Ceftin is used for treating bacterial infections (sinus, skin, lung, urinary tract, ear, and throat). It may also be used to treat Lyme disease and gonorrhea.
Other names for this medication:
Also known as: Cefuroxime.
Ceftin is a cephalosporin antibiotic. It works by interfering with the formation of the bacteria's cell wall so that the wall ruptures, resulting in the death of the bacteria.
Generic name of Ceftin is Cefuroxime.
Ceftin is also known as Cefuroxime axetil, Zinacef, Bacticef, Cefasun, Cefudura, Cefuhexal, Cefurax, Cefutil, Cetil, Froxime, Elobact, Oraxim, Zinnat.
Brand name of Ceftin is Ceftin.
Take Ceftin by mouth with or without food.
Swallow Ceftin whole. Do not break, crush, or chew before swallowing.
Ceftin works best if it is taken at the same time each day.
If you want to achieve most effective results do not stop taking Ceftin suddenly. To clear up your infection completely, take Ceftin for the full course of treatment. Keep taking it even if you feel better in a few days.
If you overdose Ceftin and you don't feel good you should visit your doctor or health care provider immediately.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.
The most common side effects associated with Ceftin are:
Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.
Do not take Ceftin if you are allergic to Ceftin components.
Ceftin should not be used for colds, flu, other virus infections, sore throats or other minor infections, or to prevent infections.
Be careful if you are pregnant, planning to become pregnant, or are breast-feeding.
Be careful if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.
Be careful if you are diabetes patient. Ceftin may cause the results of some tests for urine glucose to be wrong.
To prevent pregnancy, use an extra form of birth control because hormonal birth control pills may not work as well while you are using Ceftin.
It can be dangerous to stop Ceftin taking suddenly.
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Cefuroxime is commercially available for parenteral administration as a sodium salt and for oral administration as cefuroxime axetil, the 1-(acetoxy)ethyl ester of the drug. Cefuroxime axetil is a prodrug of cefuroxime and has little, if any, antibacterial activity until hydrolyzed in vivo to cefuroxime. In this study, the absorption of cefuroxime axetil in the small intestines of anesthetized rats was investigated in situ, by perfusion at four concentrations (11.8, 5, 118 and 200 microM). Oral absorption of cefuroxime axetil can apparently be described as a specialized transport mechanism which obeys Michaelis-Menten kinetics. Parameters characterizing absorption of prodrug in free solution were obtained: maximum rate of absorption (Vmax) = 289.08 +/- 46.26 microM h-1, and Km = 162.77 +/- 31.17 microM. Cefuroxime axetil transport was significantly reduced in the presence of the enzymatic inhibitor sodium azide. On the other hand, the prodrug was metabolized in the gut wall through contact with membrane-bound enzymes in the brush border membrane before absorption occurred. This process reduces the prodrug fraction directly available for absorption. From a bioavailability point of view, therefore, the effects mentioned above can explain the variable and poor bioavailability following oral administration of cefuroxime axetil. Thus, future strategies in oral cefuroxime axetil absorption should focus on increasing the stability of the prodrug in the intestine by modifying the prodrug structure and/or targeting the compound to the absorption site.
An esterase which hydrolyses the cephalosporin antibiotic, cefuroxime axetil has been isolated from rat intestinal washings and purified. Closely related cefuroxime esters were extremely poor substrates, but p-nitrophenyl acetate and alpha-naphthyl acetate were slowly hydrolysed by the purified enzyme. Analysis by gel filtration gave an Mr = 51,000 and on SDS-polyacrylamide gel electrophoresis the esterase resolved into two main bands of Mr = 31,500 and 26,800. Analytical isoelectric focusing resolved purified esterase into multiple forms active toward alpha-naphthyl acetate, the isoelectric points of which ranged from pH 4.5 to 6.3. The esterase bound specifically to Con A-Sepharose suggesting it could be a glycoprotein. Esterase activity was unaffected by the presence of dihydroxy bile salts (1-8 mM) and inhibition studies using organophosphates and eserine salicylate have classified the enzyme as a carboxylesterase.
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A study of the efficacy of cefuroxime axetil was conducted for the treatment of acute sinusitis in childhood. Thirty-nine patients aged 5-14 years were given cefuroxime axetil 20 mg/kg/day divided into two doses for seven days. The diagnosis of acute sinusitis was based on history, physical examination, and radiological findings. The results of throat cultures before treatment were 17 patients with group A beta-haemolytic streptococci, seven patients with pneumococci, and two patients with Staphylococcus aureus; in the remainder of the patients only normal throat flora were isolated. In 36 patients (92%) a satisfactory improvement was reported at the end of the treatment. It was found that cefuroxime axetil was efficaceous for the treatment of sinusitis in childhood.
