If complex infections are found that penicillin-based antibiotics cannot cope with, doctors prescribe Azithromycin. For children (instructions for use indicate this), this drug has a very strong effect, in some cases it can even interfere with the functioning of a completely unformed body, so you need to take it with minimal doses.
Release form and composition
The preparation consists of the active substance azithromycin and auxiliary excipients, with the help of which the tablets are given a traditional form. Thanks to these substances, the absorption of the drug is better.
In connection with the wide spectrum of antibiotic use in modern pharmacology, various forms of drug release are used:
- Hard gelatin capsules with a blue body and a blue cap, inside of which is a white or light yellow powder (or compacted mass). When pressed, they break up. In addition to the active substance, capsules contain microcrystalline cellulose, sodium lauryl sulfate and magnesium stearate.
- Azithromycin (125) describes instructions for use in children as tablets in a blue film coating, round, biconvex. On the one hand there is an engraving “PLIVA” on them, on the other - “125”. If you break it, you can see that the tablet is white in fracture. It consists of the following adjuvants: anhydrous calcium hydrogen phosphate, hypromellose, corn starch, microcrystalline cellulose, pregelatinized starch, sodium lauryl sulfate and magnesium stearate.
- The drug "Azithromycin" for children recommends taking the instructions for use in the form of a suspension, so in pharmacies you can buy a special powder for its preparation that has a cherry or banana odor.
The cost of an antibiotic increases depending on the content of the active substance.
Pharmacological characteristics
"Azithromycin" refers to broad-spectrum antibiotics. When creating high concentrations in the focus of inflammation, the death of microorganisms occurs.
Gram-positive cocci are most sensitive to the action of the drug: Streptococcus pneumoniae, streptococci of CF and G groups, Staphylococcus aureus, St. Pyogenes, St. Viridans, St. Agalactiae; gram-negative bacteria: Moraxella catarrhalis, H. Ducrei, Haemophilus influenzae, Legionella pneumophila, Bordetella pertussis, Neisseria gonorrhoeae, B. Parapertussis, Gardnerella vaginalis and Campylobacter jejuni; anaerobic microorganisms: Chlamydia trachomatis, Bacteroides bivius, Ureaplasma urealyticum, Peptostreptococcus spp, Clostridium perfringens, Borrelia burgdoferi, Treponema pallidum and Mycoplasma pneumoniae. Gram-positive bacteria resistant to erythromycin convert the antibiotic to an inactive form.
Pharmacokinetics
"Azithromycin" for children (instructions for use indicates this) is rapidly absorbed in the digestive tract due to its resistance to acidic environment and lipophilicity. It is quickly distributed throughout the body. It easily penetrates not only the respiratory tract, soft tissues and skin, but also into the organs of the urogenital tract. As a result of the low binding of azithromycin and serum proteins, the ability to penetrate eukaryotic cells and concentrate in a medium with a low hydrogen index surrounding the lysosomes, the half-life and concentration in the tissues increase.
All this determines a high indicator of the volume of distribution (31.1 liters per kilogram) and a large plasma clearance. For the destruction of intracellular pathogens, the ability of Azithromycin to accumulate directly in lysosomes is of no small importance.
Thanks to phagocytes, the drug enters the site of infection, where it is released during phagocytosis. After 12-72 hours after ingestion in the focus of inflammation, a high concentration of the drug is achieved, which is significantly higher than the minimum inhibitory concentration for pathogens.
As already mentioned, the half-life process is long, so, for example, it will take from 60 to 76 hours to remove from the tissues. The bactericidal concentration of the drug is maintained in places of inflammation for 5-7 days after the last dose, so it is possible to use the antibiotic once a day, and the course of treatment is no more than a week.
"Azithromycin" is excreted mainly with bile, and only a small part - with urination.
Indications for admission
"Azithromycin" instructions for use by children are recommended for infectious and inflammatory diseases that are provoked by bacteria sensitive to azithromycin. Such diseases include: pneumonia, bronchitis, sinusitis, pharyngitis, infections of soft tissues and skin, tonsillitis, otitis media, Lyme disease and urethritis. If pneumonia is suspected, pediatricians usually prescribe antibiotics without delay, even without the results of an X-ray examination. Treatment of this disease should begin in a timely manner, otherwise you may encounter the most sad consequences. In this case, the antibiotic is chosen taking into account all the symptoms, the suspected pathogen, and the clinical picture as a whole. When determining the microorganism that caused the infection, the age of the child is taken into account. If pneumonia is suspected in a baby aged 1 to 6 months, then. most likely, the causative agent is Staphylococcus aureus, from one to six years old is Streptococcus pneumoniae. With both types of bacteria, Azithromycin effectively fights.
