Tobrex eye drops for children. Instructions for use, price, reviews

Infectious-inflammatory diseases They are among the most common in ophthalmology. They are traditionally treated with antibacterial drugs, which include eye drops Tobrex.

Although no formal studies on the effectiveness of this tool in pediatric practice, it is widely used in the treatment of conjunctivitis, blepharitis and other pathologies. For children assigned the same dose as adults.

Composition preparation Tobrex

Tobrex, eye drops for children and adults, relates to antibacterial drugs. It comes in the form of eye drops, in plastic vials with screw neck and cap-dispenser with a dropper for applying medication at a predetermined rate.

The solution itself looks like a clear liquid, colorless or slightly yellowish tint. Dropper bottle 5ml fit into the secondary packaging - carton.

The drug has the following composition (in parentheses indicate the component content in 1 mL of solution):

• ground active substance - tobramycin (3 mg);
• Benzalkonium chloride - antiseptic active against bacteria, viruses, fungi and protozoa (0.1 mg);
• Boric acid - antiseptics (12.4 mg);
• sodium chloride - a component providing in ophthalmology decongestant action (2.78 mg);
• sodium sulfate - an antiseptic component (1.52 mg);
• tyloxapol - liquid polymer used as a surfactant to facilitate liquefaction and removal of purulent exudates (1 mg);
• sulfuric acid (or sodium hydroxide) - acidity regulator;
• Purified water (1 mL).

The drugstore chain in the sale is also a similar drug - Tobrex 2. These drugs do not differ in concentration of the active substance. Tobrex 2 comes in a thick consistency (due to the introduction of xanthan gum), which provides a long presence of the drug in the sclera of the eye and prolonged effect.

Also differs multiplicity of applications specified in the instruction - Tobrex necessary to bury every 4 h, and its thicker counterpart - 2 times a day. What kind of drug is selected for the child decides the treating ophthalmologist.

pharmacological properties

The main component of eye drops relates to aminoglycoside antibacterial agents group. As the medical research, the most common microorganisms, leading to bacterial infection of eyes are staphylococci (more than 60% of patients) and streptococci.

The largest share in the structure of such diseases occupy conjunctivitis, and bacterial flora detected in children in 70% of cases (in adults - up to half of all patients). Tobrex, eye drops to children overlaps the range of the most probable of infectious pathologies in ophthalmology.

Revealed the following dependence of the sensitivity of microbial agents with respect to this kind of aminoglycosides:

• Staphylococcus epidermidis (Staphylococcus epidermidis) - 90-95%;
• Streptococcus pneumoniae (Streptococcus pneumonia) - 75%;
• Staphylococcus aureus (Staphylococcus aureus) - 80%;
• Staphylococcus saprophiticus (Saprophytic aureus) - 100%;
• Pseudomonas aeruginosa (Pseudomonas aeruginosa) - 95-100%.

Furthermore, Tobrex used to treat diseases caused by infection by E. coli, Proteus, Klebsiella, Serratia, Enterobacteriaceae, Providencia, Shigella, Salmonella, tsitrobakter, Haemophilus influenzae, which are found less.

The effectiveness of initial therapy of bacterial etiology of disease depends on the correct choice of antibiotic. Conjunctivitis, developing in the form of lightning, can lead to corneal perforation and blindness development.

Since on the basis of tobramycin preparations exhibit a high activity against most pathogens, they are regarded as the "first tier" of drugs in ophthalmology. The main action of the active ingredient in the pathogenic bacteria is that it penetrates through the water channels inside the cell and binds to its ribosomes.

As a result of disrupted biochemical mechanism of protein generation, bacterium membrane permeability and eventually the death of the microorganism occurs. This scheme is characterized by exposure to all members of aminoglycoside group of antibiotics.

Pharmacodynamics and Pharmacokinetics

Most antimicrobials in ophthalmic represented in the form of eye drops, since they will act to instillation into the eye. Since the active ingredient has poor lipid solubility, it is practically not permeable through biological membranes.

Local treatment has no systemic effect, it provides a high level of safety in pediatric patients.

A feature of tobramycin and other aminoglycoside group of substances is that it is characterized by a small volume of distribution. Efficacy is dose-dependent and correlates with the peak concentration. The lowest risk of local side effects depends on the minimum drug concentration in the intervals between dosing.

