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1 ineqcia dReSi

1-li empiruli monoTerapiisaTvis

1-li msoflioSi saineqcio antibiotikebs Soris

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pediatria

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ბროშურა განკუთვნილია ჯანდაცვისპერსონალისათვის

24- saaTiani moqmedeba erTi ineqciis Semdgom!

rocefini - lideri saineqcioantibiotikebs Soris

ra ZiriTad moTxovnebs uyeneben sxvadasxva

specialobis eqimebi universalur antibiotiks?

1.

2.

3.

rocefini — lideri saineqcio antibiotikebs Soris. is akmayofilebs universaluri antibiotikisadmi zemoCamoTvlil yvela moTxovnas.

rocefini — arCevis preparati mravali, maT Soris mZime, sicocxlisaTvis saSiSi infeqciebis samkurnalod.

unda gamoirCeodes maRali efeqturobiT:a) organizSi moxvedrisas unda qmnides da xangrZlivad inarCunebdes maqsimalur damTrgunvel koncentracias baqteriebis gasanadgureblad;b) gamoirCeodes maRali SeRwevadobiT qsovilebsa da organoebSi;g) hqondes sarwmuno klinikuri efeqturobis da usafrTxoebis monacemebi.

farmakokinetikuri maxasiaTeblebi unda uzrunvelyofdespreparatis maRal klinikur efeqturobas.

unda axasiaTebdes usarTxoebis maRali profili.

rocefinis upiratesobebi da damaxasiaTebeli Tvisebebi

1. moqmedebis farTo speqtrirocefins axasiaTebs Zalzed maRali baqteriociduli aqtivoba paTogenTa umravlesobis mimarT, maT Soris betalaqtamazawarmomqmneli baqteriebis mimarT.

gram dadebiTi aerobebi: Staphylococcus aureus (MSSA- meticilin mgrZnobiare), Staphylococci coagulase-negative, Streptococcus pyogenes (A jgufis), Streptococcus agalactiae (B jgufis),

Streptococci (arc A, arc B jgufis), Steptococcus viridans, Steptococcus pneumoniae(SeniSvna: MR stafilokokebi, Enterococcus faecalis, Enterococcus faecium, Listeria monocytogenes rezistentulia ceftriaqsonis mimarT)

gram uaryofiTi aerobebi: Acinetobacter Acinetobacter antitratus, Aeromonas hydrophila, Ascaligenes faecalis, Ascaligenes odorans, Borrelia burgdorferi, Capnocytophaga spp., Citrobacter diversus, Citrobacter freundii, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae, Enterobacter spp., Haemophilus ducreyi, Haemophilus Haemophilus par Hafnia alvei, Klebsiella oxytoca, Klebsiella pneumoniae, Moraxella catarrhalis, Moraxella osloensis, Moraxella spp., Morganella morganii, Neisseria meningitidis, Neisseria gonorrhoea, Pasteurella mutocida, Plesiomonas shigelloides, Proteus mirabilis, Proteus pennei, Proteus vulgaris, Pseudomonas spp., Providentia rettgeri, Providentia spp., Salmonella typhi, Salmonella Spp.(aratifoiduri), Serratia marcescens, Serratia spp., Shigella spp., Vibrio spp., Yersinia enterocolitica, Yersinia spp.(SeniSvna: mcire gamonaklisis garda P. aeruginosa Stamebi mdgradia ceftriaqsonis mimarT, magram maTTan mimarTebaSi da, aseve, sxva gram uaryofiT baqteriebTan mimarTebaSi arsebobs sinergizmi rocefinsa da aminoglikozidebs Soris.)anaerobebi: Bacteroides spp., Clostrudium spp. (Cl. – s garda), Fusobacterium nucleatum, Fusobacterium spp., anaerobica (adre Peptococcus), Peptostreptococcus spp.

