세포시틴

항생제 - 2세대 세팔로스포린 (세파마이신)

세포시틴은 수의학에서 중증 또는 혼합 세균 감염을 치료하는 데 사용되는 **2세대 주사용 세팔로스포린**(엄밀히 말해 세파마이신으로 분류됨)입니다. 주요 약리학적 특징은 다음과 같습니다: * **혐기성 세균에 대한 효능**: 다른 초기 세대 세팔로스포린과 달리 세포시틴은 박테로이데스 프라질리스(*Bacteroides fragilis*)를 포함한 **혐기성 세균**에 매우 효과적입니다. * **그람 음성균 스펙트럼**: 1세대 약물에 내성을 보일 수 있는 대장균(*E. coli*), 클렙시엘라(*Klebsiella*), 프로테우스(*Proteus*)의 많은 균주에 대해 우수한 활성을 나타냅니다. * **그람 양성균 스펙트럼**: 그람 양성 구균에 대한 활성을 유지하지만, 동일 용량 기준 1세대 세팔로스포린에 비해 효능은 약간 떨어집니다. > **임상 요점**: 강력한 혐기성 세균 스펙트럼 덕분에 세포시틴은 흡인성 폐렴, 장 천공, 중증 연부조직 감염 또는 패혈증과 같은 혼합 감염에 자주 선택됩니다.

작용 기전: Cefoxitin is a **bactericidal** antibiotic that works by inhibiting bacterial cell wall synthesis. * It covalently binds to specific **Penicillin-Binding Proteins (PBPs)** located inside the bacterial cell wall. * Binding to PBPs → **inhibits the transpeptidation enzyme** responsible for cross-linking peptidoglycan strands. * Lack of cross-linking → weakens the bacterial cell wall → leads to osmotic instability, cell lysis, and bacterial death. * As a cephamycin, cefoxitin is highly resistant to degradation by many **beta-lactamases**, particularly those produced by *Bacteroides* species.

동물 종별 용량

Cats

Systemic infections · 25-30 mg/kg IV or IM q8h · IV/IM · q8h · Use as long as necessary to control initial infection, then switch to oral drugs
Sepsis · 30 mg/kg IV q5h · IV · q5h
Susceptible infections · 30 mg/kg IV q8h · IV · q8h
Non-tuberculosis mycobacteria (NTM) - second line treatment · 30-40 mg/kg IV, IM or SC q6-8h · IV/IM/SC · q6-8h · Causes pain on injection with IM or SC

Horses

Susceptible infections (Foals) · 20 mg/kg IV q4-6h · IV · q4-6h

Dogs

Mixed infections (e.g., aspiration pneumonia, bowel perforation) · 30 mg/kg SC q8h; 30 mg/kg IV q4-6h · SC/IV · q8h or q4-6h
Sepsis · 30 mg/kg IV q5h · IV · q5h
Soft tissue infections · 30 mg/kg SC q8h or 30 mg/kg IV q5h · SC/IV · q8h or q5h
Bacteremia · 15-30 mg/kg IV, IM SC q6-8h · IV/IM/SC · q6-8h
Orthopedic infections · 22 mg/kg IV, IM q6-8h · IV/IM · q6-8h · Use as long as necessary to control initial infection, then switch to oral drugs

투여 경로

IVIMSC

금기

Patients with a history of hypersensitivity to cephalosporins
Use with extreme caution in patients documented to be hypersensitive to other beta-lactams (penicillins, carbapenems)

이상반응

Hypersensitivity reactions (rashes, fever, eosinophilia, lymphadenopathy, anaphylaxis)
Pain at the injection site (IM)
Sterile abscesses or local tissue reactions
Thrombophlebitis (IV administration)
Antibiotic-associated diarrhea or altered gut flora
Superinfections
Nephrotoxicity (rare at clinical doses)
Neurotoxicity, neutropenia, thrombocytopenia, hepatitis (associated with high doses or prolonged use)

약물 상호작용

Aminoglycosides / Nephrotoxic Drugs · Potential for additive nephrotoxicity. While in vitro synergy exists against certain bacteria, they should not be mixed in the same syringe or fluid bag.
Probenecid · Competitively blocks the tubular secretion of cefoxitin, thereby increasing serum levels and prolonging elimination half-lives.

모니터링

Clinical efficacy (resolution of infection signs)
Renal function (BUN, creatinine, urinalysis) in patients with diminished renal capacity

과용량

Acute oral cephalosporin overdoses are unlikely to cause significant problems other than **gastrointestinal distress**. Massive parenteral overdoses or prolonged accumulation (especially in renal failure) may lead to: * Neurotoxicity (seizures) * Neutropenia or thrombocytopenia * Hepatitis * Nephrotoxicity (tubular necrosis) Treatment is supportive and symptomatic.

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