Anti Biotic Case No 13.First Generation Cephalosporins Antibiotic.

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Anti Biotic Case No 13.First Generation Cephalosporins Antibiotic.

There are only 4 Types Component Preparation of 1st Generation Cephalosporins Antibiotic they are :-

1.Cefadroxil Monohydrate.

2.Cefazolin Sodium. (Only Injection).

3.Cephalexin.

4.Cephradine.

Description :-

1.Cefadroxil Monohydrate:-

Indications of Cefadroxil Monohydrate:-

Cefadroxil is indicated in the treatment of the following infections.

Streptococcal pharyngitis and tonsillitis
Bronchopneumonia, bacterial pneumonia
Uncomplicated urinary tract infections: pyelonephritis, cystitis
Skin and soft tissue infections: abscesses, furunculosis, impetigo, erysipelas, pyoderma, lymphadenitis.

Pharmacology of Cefadroxil Monohydrate:-

Cefadroxil inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Dosage & Administration of Cefadroxil Monohydrate:-

The dosage of Cefadroxil depends on the susceptibility of the pathogens, the severity of the disease and on the clinical status of the patient (renal and hepatic function).

Streptococcal pharyngitis and tonsillitis–

Adult and adolescents >40 kg with normal renal function: 1000 mg once a day over at least 10 days. Dosage may be decreased.
Children <40 kg with normal renal function: 30 mg/kg/day once a day over at least 10 days.

Bronchopneumonia, bacterial pneumonia, Urinary tract infections, Skin & soft tissue infections–

Adult and adolescents >40 kg with normal renal function: 1000 mg twice a day.
Children <40 kg with normal renal function: 30-35 mg/kg/day divided into two daily doses.

Children may benefit of increased posology up to 100 mg/kg/day. Depending on the severity of the infection, adults may require increased posology. The dosage maximum is 4 g per day. Chronic urinary tract infection may require a prolonged and intensive treatment with continued testing of susceptibility and clinical monitoring. Cefadroxil 500 mg is not recommended for infants and children under 6 years. For younger children and children with a body weight <40 kg, liquid dosage oral form is recommended.

Renal impairment patients: In patients with renal impairment, the dose should be adjusted according to creatinine clearance rates to prevent accumulation of cefadroxil. In patients with creatinine clearance of 50 ml/min or less, the following reduced dosage schedule is recommended as a guideline.

Creatinine clearance 50-25 ml/min/1.73 m2: 500 mg-1000 mg every 12 hours
Creatinine clearance 25-10 ml/min/1.73 m2: 500 mg-1000 mg every 24 hours
Creatinine clearance 10-0 ml/min/1.73 m2: 500 mg-1000 mg every 36 hours
Children (<40 kg) with renal impairment: Cefadroxil is not indicated in children suffering from renal insufficiency and children requiring haemodialysis.
Dosage for haemodialysis patients: Haemodialysis eliminates 63% of 1000 mg of cephalosporin after 6 to 8 hours of haemodialysis. Elimination half-time of cephalosporin is about 3 hours during dialysis. Patients with haemodialysis receive one additional dose ofcefadroxil 500 mg-1000 mg at the end of the haemodialysis.

Hepatic impairment: No adjustment of posology is necessary.

Elderly: As cefadroxil is excreted by renal route, the dosage should be adjusted if necessary as described under impaired renal function.

Mode of administration: Bioavailability is not affected by food and cefadroxil may be taken with meals or on an empty stomach. In case of gastro-intestinal disturbances, it may be administered with food.

Duration of therapy: Treatment should be applied for 2 to 3 further days after regression of the acute clinical symptoms or evidence of bacterial eradication has been obtained. In infections caused by Streptococcus pyogenes up to 10 days treatment may be considered.

Interaction of Cefadroxil Monohydrate:-

Prothrombin time will be prolonged; bleeding may occur when taken with anticoagulants. Decreased elimination with Probenecid is also reported.

Contraindications of Cefadroxil Monohydrate:-

Cefadroxil is contraindicated in patients with a history of hypersensitivity to any of the Cephalosporins. It is also contraindicated in patients with a history of severe reactions to penicillins or to any other beta lactam drugs.Cefadroxil should not be combined with bacteriostatic antibiotics (e.g. tetracycline, erythromycin, sulfonamides, chloramphenicol) since an antagonistic effect is possible.Treatment with cefadroxil in combination with aminoglycoside antibiotics, polymyxin B, colistin or high-dose loop diuretics should be avoided since such combinations can potentiate nephrotoxic effects.