(SeniSvna: betalaqtamazwarmomqmneli Bacteroides spp. mravali Stamebi (kerZod B. fragilis ) mdgradni arian. mdgradia agreTve Clostridium .)

rocefinis da sxva cefalosporinebis mik 90 sxvadasxva paTogenTa mimarT:

rocefini - baqteriologiuri gankurnebis maCveneblebi

mik90 - aris anti-biotikis minimaluri inhibitoruli kon-centracia, romelic saWiroa gamosakvlevi mikroorganizmis Stamebis 90% is zrdis dasaTrgunavad (isaz-Rvreba mg/l, mkg/ml)

klinikuri mniSvneloba:

paTogeni rocefini mik90 (mg/l)

cefotaqsimi mik90 (mg/l)

ceftazidimi mik90 (mg/l)

Escherichia coli 0,25 1,0 2,0

Klebsiella pneumoniae 0,25 1,0 1,0

Enterobacter cloacae 16 64 64

Proteus mirabilis 0,015 0,24 1,0

Staphylococcus aureus 4 8,0 8,0

0,06 0,03 0,12

Streptococcus pneumoniae 0,025 0,06 0,5

infeqciis lokalizacia

paTogenebi

Staph. aureus

Strept. pneumoniae

E. coli

K. pneumoniae

H. Pr. mirabilis

qvemo sasunTqi gzebi 85,3% 100,0% 95,2% 92,6% 100,0% 100,0%

kani da kanqveSa qsovili 93,8% 90,0% 93,3%

baqteriuli sefsisi 88,2% 100,0% 100,0% 100,0% 100,0%

Zval-saxsrovani sistema 95,5% 100,0% 92,9% 100,0% 100,0%

saSarde gzebi 99,4% 100,0% 96,6%

muclis Rru 87,0% 97,5%

tvinis garsebi 100,0% 100,0%

saerTo maCvenebeli 93,3% 100,0% 97,7% 95,2% 100,0% 96%


maRali aqtivoba infeqciebis yvelaze

xSiri gamomwvevebis mimarT

rocefini - pirveli rigis arCevis preparati empiriuli monoTerapiisaTvis.

rocefinis upiratesobebi da damaxasiaTebeli Tvisebebi

1. moqmedebis farTo speqtrirocefins axasiaTebs Zalzed maRali baqteriociduli aqtivoba paTogenTa umravlesobis mimarT, maT Soris betalaqtamazawarmomqmneli baqteriebis mimarT.

gram dadebiTi aerobebi: Staphylococcus aureus (MSSA- meticilin mgrZnobiare), Staphylococci coagulase-negative, Streptococcus pyogenes (A jgufis), Streptococcus agalactiae (B jgufis),

Streptococci (arc A, arc B jgufis), Steptococcus viridans, Steptococcus pneumoniae(SeniSvna: MR stafilokokebi, Enterococcus faecalis, Enterococcus faecium, Listeria monocytogenes rezistentulia ceftriaqsonis mimarT)

gram uaryofiTi aerobebi: Acinetobacter Acinetobacter antitratus, Aeromonas hydrophila, Ascaligenes faecalis, Ascaligenes odorans, Borrelia burgdorferi, Capnocytophaga spp., Citrobacter diversus, Citrobacter freundii, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae, Enterobacter spp., Haemophilus ducreyi, Haemophilus Haemophilus par Hafnia alvei, Klebsiella oxytoca, Klebsiella pneumoniae, Moraxella catarrhalis, Moraxella osloensis, Moraxella spp., Morganella morganii, Neisseria meningitidis, Neisseria gonorrhoea, Pasteurella mutocida, Plesiomonas shigelloides, Proteus mirabilis, Proteus pennei, Proteus vulgaris, Pseudomonas spp., Providentia rettgeri, Providentia spp., Salmonella typhi, Salmonella Spp.(aratifoiduri), Serratia marcescens, Serratia spp., Shigella spp., Vibrio spp., Yersinia enterocolitica, Yersinia spp.(SeniSvna: mcire gamonaklisis garda P. aeruginosa Stamebi mdgradia ceftriaqsonis mimarT, magram maTTan mimarTebaSi da, aseve, sxva gram uaryofiT baqteriebTan mimarTebaSi arsebobs sinergizmi rocefinsa da aminoglikozidebs Soris.)anaerobebi: Bacteroides spp., Clostrudium spp. (Cl. – s garda), Fusobacterium nucleatum, Fusobacterium spp., anaerobica (adre Peptococcus), Peptostreptococcus spp.

