Penicillin antibiotics are active against some gram-negative and most gram-positive microorganisms. The antibacterial effect of such drugs is associated with their ability to disrupt the synthesis of bacterial cell walls.
Penicillin antibiotics are used for bacterial infections, including severe ones. One such effective medicine is Carbenicillin. Instructions for the use of this drug, its indications for use, mechanism of action and other information are presented below.
Dosage form of the medication and its composition
According to the instructions for use, "Carbenicillin" goes on sale in the form of a powder intended for the preparation of an injection solution. The latter is used for intramuscular and intravenous administration.
Carbenicillin disodium salt is a porous mass (powder) of white or almost white color. It is hygroscopic, readily soluble in water and slowly in ethanol. Carbenicillin disodium salt is insoluble in chloroform and ether. Its molecular weight is 422.36.
The active component of the drug in question is a semi-synthetic antibiotic substance from the penicillin group. It is acid resistant and is destroyed only by beta-lactamases. The molecular weight of carbenicillin is 378.40.
The mechanism of action of the drug
What is the carbenicillin antibiotic? Such a broad-spectrum drug has bactericidal and antibacterial properties. Its active component is able to acetylate the membrane-bound transpeptidase enzyme, as well as block the synthesis and permeability of cell wall peptidoglycans, causing the osmotic instability of bacteria.
According to the instructions for use, "Carbenicillin" is highly active against gram-negative microorganisms (indole-positive strains), as well as some anaerobic and gram-positive bacteria. At the same time, the medication in question does not in any way affect the staphylococcus strains that destroy penicillinase.
It should also be noted that the use of this medication for infections caused by gram-positive bacteria is impractical.
Pharmacokinetic features
In the process of using antibiotics with carbenicillin, it should be borne in mind that after intramuscular injection of the drug solution, the maximum concentration of the substance in the patient's blood is reached only after 60 minutes. About 50-60% of the drug binds to proteins. It penetrates into all tissues and fluids, including bile, peritoneal fluid, pleural effusion, intestinal mucosa, middle ear fluid, lungs, gall bladder and genitals.
Biological transformation of carbenicillin in the liver undergoes only a small part (approximately 2%). The half-life of an antibiotic is 1–1.5 hours. The drug is excreted mainly by the kidneys (unchanged, approximately 60–90%). In this case, an excessively high concentration of carbenicillin is created in the urine.
The medication in question passes through the placenta, and also passes into breast milk (in small concentrations).
Indications for appointment
In what cases can patients be prescribed drugs with an active substance such as carbenicillin? Indications for the use of such agents are bacterial infections that were caused by microorganisms sensitive to the specified substance. Typically, the drug in question is prescribed for infections of the pelvic organs, joints and bones, urinary and biliary tract, peritonitis, sepsis, septicemia and pneumonia. Also, "Carbenicillin" effectively treat brain abscess, infectious and inflammatory diseases of the soft tissues and skin, meningitis. Often it is used for purulent complications after surgery, during childbirth, infected burns and otitis media.
Contraindications
In what cases is it forbidden to use the drug "Carbenicillin"? Contraindications to the use of such a medication are:
- hypersensitivity to the active substance, including other beta-lactam antibiotics;
- arterial hypertension;
- chronic heart failure;
- bronchial asthma;
- enteritis;
- ulcerative colitis;
- eczema;
- angioedema;
- chronic renal failure;
- various bleeding (including a history).
Instructions for use "Carbenicillin"
The dosage of the antibiotic in question is strictly individual. It should be determined only by a specialist, depending on the severity of the infection, the patient's age and the sensitivity of the pathogen. For example, with a brain abscess with intravenous administration, a single dose of such a medicine is 50-80 mg / kg (4-6 times a day). The duration of the treatment procedure using a syringe is 3-4 minutes, the system - 30-40 minutes.
If the drug was prescribed for the treatment of urinary tract infections in women, it should be borne in mind that when the renal system is impaired, the dose of carbenicillin is reduced, and the intervals between doses are increased.
Side effects
Like all penicillin antibiotics, the Carbenicillin preparation has its own side effects. These include the following:
- abdominal pain, thrombocytopenia, Quincke's edema, neutropenia, conjunctivitis, leukopenia, epileptiform seizures, hemorrhagic syndrome;
- nausea, changes in potassium and sodium levels in the blood, interstitial nephritis, vomiting, anaphylactic shock, increased liver transaminases, dysbiosis, eosinophilia, pseudomembranous colitis;
- hypovitaminosis, urticaria, vaginal candidiasis, erythema, angioedema, rhinitis.
Also, while taking the medication in question, the patient may develop superinfection caused by microorganisms resistant to carbenicillin (at high dosages). With intramuscular administration, local reactions such as soreness at the injection site often occur, and with intravenous administration, phlebitis.
Drug interaction
The drug "Carbenicillin" is able to enhance the effects of indirect and direct anticoagulants, as well as fibrinolytics and antiplatelet agents. Also, this tool increases the likelihood of developing adverse reactions when combined with NSAIDs.
"Carbenicillin" is absolutely incompatible with bacteriostats (a bactericidal effect occurs), tetracycline antibiotics, macrolides and chloramphenicol. In addition, this drug must not be mixed with aminoglycosides.
It's important to know!
Before parenteral use of the drug, an intradermal test is mandatory for individual sensitivity (use 0.1 ml of the drug). Sample results are evaluated after half an hour.
With the development of allergic reactions during treatment, the medication should be discontinued and desensitizing therapy should be carried out.
The antibiotic Carbenicillin is able to increase bleeding time.
With intravenous administration of the drug, it may be necessary to identify serum sodium and potassium ions in the blood serum, as well as the bleeding period.
With an intramuscular injection of an antibiotic, you should not enter it in the same place in an amount of more than 2 g.