lebac is used in the treatment of infection caused by sensitive organisms.
upper respiratory tract infection :pharyngitis, sinusitis, otitis media,
tomsilitis , laryngotracheo-bronchitis. lower respiratory tract infection:acute and chronic bronchitis, lobar and
bronchopneumoia. urinary tract infection:cystitis,urethritis,phelonephritis.
skin and soft tissue infection:abscess, cellulitis,furunculosis, impetigo.
gastrointestinal tract infection: bacillary dysentery,enteritis, peritonitis.
bone and join infection. surgical prophylaxis:it is also used in preoperative prophylactic
administration (pro-operatively, intra-operatively and post-operatively). in cesarean section , intra-operative (after clamping the umbilical cord)
and post-operative use may reduce the incidence of certain post-operative infection
LEBAC: lebac is a cephalosporin antibiotic with broad spectrum
bactericidal activity against both gram-positive and gram-negative
bacteria. it is also highly active against most strains of penicillinase
the organisms sensitive to cephradine are: gram-positive:staphylococci
(both penicillin sensitive and resistant strains) and group D
streptococci(enterococci)and streptococcus pneunoniae.
gram-negative:E. coli, kledsiella ,P.mirabilis, haemophilus influenzae,
shigella, spp. (including salmonella typhi) and neisseria spp. enterococci
(s. faecalis) and many strains of E. coli and staphylococcus aureus are also susceptible.
reconstitution & administration
LEBAC=power for suspension
for the suspension,shake the bottle well before adding water. then add 60 ml,of boiled and cooled water (with the help of the provided cup) to the bottle.then continue shaking the bottle gently until the power is mixed properly.shake the bottle well before each use.
shake the bottle before adding water.then add 10 ml (or with the help of provided spoon) of boiled and cooled water ..then continuously shake the bottle well until well the power is mixed properly.
shake the bottle well before each use
intramuscular :add 2.0ml if water for injection BP to 500mg vial and shake. intravenous:add 5.0ml of water for injection BP to 500mg vial and shake. the solution should be slowly be slowly injection directly into a vein over a 3 to 5 minutes period.
inreamuscular:add 4.0ml of water for injection BP to 1gm vial and shake .. intravenous:add 10.0ml of water for injection BP to 1 gm vial and shake.the solution should be slowly injection directly into a vein over a 3 to 5 minutes period
Group of axithromycin
azirox (azithromycin) is an azalide antibiotic active against gram-positive and gram-negative organisms. Azirox (azithromycin) acts by binding to the 50s ribosomal subunit of susceptible organisms & thus interferes with microbial
Azirox-500: each film coated tablet contains azithromycin USP 500mg as azithromycin dehydrate.
Azirox dry syrup: after reconstitution each 5 ml contains azithromycin USP 200 mg as azithromycin dehydrate.
acute bacterial exacerbations of chronic obstructive pulmonary disease. Community acquired pneumonia, sinusitis, pharyngitis/tonsillitis and skin and soft tissue infections due to the indicated organisms; 500mg once daily orally for 3 days or as an alternative given over 5 days with 500mg dose on the first day followed by 250 mg once daily on days 2 through 5. Genital ulcer disease, non-gonococcal urethritis and cericitis; 1g as a single dose (1000 mg). urethriris and cervicitis due to neisseria conorrhoeae ; 2 g (2000mg) as a single dose. Sexually transmitted diseases; 1 g as a single dose. Thyphoid fever; 500mg once daily for 7 days.
for children over 6 month recommended dose is 10mg/kg once daily for 3 days or
15-25 kg; 200 mg once daily for 3 days
26-35 kg; 300 mg once daily for 3 days.
36-45 kg; 400 mg once daily for 3 days
Azirox should be taken at least 1 hour before or 2 hour after meal.
Contraindication: azithromycin is contraindicated in patients hypersensitive to axithromycin or any other macrolide antibiotic. Co-administration of ergot derivatives and aithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.
azithromycin is well tolerated with low incidence of side effects. Majority of the side effect are mild to moderate in nature of gastrointestinal in origin with nausea, abdominal discomfort, vomiting, flatulence and diarrhea. Allergic reactions such as rash have occurred and there have also been rare reports of serious hypersensitivity reactions. Reversible elevations in liver transaminases have been seen with a frequency similar to the comparative macrolides and penicillin’s used in clinical trials. Transient mild reductions in neutrophil counts have occasionally been observed in clinical trials, although a causal relationship to azithromycin has not been established.
as with any antibiotic observation for sings of super infection with non susceptible organisms, including fungi is recommended. No dose adjustment is needed in patients with renal impairment.
