Use of azithromycin in pediatric patients
After 1980, WHO experts included in the list of important Azithromycin medications. It is an antibiotic of the azalide group of macrolides, in its composition has the same name azithromycin active substance (ATC J01FA10 code). The drug possesses bacteriostatic effect, as inhibits growth and reproduction of pathogenic microbes. When assigning a high dose of active ingredient immediately destroys pathogens. The drug is not effective against fungi, or viruses.
Azithromycin is prescribed for diseases caused by:
- staphylococcus aureus;
- sensitive to azithromycin strains of Streptococcus;
- Haemophilus influenzae;
- chlamydia;
- Legionella;
- Toxoplasma gondii;
- Gram-positive bacteria that are not resistant to erythromycin;
- clostridia;
- bacteroids;
- bordatellami;
- Moraxella;
- mycobacteria;
- spirochete;
- Treponema pallidum;
- pulmonary mycoplasma;
- Neisser;
- borrelia;
- anaerobic bacteria.
Is it possible to assign children Azithromycin? Yes, the substance of azithromycin in an adequate exchange rate and the daily dosage does not threaten any life or health of a child. In pediatric medicine used in tablet and capsule form, powder g / suspension, ophthalmic drops. Intravenous solution d / infusion administered only 16 years.
Azithromycin can be given to children with acute and chronic bacterial diseases:
- tonsillitis;
- sore throat (In combination with other aseptic and antimicrobial drugs);
- sinusitis (including antritis);
- nasopharyngitis;
- bronchitis;
- Legionnaires' disease;
- pneumonia;
- pulmonary mycobacteriosis;
- otitis (Including purulent form);
- cystitis;
- streptoderma;
- gonorrhea;
- erysipelas;
- urethritis;
- I step borreliosis (erythema migrans);
- pyoderma and its subtypes;
- urogenital syndrome;
- H. pylori infection (in conjunction with antimicrobials complex);
- abscess, cellulitis;
- boilsAcne;
- infected wounds.
Child ophthalmic drops with azithromycin is prescribed for trachoma, Purulent, acute and chronic conjunctivitis.
Limitations and contraindications to the use of the antibiotic
In the summary of the drug observed that children Azithromycin tablets or capsules are contraindicated to 12 years. These forms of Medicine are beginning to show after their weight reaches 45 kg. But doctors admit their reception with caution before that age. Ophthalmic drops are not recommended manufacturers use in the treatment of infants (from birth to 1 year).
Azithromycin can not take children (slurry) child weighing less than 5 kg, and under six months. The doctor may prescribe this medicine babies older than 1 month at a complex bacterial infection with severe disease, and only after the confirmation of the sensitivity of the pathogen to the means of action.
You can not use the drug if you are hypersensitive to the substance of azithromycin or other macrolides, or together with ergotamine and its derivatives. Undesirable this medicine to treat children with disorders of the liver, kidneys, arrhythmia, predisposition to bleeding or to disruption of the heart.
Side effects of antibiotics
In children Azithromycin in treatment or after 1-62 days after completion of the course often causes bloating, pain or discomfort in the abdomen, diarrhea. This is due to dysbiosis, if during antibiotic child is not given probiotics "Bioporin", "Evitaliya", "Bifidumbacterin" and other preparations for the preservation of beneficial microflora.
Less commonly, after taking azithromycin in children occur skin rashes and itching. When the allergy symptoms you need to give your child an antihistamine, such as "Diazolin" and immediately consult a pediatrician.
Treatment with antibiotics can trigger the development of candidiasis, stomatitis. The emergence of a fungal infection in the mucous membranes indicates a decrease in immunity. Therefore recommend giving the child more fruits or a multivitamin.
Darkening of the color of urine, headache, vertigo, nausea and vomiting often occur due to an overdose, worsening of the liver or kidneys. Such side effects have to inform the pediatrician, get tested and, if necessary, undergo a symptomatic therapy.
Children rarely after taking Azithromycin clinicians recorded:
- toxic hepatitis (manifested yellowness proteins eye, skin);
- liver failure and / or kidney;
- upset the rhythm of the heartbeat, shortness of breath;
- fainting;
- angioedema (Swelling of the mucous membranes of the larynx, facial tissues, limbs, choking);
- deterioration swallowing, hoarseness;
- bronchoconstriction or trouble breathing;
- fever;
- anaphylactic shock;
- spasmodic pain of the digestive tract;
- bloody diarrhea.
If in the course of treatment having severe side effects, call "ambulance." At the hospital, the patient was washed stomach or prescribed medicament for cleansing the body, symptomatic therapy.
Features of the application and storage of the antibiotic
How to give your child the doctor indicates Azithromycin in prescriptions. In the selection of the number and multiplicities the medication he considers both baby weight and severity of the disease, compatibility with other medicines. The instruction is not given such nuances, and outlines the general requirements for the use of the drug. Therefore, the self is rarely effective.