(SeniSvna: betalaqtamazwarmomqmneli Bacteroides spp. mravali Stamebi (kerZod B. fragilis ) mdgradni arian. mdgradia agreTve Clostridium .)

rocefinis da sxva cefalosporinebis mik 90 sxvadasxva paTogenTa mimarT:

rocefini - baqteriologiuri gankurnebis maCveneblebi

mik90 - aris anti-biotikis minimaluri inhibitoruli kon-centracia, romelic saWiroa gamosakvlevi mikroorganizmis Stamebis 90% is zrdis dasaTrgunavad (isaz-Rvreba mg/l, mkg/ml)

klinikuri mniSvneloba:

paTogeni rocefini mik90 (mg/l)

cefotaqsimi mik90 (mg/l)

ceftazidimi mik90 (mg/l)

Escherichia coli 0,25 1,0 2,0

Klebsiella pneumoniae 0,25 1,0 1,0

Enterobacter cloacae 16 64 64

Proteus mirabilis 0,015 0,24 1,0

Staphylococcus aureus 4 8,0 8,0

0,06 0,03 0,12

Streptococcus pneumoniae 0,025 0,06 0,5

infeqciis lokalizacia

paTogenebi

Staph. aureus

Strept. pneumoniae

E. coli

K. pneumoniae

H. Pr. mirabilis

qvemo sasunTqi gzebi 85,3% 100,0% 95,2% 92,6% 100,0% 100,0%

kani da kanqveSa qsovili 93,8% 90,0% 93,3%

baqteriuli sefsisi 88,2% 100,0% 100,0% 100,0% 100,0%

Zval-saxsrovani sistema 95,5% 100,0% 92,9% 100,0% 100,0%

saSarde gzebi 99,4% 100,0% 96,6%

muclis Rru 87,0% 97,5%

tvinis garsebi 100,0% 100,0%

saerTo maCvenebeli 93,3% 100,0% 97,7% 95,2% 100,0% 96%


maRali aqtivoba infeqciebis yvelaze

xSiri gamomwvevebis mimarT

rocefini - pirveli rigis arCevis preparati empiriuli monoTerapiisaTvis.

2. farmakokinetikuri maxasiaTeblebi uzrunvelyofs preparatis maRal klinikur efeqturobas

yvelaze xangrZlivi naxevradgamoyofis periodi yvela betalaqtamur antibiotiks Soris - 8 saaTi (axalSobilebsa da moxucebSi16 saaTi) - plazmis cilebTan Seqcevadi SekavSirebis xarjze.

svadasxva betalaqtamuri antibiotikebis naxevradgamoyofis periodebi

klinikuri mniSvneloba: rocefini gamoiyeneba dReSi erTxel mZime infeqciebis mkurnalobis drosac ki.

0 2 4 6 8

cefamandoli

amoqsaciliniklavulanatiT

cefotaqsimi

cefuroqsimi

cefazolini

ceftazidimi

cefoperazoni

rocefini


xangrZlivi moqmedeba

dozirebis mosaxerxebeli reJimi _ 1 ineqcia dReSi!

maRali baqteriociduli koncentracia plazmaSi 24 saaTis ganmavlobaSi (romelic bevrad aRemateba mik

90-s ZiriTadi

paTogenebisadmi)

0 2 4 6 8 1 0 12 14 16 18 20 22 24

300

200

100

10

1

0,01

Serratia marcesce nsStaphylococcus aureus (MSSA)

