Catad_pgroup Antibiotics macrolides and azalides

Azitrox 250 mg - instructions for use

INSTRUCTIONS
on medical use of the drug

Registration number:

Tradename: Azitrox ®

International nonproprietary name:

Dosage form:

Composition per capsule

Active substance: azithromycin dihydrate in terms of azithromycin – 250 mg.

Excipients: mannitol (mannitol) – 54.58 mg, corn starch – 13.10 mg, magnesium stearate – 2.0 mg, sodium lauryl sulfate – 0.32 mg;

Hard gelatin capsules

capsule composition: body and cap– titanium dioxide (E 171), gelatin (medical gelatin).

Description: white capsules No. 0. The contents of the capsules are white or white powder with a yellowish tint.

Pharmacotherapeutic group:

ATX code:

Pharmacological properties

Pharmacodynamics

Broad-spectrum antibiotic. It is a representative of a subgroup of macrolide antibiotics – azalides. By binding to the 50S subunit of ribosomes, it inhibits peptide translocase at the translation stage, suppresses protein synthesis, slows down the growth and reproduction of bacteria, acts bacteriostatically, and has a bactericidal effect in high concentrations. Acts on extra- and intracellular pathogens.

Active against gram-positive aerobic microorganisms: Streptococcus spp. (groups A, B, C, G), Streptococcus pneumoniae (penicillin-sensitive), Streptococcus pyogenes, Staphylococcus aureus (methicillin-sensitive); gram-negative aerobic microorganisms: Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Legionella pneumophila, Neisseria gonorrhoeae, Pasteurella multocida; some anaerobic microorganisms: Prevotella spp., Clostridium perfringens, Fusobacterium spp., Porphyriomonas spp.; as well as Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi.

Microorganisms that can develop resistance to azithromycin: gram-positive aerobes (Streptococcus pneumoniae (penicillin-resistant)). Initially resistant microorganisms: gram-positive aerobes (Enterococcus faecalis, Staphylococcus spp. (methicillin-resistant staphylococci show a very high degree of resistance to macrolides), gram-positive bacteria resistant to erythromycin); anaerobes (Bacteroides fragilis).

Pharmacokinetics

Azithromycin is rapidly absorbed from the gastrointestinal tract due to its stability in an acidic environment and lipophilicity. After oral administration of 500 mg, the maximum concentration of azithromycin in the blood plasma is reached after 2.5-3.0 hours and is 0.4 mg/l. Bioavailability is 37%.

Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract (in particular the prostate gland), skin and soft tissues. The high concentration in tissues (10-50 times higher than in plasma) and the long half-life are due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes. This, in turn, determines the large apparent volume of distribution (31.1 l/kg) and high plasma clearance. 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 sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite its high concentration in phagocytes, azithromycin does not have a significant effect on their function.

Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after taking the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment.

It is demethylated in the liver, the resulting metabolites are not active.

The elimination of azithromycin from blood plasma occurs in 2 stages: the half-life is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day.

Azithromycin is excreted mainly unchanged - 50% by the intestines, 12% by the kidneys.

Indications for use

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

· infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, pharyngitis, otitis media);

· lower respiratory tract infections (pneumonia, including those caused by atypical pathogens; bronchitis, including acute, exacerbation of chronic);

· infections of the urogenital tract (urethritis, cervicitis);

· infections of the skin and soft tissues (Lyme disease (initial stage - erythema migrans), erysipelas, impetigo, secondary pyodermatoses, moderate acne).

Contraindications

Hypersensitivity to azithromycin (including other macrolides), components of the drug; severe liver failure: more than 9 points on the Child-Pugh scale (no data on effectiveness and safety); severe renal failure: creatinine clearance (CC) less than 40 ml/min (no data on efficacy and safety); children under 12 years of age weighing less than 25 kg (for this dosage form); simultaneous use of ergotamine and dihydroergotamine.

Carefully

With moderate liver dysfunction (7-9 points on the Child-Pugh scale); chronic renal failure (creatinine clearance more than 40 ml/min); arrhythmias or predisposition to arrhythmias and prolongation of the Q-T interval; while taking terfenadine, warfarin, digoxin; with myasthenia; during pregnancy.