Cefadroxil does not penetrate in the CSF and is not indicated for the treatment of meningitis. Penicillin is the first drug of choice for the treatment of the Streptococcus pyogenes and for the prevention of rheumatic fever. Data for cefadroxil are not Sufficiently substantial for prophylaxis therapy. Special caution should be exercised in patients with history of severe allergies or asthma. In patients with a history of non severehypersensitity to penicillins, or other non-cephalosporin beta-lactam drugs, cefadroxil should be used with special caution. Caution is necessary in patients with renal impairment; the dosage must be adjusted according to the grade of renal impairment. Cefadroxil should be used with caution in patients with a history of gastro-intestinal disturbances, particularly colitis. The occurrence of diarrhoea may impair the resorption of other medicaments and therefore lead to an impairment of their efficacy. Treatment must be discontinued at once if allergic reactions occur (urticaria, exanthema, pruritus, fall of blood pressure and increased heart rate, respiratory disturbances, collapse, etc.) and suitable countermeasures should be taken (sympathomimetics, corticosteroids and/or antihistaminics). Particularly on prolonged use frequent checks on the blood count and regular hepatic and renal function tests are advisable.Superinfections with fungi (e.g. candida) can occur on prolonged treatment with cefadroxil. In case of severe and persistent diarrhoea, an antibiotic-associated pseudomembranous colitis should be considered. In that case Cefadroxil must be discontinued immediately and a suitable therapy should be started. The result of the Coombs’ test can be transiently positive during or after treatment with cefadroxil. This also applies to Coombs’ tests carried out in newborns whose mothers received treatment with cephalosporins before delivery. Urinary sugar should be determined enzymatically (e.g. with test strips) during treatment with cefadroxil since reduction tests can furnish falsely elevated values.

Side Effects of Cefadroxil Monohydrate:-

Infections and infestations: Uncommon side effects are Vaginal mycoses, thrush. Blood and lymphatic system disorders: Rare side effects are eosinophilia, thrombocytopenia, leucopenia, neutropenia, agranulocytosis and very rarely occurs haemolytic anemia.

Immune system disorders: Rarely occur serum sickness-like reactions, Very rarely occur immediate allergic reaction (anaphylactic shock).

Nervous system disorders: Very rare side effects are Headache, sleeplessness, dizziness, nervousness.

Gastrointestinal disorders: Common side effects are nausea, vomiting, diarrhoea, dyspepsia, abdominal pain, glossitis and very rarely occurs Pseudomenbranous colitis.

Hepatobiliary disorders: Rarely occurs cholestase and idiosyncratic hepatic failure.

Skin and subcutaneous tissue disorders: Pruritus, rash, allergic exanthema, urticaria are common side effects. Very rarely occurs stevens Johnson syndrom and erythema multiforma.

Musculoskeletal and connective tissue disorders: Rarely occur arthralgia. Renal and urinary disorders: Rarely occurInterstitial nephritis.

General disorders: Fever is rare and fatigue is very rare.

Pregnancy & Lactation of Cefadroxil Monohydrate:-

Although animal studies and clinical experience have not shown any evidence of teratogenicity, the safe use during pregnancy has not been established. Cefadroxil is present in low concentrations in breast milk; sensitization, diarrhoea or colonization of the infants’ mucosa with fungi are possible. The use of cefadroxil during pregnancy and in lactating mothers should therefore be handled very strictly.

Precautions & Warnings

Cefadroxil binds to cholestyramine which may lead to reduced bioavailability of cefadroxil. The concomitant administration of probenecid reduces the renal elimination of cefadroxil; therefore, plasma concentrations of cefadroxil may be increased when given in combination with probenecid.

Overdose Effects

No clinical reports are as yet available on cefadroxil in this respect. However in view of experience gained with other cephalosporins the following symptoms are possible: nausea, hallucinations, hyperreflexia, extrapyramidal symptoms, clouded consciousness, or even coma and renal functional impairment.

Therapeutic Class of Cefadroxil Monohydrate:-

First generation Cephalosporins

1.Cefadroxil Monohydrate:-

Capsule 1.Adora 500mg (AS A Cefadroxil Monohydrate AS A First generation Cephalosporins).

