"Azithromycin" is a powerful antibiotic from the macrolide group, which is used by doctors of various profiles to treat diseases caused by bacteria sensitive to it. Often, the use of Azithromycin is oral. That is, it is taken in tablets, in capsules or in a suspension of different dosages. The use of an injection form is indicated in especially severe cases in a hospital setting.
pharmachologic effect
"Azithromycin" refers to broad-spectrum macrolide antibiotics. It has a mainly bacteriostatic effect. This means that the drug, introducing itself into the bacterial wall, stops the main synthetic processes in it, slowing down and stopping its development and reproduction. Large concentrations of the drug can immediately kill the microbe, that is, act bactericidal. This can occur both outside and inside the affected cell of the human body.
The order of administration and method of use of "Azithromycin" depends on the sensitivity of bacteria to this drug. Gram-positive (Staphylococcus aureus, Streptococcus pneumoniae and pyogenes) and gram-negative microorganisms (Hemophilus influenzae, Legionella, Moraxella catarilis, Pasteurella, Neisseria gonorrhea), Anaerobes (Clostridia, Fusobacteria, and Myrothelmidae pore) are sensitive to it. . Enterococcus fecal, methicillin-resistant staphylococcus, including golden, as well as fragmentoid bacteroids, are resistant to this drug.
Suction and removal
After the use of Azithromycin tablets, the drug is absorbed into the blood and reaches its maximum amount within two and a half hours. It easily passes through tissue barriers, so it quickly begins to act in the internal organs, and is also able to actively enter the affected cells. Since with the help of leukocytes the drug substance is transported throughout the body, its concentration at the site of infection is one third higher than in healthy organs and cells.
Drug processing reactions occur in the liver with the help of enzymes. The elimination half-life is on average 50 hours. Half of the drug is excreted in the feces, 6 percent - with urine. Having the properties of accumulation, "Azithromycin" is able to maintain its effect for a week after the reception has been completed.
Indications
The use of “Azithromycin” in 500 and 250 mg capsules and in tablets in similar dosages depends on the disease.
Indications for the prescription of the medication are:
- Infectious lesions of the nasopharynx, upper respiratory organs, ears, tonsillitis, tonsillitis, scarlet fever, pharyngitis (inflammation of the posterior pharyngeal wall), laryngitis (inflammatory pathology of the larynx), sinusitis (sinusitis, frontitis, ethmoiditis, sphenoiditis), otitis media.
- Pathology caused by bacteria that affect the lower respiratory tract (acute bronchitis and exacerbation of chronic, pneumonia).
- Bacterial processes in the skin and subcutaneous tissue (erysipelas, impetigo (pyoderma caused by staphylococci), moderate acne, secondary infection due to skin diseases).
- Lyme borreliosis in the initial stage, manifested by migratory erythema (ring-shaped rash).
- Damage to the urinary system by microorganisms (pyelonephritis without impaired renal function, cystitis) and genitals (cervicitis, urethritis) caused by both bacterial and chlamydial infections.
- Helicobacter pylori infection, which provoked a stomach ulcer and duodenal ulcer.
Contraindications
The instructions for the use of tablets "Azithromycin" clearly states the conditions in which you can not take this drug:
- Breastfeeding.
- Individual intolerance to the drug in the past.
- Hypersensitivity to macrolides.
- Children's age up to six months.
- Joint use with ergotamine and dihydroergotamine (migraine medication).
- Severe renal impairment.
- Liver failure.
Dosage and administration of "Azithromycin"
The drug in the form of tablets, capsules or suspensions is taken orally. The action of the drug is long, therefore it is necessary to use it once a day, at the same time. So that there is no effect of products on the absorption of the drug, this should be done by waiting two hours, or one hour before eating.
The tablet form does not need to be chewed, use a small amount of liquid. To prepare the suspension, a powder is used, to which cool boiled water is added to the desired level.
The method of use of "Azithromycin" by an adult and a child older than twelve years of age and weighing more than 45 kilograms depends on the pathology of organs and systems.
For infectious diseases of the nasopharynx, ears, lungs, bronchi, skin and underlying structures, 500 mg of the drug is taken once a day for three days in a row. Only 1.5 grams.
