Antibiotic "Tienam": purpose, release form, dosage, dosage, composition, indications and contraindications

"Tienam" is a highly effective antibiotic with a powerful bactericidal effect. The drug is active against both aerobic and anaerobic pathogens.

"Tienam" is available in powder form for the preparation of a suspension, as well as a solution for intramuscular injection. The powdery mass has a yellowish-white hue, dispensed from drugstores in glass bottles, as in the photo. "Tienam" - effective against many groups of microorganisms.

The active components of the drug are:

• imipenem;
• Cilastatin sodium is sterile.

An additional substance is sterile sodium bicarbonate. Tienam tablets do not exist.

Pharmacological actions

The drug has a bactericidal and antimicrobial effect. Its pharmacological effects are due to the properties of two active substances that are part of the structure of the drug:

1. Active substances have a bactericidal effect in relation to a wide range of various aerobic and anaerobic pathogenic microorganisms, both gram-positive and gram-negative.
2. The drug exhibits increased resistance to the breakdown of bacterial lactamases, which ensures its activity against many microorganisms that are resistant to most other antibiotics.

Tien belongs to the group of antibiotics for systemic use.

According to the results of confirmed studies, the following microorganisms are sensitive to imipenem:

1. Enterococcus fecal.
2. Staphylococcus aureus.
3. Epidermal staphylococcus.
4. Pneumococcus.
5. Streptococcus agalactia.
6. Streptococcus pyogenes.
7. Acinetobacter.
8. Enterobacteria.
9. Citrobacter.
10. E. coli.
11. Haemophilus influenzae infection.
12. Gardnerella vaginalis.
13. Morganella Morgan.
14. Klebsiella.
15. Changeable Proteus.
16. Proteus.

Indications

According to the instructions, Tienam 500 mg + 500 mg is used to eliminate moderate and severe infections provoked by pathogenic microbes, for example:

1. Pneumonia (damage to the lung tissue, usually of infectious origin with a major infection of the alveoli).
2. Bronchitis (a disease of the respiratory system in which the bronchi are involved in the inflammatory process).
3. Intraabdominal infections (a number of inflammatory diseases, the causative agents of which are specific microorganisms that enter the human body mainly through the gastrointestinal tract and affect organs and tissues of the abdominal cavity).
4. Perforated appendicitis (a pathological inflammatory process in the appendix, complicated by a breakthrough of the organ wall).
5. Gynecological infections.
6. Postpartum endomyometritis (total septic inflammation of the uterine wall with involvement of its internal mucous and muscle layers).
7. Phlegmon (acute diffuse purulent inflammation of the cellular spaces).
8. An abscess (purulent inflammation of tissues with their fusion and the formation of a purulent cavity, can develop in the subcutaneous tissue, muscles, bones, as well as in organs or between them).
9. Infected ulcers and wounds.
10. Infectious endocarditis (inflammation of the inner lining of the heart).

Contraindications

According to the instructions, "Tienam" has certain prohibitions on the use, for example:

1. Renal failure.
2. Children's age up to twelve years.
3. Increased sensitivity to the components of the drug.

Prescribing a drug during pregnancy is permissible only in situations where the benefit of treatment for the mother is higher than the risk. Imipenem passes into milk, so if its use is deemed necessary, lactation is suspended or discontinued.

How to take "Tienam"?

The drug in the form of a solution for intramuscular administration should not be used for injection into a vein. The infusion solution is not recommended to be used intramuscularly.

The dosage of the Tienama antibiotic for intramuscular administration is determined by the medical specialist taking into account the severity of the infection, the sensitivity of the pathogenic microflora to the drug, the localization of infection, the kidneys and the weight of the patient.

The drug for intramuscular injections and for infusions can never be combined with other antibacterial agents. Powder for the manufacture of a suspension or solution is injected deep into the muscle. Recommended dosages of the drug at a frequency of injections once every twelve hours:

1. Infections of the skin and soft tissues, as well as the lower respiratory tract and female genital organs - 0.5 grams each.
2. Intraabdominal infections - 0.75 grams each.

The duration of treatment depends on the type of infection and the severity of the disease. Therapy, as a rule, is carried out for at least another two days after the elimination of all signs. The safety and efficacy of treatment for more than fourteen days have not been confirmed. The total daily dosage for intramuscular injections should not exceed 1.5 grams of imipenem.

If it is necessary to use Tienama in higher dosages, an antibacterial agent should be used intravenously. To prepare a dosage of a medicine containing 0.5 grams of imipenem, 2 milliliters of solvent are added to the drug vial.

The total amount of the resulting solution is 2.8 milliliters. As a solvent, water for injection can be used, as well as saline or lidocaine hydrochloride one percent (without adrenaline).