Recent resurgence in serious streptococcal infections and rising failure rates with the standard 10-day course of therapy with penicillin V for group A beta-haemolytic streptococcus (GABHS)-associated tonsillopharyngitis (pharyngitis and/or tonsillitis) have heightened interest in alternative treatments for this infection. Reasons for failure of the standard therapy include penicillin tolerance, increased virulence of GABHS strains, inactivation by beta-lactamase, and poor compliance. Short, 4-5-day courses with oral cephalosporins, such as cefuroxime axetil, have recently proven to be effective alternatives. Cefuroxime axetil provides resolution of clinical symptoms and fever within 2.5 days of onset of therapy, and its short course of treatment may improve compliance.
Because definitive information about causative pathogens is seldom available, treatment of pneumonia is most often empiric. Antibiotic therapy can be withheld in mildly ill, ambulatory patients in whom viral infection is likely. Most guidelines suggest initial treatment with orally administered amoxicillin or amoxicillin/clavulanate or with intravenous cefuroxime when patients require hospitalization. In May, 2000, the Centers for Disease Control-convened Drug-Resistant S. pneumoniae Therapeutic Working Group identified oral beta-lactams including cefuroxime axetil, amoxicillin and amoxicillin/clavulanate as appropriate options for first line therapy of community-acquired pneumonia in ambulatory adults and children.
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Randomized controlled trials have ascertained the efficiency of antibiotics in treating erythema migrans, the hallmark of early stage Lyme borreliosis. Oral amoxicillin and doxycycline are first-line treatment options, though phenoxymethylpenicillin, cefuroxime axetil and azithromycin are alternative second-line options. Treatments for secondary and tertiary Lyme borreliosis are more poorly documented, and antibiotics are not always effective. This is due to the unique pathophysiology of late Lyme borreliosis, which involves not only bacterial infection, but also immunological response. Since there is no completely reliable method of diagnosis, it is difficult to choose the proper treatment and to evaluate treatment efficacy. However, numerous studies have shown that ceftriaxone and doxycycline are the 2 most efficient antibiotics, particularly in Lyme arthritis and in neuroborreliosis. In late Lyme borreliosis, these antibiotics are less efficient, and different treatment schemes with variations in dosage or duration did not produce convincing results.
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Oral cefuroxime axetil (1 g) plus probenecid cured 29 of 30 urethral and 6 of 6 rectal gonococcal infections in men; alone the drug cured 22 of 23 urethral and 4 of 6 rectal infections. No toxicity was observed. Cefuroxime axetil alone is effective for urethral gonorrhea in males; rectal gonorrhea probably requires additional probenecid.
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Antibiotic concentrations in serum and middle ear effusion (MEE) are important in determining treatment success in acute otitis media, but studies to measure concentration levels are often performed in chronically infected patients where there is little inflammation. In this open, single-center study, 26 patients with acute otitis media were enrolled to assess antibiotic penetration in inflamed ears. Of the 26 patients, 4 were non-evaluable, 6 formed a control group and the others were randomized into three groups. Each of the three groups was given a single oral dose of cefuroxime axetil suspension, 15 mg/kg. Food was administered approximately 20 minutes before the drug in order to maximize drug absorption. Cefuroxime concentrations in serum and MEE were assessed at 2-3 (group 1), 3-4 (group 2) and 4-5 (group 3) hours following dosing. Sampling of MEE was performed with tympanocentesis under local anesthesia and the drug was assayed by HPLC-mass spectrometry. The serum concentrations of cefuroxime were found to be above the minimal inhibitory concentration (MIC) for penicillin-sensitive Streptococcus pneumoniae for 100% of the dosing interval and 42% of the time for intermediate-resistant strains. For both Haemophilus influenzae and Moraxella catarrhalis, serum cefuroxime levels were above the MIC for 42% of the time between doses. This study indicates that cefuroxime axetil penetrates the inflamed middle ear effectively in acute otitis media after oral dosing. Serum levels were maintained above the MICs of important bacterial pathogens in otitis media for more than 5 hours after dosing, which is equivalent to 42% of the dosing interval. Thus, the important statistic of 40-50% of time above MIC, required for beta-lactam antibiotics to produce the maximal bacteriological cure rate of 80-85%, is achieved.
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Limited data are available regarding the relationship of Borrelia burden in skin of patients with erythema migrans (EM) and the disease course and post-treatment outcome.
