Intracef 500

Indications of Intracef 500

Cephradine is used to treat infections caused by Gram-positive and Gram-negative bacteria. These are some examples:

• Upper respiratory tract infections such as sinusitis, pharyngitis, tonsillitis, laryngotracheobronchitis, and otitis media are all undesirable.
• Bronchitis (acute and chronic), lobar pneumonia, and bronchopneumonia are all illnesses of the lower respiratory tract.
• Infections in the urinary system, including cystitis, urethritis, and pyelonephritis.
• Abscess, cellulitis, furunculosis, and impetigo are examples of skin and soft tissue infections.

The following bacteria are sensitive to Cephradine in vitro:

• Gram-positive organisms include Staphylococci (including penicillin susceptible and resistant strains, as well as penicillinase-producing species), Streptococci, Streptococci pyogenes (beta haemolytic), and Streptococcus pneumonia.
• Gram-negative bacteria include Escherichia coli, Klebsiella spp., Proteus mirabilis, Haemophilus influenza, Shigella spp., Salmonella spp. (including Salmonella typhi), and Neisseria spp. Many E.coli and Staphylococcus aureus strains that generate the enzyme penicillinase and are consequently ampicillin resistant are sensitive to Cephradine, which is unaffected by this enzyme.

 

Pharmaceutical Name

Beximco Pharmaceuticals Ltd.

 

Pharmacology

Cephradine is a semisynthetic broad-spectrum bactericidal antibiotic that works against infections caused by both gram-positive and gram-negative bacteria. Cephradine is active against both penicillinase generating and nonproducing staphylococci. Cephradine's primary site of action is the bacterial cell wall. Peptidoglycan is found in the cell wall of sensitive organisms. Cephradine inhibits the cross-linking process, resulting in the formation of a cell wall with numerous holes and the lysis of bacteria owing to external osmotic pressure.

 

Dosage & Administration

For oral administration-

Adults:

• Urinary tract infections: 500mg four times daily or 1g twice daily. Infections which are severe or chronic may necessitate the administration of higher doses. Where complications arise including prostatitis and epididymitis continued intensive treatment is required.
• Respiratory tract infections: 250 to 500mg four times daily or 500mg to 1g twice daily, dependent on the site and severity of the infection.
• Skin and soft tissue infections: 250 to 500mg four times daily or 500mg to 1g twice daily, again dependent on the site and severity of the infection.
• Interactions
• Bromazepam's sedative effects may be increased when coupled with other centrally active medications. Antidepressants, hypnotics, opioids, antipsychotics, sedatives, antiepileptic medicines, sedative antihistamines, and anesthetics are examples of these medications. Cimetidine may extend bromazepam's elimination half-life when taken together. Bromazepam should not be used with alcohol because the sedative effect of bromazepam may be amplified by the alcohol.

Children:

• Total daily dose of 25 to 50mg/kg given in two or four equally divided doses.
• Otitis media: Total daily dose of 75 to 100mg/kg given in divided doses 6 to 12 hourly.
• Maximum daily dosage: 4 gm

Elderly: The normal adult dose is appropriate. Patients with impaired renal or hepatic function should be monitored during treatment.

For injectable administration-

• Adult: The usual dose is 2-4 gm daily in four equally divided doses up to 8 gm daily. For prophylaxis a single preoperative dose of 1-2 gm intramuscularly or intravenously is given.
• Children: The dose is 50-100 mg/kg daily in four equally divided doses, up to 300 mg/kg daily in severe infection.

 

Interaction of Intracef 500

The use of nephrotoxic medicines, such as aminoglycosides, in conjunction with Cefradine may increase the risk of kidney injury. Diuretics (such as frusemide and ethacrynic acid) and probenecid increased the risk of kidney toxicity.

 

Contraindications

Cephradine should not be used in individuals who have a known or suspected allergy to cephalosporins.

 

Side Effects of Intracef 500

Tiredness, sleepiness, muscular weakness, numbed muscle, decreased alertness, confusion, headache, ataxia, and other common side effects include fatigue, drowsiness, muscle weakness, numbed muscle, reduced alertness, confusion, headache, ataxia, and so on. These side effects are most common at the start of therapy and generally go away after a while. Anterograde amnesia may develop when therapeutic dosages are used. Restricted mostly to gastro-intestinal problems and, on rare cases, hypersensitivity symptoms. Individuals who have previously exhibited hypersensitivity, as well as those with a history of allergy, asthma, hay fever, or urticaria, are more prone to experience the latter. Skin responses have been observed on occasion. Glossitis, heartburn, dizziness, chest tightness, nausea, vomiting, diarrhoea, stomach pain, vaginitis, candida overgrowth are all uncommon. Urticaria, skin rashes, joint aches, and oedema are examples of skin and hypersensitivity responses.

• Blood and lymphatic system disorders- Unknown: blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia)
• Immune system disorders- Unknown: Fever, serum sickness like reactions, anaphylaxis
• Psychiatric disorders- Unknown: Confusion, sleep disturbances
• Nervous system disorders- Unknown: hyperactivity, hypertonia, dizziness, nervousness; Rarely: Headache
• Hepatobiliary disorders- Frequency unknown: Liver, enzyme disturbances, transient hepatitis, cholestatic jaundice
• Renal and urinary disorders- Unknown: Reversible interstitial nephritis
• Investigations- Unknown: Elevation of blood urea nitrogen, serum creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase.

 

Pregnancy & Lactation

Although no teratogenicity has been proven in animal investigations, safety in pregnancy has not been proved. Cephradine is secreted in breast milk and should be avoided in breastfeeding women. Because the medication may produce dizziness, patients should be advised about driving potentially dangerous machinery, such as vehicles.

 

Precautions & Warnings

• Prolonged use of an anti-infective may result in the development of superinfection due to the emergence of resistant organisms.
• Cephradine should be administered with care to patients hypersensitive to penicillins because of the risk of cross-sensitivity between beta-lactam antibiotics.
• Cephalosporin antibiotics may cause a positive result in Coombs’ testing. When Coombs testing is performed on neonates whose mothers received cephalosporins prior to labour, it should be noted that a positive result may be due to the drug.
• Cephradine may cause a false positive urine glucose result when Benedict’s or Fehling’s solutions or tablets such as Clinitest are used in the testing. This does not occur with enzyme-based tests (e.g. Clinistix, Diastix).
• Dosage adjustment is necessary in renal impairment.
• This product contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

 

Therapeutic Class

First generation Cephalosporins

 

Storage Conditions

Cephradine Suspension should be made fresh. If stored at ambient temperature, reconstituted Suspension should be used within 7 days; if kept in the refrigerator, it should be used within 14 days. When stored at room temperature, Cephradine Injection solutions should be used within 2 hours. Solutions keep their efficacy for 12 hours when kept at 5°C. The color of reconstituted solutions might range from pale to straw yellow, although this has no effect on their effectiveness. Do not use after the expiry date. Keep any medications out of children's reach. Only on the prescription of a qualified physician can it be dispensed.

 

Generic of Intracef 500

Cephradine