The use of "Azithromycin" 500 mg per day for three consecutive days with the subsequent use of the drug in this dosage once a week for nine weeks is practiced with ordinary acne, proceeding in moderate form. As a result, six grams of the drug goes into the course of treatment.
Lyme borreliosis at the initial stage of symptoms is treated according to the scheme: the first day - 1 gram (two tablets of 500 mg), then from the second to fifth day the dose is reduced to one tablet of 500 mg. The total dose will be three grams.
Method of use of "Azithromycin" in chlamydia: two tablets of 500 mg one day. Just one gram.
The injection form of the drug is used for severe pneumonia, replacing the administration of tablets with intramuscular injections or intravenous drip infusions. In a medication for injection, there is 500 mg of the active ingredient, which is diluted with water for injection and injected intramuscularly, or, diluted with sodium chloride, a solution of dextrose or Ringer in an amount of 500 ml, slowly drip for three hours. After a three-day course, when the condition stabilizes, the medicine is continued to be given in the form of capsules or tablets.
The method of application of "Azithromycin" in case of kidney inflammation (pyelonephritis) depends on renal function. It should be prescribed in a standard dose of 500 mg for three days only with the preservation of renal filtration, as well as in the absence of the possibility to prescribe another antibiotic more suitable for renal inflammation.
To eradicate Helicobacter pylori infection, the drug in combination with other drugs is taken one gram per day for three days.
The use of "Azithromycin" for children
Up to 12 years, it is better to use the powder form of the drug for the preparation of the suspension in order to more accurately calculate the dosage by the weight of the child. According to the instructions for use of "Azithromycin" (250 mg), this drug is prescribed for children, having calculated it in a proportion of 10 mg / kg.
A suspension of 200 mg / 5 ml is dosed as follows:
- Children from 10 to 14 kilograms - half a spoon (100 mg) - 2.5 ml.
- From 15 to 25 kg - one spoon (200 mg) - 5 ml.
- From 26 to 35 kilograms - one and a half tablespoons (300 mg) - 7.5 ml.
- From 35-45 kg - two tablespoons (400 mg) - 10 ml.
A suspension of 100 mg / 5 ml is dosed as follows:
- Children weighing 10-14 kilograms - one measured spoon (100 mg) - 5 ml.
- From 15 to 25 kg - two tablespoons (200 mg) - 10 ml.
- A child from 26 to 35 kilograms - three spoons (300 mg) - 15 ml.
- Children 35-45 kg - four tablespoons (400 mg) - 20 ml.
Side effects
Even with the correct method of using "Azithromycin", undesirable effects may occur:
- Digestive organs can respond with dyspeptic symptoms and liver dysfunction: diarrhea (10%), nausea, vomiting, abdominal pain (9.99-1%), increased gas formation, constipation, difficulty swallowing, dry mouth, increased salivation, belching, ulceration oral mucosa, hepatitis, anorexia (0.99-0.1%), inflammation of the pancreas, cholestatic jaundice (up to 0.01%). In very rare cases, liver failure, necrotic decomposition of liver tissue, up to a fatal outcome, can occur.
- The nervous system and analyzers suffer in the form of: headache (9.99-1%), taste disturbances, dizziness, feelings of "goose bumps" in the body, sleep disturbances, irritability, visual and hearing impairments, asthenia (0.99-0.1 %), agitated behavior (0.099-0.01%), also very rarely fainting, convulsions, changes in olfactory functions, hallucinations, delusional symptoms, deafness and myasthenia gravis.
- The heart and respiratory organs react in the form of: tachycardia, shortness of breath, chest pain, redness of the face, nosebleeds (0.99-0.1%), very rarely hypotension, arrhythmia, and an increase in the Q – T interval on the electrocardiogram can occur.
- The genitourinary organs can suffer, this is expressed by pain in the projection of the kidneys, impaired urination, edema, blood discharge in women, impaired testicular function in men (0.99-0.1%), in extremely rare cases, the occurrence of acute renal failure.
- Hypersensitivity reactions in the form of Quincke's edema and skin rash, itching, urticaria and fever (0.99-0.1%), cases of an unknown incidence of anaphylactic shock, Stevens-Johnson syndrome.
- The skin, joints and musculoskeletal system can respond by the occurrence of: dryness and inflammation of the skin, sweating, arthritis, muscle pain (0.99-0.1%), increased sensitivity to sunlight (0.099-0.01%).