Under different temperatures and physiological conditions, with cefuroxime axetil concentrations in the range of 1.959 X 10(-6) to 13.71 X 10(-6) mol x L(-1), and bovine serum albumin (BSA) concentrations at 2.0 X 10(-6) mol x L(-1), the interaction between cefuroxime axetil and BSA was studied by fluorescence spectroscopy, three-dimensional fluorescence spectrum, synchronous fluorescence spectrum and UV-Vis absorption spectroscopy. After analyzing and processing the fluorescence quenching data at different temperatures according to Sterm-Volmer equation, Lineweaver-Burk equation and thermodynamic equation, the average value of the apparent binding constant (K(LB): 3.907 X 10(6) L x mol(-1)), and thermodynamics parameters (enthalpy change delta H: -13.43 kJ x mol(-1), entropy change delta S: 81.90 J x K(-1) and standard Gibbs free energy change delta G0: -38.34 kJ x mol(-1)) were calculated, and the amounts of binding sites (n: 1.042)were measured. The fluorescence quenching mechanism of BSA after cefuroxime axetil was added was discussed. BSA was bound with cefuroxime axetil and formed a new compound. The quenching belonged to static fluorescence quenching. The thermodynamic parameters agree with delta H approximately 0, delta S > 0 and delta G0 < 0, and the binding reaction is mainly entropy-driven and electro-static interaction force plays a major role in the reaction. The maximum emission wavelength of Tyr and Trp had an obvious red shift in the synchronous fluorescence spectra, the fluorescence emission wavelength of two peaks had a blue shift in the three-dimensional fluorescence spectrum of BSA in the presence of cefuroxime axetil and the maximum absorbtion wavelenghs of three systems in the UV-Vis absorption spectra were obviously different. These showed that the changes in the micro-environment of Tyr and Trp and demonstrated that the conformation of BSA changed as cefuroxime axetil had been added. This provides important information for discussing the configuration modification of BSA because of the added cefuroxime axetil, and for elucidating the pharmacological effects of cefuroxime axetil and biological effects in the organism.
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In a double-blind, multicentre trial, 382 patients with a diagnosis of acute purulent sinusitis were randomised to receive sparfloxacin 200 mg once daily for 5 days following a loading dose of 400 mg on day 1 (n = 193) or cefuroxime axetil 250 mg twice daily for 8 days (n = 189). Patients were classified as success or failure according to clinical symptoms plus bacteriological and radiological data at the end of treatment and at a follow-up visit. In analyses of the intent-to-treat (n = 374) and evaluable populations (n = 304), the 5 day course of sparfloxacin was at least as effective and well tolerated as the 8 day course of cefuroxime axetil. The success rates at the end of treatment in the evaluable population were 82.6% and 83.2% in the sparfloxacin and cefuroxime axetil groups, respectively. The pathogens isolated most frequently were Haemophilus influenzae (33%) and Streptococcus pneumoniae (28%). Response rates according to the bacterial aetiology of the acute sinusitis were similar in the two treatment groups. Both drugs were well tolerated. The commonest adverse events were gastrointestinal and were reported in 2.6% and 3.8% of sparfloxacin- and cefuroxime axetil-treated patients, respectively.
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128 Patients (45 female, 83 male) with acute exacerbations of chronic bronchitis were treated with either cefuroxime axetil 2 x 500 mg/d (n = 65) or ofloxacin 2 x 200 mg/d for 7-8 days in a randomized controlled multicenter trial. From the respective groups, the results of 61 and 59 patients could be evaluated. Positive sputum tests were available in 85 cases (56 monoinfections, 29 mixed infections) prior to treatment. According to final clinical assessment, cure was achieved with cefuroxime axetil in 75%, but only in 50% with ofloxacin. The clinical efficacy of cefuroxime axetil was judged by the physicians to be more reliable than ofloxacin. The difference is statistically significant (p less than 0.05). Therapy with ofloxacin had to be terminated in 2 cases due to side effects. Altogether 4 adverse events were documented with ofloxacin. Compared with ofloxacin, cefuroxime axetil showed better efficacy and low risk of side effects.
We assessed oral cefuroxime axetil in an open study of 30 patients with lower respiratory tract infection and then compared oral cefuroxime with oral amoxycillin in a randomized double blind study in a further 40 patients. Satisfactory clinical responses were obtained in 73% of patients receiving cefuroxime axetil 500 mg tid in the open study, and in the comparative study in 71% of patients receiving cefuroxime axetil 500 mg bd, in 60% of patients receiving cefuroxime axetil 500 mg tid and in 63% of patients receiving amoxycillin 500 mg tid. There were no significant differences in response rates between the three regimens in the comparative study. There were no important adverse effects in any of the patients. Oral cefuroxime axetil is safe and effective in the therapy of lower respiratory tract infections.
