Stacey Uses

• Stacey indications
• Uses of Stacey in details
• Stacey description
• Stacey dosage
• Stacey interactions
• Stacey side effects
• Stacey contraindications

What is Stacey?

Stacey is a cephalosporin (SEF a low spor in) antibiotic that is used to treat bacterial infections of the ear, nose, throat, lungs, skin, bones, joints, bladder, or kidneys. Stacey is also used to treat gonorrhea, meningitis, sepsis, or early Lyme disease.

Stacey injection is sometimes given just before a surgery to prevent infection.

Stacey may also be used for purposes not listed in this medication guide.

Stacey indications

Stacey is an oral prodrug of the bactericidal cephalosporin antibiotic Stacey, which is resistant to most β (beta)-lactamases and is active against a wide range of Gram-positive and Gram-negative organisms.

It is indicated for the treatment of infections caused by susceptible bacteria.

Susceptibility to Stacey will vary with geography and time and local susceptibility data should be consulted where available.

Indications include: Upper respiratory tract infections for example, ear, nose and throat infections, such as otitis media, sinusitis, tonsillitis and pharyngitis; lower respiratory tract infections for example, pneumonia, acute bronchitis, and acute exacerbations of chronic bronchitis; genito-urinary tract infections for example, pyelonephritis, cystitis and urethritis; skin and soft tissue infections for example, furunculosis, pyoderma and impetigo; gonorrhoea, acute uncomplicated gonococcal urethritis, and cervicitis; treatment of early Lyme disease and subsequent prevention of late Lyme disease in adults and children over 12 years old.

Stacey is also available as the sodium salt (Stacey) for parenteral administration. This permits the use of sequential therapy with the same antibiotic, when a change from parenteral to oral therapy is clinically indicated.

Where appropriate Stacey is effective when used following initial parenteral Stacey sodium (Stacey) in the treatment of pneumonia and acute exacerbations of chronic bronchitis.

How should I use Stacey?

Use Stacey tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Stacey tablets by mouth with or without food.
• Swallow Stacey tablets whole. Do not break, crush, or chew before swallowing.
• Stacey tablets works best if it is taken at the same time each day.
• To clear up your infection completely, take Stacey tablets for the full course of treatment. Keep taking it even if you feel better in a few days.
• If you miss a dose of Stacey tablets, take it as soon as possible. If it is almost time for your next dose, skip the missed dose, and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Stacey tablets.

Uses of Stacey in details

Use: Labeled Indications

Bone and joint infections (injection only): Treatment of bone and joint infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).

Chronic obstructive pulmonary disease, acute exacerbation (tablets only): Treatment of mild to moderate acute bacterial exacerbations of chronic bronchitis in adults and adolescents ≥13 years of age caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains), or Haemophilus parainfluenzae (beta-lactamase negative strains).

Lower respiratory tract infections (injection only): Treatment of lower respiratory tract infections, including pneumonia, caused by S. pneumoniae, H. influenzae (including ampicillin-resistant strains), Klebsiella spp., S. aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, and Escherichia coli.

Lyme disease (early) (tablets only): Treatment of adults and adolescents ≥13 years of age with early Lyme disease caused by Borrelia burgdorferi.

Otitis media, acute (tablets and oral suspension only): Treatment of pediatric patients ≥3 months of age with acute bacterial otitis media caused by S. pneumoniae, H. influenzae (including beta-lactamase-producing strains), Moraxella catarrhalis (including beta-lactamase-producing strains), or S. pyogenes.

Pharyngitis/tonsillitis (tablets and oral suspension only): Treatment of mild to moderate pharyngitis/tonsillitis caused by S. pyogenes in adults and pediatric patients ≥3 months of age.

Limitations of use: Efficacy in the prevention of rheumatic fever has not been established in clinical trials. Efficacy in the treatment of penicillin-resistant strains of S. pyogenes has not been demonstrated.

Septicemia (injection only): Treatment of septicemia caused by S. aureus (penicillinase- and non-penicillinase-producing strains), S. pneumoniae, E. coli, H. influenzae (including ampicillin-resistant strains), and Klebsiella spp.

Sinusitis, acute bacterial (tablets and oral suspension only): Treatment of mild to moderate acute bacterial maxillary sinusitis caused by S. pneumoniae or H. influenzae (non-beta-lactamase-producing strains only).

