Antibiotic Sumamed: instructions for use, analogues, reviews

What is the antibiotic Sumamed? This is a common question. We will understand it in more detail.

Before you begin treatment with a drug, you must study these instructions for its use, methods of use and recommended dosage, as well as other useful information on the use of this medication. "Sumamed" from a number of macrolide antibiotics.

It is produced in the form of tablets coated with a special film shell of bluish color, biconvex. 1 tab Sumamed antibiotic contains azithromycin dihydrate 125 mg. Also, it includes some additional substances:

• anhydrous calcium hydrogen phosphate;
• corn starch;
• hypromellose;
• microcrystalline cellulose;
• pregelatinized starch;
• sodium lauryl sulfate;
• magnesium stearate.

What group of antibiotics Sumamed has, not everyone knows.

The composition of the tablet shell includes:

• hypromellose;
• titanium dioxide;
• indigo carmine dye;
• polysorbate.

The medicine is packed in cardboard boxes, 6 pieces in one blister. The drug can also be produced in hard gelatin capsules, with a blue body, the contents of which are either white or light yellow powder. The capsule disintegrates when pressed. In 1 piece contains 250 mg of the active substance - azithromycin dihydrate.

The auxiliary components of the Sumamed antibiotic in this case are:

• microcrystalline cellulose;
• sodium lauryl sulfate;
• magnesium stearate.

Capsules, like tablets, are packed in cardboard boxes with one blister containing 6 of them.

According to the instructions, the Sumamed antibiotic is also produced in the form of a powder for suspension, which is a yellowish-white homogeneous crumbly mass with the smell of strawberries. After adding water to the powder and dissolving it, a homogeneous suspension is obtained.

As auxiliary substances in this form of the drug are used:

• sucrose;
• hyprolosis;
• xanthan gum;
• sodium phosphate;
• titanium dioxide;
• colloidal silicon dioxide;
• strawberry flavoring.

Powder for suspension is packed in plastic bottles with a resistant cap, which are placed in cardboard boxes with instructions for use and a measuring spoon.

Pharmacological properties

As the instruction indicates, the antibiotic Sumamed is a broad-spectrum agent, azalide, which acts bacteriostatically, inhibiting peptide translocase at the stages of translation and inhibiting protein synthesis. In addition, it is able to slow down the growth and reproduction of pathological bacteria and in high concentrations have a bactericidal effect. The active substance of the antibiotic "Sumamed" acts on extra - and intracellular infectious agents. It is active against the following gram-positive microorganisms:

• Streptococcus spp;
• Streptococcus pyogenes;
• Streptococcus viridans;
• Staphylococcus epidermidis;
• Streptococcus pneumoniae;
• Streptococcus agalactiae;
• Staphylococcus aureus.

Gram-negative bacteria that suppress this medication are:

• Haemophilus influenzae;
• Bordetella pertussis;
• Moraxella catarrhalis;
• Legionella pneumophila;
• Campylobacter jejuni;
• Bordetella parapertussis;
• Neisseria gonorrhoeae;
• Haemophilus ducreyi;
• Gardnerella vaginalis.

In addition, the active substances of the Sumamed antibiotic successfully fight against some anaerobic microorganisms:

• Bacteroides bivius;
• Peptostreptococcus spp;
• Clostridium perfringens;
• Chlamydia pneumonia;
• Mycobacterium avium complex;
• Treponema pallidum;
• Chlamydia trachomatis;
• Ureaplasma urealyticum;
• Mycoplasma pneumonia;
• Borrelia burgdorferi.

The substances of the medicinal product are not active against bacteria that are resistant to erythromycin.

Pharmacokinetics

The active substance of the antibiotic Sumamed is absorbed in tablets from the gastrointestinal tract, which explains its stability in an acidic environment. After administration, its maximum plasma concentration is reached after about three hours. Bioavailability is 38%. “Sumamed” quickly penetrates the respiratory organs, as well as the urogenital tract, skin and soft tissues. High concentrations in tissues and a very long period of drug excretion are due to reduced binding of the active substance to blood proteins, as well as the ability to invade eukaryotic cells. The ability of azithromycin to concentrate in lysosomes is of particular importance for the elimination of intracellular infectious agents. It is known that phagocytes can deliver azithromycin to places affected by infection, where it is released through the process of phagocytosis, and the concentration of this substance in the foci of infection is much higher than in healthy tissues.