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Three successful generations of cephalosporin antibiotics can be divided into parenteral and peroral substances. Both have similar antibacterial and hence therapeutical properties. It is usual to include into the first generation of peroral cephalosporins the so-called phenylglycine, or hydroxyphenylglycine derivatives. The carbacephem variant of Cefaclor (Panoral Lilly), Loracarbef, however, has improved properties and although it is a phenylglycine drug, it could be classified as a second generation cephalosporin. Here we include also the so-called ester-prodrugs: 2nd generation parenteral cephalosporins esterified in the position of C4 (cefuroxime-axetil, Zinnat, cefpodoxime-proxetil, Oralox, etc.). They are broad-spectrum antibiotics, not hydrolysed by resistant bacteria, and, hence, they are effective also against cephalosporin-(1. generation) resistant strains. New structures of cephalosporins, e.g. cefixime and ceftibuten (Cedax) could be classified as cephs of the 3rd generation. They, are stable even against destruction by strains resistant to Cefotaxime or Ceftazidime, and, thus, effective against such bacteria, whose number is expected to increase in the near future. It is concluded that the possibility to administer cephalosporins having different properties, spectrum and stability by both parenteral and peroral way is highly welcomed mainly in pediatric practice and that there are several new and promising drugs in this still developing group of antibacterials.
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The pharmacokinetic parameters of cefixime were determined in healthy volunteers following oral administration of 200 mg cefixime as tablet, syrup and dry suspension, respectively. All three galenic formulations showed reliable absorption. Mean peak plasma concentrations amounted to 2.4-3.4 mg/l and were reached after 3.3-3.5 h. Mean terminal half-lives were 2.9-3.1 h. The mean areas under the plasma concentration-time curves ranged between 18 and 26 mg/l.h; 18-24% of the dose administered were recovered unchanged in the urine. The best bioavailability was obtained with the dry suspension followed by the tablet and the syrup. With respect to the ester pro-drug cephalosporins, cefuroxime axetil, cefetamet pivoxyl and cefotiam hexetil, cefixime exhibits higher plasma half-life and area under the curve as well as, comparable absolute bioavailability but consistently lower urinary recovery which indicates higher non-renal clearance.
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The pharmacokinetics of the older and more recent oral cephalosporins are reviewed. With the exception of cefadroxil the older agents (cephalexin, cephradine and cefaclor) have serum elimination half-lives of less than or equal to 1 h and hence have to be administered three to four times daily. The urinary recovery of these agents is high (greater than 80% of oral dose) with the exception of cefaclor (54%). Cefaclor is also chemically unstable. The newer agents can be divided into those that are prodrugs (cefpodoxime proxetil and cefuroxime axetil) and compounds that are absorbed as such (cefixime, cefprozil and ceftibuten). They all have half-lives greater than 1.25 h and can be given once or twice daily. The penetration of these agents into an inflammatory exudate was studied and found to be cefixime 132%, ceftibuten 113%, cefpodoxime 104%, cefuroxime 92% and cefprozil 79% of the serum concentration. The penetration of cefpodoxime and cefixime into the respiratory tract was also studied; the mean percentage bronchial mucosal penetration was 52% for the former and 38% for cefixime. The urinary recovery of these newer agents (with the exception of ceftibuten) tends to be less than that of the earlier agents. There was a relationship between the serum elimination half-life of these agents and the degree of tissue penetration, those agents with longer half-lives penetrating to a greater extent.