Use during pregnancy and breastfeeding

The use of the drug during pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

Descriptions of individual cases and observational studies have shown that the use of azithromycin during pregnancy does not lead to an increase in the incidence of adverse pregnancy outcomes and is not associated with the occurrence of any specific malformations in the child.

If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.

Directions for use and doses

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

Adults for infections of the upper and lower respiratory tract, ENT organs, skin and soft tissues (except for the initial stage of Lyme disease (erythema migrans) and moderate acne) – 500 mg (2 capsules) per day for 1 dose for 3 days (course dose – 1.5 g).

In the initial stage of Lyme disease (erythema migrans) - 1000 mg (4 capsules) per day on the first day at a time, then 500 mg (2 capsules) per day daily from days 2 to 5 (course dose - 3 g).

When acne is indicated of moderate severity, on days 1, 2 and 3 of treatment, take 500 mg (2 capsules) once a day, then take a break from the fourth to the seventh day, from the eighth day of treatment take 500 mg (2 capsules) 1 time per week for 9 weeks (course dose 6 g).

For infections of the urogenital tract (urethritis, cervicitis) for the treatment of uncomplicated urethritis or cervicitis, take 1 g (4 capsules) once.

Children weighing from 25 to 45 kg for infections of the upper and lower respiratory tract, ENT organs, skin and soft tissues – 250 mg/day for 3 days; in the treatment of the initial stage of Lyme disease (erythema migrans) - 500 mg (2 capsules) on the first day and 250 mg daily from days 2 to 5 (course dose - 1.5 g).

Children weighing more than 45 kg for infections of the upper and lower respiratory tract, ENT organs, skin and soft tissues – 500 mg (2 capsules) per day for 1 dose for 3 days; in the treatment of the initial stage of Lyme disease (erythema migrans) - 1000 mg (4 capsules) on the first day and 500 mg (2 capsules) daily from days 2 to 5 (course dose - 3 g).

Side effect

Most of the observed adverse reactions are reversible after completion of the course of treatment or discontinuation of the drug.

Classification of the frequency of side effects (WHO): very often (with a frequency of more than 1/10), often (with a frequency of at least 1/100, but less than 1/10), infrequently (with a frequency of at least 1/1000, but less than 1 /100), rare (with a frequency of at least 1/10000, but less than 1/1000), very rare (with a frequency of less than 1/10000), (including isolated reports).

From the circulatory and lymphatic systems: often – lymphocytopenia, eosinophilia; uncommon – leukopenia, neutropenia; very rarely - thrombocytopenia, hemolytic anemia.

From the side of the central nervous system: often – dizziness, headache, paresthesia, impaired perception of taste, anorexia; infrequently – anxiety, nervousness, hyposthesia, insomnia, drowsiness; rarely – agitation; very rarely - fainting, convulsions, psychomotor hyperactivity, anosmia, loss of taste, parosmia, exacerbation of myasthenia gravis.

From the senses: uncommon – decreased hearing acuity, tinnitus; rarely – vertigo, decreased visual acuity, deafness.

From the cardiovascular system: infrequently – feeling of heartbeat; rarely – decreased blood pressure; very rarely - arrhythmia, including: ventricular tachycardia, increased Q-T interval, pirouette-type arrhythmia.

From the digestive system: very often - nausea, diarrhea, abdominal pain, flatulence; often – vomiting; uncommon – gastritis, constipation, melena; very rarely - discoloration of the tongue, pseudomembranous colitis, pancreatitis.

From the liver and biliary tract: infrequently – hepatitis, hyperbilirubinemia, increased activity of “liver” transaminases; very rarely - cholestatic jaundice, liver failure (in rare cases with death, mainly due to liver dysfunction), fulminant hepatitis, liver necrosis.

Allergic reactions: often – itching, rash; not often - Stevens-Johnson syndrome, photosensitivity, urticaria; very rarely - anaphylactic reactions (including angioedema) in rare cases with fatal outcome, toxic epidermal necrolysis, erythema multiforme.

