Azithromycin capsules: instructions for use. Azithromycin tablets: instructions for use In case of impaired renal function

Registration number: LSR-003652/07-010616
Brand name: Azithromycin
International generic name(INN): azithromycin
Dosage form: capsules
Composition
Active substance: azithromycin dihydrate - 265.3 mg in terms of the active substance (azithromycin) - 250.0 mg.
Excipients: microcrystalline cellulose - 104.7 mg, corn starch - 28.0 mg, low molecular weight povidone - 6.0 mg, magnesium stearate - 6.0 mg.
The composition of the capsule body: titanium dioxide - 1.0000%, iron dye yellow oxide - 0.0733%, gelatin - up to 100%.
The composition of the capsule cap: titanium dioxide - 1.0000%, iron dye yellow oxide - 0.0733%, gelatin - up to 100%.
Description
Capsules No. 0. The body and cap of the capsule are yellow, with a slightly brown tint, opaque.
The contents of the capsules are white or white with a slightly yellowish tint powder.

Pharmacotherapeutic group: antibiotic-azalide.
ATX code: J01FA10

pharmachologic effect

Pharmacodynamics
A broad-spectrum antibacterial agent, azalide, acts bacteriostatically. By binding to the 50S subunit of ribosomes, it inhibits the peptide translocase at the translation stage, inhibits protein synthesis, slows down the growth and reproduction of bacteria, and in high concentrations has a bactericidal effect. Acts on extra- and intracellular pathogens. Active against gram-positive microorganisms: Streptococcus spp. (groups C, F and G, except for those resistant to erythromycin), Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus viridans, Staphylococcus epidermidis, Staphylococcus aureus; gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Helicobacter pylori, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; as well as intracellular pathogens: Chlamydia trachomatis, Chlamydia pneumoniae, Mycoplasma pneumoniae, Mycobacterium avium complex, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdorferi. It is inactive against Gram-positive bacteria resistant to erythromycin.

Pharmacokinetics
Absorption - high, acid-resistant, lipophilic. Bioavailability after a single dose of 0.5 g - 37% (the effect of the "first pass" through the liver), the maximum concentration in blood plasma after oral administration of 0.5 g - 0.4 mg / l, the period of reaching the maximum concentration in blood plasma - 2 .5-2.9 h; in tissues and cells, the concentration is 10-50 times higher than in blood serum, the volume of distribution is 31.1 l / kg. Easily passes histohematic barriers. It penetrates well into the respiratory tract, genitourinary organs and tissues, into the prostate gland, into the skin and soft tissues; accumulates in an environment with low pH, in lysosomes (which is especially important for the eradication of intracellular pathogens). It is also transported by phagocytes, polymorphonuclear leukocytes and macrophages. Penetrates through cell membranes and creates high concentrations in them. The concentration in the foci of infection is significantly higher (by 24-34%) than in healthy tissues, and correlates with the severity of inflammatory edema. Remains in effective concentrations for 5-7 days after the last dose. Communication with plasma proteins - 7-50% (inversely proportional to the concentration in the blood). Demethylated in the liver, the resulting metabolites are not active. The isoenzymes CYP3A4, CYP3A5, CYP3A7, which it is an inhibitor of, are involved in the metabolism of the drug. Plasma clearance - 630 ml / min. The half-life between 8 and 24 hours after administration is 14-20 hours, the half-life in the range from 24 to 72 hours is 41 hours. 50% is excreted in the bile unchanged, 6% by the kidneys. Food intake significantly changes the pharmacokinetics (depending on the dosage form): capsules - the maximum concentration in the blood plasma decreases (by 52%). In elderly men (65-85 years), pharmacokinetic parameters do not change, in women the maximum concentration in blood plasma increases (by 30-50%), in children aged 1-5 years, the maximum content in blood plasma decreases, the half-life.

Indications for use

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: infections of the upper sections respiratory tract and ENT organs (pharyngitis, tonsillitis, laryngitis, sinusitis, otitis media); scarlet fever; infections of the lower respiratory tract (pneumonia (including those caused by atypical pathogens), bronchitis); infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatoses); infections urinary tract(gonorrheal and non-gonorrheal urethritis, cervicitis); Lyme disease (initial stage - erythema migrans), peptic ulcer of the stomach and duodenum associated with Helicobacter pylori (as part of combination therapy).

Contraindications

Hypersensitivity (including to other macrolides), severe hepatic / renal failure, lactation, children under 12 years of age (weighing less than 45 kg).
With caution: arrhythmia (possible ventricular arrhythmias and prolongation Q-T interval), children with impaired liver or kidney function, pregnancy.
Use during pregnancy and lactation: may be used in cases where the benefits of its use significantly outweigh the risk that always exists when using any drug during pregnancy. If necessary, the appointment of the drug during lactation should stop breastfeeding.