Use in pregnancy and lactation:
Pregnancy category B. animal reproduction studies have demonstrated that azithromycin crosses the placenta, but have revealed to evidence of harm to the fetus. Since animal reproduction studies are not always predictive of human response. Azithromycin should be used during pregnancy only if clearly needed. No data on secretion of azithromycin in breast milk is available, so azithromycin should only be used lactating mothers where adequate alternatives are not available.
Azithromycin absorption is reduced In food and antacid. So azithromycin should be administered 1 hour before or 2 hours after taking food or antacid. In patients receiving ergot alkaloids azithromycin should be avoided concurrently because of the possibility of egotism resulting from interaction of azithromycin and cytochrome p450 system. However, no cases of such interaction have been reported. Macrolides have been known to increase the plasma concentration of digoxin and cycloporin should be checked. There have been no pharmacokinetic drug interaction between azithromycin and warfarin, theophylline, carbamazepine, methylprednisolone and cimetidine.
Overdose: There is no data on overdose with azithromycin. Typical symptoms of over dosage with macrolide include hearing loss, severe nausea, vomiting and diarrhea. Gastric lavage and general supportive measures are indicated.
Cefpodoxime proxetil USP
Taxetill capsule: each capsule contains cefpodoxime proxetil USP equivalent to cefpodoxime 100 mg.
Taxeil-200 capsule: each capsule contains cefpodoxie proxetill USP equivalent to cefpodoxime
Taxetil power for suspension: after reconstitution each 5 ml suspension contains cefpodoxime proxetil USP equivalent to cefpodoxime 40mg.
Taxetil DS powder for suspension: after reconsititution each ml drops contains cefpodoxime proxetil USP equivalent to cefpodoxime
Taxetil paediatric drops: after reconstitution each ml drops
contains cefpodoxime proxetil USP equivalent to cefpodoxome 20mg.
Cefpodoxime proxtil is an orally administrated prodrug that is de-esterified in the intestinal wall to release cefpodoxime, a third generation cephalosporin. Cefpodoxime is a broad spectrum antibiotic and is active against beta lactamase producing staphylococci. Cefpodoxime binds with high affinity to penicillin binding proteins binding proteins in the bacterial cell wall thus interfering in peptidoglycan synthesis that provides the cell wall with mechanical stability cefpodoxime inhibits the transpeptidase enzyme that performs the final stage in the synthesis of prptidoglycan as a result the bacterial cell wall is weakened, and the cell swells and then ruptures.
Indications: •Upper respiratory tract infections *lower respiratory tract infections * urinary tract infections including gonorrhea * skin and soft tissue infection * gynecological infection * acute otitis media * childhood infection * typhoid fever.
Dosage and administration:
200mg as a single dose or 100-200mg twice daily for 5-14 days depending on the severity of the infection . Upper respiratory tract infection (pharyngitis and tonsillitis which are recurrent, chronic or resistant to other antibacterials): 100mg twice daily (200mg twice daily in sinusitis).
Skin and soft tissue infection: 200mg twice daily.
Uncomplicated gonorrhea: 200mg as a single dose.
The recommended dose is 4mg/kg twice daily for 5-14 days according to the severity of the infection or as follows:
15 days-6 month 4 mg/kg ever 12 hours.
6 months-2 year 40mg ever 12 hours.
3-8 years 80 mg ever 12 hours.
Over 9 years 100mg ever 12 hours.
Typhoid fever 8mg/kg ever 12 hours.
Side effect: Diarrhea and rarely antibiotic colitis and vomiting abdominal discomfort headache, allergic reactions including rashes, pruritus, urticaria, serum sickness- like reactions with rashes, fever and arthralgia, and anaphylaxis, erythemia multiform. Toxic epidermal necrolysis reported; disturbances in liver enzythemia, transient hepatitis and cholestatic jaundice; etc. other side effects reported include eosinophilia and blood disorders, reversible interstitial nephritis, hyperactivity nervousness, sleep disturbances, confusion ,hypertonia and dizziness etc.
Contraindication: Cefposoxime is contraindicated in patients with a known allergy to cephalosporin group of antibiotic or any inactive ingredient to the product.
