Efmerin time. for solution for infection. 2 g fl. No. 1

Powder for solution for injections of Efmerin is applied to treatment of following infections at adults and children, including the full-term newborns (from the birth):

• bacterial meningitis;
• community-acquired pneumonia;
• hospital pneumonia;
• sharp average otitis;
• intra belly infections;
• complicated infections of urinary tract (including pyelonephritis);
• an infection of bones and joints;
• complicated infections of leather and soft tissues;
• gonorrhea;
• syphilis;
• bacterial endocarditis.

Efmerin can be applied for:

• treatment of a sharp complication of a chronic obstructive pulmonary disease at adults;
• treatment of disseminate borreliosis of Lyme (early (the II stage) and late (the III stage)) at adults and children, including newborns aged from 15 days;
• preoperative prevention of infections in the place of surgical intervention;
• maintaining patients with a neutropenia at which fever with suspicion of a bacterial infection developed;
• treatment of patients with bacteremia which arose in connection with any of above-mentioned infections or if there is a suspicion on any of above-mentioned infections.

together with other antibacterial medicines if the possible range of bacterial activators does not fall under its spectrum of action.

Structure

Active ingredient - tseftriakson (1 bottle supports a tseftriakson of sodium it is equivalent to a tseftriakson of 2 g).

Contraindication

Hypersensitivity to a tseftriakson or to any other cephalosporin. Existence in the anamnesis of heavy reactions of hypersensitivity (for example anaphylactic reactions) to any other type beta laktamnykh antibacterial agents (penicillin, monobaktam and karbapenem).

:

• premature newborn aged ≤ 41 weeks taking into account the term of pre-natal development (gestational age + age after the birth);
• full-term newborn (aged ≤ 28 days):
  • with a hyperbilirubinemia, jaundice, a hypoalbuminemia or acidosis, as at such conditions of binding of bilirubin probably broken;
  • who demand (or it is expected that will demand) intravenous administration of medicines of calcium or infusions of kaltsiysoderzhashchy solutions as there is a risk of formation of precipitated calcium superphosphates of calcic salt of a tseftriakson.

Before intramuscular introduction of a tseftriakson should exclude surely existence of contraindications to use of lidocaine if it is applied as solvent.

Solutions of a tseftriakson containing lidocaine never should be entered intravenously.

Route of administration

Dose of medicine depends on weight, sensitivity, localization and like an infection and also on age and function of a liver and the patient's kidneys.

Following doses is all-recommended for these indications. In especially hard cases it is necessary to apply the highest dose from the recommended range.

Adults and children are more senior than 12 years (≥ 50 kg)

Community-acquired pneumonia, a system a complication of a chronic obstructive pulmonary disease, intra belly infections, the complicated infections of urinary tract (including pyelonephritis): 1-2 g once a day.

Hospital pneumonia, the complicated infections of leather and soft tissues, infections of bones and joints: 2 g once a day.

Maintaining patients with a neutropenia at whom fever developed and is suspicion of a bacterial infection; bacterial endocarditis; bacterial meningitis: 2-4 g once a day.

Indication at adults and children are more senior than 12 years (≥ 50 kg) which demand special schemes of dosing

Acute average otitis: the dose of 1-2 g of the medicine "Efmerin" can be applied once. Some data demonstrate that in case a condition of the patient heavy or the previous therapy was inefficient, tseftriakson can be effective at introduction in a dose of 1-2 g a day within 3 days.

Preoperative prevention of infections in the place of surgical intervention: 2 g once before operation.

Gonorrhoea: a single dose - 500 mg intramusculary.

Syphilis: the all-recommended doses are 500 mg - 1 g with increase in a dose up to 2 once a day at neurosyphilis within 10-14 days once a day. Recommendations about dosing at syphilis, including neurosyphilis, is based on limited data. It is necessary to consider national or local councils also.

Disseminate borreliosis of Lyme (early (the II stage) and late (the III stage)): on 2 g once a day within 14-21 days. The recommended duration treatment varies, it is necessary to consider national or local councils also.

Newborns, babies and children aged from 15 days up to 12 years (˂ 50 kg)

Intra belly infections, the complicated infections of urinary tract (including pyelonephritis), community-acquired pneumonia, hospital pneumonia: 50-80 mg/kg once a day.

Complicated infections of leather and soft tissues, infections of bones and joints, maintaining patients with a neutropenia at whom fever developed and is suspicion of a bacterial infection: 50-100 mg/kg (at most 4 g) once a day.

Bacterial meningitis: 80-100 mg/kg (at most 4 g) once a day.

