頭孢噻呋鈉
Ceftiofur Sodium
Ceftiofur sodium
別名: Naxcel · Excenel · Accent · CM 31-916 · U 64279E · ceftiofen sodium
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Susceptible Infections (extra-label) — UTI
須由已驗證獸醫確認
- q12-24h
NA
必須一併考量的臨床脈絡 (3)
- Susceptible Infections (extra-label):
- Patients with diminished renal function may require intensified renal monitoring. Therapeutic drug monitoring is not typically done.
- Concentrated ceftiofur sodium powder for reconstitution should be stored at room temperature (20°C-25°C [68°F-77°F]). Protect from light. Color of the cake may vary from off-white to tan, but this does not affect potency. 4
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
頭孢噻呋鈉是一種獸醫專用的第三代頭孢菌素類抗生素。它對多種革蘭氏陽性及革蘭氏陰性細菌具有廣效的抗菌作用，廣泛應用於多種動物。
主要臨床重點：
- 主要適應症： 對牛和豬的呼吸道疾病、牛的腐蹄病，以及犬貓的敏感性泌尿道感染 (UTIs) 和軟組織感染非常有效。
- 標示外使用： 經常在標示外用於特寵（包括爬蟲類、平胸鳥類和大象）以及小動物的各種全身性感染。
- 安全性： 通常安全，但肌肉注射 (IM) 時可能會引起短暫疼痛。具有引發過敏反應的風險，已知對β-內醯胺類過敏的病患應謹慎使用。
- 代謝： 在體內迅速轉化為其活性代謝物 desfuroylceftiofur，並保持強效的抗菌活性。
作用機轉
Ceftiofur is a time-dependent, bactericidal antibiotic.
Upon administration, ceftiofur is rapidly cleaved → furoic acid and desfuroylceftiofur (the primary active metabolite).
Desfuroylceftiofur → binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall → inhibits the third and final stage of bacterial cell wall synthesis by halting peptidoglycan cross-linking → weakens the structural integrity of the cell wall → leads to cell lysis and bacterial death.
安全性與警告
禁忌症
- Patients with a history of hypersensitivity to cephalosporins
- Caution in patients with documented hypersensitivity to other beta-lactam antibiotics (penicillins, cefamycins, carbapenems)
不良反應
- Immediate and transient local pain on IM injection
- Discoloration at SC injection sites (may persist >5 days)
- Localized post-injection bacterial infections/abscesses (cattle)
- Hypersensitivity reactions (rashes, fever, eosinophilia, lymphadenopathy, anaphylaxis)
- Acute diarrhea (especially in stressed horses)
- Granulocytopenia
- Thrombocytopenia
注意事項
Regulatory Warning: Strict adherence to withdrawal times is required for food-producing animals. Not to be used in horses intended for human consumption.
- Renal Impairment: Patients in renal failure may require dosage adjustments due to decreased clearance.
- Cross-Reactivity: Use with caution in patients allergic to penicillins due to potential cross-reactivity (estimated 1-15% in humans; unknown in veterinary species).
- Laboratory Interference: May cause false-positive urine glucose (cupric sulfate methods), falsely elevated serum/urine creatinine (Jaffe reaction), false-positive direct Coombs' test, and falsely elevated 17-ketosteroid values in urine.
- GI Flora: May alter bowel flora, potentially leading to severe diarrhea, particularly in stressed horses.
藥物交互作用
Potential for additive nephrotoxicity; in vitro synergy exists, but drugs should not be mixed in the same syringe/fluid line.
Potential for additive nephrotoxicity.
Competitively blocks the tubular secretion of most cephalosporins, increasing serum levels and serum half-lives.
監測
- Clinical efficacy (resolution of infection signs)
- Weekly CBC in small animals (recommended by some clinicians)
- Intensified renal monitoring in patients with diminished renal function
藥物動力學
吸收
Rapidly absorbed following IM or SC injection. In cattle, peak levels occur 30-45 minutes after IM dosing. In dairy goats, IM administration demonstrates 100% bioavailability.
分佈
Volume of distribution in cattle is approximately 0.3 L/kg. Cephalosporins cross the placenta and are excreted in milk in small quantities. In horses, regional IV perfusion induces significantly higher intraarticular concentrations in the radiocarpal joint compared to systemic IV administration.
代謝
Rapidly cleaved into furoic acid and desfuroylceftiofur (the active metabolite).
排除
Primarily eliminated via the kidneys.
過量
Cephalosporin overdoses are generally well-tolerated and unlikely to cause significant systemic toxicity.
- Clinical Signs: Primarily limited to gastrointestinal distress (nausea, vomiting, diarrhea) or localized injection site reactions.
- Food Animal Considerations: Overdoses in food-producing animals may result in significantly extended tissue withdrawal times. Contact FARAD for specific guidance on withdrawal interval adjustments.
可用產品
劑型
- Powder for injection (50 mg/mL when reconstituted)
獸醫用
- Ceftiofur Sodium Powder for Injection 50 mg ceftiofur/mL when reconstituted in 1 g & 4 g vials (Naxcel, generic)
各地核准狀態
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儲存與穩定性
Unreconstituted powder: Store at room temperature and protect from light. Reconstituted solution: Stable up to 7 days when refrigerated (2-8°C) and for 12 hours at room temperature (15-30°C). Frozen reconstituted solutions are stable up to 8 weeks. Thaw at room temperature or under warm running water; do not rapidly freeze/thaw.
飼主須知
• 給藥方式： 本藥物透過注射給予。在肌肉或皮下注射時，您的寵物可能會感到輕微、短暫的刺痛，這是正常現象。 • 過敏反應： 雖然罕見，但可能會發生過敏反應。如果您發現寵物出現面部腫脹、蕁麻疹、皮疹或呼吸困難，請立即聯繫您的獸醫師。 • 腸胃不適： 請留意腹瀉的跡象。在馬匹中，嚴重的腹瀉可能是嚴重的併發症；如果發生這種情況，請停止用藥並聯繫您的獸醫師。 • 儲存方式： 如果您帶回的是已配製的藥液，請將其冷藏並在 7 天內使用完畢。超過此時間請丟棄任何未使用的部分，或向獸醫師諮詢是否可以冷凍保存。
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