Dosage and administration

Inside, 1 hour before or 2 hours after meals 1 time per day.
Adults with infections of the upper and lower respiratory tract - 500 mg / day for 1 dose for 3 days (course dose - 1500 mg). For infections of the skin and soft tissues - 1000 mg / day on the first day for 1 dose, then 500 mg / day daily from 2 to 5 days (course dose - 3000 mg). In acute infections of the urinary organs (uncomplicated urethritis or cervicitis) - once 1 g. In Lyme disease (borreliosis) for the treatment of stage I (erythema migrans) - 1000 mg on the first day and 500 mg daily from 2 to 5 days (course dose - 3 G). At peptic ulcer stomach and duodenum associated with Helicobacter pylori - 1 g / day for 3 days as part of a combined anti-Helicobacter therapy.
Children over 12 years old (weighing more than 45 kg) with infections of the upper and lower respiratory tract, skin and soft tissues are prescribed 500 mg 1 time per day for 3 days.
In the treatment of erythema migrans in children (over 12 years of age), the drug is prescribed once a day at a dose of 1000 mg on the first day and 500 mg from 2 to 5 days.

Side effect

From the gastrointestinal tract: diarrhea (5%), nausea (3%), abdominal pain (3%); 1% or less - flatulence, vomiting, melena, cholestatic jaundice, increased activity of "liver" transaminases; in children - constipation, loss of appetite, gastritis; candidiasis of the oral mucosa, change in taste (1% or less).
From the side of the cardiovascular system: palpitations, pain in chest(1% or less).
From the side nervous system: dizziness, headache, drowsiness; in children - headache (in the treatment of otitis media), hyperkinesia, anxiety, neurosis, sleep disturbances (1% or less).
From the side genitourinary system: vaginal candidiasis, nephritis (1% or less).
Allergic reactions: rash, urticaria, skin itching, angioedema, in children - conjunctivitis.
Other: asthenia, photosensitivity.

Overdose

Symptoms: severe nausea, temporary hearing loss, vomiting, diarrhea.
Treatment: gastric lavage, symptomatic therapy.

Interaction with other drugs

Antacids (aluminum- and magnesium-containing), ethanol and food slow down and reduce the absorption of azithromycin.
With the joint appointment of warfarin and azithromycin (at usual doses), no change in prothrombin time was detected, however, given that the interaction of macrolides and warfarin may increase the anticoagulant effect, patients need careful monitoring of prothrombin time.
Increases the concentration of digoxin due to the weakening of its inactivation by the intestinal flora.
Ergotamine and dihydroergotamine: increased toxic effect (vasospasm, dysesthesia).
Triazolam: decreased clearance and increased pharmacological action triazolam.
Slows down the excretion and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs undergoing microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin, oral hypoglycemic drugs agents, theophylline and other xanthine derivatives), due to the inhibition of microsomal oxidation in hepatocytes by azithromycin.
Lincosamides weaken, and tetracycline and chloramphenicol increase the effectiveness of azithromycin.

special instructions

Do not take with food.
If a dose is missed, the missed dose should be taken as soon as possible and subsequent doses should be taken 24 hours apart.
It is necessary to observe a break of 2 hours with the simultaneous use of antacids.
After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Release form
Capsules of 250 mg.
3, 6 capsules in a blister pack made of PVC film and printed lacquered aluminum foil.
3, 6, 12, 18, 24, 30, 36, 42, 48, 54 or 60 capsules in polyethylene terephthalate jars or polymer jars for medicines.
One jar or 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 blister packs together with instructions for use are placed in a cardboard package (pack).

Storage conditions
Store in a place protected from light at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

You should not get carried away with antibiotics, because they have a detrimental effect not only on pathogenic bacteria, but also on beneficial microorganisms. However, in some cases, the use of antibacterial agents is justified, since they often help to avoid serious complications. One of the modern antibiotics used in the treatment of children is Azithromycin.

Properties, composition and form of release of the drug Azithromycin

The drug was named after active substance- azithromycin, which belongs to the semi-synthetic broad-spectrum antibiotics from the azalide class. The composition also includes auxiliary components: lactose, cellulose, povidone and magnesium stearate.

The antibiotic is active against gram-positive streptococci, gram-negative bacteria, and some anaerobic microorganisms. The drug is effective in the fight against chlamydia, mycoplasma and ureaplasma, but does not affect gram-positive bacteria resistant to Erythromycin.

The drug is produced in three dosage forms - in tablets, capsules and suspensions. Small children are not given tablets and capsules because there is a risk that the child will choke. The prepared suspension is more convenient to use for such patients. In addition, it allows you to calculate the dosage exactly according to the weight of the baby.

