摘要：本品为一种半合成第二代头孢菌素。对金葡菌、链球菌、脑膜炎球菌、流感杆菌、克雷白杆菌、大肠杆菌、奇异变形杆菌、沙门菌、志贺菌等有高度抗菌作用。本品可对抗β内酰胺酶对耐青霉素的金葡菌有效。本品在脑膜炎症时有足量进入脑脊液中，对脑膜炎球菌所致的脑膜炎疗效显著。对革兰阳性菌(包括耐青霉素金葡萄)的活性与第一代头孢相仿；对革兰阴性菌的作用较第一代头孢强。

头孢呋辛钠粉针剂-别名    
药物别称：西力欣、头孢呋肟酯、头孢呋肟、呋肟头孢菌素、头孢呋新、头孢氨呋肟钠、舒贝波、头孢羟苄四唑甲酸酯、甲酸苄四唑、达力新、Zinacef
英文名称：Cefuroxime

头孢呋辛钠粉针剂-适用病症：
头孢呋辛钠粉针剂适用于敏感细菌造成的感染的治疗。
下呼吸道感染：如急性支气管炎及慢性支气管炎急性发作和肺炎。
上呼吸道感染：包括耳、鼻、咽喉感染，如中耳炎、鼻窦炎、扁桃体炎及咽炎。
生殖泌尿道感染：如肾盂肾炎，膀胱炎和尿道炎。
皮肤及软组织感染：如疖病，脓皮病和脓疱病。治疗成人和12岁以上儿童的早期莱姆病，以及其后对晚期莱姆病的预防。淋病：急性无并发症的淋球菌性尿道炎和子宫颈炎。头孢呋辛也有供胃肠道外给药的钠盐剂型(西力欣注射剂)。在临床上需要将注射给药改为口服给药时，可以使用同一种抗生素进行序贯治疗。在治疗肺炎和慢性支气管炎急性发作时，继最初使用西力欣注射剂(头孢呋辛钠)后，使用适当剂量的西力欣片剂是有效的。
微生物学本药对下列细菌有很强的抗菌作用：金黄色葡萄球菌，包括耐青霉素的菌株(但少数耐甲氧苯青霉素的菌株除外)、表皮葡萄球菌、流感嗜血杆菌、克雷白氏杆菌属、肠杆菌属、化脓性链球菌、大肠杆菌、轻型链球菌(草绿色链球菌群)、梭状芽孢杆菌属、奇异变形杆菌、雷特格氏变形杆菌、伤寒沙门氏菌、鼠伤寒沙门氏菌和其它沙门氏菌属、志贺氏菌属、奈瑟氏菌属(包括产生b-内酰胺酶的淋病奈瑟氏菌)和百日咳杆菌。对普通变形杆菌、摩根变形杆菌、脆弱拟杆菌亦有中等强度的抗菌作用。
也被用于敏感革兰阴性菌所致呼吸系统、泌尿系统、骨和关节、耳鼻喉、皮肤和软组织等的感染。

头孢呋辛钠粉针剂-用法用量：    
肌注、静注或静滴：成人0.25g～0.75g/次，3～4次/日；儿童每日30mg～60mg，3～4次/日。口服：成人250mg～500mg/次，2次/日；儿童每日125mg～250mg，2次/日。
成人一般剂量为750mg/次，每日3次，肌肉注射或静脉注射。较严重的感染剂量加倍。必要时，肌注或静注的频度可增至每6小时一次，总量可达3-6g/日。
婴儿和儿童30-100mg/kg体重/日，分3-4次给药。新生儿30-100mg/kg体重/日，分2-3次给药。淋病给予单次剂量1.5g，可分别于不同部位(即双侧臀部)各注射750mg。脑膜炎成人3g/次，每8小时静脉注射1次。尚无满意的资料用以推荐鞘内用药。
头孢呋辛钠粉针剂婴儿和儿童150-250mg/kg体重/日，分3-4次静脉注射，3天后或有临床改善后，可减至100mg/kg体重/日，静脉注射。新生儿100mg/kg体重/日，病情改善后，可减至50mg/kg体重/日，静脉注射。预防感染腹部、盆腔和矫形手术：在麻醉诱导期，通常给予静脉注射1.5g，需要时在8小时和16小时后，再分别肌注750mg的补充剂量。心、肺、食道和血管手术：通常于麻醉诱导期静注1.5g，并于24-48小时内继续肌注，用法为750mg/次，3次/日。
全关节置换术：在加入液态单体之前，在每包甲基丙烯酸甲酯粘固聚合物中加入头孢呋辛药粉1.5g。肾功能损害者肌酐清除率为10-20mL/分者，给予750mg/次，2次/日。肌酐清除率<10mL/分，给予750mg/次，1次/日。透析病人，应在每次透析结束时加用750mg。除了静脉给药外，本药可加进腹膜透析液中使用(通常每2L的透析液加250mg)。