The prepared product should be white or slightly yellowish in color, it should be used within sixty minutes. Powder for the manufacture of a solution for injection is injected into a vein.

If the patient complains of nausea during the administration of Tienama, the infusion rate must be slowed down. The recommended daily pharmacological dosage, determined on the basis of imipenem, is from one to two grams, which is divided into three to four injections. For moderate infections, the daily dosage can be two grams in two procedures.

In diseases provoked by a less sensitive pathogenic microflora, the daily concentration can be increased to a maximum of up to four grams. For children from three months of age and older (weighing up to forty kilograms), the required dosage is determined at the rate of 0.015 grams per kilogram and administered once every six hours.

For the treatment of children weighing more than forty kilograms, a dosage of adults is used. The maximum children's dosage is two grams. As a solvent for Tienam injection:

• five percent dextrose;
• sodium chloride;
• dextrose;
• potassium chloride;
• mannitol solution.

Adverse reactions

As a rule, the drug "Tienam" is well tolerated by people, the negative effects are transient, mild and do not require discontinuation of therapy.

As mentioned earlier, Tienam belongs to the group of antibiotics for systemic use, and therefore the drug can cause adverse reactions. The most commonly reported adverse effects are:

1. Diarrhea (a pathological condition in which the patient has frequent bowel movements, while the stool becomes watery).
2. The risk of pseudomembranous colitis (a disease that provokes a spore-forming anaerobic microbe).
3. Hepatitis (inflammatory liver disease, usually of viral origin).
4. Hemorrhagic colitis (a type of gastroenteritis in which some strains of E. coli infect the colon and produce a toxin that causes sudden diarrhea with the appearance of blood in the stool).
5. Hepatic insufficiency (acute or chronic syndrome that develops when one or more liver functions are impaired).
6. Jaundice (icteric staining of the skin and visible mucous membranes, due to the increased content of bilirubin in the blood and tissues).
7. Gastroenteritis (an ailment characterized by inflammation in the stomach and small intestine).
8. Glossitis (a lesion of the tongue of an inflammatory nature, which can occur as an independent disease or be a manifestation of other diseases).
9. Abdominal pain.
10. Heartburn (a feeling of discomfort or burning behind the sternum, spreading to the top of the epigastric region, sometimes radiating to the neck).
11. Hypersalivation (increased secretion of the salivary glands).
12. Increased bilirubin levels.
13. Tremor (fast, rhythmic movements of the limbs or trunk, caused by muscle contractions and associated with a time delay of correcting afferent signals).
14. Confusion.
15. Paresthesia (one of the types of sensitivity disorder, characterized by spontaneously arising sensations of burning, tingling, crawling ants).
16. Vertigo (a disease characterized by brain damage).
17. Myoclonus (involuntary movements resulting from changes in various organs).
18. Headache.
19. Encephalopathy (cerebral hypoxia subsequently caused by various pathological factors).
20. Mental disorders.
21. Hyperventilation (intensive breathing that exceeds the body's oxygen requirements).
22. Shortness of breath (one of the adaptive functions of the body, which is expressed in a change in the frequency, rhythm and depth of breathing, often accompanied by sensations of lack of air).
23. Palpitations.
24. Tachycardia (rapid heart rate).
25. Rash.

What other negative effects does the Tienam antibiotic provoke?

1. Urticaria (skin disease, dermatitis mainly allergic origin).
2. Bluish color of the skin and mucous membranes, which is due to the increased concentration of carbhemoglobin in the blood.
3. Acute toxic-allergic disease, the main characteristic of which are rashes on the skin and mucous membranes.
4. Edema (an acute condition characterized by the rapid development of local edema of the mucous membrane, subcutaneous tissue and the skin itself).
5. Severe variant of allergic bullous dermatitis.
6. Exfoliative dermatitis (a severe infectious lesion of the skin of newborns, which is a malignant variant of pemphigus).
7. Anaphylaxis (an allergic reaction of an immediate type, a state of sharply increased sensitivity of the body).
8. Polyuria (increased urine output per day).
9. Anuria (a disease in which urine does not enter the bladder, and, as a result, does not stand out from it).
10. Proteinuria (protein detection in urinalysis).
11. Leukocyturia (increased number of leukocytes in the analysis of urine. Normally, the detected number of leukocytes in the field of view in a single portion of urine).
12. Cylindruria (the process by which an increased number of cylinders accumulate in the urine).
13. Erythrocyturia (increased content of red blood cells in the urine).
14. Agranulocytosis (a disease in which there is a decrease in the level of leukocytes due to granulocytes and monocytes).
15. Pancytopenia (a pathology that is characterized by a decrease in the composition of all blood components in the bloodstream).
16. Thrombocytopenia (a condition characterized by a decrease in platelets below the standard, accompanied by increased bleeding and problems with stopping bleeding).
17. Leukopenia (a decrease in the number of white blood cells in the blood).
18. Hemolytic anemia (a pathological process, the hallmark of which is the accelerated destruction of red blood cells).
19. Neutropenia (low level of neutrophilic granulocytes in the general cellular composition of the blood).
20. Eosinophilia (a condition in which there is an absolute or relative increase in the number of eosinophils).
21. Leukocytosis (a change in the cellular composition of the blood, characterized by an increase in the number of leukocytes).
22. Monocytosis (an increase in the number of monocytes in the blood).
23. Thrombocytosis (a hematological pathology characterized by an increase in blood platelet count).
24. Lymphocytosis (a pathological condition characterized by an increased number of lymphocytes in the peripheral blood).
25. Decreased hemoglobin and red blood cell volume.
26. Phlebitis (acute or chronic inflammation of the venous wall).
27. Thrombophlebitis (a condition characterized by inflammation in the vein wall if there is a blood clot in its lumen).
28. Erythema (severe redness of the skin caused by the expansion of capillaries).
29. Vein Seals.
30. Sore throat.
31. Candidiasis (one of the varieties of fungal infection caused by microscopic yeast-like fungi of the genus Candida).