From the musculoskeletal system: often – arthralgia.

From the genitourinary system: infrequently - increased residual urea nitrogen and creatinine concentration in blood plasma; very rarely - interstitial nephritis, acute renal failure.

Others: often – weakness; uncommon – chest pain, peripheral edema, asthenia, hyperglycemia, conjunctivitis.

Infections and infestations: infrequently – vaginitis, candidiasis of various localizations.

Any side effect should be reported to your doctor.

Overdose

When taking high doses of the drug, increased side effects may occur: temporary hearing loss, severe nausea, vomiting, diarrhea. In this case, gastric lavage, the administration of activated carbon, and symptomatic therapy are indicated.

Interaction with other drugs

Antacids (aluminum and magnesium-containing) do not affect the bioavailability of azithromycin, but reduce its maximum concentration in the blood by 30%, so the interval between their use should be at least 1 hour before or 2 hours after taking these drugs. When taken simultaneously with ergotamine and dihydroergotamine derivatives, their toxic effects (vasospasm, dysesthesia) may be enhanced.

When used together with indirect anticoagulants of the coumarin series (warfarin) and azithromycin (in normal doses), patients need careful monitoring of prothrombin time.

Caution must be exercised when co-prescribing terfenadine and azithromycin, since it has been found that the simultaneous use of terfenadine and macrolides can cause arrhythmia and prolongation of the QT interval. Based on this, the above complications cannot be excluded when taking terfenadine and azithromycin together.

When used simultaneously with cyclosporine, it is necessary to monitor the concentration of cyclosporine in the blood.

When taking digoxin and azithromycin together, it is necessary to monitor the concentration of digoxin in the blood, since many macrolides increase the absorption of digoxin in the intestine.

When used simultaneously with nelfinavir, it is possible to increase the frequency of adverse reactions of azithromycin (decreased hearing, increased activity of liver transaminases).

When azithromycin and zidovudine are taken together, azithromycin does not affect the pharmacokinetic parameters of zidovudine in the blood plasma or the renal excretion of it and its glucuronide metabolite, but the concentration of the active metabolite, phosphorylated zidovudine, in peripheral blood mononuclear cells increases. The clinical significance of this fact has not been determined.

When taking azithromycin and rifabutin simultaneously, in rare cases, neutropenia may develop, the mechanism of development of which, as well as the presence of a cause-and-effect relationship with taking the drug, have not been established.

When taken concomitantly, fluconazole reduces the Cmax of azithromycin by 18%.

Azithromycin does not affect the blood concentrations of carbamazepine, cimetidine, didanosine, efavirenz, fluconazole, indinavir, midazolam, theophylline, triazolam, trimethoprim/sulfamethoxazole, cetirizine, sildenafil, atorvastatin, rifabutin and methylprednisolone when used simultaneously.

The possibility of inhibition of the CYP3A4 isoenzyme by drugs of the macrolide group should be taken into account when used simultaneously with cyclosporine, terfenadine, ergot alkaloids, cisapride, pimozide, quinidine, astemizole and other drugs whose metabolism occurs with the participation of this enzyme; however, this type of interaction was not observed when using azithromycin .

special instructions

If you miss one dose of the drug, the missed dose should be taken as soon as possible, and subsequent doses should be taken at intervals of 24 hours. Azithromycin should be taken at least 1 hour before or 2 hours after taking antacid medications.

Azithromycin should be used with caution in patients with moderate hepatic impairment due to the possibility of developing fulminant hepatitis and severe liver failure in such patients. If there are symptoms of liver dysfunction (rapidly increasing asthenia, jaundice, darkening of urine, bleeding tendency, hepatic encephalopathy), azithromycin therapy should be discontinued and a study of the functional state of the liver should be performed.

In case of moderate renal failure (creatinine clearance more than 40 ml/min), the use of azithromycin should be carried out under the control of renal function.

Concomitant use of azithromycin with ergotamine and dihydroergotamine derivatives is contraindicated due to the possible development of ergotism.

