Curaxone

Description

Curaxone Injection, manufactured by Claris Lifesciences Ltd., contains Ceftriaxone 1gm as its active ingredient. It is available in Nepal with a retail price of 90.00 NPR.

Indications

Curaxone Injection is used to treat a wide range of bacterial infections, including:

• Respiratory Tract Infections: Pneumonia, Acute otitis media, and other respiratory tract infections.
• Severe Systemic Infections: Meningitis, Typhoid fever, Septicemia, and Pelvic inflammatory disease.
• Other Infections: Lyme disease, Otitis media, Skin and Skin-Structure Infections, Gonorrhea, Urinary tract infections, Bone and Joint Infections, and Chlamydia infection. It is also used for Surgical Prophylaxis.

Dosage Information

Adult Dose

• Susceptible Infections: 1-2 gm daily, administered intravenously (IV) or intramuscularly (IM). For severe infections, the dose can be increased up to 4 gm daily.
• Intra-abdominal Infections (Complicated, mild-to-moderate, community-acquired): 1-2 gm daily IV as a single dose or divided every 12 hours for 4-7 days, in combination with metronidazole.
• Meningitis: 2 gm IV every 12 hours for 7-14 days.
• Acute Uncomplicated Pyelonephritis: 1-2 gm IV once daily.
• Typhoid Fever: 2 gm IV once daily for 14 days.
• Surgical Prophylaxis: 1 gm IV administered 0.5-2 hours before the surgical procedure.
• Uncomplicated Gonococcal Infections (pharynx, cervix, urethra, or rectum): A single 250 mg IM dose of ceftriaxone plus azithromycin 1 gm orally once (preferred). Alternatively, doxycycline 100 mg orally every 12 hours for 7 days can be used.
• Pelvic Inflammatory Disease: A single 250 mg IM dose, given with doxycycline, and optionally with metronidazole, for 14 days.

Child Dose

• General Dosing (IV, IM): 50–75 mg/kg/day, with a maximum of 2 gm/day, administered every 24 hours.
• Acute Otitis Media (AOM): 50 mg/kg IM, with a maximum of 1 gm, for 1–3 doses every 24 hours.
• Meningitis: 100 mg/kg/day, with a maximum of 4 gm/day, administered every 12 hours.

Renal Dose

• Renal Impairment: Dose reduction is necessary. For individuals with creatinine clearance (CrCl) less than 10 ml/min, the maximum daily dose is 2 gm.

Administration

• IV Administration: Infuse intermittently over 30 minutes.
• IM Administration: Inject deep into a large muscle mass.

Contraindications

Curaxone is contraindicated in:

• Individuals with hypersensitivity to cephalosporins.
• Hyperbilirubinemic neonates.
• It should not be used with or within 48 hours of calcium or calcium-containing solutions or products due to the risk of calcium-ceftriaxone precipitate formation.

Precautions

Exercise caution if you have:

• A history of penicillin allergy.
• Severe renal impairment.
• Are pregnant or lactating.
• Experience superinfection.

Lactation: The drug enters breast milk in low concentrations; use with caution.

Interactions

• May increase the nephrotoxicity of aminoglycosides.
• May diminish the therapeutic effect of BCG, typhoid vaccine, and sodium picosulfate.
• May increase the anticoagulant effect of vitamin K antagonists (e.g., warfarin).
• May increase serum levels with probenecid.
• Potentially Fatal: Administration with calcium-containing IV solutions may lead to precipitation of crystalline material in the lungs and kidneys.

Adverse Effects

• Common (greater than 10%): Induration after IM injection (5-17%).
• Less Common (1-10%): Eosinophilia (6%), Thrombocytosis (5%), Diarrhea (3%), Elevated hepatic transaminases (3%), Leukopenia (2%), Rash (2%), Increased blood urea nitrogen (BUN) (1%), Induration at IV site (1%), Pain (1%).
• Rare (less than 1%): Agranulocytosis, Anaphylaxis, Anemia, Basophilia, Bronchospasm, Candidiasis, Chills, Diaphoresis, Dizziness, Dysgeusia, Flushing, Gallstones, Glycosuria, Headache, Hematuria, Hemolytic anemia, Increased alkaline phosphatase or bilirubin, Increased creatinine, Jaundice, Leukocytosis, Lymphocytosis, Lymphopenia, Monocytosis, Nausea, Neutropenia, Phlebitis, Prolonged or decreased prothrombin time (PT), Pruritus, Renal stones, Serum sickness, Thrombocytopenia, Urinary casts, Vaginitis, Vomiting.

Mechanism of Action

Ceftriaxone works by binding to one or more penicillin-binding proteins (PBPs) in the bacterial cell wall. This action inhibits the final transpeptidation step of peptidoglycan synthesis, thereby disrupting bacterial cell wall assembly and leading to bacterial cell death.