头孢呋辛钠粉针剂-不良反应：
本品不良反应不常见，而且多数程度较轻，呈一过性。如同其他头孢菌素，罕见间质性肾炎、多形性红斑、Stevens-Johnson综合征、毒性表皮坏死松解症(出疹性坏死松解)和过敏反应，包括皮疹、荨麻疹、瘙痒、药物热、血清病及非常罕见的过敏症的报道。曾有接受头孢呋辛酯治疗的患者出现胃肠道紊乱，包括腹泻、恶心和呕吐的报道。腹泻不常见，可能与较高的服用剂量有关。与其他广谱抗菌素一样，偶尔有伪膜性结肠炎的报道。亦曾有过头痛的报道。极少见血小板减少及白细胞减少(有时较严重)的报道。在用西力欣片治疗中，曾有嗜酸粒细胞增多和一过性肝酶(ALT[即SGPT]，AST[即SGOT]和LDH)水平增高的报道。与其他头孢菌素类抗生素一样，极罕见黄疸的报道。头孢菌素类药物易被吸收到红细胞表面，并且与针对此类药物的抗体发生作用，从而造成Coomb试验阳性(这可干扰交叉配血)，且在十分罕见的情况下引起溶血性贫血。
过量使用可引至神经系统异常继而导致惊厥。治疗可经血液透析或腹膜透析减低本药的血清水平。过量服用头孢菌素类药物会造成对脑的刺激，从而导致抽搐。血液透析或腹膜透析可降低头孢呋辛血药浓度。

头孢呋辛钠粉针剂-药理毒理：
头孢呋辛钠粉针剂头孢呋辛酯是杀菌性头孢菌素类抗生素头孢呋辛的口服前体药，对大多数β-内酰胺酶耐受，可广泛作用于革兰氏阳性菌和革兰氏阴性菌。微生物学头孢呋辛酯在体内的杀菌活性来自于其母体化合物头孢呋辛。头孢呋辛是一种特性明确的、有效的抗菌药，它的抗菌谱广，且对范围广泛的常见病原菌，包括产β-内酰胺酶的细菌均有杀菌活性。头孢呋辛对细菌β-内酰胺酶具有良好的稳定性，因此对许多对氨苄西林和阿莫西林耐药的菌株都有效。头孢呋辛的杀菌活性来自于通过与关键靶蛋白结合来抑制细胞壁的合成。头孢呋辛在体外通常对以下微生物有效：需氧菌革兰氏阴性菌：流感嗜血杆菌(包括氨苄西林耐药菌株)、副流感嗜血杆菌、卡他莫拉菌、大肠杆菌、克雷伯菌属、奇异变形杆菌、无定变形杆菌、普罗维登斯菌属、雷氏变形杆菌和淋病奈瑟球菌(包括产青霉素酶和不产青霉素酶的菌株)体外实验显示，摩氏摩根杆菌、肠球菌属和枸橼酸菌属的某些菌株对头孢呋辛和其他β-内酰胺类抗生素耐药。革兰氏阳性菌：金黄色葡萄球菌(包括产青霉素酶的菌株，但不包括耐甲氧西林菌株)、表皮葡萄球菌(包括产青霉素酶的菌株，但不包括耐甲氧西林菌株)、化脓性链球菌(包括其他β-溶血性链球菌)、肺炎链球菌、B族链球菌(无乳链球菌)和丙酸杆菌属。肠球菌的某些菌属，如粪链球菌是耐药的。厌氧菌革兰氏阴性和阳性球菌(包括消化球菌属和消化链球菌属)；革兰氏阳性杆菌(包括梭状芽胞杆菌属)和革兰氏阴性杆菌(包括拟杆菌属和梭杆菌属)。大多数脆弱类杆菌菌株是耐药的。其他微生物：博氏包柔氏螺旋体。假单胞菌属、弯曲菌属、醋酸钙不动杆菌属、单核细胞增多性李斯特菌属、军团菌属、沙雷氏菌属及普通变形杆菌和难辨梭状芽胞杆菌的大多数菌株对许多头孢菌素类抗生素，包括头孢呋辛耐药。 头孢呋辛钠粉针剂-注意事项    
对头孢菌素类抗生素过敏的患者禁用。妊娠B类。宜深部肌注。静脉给药时，应充分溶解，溶液澄明，缓慢静注或静滴。肾功能不全者应减量。对青霉素过敏者慎用，对头孢菌素类过敏者禁用。片剂不主张用于5岁以下儿童。虽曾有交叉反应的报导,头孢菌素类抗生素一般均可安全用于对青霉素过敏的患者,但对有青霉素过敏史的病人应加以特别注意。另外与肾功能相关的生化实验结果会发生改变,但并不具有临床意义,但对于肾功能已有损害的患者,作为预防,应对其肾功能进行监测。与丙磺舒合用，会使平均血清浓度药-时曲线下面积增加50%。透析可降低头孢呋辛血药浓度。在用头孢菌素治疗时，曾有Coomb试验呈阳性的报道。这一现象可干扰交叉配血。

