セフロキシム
セフロキシムは、経口（アキセチル）および注射（ナトリウム）の両方の製剤で利用可能な半合成の**第2世代セファロスポリン系**抗菌薬です。 * **抗菌スペクトル**: 第1世代セファロスポリン（セファレキシンなど）と比較して、特定の**グラム陰性菌**（大腸菌、肺炎桿菌、サルモネラ、エンテロバクターなど）に対して強化された活性を提供しつつ、多くのグラム陽性菌に対しても良好な有効性を維持します。 * **臨床的有用性**: 小動物医療において、第1世代セファロスポリンに耐性のある感染症の治療、**外科的予防**のためのより広範なグラム陰性菌のカバーが必要な場合、または**高い中枢神経系（CNS）濃度**が必要な場合（髄膜の炎症時に移行可能）に特に有用です。 * **制限事項**: メチシリン耐性ブドウ球菌（MRSA/MRSP）、緑膿菌、セラチア、または腸球菌には無効です。
作用機序: Cefuroxime is a **bactericidal** time-dependent antibiotic. It binds to specific **penicillin-binding proteins (PBPs)** located inside the bacterial cell wall → inhibits the third and final stage of bacterial cell wall synthesis (peptidoglycan cross-linking) → weakens the cell wall → leads to **cell lysis and death** due to osmotic pressure. *Clinical Pearl*: Like other beta-lactams, its efficacy depends on the amount of time the drug concentration remains above the Minimum Inhibitory Concentration (MIC) at the site of infection.
動物種別の用量
- Soft tissue infections · 10 mg/kg PO q12h · PO · q12h · 10 days · Extrapolated from human dosages.
- Systemic infections · 15 mg/kg IV q8h · IV · q8h · Extrapolated from human dosages.
- Meningitis · 30 mg/kg IV q8h · IV · q8h · Extrapolated from human dosages.
- Surgery prophylaxis · 20 mg/kg IV 30 minutes prior to surgery and every 2 hours during surgery. · IV · 30 mins prior and q2h during · Perioperative
- Surgical prophylaxis · 20 mg/kg · IV · 30 min prior to surgery and then repeat q1.5-3h during surgery · Perioperative · Administer slowly over 5 min
- Susceptible infections · 10-30 mg/kg · IV · q8-12h · As directed
- Surgical prophylaxis · 20 mg/kg · IV · 30 min prior to surgery and then repeat q1.5-3h during surgery · Perioperative · Administer slowly over 5 min
- Susceptible infections · 10-30 mg/kg · IV · q8-12h · As directed
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Known hypersensitivity to cefuroxime or other cephalosporins
有害事象
- Inappetence
- Vomiting
- Diarrhea
- Injection site inflammation (IV use)
- Eosinophilia
- Hypersensitivity reactions (including anaphylaxis)
- Neurologic effects (hearing loss, seizures - rare)
- Pseudomembranous colitis (rare)
- Serious dermatologic reactions (TEN, Stevens-Johnson syndrome - rare)
- Hematologic effects (pancytopenia, thrombocytopenia - rare)
- Interstitial nephritis (rare)
薬物相互作用
- Aminoglycosides · Potential for increased risk of nephrotoxicity; monitor renal function. However, may have synergistic or additive actions against some gram-negative bacteria (Enterobacteriaceae). · minor
- Furosemide · Possible increased risk of nephrotoxicity. · moderate
- Torsemide · Possible increased risk of nephrotoxicity.
- Probenecid · Reduced renal excretion of cephalosporins, potentially increasing serum levels.
- Oxytetracycline · Bacteriostatic agents may antagonize the bactericidal activity of cefuroxime. · moderate
- Erythromycin · Bacteriostatic agents may antagonize the bactericidal activity of cefuroxime. · moderate
- Amphotericin B · Increased risk of nephrotoxicity; monitor renal function. · major
モニタリング
- Clinical efficacy (resolution of infection signs)
- Renal function in patients with pre-existing renal insufficiency
- Gastrointestinal tolerance
過量投与
Cefuroxime has a wide margin of safety. Beagles receiving daily dosages up to 1600 mg/kg/day orally tolerated the drug well, with only minor vomiting, slight weight gain suppression, and minor hematologic changes at the highest doses. In humans, massive overdoses have caused **cerebral irritation and seizures**. If severe toxicity occurs, plasma levels can be reduced via hemodialysis or peritoneal dialysis. Treatment is largely supportive.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。