Ampicillin-Akos - instructions for use, dosage, adverse effects, contraindications

Antibacterial bactericidal agent from the group of semisynthetic penicillins, obtained by acetylation of 6-aminopenicillanoic acid with an aminophenylacetic acid residue, is acid-fast. Inhibits the peptidoglycan polymerase and transpeptidase, prevents the formation of peptide bonds and disrupts the late stages of the synthesis of the cell wall of the fissile microorganism, which leads to a decrease in the osmotic stability of the bacterial cell and causes its lysis.

It is active against Gram-positive (alpha and beta-hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp., most enterococci, incl. Enterococcus faecalis) and gram-negative (Haemophilus influenzae, Neisseria meningitidis, Proteus mirabilis, Pasteurella multocida many species Salmonella spp., Shigella spp., Eschenchia coli) microorganisms, aerobic non-spore-forming bacteria (Listeria spp.).

He Effective against penicillinase-producing strains Staphylococcus spp., all strains Pseudomonas aeruginosa, most strains Klebsiella spp. and Enlorobacter spp.

Pharmacokinetics:

It is evenly distributed in the organs and tissues of the body, it is found in therapeutic concentrations in pleural, peritoneal, amniotic and synovial fluids, cerebrospinal fluid, contents of blisters, urine (high concentrations), intestinal mucosa, bones, gall bladder, lungs, female genital tract, bile , in a bronchial secretion (in the purulent bronchial secretion, the accumulation is weak), paranasal sinuses, middle ear fluid, saliva, fetal tissues. Poorly penetrates the blood-brain barrier (permeability increases with inflammation of the meninges).

It is excreted mainly by the kidneys (70-80%), and in the urine very high concentrations of the unchanged antibiotic are created; partially with bile, in nursing mothers - with milk. Do not cumulate.Removed during hemodialysis.

Indications:

Bacterial infections caused by sensitive microflora: respiratory tract and ENT organs (sinusitis, tonsillitis, pharyngitis, otitis media, bronchitis, pneumonia, lung abscess), infections of the kidneys and urinary tract (pyelonephritis, pyelitis, cystitis, urethritis), infections biliary system (cholangitis, cholecystitis), gonorrhea, chlamydial infections in pregnant women (with erythromycin intolerance), cervicitis, skin and soft tissue infections: erysipelas, impetigo, secondarily infected dermatoses; infections of the musculoskeletal system; pasteurellosis, listeriosis, gastrointestinal tract infections (abdominal hyphae and paratyphoid, dysentery, salmonellosis, salmonellosis, peritonitis), endocarditis (prevention and treatment), meningitis, bacterial septicemia.

Contraindications:

Hypersensitivity (including to other penicillins, cephalosporins, carbapenems). infectious mononucleosis, lymphocytic leukemia. hepatic insufficiency, a history of gastrointestinal disease (especially colitis associated with the use of antibiotics), lactation period, children's age (up to 1 month).

Carefully:Bronchial asthma, hay fever, etc.allergic diseases, renal insufficiency, bleeding in the anamnesis, pregnancy.

Dosing and Administration:

In cases of moderate infections, adults are injected in / m 0.25-0.5 g every 6-8 h: for severe infections 1-2 g 3-4 times a day or iv 0.5 g every 6 h.

Listeriosis - in / m or in / in 50 mg / kg every 6 hours.

With meningitis - 14 g / day; the frequency of administration is 6-8 times.

With gonococcal urethritis - inside 3.5 g once or in / m 0.5 g 2 times for one day; with gonorrheal uncomplicated urethritis - once 0.5 g.

Children with severe and moderate infections - in / m at 25-50 mg / kg 4 times a day; when meningitis daily dose - 100-200 mg / kg for 6-8 injections.

With a mild infection in children, oral administration in the form of a suspension is preferable.

The duration of treatment depends on the severity of the disease (from 5-1 0 days to 2-3 honey, and in chronic processes - for several months).

