The discovery of the first antibiotic (today known to all penicillin) in the middle of the twentieth century was a real breakthrough in medicine. During the Great Patriotic War, this medicine saved the lives of thousands of defenders of the Motherland.
Since then, the biochemistry and pharmaceutical industries have rapidly developed and offered consumers more and more new antibacterial drugs. One of the most modern and widely used in various areas of medicine is Maximim, reviews of which regulate this remedy as very, very effective for various bacterial infections.
Composition and release form
The main active ingredient of this drug is cefepimadihydrochloride monohydrate. The release form is a whitish-yellowish powder for preparing a solution for subsequent intramuscular or intravenous administration. In several dosages, the manufacturer offers consumers its product "Maxipim". The antibiotic is available in 500 mg and 1 g vials.
Cooked forthe introduction of the composition can be stored at room temperature during the day. In the conditions of the refrigerator, the shelf life of the finished solution increases to 1 week. In powder form and in a sealed vial, the drug can be stored for 3 years. Necessary conditions - temperature up to + 30 ° C and a place protected from light. Changing the color of the solution does not affect the activity of the drug.
Pharmacological influence
"Maxipim" instructions for use are positioned as an antibacterial substance belonging to the group of cephalosporins of the 4th generation. The principle of exposure is to destroy the cell wall of bacteria, strains. The drug has a broad spectrum of influence in relation to a number of gram-positive and gram-negative microorganisms, characterized by their resistance to aminoglycosides and antibacterial agents of the 3rd generation of the cephalosporin group.
Maxipim is characterized by resistance to beta-lactamases and activity against a large number of gram-positive and gram-negative aerobes (a detailed list is in the instructions for use). But the drug is not active against methicillin-resistant staphylococci, penicillin-resistant pneumococci.
After administration, the antibiotic "Maxipim" (instruction for use includes such information) is completely absorbed. Therapeutically significant concentrations of the main active ingredient are found in urine, bile, bronchial secretions, in the prostate gland and peritoneal fluid.
Periodelimination half-life is approximately two hours. For comparison, we can say that, for example, in adult patients who received 2 g of the drug intravenously for 9 days with a time interval between procedures of at least 8 hours, no accumulation of cefepime in the body was found. The largest volume is excreted in the urine (up to 85% of the initial dose received by the patient in the form of unchanged cefepime is observed).
Indications for use
Antibacterial agent "Maxipim" instructions for use recommends prescribing for various types of pathology of an infectious-inflammatory nature. Good results will be obtained in the treatment of infections of the lower respiratory tract (including pneumonia and bronchitis) and urinary tract (both uncomplicated and complicated, including pyelonephritis). Positive dynamics is observed in the treatment of various intra-abdominal infectious lesions (not excluding biliary tract infections and peritonitis).
Also "Maxipim" is widely used by he alth workers for the treatment of gynecological infections, infectious lesions of the skin and soft tissues, septicemia (sepsis). In the treatment of patients suffering from febrile neutropenia, "Maxipim" instruction recommends the use as empirical therapy.
Another area of drug influence is bacterial meningitis in children. Here, this antibiotic also proved to be excellent.
For prophylactic purposes, the drug is used to prevent infections during abdominalsurgical interventions.
In general, we can say that "Maxipim" can be used for any infectious diseases, the development of which is provoked by bacteria and strains sensitive to it. To identify the pathogen and determine its (or their) sensitivity to this antibiotic, tests are supposed to be done. However, "Maxipim" affects such a wide range of bacteria and strains that it can be taken as monotherapy even before the pathogen is identified. If there is a risk of developing a mixed infection (aerobic-anaerobic), then before testing for the identification of pathogenic bacteria, treatment with Maximim can be started in tandem with a drug that affects anaerobes.
Methods of application and dosing regimens
The dosage and type of administration (in / in or / m) is determined depending on the sensitivity of the bacteria, the severity of the course of the disease and the condition of the patient's kidneys. Moreover, the intravenous route is usually preferred in cases where the infection is severe and really threatens the life of the patient.