Indications for use for children

Azithromycin is prescribed for:

• bacterial infections of the nasopharynx: sinusitis, sinusitis, otitis media with and without pus, laryngitis, pharyngitis, tonsillitis;
• infectious diseases: scarlet fever, whooping cough, Haemophilus influenzae, borreliosis;
• diseases of the respiratory organs: tracheitis, bronchitis, pneumonia;
• diseases of the gastrointestinal tract: gastritis, ulcer;
• skin lesions: dermatitis, abscesses, erysipelas.

The effectiveness of treatment depends on the pathogen that caused the disease. Before prescribing antibiotic therapy, the doctor must take an analysis - a smear, culture or scraping - and identify the bacterium and its sensitivity to antibiotics.

Often, a healthcare professional prescribes medications based on symptoms alone. Many modern drugs have a wide spectrum of action. In most cases, they kill the pathogenic flora, but sometimes they are ineffective. The doctor then prescribes an antibiotic active substance other pharmacological group.

Instructions for use: dosage by weight and age

According to the instructions, Azithromycin is taken 1 time per day, regardless of the form produced, and preferably at the same time. For better absorption, it is recommended to take the antibiotic between meals - either 1 hour before meals or two hours after. Treatment should last 3 days, according to indications, the course is increased to 5 days.

Suspension

To prepare the suspension, boiled water at room temperature is used. First, the container with dry powder is shaken well and filled with the required amount of water, then the contents of the vial are shaken well. The prepared solution can be stored in the refrigerator for a maximum of 5 days. Before each use, the drug must be shaken. The suspension is recommended to drink a small amount of water.

There are two types of bottles on sale:

• Small, containing powder for the preparation of 15 ml of the drug. Dilution requires 7.5 ml of water.
• Increased volume, designed to obtain 30 ml of suspension by adding 15 ml of water.

For small children whose body weight has not reached 15 kg, it is necessary to measure the amount of antibiotic very accurately. To do this, it is convenient to use a measuring syringe, which is included in each package. The price of its division is 0.25 ml. Starting from a body weight of 15 kg, you can use the measuring spoon for dosing, which is also included in the kit.

The dose of the drug is calculated not by age, but by body weight. This is due to the fact that both the first year of life and older children can be very different from each other. For one kilogram of body weight of a child, 10 mg of an antibiotic should be given.

Azithromycin powder is produced at a dosage of 100 mg per 5 ml and 200 mg per 5 ml. This means that 0.5 ml of the finished suspension will contain 10 mg or 20 mg, respectively.

For children weighing over 15 kg, it is more convenient to give the drug at a concentration of 200 mg / 5 ml. For children, the liquid form of the drug is preferable, not only because it is easier to swallow. Flavoring additives are included in the composition of the powder, which turns the suspension into a sweet syrup.

Tablets

Children weighing over 45 kg are preferably treated with tablets or capsules. These forms medicinal product Available in dosages of 125 mg and 250 mg.

Children from 3 to 12 years old are prescribed a medicine of 125 mg, after 12 - 250 mg. The dosage may vary depending on the pathology. Tablets and capsules must be swallowed whole and washed down with a small amount of water.

Dosage calculation

According to the instructions Azithromycin for children should be given as follows:

When is the drug contraindicated?

• According to the instructions, the antibiotic is not prescribed to infants up to 6 months of age.
• The drug is contraindicated in case of allergy or hypersensitivity to azithromycin or auxiliary components of the drug.
• If a child suffers from allergies, then it is not recommended to give the drug in the form of a suspension due to the sugar and flavoring additives it contains.
• Impaired liver and kidney function of severe degrees, with a creatinine clearance of less than 40 ml / min, are also the reason for refusing to use the drug. Even if liver dysfunction is mild, there is a risk of provoking fulminant hepatitis and severe liver failure. In such cases, drugs containing azithromycin are prescribed under medical supervision.

If symptoms such as yellowing of the skin and eye sclera, hepatic encephalopathy, asthenia, dark urine staining, bleeding appear, treatment should be interrupted until a complete examination of the liver. According to the results, therapy can be continued or replaced with other medicines.

Patients with a pronounced form of bradycardia, with a tendency to arrhythmias, patients with diabetes those suffering from heart failure should also be careful when using azithromycin-containing drugs. The use of Azithromycin in conjunction with anticoagulants and cardiac glycosides is possible only after consultation with a specialist.

Possible adverse reactions in a child

As with the use of any medicine, the use of Azithromycin can cause side effects. This does not indicate the imperfection of the drug, but is associated only with the individual characteristics of the organism.