How to give children Azithromycin:
- Medication use once a day for a specified time, preferably before lunch. Antibiotics can not drink on an empty stomach or reduce the 24-hour interval between doses it;
- The medicine should be taken between meals: 60 minutes before eating or after it, but at intervals of two hours;
- The suspension, tablets or capsules necessarily abundantly washed down with plain water;
- Child from 6 months give syrup Azithromycin. Before applying the liquid in the bottle is shaken vigorously and wait until the foam settles, and then molded into the desired dose measuring spoon;
- Children older than 12 years old with a weight of not more than 44 kg, administered tablets or capsules of 125 mg or 250 mg. They swallow whole without chewing;
- After 12 years child weighing 45 kg can drink capsule or tablet dosage of 250 mg and 500 mg;
- If you accidentally missed doses should give the child as soon as possible, to withstand the interval after a meal, and the next dose - 24 hours.
Azithromycin should be stored in a dark place with an indoor children's access at no more than + 25ยบ C. An antibiotic can not keep on windowsills or near the heating, electrical and gas appliances.
Dosage of the antibiotic
Dosage Azithromycin age child does not apply - it is calculated according to body weight. In the treatment of adolescent weighing more than 45 kg, tablets or capsules of 500 mg to 500 mg, and if it is equal to 44 kg and below - more convenient to use a slurry. Give medicine once a day.
In order to achieve a bactericidal effect, doctors use one of the regimens:
- designate the first day "loading dose" 10-20 mg azithromycin / kg / day, and 4 consecutive days - 5 mg / kg;
- three consecutive days prescribed maximum dosage of 10 mg azithromycin / kg;
- designate the first three days "loading dose" of azithromycin 10 mg / kg / 24 hours, and the fourth and fifth - 5 mg / kg.
125 mg tablets may be harder to treat children 12 kg, but on the condition that they should not be divided into parts. The kid should be able to swallow a good medicine, so he does not choke or vomit. If the mass of the child's weight is 18-44 kg borders, pediatricians are allowed to use for children Azithromycin 250 mg capsules.
Dosing of the oral suspensions
Babies Azithromycin 200 mg / 5 mL or 100 mg / 5 ml produced in powder form white or cream color, are packed into bottles weight from 12.4 g to 31 g. Comes with measuring spoon, syringe dispensing. The cost of domestic preparation starts from 200 rubles.
Before use, the antibiotic is diluted with cooled boiled water to the mark on the bottle, is shaken vigorously. Single preparation is stored up to 10 days.
In the treatment of children from 6 months to 3 years of age are used Azithromycin 100 mg / 5ml. According to the conventional scheme dosage was calculated at 10 mg / kg, which consume a minimum of three days, and then cut in half the number of - 5 mg / kg. The therapeutic course lasts a maximum of 5 days, so that the pathogen has not had time to develop resistance to the drug. But the action of the active substance is maintained within 5-7 days from the last drug administration. If you want to prolong the antibiotic, the drug is replaced with azithromycin means the other group.
In the case of severe clinical disease Azithromycin prescribed for 200 children with a body weight of 10-44 kg. In the first three days, doctors recommend to apply impact to the child dose of 0.5 ml / kg 2 (maximum 12.5 ml / 44 kg) and the volume of drug as used halved on the fourth and fifth day.
Dosage Azithromycin suspension for children on the recommendations in the instructions:
- child weighing 45 kg heavier give a day 12.5 ml of the solution of 200 mg / 5 ml;
- from 10.0 to 44.0 kg - syrup dosage of 200 mg / 5 ml to 1 ml / kg 4 (maximum 11 ml);
- at 10,0-12,0 kg total weight also gives the child suspension 100 mg / 5 ml in a volume of 1 ml / kg;
- with streptococcal infection being prescribed 20 mg azithromycin / kg body weight / 24 hours, duration of therapy is three days.
The suspension is sweet taste and smell of banana, apricot, caramel, vanilla, cherry and raspberry. Therefore the child to drink syrup is easier than to make swallow a tablet or a gelatin capsule.
Dosage of the drug in 125 mg tablets
Azithromycin is an antibiotic produced 125 mg round convex tablets in a film-coated white. They are packed in blisters of 6 pieces, sold an average of 210 rubles.
The core of each tablet contains 125 mg of azithromycin. The active substance to shape connected with aerosil, cellulose, starch, E572 thickener and other auxiliaries. The shell is made up of lactose, triacetin, hypromellose.
It can be given in pill Azithromycin 125 child weighing 12-44 kg:
- when caused by streptococcal pyogenic diseases: 20 mg azithromycin / 1 kg, with a maximum of 500 mg / 24 hours. The optimal duration of treatment is three days;
- bacterial pathologies of the respiratory and ENT system / azithromycin 10 mg / 1 kg for three consecutive days. Do not exceed the daily rate of 250 mg for children under 12 years of age with a body weight between 18-30 kg or 375 mg of 31 kg;
- at step 1 borreliosis first day antibiotic drink circuit 20 mg azithromycin / kg (maximum 500 mg) or 1-3 tablets of 125 mg. Then use four consecutive days to 10 mg azithromycin / kg.
