Assurem Nufodoxime-CV Dry Syrup 30ml | Pyoderma, RTI & UTI

FOR VETERINARY USE ONLY. Assurem Nufodoxime-CV Dry Syrup is a veterinary prescription antibiotic containing Cefpodoxime Proxetil and Potassium Clavulanate. It must not be dispensed without a valid prescription from a Registered Veterinary Practitioner (RVP) under the Drugs and Cosmetics Act, 1940. Do not use in animals with known hypersensitivity to cephalosporins, penicillins, or other beta-lactam antibiotics (cross-reactivity exists within the beta-lactam class). Complete the full prescribed course — premature discontinuation promotes antibiotic resistance and clinical relapse. After reconstitution with the specified volume of purified water, store the suspension in a refrigerator (2–8°C) and use within 10 days; discard any unused portion after this period. Keep out of reach of children.

Assurem Nufodoxime-CV Dry Syrup 30ml | Cefpodoxime Proxetil 50mg + Clavulanic Acid 31.25mg per 5ml | 3rd-Generation Cephalosporin + Beta-Lactamase Inhibitor | Pyoderma, RTI & UTI | Schedule H Rx

Assurem Nufodoxime-CV Dry Syrup is a veterinary prescription antibiotic oral suspension manufactured by Assurem, containing Cefpodoxime Proxetil (equivalent to Cefpodoxime Anhydrous 50mg per 5ml) combined with Potassium Clavulanate Diluted I.P. (equivalent to Clavulanic Acid 31.25mg per 5ml). Cefpodoxime is a third-generation oral cephalosporin (prodrug ester formulation: Cefpodoxime Proxetil is the 1-[(isopropoxycarbonyl)oxy]ethyl ester of Cefpodoxime — the proxetil ester moiety is cleaved by intestinal brush-border esterases after oral absorption, releasing active Cefpodoxime into systemic circulation) with a broad-spectrum bactericidal activity profile encompassing gram-positive and gram-negative pathogens relevant to veterinary skin, respiratory, and urinary tract infections. Clavulanic Acid is a mechanism-based irreversible beta-lactamase inhibitor (suicide inhibitor) that protects Cefpodoxime from inactivation by beta-lactamase-producing organisms, extending the antibacterial spectrum to include beta-lactamase-producing strains of Staphylococcus pseudintermedius, Pasteurella multocida, and Proteus mirabilis. The 30ml dry syrup bottle is reconstituted with purified water immediately before dispensing, yielding a palatable oral suspension for accurate weight-based dosing in dogs.

Microbiology: Bacterial Pathogens, Beta-Lactam Resistance, and the Cefpodoxime-Clavulanate Strategy