Possible adverse reactions when using Azithromycin in accordance with the WHO classification:

• very common - symptoms that occur in 1 in 10 patients: nausea, flatulence, indigestion;
• often - effects observed in at least 1 in 10 patients and not more than 1 in 100: weakness, vomiting, decreased visual acuity and hearing, changes in taste, headache, anorexia, dizziness, pruritus, eosinophilia and lymphocytopenia;
• infrequently - occurring with a frequency of at least 1 in 1000, but not more than 1 in 100: insomnia or drowsiness, anxiety, tinnitus, deafness, constipation, neutropenia, leukopenia, hepatitis, urticaria, chest pain, asthenia, edema;
• rarely - occurring in at least 1 in 1000 patients, but not more than 1 in 10,000: abnormal liver function;
• very rare - refers to cases reported in less than 1 in 10,000 patients: convulsions, syncope, anxiety, aggression, dullness of taste sensations, pancreatitis, decreased blood pressure, arrhythmia, tachycardia, hemolytic anemia, thrombocytopenia, liver failure, liver necrosis, anaphylactic shock.

If a child experiences any side effects, it is necessary to consult a doctor about the advisability of continuing to take the medication.

The specialist will either appoint additional funds, blocking negative symptoms, or pick up another antibiotic.

The cost and analogues of Azithromycin

Azithromycin is a drug Russian production, which is an analogue of Sumamed, which is manufactured by Pliva Hrvatska D.O.O., Croatia. The cost of Azithromycin for children (suspension 200 mg / 5 ml, in a vial 16.5 g) in large cities of Russia averages 250-275 rubles. Sumamed in the same form costs about 350-380 rubles (we recommend reading:).

Given the effectiveness of azithromycin against many bacteria, many countries of the world are engaged in the production of medicines based on it. Most drugs are presented in different forms - from tablets to powders for suspension. The composition may vary slightly due to excipients.

The following are preparations based on Azithromycin from various manufacturers:

• Azitrox. Domestic antibiotic. Manufactured by Pharmstandard.
• Zitromax. Made in Italy by Pfizer.
• Zimaks. An antibiotic produced in Turkey. The release is handled by Bilim Pharmaceuticals.
• Zitrolide. Another drug of Russian production. Development of OAO Valenta.
• Zitrocin. Produced by the Indian company Unique Pharmaceutical Laboratories.
• Zetamax Retard. Produced by the American company PFIZER, Puerto Rico.
• Sumamox. Development of the Indian pharmaceutical company Oxford Laboratories PVT. Ltd.
• Hemomycin. Issued by Yugoslavia. Manufacturer: Hemofarm Koncern A.D.

Usually, the attending physician prescribes a specific medicine, but if necessary, it is possible to independently choose an analogue in a pharmacy. Which manufacturer to give preference to is a personal choice for everyone. However, it is worth remembering that only patented medicines pass the tests, which in this case is Sumamed. For analogues, laboratory tests are not mandatory.

Published on this page detailed instructions by application Azithromycin. The available dosage forms of the drug (capsules and tablets 250 mg and 500 mg), as well as its analogues, are listed. Information is provided on the side effects that Azithromycin can cause, on interactions with other drugs. In addition to information about the diseases for the treatment and prevention of which the drug is prescribed (tonsillitis, bronchitis, pneumonia), the algorithms for admission, possible dosages for adults and children are described in detail, the possibility of using during pregnancy and lactation is specified. Annotation to Azithromycin is supplemented by reviews of patients and doctors. Interaction of the drug with alcohol.

Instructions for use and dosage

Inside, 1 hour before or 2 hours after meals 1 time per day.

Adults with infections of the upper and lower respiratory tract - 500 mg per day for 1 dose for 3 days (course dose - 1.5 g).

For infections of the skin and soft tissues - 1000 mg per day on the first day for 1 dose, then 500 mg per day daily from 2 to 5 days (course dose - 3 g).

In acute infections of the genitourinary organs (uncomplicated urethritis or cervicitis) - once 1000 mg.

In Lyme disease (borreliosis) for the treatment of stage 1 (erythema migrans) - 1000 mg on the first day and 500 mg daily from 2 to 5 days (course dose - 3 g).

For stomach ulcers and duodenum associated with Helicobacter pylori - 1 g per day for 3 days as part of a combined anti-Helicobacter therapy. Children over 12 years old (weighing 50 kg or more) with infections of the upper and lower respiratory tract, skin and soft tissues - 500 mg 1 time per day for 3 days.

In the treatment of erythema migrans in children, the dose is 1000 mg on the first day and 500 mg daily from days 2 to 5.

Release forms

Film-coated tablets 250 mg and 500 mg.

Capsules 250 mg and 500 mg.

Azithromycin- a broad-spectrum antibiotic. It is a representative of a subgroup of macrolide antibiotics - azalides, acts bacteriostatically. When creating high concentrations in the focus of inflammation, it has a bactericidal effect.

Acts on extra- and intracellular pathogens. Gram-positive and gram-negative microorganisms are sensitive to azithromycin; some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; as well as Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdorferi. Azithromycin is not active against Gram-positive bacteria resistant to erythromycin.

It is also active against Toxoplasma gondii.

