side effects of Cefodox includes the following symptoms:

rash;
skin itching;
headache;
diarrhea;
vomiting, nausea;
eosinophilia;
an increase in plasma levels of creatinine and urea;
violation of thrombocytopoiesis and leukocytopoiesis.

Pantsef

This representative of 3rd generation cephalosporins is based on cefexime. You can buy Pancef in the form of tablets and granules. They are indicated for treatment infectious diseases different systems body:

Urinary. Pancef is effective for gonococcal urethritis and cervicitis.
Respiratory. This antibiotic is indicated for acute and chronic bronchitis, tracheitis, pneumonia.
ENT organs. Panzef is prescribed for otitis, pharyngitis, infectious sinusitis, tonsillitis.

Contraindications for this drug include sensitivity to penicillins and cephalosporins, the elderly and age under six months. The dosage is determined taking into account the following principles:

8 mg/kg 1 time or 4 mg/kg 2 times a day – for patients over 12 years of age;
400 mg – maximum of the drug per day;
400 mg for 7-10 days, 1 time per day - for gonorrhea that occurs without complications.

8 mg/kg 1 time or 4 mg/kg 2 times a day (6-12 ml suspension) – for children 5–15 years old;
5 ml of suspension – children 2–4 years old;
2.5-4 ml of suspension – for babies from 6 months to one year.

The cost of 6 tablets of Pancef 400 mg is 350 rubles, 5 ml of suspension is 550 rubles. Side effects of the drug occur most often in the digestive tract, but there are other reactions:

anorexia;
dysbacteriosis;
dizziness;
fever;
flatulence;
nausea;
dysbacteriosis;
vomit;
jaundice;
dry mouth;
hyperbilirubinemia;
glossitis;
stomatitis;
nephritis;
skin hyperemia;
eosinophilia;
hives.

3rd generation cephalosporin Spectracef exists only in tablet form. Its active component is cefditoren in a dosage of 200 mg or 400 mg. Microorganisms that cause the following pathologies are sensitive to this substance:

Upper respiratory tract diseases, including acute sinusitis and tonsillopharyngitis.
Uncomplicated infections of the subcutaneous fat and skin, including impetigo, abscess, folliculitis, infected wounds, furunculosis.
Infections of the lower respiratory tract, such as community-acquired pneumonia. This also includes periods of relapse of chronic bronchitis.

Spectracef should be taken with liquid, preferably after a meal. The recommended dose is determined by the type of infection and its severity:

200 mg every 12 hours for 5 days - with exacerbation of bronchitis;
200 mg every 12 hours for 10 days – for skin infections, sinusitis, pharyngotonsillitis;
200 mg every 12 hours for 4–5 days – for community-acquired pneumonia.

Compared to other cephalosporins, Spectracef has more high cost– 1300–1500 rub. It is better to check the list of side effects in detailed instructions to the drug, since they are numerous. Spectracef contraindications include:

allergy to drug components and penicillins;
children under 12 years of age;
hypersensitivity to casein protein;
liver failure;
breast-feeding;
pregnancy;
being in a hospital for hemodialysis.

Tsedex

One capsule of Cedex contains 400 mg of ceftibuten dihydrate, 1 g of this drug in powder form contains 144 mg of this active component. Their price varies from 500 to 650 rubles. The list of indications for both forms of drug release includes the following diseases:

enteritis and gastroenteritis in children caused by Escherichia coli or strains of the genus Shigella and Salmonella;
otitis media;
pneumonia, bronchitis, scarlet fever, pharyngitis, acute sinusitis, tonsillitis;
urinary tract infections.

Cedex is contraindicated in patients with allergies to penicillins, intolerance to cephalosporins, severe renal failure and patients on hemodialysis. Age restrictions: suspension is allowed from 6 months, capsules - from 10 years. The dosage is determined as follows:

400 mg every day – at acute sinusitis and bronchitis;
200 mg every 12 hours for 10 days – for community-acquired pneumonia;
9 mg/kg suspension – for children from six months to 10 years.

Treatment lasts on average 5–10 days. If Streptococcus pyogenes is affected, therapy should last for at least 10 days. List of possible adverse reactions:

drowsiness;
dyspepsia;
anemia;
eosinophilia;
gastritis;
headache;
dizziness;
convulsions;
hives;
nausea, vomiting;
thrombocytosis;
ketonuria;
taste changes;
abdominal pain.

Suprax

Suprax is available in the form of dispersible tablets, i.e., soluble in water. Each contains 400 mg of cefixime. The cost of 7 tablets is about 800 rubles. List of indications for use of Suprax:

uncomplicated gonorrhea urethra or cervix;
shigellosis;
agranulocytic tonsillitis;
acute bronchitis;
urinary tract infections;
acute pharyngitis;
Otitis media, sinusitis, tonsillitis.