Limitations of use: Effectiveness for sinus infections caused by beta-lactamase-producing H. influenzae or M. catarrhalis in patients with acute bacterial maxillary sinusitis has not been established. Note: According to the IDSA guidelines for acute bacterial rhinosinusitis, Stacey is no longer recommended as monotherapy for initial empiric treatment (IDSA [Chow 2012]).

Skin and skin-structure infections (impetigo) (oral suspension only): Treatment of pediatric patients 3 months to 12 years of age with skin or skin-structure infections (impetigo) caused by S. aureus (including beta-lactamase-producing strains) or S. pyogenes.

Skin and skin-structure infections (injection; tablets [uncomplicated infections only]): Treatment of adults and pediatric patients >3 months of age with skin and skin-structure infections (including impetigo) caused by S. aureus (penicillinase- and non-penicillinase-producing strains), S. pyogenes, E. coli, Klebsiella spp., and Enterobacter spp.

Surgical prophylaxis (injection only): Prophylaxis of infection in patients undergoing surgical procedures that are classified as clean-contaminated or potentially contaminated procedures.

Urinary tract infections (tablets and injection only): Treatment of adults and pediatric patients >3 months of age with urinary tract infections caused by E. coli and Klebsiella spp.

Off Label Uses

Bite wound, prophylaxis or treatment (animal or human bite)

Based on the Infectious Diseases Society of America (IDSA) guidelines for the diagnosis and management of skin and soft tissue infections (SSTIs), Stacey, in combination with an agent appropriate for anaerobes, is an effective and recommended alternative option for prophylaxis and treatment of animal bite wounds.

Clinical experience also suggests the utility of Stacey as an alternative agent for prophylaxis and treatment of human bite wounds.

Intraabdominal infection, community-acquired (mild to moderate infection in low-risk patients)

Based on the Surgical Infection Society/IDSA guidelines for the diagnosis and management of complicated intraabdominal infection in adults and children, Stacey, in combination with metronidazole, is an effective and recommended empiric treatment option for the management of community-acquired intraabdominal infection, and, as monotherapy, for the management of mild to moderate acute cholecystitis.

Lyme disease (Borrelia spp. infection), early disseminated or late disease

Based on the IDSA guidelines for the clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis, Stacey is effective and recommended for the treatment of early disseminated Lyme disease (isolated facial nerve palsy [alternative agent] or mild carditis) or late Lyme disease (arthritis without neurologic involvement).

Stacey description

Stacey (as axetil) (Stacey) 250 mg Tablet: Each tablet contains 250 mg of Stacey (as axetil).

Stacey (as axetil) (Stacey) 500 mg Tablet: Each tablet contains 500 mg of Stacey (as axetil).

Stacey (as axetil) (Stacey) 125 mg/5 mL Granules for Suspension: Each contains 125 mg Stacey (as axetil) per teaspoon (5 mL) of suspension.

Stacey (as axetil) (Stacey) 250 mg/5 mL Granules for Suspension: Each contains 250 mg Stacey (as axetil) per teaspoon (5 mL) of suspension.

Sachet: Stacey (as axetil) (Stacey) 125 mg Granules for Suspension: Each 4.22 g of single-use sachet contains 125 mg Stacey (as axetil).

Stacey dosage

Tablet: The usual course of therapy is seven days (range 5 to 10 days).

Stacey should be taken after food for optimum absorption.

Sequential Therapy: Pneumonia: 1.5 g Stacey sodium (Stacey) three times a day or twice a day [intravenous (i.v.) or intramuscular (i.m.)] for 48 to 72 hours, followed by Stacey oral therapy 500 mg twice a day for 7 to10 days.

Acute Exacerbations of Chronic Bronchitis: 750 mg Stacey sodium (Stacey) three times a day or twice a day (i.v. or i.m.) for 48 to 72 hours, followed by Stacey oral therapy 500 mg twice a day for 5 to 10 days.

Duration of both parenteral and oral therapy is determined by the severity of the infection and the clinical status of the patient.

Stacey tablets should not be crushed and are therefore unsuitable for treatment of patients, such as younger children, who cannot swallow tablets. In children Stacey oral suspension may be used.

There is no experience of using Stacey in children under the age of 3 months.

Injection: Stacey (as sodium) (Stacey) Injection is for intravenous (i.v.) and/or intramuscular (i.m.) administration. Stacey (as sodium) (Stacey) is also available as the axetil ester Stacey (as axetil) (Stacey) for oral administration. This permits the use of sequential therapy with the same antibiotic, when a change from parenteral to oral therapy is clinically indicated.

