Uses of Zixtafy

Ceftriaxone is a Cephalosporin antibiotic with a broad spectrum of action. This active ingredient is present in many different commercial products, including the drug Zixtafy. So what does Zitaxfy do and when is it indicated?

Each vial of Zixtafy powder for injection contains Ceftriaxone Sodium, equivalent to 1g of Ceftriaxone antibiotic; The active ingredient Ceftriaxone in Zixtafy has antibacterial activity by inhibiting cell wall synthesis, thereby killing bacteria. The antibacterial spectrum of Ceftriaxone is relatively broad, covering both Gram-positive and Gram-negative bacteria that secrete beta-lactamase enzymes, including strains that are hydrolysed by penicillins and other cephalosporins.
Bacterial strains resistant to Ceftriaxone are mainly due to the production of some specific forms of beta-lactamase enzymes (including carbapenemases and some ESBLs), especially Gram-positive strains.

Zixtafy is indicated for the treatment of infections as follows:
Urinary tract infections; Lower respiratory tract infections, especially pneumonia; Gonorrhea; Skin, soft tissue and joint infections; Meningitis ; Some serious infections such as sepsis; Ear, nose and throat infections; Bacterial infections in cancer patients; Zixtafy is also used for the purpose of preventing infection in the postoperative period, prophylactic in surgery; Zixtafy is also used to treat typhoid fever.

3.1. Dosage of Zixtafy is only prescribed by the doctor with the following dosage:
Adults: Intramuscular or intravenous injection for 2-4 minutes or intravenous infusion at a dose of 1g (1 vial of Zixtafy) per day, May increase to 2-4g if infection is severe. Note that with intramuscular dosing, 1 vial of Zixtafy should be divided into 2 doses for injection at 2 different sites; Newborns: 20-50mg/kg/day, intravenous infusion over 60 minutes; Children weighing less than 50kg: Intramuscular injection, intravenous infusion over 2-4 minutes or intravenous infusion at a dose of 20-50mg/kg/day, maximum 80mg/kg/day if the infection is severe. Note that with doses of 50 mg/kg or more used only by intravenous infusion; Children over 50kg: The dose of Zixtafy is similar to that of an adult; Uncomplicated gonorrhea: Single intramuscular injection of 250mg (1⁄4 vials of Zixtafy); Prophylaxis in surgery: Intramuscular or intravenous injection in 2-4 minutes 1 vial of Zixtafy before the time of surgery; For rectal surgery: Intramuscular or intravenous injection over 2-4 minutes or intravenous infusion with a dose of 2g (2 vials of Zixtafy) before surgery. The duration of treatment with Zixtafy should be continued for an additional 2 days after the symptoms of infection disappear. For complicated infections, Zixtafy should be used for 4 to 14 days, if necessary, it can be treated for longer.
3.2. How to use Zixtafy Intramuscular: 1⁄4 to 1⁄2 vials of Zixtafy mixed with 2ml of 1% Lidocaine solution or 1 vial of Zixtafy mixed with 3.5ml of 1% Lidocaine solution; Intravenous: 1⁄4 to 1⁄2 vials of Zixtafy dissolved in 5ml of distilled water for injection or 1 vial of Zixtafy mixed with 10ml of distilled water for injection or 2 vials of Zixtafy with 20ml of distilled water for injection. The time of direct intravenous injection should be slow in about 2-4 minutes or it can be administered through a solution line. Zixtafy solution after reconstitution should be used immediately, the solution after reconstitution is stable for at least 6 hours at room temperature or 24 hours at 59°C.

Zixtafy is contraindicated in patients with a history of allergy to Ceftriaxone or other cephalosporin antibiotics.
Also do not use Zixtafy intramuscularly if the patient is sensitive (or allergic) to Lidocaine.