Side effects:

Allergic reactions: possible - skin peeling, itching, hives, rhinitis, conjunctivitis, Quincke's edema, rarely - fever, arthralgia, eosinophilia. erythematous and maculopapular rash, exfoliative dermatitis, multiforme exudative erythema, Stevens-Johnson syndrome, reactions similar to serum sickness, in single cases - anaphylactic shock.

On the part of the digestive system: dysbacteriosis, stomatitis, gastritis, dry mouth, taste change, abdominal pain, vomiting, nausea, diarrhea, stomatitis, glossitis, impaired liver function, moderate increase in activity of "liver" transaminases, pseudomembranous enterocolitis.

From the central nervous system: agitation or aggressiveness, anxiety, confusion, behavior change, depression, convulsions (with high-dose therapy).

Laboratory indicators: leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia.

Local reactions: pain at the injection site, infiltrates with the / m introduction, phlebitis with IV injection in large doses.

Other: interstitial nephritis, nephropathy, superinfection (especially in patients with chronic diseases or reduced resistance of the body), candidiasis of the vagina.

Overdose:

Symptoms: manifestations of toxic effects on the central nervous system (especially in patients with renal insufficiency); nausea, vomiting, diarrhea, disturbance of water electrolyte balance (as a consequence of vomiting and diarrhea). Treatment: gastric lavage, Activated carbon, salt laxatives, preparations to maintain the water-electrolyte balance and symptomatic. Was withdrawn by means of a hemodialysis.

Interaction:

Antacids, glucosamine, laxatives, food and aminoglycosides slow down and reduce absorption; ascorbic acid increases absorption.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine. Vancomycin, rifampicin) - synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic.

Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index); reduces the effectiveness of estrogen-containing oral contraceptives (it is necessary to use additional methods of contraception), drugs that metabolize the PABC, ethinyl estradiol (in the latter case, the risk of bleeding "breakthrough" increases).

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, HPBP and other drugs that block tubular secretion increase the concentration (due to a decrease in tubular secretion).

Allopurinol increases the risk of skin rash.

Reduces clearance and increases the toxicity of methotrexate.

Increases the absorption of digoxin.

Special instructions:

At course treatment it is necessary to monitor the status of the functions of the organs of hematopoiesis, liver and kidneys.

It is possible to develop superinfection due to the growth of insensitive microflora, which requires a corresponding change in antibacterial therapy.

In the treatment of patients with bacteremia (sepsis), the development of a bacteriolysis reaction (the Yarisch-Gerxheimer reaction) is possible.

In patients who are hypersensitive to penicillins, there may be cross-allergic reactions with cephalosporin antibiotics.

In the treatment of mild diarrhea against the background of course treatment, antidiarrheal drugs should be avoided, which reduce intestinal peristalsis; it is possible to use kaolin- or attapulgite-containing antidiarrhoeic agents. If severe diarrhea is to be treated to the doctor.

Treatment should necessarily continue for another 48-72 hours after the disappearance of clinical signs of the disease.

With the simultaneous use of estrogen-containing oral contraceptives and amoxicillin,If possible, use other or additional methods contraception.

Form release / dosage:Lyophilizate for the preparation of a solution for intravenous and intramuscular injection 250 mg, 500 mg.

Packaging:

0.25 g and 0.5 g ampicillin in vials with a capacity of 10 ml and 20 ml.

Storage conditions:

List B. In a dry, dark place at a temperature inaccessible to children.

Shelf life:

2 years. Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:P N000068 / 06

Date of registration:05.11.2008

Expiration Date:Unlimited

The owner of the registration certificate:SYNTHESIS, OJSC SYNTHESIS, OJSC Russia

Manufacturer: & nbsp

SYNTHESIS, OJSC Russia

Information update date: & nbsp20.03.2018

Illustrated instructions

Instructions

Ampicillin-AKOS (Ampicillin-AKOS)