Tablet 2.Adora 1000 mg (AS A Cefadroxil Monohydrate AS A First generation Cephalosporins).

Pediatric Drops 3.Adora 125mg/1.25ml 15ml Bottle (AS A Cefadroxil Monohydrate AS A First generation Cephalosporins).

Syrup 4. Adora 125mg/5ml, 60ml Bottle/100ml Bottle (AS A Cefadroxil Monohydrate AS A First generation Cephalosporins).

2.Cefazolin Sodium:-(This group only Injection)

Description:-

Indications of Cefazolin Sodium:-

Cefazolin is indicated in the treatment of the following serious infections due to susceptible organisms: Respiratory Tract Infections, Urinary Tract Infections, Skin and Skin Structure Infections, Biliary Tract Infections, Bone and Joint Infections, Genital Infections, Septicemia, Endocarditis and Perioperative Prophylaxis.

Pharmacology of Cefazolin Sodium:-

Cefazolin is a 1st generation broad spectrum parenteral Cephalosporin antibiotic.It interferes with the synthesis of bacterial cell wall by inhibiting transpeptidase enzyme. As a result the bacterial cell wall is weakened,the cell swells and then ruptures.

Dosage & Administration of Cefazolin Sodium:-

Adult Dose

Moderate to severe infection: 500 mg to 1 gm for every 6 to 8 hours
Mild infections caused by susceptible Gram-positive cocci: 250 mg to 500 mg for every 8 hours
Acute uncomplicated urinary tract infections: 1 gm for every 12 hours
Pneumococcal pneumonia: 500 mg for every 12 hours
Severe life-threatening infections (e.g. Endocarditis, Septicemia): 1 gm to 1.5 gm for every 6 hours. In rare instances, doses up to 12 gm per day can be used

Perioperative Prophylactic Use: To prevent postoperative infection in contaminated or potentially contaminated surgery, recommended doses are:

1 gm IM or IV administered half hour to 1 hour prior to the start of surgery.
For lengthy operative procedures (e.g. 2 hours or more), 500 mg to 1 gm IM or IV during surgery.
500 mg to 1 gm IM or IV every 6 to 8 hours for 24 hours postoperatively.

In surgery where the occurrence of infection may be particularly devastating (e.g. open-heart surgery and prosthetic arthroplasty), the prophylactic administration may be continued for 3 to 5 days following the completion of surgery.

Interaction of Cefazolin Sodium:-

Probenecid may decrease renal tubular secretion of Cephalosporins when used concurrently, resulting in increased and more prolonged Cephalosporin blood levels.

Contraindications of Cefazolin Sodium:-

Cefazolin is contraindicated in patients with known allergy to the Cephalosporin group of Antibiotics.

Side Effects of Cefazolin Sodium:-

Common side effects include:Injection site reactions (pain, swelling, skin rash, or a hard lump), diarrhea, stomach pain, stomach cramps, nausea, vomiting, loss of appetite, skin rash or itching, hives, white patches or sores inside the mouth or on the lips, vaginal itching or discharge,heartburn, gas,rectal itching,confusion, weakness, hypotension, drowsiness, headache and allergic reactions.

Pregnancy & Lactation of Cefazolin Sodium:-

Pregnancy Category B. Cefazolin is present in very low concentrations in the milk of nursing mothers.Caution should be exercised when Cefazolin is administered to a nursing woman.

Precautions & Warnings of Cefazolin Sodium:-

As with all Cephalosporins, Cefazolin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly Colitis.
As with other β-lactam antibiotics, seizures may occur if inappropriately high doses are administered to patients with impaired renal function.

Use in Special Populations of Cefazolin Sodium:-

Patients with Impaired Renal Function:

Creatinine clearance 35 to 54 ml/min: 1 unit dose (based on unit doses of 500 mg & 1 gm) Every 8 hours
Creatinine clearance 11 to 34 ml/min: ½ unit dose (based on unit doses of 500 mg & 1 gm) Every 12 hours
Creatinine clearance 10 ml/min: ½ unit dose (based on unit doses of 500 mg & 1 gm) Every 18 to 24 hours

Patients with Hepatic Insufficiency: No dosage adjustment is necessary in patients with hepatic insufficiency.

Pediatric Dose: In pediatric patients, a total daily dosage of 25 to 50 mg per kg of body weight, divided into 3 or 4 equal doses, is effective for most mild to moderate infections. Total daily dosage may be increased to 100 mg per kg of body weight for severe infections. Safety for use in premature infants and in neonates has not been established.