Pharmacokinetics

Azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract (in particular, into the prostate gland), into the skin and soft tissues. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to the sites of infection, where it is released during phagocytosis. The concentration of azithromycin in the foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite the high concentration in phagocytes, azithromycin does not significantly affect their function. Azithromycin persists at bactericidal concentrations for 5-7 days after the last dose, which allowed the development of short (3-day and 5-day) courses of treatment. Demethylated in the liver, the resulting metabolites are not active. 50% is excreted unchanged in the bile, 6% - by the kidneys.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

• infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, pharyngitis, otitis media);
• scarlet fever;
• infections of the lower respiratory tract (including those caused by atypical pathogens);
• infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatoses);
• infections of the urogenital tract (uncomplicated urethritis and / or cervicitis);
• Lyme disease (borreliosis), for the treatment of the initial stage (erythema migrans);
• diseases of the stomach and duodenum associated with Heliobactcr pylori (as part of combination therapy).

Contraindications

• hepatic and / or renal failure;
• lactation period;
• children's age up to 12 years;
• hypersensitivity (including to other macrolides).

special instructions

If a dose is missed, the missed dose should be taken as soon as possible and subsequent doses should be taken 24 hours apart.

It is necessary to observe a break of 2 hours with the simultaneous use of antacids. After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Side effect

• diarrhea;
• nausea;
• abdominal pain;
• dyspepsia (flatulence, vomiting);
• constipation;
• anorexia;
• taste change;
• candidiasis of the oral mucosa;
• heartbeat;
• chest pain;
• dizziness;
• headache;
• drowsiness;
• neurosis;
• sleep disturbance;
• vaginal candidiasis;
• rash;
• angioedema;
• skin itching;
• hives;
• conjunctivitis;
• increased fatigue;
• photosensitivity.

drug interaction

Antacids (aluminum and magnesium containing), ethanol (alcohol) and food slow down and reduce absorption. With the joint appointment of warfarin and azithromycin (in normal doses), no change in prothrombin time was detected, however, given that the interaction of macrolides and warfarin may increase the anticoagulant effect, patients need careful monitoring of prothrombin time.

Digoxin: increased concentration of digoxin.

Ergotamine and dihydroergotamine: increased toxic effect (vasospasm, dysesthesia).

Triazolam: decreased clearance and increased pharmacological action of triazolam. Slows down the excretion and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs undergoing microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexo-barbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin, oral hypoglycemic agents, theophylline and other xanthine derivatives) - due to the inhibition of microsomal oxidation in hepatocytes by azithromycin.

Lincosamines weaken the effectiveness, tetracycline and chloramphenicol - increase.

Analogues medicinal product Azithromycin

Structural analogues for the active substance:

• Azivok;
• Azimicin;
• Azitral;
• Azitrox;
• Azithromycin Forte;
• Azithromycin OBL;
• Azithromycin McLeods;
• Azithromycin dihydrate;
• AzitRus;
• AzitRus forte;
• Azicide;
• Vero Azithromycin;
• Zetamax retard;
• Zitnob;
• Zitrolide;
• Zitrolide forte;
• Zitrocin;
• Sumazid;
• Sumaclid;
• Sumamed;
• Sumamed forte;
• sumamecin;
• sumamecin forte;
• Sumamox;
• Sumatrolide solutab;
• Tremak Sanovel;
• Hemomycin;
• Ecomed.

Use in children

Contraindicated in children under 12 years of age.

Use during pregnancy and lactation

Azithromycin may be used during pregnancy when the benefits far outweigh the risks associated with the use of any drug during pregnancy.

If it is necessary to prescribe the drug during lactation, it is necessary to resolve the issue of stopping breastfeeding.

Over the past 35 years, scientists have discovered thousands of antibiotics with various spectrums of action. But only a few are used in medicine, especially in the therapy of children.

Azithromycin is one of those drugs that has been successfully used to treat many diseases.

Let us examine in more detail the instructions for the use of the drug Azithromycin 250 mg for children: what is the dosage of the drug for children of different ages, the price in pharmacies, reviews of parents.

Description

Azithromycin is a semi-synthetic antibiotic, a representative of a subclass of azalides, which are somewhat different in structure from macrolides. This development of the pharmaceutical company Pliva from Croatia.

The active substance is azithromycin (250 mg), a white crystalline powder. Additionally, the composition includes lactose, povidone, magnesium stearate, aerosil, microcellulose.

For pediatric use, Azithromycin is available in two forms:

• capsules;
• film-coated tablets.

The package contains 6 tablets (capsules) in individual cells.

Indications

Azithromycin is prescribed for infections caused by antibiotic-sensitive microorganisms:

Sensitivity to the active substance is shown:

• gram-positive bacteria: Staphylococcus aureus, Streptococcus spp;
• gram-negative bacteria: Borrelia burgdorferi, Bordetella parapertussis, Bordetella pertussis, Campylobacter spp., Escherichia coli, Haemophilus ducreyi, Helicobacter pylori, Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrhalis, Neisseria gonorrhoeae;
• other microorganisms - Mycoplasma pneumoniae, Chlamydia trachomatis, Mycoplasma hominis, Bacteroides fragilis, Treponema pallidum.