Despite the concentration in phagocytes, azithromycin is not able to exert a significant effect on their work. It remains in the necessary concentrations in the foci of inflammation for almost seven days after the last dose, which allowed pharmacists to develop short courses of treatment with this drug.

The elimination of the active substance from the body takes place in 2 main stages: the half-life, which is usually 15-20 hours with an interval of 9 to 25 hours after ingestion and 40 hours with an interval of 25 to 70 hours. This allows you to use the medicine 1 time per day.

Are Sumamed antibiotics effective for angina? Experts answer this question this way: "Yes, they are very effective."

Indications for use

A variety of infectious and inflammatory diseases that are caused by pathological microorganisms that are sensitive to the drug:

1. Infections affecting the upper respiratory tract and ENT organs: pharyngitis, tonsillitis, tonsillitis, sinusitis, otitis media.
2. Infections affecting the lower respiratory tract: acute bronchitis, chronic bronchitis, pneumonia, including those that could be caused by atypical pathogens.
3. Infectious changes in the skin and soft tissues; impetigo, erysipelas, acne, infected dermatoses.
4. Initial stages of Lyme disease: erythema migrans.
5. Infectious lesions of the genitourinary tract caused by a pathogen such as chlamydia: urethritis, cervicitis.

The use of the antibiotic "Sumamed" should be very careful.

Contraindications

This medication is contraindicated in the following cases:

1. Increased susceptibility of the body to azithromycin and erythromycin, as well as other macrolides or ketolides.
2. Disorders in the liver.
3. Concomitant use with substances such as ergotamine or dihydroergotamine.
4. Deficiency of sucrose or isomaltase, as well as fructose intolerance.
5. Antibiotic "Sumamed" for children is also suitable. But contraindications include children under 12 years old (for taking tablets with a dosage of 500 mg), up to 3 years (for taking the drug with a dosage of up to 250 mg) and up to 6 months (for taking a suspension with a dosage of 125 mg).

With caution, the drug "Sumamed" should be used in the following cases

1. Myasthenia gravis
2. Disorders of the basic functions of the liver of a moderate degree.
3. Terminal renal failure.
4. The presence of proarrhythmogenic factors in patients
5. Violation of the water-electrolyte balance in the body, for example, with hypokalemia or hypomagnesemia.
6. With bradycardia, arrhythmias and other heart rhythm disturbances, as well as with various forms of severe heart failure.
7. With the combined use of substances such as digoxin, warfarin and cyclosporine.
8. Diabetes.
   

Dosage

The drug in capsules is used once a day, the dose for an adult is 500 mg.

For children, the Sumamed antibiotic is prescribed as follows: up to 12 years - 250 mg, up to 3 years - 125 mg. This dosage is indicated for general cases of diseases with moderate severity. In cases of severe pathologies, the dosage of the drug is prescribed by a specialist.

How is the antibiotic Sumamed used? This is described below.

Suspension preparation

To the powder contained in a plastic bottle intended for the preparation of a suspension (nominal volume of 20 ml), using a special dosing syringe, add 12 ml of water and shake until the mixture is homogeneous. The volume of this suspension should be approximately 25 ml, which, as a rule, exceeds the nominal volume by 5 ml, which is provided in order to compensate for the loss of the substance when dosing the drug. The finished suspension of the Sumamed antibiotic can be stored in the refrigerator for no more than 5 days.

Side effects

The frequency of such phenomena is classified as follows:

• very often (in 10% of cases);
• often (in <10%);
• infrequently (in <1%);
• rarely (in <0.1%);
• very rarely (in <0.01%);
• with unknown frequency (no data due to lack of observations).

