Avlosef

Indications

Avlosef is designed to treat infections caused by susceptible Gram-positive and Gram-negative bacteria, including:

• Upper Respiratory Tract Infections: Sinusitis, pharyngitis, tonsillitis, laryngotracheobronchitis, and otitis media.
• Lower Respiratory Tract Infections: Bronchitis (acute and chronic), lobar pneumonia, and bronchopneumonia.
• Urinary Tract Infections: Cystitis, urethritis, and pyelonephritis.
• Skin and Soft Tissue Infections: Abscesses, cellulitis, furunculosis, and impetigo.

Susceptible Microorganisms

Avlosef is effective against the following microorganisms:

Gram-positive bacteria:

• Staphylococci (including both penicillin-sensitive and resistant strains).
• Streptococci, Streptococcus pyogenes (beta-hemolytic), and Streptococcus pneumonia.

Gram-negative bacteria:

• Escherichia coli, Klebsiella species, Proteus mirabilis, Haemophilus influenzae, Shigella species, Salmonella species (including Salmonella typhi), and Neisseria species.

Avlosef effectively targets penicillinase-producing strains of Escherichia coli and Staphylococcus aureus, which are resistant to ampicillin.

Pharmacology

Cephradine, the active ingredient in Avlosef, is a semisynthetic, broad-spectrum bactericidal antibiotic. Its mechanism of action involves targeting bacterial cell walls, specifically inhibiting the cross-linking of peptidoglycan. This process creates pores in the bacterial cell wall, causing lysis under external osmotic pressure, ultimately eliminating the bacteria.

Dosage & Administration

Oral Administration:

Adults:

• Urinary Tract Infections: 500 mg four times daily or 1 g twice daily. Severe or chronic infections may require higher doses.
• Respiratory Tract Infections: 250–500 mg four times daily or 500 mg–1 g twice daily, depending on infection severity.
• Skin and Soft Tissue Infections: 250–500 mg four times daily or 500 mg–1 g twice daily, adjusted per infection severity.

Children:

• Total daily dose: 25–50 mg/kg in two or four divided doses.
• Otitis Media: 75–100 mg/kg daily, divided into 6–12-hour intervals.
• Maximum daily dosage: 4 g.

Elderly:

• Standard adult dosage applies, with close monitoring for patients with renal or hepatic impairment.

Injectable Administration:

Adults:

• Usual dose: 2–4 g daily, divided into four doses, up to a maximum of 8 g daily.
• For surgical prophylaxis: 1–2 g intramuscularly or intravenously preoperatively.

Children:

• Dose: 50–100 mg/kg daily, divided into four doses, up to 300 mg/kg in severe cases.

Interactions

Combining Avlosef with nephrotoxic drugs like aminoglycosides or diuretics (e.g., furosemide) increases the risk of kidney damage. Probenecid may also enhance renal toxicity.

Contraindications

Do not use Avlosef in patients with known hypersensitivity to cephalosporins.

Side Effects

Common side effects include gastrointestinal disturbances, such as nausea, vomiting, diarrhea, and occasional hypersensitivity reactions. Rare reactions include skin rashes, dizziness, liver enzyme abnormalities, and hematologic changes like thrombocytopenia or anemia.

Pregnancy & Lactation

While animal studies show no teratogenic effects, the safety of Avlosef during pregnancy remains unestablished. Cephradine is excreted in breast milk, so caution is advised for nursing mothers.

Precautions & Warnings

• Prolonged use may lead to superinfections caused by resistant organisms.
• Cross-sensitivity to penicillin may occur; use cautiously in penicillin-allergic patients.
• Cephalosporins may interfere with Coombs’ test and urine glucose testing.

Storage Conditions

• Reconstituted suspension: Use within 7 days at room temperature or 14 days if refrigerated.
• Reconstituted injection solutions: Use within 2 hours at room temperature or 12 hours if stored at 5°C.
• Store all forms of Avlosef out of children’s reach.