Indications
Pharyngitis/tonsillitis caused by Streptococcus pyogenes
Acute bacterial otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Moraxella Catarrhalis (including beta-lactamase-producing strains) or Streptococcus pyogenes

Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non-beta-lactamase-producing strains only)

Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, Escherichia coli

Acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis caused by Streptococcus penumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains)

Skin and Skin-Structure Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, Escherichia coli, Klebsiella spp. and Enterobacter spp.

Urinary tract infections caused by Escherichia coli or Klebsiella pneumoniae

Bone and Joint Infections caused by Staphylococcus aureus (penicillinase and non-penicillinase producing strains)

Gonorrhea: Uncomplicated and disseminated gonococcal infections due to Neisseria gonorrhoeae (penicillinase- and non-penicillinase-producing strains) in both males and females

Early Lyme disease (erythema migrans) caused by Borrelia burgdorferi

Septicemia caused by Staphylococcus aureus (penicillinase and non-penicillinase producing strains), Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae (including ampicillin-resistant strains), and Klebsiella spp.

Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin resistant strains), Neisseria meningitidis and Staphylococcus aureus (penicillinase and non-penicillinase producing strains)

Switch therapy (injectable to oral) after surgery when patient’s condition is improved.

Contraindications
Patients with known allergy to cephalosporins & pseudomembranous colitis are contraindicated.

Precautions & Warnings

Generally Cefuroxime and Clavulanic acid are well tolerated. However, a few side effects like nausea, vomiting, diarrhea, abdominal discomfort or pain may occur. As with other broad-spectrum antibiotics, prolonged administration of Cefuroxime and Clavulanic acid combination may result in overgrowth of nonsusceptible microorganisms. Rarely (<0.2%) renal dysfunction, anaphylaxis, angioedema, pruritis, rash and serum sickness like urticaria may appear.

Agextim-CV should be given with care to patients receiving concurrent treatment with potent diuretics & who have history of colitis.

Drug Interactions
Concomitant administration of probenecid with Cefaclav increases the area under the serum concentration versus time curve by 50%. Drug that reduces gastric acidity may result in a lower bioavailability of Cefuroxime and tend to cancel the effect of postprandial absorption.

Dosage & Administration

Adolescents & Adults:
Pharyngitis or Tonsillitis: 250 mg twice daily 5-10 days
Acute bacterial maxillary sinusitis: 250 mg twice daily 10 days
Acute bacterial exacerbation of chronic bronchitis: 250-500 mg twice daily 10 days
Secondary bacterial infections of acute bronchitis: 250-500 mg twice daily 5-10 days
Community acquired pneumonia: 250-500 mg twice daily 5-10 days
Uncomplicated skin & skin-structure infections: 250-500 mg twice daily 10 days
MDR Typhoid fever: 500 mg twice daily 10-14 days
Uncomplicated urinary tract infection: 250 mg twice daily 7-10 days
Uncomplicated gonorrhea: 1000 mg single dose
Lyme disease: 500 mg twice daily 20 days
Paediatric patients (3 months to 12 years)
Pharyngitis or Tonsillitis: 20 mg/kg/day in two divided doses 5-10 days
Acute otitis media: 30 mg/kg/day in two divided doses 10 days
Acute bacterial maxillary sinusitis: 30 mg/kg/day in two divided doses 10 days
Community acquired pneumonia: 30 mg/kg/day in two divided doses 5-10 days
MDR Typhoid fever: 30 mg/kg/day in two divided doses 10-14 days
Uncomplicated skin & skin-structure infections: 30 mg/kg/day in two divided doses 10 days
Uncomplicated urinary tract infection: 20 mg/kg/day in two divided doses 7-10 days
Agextim-CV may be administered without regard to meals.

Presentations
Agextim-CV 625: Strip of 6 Tablets