Str. pneumoniae

Pruteus vulgaris Enterobacter a nes

St. aureus

St. pneumoniae

E. coliK. pneumoniae

300

meryeoba

preparatis plazmaSi koncentraciis

1g yovel 6 saaTSi erTxel

intravenuriSeyvanis Semdgom

200

100

10

1

0,1

0,010 2 4 6 8 10 12 14 16 18

Haemophilus infuenzae

K. pneumo Proteus mirabilisStreptococcus pneumoniae

S. pyogenes (group A )

niaeNeisseria gonorrhoeaeN. meningitidis

E. coli

0,5

0,1

H. in�uenzae

20 22 24

"Cavardnebi" xanmokle moqmedebis cefalosporinebis baqteriocidul moqmedebaSi cefotaqsimis magaliTze

rocefinis da zogierTi cefalosporinis koncentracia plazmaSi

rocefiniskoncentracia plazmaSi

koncentracia plazmaSi24 saaTis Semdgom

dro (saaTi)

konc

ent

rac

ia (m

kg/m

l)

2 mkg/ml

0,015 mkg/ml

0,06 mkg/ml

0,12 mkg/ml

_<0,25

0,12 mkg/ml

0,06 mkg/ml

0,03 mkg/ml

mik90

mik90

_<0,5mik90

_<4,0mik90

15,1 mgk/ml

9,3 mgk/ml

5,3 mgk/ml

konc

ent

rac

ia (m

kg/m

l)

dro (saaTi)

ceftazidimi1 g i/v (2,4 mgk/ml)

cefuroqsimi750 mg i/m (0,7 mgk/ml)

2g i/v

1g i/v

500 mg i/v

cefoperazoni1 g i/v (0,5 mgk/ml)

cefotaqsimi1 g i/v (0,4 mgk/ml)


preparatis maRali da stabiluri done plazmaSi

saSualo doza mozrdilTaTvisSeadgens 1-2 grams dReSi

eroge

myisieri da maRali SeRwevadoba organoebsa da qsovilebSi

50

40

30

20

10

0

ko

nc

en

tr

aci

a(m

kg

/ml

)

doza

dro (s)

qsovili/kani

barZayis Tavi

Tavzurg-tvinis siTxe

plevris siTxe

kani filtvisqsovili

gulis sarqvlebi

sakvercxeebiSardi miometriumi

35,0mkg/ml

mkg/ml

32,7mkg/ml

mkg/mlmkg/ml

mkg/ml

6,4

57,4

995

44,6

30,5

2 g

175mg/kg

1-6500mg

6,51 g

42 g

1-21 g

0-22 g

2-32 g

2-31 g

2

37,8

7,0-8,7 mkg/ml

mkg/ml

mkg/ml

mkg/ml

rocefinis koncentraciis done qsovilebsa da qsovilovan siTxeebSi

mik90 zeda zRvari rocefinisadmi mgrZnobiare paTogenebisa Seadgens 4 mkg/ml

klinikuri mniSvneloba: warmoadgens arCevis preparats mravali infeqciuri daavadebis samkurnalod, maT Soris, baqteriuli meningitis (preparati kargad gadis hematoencefalur bariers), pnevmoniis, baqteriuli endokarditis, uroginekologiuri infeqciebis, osteomielitis da a.S.

0 20 40 60 80 100

92%

rocefinis da zogierTi sxva antibiotikis penetraciis indeqsi

ceftazidimi (2 g)

cefotaqsimi (2 g)

piperacilini (2 g)

rocefini (1 g)


maRali bioSeRwevadoba

Cvenebebis farTo speqtri 24- saaTiani moqmedeba erTi ineqciis Semdgom!

30 welia warmatebiT gamoiyeneba mTels msoflioSi

maRali klinikuri efeqturoba dadasturebuli mravali klinikuri kvleviT

klinikur kvlevebSi rocefiniT mkurnalobis Sedegebi

klinikuri mniSvneloba: mkurnalobis kargi Sedegi miiRweva SemTxvevaTa umravlesobaSi