Thus, during the use of the drug "Sumamed", the following side effects may occur:

1. In infectious diseases: infrequently - thrush (candidiasis), pneumonia, gastroenteritis, pharyngitis, rhinitis, respiratory diseases. With an unknown frequency - pseudomembranous colitis.
2. From the hematopoiesis and lymphatic system: rarely - neutropenia, leukopenia, eosinophilia; very rarely - hemolytic anemia, thrombocytopenia.
3. In terms of metabolism: very rarely - anorexia.
4. Allergic manifestations: infrequently - a hypersensitivity reaction, angioedema; with an unknown frequency - anaphylactic reactions.
5. Nervous system: often - headaches; infrequently - violation of the taste buds, dizziness, drowsiness, paresthesia, insomnia, neurosis; rarely - agitation; with an unknown frequency - anxiety, hypesthesia, fainting, aggression, convulsions, psychomotor hyperactivity, impaired olfactory function, myasthenia gravis, loss of taste, hallucinations, delirium.
6. From the point of view: infrequently - a violation of color perception.
7. Hearing impairment: infrequently - vertigo, hearing impairment; with unknown frequency - deafness, tinnitus.
8. Cardiovascular system: rarely - palpitations; with unknown frequency - lowering blood pressure, lengthening the QT interval, arrhythmia, ventricular tachycardia.
9. On the part of the respiratory system: infrequently - shortness of breath, nosebleeds.
10. From the digestive tract: very often - diarrhea; often - symptoms of nausea, vomiting, sharp abdominal pain; infrequently - bloating, dyspepsia, gastritis, constipation, dysphagia, dry mucosa and ulcerative lesions of the oral cavity, belching, increased production of saliva; very rarely - pancreatitis.
11. From the bile ducts and liver: infrequently - hepatitis; rarely - impaired hepatic function, cholestatic jaundice; with an unknown frequency - liver failure (in extremely rare cases, deaths are known, as a rule, against the background of severe violations of the liver), fulminant hepatitis, liver necrosis.
12. From the skin and underlying tissues: infrequently - a rash of various origins, itching, dermatitis, urticaria, dry skin, excessive sweating; rarely - photosensitivity; with unknown frequency - Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis.
13. Musculoskeletal system: infrequently - myalgia, osteoarthritis, pain in the back and neck; with unknown frequency - arthralgia.
14. Urinary organs: infrequently - pain in the kidneys, dysuria; with unknown frequency - interstitial nephritis, acute kidney failure.
15. From the reproductive system and mammary glands: infrequently - metrorrhagia, impaired testicular function.
16. Other side effects: infrequently - general malaise, asthenia, fatigue, swelling of the face, fever, chest pain, peripheral edema.

The side effects of Sumamed from the macrolide antibiotic group are as follows:

• a decrease in the number of lymphocytes, an increase in the number of eosinophils, basophils, monocytes, neutrophils, platelets:
• decrease in plasma bicarbonates:
• increase in the main activity of ALT and AST;
• increase in plasma bilirubin, creatinine, chlorine, glucose and urea;
• a change in the amount of potassium and sodium in plasma;
• increased phosphatase activity, increased hematocrit and plasma bicarbonate concentration.

Drug overdose

Symptoms of an overdose with the Sumamed medication are: nausea, hearing loss, vomiting, diarrhea. In this case, treatment is symptomatic, in the form of gastric lavage, intake of a large volume of liquid and activated charcoal. The drug should be discontinued.

It is important to always remember which antibiotics Sumamed refers to in order to provide the right help in case of overdose.

Interaction with other medications

Antacids do not affect the absorption of azithromycin, but reduce C _max in the blood by about 30%, so this drug should be taken one hour before taking these drugs and food. Concomitant use of azithromycin and cetirizine has no contraindications. The simultaneous use of macrolide antibacterial drugs, with substrates of P-glycoprotein, for example, digoxin, leads to an increase in the blood substrate of P-glycoprotein. The concomitant use of azithromycin and zidovudine has an effect on the pharmacokinetics and excretion of the glucuronide metabolite of zidovudine by the kidneys. Azithromycin weakly reacts with isoenzymes of cytochrome P450. Given the possibility of developing ergotism, the use of an active substance with ergot derivatives is not welcome.

A study of the interactions of this drug with anticoagulants showed that azithromycin does not affect the anticoagulant effect of a substance such as warfarin. Its potentiation of the use of azithromycin and coumarin derivatives has been reported. Despite the fact that the reason for this has not been established, prothrombin time should be monitored when using the drug "Sumamed" in patients receiving oral anticoagulants. Some caution should also be exercised during the use of this drug with cyclosporine.

