Ceftizoxime sodium

Pharmacology

It belongs to a third-generation cephalosporin with strong antibacterial effect on gram-positive bacteria, gram-negative bacteria, aerobic and anaerobic bacteria. Its antibacterial effect on the majority of Gram-negative bacteria such as Escherichia coli, Salmonella, Enterobacter, Proteus mirabilis and bacillus influenza is significantly higher than the first- and second-generation cephalosporins, but also stronger than the third-generation cefoperazole. In particular, it has a strong antibacterial activity on Enterobacteriaceae. It also has good efficacy in the treatment of infections associated with penicillin, cephalosporin and aminoglycoside-resistant, gram-positive and negative aerobic and anaerobic bacteria with especial excellent efficacy on pancreatitis and meningitis associated with dogs. Clinical application of this product for the treatment of prostatitis, orchitis, epididymitis, enteritis, liver abscess, cholangitis and anonymous fever can also obtain satisfied results.
Oral administration leads to no absorption; rapid absorption can be achieved through intramuscular and intravenous injection, 30% to 50% is subject to acetylation metabolism in the liver into cefotaxime. Its antibacterial activity is 20% to 30% of cefotaxime. This product is rapidly and widely distributed in the body tissues and body fluids. The concentrations in various tissues and body fluids generally exceed the minimum inhibitory concentration. Normal cerebrospinal fluid drug concentration is very low. Upon meningitis, cerebrospinal fluid can have an effective concentration. It can penetrate through the placental barrier into the fetal blood circulation with a small amount entering into the milk as well. Approximately 80% is excreted by the kidneys, of which 50% to 60% is prototype drug. The rest is the deacetylcefamide and inactive metabolites. Cefotaxime concentration in the urine is 100 times the minimal inhibitory concentrations (MIC) of most common pathogenic bacteria.
It is clinical mainly used for the treatment of animal-induced respiratory tract infections, urinary tract infections, gastrointestinal infections, sepsis, soft tissue infections, orthopedic infections and reproductive system infections such as avian colibacillosis, salmonellosis, dogs and cats meningitis, pancreas Inflammation and cholangitis and so on.

Adverse reactions

Allergic reactions, diarrhea, nausea, vomiting, loss of appetite, anemia, can cause mildly elevation in alkaline phosphatase and serum aminotransferase; transient increase in serum bilirubin, BUN and Cr. Occasionally it may be occurred of headache, numbness, dizziness, vitamin K and vitamin B deficiency, anaphylactic shock.

Compatibility

It has synergistic effect when used in combination with aminoglycosides during the treatment of some pathogens, but can also cause increased nephrotoxicity. Mixed intravenous infusion or injection of drugs can reduce potency.
Probenecid can reduce the renal clearance of cefotaxime by 5% and extend the half-life by 45%.
Combination with tobramycin has a synergistic effect on Pseudomonas aeruginosa; combination with gentamicin and amikacin has a synergistic effect on E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. It has no effect on Staphylococcus aureus. Care should be taken during monitoring renal function, two drugs can’t be the injected together. Compatibility table

Precautions

Long-term or large-scale application can cause double infection.
The side effects of this product is very small, individual animals may have gastrointestinal reactions (such as nausea, vomiting, diarrhea) and allergic reactions (urticaria, itching, etc.).
Intramuscular injection can cause local pain; apply the medium of 0.2% lidocaine to reduce or avoid.
Caution should be taken for animals allergic to penicillin and allergies, disable animals allergic to other cephalosporins.
Be cautious of applying it to animals with poor kidney function.

Description

Ceftizoxime was synthesized by Fujisawa Pharmaceutical Industries in 1979. It possesses the (iminothiazolyl)methoxyiminomethyl group at the 7 position of the cephem nucleus, but there is no side chain at the 3 position. The compound shows excellent activity against gram-positive and gram-negative bacteria, behavior similar to that of cefotaxime. Unlike cefotaxime, however, it is not metabolized in vivo.

Chemical Properties

Cefotaxime Sodium is white, white or light yellow crystalline powder; odorless; insoluble in organic solvents but soluble in water. The 10% solution has a pH of 4.5 to 6.5. Dilute solution is colorless or yellowish while high-concentration solution is grayish yellow. Dark yellow or brown color indicates that the drug has been deteriorated. The aqueous solution can be stored at 5 ℃ for 1 week.

Originator

Eposelin,Fujisawa,Japan,1982

Uses

A broad spectrum antibiotic targeting a wide variety of Gram-positive and Gram-negative bacteria

Uses

Antibacterial.

Definition

ChEBI: The sodium salt of ceftizoxime.

Manufacturing Process

Phosphorus oxychloride (2.0 g) was added at one time at 5°C to 10°C to a suspension of 2-methoxyimino-2-(2-amino-1,3-thiazol-4-yl)acetic acid (syn isomer) (2 g) in dry ethyl acetate (20 ml). After stirring for 20 minutes at 7°C to 10°C, bis(trimethylsilyl)acetamide (0.4 g) was added thereto at the same temperature. After stirring for 10 minutes at 7°C to 10°C, phosphorus oxychloride (2.0 g) was dropwise added thereto at the same temperature. The resulting mixture was stirred for 10 minutes at 7°C to 10°C, and dry dimethylformamide (0.8 g) was dropwise added thereto at the same temperature. The mixture was stirred for 30 minutes at 7°C to 10°C to give a clear solution. On the other hand, trimethylsilylacetamide (7.35 g) was added to a suspension of 7-aminocephalosporanic acid (2.45 g) in dry ethyl acetate (8 ml), after which the mixture was stirred at 40°C to give a clear solution.
To this solution was added at one time the above-obtained ethyl acetate solution at -15°C, and the resulting mixture was stirred for 1 hour at -10°C to -15°C. The reaction mixture was cooled to -30°C, and water (80 ml) was added thereto. The aqueous layer was separated, adjusted to pH 4.5 with sodium bicarbonate and subjected to column chromatography on Diaion HP-20 resin (Mitsubishi Chemical Industries Ltd.) using 25% aqueous solution of isopropyl alcohol as an eluent. The eluate was lyophilized to give 7-[2- methoxyimino-2-(2-amino-1,3-thiazol-4-yl)acetamido]cephalosporanic acid (syn isomer) (1.8 g), MP 227°C (decomp.).

brand name

Cefizox (Astellas).

Therapeutic Function

Antibacterial

Clinical Use

Ceftizoxime (Cefizox) is a third-generation cephalosporinthat was introduced in 1984. This β-lactamase–resistant agentexhibits excellent activity against the Enterobacteriaceae,especially E. coli, K. pneumoniae, E. cloacae, Enterobacteraerogenes, indole-positive and indole-negative Proteus spp.,and S. marcescens. Ceftizoxime is claimed to be more activethan cefoxitin against B. fragilis. It is also very active againstGram-positive bacteria. Its activity against P. aeruginosa issomewhat variable and lower than that of either cefotaxime orcefoperazone.
Ceftizoxime is not metabolized in vivo. It is excretedlargely unchanged in the urine. Adequate levels of the drugare achieved in the cerebrospinal fluid for the treatment ofGram-negative or Gram-positive bacterial meningitis. It mustbe administered on a thrice-daily dosing schedule because ofits relatively short half-life. Ceftizoxime sodium is very stablein the dry state. Solutions maintain potency for up to 24hours at room temperature and 10 days when refrigerated.