Mode of application
The treatment regimen will depend on the disease, however, the total dose should be maintained. The doctor may prescribe the drug "Azithromycin" for children. The instructions for use of the tablet are allowed to be taken only by adults, since they contain from 250 to 500 mg of the active substance, and this amount is calculated on a rather large mass. The fact is that the tablets must be swallowed whole, they are not recommended to be broken or chewed, therefore, it will not be possible to maintain the recommended single-use dosage (10 mg / kg). It is for this reason that adolescents are prescribed Azithromycin as an antibacterial agent (125). The instruction for use for children does not allow tablets to be taken up to 12 years old; they can be replaced with syrup or suspension.
For the treatment of acute inflammatory diseases of the respiratory tract, otitis media, pneumonia, a single dose of the drug is prescribed (10 mg / kg). The drug "Azithromycin" (125) recommends taking the tablets for children only after reaching the age of 14. Treatment of babies is carried out exclusively using a suspension.
It should be noted that 5 grams of Sumamed syrup (a teaspoon) and other analogues of the drug also contain 125 mg of the active substance. Accordingly, the standard dose for older children is 1-2 tablespoons depending on weight. Over the next four days, treatment continues, but the dosage is reduced to 5 mg / kg. In the case of a severe course of the disease, the dose can be doubled, however, in this situation, the use of an antibiotic is permissible only under the supervision of a specialist. The drug "Azithromycin" (125), the instructions for use for children can be used only in the case of a single or double dose at a dose of 30 mg / kg body weight.
Contraindications
The drug "Azithromycin" for children instructions for use prohibits taking with a weight of less than five kilograms. In addition, it is contraindicated in patients with hypersensitivity to the components contained in the composition or to other macrolide antibiotics. This drug is in no case allowed to be used for severe hepatic and renal failure.
Overdose and side effects
For those mothers who will use the drug "Azithromycin" for children, the instructions for use (patient reviews about taking the antibiotic are presented in this material) provides a list of side effects. From the lymphatic system and blood formation, thrombocytopenia is possible.
Patients show aggressiveness, hyperactivity, nervousness and anxiety. From the nervous system, dizziness, cramps, headaches, drowsiness, and even fainting are possible. In rare cases, taking the drug causes insomnia, asthenia, paresthesia, and the perception of odors and taste is also impaired.
Infrequently, macrolides (a group of drugs whose chemical structure is based on a macrocyclic 14- or 16-membered lactone ring with attached carbohydrate residues), to which Azithromycin belongs, lead to hearing impairment. Rarely, but still there are side effects of a dyspeptic nature and allergic reactions occur.
"Azithromycin" instructions for use for children can be used, however, for children, the drug can be taken only in the form of a suspension. For older children, the capsule form of the antibiotic is also suitable. Before using the medicine, you must obtain the permission of the doctor and carefully read the instructions enclosed in the package.
Overdose may be indicated by diarrhea, temporary hearing loss, nausea and vomiting. In case of exceeding the recommended doses, you need to immediately rinse the stomach, and then proceed to symptomatic therapy.
special instructions
The use of "Azithromycin" during pregnancy is extremely undesirable, but permissible if it is impossible to help a woman without its use (the effect of the drug on fetal development is not 100% studied). During the lactation period, when using an antibiotic at the time of treatment, it is necessary to interrupt breastfeeding.
Children under 12 years old should choose the analogue of Azithromycin.
Alcohol intake does not affect the effect of the drug, however, during its use, the course of any disease is exacerbated. Therefore, it is recommended to reduce the amount of alcohol consumed to the maximum, and even better, completely refuse the treatment time.
Drug interaction
When taking "Azithromycin" with antacids containing calcium, magnesium and aluminum, the absorption of the antibiotic slows down, therefore, a 2-hour interval between doses of these drugs must be observed.
The main difference between this medication and other macrolide antibiotics is the lack of communication with the isoenzymes of the cytochrome system. Therefore, when taken with "Theophylline", "Carbamazepine", "Digoxin", "Terfenadine" and "Triazolam" no interaction is observed.
If the drug is used with Warfarin, it is necessary to control the prothrombin time.
Lincosamides reduce the effectiveness of the antibiotic, and chloramphenicol and tetracycline increase.
Terms and conditions of storage
It is recommended to store the antibiotic out of the reach of children at temperatures up to 25 degrees. The shelf life is indicated by the instructions for use available for the drug "Azithromycin" (for children). The suspension prepared can be stored for no more than 5 days, the powder itself - 2 years, and tablets and capsules - up to 3 years.
Analogues and opinions of patients
Those who used "Azithromycin" for children (the instruction for use of the capsule does not recommend taking in childhood), the reviews were mostly positive. After the first administration of an antibiotic, significant improvements are distinguished, progressing in the future.
The analogues of the drug include "Azitsin", "Zomax", "Sumamed", "Azitral", "Azax", "Zitroks" and others.