In case of detection of complex infections 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 disrupt the work of a fully formed organism, so it must be taken in minimal doses.
Form and composition
The preparation consists of the active substance of azithromycin and auxiliary fillers, with the help of which the tablets are given the traditional form. Also, thanks to these substances, the absorption of the drug is better.
Due to the wide spectrum of antibiotic use in modern pharmacology, various forms of drug release are used:
- Hard gelatin capsules with blueblue body and cap, inside which is a white or light yellow powder (or compacted mass). When pressed, they disintegrate. In addition to the active ingredient, the capsules contain microcrystalline cellulose, sodium lauryl sulfate and magnesium stearate.
- "Azithromycin" (125) instructions for use for children describes how tablets in a blue film sheath, round, biconvex. On one side they have the engraving "PLIVA", on the other - "125". If you break it, you can see that the tablet is white at the break. Consists of the following excipients: anhydrous calcium hydrogen phosphate, hypromellose, corn starch, microcrystalline cellulose, pregelatinized starch, sodium lauryl sulfate and magnesium stearate.
- The drug "Azithromycin" for children instructions for use recommends taking in the form of a suspension, so in pharmacies you can buy a special powder for its preparation, which has a cherry or banana smell.
The cost of an antibiotic increases depending on the content of the active substance.
Pharmacological characteristics
"Azithromycin" refers to broad-spectrum antibiotics. When high concentrations are created in the focus of inflammation, microorganisms die.
Gram-positive cocci are the most sensitive to the action of the drug: Streptococcus pneumoniae, streptococci of groups CF and G, Staphylococcus aureus, St. Pyogenes, St. Viridans, St. Agalactiae; gram negativebacteria: 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 render the antibiotic inactive.
Pharmacokinetics
"Azithromycin" for children (instructions for use indicates this) is rapidly absorbed in the gastrointestinal tract due to its acid resistance and lipophilicity. It is quickly distributed throughout the body. Easily penetrates not only into 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 to serum proteins, the ability to penetrate into eukaryotic cells and concentration in the low pH environment surrounding lysosomes, the half-life and concentration in tissues increase.
All this determines a high 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 in the process of phagocytosis. After12-72 hours after ingestion, a high concentration of the drug is reached in the focus of inflammation, 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 remains at the site of inflammation for 5-7 days after the last dose, so it is possible to use the antibiotic once a day, while 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 for children recommends prescribing for infectious and inflammatory diseases that are provoked by bacteria sensitive to azithromycin. These diseases include: pneumonia, bronchitis, sinusitis, pharyngitis, soft tissue and skin infections, 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. Treatment of this disease must begin in a timely manner, otherwise you may face the most sad consequences. In this case, the antibiotic is chosen taking into account all the symptoms, the alleged 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 pneumoniasuspected in a baby aged 1 to 6 months, then. most likely, the causative agent is Staphylococcus aureus, from one to six years - Streptococcus pneumoniae. Azithromycin effectively fights both types of bacteria.
How to use
The treatment regimen will depend on the disease, but the total dose should be maintained. The doctor may prescribe the drug "Azithromycin" for children. Instructions for use of the tablet allow only adults to take it, since they contain from 250 to 500 mg of the active substance, and this amount is calculated for 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 dosage of a single use (10 mg / kg). It is for this reason that Azithromycin is prescribed as an antibacterial agent in adolescents (125). Instructions for use for children prohibit taking pills under 12 years old, they can be replaced with syrup or suspension.
For the treatment of acute inflammatory diseases of the respiratory tract, otitis, pneumonia, a single dose of medication (10 mg / kg) is prescribed. The drug "Azithromycin" (125) instructions for use for children in tablets recommends taking only after reaching the age of 14. Treatment of babies is carried out exclusively using a suspension.
It should be mentioned that 5 grams of Sumamed syrup (teaspoon) and other analogues of the drug also contain 125mg of 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, but in such a situation, the use of an antibiotic is permissible only under the supervision of a specialist. The drug "Azithromycin" (125) instructions for use for children allows use only in the case of a single or double dose at a dosage 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 case of hypersensitivity of patients to the components contained in the composition or others to macrolide antibiotics. This drug should never be used in severe hepatic or renal impairment.
Overdose and side effects
For those mothers who will use the drug "Azithromycin" for children, instructions for use (patient reviews on taking the antibiotic are presented in this material) provides a list of side effects. From the side of the lymphatic system and hematopoiesis, the development of thrombocytopenia is possible.
Patients show aggressiveness, hyperactivity, nervousness and anxiety. From the side of the nervous system, dizziness, convulsions, headaches, drowsiness and even fainting are possible. In rare cases, taking the drug causes insomnia, asthenia,paresthesia, the perception of smells and taste is also disturbed.
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 loss. Rarely, but still there are side effects of a dyspeptic nature and allergic reactions appear.
"Azithromycin" instructions for use for children allow use, but babies can only take the drug 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 should immediately rinse the stomach, and then proceed to symptomatic therapy.
Special Instructions
The use of "Azithromycin" during pregnancy is highly undesirable, but it is permissible if it is impossible to help a woman without its use (the effect of the drug on fetal development has not been 100% studied). During the lactation period, when using an antibiotic at the time of treatment, it is necessary to interrupt breastfeeding.
Children under 12 are better off choosing an analogue of Azithromycin.
Alcohol intake does not affect the effect of the drug, but its use aggravates the course of any disease. Sothe amount of alcohol consumed is recommended to be reduced to the maximum, and it is even better to refuse completely for the duration of treatment.
Drug Interactions
When taking Azithromycin with antacids containing calcium, magnesium and aluminum, the absorption of the antibiotic slows down, so a 2-hour interval between doses of these drugs must be observed.
The main difference between this drug and other macrolide antibiotics is the lack of connection 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, while chloramphenicol and tetracycline increase it.
Terms and conditions of storage
Antibiotic is recommended to be stored out of the reach of children at temperatures up to 25 degrees. The expiration date is indicated by the instructions for use available for the drug "Azithromycin" (for children). The prepared suspension can be stored for no more than 5 days, the powder itself - 2 years, and tablets and capsules - up to 3 years.
Analogues and patient opinions
Those who used "Azithromycin" for children (the instructions for using the capsule do not recommend taking it in childhood), the reviews were mostly positive. Afterthe first dose of an antibiotic reveals significant improvements in the condition, progressing in the future.
Analogues of the drug include "Azicin", "Zomax", "Sumamed", "Azitral", "Azax", "Zitrox" and others.