People with he althy kidneys and a body weight of more than 40 kg are injected every 12 hours at doses prescribed by a doctor. Lesions of the urinary tract of mild and moderate severity, other infections that occur with the same intensity, are treated with dosages of 0.5-1 g administered intramuscularly or intravenously (as the doctor decides). To combat severe infections, it is practiced to inject 2 g of the substance intravenously (the frequency is the same - 12 hours). For very severe and life-threatening infections, the necessarythe dosage is also 2 g, but the frequency is every 8 hours.
The antibiotic "Maxipim" is used for influenza only in cases where a bacterial infection is also connected during the course of a viral infection.
In the process of surgical interventions (1 hour before the start), for preventive purposes, 2 g of "Maxipim" is administered intravenously for half an hour, after which 500 mg of metronidazole is additionally infused. Do not give both drugs at the same time.
The average volume of the drug for patients under 40 kg body weight in the treatment of urinary tract infections (complicated and not complicated), soft tissue and skin lesions (not complicated), pneumonia and empirical treatment of neutropenic fever is 50 mg per kilogram of body weight. Injections are made at intervals of 12 hours. For bacterial meningitis and neutropenic fever, the same 50mg/kg is recommended at 8-hour intervals between treatments.
For patients suffering from abnormal kidney function, the maintenance dose needs to be adjusted. Antibiotic "Maxipim" description of the drug (the dosage depending on the type of pathogen and the severity of the infection will be selected by the attending physician) recommends that the initial amount of the drug be taken the same as for people with he althy kidneys, and the maintenance dosage should be selected depending on the values of creatine clearance.
Those patients who take "Maxipim" and undergo hemodialysis are recommended to re-administer a new dose at the end of the procedureantibiotic equal to the original. This is necessary, because in 3 hours of hemodialysis, up to 68% of the total amount of the drug "Maxipim" will be removed from the body (the instruction contains this information).
Contraindications for taking Mexipim
Despite the extremely wide range of effects of this antibacterial drug, it does not have a large list of contraindications. "Maxipim" instructions for use prohibits people with individual hypersensitivity from taking cefepime and L-arginine. It is also unacceptable to prescribe it to patients with immediate hypersensitivity reactions to penicillins, other beta-lactam drugs, cephalosporin-type antibacterial drugs.
Pregnant women and nursing mothers, people suffering from diseases of the digestive tract, especially such ailments as ulcerative or antibiotic-associated colitis, regional enteritis should be attentive to their well-being during the period of treatment with Maximim.
As for the effect on reproductive function, it must be said that in clinical trials on animals, no negative effects on the body of the mother and fetus have been identified. However, well-controlled studies on the effect on the body of a woman have not been made. Therefore, it is permissible for pregnant women to take "Maxipim" only under the supervision of a doctor. In women's breast milk, the drug is excreted in very small quantities, but it's not worth the risk. During lactation, the medication should be taken withcaution.
In addition, the instruction recommends using the antibiotic "Maxipim" with great caution for those who suffer from severe forms of chronic renal failure. Studies have shown that in patients with chronic renal failure, the half-life of the substance from the body increases. At the same time, people with impaired liver function or cystic fibrosis do not experience any pharmacokinetic changes associated with the absorption and excretion of cefepime from the body.
Side effects, overdose
In general, we can say that "Maxipim" is well tolerated by patients, and the incidence of side effects is not high. Of all the reported cases, most often it was about disorders of the functioning of the gastrointestinal tract (dyspepsia, diarrhea, constipation, nausea, vomiting) and hypersensitivity reactions (rash, itching, fever).
In addition, the information available about such a drug as the antibiotic "Maxipim" - a description of the drug, instructions for its use - indicates the possibility of reactions from the cardiovascular system in the form of tachycardia (rapid heartbeat) and chest pains. Respiratory organs can declare themselves with sore throat, shortness of breath and cough. The most likely reactions from the side of the central nervous system will be insomnia, headaches, dizziness, anxiety, confusion, paresthesia are possible. Among other manifestations, we can talk about asthenia, vaginitis, sweating, pain in the back, peripheral edema. Also, as side effects, medical experts talk aboutpossible change in laboratory parameters.