No need to adjust the dose in the treatment of children with mild, moderate degree of functional disorders of the internal organs. Azithromycin stop giving, and immediately inform your doctor if you show one or more side effects.
Dosage of the drug in 250 mg tablets
Composition excipients same as that of the drug of 125 mg. The blister pack contained 3 * 250 mg tablets. They are sold in packages of paper with one or two plates (3 and 6 tab.). In pharmacies, the price starts from 30 rubles.
Doctors are allowed to give Azithromycin 250 children weighing more than 31 kg. Medication use caution in the case of liver disorders table Child-Pugh score below 9 or disorder, renal activity with clearance above 40 ml / minute.
Instructions for use Azithromycin 250 children:
- Jr. 12 weighs more than 31 kg of bacterial infections of the ear, throat, respiratory tract, lung, soft tissue or skin give 1-2 * 250 mg tablets / day (according to the doctor's prescription) for three consecutive days;
- over 12 years old with a weight of 45 kg for the treatment of erythema migrans once given 4 tablets * 250 mg (1 g), and the next four days - 2 pieces * 250 mg / day. Over the course of the child should drink 3 g of azithromycin;
- older than 12 years with a body weight of 45 kg bacterial infections of the respiratory system, ENT, soft tissue provide two tablet dose of 250 mg. Per course need to drink 1.5 g of azithromycin of 500 mg / day every 24 hours;
- over 12 years old and weighs 45 kg and more in acne give 2 tablets. (500 mg) three consecutive days, and then weekly for two months.
Dosages described in order to review. Given a schema change instruction physician if the patient complex appointed other medicines, or have liver disease, renal infarction.
Dosage of the drug in 250 mg capsules
Azithromycin capsules are packaged in blister 6 or 10 pieces. In each powder contained 250 mg azithromycin, the shell is made of gelatin, preservatives and food additives E218, E171, E216. The drug is sold in packages of paper on one or two plates (10 and 20 units * 250 mg) as low as 27 to 380 rubles.
According to the instructions assigned capsule Azithromycin 250 child over 12 years of age with infectious diseases caused by germs sensitive to the active substance. Doctors allow their use in the treatment of children weighing more than 18 kg. Dosages and regimens used are the same as for the 250 mg tablet formulation.
Dosing of capsule and tablet form 500 mg of the drug
Azithromycin 500 children are given strictly on prescription, since in each tablet or capsule contains a large concentration of azithromycin for the child - 500 mg. It sold at a price of 64 rubles in 1.5 g (3 pieces). Excipients are the same as in the compositions of the antibiotic 125 mg or 250 mg of the same dosage form.
Children Azithromycin capsules or 500 mg tablets given 12 years. The dosage employed for adult, if the body weight exceeds 44 kg. "Loading dose" for a baby weighing less than 45 kg is 10-20 mg / 1 Kg / day.
Actions antibiotic overdose or poisoning
The signs of overdose or poisoning azithromycin include cramps, pain in the gastrointestinal tract, deterioration or loss of hearing, diarrhea, nausea, hair loss, fatigue, worsening of side effects. Development of internal organ failure, bleeding may end in the death of the child. "02" When the overdose symptoms require immediate service call.
Before the arrival of emergency child is given to drink 1-4 cups of plain water and provoke vomiting. The procedure is performed up to 3 times faster to clean the stomach of azithromycin.
In a hospital patient or make washing hemodialysis prescribed sorbents, diuretics, dropper with physiological solutions. These activities are aimed at the rapid cleansing of the body of the child from the azithromycin. During detoxification therapy or after it conducted drug support functions of the heart, liver and kidneys.
analogues of the antibiotic
For children Azithromycin 250 mg, 125 mg, 500 mg in tablets and capsules or powder d / slurry 100 mg / 5 ml and 200 mg / 5 ml can be replaced by a medicine containing only one active substance azithromycin. The structural analogs include "azivok" (India), "Azitrus" (Russia), "Sumamed" (Croatia), "Zitnob" and "Tremak-Sanovel" (Turkey), "Hemomitsin" (Serbia), other antibiotics ATC code J01FA10.
Important information
Never give Azithromycin child if violated conditions of storage, or after the end of the drug at the expiration date. The drug becomes toxic, it loses its medicinal properties.
Tablets should not be crushed, chewed, and pour the contents of the capsules and powder drink only! Because of the ruined shell of azithromycin is absorbed too quickly and run the risk of gastric mucosal inflammation, destruction of liver cells, worsening kidney function or infarction.
When side effects, stop giving the antibiotic and immediately consult your pediatrician for further action. In case of overdose or poisoning requires medical care to avoid the child's death.
sources:
Vidal: https://www.vidal.ru/drugs/azithromycin__24064
GRLS: https://grls.rosminzdrav.ru/Grls_View_v2.aspx? routingGuid = 464b69bc-52b8-420f-a2fd-5160efbe8523 & t =
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