Precautions: In patients with transient or persistent reduction in urinary output due to renal insufficiency, the total daily dose of cefpodoxime should be reduced because high and prolonged serum antibiotic concentration can occur in such individuals following usual doses, cefposoxime should be administered with caution to patients receiving concurrent treatment with potent diuretic. As with other antibiotic-prolonged use to cefpodoxime may result In overgrowth of non-susceptible organisms. If superinfection occurs during therapy. Appropriate measures should be taken.
Drug interaction: Antacids: concomitant administration of high doses of antacids (sodium bicarbonate and aluminum hydroxide) or H2 blockers reduce peak levels by 24% to 42% and the extent to absorption by 27% to 32% respectively, though the rare of absorption is not altered by these concomitant medications. Oral anticholinergics delay peak plasma levels, but do not affect the extent of absorption.
Probenecid: prodencid inhibits the excretion of cefodoxime
Nephrotixic drug: although nephrotoxicity has not been noted when cefpodoxime was given alone, close monitoring of renal function is advised when cefpodoxime is administered concomitantly with compounds of known nephrotoxic potential.
Use in pregnancy:
Pregnancy category B. there are no adequate & well-controlled studies in pregnant women. So this drug should be sued during pregnancy only of clearly needed.
Use in lactation:
cefodoxime proxetil is excreted in human milk. Because of the potential for serious reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
(Capsule/DS capsule/powder for suspension)
Fix-A (cefixime) is a third generation semisynthetic cephalosporin antibiotic for oral administration. Fix-A (cefixime) is bactericidal against a broad spectrum of gram positive and gram-negative bacteria at easily achievable plasma concentrations. Fix-A (cefixime) is also highly stable in the presence of beta-lactamase enzyme. As a result, many organism resistant to penicillin’s and some cephalosporin due to the presence of beta-lactamases, may be susceptible to fix-A (cefixime). Fix-A (cefixime) exhibits every good activity against most of the enterobacteriaceae, haemophilus influenza and neisseria gonorrhoeae (including B-lactamase producing strains), B-hemolytic streptococci of groups A and B and streptococcus pneumonia. Absorption Is about 40% to 50% whether administered whit or without food.
Capsule: each capsule contains cefixime trihydrate usp equivalent to cefixime 200mg.
Ds capsule: each capsule contains cafixime trihydrate USP equivalent to cefixime 400mg.
Power of suspension: each 5 ml suspension contains cefixime trihydrate USP equivalent to cefixime 100mg after reconstitution.
Fix-A (cefixime) is indicated for the treatment of the following acute infection caused by the susceptible microorganisms. 1) upper respiratory tract infections e.g. otitis media and other URTI where the causative organism is known or suspected to be other commonly used antibiotics, or where treatment failure may carry significant risk. 2) Lower respiratory tract infections e.g. bronchitis. 3) Urinary tract infections e.g. cystitis, cystourethritis, uncomplicated pyelonephritis. 4) Uncomplicated gonorrhea (cervical/ urethral).
Dosage and administration:
Adult and children over 12 years: the recommended adult dose is 200-400 mg daily , given either as a single dose or in two divided doses for 7-14 days depending on the severity of the infection. For the treatment of uncomplicated cervical/urethral gonococcal infections, a single oral dose of cefixime 400mg (fix-A DS) is recommended. Single 800mg may be given if essential.
Children upto 12 years: usually 8mg/kg/day given as single dose or in two divided or for children of age;
½ - year : 3.75ml or 75 mg
1-4 years: 5ml or 100mg
5-10 years: 10ml or 200mg
11-12 years: 15ml or 300mg
Above 12 years: adult dose should be given.
Or as directed by the physician.
The drug is generally well tolerated. The most frequent side effects observed are diarrhea and stool changes; that has been more commonly associated with higher doses. The drug should be discontinued if marked diarrhea occur. Other side effects seen less frequently are nausea, abdominal pain, dyspepsia, vomiting, flatulence, headache and dizziness. Allergies in the form of rash, pruritus, urticaria, drug fever and arthralgia have been reported. These reactions usually subsided upon discontinuation of therapy.
Precautions: The drug should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis. The drug should be given with caution in patients with marked impaired renal function as well as those undergoing continuous ambulatory peritoneal dialysis and hemodilysis. Dosage adjustment is only necessary in sever renal failure (creatinine clearance <20ml. min-2), in that case a dose of 200mg once daily should not be exceeded.
Use in pregnancy and lactation:
There are no adequate and well controlled studies in pregnant women. Fix-A (cefixime) should therefore not be used in pregnancy or in nursing mothers unless considered essential by the physician.
Hypersensitivity to cephalosporin antibiotic …..