DENVAR DS 200 mg/5 ml

Indications
Denvar DS is a third-generation cephalosporin antibiotic with potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms. It is indicated for treating the following acute infections caused by susceptible microorganisms:

1. Upper Respiratory Tract Infections (URTI):

   • Conditions such as otitis media and other URTIs, particularly when resistant to commonly used antibiotics or when treatment failure carries significant risk.

2. Lower Respiratory Tract Infections:

   • Conditions such as bronchitis.

3. Urinary Tract Infections (UTI):

   • Including cystitis, cystourethritis, and pyelonephritis.

Denvar DS is effective against pathogens such as Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella species, Haemophilus influenzae (beta-lactamase positive and negative), Moraxella catarrhalis (beta-lactamase positive and negative), and Enterobacter species. It remains highly stable in the presence of beta-lactamase enzymes.

Pharmacology
Cefixime, the active ingredient in Denvar DS, is a third-generation semisynthetic cephalosporin antibiotic. It is bactericidal, targeting a broad spectrum of Gram-positive and Gram-negative bacteria by inhibiting bacterial cell wall synthesis. This antibiotic is resistant to degradation by beta-lactamase enzymes, making it effective against organisms resistant to penicillins and some cephalosporins. Cefixime’s absorption is approximately 40-50%, irrespective of food intake.

Dosage and Administration
Denvar DS can be taken with or without food. The typical treatment duration is 7 days, extendable to 14 days if necessary.

• Adults and Children over 10 Years:

  • 200-400 mg daily, depending on infection severity, given as a single dose or in two divided doses.

• Elderly Patients:

  • Same dosage as adults. Renal function should be monitored, and dosage adjusted for severe renal impairment.

• Children:

  • Recommended dose: 8 mg/kg/day, as a single or divided dose.

  • General Dosage Guide:

    • 6 months to 1 year: 3.75 ml daily

    • 1-4 years: 5 ml daily

    • 5-10 years: 10 ml daily

  • Typhoid Fever: 5 mg/kg body weight twice daily for 10-14 days.

  • Children over 50 kg or older than 10 years: Treat with the adult dose.

• Renal Impairment:

  • Normal dosage can be administered if creatinine clearance is ≥20 ml/min. For clearance <20 ml/min, a maximum dose of 200 mg once daily is recommended.

Interactions
Denvar DS may increase prothrombin time in some patients, necessitating caution in those receiving anticoagulants.

Contraindications

• Hypersensitivity to cephalosporin antibiotics.

Side Effects
Common side effects include:

• Gastrointestinal Issues: Diarrhea, nausea, vomiting, abdominal pain, and flatulence.

• Central Nervous System Effects: Headache, dizziness.

• Hypersensitivity Reactions: Rash, itching, hives, drug fever, arthralgia.

• Hematological Changes: Rare occurrences of thrombocytopenia, leukopenia, and eosinophilia.

• Other Reactions: Vaginitis, genital itching.

Most adverse effects are mild and resolve after discontinuing the medication.

Pregnancy and Lactation

• Use only if clearly necessary, as adequate studies in pregnant women are lacking.

• Unknown if Cefixime is excreted in human milk; caution is advised when prescribing to nursing mothers.

Precautions and Warnings

• Use with caution in patients with a history of hypersensitivity to cephalosporins or penicillins. Severe allergic reactions may occur.

• Discontinue immediately if allergic reactions develop.

• Monitor renal function in patients with impaired kidney function.

Overdose Effects
In the event of an overdose:

• Gastric lavage may be necessary.

• Denvar DS is not significantly removed by hemodialysis or peritoneal dialysis.

Therapeutic Class
Third-generation Cephalosporins.

Storage Conditions
Store below 30°C, protected from light and moisture. Keep out of reach of children.

Quick Tips

1. Complete the full course of treatment as prescribed, even if symptoms improve.

2. Take with food if stomach upset occurs.

3. Inform your doctor if diarrhea persists or worsens.

4. Avoid alcohol during treatment to prevent side effects.

5. Discontinue and consult your doctor if allergic reactions occur.