Therapeutic Class of Cefazolin Sodium:-

First generation Cephalosporins

2.Cefazolin Sodium. (Only Injection)

Injection 1.Cefazol IM/IV 500mg/vial 500mg Vial (AS A Cefazolin Sodium AS A First generation Cephalosporins).

Injection 2.Cefazol IM/IV 1gm/vial 1mg Vial (AS A Cefazolin Sodium AS A First generation Cephalosporins).

3.Cephalexin:-

Description:-

Indications of Cephalexin :-

Cephalexin is indicated for the treatment of the following infections when caused by susceptible organisms.

Respiratory tract infections: Acute and chronic bronchitis and infected bronchiectasis.
Genito-urinary tract infections: Acute and chronic nephritis, cystitis, urethritis and prostatitis, prophylaxis of recurrent urinary tract infections.
Skin and soft tissue infections: Caused by staphylococci and/or streptococci.
Ear, Nose and Throat infections: Otitis media, mastoiditis, sinusitis, follicular tonsillitis and pharyngitis.
Bone infections: Caused by staphylococci and/or P. mirabilis.

Pharmacology of Cephalexin :-

Cephalexin is a semisynthetic analogue of Cephalosporin C. It kills bacteria by interfering in the synthesis of the bacterial cell wall. Peptidoglycan is a heteropolymeric structure that provides the cell wall with mechanical stability. The final stage in the synthesis of peptidoglycan involves the completion of the cross-linking and the terminal glycine residue of the Pentaglycine Bridge is linked to the fourth residue of the pentapeptide (d-alanin). The transpeptidase enzyme that performs this step is inhibited by penicillins and cephalosporins. As a result the bacterial cell wall is weakened, the cell swells and then ruptures. Cephalexin is a first generation cephalosporin that is active by mouth.

Dosage & Administration of Cephalexin :-

Adult:

The usual dose is 250 mg to 500 mg every 6 hour.
For skin and soft tissue infections, streptococcal pharyngitis and uncomplicated cystitis, in patients over 15 years of age: 500 mg of the drug may be administered every 12 hour.
In severe or deep seated infections the dose can be increased up to 3 g to 6 g daily.

Children: The dosage range is 25-100 mg/kg/day in divided doses to a maximum of 4 g daily

Children’s Weight Recommended Dose:

10 kg (22 Ibs): 62.5 mg to 125 mg qid or 125 mg to 250 mg bid
20 kg (44 Ibs): 125 mg to 250 mg qid or 250 mg to 500 mg bid
40 kg (88 Ibs): 250 mg to 500 mg qid or 500 mg to 1 g bid

For streptococcal pharyngitis, skin and soft tissue infections and in patients over 1 year of age the total daily dose may be divided and administered every 12 hour. In the therapy of otitis media 75-100 mg/kg/day in four divided doses may be required. In the treatment of β haemolytic streptococcal infections a therapeutic dosage of the drug should be given at least for 10 days.

Contraindications of Cephalexin :-

Cephalen is contraindicated in patients with known hypersensitivity to the cephalosporin group of antibiotics.

Side Effects of Cephalexin :-

Side effects include nausea, vomiting, diarrhoea and abdominal discomfort. Symptoms of pseudomembranous colitis may appear either during or after antibiotic treatment. Skin rash, angio oedema, rise in serum aminotransferases, eosinophilia, neutropenia have been reported very rarely. Superinfection with resistant micro organisms, particularly candida may follow the treatment.

Pregnancy & Lactation of Cephalexin :-

Pregnancy Category B. Cefalexin may be used during pregnancy when it is considered essential. Cefalexin is found in the milk of nursing mothers, hence caution should be taken when it is administered to nursing mothers.

Precautions & Warnings of Cephalexin :-

Cefalexin should be given with caution in patients with renal impairment. Under such condition, careful clinical observation should be made because safe dosage may be lower than the usually recommended. The urine of patients receiving Cefalexin may give a false positive reaction for glucose with copper reduction reagent. Positive results to Coombs’ test have been reported. Although there is no evidence of teratogenicity in animal tests, Cefalexin may be used during pregnancy when it is considered essential. Cefalexin is found in the milk of nursing mothers, hence caution should be taken when it is administered to nursing mothers.