Cveneba avadmyofebis

raodenobaklinikuri

efeqti

septicemia 757 91%

endokarditi 44 100%

meningiti 1 343 88,7%

pnevmonia 914 90,4%

yel-yur-cxviris infeqciebi 427 91,8%

Zval-saxrovani sistemis infeqciebi 649 86,9%

kanisa da rbili qsovilebis infeqciebi 546 93,6%

peritoniti 124 96,8%

sanaRvle gzebis infeqciebi 96 91,7%

saSarde sistemis infeqciebi 1 824 83,8%

infeqciebi meanoba-ginekologiaSi 271 90,4%

perioperaciuli profilaqtika 5 873 91,8%

gonorea 1 962 98%

sifilisi 130 99,2%


30 welia warmatebiT gamoiyeneba mTels msoflioSi

maRali klinikuri efeqturoba dadasturebuli mravali klinikuri kvleviT

klinikur kvlevebSi rocefiniT mkurnalobis Sedegebi

klinikuri mniSvneloba: mkurnalobis kargi Sedegi miiRweva SemTxvevaTa umravlesobaSi

Cveneba avadmyofebis

raodenobaklinikuri

efeqti

septicemia 757 91%

endokarditi 44 100%

meningiti 1 343 88,7%

pnevmonia 914 90,4%

yel-yur-cxviris infeqciebi 427 91,8%

Zval-saxrovani sistemis infeqciebi 649 86,9%

kanisa da rbili qsovilebis infeqciebi 546 93,6%

peritoniti 124 96,8%

sanaRvle gzebis infeqciebi 96 91,7%

saSarde sistemis infeqciebi 1 824 83,8%

infeqciebi meanoba-ginekologiaSi 271 90,4%

perioperaciuli profilaqtika 5 873 91,8%

gonorea 1 962 98%

sifilisi 130 99,2%


mkurnalobis kargi amtanoba

cxovrebis xarisxis gaumjobeseba,fulisa da drois ekonomia!

3. mkurnalobis usafrTxoeba da kargi amtanoba!

rocefini erT-erTi yvelaze usafrTxo preparatia, romelsac ar axasiaTebs nefro - da hepatotoqsiuroba, imunitetis daTrgunva.

gverdiTi movlenebis sixSire rocefiniT mkurnalobisas 20628 pacientSi (486 publikaciis monacemi)

rocefiniT mkurnalobis usafrTxoebas aZlierebs organizmidan misi gamoyofis ormagi urTierTkompensatoruli gza - Tirkmlebidan da RviZlidan.

kompensatoruli gamoyofa

Tirkmlebis ukmarisoba

RviZlis ukmarisoba

kompensatoruli gamoyofa

rocefini

klinikuri mniSvneloba: rocefiniT mkurnaloba dasaSvebia sxvadasxva asakobrivi

jgufis pacientebSi, avadmyofebSi daqveiTebuli imunitetiT.

pacientebSi RviZlisa da Tirkmlebis disfunqciiT ar

saWiroebs dozis koreqcias.

gverdiTi movlenebi sixSire, %mkurnalobis Sewyvetis

sixSire, %

eozinofilia, Trombocitopenia, leikopenia 1.9 0.11

kanis reaqciebi (gamonayari, alergiuli dermatiti, qavili, WinWris cieba)

0.8 0.15

Txeli ganavali, diarea, gulisreva, Rebineba 2.4 0.09


rocefini

pirveli da erTaderTi betalaqtamuriantibiotiki yvelaze xangrZlivi naxevradgamoyofis periodiT - 8saaTi.

1 ineqcia dReSi sakmarisia baqteriociduli moqmedebis misaRwevad da SesanarCuneblad 24 saaTis ganmavlobaSi

swrafi difuzia SratSi da intersticiur siTxeSimaRali efeqtianoba Cvenebebis farTo wreSi mZime infeqciebis CaTvliT (septicemia, meningiti, pnevmonia, gastrointestinuri da saSarde sistemebis infeqciebi.)

maRali koncentraciis SenarCuneba qsovilebsa da qsovilovan siTxeebSi

kargi klinikuri Sedegebi in vitro dabali mgrZnobelobis paTogenebis mier gamowveuli infeqciebis mkurnalobaSi. gamoxatuli Sedegianoba qirurgiuli Carevis dros postoperaciuli infeqciebis profilaqtikaSi.

