"Azithromycin" is a powerful antibiotic from the group of macrolides, which is used by doctors of various profiles to treat diseases caused by bacteria sensitive to it. Often, the method of application of "Azithromycin" is oral. That is, it is taken in tablets, capsules or suspensions of various dosages. The use of the injection form is indicated in especially severe cases in a hospital setting.
Pharmacological action
"Azithromycin" refers to broad-spectrum macrolide antibiotics. It has mainly a bacteriostatic effect. This means that the drug, penetrating 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, thenis to act bactericidal. This can occur both outside and inside the affected cell of the human body.
The order of appointment and method of application of "Azithromycin" depends on the sensitivity of bacteria to this drug. Gram-positive (staphylococcus aureus, streptococcus pneumoniae and pyogenes) and gram-negative microorganisms (hemophilic bacillus, legionella, moraxella catarrhalis, pasteurella, gonorrhea neisseria), anaerobes (clostridia, fusobacteria, prevotella, porphyromonas), as well as chlamydia, mycoplasma and borrelia have sensitivity to it.. Fecal enterococcus, methicillin-resistant staphylococcus aureus, as well as fragilis bacteroids are resistant to this drug.
Absorption and excretion
After using Azithromycin tablets, the drug is absorbed into the bloodstream and reaches its maximum amount within two and a half hours. It easily passes through tissue barriers, therefore it quickly begins to act in the internal organs, and is also able to actively get inside the affected cells. Since the medicinal substance is transported throughout the body with the help of leukocytes, its concentration at the site of infection is one third higher than in he althy organs and cells.
Reactions for the processing of the drug occur in the liver with the help of enzymes. The half-life is on average 50 hours. Half of the drug is excreted in the feces, 6 percent in the urine. Having accumulation properties, "Azithromycin" is able to maintain its effect for a week after the reception wasover.
Indications
The use of "Azithromycin" in capsules of 500 and 250 mg and tablets in similar dosages depends on the disease.
Indications for prescribing 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, frontal sinusitis, ethmoiditis, sphenoiditis), otitis media.
- Pathology caused by bacteria affecting the lower respiratory tract (acute bronchitis and chronic exacerbation, 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 erythema migrans (annular rash).
- Microorganism damage to the urinary system (pyelonephritis without impaired kidney function, cystitis) and genital organs (cervicitis, urethritis) caused by both bacterial and chlamydial infection.
- Helicobacter pylori infection that provoked a stomach and duodenal ulcer.
Contraindications
The instructions for use of Azithromycin tablets clearly state the conditions under which this drug should not be taken:
- Breastfeeding the baby.
- Individual intolerance to the drug inpast.
- Increased sensitivity to macrolides.
- Baby age up to six months.
- Combined with ergotamine and dihydroergotamine (medicines for migraine).
- Severe kidney dysfunction.
- Liver failure.
Method of application and dose of "Azithromycin"
The drug in the form of tablets, capsules or suspensions is taken orally. The action of the drug is long, so it must be taken once a day, at the same time. To avoid the effect of products on the absorption of the medication, this should be done by waiting two hours, or one hour before eating.
Tablet forms do 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 mark.
The method of using "Azithromycin" for adults and children over the age of twelve and weighing more than 45 kilograms depends on the pathology of organs and systems.
In infectious diseases of the nasopharynx, ears, lungs, bronchi, skin and underlying structures, take 500 mg of the drug once a day for three days in a row. Just 1.5 grams.
The use of "Azithromycin" 500 mg per day for three consecutive days with further use of the drug in this dosage once a week for nine weeks is practiced with acne vulgaris, occurring in moderate form. As a result, six grams of the drug comes out for a course of treatment.
Lyme borreliosis at the initial stagemanifestations of symptoms are treated according to the scheme: the first day - 1 gram (two tablets of 500 mg), then from the second to the fifth day the dose is reduced to one tablet of 500 mg. The total dose will be three grams.
The method of using "Azithromycin" for chlamydia: two tablets of 500 mg one day. Just one gram.
The injectable form of the drug is used for severe pneumonia, replacing pills with intramuscular injections or intravenous drip infusions. The drug for injection contains 500 mg of the active ingredient, which is diluted with water for injection and injected intramuscularly or, diluted with sodium chloride, dextrose or Ringer's solution in an amount of 500 ml, slowly instilled for three hours. After a three-day course, with stabilization of the condition, the medicine is continued to be given in the form of capsules or tablets.
The method of using "Azithromycin" for inflammation of the kidneys (pyelonephritis) depends on the kidney functions. It should be prescribed at a standard dose of 500 mg for three days only if renal filtration is preserved, and also if it is not possible to prescribe another antibiotic more suitable for renal inflammation.
For the eradication of Helicobacter pylori infection, the drug in combination with other drugs is taken one gram per day for three days.
The method of using "Azithromycin" for children
Up to 12 years, it is better to use the powder form of the drug for the preparation of a suspension in order to more accurately calculate the dosage according to the weight of the child. According to the instructions for use "Azithromycin" (250mg) this drug is prescribed to children, having calculated it in the proportion of 10 mg / kg.
Suspension 200 mg/5 ml dosed as follows:
- Children from 10 to 14 kilograms - half a scoop (100 mg) - 2.5 ml.
- 15 to 25 kg - one scoop (200 mg) - 5 ml.
- From 26 to 35 kilograms - one and a half spoons (300 mg) - 7.5 ml.
