Ampicillin trihydrate - instructions for use, dose, side effects, contraindications

Antibacterial broad-spectrum antibacterial agent from the group of semisynthetic penicillins obtained by acylation of 6-aminopenicillanic 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., Escherichia 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 Enterobacter spp.

Pharmacokinetics:

Absorption after oral administration - fast, high, bioavailability - 40%; The time to reach the maximum concentration at oral intake of 500 mg - 2 hours, the maximum concentration - 3-4 ng / ml. Connection with plasma proteins - 20%.

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. Poor penetrates the hemato-encephalic barrier (permeability increases with inflammation).

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 of the 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 (typhoid and paratyphoid, dysentery, salmonellosis, salmonella).

Contraindications:

Hypersensitivity (including to other penicillins, cephalosporins, carbapenems), infectious mononucleosis, lymphocytic leukemia, hepatic insufficiency, history of gastrointestinal disease (especially colitis associated with the use of antibiotics), lactation period, children's age (up to 4 years).

Carefully:Allergic diseases (incl.in the anamnesis), renal insufficiency, bleeding in the anamnesis, pregnancy.

Pregnancy and lactation:The use of the drug during pregnancy is possible only if the intended benefit to the mother exceeds the potential risk to the fetus. If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.

Dosing and Administration:

Inside, adults - 0.25 g 4 times a day for 0.5-1 h before meals with a small amount of water; if necessary, increase the dose to 3 g / day.

Infections of the gastrointestinal tract and organs of the genitourinary system: 0.5 g 4 times a day.

With gonococcal urethritis - inside 3.5 g once.

With a mild infection in children, it is preferable to take a suspension.

Children over 4 years of age are prescribed 1-2 g per day. The daily dose is divided into 4-6 receptions.

The duration of treatment depends on the severity of the disease (from 5-10 days to 2-3 weeks, and in chronic processes - for several months).

Side effects:

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

From the gastrointestinal tract: dysbacteriosis, stomatitis, gastritis, dry mouth, taste change, abdominal pain, vomiting, nausea, diarrhea, stomatitis, glossitis, impaired liver function, moderate increase in the level 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.

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, violation 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. It is excreted by hemodialysis.

Interaction:

Antacids, glucosamine, laxatives, food slows down and reduces 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, in the process of metabolism of which forms the steam-amino-benzoic acid, ethinyl estradiol (in the latter case, the risk of bleeding "breakthrough" increases).

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs; drugs,blocking 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.

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 ampicillin, other or additional methods of contraception should be used whenever possible.

Form release / dosage:

Tablets of 250 mg.

Packaging:

24 tablets in cans of glass glass of dark glass.

10, 20, 30, 40 50 tablets in cans of polymeric.

For 10, 20, 24 or 30 tablets in a contour cell package.

For 10 tablets in a contour non-jawed package.

Each jar or 1, 2 contour mesh or non-jawed packages with Instructions for use are placed in a pack. 1 circuit cell pack with the instruction for use is placed in cover from cardboard.

Storage conditions:

In a dry place at a temperature not exceeding 20 ° С.

Keep out of the reach of children.

Shelf life:2 of the year. Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:P N001167 / 01

Date of registration:19.11.2008

Expiration Date:Unlimited

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

Manufacturer: & nbsp

URALBIOFARM, OJSC Russia

Information update date: & nbsp22.08.2017

Illustrated instructions

Instructions

Ampicillin trihydrate (Ampicillin Trihydrate)