Instructions for the use of suspensions, tablets and capsules azithromycin. Azitroks - official instructions for use.

Title:

azithromycin, capsules, 250mg

INN:

Azithromycin (Azithromycin)
Synonyms:

Azikar, Azilid, Azimed, Azitroks, AzitRus, Azivok, Azitral, Zitrolid, Zi-factor, Sumarom, Sumamed @, Sumamecin, Sumamoks, Sumarom, Hemomitsin
Pharmacotherapeutic group

Antibacterial agents. Antibiotics - macrolides.
Composition

1 capsule contains 250 mg of azithromycin.
ATH code: J01FA10.
pharmachologic effect
Pharmacodynamics

Azithromycin (9-deoxo-9a-aza-9a-methyl-9a-homoerythromycin A) has an antibacterial (bacteriostatic) effect. It binds to the 50S subunit of ribosomes, inhibits peptide translocase at the translation stage and inhibits protein biosynthesis, slowing the growth and reproduction of bacteria; at high concentrations, a bactericidal effect is possible.

Spectrum antimicrobial action  azithromycine, it is a good place in the country. Bordella (Mycoplasma pneumoniae), ureaplasma (Ureaplasma urealyticum), spirochetes (Treponema pallidum).
Pharmacokinetics

Resistant to acidic, lipophilic. Rapidly absorbed in the digestive tract. After a single dose of 500 mg, bioavailability is 37%, the maximum concentration in the blood (0.4 mg / l) is reached after 2-3 hours. Eating and drinking reduces the speed and completeness of absorption. In the case of taking the drug soon after a meal, the maximum concentration in the blood (C max) is reduced by about 50%. The apparent volume of distribution is 31.1 l / kg, binding to proteins is inversely proportional to the concentration in the blood and is 7-50%. The half-life of T1 / 2 is 68 hours. Stable plasma levels are reached after 5-7 days.

Azithromycin easily passes histohematogenous barriers and enters the tissue. It is also transported by phagocytes, polymorphonuclear leukocytes and macrophages to the site of infection, where it is released in the presence of bacteria. Penetrates through the cell membrane (effective for infections caused by intracellular pathogens). Concentrations in tissues and cells are 10-50 times higher than in plasma, and in the source of infection - by 2 4-34% more than in healthy tissues. A high level of concentration is maintained in the tissues for 5-7 days after the last injection. In the liver, azithromycin is demethylated, the resulting metabolites are inactive. Plasma clearance - 630 ml / min. About 50% of the accepted dose of azithromycin is excreted in the bile unchanged, 6% - in the urine. In elderly men (65–85 years old), the pharmacokinetic parameters do not change, in older women, C max increases (by 30–50%). In children aged 1-5 years, compared with adults, the maximum concentration in the blood, the half-life and the AUC indicator are reduced.

Indications for use

• Upper infections (bacterial pharyngitis and tonsillitis) and lower infections (bacterial exacerbation of chronic obstructive pneumonia, interstitial and alveolar pneumonia, bacterial bronchitis) respiratory tract, ENT organs (sore throat, otitis medialaryngitis and sinusitis);
• Urinary system (urethritis and / or cervicitis);
• Skin and soft tissues (erysipelas, impetigo, secondarily infected dermatosis), chronic stage of migrating erythema (initial stage of Lyme disease);
• Diseases of the stomach and duodenum 12 associated with Helicobacter pylori.

Dosage and administration

Take inside

Take 1 time per day inside for 1 hour before meals or 2 hours after meals. On the first day of treatment, adults are prescribed at a dose of 0.5 g / day, from 2 to 5 days - 0.25 g / day. Heading dose - 1.5 g.

With urogenital diseases  —1,0 g once,

For Lyme disease  - 1 g on the first day, from 2 to 5 day - to 0.5 g (course dose - 3 g).

With diseases of the stomach and duodenum 12associated with Helicobacter pylori take 1 g / day for 3 days as part of combination therapy.