kargi SeRwevadoba cerebrospinalur siTxeSi arCevis preparati Cirqovani meningitebis TerapiaSi

kargi SeRwevadoba Zvlebsa da rbil qsovilebSinaCvenebia Zvlebisa da rbili qsovilebis infeqciebis samkurnalod: osteomieliti, abscesebi da a.S.

mZlavri antibaqteriuli moqmedeba gramdadebiT da gramuaryofiT paTogenebze

standartuli doza 1-2g erT ineqciad dReSi. gaurTulebeli gonoreis samkurnalod sakmarisia 250mg erTjeradad

ar ganicdis metabolizms adamianis organizmSipreparatis aqtivoba ar mcirdeba organizmSi misi arsebobis drois ganmavlobaSi

brwyinvale mdgradoba betalaqtamazebis mimarT mikrobuli rezistentobis ganviTarebis dabali albaToba

urTierTmakompensirebeli ormxrivi gamoyofis gza TirkmelebiTa da RviZliT

ar saWiroebs dozis koreqcias Tirkmlebis ukmarisobis dros (gamonaklisi ix. dozireba)

dabali toqsiuroba gverdiTi movlenebis simcire

ar axasiaTebs disulfirammsgavsi reaqciadasaSvebia misi gamoyeneba im pacientebSi, visac miRebuli aqvs alkoholi

SemTxvevaTa umravlesobaSi SesaZlebelia ambulatoriuli mkurnaloba martivi da mosaxerxebeli Seyvanis reJimis xarjze - 1 ineqcia dReSi

mkurnalobis Rirebulebis Semcireba

Taviseburebani klinikuri mniSvneloba


mokle informacia preparat rocefinis® (ceftriaqsoni) gamoyenebis Sesaxeb Cvenebebi:

dozireba

sefsisi

infeqciis profilaqtika da mkurnaloba qirurgiaSi

muclis Rrus infeqciebi

meningiti

Tirkmlebisa da saSarde sistemis infeqciebi

sasqeso organoebis infeqciebi

sasunTqi sistemis infeqciebi

Zvlebis, saxsrebis, rbili qsovilebis infeqciebi

kanis infeqciebi, maT Soris Wrilobis infeqciebi

yel-yur-cxviris infeqciebi

infeqciebi pacientebSi daqveiTebuli imunitetiT

mozrdilebi da bavSvebi 12 wels zemoT

mZime infeqciebi gamowveuli saSualod mgrZnobiare mikroorganizmebiT

1 -2 g erTxel dReSi

4 gramamde erTxel dReSi

axalSobilebi da 1 wlamde asakis bavSvebi (3 kviridan 12 Tvemde)

20-80mg/kg wonaze erTxel dReSi

axalSobilebi (2 kviramde) 20-50mg/kg wonaze erTxel dReSi

pacientebi Tirkmlebis ukmarisobiT kreatininis klirensi >10ml/wT kreatininis klirensi <10ml/wT

standartuli dozamaqsimaluri doza 2g erTxel dReSi (mozrdilebSi)

profilaqtika qirurgiaSierTjeradad 1-2g operaciul Carevamde 30-90 wuTiT adre.

dozireba gansakuTrebul SemTxvevebSimeningiti axalSobilebi meZuZuri da patara asakis bavSvebi mozrdilebigonorea (gaurTulebeli)

50mg/kg wonaze erTxel dReSi 100mg/kg wonaze erTxel dReSi50mg/kg wonaze erTxel dReSi250mg i/m erTjeradad

gamoyenebis instruqcia

rocefini SehyavT intramuskularulad an intravenurad.intramuskularuli ineqcia: rocefinis 250mg an 500mg dozas

xnsian lidokainis hidroqloridis 1%-iani xnaris 2 ml-Si, 1g-ian dozas -3,5ml-Si da SehyavT intramuskularulad.

intravenuri ineqcia: rocefinis 250mg an 500mg dozas xnsian steriluri saineqcio xsnaris 5 ml-Si, 1g-ian dozas - 10 ml-Si. intravenuri Seyvana xorcieldeba nela 2-4 wuTis ganmavlobaSi.