When using the drug, both while taking it and 2-3 weeks after stopping treatment, diarrhea caused by Clostridium difficile (pseudomemranous colitis) may develop. In mild cases, it is sufficient to discontinue treatment and use ion exchange resins (colestyramine, colestipol); in severe cases, replacement of loss of fluid, electrolytes and protein, and the appointment of vancomycin, bacitracin or metronidazole are indicated. Do not use medications that inhibit intestinal motility.

Since QT interval prolongation is possible in patients receiving macrolides, including azithromycin, caution should be exercised when using azithromycin in patients with known risk factors for QT interval prolongation: advanced age; electrolyte imbalance (hypokalemia, hypomagnesemia); congenital long QT syndrome; heart disease (heart failure, myocardial infarction, bradycardia); simultaneous use of medications that can prolong the QT interval (including antiarrhythmic drugs of classes IA and III, tricyclic and tetracyclic antidepressants, antipsychotics, fluoroquinolones).

Azithromycin can provoke the development of myasthenic syndrome or cause an exacerbation of myasthenia gravis.

WHO Europe recommends azithromycin as the drug of choice for the treatment of chlamydial infection in pregnant women. Azithromycin is classified as Category B by the FDA for use in pregnant women (animal reproduction studies have not shown fetal harm from azithromycin, but controlled studies have not been conducted in pregnant women).

Impact on the ability to drive vehicles and machinery

If adverse reactions from the central nervous system occur, patients are advised to refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration, speed of psychomotor and motor reactions.

Release form

Capsules 250 mg.

6 or 10 capsules in a blister pack. 1, 2, 6 or 12 blister packs with instructions for use in a cardboard pack.

Storage conditions

Store at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Best before date

3 years. Do not use after the expiration date stated on the package.

Conditions for dispensing from pharmacies

On prescription.

Name and address of the manufacturer/organization accepting the complaint:

PJSC “Pharmstandard-Leksredstva”, 305022, Russia, Kursk, st. 2nd Aggregatnaya, 1a/18

Azithromycin 250 is a modern semi-synthetic medicine with a powerful antibacterial effect. Due to its semi-synthetic composition, the remedy can be classified as a subclass of azalides and a group of macrolides. The medicine is endowed with a powerful spectrum of effects on pathogenic microorganisms, as well as a bacteriostatic effect. Azithromycin 250 is especially often prescribed to patients if the bacterial flora could not be suppressed by the penicillin series of medications. It is necessary to take the drug strictly according to the instructions and indications of the doctor, especially if complex therapy has been prescribed to the child.

The main active component of the drug is azithromycin dihydrate, which provides a powerful bactericidal effect of the drug. This therapeutic agent is distinguished by the ability to quickly penetrate human tissues and organs, which ensures a rapid therapeutic effect. Immediately after taking Azithromycin, its main active components penetrate into the blood from the intestines.

It is important to note that the active substance of the drug is not afraid of an acidic environment, and it also quickly dissolves in fats, which provides a quick therapeutic effect, which is achieved only if the drug is taken correctly.

Azithromycin dihydrate is an active substance with a prolonged action. Therefore, if the patient regularly takes the drug according to the course of treatment prescribed by the doctor, this will allow the main substance of the drug to remain in the patient’s body for 6 days. Already 2 hours after taking Azithromycin, the maximum concentration of the main active component is observed, which helps to achieve a rapid therapeutic effect after taking the first dose of the drug.

Thanks to this feature (providing a quick therapeutic effect), it is possible to quickly and effectively cure serious infectious diseases in a short course - usually it is 3-5 days. Moreover, the patient will need to take Azithromycin once a day, which is considered a convenient dose for many people. Thanks to this, the drug is actively used to treat infectious diseases in children and adolescents.

The positive qualities of the remedy, which glorify it, include:

• optimal price for many segments of the population;
• minimal number of side effects;
• Even children and adolescents can be treated;
• composition that is gentle on the body.

However, it is important to remember that you should take Azithromycin only as directed by a doctor, otherwise the antibacterial medicine can cause serious harm to your health.