Older children12 months on the first day of therapy - 10 mg / kg of body weight 1 time per day, then for 4 days of therapy - 5 mg / kg / day or 10 mg / kg / day for 3 days (the course dose is 30 mg / kg body weight).

For Lyme disease - on the first day 20 mg / kg / day, from 2 to 5 days - 10 mg / kg / day. In case of skipping a dose of a drug, take the missed dose as soon as possible, and the next dose should be taken at intervals of 24 hours.
special instructions

Older people and patients with impaired renal function do not need to change the dosage.

Side effects

From the digestive tract:

Nausea, vomiting, diarrhea, constipation, flatulence, abdominal pain, melena, cholestatic jaundice.

Since the cardiovascular system:

chest pain, weakness, palpitations,

From the side nervous system:

headache, dizziness, drowsiness, insomnia,

Others:

conjunctivitis, nephritis, vaginitis, neutropenia or neutrophilia, reversible moderate increase in liver enzymes, pseudomembranous colitis, candidiasis, photosensitization, skin rash, angioedema, eosinophilia, in children, in addition, hyperkinesia.

Contraindications

• Hypersensitivity (including to other macrolides);
• Severe abnormal liver function;
• Pregnancy, lactation (at the time of treatment, breastfeeding is suspended).

Precautionary measures

Caution is prescribed

• When expressed impaired renal function;
• Impaired liver function (especially children);
• In cardiac arrhythmias (ventricular arrhythmias and prolongation of the QT interval are possible).

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, in which case specific therapy is required under the supervision of a physician.
Interaction with other drugs

Antacids reduce the absorption of azithromycin (a break of at least 2 hours between doses is recommended).

Despite the fact that azithromycin is weaker than erythromycin, it inhibits cytochrome P 450, careful monitoring of the condition of patients is required, while the administration of drugs metabolized in the liver is required. Azithromycin enhances the action of ergot alkaloids, dihydroergotamine. Deactivates the plasma concentration medicines). Lincosamides impair efficacy, tetracycline and chloramphenicol increase. Pharmaceutical incompatible with heparin.

It is dangerous to combine azithromycin with drugs that extend the QT interval on the ECG.
Overdose

Symptoms:

Temporary hearing loss, nausea, vomiting, diarrhea.

Treatment:

symptomatic (no specific antidote).
Release form

250 mg capsules in a blister pack of number 6.

Manufacturer:

Registration number: LSR-003652 / 07-010616
  Trade name: Azithromycin
  International Nonproprietary Name (INN): Azithromycin
  Dosage Form: capsules
  Composition
  Active ingredient: azithromycin dihydrate - 265.3 mg, calculated on 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 of color, opaque.
  The contents of the capsules are white or white with a slightly yellowish tint.

Pharmacotherapeutic group: antibiotic-azalide.
  ATX code: J01FA10

pharmachologic effect

Pharmacodynamics
  Broad-spectrum antibacterial agent, azalide, bacteriostatic. By binding to the 50S subunit of ribosomes, it inhibits peptide translocation at the translation stage, inhibits protein synthesis, slows the growth and reproduction of bacteria, has a bactericidal effect in high concentrations. It acts on extracellular and intracellular pathogens. Active against gram-positive microorganisms: Streptococcus spp. (groups C, F and G, except 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 gonorrhoe, and a couple of women and women, and a group of women and women, and a couple, and a couple, a year and a couple, a year and a couple of ages and a few 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. 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 "first passage" through the liver), the maximum plasma concentration after oral administration of 0.5 g - 0.4 mg / l, the period of reaching the maximum plasma concentration - 2 5-2.9 h; in tissues and cells, the concentration is 10-50 times higher than in serum, the volume of distribution is 31.1 l / kg. Easily passes histohematic barriers. It penetrates well into the respiratory tract, urinary organs and tissues, the prostate gland, the skin and soft tissues; accumulates in a low pH environment, in lysosomes (which is especially important for the eradication of intracellularly located pathogens). Transported also by phagocytes, polymorphonuclear leukocytes and macrophages. It penetrates cell membranes and creates high concentrations in them. Concentration in the foci of infection is significantly higher (by 24-34%) than in healthy tissues, and correlates with the severity of inflammatory edema. It is stored 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). In the liver it is demethylated, the resulting metabolites are not active. CYP3A4, CYP3A5, CYP3A7 isoenzymes are involved in the metabolism of the drug, of which it is an inhibitor. 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 dosage form): capsules - the maximum concentration in the blood plasma is reduced (by 52%). In elderly men (65–85 years), pharmacokinetic parameters do not change, in women, the maximum plasma concentration increases (by 30–50%), in children aged 1–5 years, the maximum plasma content decreases, the half-life.

