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Zinoximor

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Indications:

Cefuroxime axetil is indicated for the treatment of infections caused by sensitive bacteria. Lower respiratory tract infections for example, acute bronchitis, acute exacerbations of chronic bronchitis, and pneumonia. Upper respiratory tract infections for example, ear, nose, throat infections, such as otitis media, sinusitis, tonsillitis and pharyngitis. Genito-urinary tract infections for example, pyelonephritis, cystitis and urethritis. Skin and soft tissue infections for example, furunculosis, pyoderma and impetigo. Treatment of early Lyme disease and subsequent prevention of late Lyme disease in adults and children over 12 years old. Gonorrhoea acute uncomplicated gonococcal urethritis, and cervicitis. Cefuroxime is also available as the sodium salt (Zinacef) for parenteral administration. This permits the use of sequential therapy with the same antibiotic, when a change from parenteral to oral therapy is clinically indicated. Where appropriate this medicine is effective when used following initial parenteral Zinacef (cefuroxime sodium) in the treatment of pneumonia and acute exacerbations of chronic bronchitis.

Contraindications:

Hypersensitivity to cephalosporin antibiotics.

Adverse reactions:

GI Nausea; vomiting; diarrhea; anorexia; abdominal pain or cramps; flatulence; colitis, including pseudomembranous colitis. Genitourinary Pyuria; renal dysfunction; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy. Hematologic Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; aplastic anemia; hemorrhage. Hepatic Hepatic dysfunction; abnormal LFT results. Miscellaneous Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness–like reactions (eg, skin rashes, polyarthritis, arthralgia, fever); phlebitis, thrombophlebitis, and pain at injection site.

Interactions:

In common with other antibiotics, this medicine may affect the gut flora, leading to lower oestrogen reabsorption and reduced efficacy of combined oral contraceptives. As a false negative result may occur in the ferricyanide test, it is recommended that either the glucose oxidase or hexokinase methods are used to determine blood/plasma glucose levels in patients receiving cefuroxime axetil. This antibiotic does not interfere in the alkaline picrate assay for creatinine. Concurrent administration of probenecid increases the area under the mean serum concentration time curve by 50%. Serum levels of cefuroxime are reduced by dialysis. A positive Coomb’s test has been reported during treatment with cephalosporins. This phenomenon can interfere with cross matching of blood.

Warnings:

Special care is indicated in patients who have experienced an allergic reaction to penicillins or other beta-lactams. As with other antibiotics, use of cefuroxime axetil may result in the overgrowth of Candida. Prolonged use may also result in the overgrowth of non-susceptible organisms (e.g. Enterococci and Clostridium difficile), which may require interruption of treatment. Pseudomembranous colitis has been reported with the use of broad-spectrum antibiotics, therefore, it is important to consider its diagnosis in patients who develop serious diarrhoea during or after antibiotic use. The Jarisch-Herxheimer reaction has been seen following this medicine treatment of Lyme disease. It results from the bactericidal activity of this medicine on the causative organism of Lyme disease, the spirochaete Borrelia burgdorferi. Patients should be reassured that this is common and usually self-limited consequence of antibiotic treatment of Lyme disease. With a sequential therapy regime the timing of change to oral therapy is determined by severity of the infection, clinical status of the patient and susceptibility of the pathogens involved. The change to oral therapy should only be made once there is a clear clinical improvement. If there has been no clinical improvement after 72 hours of parenteral treatment, then the patient’s treatment should be reviewed. Please refer to the relevant prescribing information for cefuroxime sodium before initiating sequential therapy

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