Since Azithromycin is a powerful antibacterial agent, it is not recommended to use it during mild illnesses. If a person has special indications for use, then Azithromycin is used as an additional powerful agent.

The remedy is available in several forms. This:

• tablets in dosages of 125 and 250 mg;
• capsules 250 mg;
• suspension or syrup.

One blister contains 6 capsules and tablets. Syrup is more often prescribed by doctors to treat children, since not every one of them will agree to swallow a tablet, much less a capsule.

The instructions for the suspension say that 5 ml, depending on the dosage of the drug, contains 100 or 200 mg of the main active substance, based on which the doctor will be able to select the correct dosage for each person. Also, the doctor independently determines the course of taking the drug, which depends on the type of disease, its severity and the general health of the patient.

It is important to note that treatment with any antibacterial agent without a doctor’s testimony is unacceptable (especially if a child is sick), since an incorrectly calculated dose can cause side effects or lead to the development of complications.

How to take the medicine correctly:

1. A dosage of 125-250 mg is prescribed for children whose body weight exceeds 45 kilograms. If the baby's weight is less, he should take the suspension in the dosage prescribed by the doctor. As a rule, the doctor prescribes 10 mg of medication per kilogram of weight. This means that if the patient weighs 10 kilograms, he will need to take 100 mg of medicine (syrup) daily, which is done once a day.
2. An adult should take the medicine in the dosage prescribed by the doctor. As a rule, it is 300-500 mg, depending on the type of disease and general health.

Azithromycin should be taken before or after meals. The break should be 1-2 hours so that the active component of the medicine has time to be completely absorbed into the blood through the intestines - otherwise part of it will not be able to penetrate the bloodstream, which means that the effect of the drug cannot be called complete.

It is required to take tablets and other forms of Azithromycin at the same time every day, for example, at 11:00. The capsule and tablet do not need to be chewed and should be taken with plenty of water.

Solid forms of the medicine are prescribed to adults and children, who can swallow them on their own. As many reviews say, it is easiest and most pleasant to take capsules, as they quickly slip inside, do not stick to the tongue, and do not leave an unpleasant aftertaste.

It is important to note that children under 6 months of age are prohibited from taking Azithromycin, as it can lead to seizures and disruption of the gastrointestinal tract. The most dangerous side effect in young children is the development of gastric bleeding, which is considered a serious complication for children.

The price of Arithromycin 250 varies between 50-90 rubles, although sometimes some forms of the drug can be found for only 30 rubles. As a rule, analogues of this medicine are more expensive than Azithromycin. For example, the most famous similar remedy costs 350 rubles.

Indications for taking Azithromycin

The medication is prescribed to a child and an adult with the following diseases:

• otitis;
• angina;
• sinusitis (the disease is a lesion of the nasal sinuses);
• tracheitis;
• tonsillitis, occurring in acute or chronic form (sometimes medicine is prescribed in case of relapse);
• pharyngitis;
• pneumonia;
• erysipelas;
• pleurisy (Azithromycin will be effective in the early stages of the disease);
• infectious type dermatosis;
• scarlet fever;
• furunculosis;
• genitourinary infections;
• Lyme disease;
• when carrying out complex treatment of the gastrointestinal tract.

For treatment to be effective, it is important to make a correct diagnosis. First of all, it is necessary to carry out bacterial culture for microflora, which is carried out using an antibiogram.

This analysis will help identify the causative agent of the disease, as well as determine whether the remedy will help completely get rid of the disease, and whether its active component can completely eliminate the causative agent of the pathology.

In each specific case, a smear is taken from the affected area. For example, if a person suffers from a sore throat, a smear for bacterial culture must be taken from the inflamed tonsils.

It is important to note that often the result of a smear can only be obtained 5-10 days after it is taken. And since most infectious diseases are quite insidious, the disease will not wait until a person begins treatment. Therefore, many doctors prescribe therapy to patients blindly - if the antibiotic does not help the patient get rid of the unpleasant symptoms of the disease after 3-5 days, it will be replaced with another, more effective medicine.