Before initiating Zixtafy, the physician should carefully review the history of hypersensitivity to Cephalosporins, penicillins or any other drug, in which caution should be exercised when prescribing Zixtafy to patients sensitive to penicillins.
Pseudomembranous colitis has been reported with nearly all antibiotics, including Zixtafy, to varying degrees. Therefore, the diagnosis of the condition should be considered for patients with diarrhea following Zixtafy use.
Treatment with Zixtafy may alter the normal flora in the intestinal tract and facilitate the overgrowth of Clostridia strains. Studies show that toxins produced by Clostridium difficile are the leading cause of antibiotic-associated colitis. Mild cases of pseudomembranous colitis usually improve upon discontinuation of Zixtafy. In moderate to severe cases, in addition to discontinuation of the drug, consideration should be given to fluid, electrolyte, and protein replacement and treatment with an antibiotic sensitive to Clostridium difficile.

The nephrotoxic potential of Zixtafy is similar to that of other Cephalosporin antibiotics. Note that Ceftriaxone is excreted by the kidneys and bile, therefore, patients with renal impairment may not require dose adjustment of Zixtafy at the recommended dose but should periodically monitor the serum concentration of Ceftriaxone. In case there are signs of drug accumulation, reduce the dose of Zixtafy accordingly.
No dose adjustment of Zixtafy is necessary in patients with hepatic dysfunction. However, patients with both liver dysfunction and severe kidney disease should not take more than 2 vials of Zixtafy daily if it is not possible to closely monitor blood levels of Ceftriaxone.
Alterations in prothrombin time have rarely occurred in patients treated with Zixtafy . Patients with diseases that cause reduced vitamin K synthesis or low vitamin K stores (such as chronic liver disease and malnutrition) need to monitor prothrombin time during treatment with Ceftriaxone. If prothrombin time is prolonged, vitamin K may be indicated (10mg per week).
Prolonged use of Zixtafy may stimulate excessive growth of strains of bacteria that are not sensitive to Ceftriaxone. Therefore, the patient should be carefully monitored, if superinfection occurs, appropriate treatment measures should be used.
Caution is advised when prescribing Zixtafy to patients with a history of gastrointestinal disease, especially colitis.
There have been reports of abnormal gallbladder ultrasound findings in patients receiving Zixtafy . This condition was transient and reversible upon discontinuation of ceftriaxone. Therefore, Zixtafy should be discontinued in patients who develop signs and symptoms presumed to be gallbladder disease and/or abnormal gallbladder ultrasound findings.
There are no adequate and well-controlled studies with the use of Zixtafy in pregnant women, and should be used during pregnancy only if clearly needed.
Ceftriaxone is excreted in human milk at low concentrations, therefore caution should be exercised when Zixtafy is administered to a nursing woman.
Ceftriaxone causes dizziness which may affect the ability to drive and use machines.

In general, Ceftriaxone is well tolerated. In clinical trials, the following adverse reactions were considered to be related to Zixtafy therapy or of unknown etiology:
Local reactions: Pain, tissue stiffness or increased pain sensitivity. With intravenous injection, phlebitis side effects were less than 11%; Hypersensitivity: Rash (1.7%) or symptoms such as itching, fever or chills (less than 1%); Hematology: Eosinophilia (6%), thrombocytopenia (5.1%) and leukopenia (2.1%). Less frequently reported (<1%) were anemia, hemolytic anemia, neutropenia, thrombocytopenia and prolongation of prothrombin time; Gastrointestinal: Diarrhea (2.7%) or less common effects (<1%) such as nausea, vomiting and taste disturbances; Liver: Increased SGOT (3.1%) or SGPT (3.3%) or, less commonly, increased phosphatase and bilirubin; Renal: Hyperuremia (1.2%) or less commonly (<1%) effect is increased creatinine or urinary casts; Central nervous system: Headache or dizziness (in less than 1%); Vaginitis or candida infection; Other side effects: Facial flushing and sweating. Patients should inform the doctor about the undesirable effects encountered when using Zixtafy.

Alcohol: Concomitant use of alcohol with Zixtafy can cause disulfiram-like reactions; Anticoagulants, heparin or thrombolytics: Ceftriaxone may inhibit vitamin K synthesis, therefore concomitant use of Zixtafy with these drugs may increase the risk of bleeding; Prothrombin time: May be prolonged because Cephalosporins inhibit vitamin K synthesis by blocking intestinal bacteria synthesis; Coomb's test: A positive Coomb reaction usually occurs in patients receiving high doses of Cephalosporins such as Zixtafy.