Most often, the drug is used to treat the organs of the upper respiratory tract.

About the symptoms and methods of treatment of tuberculosis in children from our next article.

Contraindications

Azithromycin in tablets and capsules 250 mg is not prescribed for children who weigh less than 45 kg, since it is difficult to find a dosage. For lighter weights, suspensions are used.

The prescription of the drug is contraindicated in such diseases and conditions:

• hypersensitivity - not only to this agent, but also to other macrolides;
• severe forms of disorders of the liver and kidneys.

An antibiotic is used with caution for moderate violations of the hepatic, renal functions, cardiac arrhythmia and a predisposition to such a pathology.

For pregnant women, this remedy is prescribed only when absolutely necessary. Breast-feeding stop during treatment.

How the drug works

Azithromycin is a macrolide, but structurally different from them. It has not a 14-atomic lactone, but a 15-atomic ring, as a result of which it ceases to be lactone.

Thanks to this rearrangement, the acid resistance of the active substance is 300 times greater than that of Erythromycin, the first macrolide antibiotic.

Once in the stomach, azithromycin is not destroyed by hydrochloric acid. In the body, the substance does not create a high concentration in the blood, it is well distributed and penetrates into many organs.

Accumulates in tissues, creating high concentrations, and remains there for a long time. It has a wider spectrum of activity against pathogenic microbes.

Other advantages of Azithromycin in comparison with Erythromycin:

• better overcomes the membrane of cells of gram-negative bacteria;
• better penetrate into paranasal sinuses nose
• active against Haemophilus influenzae Pfeiffer (H.influenzae) - the causative agent of pneumonia, meningitis, epiglottitis (inflammation of the pharynx);
• creates high intracellular concentrations;
• acts bactericidal on pathogens inside cells.

This superiority extends to spirochetes (Lyme disease), rickettsiae (SARS), Toxoplasma gondii (toxoplasmosis), gram-negative rods, gram-negative cocci.

Azithromycin is excreted from the body along with feces.

Dosage at different ages

According to the instructions for use of Azithromycin 250 mg, the dosage for children is prescribed depending on the sensitivity of the pathogen to the antibiotic and the severity of the disease. Standard doses - 5 to 10 mg per 1 kg once a day. The duration of the course of treatment is from 2 to 5 days.

In some diseases, a correction or division of the dose into several doses is necessary.

If a dose is missed, then the next dose is taken as soon as possible, and then an interval of 24 hours between doses is observed.

Method of administration, special instructions

Capsules and tablets are taken orally, do not chew or remove from the capsule, do not remove the shell.

Food slows down the absorption of the drug, so Azithromycin is taken 1 hour before meals or 2 hours after it.

The same should be the interval between the medicine and antacids - drugs that reduce the acidity of the stomach.

Interaction with other substances

Azithromycin reacts with such medicinal substances:

• antacids - reduce the blood concentration of the substance by 30%;
• indinavir, triazol, midazolam, cimetidine, fluconazole, cotrimoxazole - a decrease in the concentration of these drugs is possible;
• digoxin, cyclosporine - it is possible to change the concentration of these drugs;
• warfarin - prothrombin time should be monitored;
• disopyramide - the risk of developing ventricular fibrillation;
• terfenadine - arrhythmia occurs;
• ergot alkaloids - the risk of developing ergotism (ergot poisoning);
• rifabutin - the risk of neutropenia and leukopenia (decrease in the level of neutrophils and leukocytes).

Overdose and side effects

In case of an overdose, the patient experiences nausea, and hearing decreases for a short time. If these symptoms occur, seek medical attention immediately.

Azithromycin - modern semi-synthetic antibacterial drug subclass of azalides (group of macrolides), which has a wide spectrum of action on pathogenic microflora and has a pronounced bacteriostatic effect.

It is used for inflammatory and infectious lesions, especially in cases where the penicillin series does not suppress the bacterial flora.

The active (active) substance is azithromycin dihydrate, the chemical compound of which is as follows: 9-deoxo-9a-aza-9a-methyl-9a-homoerythromycin A.

Azithromycin is distinguished by its ability to quickly penetrate into all organs and tissues. This is achieved due to the active absorption of the medicinal substance from the intestine into the blood. The active substance is not afraid of acidic environments, and quickly dissolves in fats.

Azithromycin dihydrate - a substance of prolonged action, and a single use of the drug, especially in a loading dose, retains its presence in the body for up to 6 days. After taking azithromycin, literally after 2 hours, the maximum concentration of the active substance in the body is observed, which makes it possible to achieve a high therapeutic effect after the first doses of treatment.