No more than 750 mg should be injected at one intramuscular site.

General Dosing Recommendations: Adults: Many infections respond to 750 mg three times daily by i.m. or i.v. injection. For more severe infections the dose should be increased to 1.5 g three times daily given i.v. The frequency of administration may be increased to 6-hourly if necessary, giving total daily doses of 3 to 6 g. Where clinically indicated, some infections respond to 750 mg or 1.5 g twice daily (i.v. or i.m.) followed by oral therapy with Stacey (as axetil) (Stacey).

Infants and Children: 30 to 100 mg/kg/day given as 3 or 4 divided doses. A dose of 60 mg/kg/day is appropriate for most infections.

Neonates: 30 to 100 mg/kg/day given as 2 or 3 divided doses..

Gonorrhea: Adults: 1.5 g as a single dose (as 2 x 750 mg injections given i.m. with different sites e.g. each buttock).

Meningitis: Stacey (as sodium) (Stacey) is suitable for sole therapy of bacterial meningitis due to sensitive strains.

Adults: 3 g given i.v. every 8 hours.

Infants and Children: 150 to 250 mg/kg/day given i.v. in 3 or 4 divided doses

Neonates: The dosage should be 100 mg/kg/day given i.v.

Prophylaxis: The usual dose is 1.5 g given i.v. with induction of anaesthesia for abdominal, pelvic and orthopaedic operations. This may be supplemented with two 750 mg i.m. doses 8 and 16 hours later.

In cardiac, pulmonary, oesophageal and vascular operations, the usual dose is 1.5 g given i.v. with induction of anaesthesia, continuing with 750 mg given i.m. three times daily for a further 24 to 48 hours.

In total joint replacement, 1.5 g Stacey (as sodium) (Stacey) powder may be mixed dry with each pack of methyl methacrylate cement polymer before adding the liquid monomer.

Sequential Therapy: Adults: Duration of both parenteral and oral therapy is determined by the severity of the infection and the clinical status of the patient.

Pneumonia: 1.5 g Stacey (as sodium) (Stacey) three times daily or twice daily (given i.v. or i.m.) for 48 to 72 hours, followed by 500 mg twice daily Stacey (as axetil) (Stacey) (Stacey) oral therapy for 7 to 10 days.

Acute Exacerbations of Chronic Bronchitis: 750 mg Stacey (as sodium) (Stacey) three times daily or twice daily (given i.v. or i.m.) for 48 to 72 hours, followed by 500 mg twice daily Stacey (as axetil) (Stacey) (Stacey) oral therapy for 5 to 10 days.

Renal Impairment: Tablet: Stacey is primarily excreted by the kidneys. In patients with markedly impaired renal function it is recommended that the dosage of Stacey be reduced to compensate for its slower excretion.

Stacey is also available as the axetil ester for oral administration. This permits parenteral therapy with Stacey to be followed by oral therapy in situations where a change from parenteral to oral is clinically indicated.

Injection: Stacey is excreted by the kidneys. Therefore, as with all such antibiotics, in patients with markedly impaired renal function it is recommended that the dosage of Stacey (as sodium) (Stacey) should be reduced to compensate for its slower excretion.

It is not necessary to reduce the standard dose (750 mg to 1.5 g three times daily) until the creatinine clearance falls to 20 mL/min or below.

In adults with marked impairment (creatinine clearance 10 to 20 mL/min) 750 mg twice daily is recommended and with severe impairment (creatinine clearance <10 mL/min) 750 mg once daily is adequate.

For patients on haemodialysis a further 750 mg dose should be given i.v. or i.m. at the end of each dialysis. In addition to parenteral use, Stacey (as sodium) (Stacey) can be incorporated into the peritoneal dialysis fluid (usually 250 mg for every 2 litres of dialysis fluid).

For patients in renal failure on continuous arteriovenous haemodialysis or high-flux haemofiltration in intensive therapy units a suitable dosage is 750 mg twice daily. For low-flux haemofiltration follow the dosage recommended under impaired renal function.

Stacey interactions

See also:
What other drugs will affect Stacey?

Tablet: Drugs which reduce gastric acidity may result in a lower bioavailability of Stacey tablet compared with that of the fasting state and tend to cancel the effect of enhanced postprandial absorption.

In common with other antibiotics, Stacey may affect the gut flora, leading to lower estrogen reabsorption and reduced efficacy of combined oral contraceptives.

