Exephin 250 mg/vial is a third-generation broad-spectrum cephalosporin antibiotic used to treat a wide variety of bacterial infections. Its potent bactericidal action targets both Gram-positive and Gram-negative bacteria, making it a versatile option for serious and complicated infections. It is administered parenterally via intravenous (IV) or intramuscular (IM) injection and is especially valued for its relatively long half-life, allowing once-daily dosing in many cases.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Third-generation cephalosporin antibiotic

Indications

Exephin 250 mg/vial is indicated for the treatment and prevention of the following infections:

• Lower respiratory tract infections – including pneumonia and bronchitis

• Acute bacterial otitis media

• Skin and soft tissue infections

• Urinary tract infections

• Gonorrhea – uncomplicated infections

• Bacterial septicemia

• Bone and joint infections

• Meningitis

• Perioperative prophylaxis – prevention of postoperative infections associated with surgery

Its broad-spectrum activity and high tissue penetration make it effective in both community-acquired and hospital-acquired infections.

Pharmacology

Exephin exerts its antibacterial effect by inhibiting bacterial cell wall synthesis, similar to other beta-lactam antibiotics. It binds to penicillin-binding proteins, disrupting cell wall formation, leading to bacterial lysis and death. A significant feature is its high stability in the presence of beta-lactamases, enzymes that commonly inactivate other antibiotics.

• Protein binding: Approximately 95%

• Elimination half-life: 6–9 hours

• Excretion: 40–65% unchanged in urine, remainder via bile into feces

• Metabolism: Not metabolized in the body

This pharmacokinetic profile allows for flexible dosing regimens and suitability for severe infections requiring intensive therapy.

Dosage & Administration

Adults:

• Typical dose: 1–2 g IV or IM once daily, or divided into two doses per day

• Maximum dose: 4 g/day

• Gonorrhea: 250 mg IM single dose

• Surgical prophylaxis: 1 g IV 30–120 minutes before surgery

Children (≥1 month):

• General infections: 50–75 mg/kg IV or IM once daily (max 2 g/day)

• Otitis media: 50 mg/kg IM single dose (max 1 g)

• Meningitis: 100 mg/kg IV/IM daily (max 4 g)

Administration:

• IM injection: dissolve in Lidocaine HCl 1%

• IV injection: dissolve in water for injection, administer over 2–4 minutes, or by infusion over 30 minutes (10–40 mg/mL concentration)

Contraindications

• Hypersensitivity to cephalosporins or beta-lactam antibiotics

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Side Effects

Exephin is generally well tolerated. Possible adverse reactions include:

• Gastrointestinal: diarrhea, nausea, vomiting, stomatitis

• Cutaneous: rash, pruritus, urticaria, edema

• Hematologic: eosinophilia, thrombocytopenia, leucopenia

• Hepatic: elevated SGOT/SGPT, bilirubinemia

• CNS: headache, dizziness, confusion, convulsions

• Local: phlebitis at injection site (rare, minimized by slow injection)

Precautions & Warnings

• Monitor for anaphylaxis, even in patients with no prior cephalosporin allergy

• Rare gallbladder “sludge” formation may occur, reversible on discontinuation

• Blood counts should be monitored during prolonged therapy

• Not recommended for premature neonates or newborns under 28 days

Pregnancy & Lactation

• Use only if clearly indicated; safety in human pregnancy is not established

• Excreted in low concentrations in breast milk; exercise caution during lactation

Overdose

• No specific antidote

• Treatment: supportive and symptomatic care

Storage

• Store in a cool, dry place below 30°C, protected from light and moisture

• Keep out of reach of children

Mode of Action

Exephin works by irreversibly binding to bacterial cell wall enzymes, inhibiting peptidoglycan cross-linking, resulting in bacterial lysis and death. Its broad-spectrum activity and long half-life make it suitable for severe infections, including meningitis, septicemia, and post-operative prophylaxis.