Due to this feature, the drug successfully treats serious infections in short courses(from 3 to 5 days), and with a convenient dosage - 1 dose per day. Due to this, azithromycin has gained great popularity in pediatric practice and is used for many infections in the younger generation.

Forms and dosages of azithromycin for children

Due to the fact that azithromycin is a powerful remedy for bacteria, with a mild course of the disease, the drug is not recommended. Only if there are special indications is it “connected” as a percussion tool. For children, azithromycin is prescribed in tablets of 125 and 250 mg, as well as capsules of 250 mg (according to the current instructions for use of the drug). One blister contains 6 tablets or capsules.

For ease of use, there is another form of azithromycin for children - this is a suspension (syrup), but the packages do not indicate 250 mg, as in tablet form, but the following information is given: 100 mg / 5 ml or 200 mg / 5 ml. For example, to obtain a suspension at a dose of 250 mg, it is necessary to give the child 12.5 ml once (at a dose on the package of 100 mg / 5 ml).

The dosage of the drug and the duration of administration is determined only by the doctor. Any antibacterial agent not subject to independent use, especially in children.

A dose of azithromycin 125-250 mg is prescribed for a body weight of at least 45 kg, in other cases it is recommended dosage form in the form of a suspension. For children weighing up to 45 kg, the calculation of the drug is carried out at the rate of 10 mg / kg (reception 1 time per day).

The drug is taken without food (one hour or two hours after a meal). The time of taking the medicine should be fixed, for example, at 11 am. Do not chew the tablet or capsule and drink plenty of water.

Instructions for use of azithromycin for children tells about the method of taking all forms of the drug, but The most convenient capsules are 250 mg.. They are easy to swallow, because. they slip, and there is no unpleasant sensation on the tongue, as from taking pills. Solid forms of azithromycin are already used in children old enough to be able to take them correctly without difficulty.

Important ! Azithromycin is not indicated for children under 6 months of age, due to the high likelihood of convulsive reactions and gastrointestinal disorders (up to bleeding).

The price of azithromycin 250 varies between 50-90 rubles and above, depending on the pharmacological company, although you can also meet social offers, for example, from Vertex (Russia) - 32 rubles. Azithromycin analogues have a higher price. The cost of sumamed (Teva, Israel), the most famous analogue, is within 350 rubles.

Indications for the use of azithromycin

The drug is prescribed for the following pathological processes:

• sinusitis (sinus infections);
• tonsillitis (acute and recurrent forms);
• pharyngitis;
• bronchitis;
• tracheitis;
• pleurisy (in initial stages disease);
• pneumonia;
• erysipelas;
• infectious dermatoses;
• furunculosis;
• scarlet fever;
• urinary tract infections;
• impetigo;
• in complex schemes treatment of the gastrointestinal tract;
• Lyme disease (tick-borne borreliosis).

In order for the treatment to be effective, a bacterial culture on the microflora with an antibiogram should be carried out. This analysis will determine the causative agent of the disease and help determine whether azithromycin is suitable in a particular case. For example, with angina, a smear is taken from the area of ​​\u200b\u200bthe affected tonsils.

The negative point is that bakposev is prepared for 5-10 days, and the disease is an insidious thing, and will not wait long. Therefore, in most cases, sowing is performed, but the treatment is prescribed blindly. If the antibiotic did not fit, then upon receipt of the results of the smear, it will be possible to accurately apply the sensitive drug to the pathogenic microflora.

You can check out other effective medicines from a runny nose.

Contraindications and side effects

Azithromycin, like all antibacterial agents, has a number of disadvantages and not approved for use under the following conditions:

• intolerance to macrolides;
• arrhythmias (severe forms);
• propensity to allergic reactions;
• myasthenia gravis;
• severe liver and kidney disease;
• age up to 6 months.

Adverse reactions are possible in the form of:

• diarrhea
• vomiting;
• persistent nausea;
• dizziness;
• pain or cramps in the abdomen;
• flatulence;
• tachycardia;
• refusal to eat;
• skin rashes;
• irritability;
• sleep disorders;
• violations of biochemical parameters of blood (more often with an overdose).

The appearance of severe side effects requires immediate discontinuation of the drug.

can be accepted antihistamine(erius, claritin, loratadine). Usually, the doctor prescribes one of these drugs to “cover” antibiotics, warning in advance dangerous symptoms. Even if there is a reaction to the antibiotic, it will pass in the most harmless form.

How to properly store Azithromycin 250?

The medicinal product should be kept away from children and sunlight. The recommended storage temperature is 15-25°C. The shelf life of azithromycin is indicated on the package, and is 2-3 years, depending on the manufacturer.

It should be remembered that azithromycin 250 in tablets and capsules is stored for a long time, because. each pill is protected by a blister, and the syrup (suspension) in the open form quickly deteriorates, it should not be stored for more than 10 days.