Suprax should not be used for colitis, kidney failure, pregnancy, colitis and old age. You can take the drug regardless of food. Daily dose calculated as follows:

400 mg in 1–2 doses – for body weight more than 50 kg;
200 mg at a time – with a weight of 25 to 50 kg.

For gonorrhea, treatment lasts 1 day, for mild infections of the genitourinary system - 3-7 days, for sore throat - 1-2 weeks. To prepare the suspension, crush one tablet and add a small amount of water, then shake well. List side effects for Supraxa:

nephritis;
rash;
hives;
headache;
constipation;
vomit;
skin itching;
nausea;
pain in the epigastric region;
bleeding;
kidney dysfunction.

In powder form

To prepare a solution for injection, third generation cephalosporins are used in powder form. When administered intramuscularly, drugs have a more fast action and rarely call adverse reactions, because they enter the body bypassing the digestive tract. Also, cephalosporin antibiotics in powder form are used for those who, due to physiological characteristics can't take pills. From this form of medicine you can prepare a suspension that is easier to give to children.

The active component of Fortum is ceftazidime in a dosage of 250, 500, 1000 or 200 mg. The drug is presented as a white powdery mass for the preparation of solutions for injections. The cost of 1 g is 450 rubles, 0.5 g – 180 rubles. The list of indications for use of Fortum includes infections:

respiratory tract, including lesions due to cystic fibrosis;
ENT organs;
organs of the musculoskeletal system;
subcutaneous tissue and skin;
genitourinary tract;
infections caused by dialysis;
in patients with suppressed immunity;
meningitis, bacteremia, peritonitis, septicemia, infected burns.

Fortum is contraindicated in case of sensitization to ceftazidime, penicillins and antibiotics from the group of 3rd generation cephalosporins. The drug is prescribed with caution to pregnant and lactating women, with renal failure and in combination with aminoglycosides. The daily dose is selected as follows:

the dosage per day should not be more than 6 g;
adults are administered 1–6 g, divided into 2–3 doses;
with reduced immunity and severe forms infections are administered 2 g 2–3 times or 3 g 2 times;
in case of damage to the urinary tract, 0.5-1 g is administered 2 times.

Adverse reactions after the administration of Fortum can occur in almost all systems and organs. Most often, patients note:

nausea;
diarrhea;
vomiting;
candidiasis of the mucous membranes of the mouth and pharynx;
abdominal pain;
dizziness;
fever;
paresthesia;
tremor;
convulsions;
Quincke's edema;
neutropenia;
thrombophlebitis;
hives;
itching, rash.

Tizim

This antibiotic is based on ceftazidime. One bottle of Tizim contains 1 g of the specified active ingredient. The price of the drug is 300–350 rubles. The list of diseases for which Tizim is effective includes the following pathologies:

sepsis;
cholangitis;
peritonitis;
infections of bones, skin, joints, soft tissues;
pyelonephritis;
infected burns and wounds;
infections caused by hemodialysis and peritoneal dialysis.

The dosage is set for each patient individually, taking into account the location and severity of the disease. The drug is administered intramuscularly or intravenously in the following dosages:

0.52 g every 8–12 hours – for adults;
30–50 mg per 1 kg of body weight 2–3 times a day – for children from 1 month to 12 years;
30 mg/kg/day. With an interval of 12 hours - for children up to 1 month.

A maximum of 6 g of Tizim per day is allowed. A contraindication to the use of this drug is high sensitivity to ceftazidime. The list of possible side effects includes:

nausea, vomiting;
hepatitis;
cholestatic jaundice;
eosinophilia;
diarrhea;
hypoprothrombinemia;
interstitial nephritis;
candidiasis;
phlebitis;
pain at the injection site.

Drug interactions

When using 3rd generation cephalosporins while drinking alcohol, there is a high risk of developing a disulfiram-like effect. This deviation is similar to the state of the body during poisoning ethyl alcohol. Against this background, the patient develops an aversion to alcohol. The effect persists for several days after discontinuation of cephalosporins. Danger in possible development hypoprothrombinemia - increased tendency to bleeding. Interaction of cephalosporins with drugs:

simultaneous use of antacids reduces the effectiveness of antibiotic therapy;
combination with loop diuretics is not allowed due to the risk of nephrotoxic effect;
combination with thrombolytics, anticoagulants and antiplatelet agents is also not recommended due to the increased likelihood of intestinal bleeding.

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