Bacterial endocarditis: 100 mg/kg (at most 4 g) once a day.

to Children with body weight from 50 kg should apply usual doses of adults.

Indication at newborns, babies and children aged from 15 days up to 12 years (˂ 50 kg) who demand special schemes of dosing

Acute average otitis: the disposable injection of medicine in a dose of 50 mg/kg can be applied to initial treatment of sharp average otitis. Some data demonstrate that in case a condition of the child heavy or the previous therapy was inefficient, tseftriakson can be effective at intramuscular introduction in a dose of 50 mg/kg within 3 days.

Preoperative prevention of infections in the place of surgical intervention: 50-80 mg/kg once before operation.

Syphilis: generally the recommended doses are 75-100 mg/kg (at most 4 g) within 10-14 days once a day. Recommendations about dosing at syphilis, including neurosyphilis, are based on very limited data. It is necessary to consider national or local councils also.

Disseminate borreliosis of Lyme (early (the II stage) and late (the III stage)): 50-80 mg/kg once a day within 14-21 days. The recommended duration of treatment varies, it is necessary to consider national or local councils also.

Newborn up to 14 days

Efmerin is contraindicated to premature newborns aged ≤ 41 weeks taking into account the term of pre-natal development (gestational age + age after the birth).

Intra belly infections, the complicated infections of leather and soft tissues, the complicated infections of urinary tract (including pyelonephritis), community-acquired pneumonia, hospital pneumonia, infections of bones and joints, maintaining patients with a neutropenia at which fever developed and is suspicion of a bacterial infection: 2050 mg/kg once a day.

Bacterial meningitis, bacterial endocarditis: 50 mg/kg once a day.

should not exceed the maximum daily dose of 50 mg/kg.

Indication at newborns aged up to 14 days which demand special schemes of dosing

Acute average otitis: the disposable injection of the medicine "Efmerin" in a dose of 50 mg/kg can be applied to initial treatment of sharp average otitis.

Preoperative prevention of infections in the place of surgical intervention: 20-50 mg/kg once before operation.

Syphilis: the general recommended dose - 50 mg/kg once a day within 10-14 days. Recommendations about dosing at syphilis, including neurosyphilis, are based on very limited data. It is necessary to consider national or local councils also.

treatment Duration

Duration of treatment depends on the course of the disease. Considering the general recommendations about antibiotic treatment, application of a tseftriakson should be continued within 48-72 hours after disappearance of fever or confirmation of achievement of an eradikation of a bacterial infection.

Feature of application

Pregnant

Tseftriakson gets through a placental barrier. There are limited data on application of a tseftriakson to pregnant women. During pregnancy, especially in the first trimester, tseftriakson it is possible to apply, only if the advantage exceeds risk.

Tseftriakson gets into breast milk in low concentration, but at use of medicine in therapeutic doses no influence on babies who are nursed is expected. However it is impossible to exclude risk of developing diarrhea and a fungal infection of mucous membranes. It is necessary to consider a possibility of a sensitization. It is necessary to make the decision on the feeding termination by a breast or termination/refusal of application of a tseftriakson taking into account advantage of breastfeeding for the child and advantage of therapy for the woman.

In researches of reproductive function did not reveal signs of undesirable influence on male or female fertility.

Drivers

during treatment tseftriaksony can arise such side reactions as dizziness that can affect ability to steer vehicles or to work with difficult mechanisms. Patients should be careful at control of motor transport or work with other mechanisms.

At overdose the nausea, vomiting, diarrhea are possible

. In case of overdose the hemodialysis or peritoneal dialysis will not reduce excessive concentration of medicine in blood plasma. Specific antidote does not exist. Overdose treatment symptomatic.

Side effects

Side reactions which were most often observed at application of a tseftriakson is the eosinophilia, a leukopenia, thrombocytopenia, diarrhea, rash and increase in level of liver enzymes.

Tseftriakson is incompatible

with amsakriny, Vancomycinum, flukonazoly and aminoglycosides.

should not mix or add

to other drugs, except those which are specified in the section "Route of administration". Tseftriakson it is not necessary to mix with kaltsiysoderzhashchy solutions, such as Ringera solution or Gartman's solution because precipitated calcium superphosphates can be formed. Tseftriakson it is not necessary to mix or enter along with solutions, calciferous, including solutions for parenteral nutrition.

Storage conditions

to Store

in original packing at a temperature not above 25 °C, out of children's reach.

Prepared solution to store

no more than 6 hours at the room temperature and no more than 24 hours at a temperature from 2 °C to 8 °C.

Expiration date - 2 years.