• Cephalosporin antibiotics and the beta-lactam pharmacophore: beta-lactam antibiotics (penicillins, cephalosporins, carbapenems, monobactams) all share the four-membered beta-lactam ring (2-azetidinone) as their pharmacophore — the strained amide bond of the beta-lactam ring is the electrophilic warhead that acylates the active-site serine of penicillin-binding proteins (PBPs); cephalosporins (7-aminocephalosporanic acid [7-ACA] nucleus: the bicyclic beta-lactam-dihydrothiazine ring system, distinguished from penicillin's beta-lactam-thiazolidine bicyclic nucleus by the six-membered dihydrothiazine ring) are grouped into generations based on antimicrobial spectrum; 3rd-generation cephalosporins (cefpodoxime, cefovecin, ceftiofur) have: broad gram-positive and gram-negative coverage; enhanced stability to most plasmid-mediated class A and some class C beta-lactamases; superior PBP3 affinity in gram-negative bacteria; cefpodoxime's antibacterial spectrum covers: gram-positive: Staphylococcus pseudintermedius (methicillin-susceptible strains [MSSP]; methicillin-resistant S. pseudintermedius [MRSP] carrying mecA/mecC encoding PBP2a is resistant to all beta-lactams); Streptococcus canis (group G streptococcus; intrinsically cephalosporin-susceptible); gram-negative: Pasteurella multocida; Proteus mirabilis; Escherichia coli (uncomplicated, non-ESBL-producing strains); Klebsiella pneumoniae (non-ESBL strains)
• Beta-lactamase-mediated resistance and clavulanic acid as a mechanism-based inhibitor: beta-lactamases (the penicillin amidohydrolases that hydrolyse the beta-lactam C-N bond, producing ring-opened, microbiologically inactive products) are the primary mechanism of beta-lactam resistance in veterinary pathogens; Ambler classification: Class A serine beta-lactamases (TEM, SHV, CTX-M, PC1/BlaZ) — Class A includes: PC1 staphylococcal penicillinase (S. pseudintermedius penicillinase; narrow-spectrum; efficiently hydrolyses penicillin G and amoxicillin but NOT 3rd-generation cephalosporins; inhibited by clavulanic acid); ESBL variants (CTX-M-type ESBLs hydrolyse extended-spectrum cephalosporins including cefpodoxime; partially inhibited by clavulanic acid in vitro but cefpodoxime-clavulanate is not reliably effective against confirmed ESBL-producing E. coli in clinical practice); Class C AmpC beta-lactamases (chromosomal cephalosporinases of Enterobacter, Pseudomonas; NOT inhibited by clavulanic acid); Class B metallo-beta-lactamases (NDM, VIM; NOT inhibited by clavulanic acid); clavulanic acid mechanism-based (suicide) inhibition of Class A beta-lactamases: (1) recognition: clavulanic acid binds the Class A active-site serine (Ser70) non-covalently, mimicking the beta-lactam substrate; (2) acylation: Ser70 attacks the clavulanic acid beta-lactam carbonyl → covalent acyl-enzyme intermediate; (3) irreversible inactivation: the acyl-enzyme undergoes ring-opening and enamine rearrangement → stable, non-hydrolysable modified enzyme species → irreversible inactivation; each clavulanic acid molecule stoichiometrically and irreversibly inactivates one beta-lactamase molecule, providing sustained protection to co-administered cefpodoxime
• Cefpodoxime PBP targeting and bactericidal mechanism: penicillin-binding proteins (PBPs) are the DD-transpeptidase and transglycosylase enzymes that cross-link the peptidoglycan cell wall; cefpodoxime preferentially acylates PBP2 and PBP3 in S. pseudintermedius and PBP3/FtsI (the essential cell division transpeptidase) in gram-negative bacteria; the PBP acylation mechanism: the cefpodoxime beta-lactam carbonyl is attacked by the PBP active-site serine (SXXK motif Ser) → covalent acyl-enzyme intermediate (cefpodoxime-O-Ser-PBP) that deacylates extremely slowly (half-life of hours) → effectively permanent PBP inactivation during drug exposure; bactericidal consequence: PBP inhibition → failure of peptidoglycan cross-link formation during cell division → accumulation of mechanically weak, uncross-linked peptidoglycan → osmotic lysis; pharmacodynamic driver: cefpodoxime is time-dependent (T>MIC — the percentage of the dosing interval with free plasma concentration above the MIC is the PK/PD target for bactericidal effect; target T>MIC: 40–60% of the dosing interval)

Composition (per 5ml reconstituted suspension)

• Cefpodoxime Proxetil I.P. — equivalent to Cefpodoxime Anhydrous 50mg
• Potassium Clavulanate Diluted I.P. — equivalent to Clavulanic Acid 31.25mg
• Excipients q.s.; Colour: Tartrazine
• Net volume: 30ml (after reconstitution of dry syrup)
• Schedule H Prescription Drug — valid veterinary prescription required for dispensing

Indications

• Pyoderma (superficial and deep) — S. pseudintermedius and beta-lactamase-producing staphylococcal skin infections in dogs
• Wounds and soft tissue infections — including abscesses and infected bite wounds
• Respiratory tract infections (RTIs) — including tracheobronchitis and Pasteurella-associated pneumonia
• Urinary tract infections (UTIs) — susceptible E. coli and Proteus mirabilis lower UTIs in dogs

Directions for Use (under veterinary prescription only)

• Administer orally as directed by a Registered Veterinary Practitioner; a valid Schedule H prescription is legally required
• Recommended dose: 5–10 mg/kg body weight (Cefpodoxime equivalent), once daily, or as directed by the prescribing veterinarian
• Reconstitution: add the specified volume of purified/cooled boiled water to the dry powder; shake well until completely dissolved; shake before each dose
• Treatment duration: deep pyoderma: minimum 17–21 days plus 10–14 days post-clinical remission; superficial pyoderma: minimum 12–15 days plus 7–10 days post-clinical recovery; RTI and UTI: 10–14 days; or as prescribed
• After reconstitution: store in a refrigerator (2–8°C); use within 10 days; discard any unused portion

Contraindications

• Known hypersensitivity to cephalosporins, penicillins, or other beta-lactam antibiotics
• Animals with severe renal impairment (dose adjustment required; consult prescribing veterinarian)

Safety Information

• Schedule H Rx — for veterinary prescription use only; dispensing without a valid prescription is an offence under the Drugs and Cosmetics Act, 1940
• Complete the full prescribed course — premature discontinuation promotes resistance and clinical relapse
• After reconstitution: refrigerate at 2–8°C; use within 10 days; do not freeze
• Mild adverse effects: transient GI signs (vomiting, diarrhoea, inappetence) may occur; usually self-limiting; may administer with food if GI upset occurs
• Store dry syrup below 25°C in a cool, dry place before reconstitution; keep out of reach of children