Another important characteristic is the prolonged effect of the drug, which is different duration for pathogens infectious inflammation. It is expressed in the suppression of microbial growth even after reducing the therapeutic concentration.

Tobrex has a broad antimicrobial spectrum. However, medicines on the basis of Tobramycin historically used more in the field of therapy associated with its pseudomonas activity.

In severe cases, combined treatment regimen using various eye drops (combination of several types of drugs) is administered to children, showing good results. Indicators of tobramycin is higher than that of fluoroquinolones and other groups of antibiotics, which is confirmed by clinical studies in different countries.

Indications

The drug is used to treat the following pathologies associated with infectious infection of various localization:

• Bacterial conjunctivitis. It occurs most often (70% of the total burden of disease). This is due to an abundance of flora in the cavity of the eyeball. The course of the disease in the acute form is most often associated with Pseudomonas aeruginosa, staphylococcus, and gonococcus. A characteristic feature of the disease is a bacterial purulent discharge from the eyes, yellow or greenish tinge. Children most often pathology develops at the age of 2-7 years, is spreading fast in children's groups. The infection occurs mainly via dirty hands. First one eye is inflamed, and in 2-3 days - the second. The disease can also occur against the background of infectious lesions of the skin, ear, nose and throat. Since viral and allergic conjunctivitis have many similarities on the clinical signs, the differential diagnosis is required. Antibacterials, including Tobrex ineffective for the treatment of viral diseases and allergic nature, a doctor can prescribe it only means for the prevention of secondary bacterial infection.
  
• blepharitis, which is an inflammation of the eyelids. A feature of the disease is that it tends to relapse again. Like conjunctivitis, it can be caused not only by bacteria, so the self is not allowed. Blepharitis often occurs when malnutrition, metabolic disorders, parasitic infestations, lesions of teeth, nose, throat, tonsils. As complications may develop corneal ulcers. This pathology also often occurs with conjunctivitis.
• bacterial keratitis, Wherein the corneal inflammation of the eye occurs. In children, it is most likely to occur when non-compliance with the rules of hygiene, injury of organs of vision (including including when you try to remove the foreign body), on the background of other infectious diseases localization. Keratitis is also often associated with conjunctivitis. If it affects the deeper layers of the cornea may remain scars, reducing visual acuity. A characteristic symptom, along with reddening of the conjunctiva, is a reduction in gloss and transparency of the cornea.
• Iridocyclitis. This disease is rarely observed. When it occurs inflammation of the iris of the eye and average. It can occur in the background keratitis or infectious pathologies other sites - herpes infection, measles, influenza, pneumonia, sinusitis, rhinopharyngitis, as well as eye injuries. Characteristic signs of injury are pain in the eye, constricted pupil and iris color change. As complications of adhesions may occur, vision deteriorates.
• dacryocystitis, or inflammation of the lacrimal sac. In newborns this is due to improper development of the nasolacrimal duct, which blocked the film in utero. After the birth, she has to go in the nose during the first spontaneous breathing, but some children do not. As a result of impaired outflow of tear fluid, there is inflammation, which may progress to abscess.
• endophthalmitis, wherein inflammation develops inside the eyeball. This condition occurs as a result of infection with eye injuries or after surgery. It can lead to complete loss of vision. As a result, after surgery on the organs of vision for the prevention of complications in patients prescribed antibiotics, including Tobrex.
• Barley, is an inflammation of the hair follicles of the eyelashes or the sebaceous glands, which are located on the edge of the eyelid. Most often it is caused by staphylococci. The disease is dangerous because the infection can spread to the eye socket, and even the brain. Children barley most often occurs with weakened immunity, after infectious diseases and because of non-compliance with the rules of personal hygiene (brushing eyes with dirty hands). Triggering factor may also be hypothermia.

For all types of infectious eye disease pathogens are most often staphylococci. Predisposing factors for infection are injuries, increased dryness of the eyes, reduced general immunity.

Contraindications

Tobrex, eye drops to children has only contraindication to the use of: idiosyncrasy components.

At what age can use the drug

Despite the fact that the official instruction to this drug given the lack of sufficient experience of its application in pediatric practice, it is used successfully for the treatment of infectious pathologies eye. Tobrex well tolerated in children of all ages.