Indications for use

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: infections of the upper respiratory tract and upper respiratory tract (pharyngitis, tonsillitis, laryngitis, sinusitis, otitis media); scarlet fever; infections of the lower respiratory tract (pneumonia (including caused by atypical pathogens), bronchitis); infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatosis); urinary tract infections (gonorrheal and non-urethral urethritis, cervicitis); Lyme disease (initial stage - erythema migrans), peptic ulcer and 12 duodenal ulcer associated with Helicobacter pylori (as part of combination therapy).

Contraindications

Hypersensitivity (including to other macrolides), severe hepatic / renal failure, lactation period, children under 12 years old (with a body weight less than 45 kg).
  With caution: arrhythmia (ventricular arrhythmias and prolongation of the Q-T interval are possible), children with impaired liver or kidney function, pregnancy.
  Use during pregnancy and lactation: can be used in cases where the benefits of its use significantly exceeds 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 reception for 3 days (course dose - 1500 mg). With infections of the skin and soft tissues - 1000 mg / day on the first day for 1 reception, then 500 mg / day daily from 2 to 5 days (course dose - 3000 mg). With acute infections  urinary organs (uncomplicated urethritis or cervicitis) - once 1 g. For Lyme disease (borreliosis) for stage I treatment (erythema migrans) - 1000 mg on the first day and 500 mg daily from day 2 to 5 (course dose - 3 g). In case of gastric ulcer and duodenal ulcer associated with Helicobacter pylori, 1 g / day for 3 days as part of a combination anti-helicobacter therapy.
  Children older than 12 years (c weight more than 45 kg) with infections of the upper and lower respiratory tract, skin and soft tissues prescribed 500 mg 1 time per day for 3 days.
  In the treatment of erythema migrans in children (over 12 years old), the drug is prescribed 1 time per day at a dose of 1000 mg on the first day and 500 mg from day 2 to day 5.

Side effect

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

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.
  When co-administered with warfarin and azithromycin (in usual doses), there is no change in the prothrombin time, however, given that the interaction of macrolides and warfarin may increase the anticoagulant effect, patients need careful control of the prothrombin time.
  Increases the concentration of digoxin due to the weakening of its inactivation of the intestinal flora.
  Ergotamine and dihydroergotamine: increased toxic effects (vasospasm, dysesthesia).
  Triazolam: reduced clearance and increased pharmacological action of triazolam.
  Slows down the concentration of celiac funds, theophylline and others. Xanthine derivatives), due to inhibition of microsomal oxidation in hepatocytes by azithromycin.
  Lincosamides weaken, and tetracycline and chloramphenicol enhance the effectiveness of azithromycin.

special instructions

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

Release form
  250 mg capsules.
  On 3, 6 capsules in a blister strip packaging from a film of polyvinyl chloride and aluminum foil printed lacquered.
  On 3, 6, 12, 18, 24, 30, 36, 42, 48, 54 or 60 capsules in cans from polyethylene terephthalate or polymer cans for medicines.
  One can or 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 blister packs together with the instructions for use are placed in a carton (pack).

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

Azithromycin is a broad-spectrum antibiotic. The drug has special pharmacokinetic properties and combines high activity with good tolerance for patients of any age. This allows azithromycin to be treated in both children and adults.