intravenuri gadasxma: infuzia unda ganxorcieldes 30 wuTis ganmavlobaSi. intravenuri infuziisaTvis rocefinis 2g xsnian sainfuzio xsnaris 40 ml-Si; sainfuzio xsnarebi: natriumis qloridi 0.9%; natriumis qloridi 0.45% + glu-koza 2.5%; glukoza 10%; deqstranis xnsari 6%, glukozis xsnari 5%; saineqcio wyali. (kalciumis ionebis Semcvel xsnarebSi rocefinis gaxsna dauSvebelia)

mkurnalobis xangrZlivoba mkurnalobis xangrZlivoba damokidebulia daavadebis

mimdinareobaze. iseve rogorc sxva antibiotikebiT mkur-nalobisas, avamdyofebma unda gaagrZelon rocefinis miReba temperaturis normalizebidan da analizebiT gamomwvevis eradikaciis dadasturebis Semdgom minimum 42-72 saaTis ganmavlobaSi.

kombinirebuli Terapia gamokvlevebma aCvenes, rom mravali gramuaryofiTi baqte-

riis mimarT arsebobs sinergizmi preparat rocefinsa da aminoglikozidebs Soris. fizikuri SeuTavseblobis gamo

ceftriaqsoni da aminoglikozidebi unda Seyvanil iqnes cal-calke rekomendirebul dozebSi

ukuCvenebebi momatebuli mgrZnobeloba cefalosporinebisadmi. peni-

cilinisadmi momatebuli mgrZnobelobis SemTxvevaSi gaT-valiswinebuli unda iqnas jvaredini alergiuli reaqciis ganviTarebis SesaZlebloba.

sifrTxile anafilaqsiuri Soki. orsuloba (gansakuTrebiT pirveli

trimestri), laqtacia. axalSobilTa hiperbilirubinemia.

gverdiTi movlenebi movlenebi kuW-nawlavis traqtis mxriv (SemTxvevaTa

daaxlovebiT 2%), cvlilebebi sisxlSi (daaxloebiT 2%), reaqciebi kanis mxriv (daaxloebiT 1%).

gansakuTrebuli SeniSvnebi rocefini ar unda daematos xsnarebs, romlebic Seicaven

kalciums, rogorebicaa hartmanis xsnari da ringeris xsnari.

stabiloba. rocefini Senaxul unda iqnas 30 0C -mde tem-peraturaze. rocefinis mza xsnarebi inarCuneben fizikur da qimiur stabilobas 6 saaTis ganmavlobaSi oTaxis tem-peraturaze (an 24 saaTis ganamavlobSi macivarSi 2-8 0C temperaturaze).

preparati ar unda iqnas gamoyenebuli kolofze miTiTe-buli Senaxvis vadis gasvlis Semdeg.

rocefini (ceftriaqsoni) aTq kodi: J01DD04

gamoSvebis forma:SefuTva i/m ineqciisaTvis: flakonebi mSrali aqtiuri nivTierebiT, romelic Seesabameba 0.25g, 0.5g da 1g ceftriaqsons da lidokainis 1%-iani xnsaris 2 an 3.5 ml Semcveli ampulebi. SefuTva i/v ineqciisaTvis: flakonebi mSrali aqtiuri nivTierebiT, romelic Seesabameba 0.5g da 1g ceftriaqsons da saineqcio xsnaris 5 an 10 ml Semcveli ampulebi.flakonebi i/m da i/v ineqciisaTvis _ mSrali aqtiuri nivTierebiT, romelic Seesabameba ceftriaqsonis 0.25 g da 1grams, gamxsnelis gareSe.

1. Swiss Drug Compendium for 19892. Cleeland R., Squires E.Am J Med 77:3-11,Oct 19, 19843. Hadina S.M. et al: J. Antimicrob Chemother 8 (suppl B) 263-

272,19814. Patel IH, et al. Pharmacokinetics of ceftriaxone in humans. Antimi-

crob Agents Chemother. 1981,20:634-641.5. Physicians’ Desk Reference®. 48th ed. Montvale, NJ: Medical Eco-

nomics Data Production Company; 1994;Cefobid® (cefoperazone sodium):1973-1978.