Azithromycin analogs

Analogues may match the active substance or the mechanism of action. So, here is a list of analogues that have azithromycin in their composition:

• chemomycin;
• sumamed;
• clubax;
• sumamox;
• azitrox;
• zitrocin;
• Azicide;
• sumaclid;
• zitrolide;
• other.

These funds replace azithromycin if the drug itself was not entirely suitable. All these analogues have their price, and it is slightly higher than the price of azithromycin.

The following drugs are suitable for a similar mechanism of action:

• clarithromycin;
• erythromycin;
• lecoclair;
• arvicin;
• spiramycin;
• macrofoams;
• rovamycin;
• fromelide;
• other.

Analogues, reviews, side effects Azithromycin

Feedback on the use of azithromycin 250

Before using azithromycin 250, parents carefully study the instructions for use for children, reviews, and analyze whether the antibiotic will harm the child? Such an approach is undoubtedly justified and deserves respect. Unfortunately, some unfortunate doctors practice the use of azithromycin for other purposes, when lighter antibiotics can also cope with the disease.

Of course, the effect of azithromycin will be lightning fast, but then how to treat complex infections if the body gets used to receiving a strong antibiotic in simple forms of illness. This is a rather serious moment in treatment and parents should be aware of this. Trust but check. If in doubt, seek advice from another specialist.

And now let's get acquainted with the reviews of parents, taken from the correspondence of users from well-known forums.

Nastya

My daughter (14 years old) is constantly ill with ARVI, and, unfortunately, very often the disease is complicated by tracheitis or bronchitis, and the complication after the virus comes quickly. Recently got very ill. The pediatrician prescribed Augmentin, ACC, Erespal in syrup. There was practically no result, wheezing went down lower. When my daughter coughed, it was clear to me, not even a doctor, that her breathing was weakened, and the cough seemed to be heard from within.

The antibiotic was replaced with azithromycin 250. After the first tablet, the temperature returned to normal. And after three days the child was healthy. Only three pills and such results. The tool deserves a high rating, and I give it.

Valentine

The doctor canceled amoxiclav and prescribed sumamed (5 tablets in total). I want to warn you, sumamed is an analogue of azithromycin, but much more expensive. The pharmacist suggested this information to me, I really doubted at first, but still took azithromycin. At 15:00 I took the first pill. In the morning I checked my throat, and I was pleased with the result: the raids went down by 50%. Finished all the pills. Then they drank Narine (kefir for dysbacteriosis) for 10 days for prevention. Azithromycin overcame severe sore throat with a bang.

Natalia

My son was 10 years old when he caught a serious cold. Strongly coughed, sweated, the temperature was kept within 37.3 degrees. The doctor, after listening to the child, determined that the breathing was hard, weak and similar to right-sided dry pleurisy. On the first day it was prescribed: azithromycin 250, and the remaining four days took a smaller dose - 125 mg each. The child recovered quickly.

After a while, the son was given a fluorographic picture, and the radiologist drew attention to the fact that the sinus was “soldered” - this means that there was once pleurisy. So azithromycin helped, and we did without injections at that time. Great antibiotic!

Yanina

Everyone writes only positive things, but my experience is different. I am 24 years old, no longer a child, but the dose of the drug azithromycin was prescribed in a children's dosage - 250 mg. It’s just that my weight is 49 kg, and that’s why they gave me such a dose. Treat tracheobronchitis. She complained of cough, thick sputum, shortness of breath, lethargy and headache.

Bronchitis passed, but a day after taking the last pill (fifth in a row), a terrible rash began all over my body. There were no acne only on the face and hands. They put me on a diet, prescribed Karsil, Holosas and Erius. But, despite all this treatment, the rash went down very slowly. Only after two months the skin was completely cleared.

The reasons for this phenomenon were not found, except for the comment of the immunologist - weak immunity and the liver is poorly cleansed, although the results of blood and ultrasound did not find any pathology with the liver. Here is my experience of treatment with azithromycin.

Alexandra

I got sick at the cottage. Runny nose, fever, and then a painful cough began. Moreover, I also infected my daughter, most likely viral infection"worked". I had to go to work on Monday, but the boss made it clear on the phone that I could only be ill for three days or they would find a replacement for me. Saved only sumamed - an analogue of azithromycin.

My daughter developed severe bronchitis, and our district police officer also advised me to drink sumamed only in a children's dosage. Moreover, my daughter's purulent acne, which we have been fighting for the second year, has disappeared. Apparently the rash had an infectious origin. They were very satisfied with the drug, I can even say more, I have not seen such an instant effect from antibiotics before.

Azithromycin is a highly effective antibacterial agent with a relatively low price, a long half-life and a low percentage of side effects (no more than 2%). The antibiotic occupies a leading position in the frequency of prescriptions in the treatment of childhood infections and shows excellent results of therapy.