Therapeutic Class of Cephalexin :-

First generation Cephalosporins

3.Cephalexin:-

Capsule 1.Cefex 250mg (AS A Cephalexin AS A First generation Cephalosporins).

Capsule 2.Cefex 500mg (AS A Cephalexin AS A First generation Cephalosporins).

Syrup 3.Cefex 125mg/5ml 100ml Bottle (AS A Cephalexin AS A First generation Cephalosporins).

4.Cephradine:-

Descriptition:-

Indications of Cephradine :-

Cephradine is indicated for the treatment of infections caused by sensitive Gram-positive and Gram-negative bacteria. These include-

Undesirable Upper respiratory tract infections: sinusitis, pharyngitis, tonsillitis, laryngo-tracheo bronchitis and otitis media, and also
Lower respiratory tract infections: bronchitis (acute and chronic), lobar pneumonia and bronchopneumonia.
Urinary tract infections: cystitis, urethritis and pyelonephritis.
Skin and soft tissue infections: abscess, cellulitis, furunculosis and impetigo.

The following microorganisms are susceptible, in vitro to Cephradine:

Gram-positive: Staphylococci (both penicillin sensitive and resistant strains and penicillinase-producing species), Streptococci, Streptococci pyogenes (beta haemolytic), Streptococcus pneumonia.
Gram-negative: Escherichia coli, Klebsiella spp, Proteus mirabilis, Haemophilus influenza, Shigella spp, Salmonella spp (including Salmonella typhi), Neisseria spp Many strains of E.coli and Staphylococcus aureus that produce the enzyme penicillinase and thus are ampicillin resistant, are susceptible to Cephradine which is unaffected by this enzyme.

Pharmacology of Cephradine :-

Cephradine is a semisynthetic broad spectrum bactericidal antibiotic, it is active against infections caused by both gram-positive and gram-negative microorganisms. Both penicillinase producing and nonproducing staphylococci are sensitive to Cephradine. The main site of action of Cephradine is the cell wall of bacteria. Cell wall of sensitive organism contains peptidoglycan. Cephradine inhibits cross-linking process and as a result cell wall with many pores are formed, thus lysis of bacteria occur due to external osmotic pressure.

Dosage & Administration of Cephradine :-

For oral administration–
Adults:

Urinary tract infections: 500mg four times daily or 1g twice daily. Infections which are severe or chronic may necessitate the administration of higher doses. Where complications arise including prostatitis and epididymitis continued intensive treatment is required.
Respiratory tract infections: 250 to 500mg four times daily or 500mg to 1g twice daily, dependent on the site and severity of the infection.
Skin and soft tissue infections: 250 to 500mg four times daily or 500mg to 1g twice daily, again dependent on the site and severity of the infection.

Children:

Total daily dose of 25 to 50mg/kg given in two or four equally divided doses.
Otitis media: Total daily dose of 75 to 100mg/kg given in divided doses 6 to 12 hourly.
Maximum daily dosage: 4 gm

Elderly: The normal adult dose is appropriate. Patients with impaired renal or hepatic function should be monitored during treatment.

For injectable administration–

Adult: The usual dose is 2-4 gm daily in four equally divided doses up to 8 gm daily. For prophylaxis a single preoperative dose of 1-2 gm intramuscularly or intravenously is given.
Children: The dose is 50-100 mg/kg daily in four equally divided doses, up to 300 mg/kg daily in severe infection.

Interaction of Cephradine :-

The concomitant use of nephrotoxic drugs such as aminoglycosides with Cefradine may increase the risk of kidney damage. Diuretics (e.g. frusemide, ethacrynic acid) and probenecid enhanced the possibility of renal toxicity.

Contraindications of Cephradine :-

Cephradine should not be used in patients with known or suspected hypersensitivity to cephalosporins.

Side Effects of Cephradine :-

Limited essentially to gastro-intestinal disturbances and on occasions to hypersensitivity phenomena. The latter are more likely to occur in individuals, who have previously demonstrated hypersensitivity and thos with a history of allergy, asthma, hay fever or urticaria. Skin reactions have occasionally been reported. Rare- Glossitis, heartburn, dizziness, tightness in the chest, nausea, vomiting, diarrhoea, abdominal pain, vaginitis, candida overgrowth. Skin and hypersensitivity reactions include urticaria, skin rashes, joint pains, oedema.