Cefdinir (Omnicef) is an oral third-generation cephalosporin with good in vitro activity against many pathogens commonly causative in community-acquired infections. The drug provides good coverage against Haemophilus influenzae, Moraxella catarrhalis and penicillin-susceptible Streptococcus pneumoniae, the most common respiratory tract pathogens. Cefdinir is stable to hydrolysis by commonly occurring plasmid-mediated beta-lactamases and retains good activity against beta-lactamase-producing strains of H. influenzae and M. catarrhalis. The drug distributes into various tissues (e.g. sinus and tonsil) and fluids (e.g. middle ear), and has a pharmacokinetic profile that allows for once- or twice-daily administration.Cefdinir, administered for 5 or 10 days, has shown good clinical and bacteriological efficacy in the treatment of a wide range of mild-to-moderate infections of the respiratory tract and skin in adults, adolescents and paediatric patients in randomised, controlled trials. In adults and adolescents, cefdinir is an effective treatment for both lower (acute bacterial exacerbations of chronic bronchitis [ABECB], community-acquired pneumonia) and upper (acute bacterial rhinosinusitis, streptococcal pharyngitis) respiratory tract infections, and uncomplicated skin infections. Its bacteriological and clinical efficacy in patients with lower respiratory tract infections was equivalent to that of comparator agents (cefprozil [bacteriological only], loracarbef, cefuroxime axetil and cefaclor). In one trial in patients with ABECB, cefdinir produced a higher rate of clinical cure than cefprozil (95% CIs indicated nonequivalence). Cefdinir also produced good clinical and bacteriological responses equivalent to responses with amoxicillin/clavulanic acid in patients with acute bacterial rhinosinusitis. In addition, it was at least as effective as penicillin V (phenoxymethylpenicillin) in streptococcal pharyngitis/tonsillitis and as effective as cefalexin in uncomplicated skin infections. In paediatric patients aged > or =6 months, cefdinir showed similar efficacy to that of amoxicillin/clavulanic acid or cefprozil in acute otitis media, and cefalexin in uncomplicated skin infections. Cefdinir given for 5 or 10 days was at least as effective as penicillin V for 10 days in patients with streptococcal pharyngitis/tonsillitis. Cefdinir is usually well tolerated. Diarrhoea was the most common adverse event in trials in all age groups. Although the incidence of diarrhoea in cefdinir recipients was generally higher than in adults and adolescents treated with comparators, discontinuation rates due to adverse events were generally similar for cefdinir and comparator groups. In conclusion, cefdinir is a third-generation cephalosporin with a broad spectrum of antibacterial activity encompassing pathogens that are commonly causative in infections of the respiratory tract or skin and skin structure. Depending on the infection being treated, cefdinir can be administered as a convenient once- or twice-daily 5- or 10-day regimen. Clinical evidence indicates that cefdinir is an effective and generally well tolerated drug with superior taste over comparator antibacterial agents and is therefore a good option for the treatment of adults, adolescents and paediatric patients with specific mild-to-moderate respiratory tract or skin infections, particularly in areas where beta-lactamase-mediated resistance among common community-acquired pathogens is a concern.
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Patients were randomized (1:1:1) to 1 of 3 treatment groups: group 1 received 2 days of i.v. and 8 days of oral therapy; group 2 received 5 days of i.v. and 5 days of oral therapy; and group 3 received 10 days of i.v. therapy. Antibiotics consisted of cefuroxime, 750 mg every 8 h for the i.v. course, and cefuroxime axetil, 500 mg every 12 h for the oral therapy.
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Healthy native snakes were captured and kept in a designated centre. Snake species were identified by experienced herpetologists. Mouth swabs were taken by the veterinarian using strict aseptic techniques. The snakes were released back to the wild immediately after the above procedure. Swabs were sent for microbiological studies of bacterial culture and antibiotic sensitivity.
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Cefuroxime axetil, a prodrug of the cephalosporin cefuroxime, has proven in vitro antibacterial activity against several gram-positive and gram-negative organisms, including those most frequently associated with various common community-acquired infections. In numerous randomised, controlled trials, 5 to 10 days' treatment with oral cefuroxime axetil (250 or 500 mg twice daily) was an effective treatment in patients with upper (URTI) and lower respiratory tract infections (LRTI) as assessed by clinical and bacteriological criteria. The drug was as effective as several other cephalosporins, quinolones, macrolides and amoxicillin/clavulanic acid. Shorter courses (5 to 10 days') of cefuroxime axetil were at least as effective as a 10 day course. Furthermore, sequential therapy with intravenous cefuroxime (750 mg 2 or 3 times daily for 2 to 5 days) followed by oral cefuroxime axetil (500 mg twice daily for 3 to 8 days) proved an effective treatment in adult patients with community-acquired pneumonia (CAP). This approach provided similar efficacy to intravenous ampicillin/sulbactam followed by oral amoxicillin/clavulanic acid, a full parenteral course of cefuroxime, or intravenous then oral azithromycin or clarithromycin. Additionally, cefuroxime axetil was an effective treatment in patients with genitourinary, skin and soft-tissue infections, and erythema migrans associated with early stage Lyme disease. The drug is well tolerated by adult and paediatric patients, with adverse effects that are consistent with those of other cephalosporins. The majority of adverse events (primarily gastrointestinal disturbances) were mild to moderate in intensity and reversible upon discontinuation of treatment, with very few serious adverse events reported.
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