Alembic C4ALL Cefquinome Sulphate Injection for Dogs | 4th Generation Cephalosporin | Broad-Spectrum Veterinary Antibiotic | 50mg / 100mg

PRESCRIPTION VETERINARY MEDICINE — For veterinary use only. Must be prescribed and dispensed by or under the supervision of a licensed veterinarian. FOR USE IN DOGS ONLY as sold in this listing. Administer by subcutaneous (SC) or intramuscular (IM) injection as directed. Do not administer intravenously unless specifically directed by a veterinarian. Shake well before use. Keep out of reach of children. Store at 2–8°C (refrigerate); do not freeze.

Alembic C4ALL Cefquinome Sulphate Injection for Dogs | 4th Generation Cephalosporin Broad-Spectrum Veterinary Antibiotic | 50mg / 100mg

Alembic C4ALL is a veterinary-grade injectable antibiotic for dogs containing Cefquinome Sulphate — a 4th-generation (extended-spectrum) cephalosporin of the beta-lactam antibiotic class. Cefquinome is the only cephalosporin developed exclusively for veterinary use and is designated as a Critically Important Antimicrobial (CIA) by the World Health Organisation (WHO) and the World Organisation for Animal Health (WOAH/OIE). C4ALL is indicated for the treatment of serious and systemic bacterial infections in dogs caused by susceptible Gram-positive and Gram-negative organisms, including infections resistant to earlier-generation beta-lactams. Administer strictly as prescribed by a licensed veterinarian following culture and sensitivity testing where possible.

Active Ingredient & Mechanism of Action

• Cefquinome Sulphate — 4th generation cephalosporin — beta-lactam cell wall synthesis inhibitor: Cefquinome is a semi-synthetic aminothiazolyl oxyimino cephalosporin with a zwitterionic structure (positively charged quaternary ammonium group on the C-3 side chain at physiological pH) that enables rapid outer membrane (OM) penetration of Gram-negative bacteria via OmpF and OmpC porin channels without relying on active uptake; the beta-lactam ring of Cefquinome irreversibly acylates the active-site serine residue of penicillin-binding proteins (PBPs) — specifically PBP1a, PBP1b, PBP2, and PBP3 in Gram-negative bacteria, and PBP1, PBP2, and PBP3 in Gram-positive bacteria; PBPs are the DD-transpeptidases, DD-carboxypeptidases, and DD-endopeptidases responsible for the final transpeptidation cross-linking reaction in peptidoglycan cell wall biosynthesis (formation of the 4−3 interpeptide bond between the D-Ala at position 4 of one stem peptide and the meso-DAP or L-Lys at position 3 of an adjacent stem peptide); covalent Cefquinome-PBP adduct formation blocks transpeptidation, preventing new peptidoglycan crosslinks — existing crosslinks are continuously cleaved by bacterial autolysins (N-acetylmuramyl-L-alanine amidase, endopeptidase, lytic transglycosylase) as part of normal cell wall remodelling; without new crosslinks to replace those cleaved by autolysins, the peptidoglycan layer loses structural integrity → loss of osmotic protection → cell lysis and bactericidal killing; the 4th-generation classification of Cefquinome reflects its enhanced stability against beta-lactamase enzymes (AmpC-type chromosomal cephalosporinases in Gram-negative Enterobacteriaceae — produced constitutively or inducibly by Enterobacter spp., Citrobacter freundii, Serratia spp., Morganella morganii, Providencia spp. — the CESCAPE/ESCPM group) compared to 3rd-generation cephalosporins; Cefquinome’s zwitterionic outer membrane penetration, combined with AmpC stability and broad PBP affinity, produces bactericidal activity against both Gram-positive cocci (Staphylococcus pseudintermedius, Staphylococcus aureus, Streptocephalides canis) and Gram-negative rods (Escherichia coli, Klebsiella pneumoniae, Pasteurella spp., Proteus mirabilis, Pseudomonas aeruginosa — with variable activity)
• Spectrum of antimicrobial activity: Gram-positive: Staphylococcus pseudintermedius (MSSP — methicillin-susceptible; not for MRSP), Staphylococcus aureus (MSSA), Streptococcus canis, Streptococcus equi; Gram-negative: Escherichia coli (including some AmpC-producing strains), Klebsiella pneumoniae, Pasteurella multocida, Proteus mirabilis, Haemophilus influenzae; variable: Pseudomonas aeruginosa (confirm MIC susceptibility with culture before use); NOT active against: MRSA, MRSP (methicillin-resistant Staphylococci), ESBL (extended-spectrum beta-lactamase)-producing Enterobacteriaceae, anaerobes (limited activity), Enterococcus spp. (intrinsically resistant)

Indications in Dogs

• Respiratory tract infections — bacterial pneumonia, bronchopneumonia (Pasteurella spp., Klebsiella spp., E. coli)
• Urinary tract infections (UTI) — bacterial cystitis, pyelonephritis (E. coli, Proteus mirabilis, Klebsiella spp.)
• Skin and soft tissue infections — deep pyoderma, cellulitis, abscesses, wound infections (Staphylococcus pseudintermedius, Streptococcus canis)
• Systemic bacterial infections and septicaemia — when caused by susceptible organisms and when oral antibiotic therapy is insufficient
• Post-operative infection prevention and treatment under veterinary direction

Dosage & Administration

• Administer by subcutaneous (SC) or intramuscular (IM) injection; confirm route with veterinarian
• Dose based on body weight (mg/kg) and indication — follow veterinarian’s prescription exactly
• Available in 50mg and 100mg vials — select appropriate strength per veterinarian’s prescription
• Shake well before use; use aseptic technique for vial entry and injection
• Complete the full prescribed course even if clinical improvement is apparent — incomplete courses increase the risk of antimicrobial resistance development

Antimicrobial Stewardship & Responsible Use

• Cefquinome is classified as a Critically Important Antimicrobial (CIA) by WHO and WOAH — reserved for cases where first-line antibiotics have failed or are contraindicated, and ideally used on the basis of culture and sensitivity testing
• Do not use for viral infections (viral respiratory infections, parvovirus, distemper) — antibiotics are ineffective against viruses; use only for confirmed or strongly suspected bacterial infections
• Do not use prophylactically without veterinary justification
• Complete the full course — incomplete antibiotic courses are a primary driver of antimicrobial resistance (AMR)

Contraindications & Safety

• Do not use in dogs with known hypersensitivity (allergy) to cephalosporins or penicillins — cross-reactivity between cephalosporins and penicillins occurs due to shared beta-lactam ring structure (estimated 1–10% cross-reactivity rate; particularly with 1st-generation cephalosporins)
• Use with caution in dogs with renal impairment — cephalosporins are primarily renally excreted; dose adjustment may be required
• Safety in pregnant and lactating bitches has not been fully established — confirm with veterinarian
• Most common adverse effects: pain at injection site, mild transient GI signs; rare hypersensitivity reactions (urticaria, angioedema, anaphylaxis — have adrenaline/epinephrine available)
• Refrigerate at 2–8°C; do not freeze; keep in original packaging; use within shelf-life stated on label