Azithromycin 250, like other antibacterial agents, has several disadvantages. For example, these include a number of contraindications, namely:

• the patient's age is less than 6 months;
• arrhythmia occurring in severe form;
• macrolide intolerance;
• severe kidney and liver diseases, due to which the medicine is eliminated;
• a person's tendency to develop an allergic reaction.

Also, when taking Azithromycin, patients may experience side effects, which include:

• flatulence;
• diarrhea that cannot be stopped with the help of “fixing” drugs or can be done temporarily;
• nausea, which may lead to vomiting;
• tachycardia;
• pain or cramping in the abdomen;
• disturbance or deterioration in sleep quality;
• refusal to eat, which is characterized by deterioration of appetite;
• frequent dizziness;
• the appearance of rashes on the body;
• frequent and causeless irritability;
• violation of the biochemical composition of the blood (more often this happens with an overdose of Azithromycin).

If the patient experiences side effects, the medication must be stopped immediately and an ambulance must be called. Before the doctor arrives, the victim must take any sorbent (Enterosgel, activated carbon, Polysorb, etc.).

The patient can also take any antihistamine, but this must be done strictly according to the instructions. These medications include Claritin, Erius and Loratadine. Typically, these drugs are often prescribed by a doctor to prevent unpleasant symptoms during treatment of the disease. Therefore, signs in a person will not appear at all or will be expressed in a weak form.

Analogues of the drug "Azithromycin 250" are usually similar to it in composition or mechanism of action on the body. The most well-known similar drugs that are prescribed to patients today are:

• Zithrocin;
• Sumamox;
• Sumamed;
• Sumaclid;
• Clubax;
• Azitrox;
• Zitrolide.

These analogues are similar to Azithromycin 250 in terms of the main active component. If we talk about a similar mechanism of action on the patient’s body, we can distinguish the following similar drugs:

• Fromelid;
• Macropen;
• Lecoclair;
• Erythromycin;
• Arvicin;
• Rovamycin;
• Spiramycin.

As mentioned earlier, all analogues have a slightly higher price than the original medicine.

They must be taken strictly as prescribed by a doctor, since each of them has its own side effects, contraindications and peculiarities of administration.

Judging by numerous reviews, the effect of the medicine on the body is fast and effective. Side effects when taken correctly are rarely observed in patients, so doctors often prescribe treatment with Azithromycin for children and adults. The main thing is to correctly follow the instructions for use of the medicine, otherwise you can cause an overdose, which will negatively affect the patient’s health.

Recently, quite often children of different ages have to take certain medications. Antimicrobial agents are used by doctors only in special cases when the baby’s body is not able to cope with the pathological condition on its own. One of the quite popular drugs is the drug Azithromycin. For children, suspension and tablets should only be prescribed by a doctor in an individual dose. This article will tell you about how this medication is used in pediatrics. You will also find out what the price of Azithromycin for children is.

Release form and composition of the drug

This medicine can be produced in the form of gelatin-coated capsules or hard tablets. The manufacturer also offers a dosed powder that needs to be diluted with water, or a mass for preparing a suspension. Azithromycin 250 is usually prescribed to children. But this medication also has a different dosage: 500 and 1000 milligrams.

The drug "Azithromycin" is antibacterial and antimicrobial. The main substance that affects the patient’s body is the component of the same name - azithromycin. The medicine also contains additional components. They depend on what form of medication you are using.

When is medicine prescribed for children?

The described drug is often used in pediatrics to treat various pathological conditions. It is often prescribed by otorhinolaryngologists. What are the indications for the use of Azithromycin in children?

Doctors prescribe this medicine for various respiratory diseases. It does not matter whether the lower or upper sections are affected. The drug copes well with sinusitis, tonsillitis, pneumonia, bronchitis and other pathologies. It is worth noting that the effect of treatment will only be if the disease is caused by a bacterial infection.

In what situations should the medication not be used for a child?

The drug "Azithromycin" is not prescribed to children if they have hypersensitivity to one of the components of the drug. If a child has acute kidney or liver diseases, then it is also worth choosing an alternative method of correction. The drug should not be prescribed in the presence of heart failure or blood pressure disorders.

