세포베신

항생제 - 3세대 세팔로스포린Critically Important

**세포베신 (Cefovecin)** 은 개와 고양이를 위해 승인된 장기 지속형 주사용 3세대 세팔로스포린계 항생제입니다. **주요 임상 특징:** * **순응도 해결:** 보호자가 경구 투여 일정을 지키기 어렵거나, 환자가 경구 항생제를 잘 견디지 못하거나 흡수하지 못할 때 주요한 임상적 이점을 제공합니다. * **항균 스펙트럼:** 3세대 세팔로스포린으로서 광범위한 활성을 가집니다. *Staphylococcus pseudintermedius*, *Streptococcus canis* (Group G), *Pasteurella multocida* 와 같은 흔한 피부 병원균에 매우 효과적입니다. * **한계점:** 녹농균(*Pseudomonas* spp.)이나 장구균에는 **효과가 없습니다**. 또한 단백질 결합률이 매우 높기 때문에 표준 라벨 용량으로는 전신성(비뇨기계 제외) 대장균 감염을 치료하기 위한 유효 혈청 농도에 도달하지 못합니다. * **약동학적 특징:** 혈장 단백질에 대한 높은 친화력과 느린 해리 속도로 인해 반감기가 매우 길며, 1회 주사로 표적 병원균의 최소억제농도(MIC)에 따라 수일에서 수주 동안 치료적 항균 농도를 제공할 수 있습니다.

작용 기전: Cefovecin is a **time-dependent, bactericidal** beta-lactam antibiotic. * **Mechanism:** Like other cephalosporins, cefovecin mimics the D-alanyl-D-alanine terminal of the peptidoglycan chain. It binds to and irreversibly inhibits bacterial **Penicillin-Binding Proteins (PBPs)**, specifically **transpeptidases** and **carboxypeptidases**. * **Pathway:** Inhibition of PBPs → Prevents cross-linking of peptidoglycan chains → Weakens the bacterial cell wall → Osmotic instability → **Bacterial cell lysis and death**. * **Efficacy:** Because it is a time-dependent antibiotic, maintaining free (unbound) drug concentrations above the Minimum Inhibitory Concentration (MIC) of the target pathogen for a significant portion of the dosing interval is critical for its bactericidal efficacy.

동물 종별 용량

Dogs

Skin infections due to S. intermedius or S. canis (Group G) (USA Label) · 8 mg/kg SC once. A second injection (same dose/route) may be administered if response to therapy is not complete 7 days later (for S. intermedius infections) and 14 days later for S. canis (Group G) infections. Maximum treatment should not exceed 2 injections. · SC · once (may repeat in 7-14 days) · Maximum 2 injections
Skin and soft tissue infections (UK Label) · 8 mg/kg SC once. If required, treatment may be repeated at 14 day intervals up to a further three times. · SC · once (may repeat q14d) · Up to 4 injections total · Treatment of pyoderma should be extended beyond complete resolution of clinical signs.
Severe infections of the gingival and periodontal tissues (UK Label) · 8 mg/kg SC once. · SC · once · Single dose · Used as adjunctive treatment to mechanical or surgical periodontal therapy.
Urinary Tract Infections (UK Label) · 8 mg/kg SC once. · SC · once · Single dose
Skin, soft tissue, urinary tract infections, and severe periodontal disease · 8 mg/kg · SC · every 14 days · up to 3 times · Equivalent to 1 ml/10 kg of reconstituted drug.

Cats

Skin infections (wounds and abscesses) caused by susceptible strains of Pasteurella multocida (USA Label) · 8 mg/kg SC as a single, one-time subcutaneous injection. · SC · once · Single dose · Therapeutic concentrations are maintained for approximately 7 days for P. multocida infections.
Skin and soft tissue abscesses and wounds (UK Label) · 8 mg/kg SC once. If required, an additional dose may be administered 14 days after the first injection. · SC · once (may repeat in 14 days) · Up to 2 injections

투여 경로

금기

Known allergy or hypersensitivity to cefovecin, other cephalosporins, or penicillins (beta-lactams)
Small herbivores (e.g., guinea pigs, rabbits) due to risk of fatal dysbiosis
Dogs or cats less than 4 months of age (USA label) or less than 8 weeks of age (UK label)

이상반응

Lethargy and depression
Anorexia
Vomiting
Mild to moderate increases in liver enzymes (ALT, GGT)
Increases in BUN and moderately elevated serum creatinine (observed in cats)
Injection site irritation, vocalization, and transient edema
Hypersensitivity reactions and anaphylaxis (rare but potentially fatal)
Myelotoxicity creating toxic neutropenia (rare class effect)
Anemia, thrombocytopenia, and prolonged coagulation times (rare class effect)

약물 상호작용

Carprofen · May compete for plasma protein binding sites, potentially increasing the free (active) concentrations of either drug.
Furosemide · May compete for plasma protein binding sites. · moderate
Doxycycline · May compete for plasma protein binding sites.
Ketoconazole · May compete for plasma protein binding sites.
NSAIDs, Propofol, Cardiac, Anticonvulsant, and Behavioral medications · Concurrent use of highly protein-bound drugs may compete with cefovecin binding and cause adverse reactions, though actual clinical significance is not fully established.
NSAIDs · Competition for plasma protein binding, potentially altering free drug concentrations · moderate

모니터링

Clinical efficacy (resolution of clinical signs of infection)
Adverse effects (e.g., gastrointestinal upset, lethargy, injection site reactions)
Renal and hepatic parameters in patients with pre-existing organ dysfunction

과용량

Acute overdoses are generally well tolerated and relatively safe. * **Dogs:** Administered SC up to 180 mg/kg (22.5X the labeled dose) showed only injection site irritation, vocalization, and transient edema (which resolved within 8-24 hours). * **Cats:** Administered the same 22.5X dose showed similar injection site signs. However, 10 days post-injection, treated cats had lower mean white blood cell counts compared to controls, and one cat exhibited a small amount of bilirubinuria on day 10. * **Treatment:** If massive overdose occurs or severe adverse effects are noted, treatment is symptomatic and supportive. Due to the long half-life, prolonged monitoring may be required.

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