As for exceeding the allowable doses of the antibiotic "Maxipim", the instructions for use report on the effectiveness of hemodialysis in such cases.
What should I pay attention to?
A lot of different extraordinary situations can develop during the period when the antibiotic "Maxipim" is prescribed. How to apply it in such cases? If against the background of "Maxipim" pseudomembranous colitis with prolonged diarrhea develops, it is generally stopped taking and vancomycin or metronidazole is prescribed.
If a patient suffers from combined severe hepatic and renal insufficiency, the medical staff should constantly monitor the concentration of the drug in the blood plasma and, depending on the indicators, adjust the dosage.
If the antibiotic has been used for a long period of time, it is important to regularly monitor the composition of peripheral blood and functional indicators of the kidneys and liver.
In cases where a patient from a remote infectious focus has meningeal dissemination (the spread of the pathogen both within the focus and throughout the body), there are suspicions of meningitis or such a diagnosis has already been established, treatment with Maximim should be abandoned.” and prescribe an alternative antibacterial agent with proven effectiveness for this diagnosis.
There is a possibility of detecting a positive reaction to the Coombs test, a false positive - to the presence of glucose in the urine.
"Maxipim"for flu and colds (i.e. for viral infections) will not be effective.
Interaction with other substances
If the patient is prescribed to receive "Maxipim", the use of other drugs in parallel should be under the supervision of a physician. This antibiotic is not pharmaceutically compatible with other antimicrobials and heparin.
Tubular secretion of cefepime will be significantly reduced when combined with diuretics, aminoglycosides and polymyxin B. The same tandem of drugs will increase the concentration of "Maxiprim" in the blood serum, increase nephrotoxicity up to the development of nephronecrosis. In addition, the half-life will increase.
Combining "Maxiprim" with NSAIDs (non-steroidal anti-inflammatory drugs) will slow down the excretion of cephalosporins from the body and may cause bleeding.
Use in combination with other bactericidal antibiotics (aminoglycosides) will result in synergy, with bacteriostatic - antagonism.
Analogues
Analogue drugs are selected based on the international non-proprietary name (INN), the name of the main active ingredient (for "Maxipim" this is cefepime). The most popular analogues of the antibacterial agent "Maxipim" reviews of experts call such drugs as "Cefepim-Alpa", "Cefepim", "Movizar", "Maxicef", "Cefepim Sterile".
This is not a complete list, but as for the name "Cefepim",then here, in addition to the above, there are also "Cefepim-Vial", "Cefepim-Agio", "Cefepim-Jodas", "Cefepim-Alchem", "Cefepim Hydrochloride".
Also, for various types of bacterial infections, he alth workers prescribe Ladef, Efipim, Kefsepim, Cefomax, Tsepim.
As for generic drugs, they may not always be as effective as the licensed drug.
The opinion of patients and he alth workers
Since the drug has a wide range of applications in a variety of microbial infections, there are both positive and negative opinions about Maximim. Most people who took the antibiotic were satisfied with the results. Improvement in the state of he alth, even in severe forms of bacterial infections, occurred 2-3 days after the start of the course of therapy. According to he alth workers, the drug has also proven itself in a variety of clinical situations. And the cost of the drug is not so very high (there are cheaper medicines, but at the same time there are also much more expensive than Maximim).
However, there are not so rosy opinions about this medicine. Mostly those patients who have side effects during the treatment process react negatively. In addition, a negative opinion was expressed by a separate group of people who took the antibiotic "Maxipim" for a cold. Although in this case the result is, so to speak, expected. Any cold has a viral nature, and "Maxipim" is a bactericidal drug, the principle of action of which is based on the destruction of cellularmembrane bacteria.
You can buy medication only with a prescription from your doctor. And rightly so: a physician with special knowledge and experience will thus select an antibacterial drug and calculate the minimum effective dose, so that all risks of side effects will be minimized, and the positive effect on the body will be maximum.