Ophthalmologist can prescribe this medicine with the first days of life. Another type of issue - Tobrex 2 is recommended for the treatment of children at the age of 1 year and older.

Instructions for use, drug dosage for children

The drug is only used locally.

Step by step procedure for conducting the procedure is as follows:

1. Wash hands thoroughly with soap and water. Before applying the funds that are made in the conjunctival cavity must be strict adherence to personal hygiene, because otherwise you can put in the eye infection.
2. Shake the bottle-dropper with a solution.
3. Throw back the patient's head back (better to produce landfill in the supine position).
4. Open a bottle of medication.
   
5. With one hand, gently pulls down the lower eyelid and the other squeeze 1-2 drops. vial tip must not come into contact with the surface of the eye or surrounding skin, as it may lead to infection and contamination during subsequent use.
6. Then release the lid, close the eyelids, little pressure with your finger on the inner corner of the eye. Wait 5-10 minutes. If necessary, repeat the steps for the second eye.
7. Carefully close the vial cap and clean the medicine out of the reach of children.

In uncomplicated inflammation of this procedure is carried out every 4 hours. If the pathological process takes place in an acute form, the drops are used every hour. The total duration of treatment - to eliminate symptoms, but if you do not start to improve, you need to consult your doctor for further investigation and the appointment of other drugs.

Side effects

Tobrex - eye drops for children, which are distinguished by good tolerability.

In rare cases (about 1% of patients) may develop following side effects:

• an allergic reaction, which manifests itself in the form of itching (mostly centuries), and redness of the conjunctiva age, increased release of tear fluid, edema, swelling of the eyelids and the conjunctiva, discomfort eye;
• burning, pain, foreign body sensation in the presence of authorities;
• pronounced mucosal edema eye;
• deposition of crystals in the conjunctival sac;
• inflammation of the cornea, its ulceration.

If you experience these symptoms should stop using the medication and seek medical attention.

Overdose

In case of overdose occur the same characteristics as those described under "Adverse reactions". In such cases it is necessary to wash out the eye with warm boiled water and seek medical advice. Treatment of symptomatic, depending on the individual response on the part of the organs of vision.

special instructions

If the patient uses contact lenses, they must be removed for 15-20 minutes prior to instillation. Wear lenses after the same period of time after application of drops into the conjunctival sac.

Since the use of the drug can cause discomfort, it is recommended to refrain from driving and other high-risk technical means within half an hour procedure.

An important condition for the effectiveness of the therapy is the treatment of regularity. Periodic not systematic use of antibacterial agents and their long-term use leads to the formation of resistance by bacterial strains to the drug.

drug interactions

As the inflammation of the organs of vision often occurs on the background of infectious pathologies of other sites, the physician may prescribe antibiotics for oral (systemic therapy). In this case, an increased risk of side effects described above.

analogs

A complete analogue of the drug concentration of the active ingredient release form and pharmacological effect of the drug is Tobropt. Indications and method of using same for him. As restrictions on its use, according to official instructions, serves children up to 18 years of age, pregnancy and lactation.

Clinical studies also noted that Tobropt often causes allergic reactions (up to 15% of cases).

Analogues of the spectrum of action and form release formulations are listed in the table below:

Title	The active ingredient	Average price, RR.
Vigamoks	moxifloxacin	240
Floksal	ofloxacin	170
Tsipromed	ciprofloxacin	100

Terms, conditions of sale and storage

Shelf life of sterile, unopened package is 3 years from the date of release of the drug. Opened vials should be disposed of after 4 weeks from the beginning of its use. Storage conditions: Temperature 8-30 ° C. The drug belongs to the category of prescription and strong. It should not be used without medical supervision because of possible complications.

Price in drugstores of Moscow, St. Petersburg, regions

The average price of the medicine in Moscow and St. Petersburg is about 170 rubles. In regions value can slightly vary within 10%. Tobrex - antibacterial formulation as eyedrops, active against the most important infectious agents in ophthalmology.

Its use is justified for ocular different localization - inflammation of eyelids to the cornea. it is used for the same indications as for adults for children of any age. Tobrex also prescribed to patients for the prevention of postoperative complications.

Videos about the drug Tobrex

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