It must be remembered that Azithromycin can only be prescribed to children by a doctor after a thorough examination and assessment of all possible risks. Independent use of the composition may lead to the development of adverse reactions.

"Azithromycin" (suspension) for children

The price of this product is approximately 100 rubles. The drug must be prepared independently. For this purpose, a measuring syringe is included with the medicine. It is worth noting that this type of medicine is available in a dose of 100 or 200 milligrams of azithromycin per 5 milliliters of suspension.

It is recommended to give this medication to children under 12 years of age. In this case, the dose of the medicine is calculated individually. For each kilogram of the child’s body weight, 5 to 10 milligrams of the active substance are prescribed. The amount of the drug is selected depending on the severity of the symptoms. If a child weighs, for example, ten kilograms, then you need to give him from 50 to 100 milligrams of the active substance. This corresponds to 2.5 or 5 milligrams of the drug in suspension. Treatment lasts no more than three days. Only in particularly difficult situations is the medication extended for up to 4-5 days. Doctors say that this drug has a residual effect. In other words, when you finish treatment, the medication will still work for several days.

"Azithromycin 250": instructions

Children are prescribed tablets only if they can swallow the capsule whole. Otherwise, a suspension is prescribed. The manufacturer does not recommend grinding Azithromycin for children.

The dosage of tablets can be 250 and 500 milligrams of the active substance. A large portion of the drug is prescribed only to children whose body weight is more than 45 kilograms. For other children over 12 years of age, it is recommended to use the children's dosage (250). To correct the pathology, pediatricians prescribe one capsule of the drug. In this case, the medication should be taken one hour before or after a meal. Otherwise, the effect of the medication may be incomplete. The correction continues exactly as long as the doctor recommends. Usually the duration of treatment does not exceed three days. If the skin is affected, treatment is carried out within five days. During this time, only the dosage of the drug is adjusted. On the first day, the dose of medication can be doubled.

Cost of the drug

How much does Azithromycin (suspension for children) cost? The price of the medicine has already been presented to your attention in the article. Also, many patients are interested in the cost of the tablet form. It is worth recalling that the medication is available in dosages of 250 and 500 milligrams. The number of capsules in a package can be 3 or 6.

For Azithromycin for children, the price ranges from 70 to 130 rubles. In this case, the number of capsules in one package is six. A small pack of medicine will cost you twice as much.

Azithromycin is a broad-spectrum antibiotic. The drug has special pharmacokinetic properties and combines high activity with good tolerability by patients of any age. This makes it possible to treat both children and adults with azithromycin.

Compound

Main active ingredient: azithromycin (250 mg).

Excipients are:

• Lactose (milk sugar);
• Low molecular weight medical polyvinylpyrrolidone;
• Colloidal silicon dioxide;
• Microcrystalline cellulose;
• Magnesium stearate.

Capsule composition:

• Water;
• Gelatin;
• Titanium dioxide

Release form of Azithromycin

Azithromycin is available in 6 or 10 capsules:

• In light-protective glass jars;
• In polymer jars;
• In blister packs;
• In polymer bottles.

Analogues

Azithromycin monohydrate, Azivok, Azitrox, Azitral, ZI-Factor, Zitrolide, Zitrocin, Sumazid, Sumamed, Sumamecin, Sumamox, Hemomycin.

Pharmacological action of Azithromycin

An azalide antibiotic, a representative of the subgroup of macrolide antibiotics. Has a wide spectrum of action. High concentrations at the site of inflammation produce a bactericidal effect.

A number of gram-negative and gram-positive bacteria, as well as anaerobic microorganisms, are sensitive to azithromycin:

• Moraxella catarrhalis;
• Legionella pneumophila;
• B. parapertussis;
• Haemophilus influenzae;
• Campylobacter jejuni;
• Bordetella pertussis;
• Neisseria gonorrhoeae;
• H. ducrei;
• Gardnerella vaginalis;
• Streptococcus pneumoniae;
• St. agalactiae;
• St. pyogenes;
• St. viridans;
• Streptococci of groups CF and G;
• Staphylococcus aureus;
• Bacteroides bivius;
• Peptostreptococcus spp;
• Clostridium perfringens.