贮藏：需冷藏。

【原产地英文商品名】ZINACEF/WATER 1.5g/50ml/frozen bag 24frozen bags/case
【原产地英文药品名】CEFUROXIME SODIUM/WATER FOR INJECTION,STERILE
【中文参考商品译名】西力欣/水 1.5克/50毫升/冷藏袋 24冷藏袋/盒
【中文参考药品译名】头孢呋辛钠/注射用水,STERILE
【生产厂家中文参考译名】葛兰素史克
【生产厂家英文名】GLAXOSMITHKLINE

Zinacef
Generic Name: Cefuroxime (SEF-ue-ROX-eem)
Brand Name: Zinacef

Zinacef is used for:
Treating bacterial infections or preventing bacterial infections before, during, or after certain surgeries.

Zinacef is a cephalosporin antibiotic. It works by killing sensitive bacteria.

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Do NOT use Zinacef if:
you are allergic to any ingredient in Zinacef or to any other cephalosporin (eg, cephalexin)

Contact your doctor or health care provider right away if any of these apply to you.

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Before using Zinacef:
Some medical conditions may interact with Zinacef. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
if you are pregnant, planning to become pregnant, or are breast-feeding
if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to a penicillin (eg, amoxicillin) or other beta-lactam antibiotic (eg, imipenem)
if you have stomach or bowel problems (eg, inflammation), blood clotting problems, kidney or liver problems, or poor nutrition

Some MEDICINES MAY INTERACT with Zinacef. Tell your health care provider if you are taking any other medicines, especially any of the following:
Aminoglycosides (eg, tobramycin) or diuretics (eg, furosemide) because the risk of kidney problems may be increased
Anticoagulants (eg, warfarin) because the risk of their side effects may be increased by Zinacef

This may not be a complete list of all interactions that may occur. Ask your health care provider if Zinacef may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

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How to use Zinacef:
Use Zinacef as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Zinacef is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Zinacef at home, a health care provider will teach you how to use it. Be sure you understand how to use Zinacef. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
To clear up your infection completely, use Zinacef for the full course of treatment. Keep using it even if you feel better in a few days.
Do not use Zinacef if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
If you miss a dose of Zinacef, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Zinacef.

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Important safety information:
Zinacef only works against bacteria; it does not treat viral infections (eg, the common cold).
Be sure to use Zinacef for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
Long-term or repeated use of Zinacef may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur during treatment or within several months after treatment with Zinacef. Do not treat diarrhea without first checking with your doctor.
Diabetes patients - Zinacef may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.
Zinacef may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Zinacef.
Lab tests, including kidney function, may be performed while you use Zinacef. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
Use Zinacef with caution in the ELDERLY; they may be more sensitive to its effects.
Zinacef should be used with extreme caution in CHILDREN younger than 3 months old; safety and effectiveness in these children have not been confirmed.
Use Zinacef with extreme caution in CHILDREN younger than 10 years old who have diarrhea or an infection of the stomach or bowel.
PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zinacef while you are pregnant. Zinacef is found in breast milk. If you are or will be breast-feeding while you use Zinacef, check with your doctor. Discuss any possible risks to your baby.

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Possible side effects of Zinacef:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Pain, swelling, or redness at the injection site.

Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; decreased urination; fever, chills, or sore throat; hearing loss; seizures; severe diarrhea, nausea, or vomiting; stomach pain or cramps; unusual bruising or bleeding; vaginal irritation or discharge; vein swelling at the injection site; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.

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If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center or emergency room immediately. Symptoms may include seizures.

Proper storage of Zinacef:
Zinacef is usually handled and stored by a health care provider. If you are using Zinacef at home, store Zinacef as directed by your pharmacist or health care provider.

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General information:
If you have any questions about Zinacef, please talk with your doctor, pharmacist, or other health care provider.
Zinacef is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Zinacef. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.