Composition

The main active ingredient: azithromycin (250 mg).

Auxiliary substances are:

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

Capsule Composition:

• Water;
• Gelatin;
• Titanium dioxide.

Form release Azithromycin

Azithromycin is available in 6 or 10 capsules:

• In banks of light-protective glass;
• In polymer cans;
• In blisters;
• In polymeric bottles.

Analogs

Azithromycin monohydrate, Azivok, Azitroks, Azitral, ZI-Factor, Zitrolid, Zitrotsin, Sumazid, Sumamed, Sumametsin, Sumamoks, Hemomitsin.

Pharmacological action of azithromycin

Antibiotic-azalide, a representative of the macrolide antibiotic subgroup. It has a wide spectrum of action. High concentrations in the outbreak 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 groups CF and G;
• Staphylococcus aureus;
• Bacteroides bivius;
• Peptostreptococcus spp;
• Clostridium perfringens.

Azithromycintactivally active pathogens like Mycoplasma pneumoniae, Treponema pallidum, Chlamydia trachomatis, Borrelia burgdoferi, Ureaplasma urealyticum. Ineffective against gram-positive bacteria resistant to erythromycin.

Antibiotic is lipophilic and resistant to acidic environment, therefore it is well absorbed from the gastrointestinal tract. Bioavailability - 37%. In plasma, the maximum concentration is reached in 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 causes a long half-life and a high concentration of azithromycin in the tissues. The ability to accumulate in lysosomes plays an important role in the elimination of intracellular pathogens.

In the process of phagocytosis, the substance is released in the foci of infection. Its concentration is interrelated with the degree of inflammatory edema. Short three-day and five-day courses of therapy are developed due to the fact that the action of the antibiotic in places of localization of inflammation continues for 5-7 days after the last dose.

Azithromycin, according to the instructions, can be taken 1 time per day. Removal of the drug occurs 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 removed completely.

Indications for use Azithromycin

Azithromycin, according to the instructions, is shown at infectious diseasescaused by drug-sensitive pathogens:

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

Contraindications

Azithromycin is contraindicated in case of hypersensitivity to macrolide antibiotics. Care must be taken when prescribing the drug to patients with liver or kidney dysfunction, as well as allergic reactions  in the anamnesis.

The active substance penetrates through the placenta, so during pregnancy the drug is prescribed only in cases where the potential benefits of the use outweigh the risk to the fetus. Breastfeeding for the period of treatment is stopped.

Azithromycin

Azithromycin should be taken 1 time per day 2 hours after a meal or 1 hour before a meal, as food reduces absorption.

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

For acute urogenital infections, it is prescribed once for 1 year.

In Borreliosis (Lyme disease) in the first stage, 1 g is prescribed on the first day and 0.5 g daily from the second to the fifth day.

Azithromycin dose for children is determined by 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. With a three-day course of treatment, a single dose is 10 mg / kg (course dose 30 mg / kg).

With the simultaneous appointment of an antibiotic with drugs that reduce the acidity of the stomach, it is recommended to observe the two-hour interval between their intake.

Side effects of azithromycin

Diarrhea, abdominal pain, flatulence, nausea, vomiting. In some cases, a transient increase in liver enzyme activity. Very rarely - skin rash.

Drug interaction

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

Food, antacids and ethanol inhibit absorption. The drug reduces excretion, increases the concentration and enhances the toxicity of cycloserine, indirect anticoagulants, felodipine and methylprednisolone. Azithromycin inhibits microsomal oxidation in hepatocytes, prolongs the half-life, slows the 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 out of the reach of children.
  Shelf life - 2 years.

Azithromycin - modern semi-synthetic antibacterial drug  a subclass of azalides (a group of macrolides) that has wide range  effects on pathogenic microflora and has a pronounced bacteriostatic action.

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

Properties and composition of the drug

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

Azithromycin has the ability to quickly penetrate into all organs and tissues. This is achieved through active suction. medicinal substance from the intestines to the blood. The active substance is not afraid of acidic environments, and quickly dissolves in fats.