Use of the drug during pregnancy and lactation

In such periods, the use of a medication is possible only when the expected benefits of treatment for the mother outweigh the risk to the fetus. If there is an urgent need to use this medication during lactation, it should be suspended. This confirms the instructions for use for the antibiotic "Sumamed".

special instructions

The use of a medication in some cases can cause the onset of myasthenic syndrome or exacerbation of myasthenia gravis. When used in patients with diabetes mellitus and those who follow a low-calorie diet, it should be borne in mind that sucrose is part of the suspension of this medication.

In the event of negative effects from the point of view of the functioning of the nervous system and organs of vision, care must be taken when performing actions that require increased attention and speed of motor reactions.

In case of impaired liver function, the drug is contraindicated. In addition, they are used with extreme caution in cases of impaired renal function.

In elderly patients, the drug "Sumamed" is used in the same dosages as in young people. Nevertheless, due to the fact that in such a category of patients the occurrence of proarrhythmogenic conditions is not excluded, regular monitoring of cardiac activity should be carried out.

Analogs of the antibiotic "Sumamed"

The drug is considered a broad-spectrum antibiotic. It is highly effective against a wide variety of pathological microorganisms that can cause very serious diseases, but the drug has many contraindications and side effects. In this regard, it is possible to replace this medication with others that are similar in therapeutic effect, but do not have such a number of negative manifestations. These medicines include:

• "Azit";
• Ziramin;
• Azitroks
• Aziklar;
• Hemomycin;
• "Azo";
• "Azitro";
• "Azithromycin";
• "Zatrin";
• "Azithromycin Grnidex";
• "Free Max OD";
• "Clamed";
• Clubax
• Ezeklar-OD;
• “Meristat-Sanovel”;
• "Dazel";
• "Roxide";
• Azinot-Farmeks;
• Wilprafen
• Zomax
• Azitsin;
• Azibiot.

The cheapest analogue among the above funds is Azithromycin. He also has a high bactericidal activity, which allows him to cope with serious inflammation, blocks the reproduction of pathogenic microorganisms. In this case, you can find the same concentration and content of the active substance in "Azithromycin" similar to those in "Sumamed".

The only drawback of the described generic is the lack of clinical trials in its production. Therefore, patients often have a common side effect - severe cutting pain in the abdomen about half an hour after taking even a small dose of the drug. According to the results of medical practice, the remedy in question has no such effect.

It can be said that Sumamed tablets do not have an analogue that fully complies with the indicated agent and satisfies the requirements for bactericidal activity. Therefore, before choosing a generic, you should first get a consultation with a doctor.

Reviews

Many medical specialists have a positive attitude to the drug and very often recommend it for use even in young children. Nevertheless, it is necessary to understand the main thing that it is absolutely impossible to give this remedy to children without a doctor’s prescription, since the effect of it does not exceed possible side effects. Reviews about the antibiotic Sumamed are presented below.

Another reason why doctors prefer this of all antibacterial drugs is its advantage due to the short course of use. This helps to significantly reduce the harmful effects of its active substance on the intestinal and mucous microflora, reducing, in turn, the risk of dysbiosis and candidiasis. Despite this, when treating with this drug, it is necessary to take probiotics, which will help maintain the balance of flora in these areas.

Like any other medicine, the drug "Sumamed" has both positive and negative reviews. Thus, people who used it in the treatment of one or another infectious disease note that the drug is very effective, well tolerated by a healthy person and helps even in cases of severe pathological conditions. This happens in an extremely short time, so patients say that in cases where a person needs urgent help, the drug “Sumamed” can be a great way to solve the problem. Many patients are satisfied that the medication is taken once a day, unlike other antibiotics, which are usually taken several times.

Negative reviews contain a large amount of information about the onset of side effects after taking this medication, and this applies, first of all, to young patients and the elderly. Frequent cases of this nature were attacks of arrhythmia and other cardiac disorders in the elderly, and in children - the occurrence of various digestive disorders in the form of acute diarrhea, loss of appetite and vomiting.

This is the Sumamed antibiotic.