Azithromycin is also active against pathogens such as Mycoplasma pneumoniae, Treponema pallidum, Chlamydia trachomatis, Borrelia burgdoferi, Ureaplasma urealyticum. Ineffective against gram-positive bacteria resistant to erythromycin.

The antibiotic is lipophilic and resistant to acidic environments, therefore it is well absorbed from the gastrointestinal tract. Bioavailability – 37%. In plasma, the maximum concentration is reached after 2.5-2.96 hours, amounting to 0.4 mg/l.

The drug penetrates well into the skin, soft tissues, respiratory tract, as well as into the tissues and organs of the urogenital tract, namely the prostate gland. Poor binding to blood proteins results in a long half-life and high concentration of azithromycin in tissues. The ability to accumulate in lysosomes plays an important role in the elimination of intracellular pathogens.

During the process of phagocytosis, the substance is released at the sites of infection. Its concentration is related to the degree of inflammatory edema. Short three-day and five-day courses of therapy were developed due to the fact that the action of the antibiotic in areas of localization of inflammation continues for 5-7 days after the last dose.

Azithromycin, according to the instructions, can be taken once a day. The drug is removed in 2 stages. Within 8-24 hours after administration, the half-life begins, which lasts 14-20 hours. After 2-3 days the drug is completely eliminated.

Indications for use of Azithromycin

Azithromycin, according to the instructions, is indicated for infectious diseases caused by drug-sensitive pathogens:

• Sore throat;
• Tonsillitis;
• Sinusitis;
• Otitis media;
• Scarlet fever;
• Pneumonia;
• Bronchitis;
• Impetigo;
• Dermatosis;
• Urethritis;
• Cervicitis;
• Lyme disease.

Contraindications

The use of Azithromycin is contraindicated in cases of hypersensitivity to macrolide antibiotics. Caution is required when prescribing the drug to patients with liver or kidney dysfunction, as well as a history of allergic reactions.

The active substance crosses the placenta, so during pregnancy the drug is prescribed only in cases where the potential benefit outweighs the risk to the fetus. Breastfeeding is stopped for the period of treatment.

How to use Azithromycin

Azithromycin should be taken once a day 2 hours after meals or 1 hour before meals, as food reduces absorption.

Adults with infections of the upper and lower respiratory tract, soft tissue and skin are prescribed 0.5 g on the first day, then 0.25 g on the second to fifth days (or 0.5 g daily for three days).

For acute urogenital infections, a one-time dose of 1 g is prescribed.

For borreliosis (Lyme disease) at the first stage, 1 g is prescribed on the first day and 0.5 g daily from the second to the fifth day.

The dose of Azithromycin for children is determined taking into account body weight. With a weight of more than 10 kg on the first day - 10 mg/kg; in the next 4 days – 5 mg/kg. For a three-day course of treatment, the single dose is 10 mg/kg (course dose 30 mg/kg).

When prescribing an antibiotic simultaneously with drugs that reduce gastric acidity, it is recommended to maintain a two-hour interval between doses.

Side effects of Azithromycin

Diarrhea, abdominal pain, flatulence, nausea, vomiting. In some cases, there is a transient increase in the activity of liver enzymes. Very rarely - skin rash.

Drug interactions

Azithromycin enhances the effect of dihydroergotamine, ergot alkaloids. Chloramphenicol and tetracycline increase, and lincosamides reduce the effect.

Food, antacids and ethanol slow absorption. The drug reduces excretion, increases concentration and enhances the toxicity of cycloserine, indirect anticoagulants, felodipine and methylprednisolone. Azithromycin inhibits microsomal oxidation in hepatocytes, lengthens the half-life, slows release, increases the toxicity and concentration of carbamazepine, valproic acid, ergot alkaloids, hexobarbital, disopyramide, phenytoin, bromocriptine, theophylline. Incompatible with heparin.

Storage conditions

Azithromycin should be stored in a place protected from light and moisture, at a temperature of 15-25 °C. Keep away from children.
Shelf life – 2 years.