Azithromycin dihydrate - a substance of prolonged action, with a single use of the tool, especially in the loading dose,   maintains its presence in the body for up to 6 days. After taking azithromycin, literally after 2 hours, there is a maximum concentration of the active substance in the body, which allows 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 reception per day. Due to this, azithromycin has become very popular 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 powerful tool  from bacteria in case of mild disease the drug is not recommended to use. Only in the presence of special testimony, his "connect" as a shock tool. For children, azithromycin is administered in tablets of 125 and 250 mg, as well as 250 mg capsules (according to current instruction  on the use of funds). One blister contains 6 tablets or capsules.

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

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

The dose of azithromycin 125-250 mg is prescribed with a body weight of at least 45 kg, in other cases, the dosage form is recommended as a suspension. For children weighing up to 45 kg, the drug is calculated at the rate of 10 mg / kg (once daily).

The drug is taken outside the meal (an hour or two hours after a meal). The time of use of the medicine should be fixed, for example, at 11 am. Do not chew a 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 250 mg capsules are considered the most convenient.. They are easy to swallow, because they slip and language does not remain discomfortlike taking pills. Solid forms of azithromycin have been used in sufficiently adult children, who can easily take them correctly.

Important ! Azithromycin is not indicated for children up to 6 months, due to the high probability of the appearance of convulsive reactions and gastrointestinal disturbances (even bleeding).

The price of azithromycin 250 varies in the range of 50-90 rubles  and higher, depending on the pharmacological company, although it is possible to meet social offers, for example, from the Vertex company (Russia) - 32 rubles. Analogs of azithromycin have a higher price. The cost of a sumamed (Teva, Israel), the most well-known analogue, is within 350 rubles.

Indications for use azithromycin

The drug is prescribed for the following pathological processes:

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

For the treatment to be effective, it is necessary to carry out bacterial seeding on the microflora with an antibiogram. This analysis will determine the causative agent and help determine whether azithromycin is appropriate for a particular case. For example, in case of tonsillitis a smear is taken from the area of ​​the affected tonsils.

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

Contraindications and side effects

Azithromycin, like all antibacterial agents, has several disadvantages and not allowed for use under the following conditions:

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

Adverse reactions are possible in the form of:

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

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

You can take an antihistamine drug (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 take place in the most innocuous form.

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How to store azithromycin 250?

The drug 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 packaging, and is 2-3 years, depending on the manufacturer.

It should be remembered that azithromycin 250 tablets and capsules are 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

Analogs can coincide on the active substance or on the mechanism of action. So, here is a list of analogues that contain azithromycin:

• hemomycin;
• sumamed;
• clubbacks;
• sumamox;
• azitrox;
• citrocin;
• azicide;
• sumaclid;
• nitrolide;
• others.

These funds replace azithromycin if the drug itself was not entirely appropriate. 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;
• lekoclar;
• arvicin;
• spiramycin;
• macropene;
• rovamycin;
• fromelide;
• others.

Analogs, reviews, side effects  Azithromycin

Reviews 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. To my deep regret, some pseudo-doctors practice the use of azithromycin for inappropriate purposes, when lighter antibiotics can cope with the disease.

Of course, the effect of azithromycin will be lightning-fast, but then how can you treat complex infections if the body gets used to getting a strong antibiotic for simple forms of disease. This is quite a serious moment in treatment and parents should know about it. Trust but check. If in doubt, consult another specialist.

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

Nastya

A daughter (14 years old) constantly suffers from acute respiratory viral infections, and, unfortunately, very often the disease is complicated by tracheitis or bronchitis, and the complication after the virus comes quickly. Recently strongly ill. Pediatrician prescribed augmentin, ACC, heap in syrup. There was almost no result, wheezing went down below. My daughter, when she coughed, it was clear to me, not even to the doctor, that my breathing was weakened, and the cough was 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 is commendable, 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. This information was suggested to me by the pharmacist, I really doubted at first, but nevertheless took azithromycin. At 15:00 we 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 10 days of Narine (kefir for dysbacteriosis) for prevention. Heavy sore throat  Azithromycin overcame with a bang.