- The occurrence of infectious pathological processes: candidiasis, inflammation of the lungs, back wall of the pharynx, nose, gastroenteritis (0.99-0.1%), as well as the occurrence of pseudomembranous colitis in an unknown percentage.
- In the blood, a decrease in leukocytes due to the lymphocytic component, an increase in eosinophils, monocytic cells and basophils (9.99-1%), growth of liver enzymes in the biochemistry of blood, bilirubin, urea, creatinine, chlorine, glucose, sodium, platelets and hematocrit (0, 99-0.1%), decrease in platelets, hemolytic anemia (0.099-0.01%).
Some features
The use of "Azithromycin" (method see above) should be carried out with caution:
- With diseases of the liver and kidneys that cause serious impairment of the functions of these organs.
- Heart diseases (arrhythmias, increased Q-T interval length).
- Myasthenia gravis
For mild and moderate impaired functioning of the kidneys and liver, as well as in elderly patients, the dose of the antibiotic does not need to be reduced.
In cases of drug overdose, dyspeptic symptoms can occur, as well as hearing loss, which disappears over time.
With the development of allergic reactions, a visit to a doctor is strictly necessary. Treatment and observation in this case may take some time.
Due to the possibility of developing reactions from the nervous system, extreme caution should be exercised when working at height and driving a car.
Drug interaction
Antacids ("Rennie", "Vicalin") are able to reduce by 30% the maximum content of "Azithromycin" in the bloodstream, therefore, two hours should elapse between medications.
Joint administration with "Digoxin" increases its content in the blood. You may need a dose adjustment of Digoxin.
When using “Azithromycin” with “Cyclosporine”, the concentration of the latter can increase, which requires a reduction in its dosage.
Large doses of Azithromycin and Nelfinavir can increase the amount of the first in the blood, but without increasing side effects.
Combination with Warfarin requires INR control at more frequent intervals.
Medicines for migraine with ergotamine and dihydroergotamine in the composition may be toxic to the body when interacting with "Azithromycin".
Analogs
- Azitral, Shreya life sciences Pvt. Ltd. (manufacturing country - India) is available in 250 mg capsules, packaged in blisters for 6, 12, 18 or 24 pieces, as well as in 500 mg capsules of 3, 6, 9 or 12 pieces in a box. The price ranges from 210 to 343 rubles.
- Sumamed, PLIVA HRVATSKA, doo (Croatia) is produced in tablets of 125 mg (six tablets), 500 mg (three), in the form of a powder for the manufacture of 100 mg / 5 ml infant suspension in one bottle with a spoon and syringe for dosing. Cost - from 330 to 1650 rubles.
- Hemomycin, HEMOFARM AD (Serbia) is available in capsule form of 250 mg (6 pieces), in powder form for reconstitution of a suspension taken orally at a dose of 200 mg / 5 ml or 100 mg / 5 ml (for different children age groups) , in tablets of 500 mg (for adults) in an amount of three pieces, as well as in the form of a lyophilisate for the preparation of a solution for infusion at a dose of 500 mg per vial. The price varies from 270 to 340 rubles.
- “Azithromycin Ekomed”, JSC “ABVA RUS” of domestic production in tablets of six pieces in a dosage of 250 mg and three pieces in a dosage of 500 mg at a price of 156 to 217 rubles.
- Azitroks, Pharmstandard-Leksredstva OJSC (Russia) is a powdery substance for the manufacture of a suspension taken orally at a dose of 100 mg / 5 ml and 200 mg / 5 ml. The bottle contains 15.9 grams of powder, placed in a box with a measuring spoon. As well as 250 mg capsules, six pieces and 500 mg three pieces, costing from 263 to 358 rubles.
- "Azitrus", OJSC "Synthesis" is produced in Russia in capsules of 250 (6 pieces), in powder for administration as a suspension in a suspension of children 200 mg / 5 ml, 100 mg / 5 ml, and also in powder for independent dilution of a suspension in a dose 50 mg (three or six pieces), 100 mg and 200 mg. It costs in the pharmacy chain from 210 to 559 rubles.
So, you have read the instructions for use of "Azithromycin" (250 and 500 mg).