Blood and lymphatic system disorders- Unknown: blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia)
Immune system disorders- Unknown: Fever, serum sickness like reactions, anaphylaxis
Psychiatric disorders- Unknown: Confusion, sleep disturbances
Nervous system disorders- Unknown: hyperactivity, hypertonia, dizziness, nervousness; Rarely: Headache
Hepatobiliary disorders- Frequency unknown: Liver, enzyme disturbances, transient hepatitis, cholestatic jaundice
Renal and urinary disorders- Unknown: Reversible interstitial nephritis
Investigations- Unknown: Elevation of blood urea nitrogen, serum creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase.

Pregnancy & Lactation of Cephradine :-

Although animal studies have not demonstrated any teratogenicity, safety in pregnancy has not been established. Cephradine is excreted in breast milk and should be used with caution in lactating mothers. Since the medicine may cause dizziness, patients should be cautioned about operating hazardous machinery, including automobiles.

Precautions & Warnings of Cephradine :-

Prolonged use of an anti-infective may result in the development of superinfection due to the emergence of resistant organisms.
Cephradine should be administered with care to patients hypersensitive to penicillins because of the risk of cross-sensitivity between beta-lactam antibiotics.
Cephalosporin antibiotics may cause a positive result in Coombs’ testing. When Coombs testing is performed on neonates whose mothers received cephalosporins prior to labour, it should be noted that a positive result may be due to the drug.
Cephradine may cause a false positive urine glucose result when Benedict’s or Fehling’s solutions or tablets such as Clinitest are used in the testing. This does not occur with enzyme-based tests (e.g. Clinistix, Diastix).
Dosage adjustment is necessary in renal impairment.
This product contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Use in Special Populations of Cephradine :-

Renal Impairment: The following doses are recommended (based on 500 mg every 6 hours) for patients not on haemodialysis:

CrCl: >20 ml/min: 500 mg every 6 hours
CrCl: 5-20 ml/min: 250 mg every 6 hours
CrCl: <5 ml/min: 250 mg every 50-70 hours.

Recommendations for patients on chronic, intermittent haemodialysis:

250 mg at the start of haemodialysis
250 mg 6 to 12 hours after the start
250 mg 36 to 48 hours after the start
250 mg at the start of the next haemodialysis session if more than 30 hours have elapsed since the last dose.

Additional Information for all patients Regardless of patient age or weight, higher doses of up to 1 gm four times daily may be required for infections which are chronic or severe. Treatment should continue for at least 2 to 3 days after symptoms have resolved or bacteria have been eradicated. To reduce the possibility of rheumatic fever or glomerulonephritis resulting from infections with haemolytic streptococci, treatment should be continued for at least 10 days. Throughout treatment of chronic urinary tract infections and for several months thereafter, regular bacteriological and clinical monitoring is required.

Doses below those recommended above should not be prescribed. Paediatric dosages should not exceed those specified for adults, regardless of severity of infection. It may be necessary to continue Cephradine therapy for several weeks in persistent infections. Patients may be transferred from intramuscular/intravenous Cephradine therapy to oral treatment at the same dosage level.

Overdose Effects of Cephradine :-

The symptoms of Sefrad overdose are non-specific and are generally nausea, vomiting, diarrhoea and gastric upsets. Treatment is mainly supportive although gastric lavage will be necessary if a large amount has been ingested.

Therapeutic Class of Cephradine :-

First generation Cephalosporins

4.Cephradine:-

Capsule 1.Lebac 250mg (AS A Cephradine AS A First generation Cephalosporins).

Capsule 2.Lebac 500mg (AS A Cephradine AS A First generation Cephalosporins).

Syrup 3.Lebac 125mg/5ml 100ml Bottle (AS A Cephradine AS A First generation Cephalosporins).

Syrup 4. Lebac 250mg/5ml 100ml Bottle (AS A Cephradine AS A First generation Cephalosporins).

Pediatric Drop 5. . Lebac 125mg/1.25ml 15ml Bottle (AS A Cephradine AS A First generation Cephalosporins).

Injection 6.Lebac IM/IV 500mg/vial 500mg vial (AS A Cephradine AS A First generation Cephalosporins).

Injection 7.Procef IM/IV 1gm/Vial (AS A Cephradine AS A First generation Cephalosporins).

Raiyyan Tahsan Date:-30-01-2025 Thursday Time:-10-30-55 Pm

Raiyyan Tahsan

Raiyyan Tahsan