Nataliya

The son was 10 years old when he seriously caught a cold. He coughed heavily, sweated, the temperature kept within 37.3 degrees. The doctor, after listening to the child, determined that breathing was hard, weak, and similar to right-sided dry pleurisy. On the first day, azithromycin 250 was prescribed, and the remaining four days were given a lower dose of 125 mg each. The child quickly went on the mend.

After a while, my son was taken a x-ray, and the radiologist noticed that the sinus was “soldered” - this means that pleurisy was once. So azithromycin helped, and at that time we did without injections. Great antibiotic!

Ianina

That's all they write only positive, but I have another experience. I am 24 years old, not a child anymore, but the dose of azithromycin was prescribed in the pediatric dosage - 250 mg. Just my weight is 49 kg, and therefore gave such a dose. Treated tracheobronchitis. She complained of cough, thick phlegm, shortness of breath, lethargy and headache.

Bronchitis has passed, but a day after taking the last pill (fifth), a terrible rash began all over the body. There was no acne on the face and hands. They put on a diet, prescribed Kars, holosas and Erius. But, despite all this treatment, the rash went very slowly. Only two months later the skin was completely cleansed.

The reasons for this phenomenon were not found, except for the commentary 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. This is my experience with azithromycin.

Alexandra

Ill in the country. A runny nose, fever, and then the agonizing cough began. Not only that, and I infected the daughter, most likely viral infection  "Worked." It was necessary to go to work on Monday, but the boss on the phone made it clear that I can only be ill for three days or I will find a replacement. Saved only sumamed - an analogue of azithromycin.

My daughter started severe bronchitis, and our precinct also advised to drink Sumamed only in the children's dosage. Moreover, my daughter had a purulent acne, with which the second year we fought. Apparently the rash had an infectious origin. I was very pleased with the drug, I can even say more, I have never met such an instant effect from antibiotics.

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 appointments in the treatment of childhood infections and shows excellent results of therapy.

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Azithromycin is a popular antibacterial agent that is used to treat diseases of the upper and lower respiratory tract and bacterial lesions of the urogenital system, including in children. It has a low level of toxic effects on the child’s body and a long lasting effect. Therefore, the drug can be taken only once a day.

The antibiotic Azithromycin is sold in any pharmacy in the form of tablets, capsules and powder for suspension.

There are also a number of its full analogues:, Azitrus, Azivok, Sumemetsin, Zitrolid, Zitrotsin, Ecomed, ZI-factor, and so on.

The listed preparations were prepared on the basis of one active substance - 9-Deoxo-9a-aza-9a-methyl-9a-homoerythromycin A, and all of them have identical action.

How does the medicine work?

Azithromycin belongs to the group of drugs called macrolides because of their special structure (if you delve into chemistry, they are based on a 14 or 16-membered lactone ring with attached carbohydrate residues).

The most famous representative of macrolides is Erythromycin, which was also used to treat fathers and mothers, grandparents of today's toddlers.

Azithromycin is a new generation of medicine, which means it has fewer side effects.

It is effective against a whole spectrum of pathological microorganisms resistant to other antibiotics. Among them are many species - the plague of the twentieth century, as experts call it. In addition, it the only drug that can fight hemophilic wand  the host, together with staphylococcus, is actively involved in the development of pneumonia and meningitis.

The drug has the ability to easily penetrate and accumulate in sputum, located in the bronchi, as well as in the tissues of the bronchi and lungs, organs of the genitourinary system and skin. This allows the drug to act directly on the site of inflammation. The mechanism of action of the antibiotic is based on the fact that it prevents microbial cells from synthesizing protein. And without this basic “building material” no cell can exist. Azithromycin reaches the highest concentration in the blood plasma of a child within 2-3 hours after admission. From there, it penetrates into the foci of inflammation, accumulates in the tissues of the affected organs and immediately begins its work.