- From 35-45 kg - two spoons (400 mg) - 10 ml.
Suspension 100 mg/5 ml dosed as follows:
- Children weighing 10-14 kilograms - one scoop (100 mg) - 5 ml.
- 15 to 25 kg - two scoops (200 mg) - 10 ml.
- Child from 26 to 35 kilograms - three spoons (300 mg) - 15 ml.
- Children 35-45 kg - four scoops (400 mg) - 20 ml.
Side effects
Even with the correct method of using Azithromycin, undesirable effects may occur:
- Digestive organs can react with dyspeptic symptoms and liver disorders: diarrhea (10%), nausea, vomiting, abdominal pain (9.99-1%), increased gas formation, constipation, difficulty swallowing, dryness of the oral mucosa, increased salivation, belching, ulceration of the 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 death can occur.
- The nervous system and analyzers suffer in the form of: headache (9.99-1%), taste disturbances, dizziness, feelings"Goosebumps" on the body, sleep disturbances, irritability, visual and hearing impairments, asthenia (0.99-0.1%), agitated behavior (0.099-0.01%), fainting, convulsions can also very rarely occur, changes in olfactory functions, hallucinations, delusional symptoms, deafness and myasthenia gravis.
- Heart and respiratory organs react in the form of: tachycardia, shortness of breath, pain in the chest, redness of the face, nosebleeds (0.99-0.1%), very rarely hypotension, arrhythmia, an increase in the Q-interval can occur T on electrocardiogram.
- The genitourinary organs may suffer, this is expressed by pain in the projection of the kidneys, urination disorders, edema, blood discharge in women, testicular dysfunction in men (0.99-0.1%), in extremely rare cases, an acute kidney failure.
- Hypersensitivity reactions in the form of Quincke's edema and skin rash, itching, urticaria and fever (0.99-0.1%), there have been cases of an unknown incidence of anaphylactic shock, Stevens-Johnson syndrome.
- Skin, joints and musculoskeletal system may react with: dry and inflamed 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, posterior pharyngeal wall, 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 tolymphocytic component, increase in eosinophils, monocytic cells and basophils (9.99-1%), growth of liver enzymes in blood biochemistry, bilirubin, urea, creatinine, chlorine, glucose, sodium, platelets and hematocrit (0.99-0.1%), decreased platelets, hemolytic anemia (0.099-0.01%).
Some Features
The use of "Azithromycin" (see above method) should be carried out with caution:
- In diseases of the liver and kidneys, causing serious dysfunction of these organs.
- Heart disease (arrhythmias, increased QT interval).
- Myasthenia gravis.
In mild to moderate impairment of kidney and liver function, as well as in elderly patients, the dose of the antibiotic does not need to be reduced.
In cases of drug overdose, dyspeptic symptoms may occur, as well as hearing loss that disappears over time.
When developing allergic reactions, it is strictly necessary to consult a doctor. Treatment and observation in this case may take some time.
Due to the possibility of developing reactions from the nervous system, extreme caution must be exercised when working at height and driving a car.
Drug Interactions
Antacids ("Renny", "Vikalin") can reduce the maximum content of "Azithromycin" in the bloodstream by 30%, therefore, two hours must pass between taking medications.
Joint reception with "Digoxin" increases its content inblood. You may need to adjust the dose of Digoxin.
When using Azithromycin with Cyclosporine, the concentration of the latter can increase, which requires a reduction in its dosage.
High doses of Azithromycin and Nelfinavir can increase the amount of the first in the blood, but without increasing side effects.
Combination with Warfarin requires more frequent INR monitoring.
Migraine drugs with ergotamine and dihydroergotamine in the composition can be toxic to the body when interacting with "Azithromycin".
Analogues
- Azitral, Shreya life sciences Pvt. Ltd. (manufacturing country - India) is available in 250 mg capsules, packed in blisters of 6, 12, 18 or 24 pieces, as well as in 500 mg capsules of 3, 6, 9 or 12 pieces per box. The price ranges from 210 to 343 rubles.
- Sumamed, PLIVA HRVATSKA, d.o.o. (Croatia) is produced in tablets of 125 mg (six tablets each), 500 mg (three tablets), as a powder for the manufacture of a 100 mg / 5 ml children's suspension in one vial, along with a spoon and a dosing syringe. Cost - from 330 to 1650 rubles.
- Hemomycin, HEMOFARM A. D. (Serbia) is available in encapsulated form of 250 mg (6 pieces), in powder form for diluting a suspension taken orally at a dose of 200 mg / 5 ml or 100 mg / 5 ml (for different children's age groups), in tablets of 500 mg (for adults) in the 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 perbottle. The price varies from 270 to 340 rubles.
- "Azithromycin Ecomed", JSC "AVVA RUS" of domestic production in tablets of six pieces at a dosage of 250 mg and three pieces at a dosage of 500 mg at a price of 156 to 217 rubles.
- "Azitroks", OJSC "Pharmstandard-leksredstva" (Russia) is a powdered 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 capsules of 250 mg six pieces and 500 mg three pieces costing from 263 to 358 rubles.
- "Azitrus", OJSC "Sintez" is produced in Russia in capsules of 250 (6 pieces), in powder for administration as a suspension for children 200 mg / 5 ml, 100 mg / 5 ml, as well as in powder for self-dilution of the suspension at a dose of 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).