Features

Patients over sixty-five years old must adhere to the lower dosage limit and constantly monitor the excretory function of the kidneys. Since some of the negative effects that are recorded when using the Tienama antibiotic can negatively affect the speed of psychomotor reactions and attention, therefore, people need to refrain from driving and working with complex mechanisms.

Can I use the drug during pregnancy and breastfeeding?

Due to the lack of clinical information, the effect of the drug on the course of the "interesting position" and the condition of the fetus, "Tienam" when bearing a child is prescribed only according to strict indications, provided that the probable benefit of the therapy for the mother exceeds the possible risk to the fetus.

According to the instructions for use with the Tienam antibiotic, it is known that the active substance passes into breast milk, so if you need to use the drug, you need to stop lactation. In pediatrics, "Tienam" is used for the same reasons as in adults, but subject to the following specific prohibitions.

In case of impaired kidney function

People with kidney diseases need a dosage adjustment that is carried out by a medical specialist, taking into account the patient’s body weight, the pathogen’s sensitivity to Tienama, and severity.

The appointment of the drug during hemodialysis is permissible only in situations where the benefits of therapy exceed the possible risk of seizures. With the method of extrarenal blood purification in acute and chronic renal failure, imipenem and cilastatin are removed from the general bloodstream, therefore, Tienama injections should be carried out after the procedure and then twelve hours after its completion.

With impaired liver function

There is no need to adjust the dosage of the drug in people with liver disease. Due to the risk of hepatotoxicity, careful monitoring of liver function is required. People of retirement age with normal kidney function do not require dosage adjustment. When administering the drug intramuscularly to patients over sixty-five years old, it is important to consider the decrease in the function of the liver or kidneys, as well as the heart and blood vessels, and the presence of diseases. The dosage should be selected with caution, adhering to lower concentrations, if possible, it is necessary to monitor the excretory function of the kidneys.

Interaction

The drug for intramuscular and intravenous administration is not recommended to be mixed with other antibacterial agents or added to their solutions. The combined use of "Ganciclovir" and "Tienama" in the form of intravenous injections can provoke generalized convulsions, therefore, their joint use is not recommended, except for the excess of the probable benefit of the treatment over the possible risks.

"Probenecid" slightly increases the plasma content and half-life of the drug, the simultaneous use of drugs is prohibited. "Tienam" lowers the plasma content of valproic acid, increasing the risk of convulsive activity, so it is recommended to monitor the level of valproic acid. Joint isolated use of other antibacterial agents with the injection of Tienama is allowed.

Analogs

Substitutes for "Tienama" are:

1. Aquapenem.
2. "Meropenem."
3. Grimipenem.
4. Imipenem.
5. Meronem.
6. "Cilastatin Spencer."
7. Tiepenem.
8. "Invasion".
9. Doriprex.
10. Tsilapenem.

Keep in a place inaccessible to children at a temperature of no more than twenty-five degrees. It is released on prescription by a medical specialist.

Opinions

Many patients leave only positive reviews about the Tienam antibiotic. With the help of high antimicrobial effectiveness, the medication copes with the problem if other drugs are not affected.

They describe situations when, using a timely course of antibiotic therapy, operations were avoided. The extensive spectrum of its antimicrobial effects is emphasized separately.

Despite the increased price of the drug, if the doctor prescribed this drug, patients need to use it. The estimated cost of Tienama in pharmacies varies from 5,000 to 6,000 rubles.