  An antibiotic is taken once a day. It'll be enough.

In addition to speed, the drug is slow in excretion from the body, which prolongs therapeutic effect. An antibiotic is usually eliminated from a child’s body within 35-55 hours.  It is this property of Azithromycin that makes it possible to take it only once a day.

One of the main advantages of the antibiotic is the absence of any interaction with anti-allergic drugs. This allows you to take it to children suffering from allergic diseases and, in particular, bronchial asthma.

In what cases is prescribed?

Children Azithromycin is usually treated for respiratory diseases:

• bronchitis, pneumonia caused by chlamydia and mycoplasma;
• complicated pneumonia with an established pathogen that is sensitive to the drug;
• during exacerbations of chronic bronchitis;
• in the absence of the effect of treatment with antibiotics related to cephalosporins and penicillins, as well as intolerance to these drugs;
• if the child has allergies, asthma.

  If pneumonia is suspected, pediatricians usually prescribe Azithromycin.

In addition to these diseases, Azithromycin is used to treat:

•   , angina;
• scarlet fever;
• skin diseases - erysipelas, impetigo, pustular lesions;
• inflammation of the urethra;
• lyme disease.

How to navigate in the variety of analogs and forms of releases?

Azithromycin has several forms of release, of which it is possible to choose the most suitable:

1. Powder for the preparation of suspensions or ready-made suspensions of 100 mg / 5 ml, equipped with a syringe dispenser for children from six months to three years.
2. Powder for suspension or ready suspension 200 mg / 5 ml - from three to 14 years.
3. Tablets 125 mg.
4. Tablets with a dosage of 250 mg - they are rarely used to treat children.

Speaking of dosage, we mean that it is the same for all Azithromycins, which appear under different names, which were discussed above. Some drugs, for example, Sumamed, are represented by all dosage forms - in the form of tablets, powder for suspension and capsules, but Azimed, Azitrus, Azitroks - are intended only for the preparation of suspensions. Ecomed is a ready-to-use mixture.

  The more expensive analog of Azithromycin with the same basic active ingredient  - Sumamed.

Dosage and regimen

Before you start using the drug, be sure to read the instructions for use (). Azithromycin dosage depends on the child's body weight.

Thus, the total dose required for the course is 30-50 mg per kilogram of weight.

Example: if Alyosha weighs 14 kg, then he will need 140 mg of Azithromycin per day at a time. You can split in half 280-milligram pill or give a suspension. The boy will need 5 ml of the suspension obtained from a 100-milligram bottle of powder (according to the table below). If the weight of Alyosha was, for example, 15 kg, it would be impossible to divide the tablet exactly. In this case, it is advisable to apply the suspension. Here is a table (from the instructions for use), which will help calculate the required amount of suspension, based on the weight of the child:

The drug should not be given simultaneously with food - either an hour before a meal, or two hours after it.

  Taking the drug is strictly on an empty stomach!

In some cases, during the treatment process, it is necessary to adjust the dosage or replace the drug, and this can only be done by a doctor. Therefore, the reception of the antibiotic should be carried out only under the supervision of a pediatrician and on his recommendation.

How to prepare a suspension of powder

Suspension is prepared immediately before the first use. On a bottle with 100 mg of the drug, add 11 ml of boiled cooled water using a syringe dispenser and shake well to obtain a homogeneous liquid. Bottles with 200 mg of the drug diluted with 14.5 ml of water - here the concentration of the drug is higher.

The resulting suspension is given to the child using a double-sided dosing spoon or syringe dispenser. Divorced medicine  stored in the refrigerator for no more than 5 days.

  Syringe dispenser - a great helper for moms!

Very young children more convenient to give a suspension with a syringe dispenser. To do this, place the child as for feeding, carefully insert the tip of the syringe into his mouth and slowly squeeze out the medicine so that he can swallow.

Prices

The price of Azithromycin ranges from 30 to 300 rubles, depending on the manufacturer (brand), dosage and dosage form of the drug.

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