6. Harding SM, et al. The comparative pharmacokinetics of ceftazi-dime and cefotaxime in healthy volunteers. J Antimicrob Chemoth-er. 1981 ;8(suppl B):263-272.

7. Physicians’ Desk Reference® 48th ed. Montvale, NJ: Medical Economics Data Production Company; 1994;Cefizox R (sterile ceftizoxime sodium):963-966.

8. Foord RD. Cefuroxime: human pharmacokinetics. Antimicrob Agents Chemother. 1976:9:741-747.

9. Jones RN, Barry AL, Thornsberry C. Ceftriaxone: a summary of in vitro antibacterial qualities including recommendations for suscep-tibility tests with 30-ug disks. Diagn Microbiol Infect Dis. 1983:1:295-311.

10. Neu HC. The new beta-lactamase-stable cephalosporins. Ann Intern Med. 1982:97:408-419.

11. Jacobs MR. Treatment and diagnosis of infections caused by drug-resistant Streptococcus pneumoniae. Clin Infect Dis. 1992; 15:119-127.

12. Craig WA. The rationale for continuous-infusion dosing of beta-lac-tams. Infections in Medicine. 1992;9(suppl B):6-9

13. Abd-Elalim Eltahawy, A.T., Fouad Khalaf, R.M. Comparative in vitro activity of amoxicillin|clavulanate (Augmentin), ceftazidime and ceftriaxone against hospital strains of gram-negative and positive bacteria. Chemioterapia 7, 75-78 (1988)

14. Emmerson A.M. et al. Ceftriaxone: a three center comparative in vitro susceptibility study. Eur J Clin Nicrobiol 4,142-144 1(1985)

15. Gieringer J.H., WenzA.R, Lust, H.-M., Daschner F.D.; Chemotera-pe 32, 418-424 (1986)

16. Le Noc P., Bryskier A., Le Noc D. Activite antibacterienne in vitro d une novelle cephalosporine: le cefpirome (HR 810 ) PatholBiol 34, 567-571(1986)

17. Liebowitz L.D. et al.; A comparison of the in vitro activity of cef-triaxone with other (3-lactam antibiotics and tobramycin against 2180 clinical isolates at a community hospital. Current Therapeytic Research 36, 86-91 (1984)

18. Soussy C. J. et al.; Activite in vitro de la ctftriaxone sur les bacteries hospitalieres. Pathok Biol 33, 469-472 (1985)

19. Richards DM, et al: Ceftriaxone: a review of its antibacterial activity, pharmacological properties and therapeutic use. Drugs. 1984; 27:469-527

20. Steele RW, et al. Pharmacocinetics of ceftriaxone in pediatric patients with meningitis. Antimicrob Agents Chemother. 1983:; 23:191-194

21. Seddon M et al. Pharmacocinetics of Ro 1309904, a broad-spe-ktrum cephalosporin. Antimicrob Agents Chemother. 1980: 18;240-242

22. Bennoni G. Et al. Penetration of ceftriaxone in human pleural fluid. Antimicrob Agents Chemother 1986: 29; 906-908

23. Just H-M et al. Concentrations of ceftriaxone in serum and lung tissue. Chemotherapy. 1984; 30: 81-83

24. Daschner FD. Et al. Concentrations of ceftriaxone in serum and gynecological tissues. Chemotherapy. 1983; 29; 153-155

25. Beam TR et al. Comparison of ceftriaxone and cefazolin prophy-laxis against infection in open heart surgery. Am J Surg 1984; 148 (4a): 8-14

26. Data on file, F. Hoffmann-La Roche Ltd, Basel, Switzerland27. Rouhan, D., Le Noc, P., Le Noc, D.: Activite in vitro de la ceftriax-

one sur des bacilles negatifs presentant differents phenotypes des resistance aux cephalosporines. Pathol Biol 34,404-409(1986)

24- saaTiani moqmedeba erTi ineqciis Semdgom!mosaxerxebelia gamosayeneblad

detaluri informacia ixileT preparatis gamoyenebis srul instruqciaSi

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