As a false negative result may occur in the ferricyanide test, it is recommended that either the glucose oxidase or hexokinase methods are used to determine blood/plasma glucose levels in patients receiving Stacey. Stacey does not interfere in the alkaline picrate assay for creatinine.

Injections: Stacey sodium does not interfere in enzyme-based tests for glycosuria.

Slight interference with copper reduction methods (Benedict's, Fehling's, Clinitest) may be observed. However, this does should not lead to false-positive results, as may be experienced with some other cephalosporins.

Incompatibilities: Stacey injection should not be mixed in the syringe with aminoglycoside antibiotics.

The pH of sodium bicarbonate 2.74% w/v injection considerably affects the color of the solution and therefore, this solution is not recommended for the dilution of Stacey injection. However, if required, for patients receiving sodium bicarbonate injection by infusion Stacey injection may be introduced into the tube of the giving set.

Stacey side effects

See also:
What are the possible side effects of Stacey?

Stacey (Stacey (Stacey injection) injection) is generally well tolerated. The most common adverse effects have been local reactions following IV administration. Other adverse reactions have been encountered only rarely.

Local Reactions: Thrombophlebitis has occurred with IV administration in 1 in 60 patients.

Gastrointestinal: Gastrointestinal symptoms occurred in 1 in 150 patients and included diarrhea (1 in 220 patients) and nausea (1 in 440 patients). The onset of pseudomembranous colitis may occur during or after antibacterial treatment.

Hypersensitivity Reactions: Hypersensitivity reactions have been reported in fewer than 1% of the patients treated with Stacey (Stacey (Stacey injection) injection) and include rash (1 in 125). Pruritus, urticaria, and positive Coombs' test each occurred in fewer than 1 in 250 patients, and, as with other cephalosporins, rare cases of anaphylaxis, drug fever, erythema multiforme, interstitial nephritis, toxic epidermal necrolysis, and Stevens-Johnson syndrome have occurred.

Blood: A decrease in hemoglobin and hematocrit has been observed in 1 in 10 patients and transient eosinophilia in 1 in 14 patients. Less common reactions seen were transient neutropenia (fewer than 1 in 100 patients) and leukopenia (1 in 750 patients). A similar pattern and incidence were seen with other cephalosporins used in controlled studies. As with other cephalosporins, there have been rare reports of thrombocytopenia.

Hepatic: Transient rise in SGOT and SGPT (1 in 25 patients), alkaline phosphatase (1 in 50 patients), LDH (1 in 75 patients), and bilirubin (1 in 500 patients) levels has been noted.

Kidney: Elevations in serum creatinine and/or blood urea nitrogen and a decreased creatinine clearance have been observed, but their relationship to Stacey (Stacey (Stacey injection) injection) is unknown.

Postmarketing Experience with Stacey (Stacey (Stacey injection) injection) : In addition to the adverse events reported during clinical trials, the following events have been observed during clinical practice in patients treated with Stacey (Stacey (Stacey injection) injection) and were reported spontaneously. Data are generally insufficient to allow an estimate of incidence or to establish causation.

Neurologic: Seizure.

Non-site specific: Angioedema.

Cephalosporin-class Adverse Reactions: In addition to the adverse reactions listed above that have been observed in patients treated with Stacey (Stacey (Stacey injection) injection), the following adverse reactions and altered laboratory tests have been reported for cephalosporin-class antibiotics:

Adverse Reactions: Vomiting, abdominal pain, colitis, vaginitis including vaginal candidiasis, toxic nephropathy, hepatic dysfunction including cholestasis, aplastic anemia, hemolytic anemia, and hemorrhage.

Several cephalosporins, including Stacey (Stacey (Stacey injection) injection), have been implicated in triggering seizures, particularly in patients with renal impairment when the dosage was not reduced. If seizures associated with drug therapy should occur, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated.

Altered Laboratory Tests: Prolonged prothrombin time, pancytopenia, agranulocytosis.

Stacey contraindications

See also:
What is the most important information I should know about Stacey?

Stacey (Stacey (Stacey injection) injection) for Injection USP and Dextrose Injection USP is contraindicated in patients with known allergy to the cephalosporin group of antibiotics. Solutions containing dextrose may be contraindicated in patients with hypersensitivity to corn products.

Active ingredient matches for Stacey:

Cefuroxime in India.

Cefuroxime axetil in India.

References

1. PubChem. "cefuroxime". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
2. DrugBank. "cefuroxime". http://www.drugbank.ca/drugs/DB01112 (accessed September 17, 2018).
3. MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology