Azithromycin 250 dosage. Dosage at different ages

Azithromycin 250 is a modern semi-synthetic drug endowed with a powerful antibacterial effect. Due to its semi-synthetic composition, the therapeutic agent can be attributed to the azalide subclass and the macrolide group. The drug is endowed with a powerful spectrum of effects on pathogenic microorganisms, as well as a bacteriostatic effect. Especially often, Azithromycin 250 is prescribed to patients if the bacterial flora could not be suppressed by the penicillin series of therapeutic agents. It is required to take the drug strictly according to the instructions and indications of the doctor, especially if complex therapy was prescribed to the child.

The main active component of the drug is azithromycin dihydrate, with the help of which a powerful bactericidal effect of the drug is carried out. This therapeutic agent is distinguished by the possibility of rapid penetration into human tissues and organs, which provides a quick therapeutic effect. Immediately after taking Azithromycin, its main active components penetrate into the blood from the intestines.

It is important to note that the active substance of the drug is not afraid of an acidic environment, and it also quickly dissolves in fats, which provides a quick therapeutic effect, which is achieved only with the right medication.

Azithromycin dihydrate is an active substance endowed with a prolonged action. Therefore, if the patient regularly takes the drug according to the course of treatment that was prescribed by the doctor, this will allow the main substance of the drug to linger in the patient's body for 6 days. Already 2 hours after taking Azithromycin, the maximum concentration of the main active ingredient is observed, which helps to achieve an early therapeutic effect after taking the first dose of the therapeutic agent.

Thanks to this feature (providing a quick therapeutic effect), it is possible to quickly and effectively cure serious infectious diseases in a short course - usually it is 3-5 days. Moreover, the patient will need to drink Azithromycin once a day, which is considered a convenient technique for many people. Due to this, the drug is actively used to treat infectious diseases in children and adolescents.

The positive qualities of the remedy, which glorify it, include:

optimal price for many segments of the population;
the minimum number of side effects;
even children and adolescents can be treated;
gentle composition for the body.

However, it is important to remember that taking Azithromycin is required only as directed by a doctor, otherwise an antibacterial medicine can cause serious harm to health.

Since the drug "Azithromycin" is a powerful antibacterial agent, it is not recommended to use it during the course of mild diseases. If a person has special indications for admission, then Azithromycin is used as an additional powerful remedy.

The drug is available in several forms. This:

tablets at a dosage of 125 and 250 mg;
capsules of 250 mg;
suspension or syrup.

One blister contains 6 capsules and tablets. Syrup is more often prescribed by doctors for the treatment of children, since not every one of them will agree to swallow a pill, and even more so a capsule.

The instructions for the suspension say that in 5 ml, depending on the dosage of the drug, there are 100 or 200 mg of the main active substance, on the basis of which the doctor will be able to choose the right dosage for each person. Also, the doctor independently determines the course of taking the drug, which depends on the type of disease, its severity and the general health of the patient.

It is important to note that treatment with any antibacterial agent without a doctor's indication is unacceptable (especially if a child is sick), since an incorrectly calculated dose can cause side effects or lead to the development of complications.

How to take the medicine correctly:

A dosage of 125-250 mg is prescribed for children whose body weight exceeds 45 kilograms. If the baby's weight is less, he should take the suspension in the dosage prescribed by the doctor. As a rule, the doctor prescribes 10 mg of medication per kilogram of body weight. This means that if the patient weighs 10 kilograms, he will need to take 100 mg of medicine (syrup) daily, which is done once a day.
An adult needs to take the medicine in the dosage that will be prescribed by the doctor. As a rule, it is 300-500 mg, depending on the type of disease and general health.

Azithromycin should be taken before or after meals. The break should be 1-2 hours so that the active component of the drug can be completely absorbed into the blood through the intestines - otherwise, part of it will not be able to penetrate into the bloodstream, which means that the effect of the drug cannot be called complete.

It is required to take tablets and other forms of Azithromycin daily at the same time, for example, at 11:00. The capsule and tablet do not need to be chewed, and should also be washed down with plenty of water.

Solid forms of the drug are prescribed to adults and children who can swallow them on their own. As many reviews say, capsules are the easiest and most pleasant to take, as they quickly slip inside, do not stick to the tongue, and also do not leave an unpleasant aftertaste.

It is important to note that children under 6 months of age should not take Azithromycin, as it can lead to seizures and disruption of the gastrointestinal tract. The most dangerous side effect in young children is the development of gastric bleeding, which is considered a serious complication for babies.

The price of Arythromycin 250 varies between 50-90 rubles, although sometimes some forms of the drug can be found for as little as 30 rubles. As a rule, analogues of this drug are more expensive than Azithromycin. For example, the most famous similar remedy costs 350 rubles.

Indications for taking Azithromycin

The drug is prescribed to a child and an adult in the presence of the following diseases:

otitis;
angina;
sinusitis (the disease is a lesion of the sinuses);
tracheitis;
tonsillitis occurring in acute or chronic form (sometimes the medicine is prescribed in case of a relapse);
pharyngitis;
pneumonia;
erysipelas;
pleurisy (Azithromycin will be effective in the course of the disease at the initial stage);
dermatosis of an infectious type;
scarlet fever;
furunculosis;
urinary tract infections;
Lyme disease;
during complex treatment of the gastrointestinal tract.

In order for the treatment to be effective, it is important to correctly diagnose. First of all, it is required to conduct a bacterial culture on the microflora, which is carried out using an antibiogram.

This analysis will help to identify the causative agent of the disease, as well as to establish whether the remedy will help to completely get rid of the disease, and whether its active component can completely eliminate the causative agent of the pathology.

In each case, a smear is taken from the affected area. For example, if a person suffers from a sore throat, a smear for bacterial culture must be taken from inflamed tonsils.

It is important to note that often the result of a smear can be obtained only 5-10 days after it was taken. And since most infectious diseases are quite insidious, the disease will not wait until a person begins to treat it. Therefore, many doctors prescribe therapy to patients blindly - if the antibiotic does not help the patient get rid of the unpleasant symptoms of the disease after 3-5 days, it will be replaced with another, more effective medicine.

Azithromycin 250, like other antibacterial agents, has several disadvantages. For example, they include a number of contraindications, namely:

the patient's age is less than 6 months;
arrhythmia, occurring in severe form;
macrolide intolerance;
severe kidney and liver diseases, due to which the drug is excreted;
a person's tendency to develop an allergic reaction.

Also, when taking Azithromycin, patients may experience the appearance of side effects, which include:

flatulence;
diarrhea that cannot be stopped with the help of “fixing” drugs, or it can be done for a while;
nausea, which can turn into vomiting;
tachycardia;
pain or a feeling of pain in the abdomen;
disturbance or deterioration in the quality of sleep;
refusal to eat, which is characterized by a deterioration in appetite;
frequent dizziness;
the appearance of rashes on the body;
frequent and causeless irritability;
violation of the biochemical composition of the blood (more often this happens with an overdose of Azithromycin).

If the patient has side effects, the medication must be urgently canceled, as well as call an ambulance. Before the arrival of the doctor, the victim must be sure to take any sorbent (Enterosgel, activated carbon, Polysorb, and so on).

Also, the patient can take any antihistamine, but this must be done strictly according to the instructions. These drugs include Claritin, Erius and Loratadine. Usually, these drugs are often prescribed by a doctor to prevent unpleasant symptoms during the treatment of the disease. Therefore, signs in a person will not appear at all or will be expressed in a weak form.

Analogues of the drug "Azithromycin 250" are usually similar to it in composition or mechanism of action on the body. The most famous similar drugs that are prescribed to patients today are:

Zitrocin;
Sumamox;
Sumamed;
Sumaclid;
Clubax;
Azitrox;
Zitrolide.

These analogues are similar to Azithromycin 250 in terms of the main active ingredient. If we talk about a similar mechanism of action on the patient's body, we can distinguish the following similar drugs:

Fromelide;
Macrofoam;
Lecoclar;
Erythromycin;
Arvicin;
Rovamycin;
Spiramycin.

As mentioned earlier, all analogues have a slightly higher price than the original medicine.

They are required to be taken strictly according to the indications of the doctor, since each of them has its own side effects, contraindications and features of the reception.

Judging by the numerous reviews, the effect of the drug on the body is fast and effective. Side effects when taken correctly are rarely observed in patients, so doctors often prescribe Azithromycin treatment for children and adults. The main thing is to correctly follow the instructions for using the medicine, otherwise you can cause an overdose, which will adversely affect the health of the patient.

The timely appointment of an antibiotic helps in the fight against infections of the respiratory tract, genitourinary system and other organs. And one of the most popular drugs in this group is Azithromycin. It attracts with low toxicity and long-term effect, due to which the medicine is taken only once a day, and the course of antibiotic therapy with Azithromycin is often short. But is it possible to give this medication to children, at what dose is it used in childhood, and when should a child not be treated with Azithromycin?

Composition and trade names

The active substance in the drug Azithromycin is represented by a compound with the same name. At the same time, the domestic drug Azithromycin is not the only one with this active ingredient. Azithromycin is the basis of other drugs:

Azitral
Zitrolide
Ecomed
ZI factor
Azimicin
Suitrox
Sumatrolide solutab
Zitrocin and others.

All these drugs containing azithromycin can replace each other, therefore, we will consider the features of all these drugs at once, calling them Azithromycin.

Auxiliary ingredients, depending on the form of the drug, may be lactose, sucrose, silicon dioxide, magnesium stearate, gelatin, xanthan gum, dyes, flavors and other substances. Therefore, when buying any of the options for Azithromycin, a child with a tendency to allergies should pay attention to additional components.

Watch an interview with a practicing dermatovenereologist, in which he answers questions regarding ezitromycin preparations:

Release form

Azithromycin is available in many forms, which allows you to choose the most suitable medicine for a child of different ages. The medicine is presented with the following options:

Powder. It is presented as white granules or crystals, which may have a creamy yellow tint. The powder is packaged in vials, where you need to add water to make a suspension. In the package, as a rule, there is a dosing syringe, as well as a dosing spoon. The powder form of Azithromycin is represented by two dosages - a medicine, in 5 ml of which, after preparing the suspension, there will be 100 mg of the active substance (Sumamed, Hemomycin, Suitrox, Azitrox, AzitRus, Azithromycin Zintiva, Azithromycin Sandoz) and a drug, 5 ml of the finished solution of which will contain 200 mg azithromycin (AzitRus, Azithromycin Zintiva, Hemomycin, Azithromycin Sandoz, Azitrox, Suitrox). The prepared liquid has a sweet taste and a pleasant smell, so many children drink this syrup without any problems.
Pills. This form of Azithromycin is represented by both dispersible tablets (Sumamed, Sumatrolid solutab) and coated tablets (Sumamed, ZI-factor, Azithromycin, Hemomycin, Azithromycin Forte, Azithromycin Zintiva, Ecomed, AzitRus Forte, Zitnob). The content of the active substance in such tablets is often 125 or 500 mg, but there are also drugs with 250 or 1000 mg of azithromycin. Most drugs are packaged in a blister of 3 or 6 tablets.
Capsules. In this form, Sumamed, Zitrolid, AzitRus, Ecomed, Azithromycin, ZI-factor, Hemomycin, Azitrox, Azitral, Azithromycin-OBL are produced. Each capsule contains 250 mg (less often 500 mg) of azithromycin, and 1 pack may contain 3, 6, 10, 12 or more capsules.

The drug Azitrox is available in different forms, which makes it convenient for both adults and children of all ages.

There is also Azithromycin for injection, for example, Sumamed or Hemomycin lyophilisate. Such a drug in injections is in demand for very severe infections, but is not used in childhood.

Operating principle

Azithromycin belongs to the group of macrolides. Such antibiotics have a fairly wide range of effects on harmful bacteria. After entering the patient's body, they are transferred to the site of inflammation and penetrate both through tissue barriers and through cell walls.

Azithromycin is absorbed quickly enough, as a result of which, after 2-3 hours, its concentration in the bloodstream will be maximum. After discontinuation, the drug circulates in the plasma for another 5-7 days, providing a therapeutic effect.

Azithromycin is prescribed for infectious diseases of the throat

In a moderate dose, Azithromycin is able to suppress the formation of proteins in bacterial cells, which slows down their reproduction. A high concentration of the drug has a bactericidal effect (destroys the pathogen).

Reception of Azithromycin is effective in case of infection:

Staphylococcus aureus.
Epidermal staphylococcus.
Streptococcus group B and other groups.
Pneumococcus.
Pyogenic streptococcus.
Haemophilus stick.
Moraxella.
Pertussis stick.
A stick of parapertussis.
Campylobacter.
Legionella.
Gonococcus.
Gardnerella.
Bacteroids.
Peptostreptococcus.
Clostridia.
Chlamydia.
Mycobacteria.
Ureaplasma.
Mycoplasma.
Pale treponema.
Borrelia.

However, it happens that the drug does not help if the microorganisms have developed resistance to such an antibiotic. This situation requires the replacement of the drug after determining the sensitivity of the pathogen to other antimicrobial agents.

Indications

Angina.
Laryngitis.
Tick-borne borreliosis.
Bronchitis.
Pneumonia.
Sinusitis and other sinusitis.
Streptococcal pharyngitis.
Otitis media.
Whooping cough.
Erysipelas and pustular skin lesions.
Infectious dermatitis.
Urethritis and other infections of the urinary system.
Peptic ulcer of the gastrointestinal tract.

Quite often, the reason for the appointment of Azithromycin is a cold that was not properly treated., as a result of which it was complicated by a more serious bacterial infection. Also, this antibiotic can be prescribed to children when such popular antibacterial agents as penicillins and cephalosporins (for example, Amoxicillin turned out to be ineffective) do not act on the causative agent of the infection.

Infectious colds in a complicated form can be treated with Azithromycin

At what age is it allowed to take?

Azithromycin is not used in the treatment of children under 6 months of age.. If the child is already six months old, the doctor may prescribe such a medicine in the form of a suspension. Tablet form or Azithromycin capsules are given to older children who can swallow such drugs. The dosage is calculated based on the body weight of the child. Azithromycin infusions are contraindicated before the age of 16.

Contraindications

Any form of Azithromycin should not be taken in case of hypersensitivity to such an active substance. The medicine is also contraindicated in case of allergy to other macrolide antibiotics. Also, the drug is not given:

With severely impaired liver function.
With severe kidney disease.

Azithromycin should be prescribed with caution in case of a tendency to arrhythmias, water and electrolyte imbalances, problems with the functioning of the kidneys or liver, diabetes mellitus (for drugs with sucrose), carbohydrate metabolism disorders (for suspensions).

Side effects

The children's body sometimes reacts to Azithromycin with the appearance of:

Vertigo.
Excited state.
Rapid fatigue.
Drowsiness.
Feelings of tingling or numbness in the extremities.
Headache.
Anxious mood.
conjunctivitis.
Sleep disorders.
Pain in the chest.
Sensations of strong heartbeats.
Nausea.
Flatulence.
Jaundice.
Liquid stool.
Pain in the stomach.
Vomiting.
Decreased appetite.
Inflammation of the stomach.
Skin itching.
Pain in the muscles.
Urticaria.
Eruptions on the skin.

More rare side effects of azithromycin preparations are:

Hearing loss or tinnitus.
Visual impairment.
Constipation.
Liver damage.
Inflammation of the intestine.
Nephritis.
Quincke's edema.
Increased sensitivity to ultraviolet light.
Changes in blood tests.
Anaphylactic shock.
Pancreatitis.

Instructions for use

The frequency of taking Azithromycin - 1 time per day, and the duration of treatment is usually 3 days. With tick-borne borreliosis, the drug is prescribed for 5 days.
It should be taken into account that the absorption of the active substance Azithromycin is affected by food intake. For this reason, taking the medicine should not coincide with feeding the baby. The drug is given either after about 2 hours after a meal, or 60 minutes before a meal.
Azithromycin powder is diluted with boiled cool water. To find out how much water is required and how to dilute the medicine, you should clarify such information in the instructions. For example, 12 ml of water should be poured into Sumamed powder.
It is important to shake the suspension bottle before each use., then select the desired dose with a syringe or pour it into a spoon.
If the next dose of Azithromycin is missed, it must be taken immediately, as soon as this fact was discovered. The next dose of the medicine should be 24 hours after the missed dose.
Tablets or capsules should be swallowed without biting and then drink water. What to do if the child chewed this form of Azithromycin? This does not pose any danger, but for a more effective action, the drug shell is not recommended to be broken.

Dosage

Suspension

The dose of this form of Azithromycin is calculated according to the weight of the child- for one kilogram of the body weight of a sick baby, 10 mg of the active substance is needed. If a drug with a dosage of 100 mg / 5 ml is used, then 10 mg of azithromycin will be in 0.5 ml of the finished solution. It turns out that a child weighing 5 kg should be given 2.5 ml of the drug (this is 50 mg of the active substance), with a body weight of 6 kg - 3 ml of the drug, with a weight of 7 kg - 3.5 ml and so on.

With a weight of 10-14 kg, for example, at 2 years old, the baby is given 100 mg of azithromycin, which corresponds to 5 ml of suspension. If the child is 3 years old and his weight is already 15 kg, then for treatment he will need 150 mg of azithromycin, so they switch to a more concentrated medicine - 200 mg / 5 ml. A single dose of such a suspension is also determined by weight:

Children with a weight of 15-25 kg (for example, at the age of 6 years or 8 years) are given 5 ml of the drug at a time, which contains 200 mg of the active substance.
A child who weighs 25-35 kg (approximately aged 9-10 years) needs 300 mg of azithromycin, which corresponds to 7.5 ml of the drug.
For children weighing 35-45 kg (at 11-12 years old), the therapeutic dosage of azithromycin is 400 mg, so they are given 10 ml of suspension to drink.
With a weight of over 45 kg (12-13 years), a single dose of the drug is 12.5 ml, which corresponds to 500 mg of the active substance and allows you to use tablets or capsules.

125 mg

This dosage of Azithromycin is presented only in tablets. If they are in the shell, then the medicine is recommended not earlier than 3 years of age, when the child can already swallow it.

250 mg

Azithromycin with this dosage is prescribed from the age of 12. The child is given 2 capsules or 2 tablets at a time for diseases of the respiratory system, soft tissues or ENT pathologies. With borreliosis on the first day, a single dose will be 4 capsules or tablets, and then the dose is reduced to two capsules / tablets per dose.

500 mg

This dosage of Azithromycin is used in the treatment of children over 12 years of age and adults. The drug is taken 1 tablet or 1 capsule per day.

Overdose

If a child accidentally drinks a very high dose of Azithromycin, it will result in vomiting, severe nausea, or diarrhea. You may also lose hearing for a while. To help the baby, you should immediately rinse the stomach and consult a doctor for symptomatic treatment.

It is important to choose the correct amount of Azithromycin for the child in order to avoid overdose.

Interaction with other drugs

If the child is already taking any medications, and he was prescribed Azithromycin, this requires attention from the pediatrician, because many drugs should not be combined with such an antibiotic. For example, if the baby is given antacids, this will impair the absorption of azithromycin and affect the results of treatment.

Other antibacterial agents also affect the activity of the drug, for example, the appointment of tetracycline will enhance the effect of Azithromycin, and lincomycin antibiotics will weaken its therapeutic effect.

Azithromycin also has an effect on treatment with carbamazepine, theophylline, zidovudine, cetirizine, fluconazole, digoxin, phenytoin, warfarin, and many other drugs. That is why the appointment of Azithromycin to children who take other medications should be carefully monitored by a doctor.

Terms of sale

You can buy Azithromycin in a pharmacy only after presenting a prescription received from a doctor. The price of the medicine will depend on many factors, including the form of release, dosage, manufacturing company and others. Domestic drugs are cheaper (their price is from 30 rubles), while foreign ones are more expensive.

Storage conditions and shelf life

Keep Azithromycin in a place where a small child cannot reach. Storage temperature - room temperature (up to +25°C). It is impossible to use a medicine that has expired (it is 2 or 3 years for Azithromycin, depending on the manufacturer and the form of the drug). The suspension prepared from the powder form is not stored for more than five days.

All medicines must be kept out of the reach of children.

The article provides detailed instructions for the use of Azithromycin 500, 250 dl for children and adults. The drug is in capsules, tablets, suspension. Reviews. Analogues. Price.

Azithromycin is a macrolide that protects the body from the harm caused by many types of bacteria. At a high level of the active substance in the body, the bactericidal effect of the drug is noted.

Dosage forms

The drug can be purchased in different forms - in powder form, in tablets, capsules. Tablets and capsules are sold in pharmacies in 6 pieces. The tablets are also available in packs of 3. The drug in powder is available in 20 g vials. The composition of capsules and tablets includes 250 and 500 mg of the active ingredient. 1 g of powder contains 15, 30 and 75 mg of azithromycin.

Description of the drug

The drug is a semi-synthetic antibiotic, prevents the growth of microbes, disrupts the processes necessary for their life.

The following are sensitive to the drug:

The properties of the drug are preserved in an acidic environment. The components are quickly absorbed from the digestive tract, their maximum content in the blood is reached in an average of 2.5 hours. The drug is partially removed from the body for three days. It takes five to seven days for the drug to reach a stable blood level. In tissues affected by the disease, the concentration of the drug is 24-34% higher than in healthy tissues. Most of the accepted dose of Azithromycin is excreted in the bile, about 6% in the urine.

Indications

The drug is used to treat:

scarlet fever;
infections of the respiratory system;
diseases accompanied by lesions of the duodenum and stomach;
uncomplicated infectious processes in which the urogenital tract is affected;
beginning borreliosis;
infectious processes affecting the skin and soft tissues.

Contraindications

The drug is not used for severe liver and kidney damage, it is not prescribed for a negative reaction to macrolide antibiotics. Azithromycin in the form of a suspension is not treated for children weighing less than 5 kg. For the treatment of children weighing less than 45 kg, only powder is used.

Side effects

Most often, the body undergoes such negative reactions:

lymphocytopenia;
nausea with vomiting;
diarrhea
visual impairment;
the appearance of discomfort in the abdomen;
decrease in the level of bicarbonates in the blood.

The following side effects are rarely recorded:

skin itching, rashes;
convulsions;
oral candidiasis;
vaginitis;
violation of the process of processing and assimilation of food;
leukopenia;
drowsiness;
fast fatiguability;
dizziness;
headache;
vaginal infections;
gastritis;
syncope;
flatulence;
arthralgia;
ephosinophilia;
decreased frequency of bowel movements;
hypoesthesia;
anorexia;
increase in the concentration of k, AlAt, AsAt, urea, creatinine, bilirubin in the blood;
distorted sense of smells and tastes.

Very rarely there are such violations:

candidiasis;
constipation;
anxiety;
angioedema;
asthenia;
increased excitability and activity;
neutrophilia;
neurosis;
thrombocytopenia;
hepatitis;
insomnia;
Lyell's syndrome;
hemolytic anemia;
hives;
nervousness;
exanthema;
lethargy;
acute renal failure;
aggressiveness;
photosensitivity;
sleep disturbance;
anaphylaxis;
cholestatic jaundice;
paresthesia;
exudative erythema;
interstitial nephritis;
changing the color of the tongue;
angioedema.

Some patients develop during treatment:

arterial hypotension;
strong heartbeat;
pain in the chest;
paroxysmal tachycardia;
ventricular arrhythmia;
increase in the QT interval.

The frequency of the following disorders has not been established:

necrotizing hepatitis;
myasthenia gravis;
liver failure;
fulminant hepatitis;
agitation.

In some patients, as a result of taking the drug, hearing deteriorated, deafness developed, ringing in the ears appeared. Most of the disturbances were found during studies with high doses of the drug and disappeared over time.

Azithromycin capsules and tablets 500: instructions for use

The antibiotic is taken 60 minutes before eating or 120 minutes after eating. The drug is used once a day. If the medication was missed, the necessary dose of the drug is taken in the near future, the next one - in a day.

According to the instructions for use, the optimal dose of azithromycin 500 for patients weighing 45 kg or more with skin lesions, diseases of the respiratory system is 500 mg per day. The therapy is carried out for three days.

With urethritis, cervicitis, which occur without complications, use 1 g of the drug. Patients with migrating erythema are prescribed 2 tablets or capsules of 500 mg. On other days, it is recommended to use one tablet (capsule). Treatment is carried out for five days.

Azithromycin Forte: how to use

In cases where the skin, organs of the respiratory system, soft tissues are affected, use 1.5 g of the drug in three divided doses. A single dose is 500 mg. The medicine must be taken at intervals of one day.

When acne appears within three days, use 500 mg of the drug per day. After 4 days, the treatment is extended for nine weeks, but the dose is reduced to 500 mg per week, the drug is taken once. Between taking the following doses, an interval of one week is maintained.

With uncomplicated urethritis and cervicitis, 1 g of the drug is taken once. In Lyme disease, 1 g of the drug is used on the first day, in the following days until the last fifth day of therapy, inclusive, 500 mg each. One course of treatment requires 3 g of the drug. When prescribing Azithromycin to children, the dose is selected taking into account weight. Usually the daily dosage is determined at the rate of 10 mg / kg. One of two treatment regimens is used:

on the first day - 10 mg / kg once, on the next four days - 5-10 mg / kg;
10 mg / kg every 24 hours - the drug is taken in three doses.

In cases where a developing Lyme disease is detected in a child, 20 mg of the drug per 1 kg of body weight is used on the first day. Further, the dose is reduced to 10 mg / kg and the drug is taken for another four days.

Azithromycin for pneumonia

In the inflammatory process in the lungs, the drug is administered intravenously.

At least two days, 500 mg of the drug is administered per day. Later, the transition to capsules is performed. The duration of the course is 1-1.5 weeks. To achieve a stable positive effect in pneumonia, 500 mg of azithromycin per day is required.

Treatment of diseases of the small pelvis

In diseases developing in the small pelvis, infusion therapy is first performed. Later treatment is carried out by taking capsules. The recommended daily dosage corresponds to 500 mg of the drug in the form of capsules (250 mg capsules). The duration of treatment is 7 days. The transition to capsules and tablets is carried out depending on the results of treatment.

As indicated in the instructions for use of Azithromycin 500, when using a powdered substance, 60 ml of water is required per 2 g of the product. An injection solution is obtained by adding 0.5 g of the drug to 4.8 ml of water. When performing infusion therapy, a solution of dextrose (5%) or Ringer's (0.9%) is used. Depending on the solution used, the duration of the infusion is 1 or 3 hours.

Treatment regimen for ureaplasma

Treatment must be comprehensive. Before the use of the drug, immunomodulators are used. After a few days, Azithromycin is injected into the muscle. The drug is used every other day. The use of Azithromycin in the form of injections is carried out during the entire period of treatment.

In combination with an immunomodulator (second dose), they take an antibiotic that has a bactericidal effect, later they switch to Azithromycin - they use it for 5 days in an amount of 1 g. The remedy is taken in the morning 1.5 hours before eating. After a break for 5 days, take 1 g of Azithromycin. After 5 days, the drug is taken again at the same dose. During therapy (for 15-16 days), 2-3 times a day, it is recommended to take:

polyene antimycotics;
substances that stimulate the synthesis of interferons.

After a course of treatment based on the use of antibiotics, it is required to take drugs that restore the functions of the digestive tract and microflora. To obtain positive results, maintenance therapy for a period of at least two weeks is necessary.

Azithromycin treatment regimen for chlamydia

Since the drug is well tolerated by the body, it is used to treat chlamydia during childbearing and in adolescence in cases where the lower parts of the genitourinary system are affected.

Reception of 1 g of medicine is carried out once a day.

In the infectious process in the upper sections, short courses of treatment with long intervals are recommended. It is necessary to take 1 g of funds on the first, seventh and fourteenth days.

Therapy for angina in adults and children

Angina is treated with an antibiotic for 3-5 days. Azithromycin is much more easily tolerated by the patient's body than drugs belonging to the penicillin series.

With a body weight of more than 45 kg per day, 500 mg of the drug is used. Children aged 6 months to 12 years are prescribed a powdered drug to be taken once a day. Therapy is carried out for three days or longer using an individually prescribed dose of the drug. As the reviews show, in patients with purulent tonsillitis, the state of health improves significantly after 6 hours after using the medicine.

Treatment of sinusitis with Azithromycin

The drug is prescribed for daily use for four days (dosage 500 mg). Another option is possible - taking the indicated dose of the drug, followed by a decrease to 250 mg / day in the next four days.

Children under 12 years of age are treated with a suspension. For 1 kg of body weight, 10 mg of the drug is required. The drug is used for three days, taken once a day.

Sometimes 10 mg / kg of weight is used only on the first day, on the remaining 4 days - 5 mg / kg of weight. The maximum dose is 30 mg/kg. With sinusitis, the components of the medication accumulate in the affected area, destroy bacteria and eliminate the inflammatory process in the sinuses.

How to use for cystitis in women

According to the instructions for use, for the treatment of cystitis in women, Azithromycin requires 1 g per day. The most convenient form of the drug is capsules and tablets of 500 mg. In most cases, it is enough to take the drug for 3-5 days.

Carrying and feeding a child

It is permissible to use Azithromycin during the period of bearing a child and breastfeeding. Treatment with the drug is carried out on the recommendation of a doctor in cases where the benefit significantly outweighs the possible harm to the mother and fetus / child. During therapy, breastfeeding is recommended to be interrupted.

Alcohol compatibility

As a result of drinking alcohol, the absorption of the drug decreases, which leads to a slowdown in metabolism, a serious burden on the liver and the destruction of hepatocytes. Alcohol can be taken once in a small amount a few days after completion of therapy.

Azithromycin for children

With a body weight of more than 45 kg, tablets and capsules are used. The required dosage is determined by the doctor, taking into account the indications.

Small patients are prescribed a suspension.

Negative reviews are rare. Usually, treatment is required for 3-5 days to improve the condition (other antibiotics need to be applied for 10 days). The action of the drug is continued for 7 days after completion of therapy.

Attention

In 2013, a very rare but terrible side effect of the drug was revealed in the United States, namely, sudden cardiac arrest. This is explained by the fact that azithromycin changes the electrical conductivity of the heart muscle, which is fraught with cardiac arrest. From overdose one infant died in 2011.

Every mother tries to avoid the use of antibiotics during her child's illness. When the pediatrician declares the need for such funds, most parents start to panic. However, not everything is so scary. In some cases, antibacterial drugs can quickly cope with the infection and return the baby to good health. One of the commonly prescribed medications is Azithromycin. Instructions for use (for children, the drug is used quite often) will be presented to your attention below. You can also learn about substitutes for this drug and reviews about it.

What is Azithromycin?

For a child, the choice of drug is very important. This medication is an antibiotic. It represents a group of macrolides. The drug has a bactericidal and bacteriostatic effect on the patient's body. The drug is available in dosages of 100, 125, 250 and 500 milligrams. The main active ingredient is azithromycin. Depending on the form of release, the drug may have additional components. So, the drug is available in the form of capsules in a gelatin shell, solid tablets, suspension and powder for its preparation.

"Azithromycin" for a child is one of the commonly prescribed drugs. It is very easy to use and can give a quick positive effect. Also, this tool is quite safe for the child's body.

When do children need the described antibiotic?

The drug "Azithromycin" for a child should be prescribed exclusively by a pediatrician. Self-administration can lead to negative reactions and unpleasant consequences. The medicine is usually prescribed after the analysis. An antibiotic is also indicated when other medicines have not given a positive result within five days. The main indications for the use of the drug "Azithromycin" for a child are the following situations:

diseases affecting the upper respiratory tract (tonsillitis, tonsillitis, sinusitis, laryngitis, nasopharyngitis, and so on);
infections affecting the lower respiratory tract (bronchitis, pneumonia, tuberculosis, and others);
scarlet fever;
infections that cause damage to soft tissues and mucous membranes;
urinary tract infections.

Also, this medicine can be prescribed by doctors in other situations. In this case, each case is considered individually.

Contraindications to treatment

In what cases is it worth limiting the use of a medication or completely abandoning treatment with Azithromycin? Instructions for use (for children it is especially important to take into account contraindications) reports the following situations:

the age of the child is less than 12 years (capsules, tablets) or less than 6 months (suspension);
renal failure in an advanced form;
liver diseases, including acquired ones;
hypersensitivity to azithromycin;
some diseases of the stomach and intestines.

Dosage of the drug

Usually doctors prescribe the medicine "Azithromycin 250 mg" for children. However, for children under three years of age, it is preferable to give a suspension. The dosage of the drug depends on the age of the patient and the choice of dosage form.

For children under 16 years of age, the drug is prescribed at the rate of 10 milligrams of azithromycin per kilogram of body weight. Since it is preferable to choose a medicine for up to 12 years in the form of a suspension, the dose is calculated as follows. For example, your child weighs 10 kilograms. In this case, he needs to be given 100 milligrams of azithromycin. The syrup is available in two doses: 100 and 200 mg per 5 milliliters of the drug. So, in the first case, the baby needs to be given 5 ml of medicine, and in the second - 2.5.

Tablets at a dose of 250 mg are recommended for children over 12 years of age. At the same time, you need to drink no more than one capsule or pill per day. It is worth noting that the treatment with this medication is carried out for only three days. Only in particularly difficult situations, this period can be extended to 4-5 days.

Features of the use of the drug

If tablets "Azithromycin 250 mg" for children are prescribed, then they should not be chewed and crushed. The drug should enter the stomach unchanged. When using the suspension, it is necessary to shake it well each time before use. Also, the medicine should be washed down with plenty of water. Especially it concerns

The medication is taken one hour before a meal or two after a meal. It is also worth recalling the simultaneous use of other drugs. Many drugs are able to suppress or enhance the action of each other. That is why doctors recommend taking a break of two hours between various drugs and Azithromycin.

Side effects

What does the instruction say about the drug "Azithromycin"? For children, as the summary reports, antibiotics should be prescribed only by a doctor, because this drug can cause side effects. However, doctors assure that, subject to the indicated dosage, the medication is well tolerated. Among the most common side effects, experts note weakness, malaise or anxiety, abdominal pain, impaired stool or nausea.

Instructions for use

compound

active ingredient: azithromycin;

1 tablet contains azithromycin dihydrate equivalent to azithromycin 250 mg;

excipients: microcrystalline cellulose, sodium lauryl sulfate, sodium starch, polyvinylpyrrolidone, croscarmellose sodium, talc, magnesium stearate, Ponceau 4R (E 124), titanium dioxide (E171), hypromellose, macrogol 400.

Pharmacotherapeutic group

Antibacterial agents for systemic use. Macrolides, lincosamides and streptogramins. Azithromycin. ATC code J01F A10.

Indications

Infections caused by microorganisms sensitive to azithromycin:

contraindications

Hypersensitivity to azithromycin, erythromycin, other macrolide or ketolide antibiotics, or to any other component of the drug. Severe impairment of liver or kidney function.

Dosage and administration

Azithromycin 250 is taken orally 1 time per day, at least 1 hour before or 2 hours after a meal.

For adults and children weighing more than 45 kg: for infections of the respiratory tract, skin and soft tissues (with the exception of chronic erythema migrans): 500 mg for 3 days.

For chronic erythema migrans: 1 g on the 1st day, then 500 mg from the 2nd to the 5th day of treatment. The course of treatment is 5 days.

Uncomplicated and complicated urethritis / cervicitis: once 1 g (4 tablets of 250 mg). Heading dose - 1 g.

In renal insufficiency with slight renal dysfunction (creatinine clearance> 40 ml / min), there is no need to change the dosage. No studies have been conducted in patients with creatinine clearance<40 мл / мин. Поэтому следует с осторожностью применять азитромицин таким пациентам.

In hepatic insufficiency, the drug should not be used in patients with severe liver disease, since azithromycin is metabolized in the liver and excreted in the bile.

Elderly patients do not require dose adjustment. If a dose is missed, the missed dose should be taken as soon as possible and the next dose should be taken 24 hours later.

adverse reactions

The evaluation of adverse reactions is based on a classification taking into account the frequency of reactions: very often ≥ 10%; often: ≥ 1% -<10%; нечасто ≥ 0,1% - <1%; редко ≥ 0,01% - <0,1%; очень редко <0,01%, в том числе единичные случаи.

Infections and invasions: infrequently - oral candidiasis, vaginal infections.

From the blood and lymphatic system: infrequently - eosinophilia, leukopenia; rarely - thrombocytopenia, neutrophilia, hemolytic anemia. There have been isolated reports of periods of transient, mild neutropenia.

Mental disorders: rarely - aggressiveness, psychomotor hyperactivity, anxiety and nervousness; frequency not set - agitation.

From the nervous system: often - dizziness / vertigo, hypesthesia, drowsiness, syncope, headache, convulsions (it was found that they are also caused by other macrolide antibiotics), distortion or loss of taste and smell; rarely - paresthesia, asthenia, neurosis, lethargy, insomnia, sleep disturbance; frequency not established - myasthenia gravis.

On the part of the organs of vision: often - visual impairment.

On the part of the hearing organs: rarely - macrolide antibiotics cause hearing loss. Hearing impairment, deafness and tinnitus have been reported in some patients treated with azithromycin. Most of these cases are associated with experimental studies in which azithromycin was used in high doses for a long time. According to the available follow-up reports, most of these problems were reversible.

From the side of the heart: palpitations, chest pain, paroxysmal ventricular tachycardia of the "pirouette" type, ventricular arrhythmia, including ventricular tachycardia (it was found that they were also caused by other macrolide antibiotics) were rarely reported. Rarely, prolongation of the QT interval and ventricular flutter, arterial hypotension have been reported.

From the gastrointestinal tract: often - nausea, vomiting, diarrhea, discomfort in the abdomen (pain / cramps); infrequently - loose stools, flatulence, indigestion, gastritis, anorexia; rarely - constipation, discoloration of the tongue. Pseudomembranous colitis and pancreatitis have been reported.

On the part of the digestive system: rarely reported hepatitis and cholestatic jaundice, including altered liver function tests, as well as rare cases of severe hepatitis and liver dysfunction, in rare cases fatal; frequency not established - liver failure, fulminant hepatitis, necrotizing hepatitis.

From the skin: infrequently - allergic reactions, including itching and rashes; rarely - exanthema, allergic reactions, including angioedema, urticaria and photosensitivity; serious skin reactions, namely polymorphic erythema, Stevens-Johnson syndrome and toxic epidermal necrolysis.

From the musculoskeletal system: infrequently - arthralgia.

From the urinary system: rarely - interstitial nephritis and acute renal failure.

From the reproductive system: infrequently - vaginitis.

Systemic disorders: rarely - anaphylaxis, including edema (leads in rare cases to death), candidiasis, angioedema.

General disorders: infrequently - increased fatigue.

Changes in laboratory parameters: often - lymphocytopenia, a decrease in the amount of blood bicarbonates; infrequently - an increase in the level of aspartate aminotransferase, an increase in the level of alanine aminotransferase, an increase in the level of bilirubin in the blood, an increase in the level of urea, an increase in the level of blood creatinine, a change in the content of potassium in the blood.

Treatment: gastric lavage, activated charcoal, symptomatic therapy aimed at maintaining the vital functions of the body. There is no specific antidote.

Use during pregnancy or lactation

Given the lack of data on the safety of the drug, it is not recommended to prescribe azithromycin during pregnancy and lactation, unless the expected positive effect for the mother outweighs the possible risk from the use of the drug for the fetus or infant.

children

The drug in this dosage form can be used in children weighing more than 45 kg.

application features

Allergic reactions. In rare cases, azithromycin has been reported to have serious allergic (rarely fatal) reactions such as angioedema and anaphylaxis. Some of these reactions led to the development of recurrent symptoms and required long-term observation and treatment.

Impaired liver function. Since the liver is the main route of elimination of azithromycin, azithromycin should be administered with caution to patients with severe liver disease. Cases of fulminant hepatitis causing life-threatening liver failure have been reported with azithromycin. It is necessary to monitor liver function in case of development of signs and symptoms of liver dysfunction, such as asthenia, which develops rapidly and is accompanied by jaundice, dark urine, bleeding tendency and hepatic encephalopathy.

Impaired kidney function. In patients with severe renal dysfunction (glomerular filtration rate<10 мл / мин) наблюдалось 33% увеличение системной экспозиции азитромицина.

Prolongation of cardiac repolarization and the QT interval, which increases the risk of developing cardiac arrhythmias and ventricular flutter, have been observed with other macrolide antibiotics. A similar effect of azithromycin cannot be completely excluded in patients with an increased risk of prolongation of cardiac repolarization, therefore, patients should be treated with caution:

Myasthenia gravis: Exacerbation of symptoms of myasthenia gravis or new development of myasthenic syndrome has been reported in patients receiving azithromycin therapy.

Streptococcal infections: Azithromycin is generally effective in the treatment of inflammatory diseases of the oropharynx caused by streptococcus, but there are no data that demonstrate the effectiveness of azithromycin in the prevention of acute rheumatic fever.

Superinfection: As with other antibacterial drugs, there is the possibility of superinfection (mycosis).

Special precautions must be taken when using azithromycin in patients with hepatic impairment.

In patients taking ergot derivatives, ergotism has sometimes occurred due to the simultaneous use of certain macrolide antibiotics. There are no data on a possible drug interaction between horns and azithromycin, however, due to the theoretical possibility of ergotism, azithromycin should not be administered simultaneously with ergot derivatives.

Clostridium difficile-associated diarrhea has been reported with almost all antibacterial agents, including azithromycin, ranging from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the large intestine, leading to overgrowth of C. difficile.

C. difficile produce toxins A and B, which contribute to the development of diarrhea associated with Clostridium difficile. Hypertoxin-producing C. difficile strains increase morbidity and mortality because these infections may be resistant to antibiotic therapy and may lead to colectomy. The possibility of Clostridium difficile-associated diarrhea should be considered in all patients with diarrhea following antibiotic use. It is necessary to carefully analyze the anamnesis, since it has been reported that diarrhea associated with Clostridium difficile can develop 2 months after taking antibacterial drugs.

The ability to influence the reaction rate when driving or working

with other mechanisms.

The possibility of developing adverse reactions from the nervous system, such as dizziness, drowsiness, visual impairment, should be taken into account.

Interaction with other medicinal products and other forms of interaction

Care should be taken to prescribe azithromycin to 250 patients along with other drugs that can prolong the QT interval (see section "Peculiarities of use").

Antacids: When studying the effect of the simultaneous use of antacids on the pharmacokinetics of azithromycin, in general, no changes in bioavailability were observed, although plasma peak concentrations of azithromycin decreased by 30%. Azithromycin 250 must be taken at least one hour before or 2 hours after taking an antacid.

Carbamazepine In a pharmacokinetic interaction study in healthy volunteers, azithromycin showed no significant effect on plasma levels of carbamazepine or on its active metabolites.

Cyclosporine: Some of the related macrolide antibiotics interfere with the metabolism of cyclosporine. Since pharmacokinetic and clinical studies of possible interactions have not been conducted while taking azithromycin and cyclosporine, the therapeutic situation should be carefully weighed before prescribing the simultaneous administration of these drugs. If combination therapy is warranted, ciclosporin levels should be carefully monitored and dosage adjusted accordingly.

Indirect anticoagulants An increased tendency to bleeding has been reported in connection with the simultaneous use of azithromycin and warfarin or coumarin-like oral anticoagulants. Attention should be paid to the frequency of monitoring of prothrombin time.

Digoxin: In some patients, certain macrolide antibiotics have been reported to interfere with intestinal metabolism of digoxin. Therefore, with the simultaneous use of azithromycin and digoxin, one should be aware of the possibility of increasing the concentration of digoxin and monitor the level of digoxin.

Methylprednisolone: In a pharmacokinetic interaction study in healthy volunteers, azithromycin did not show a significant effect on the pharmacokinetics of methylprednisolone.

Terfenadine: No interactions between azithromycin and terfenadine have been reported in pharmacokinetic studies. As with other macrolide antibiotics, azithromycin should be used with caution in combination with terfenadine.

Theophylline azithromycin did not affect the pharmacokinetics of theophylline while taking azithromycin and theophylline in healthy volunteers. The combined use of theophylline and other macrolide antibiotics sometimes led to an increase in theophylline serum levels.

Zidovudine: 1000 mg single doses and 1200 mg or 600 mg multiple doses of azithromycin did not affect the plasma pharmacokinetics and urinary excretion of zidovudine or its glucuronide metabolites. However, azithromycin increased the concentration of phosphorylated zidovudine, a clinically active metabolite in peripheral blood mononuclear cells. The clinical significance of these findings has not been determined, but may be of benefit to patients.

Nelfinavir - the use of nelfinavir causes an increase in the equilibrium concentrations of azithromycin in the blood serum. Although dose adjustment of azithromycin when co-administered with nelfinavir is not recommended, careful monitoring of the known side effects of azithromycin is warranted.

Didanosine: Co-administration of daily doses of 1200 mg azithromycin with didanosine in six subjects showed no effect on the pharmacokinetics of didanosine compared with placebo.

Rifabutin: the simultaneous use of azithromycin and rifabutin did not affect the plasma concentrations of these drugs. Neutropenia has been observed in patients taking both azithromycin and rifabutin. Although neutropenia has been associated with the use of rifabutin, a causal relationship with concomitant use with azithromycin has not been established.

Ergot derivatives: given the theoretical possibility of ergotism, the simultaneous use of azithromycin with ergot derivatives is not recommended.

Macrolide antibiotics are known to react with astemizole, triazolam, midazolam and alfentanil. Since there are no data on the interaction between azithromycin and the above drugs, it is recommended to carefully monitor patients if these drugs are used simultaneously.

The effect of azithromycin on cimetidine blood levels has not yet been reported.

Unlike most macrolide antibiotics, azithromycin does not affect cytochrome P450, so far there have been no data on the interaction between azithromycin and the above drugs.

Pharmacological properties

Pharmacodynamics.

Azithromycin is a representative of a group of macrolide antibiotics - azalides, which have a wide spectrum of antimicrobial activity. The mechanism of action of azithromycin is to inhibit bacterial protein synthesis by binding to the 50S subunit of ribosomes and preventing peptide translocation without affecting polynucleotide synthesis.

The mechanism of resistance resistance to azithromycin may be congenital or acquired. Complete cross-resistance exists among Streptococcus pneumoniae, group A beta-hemolytic streptococcus, Enterococcus faecalis, and Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA) to erythromycin, azithromycin, other macrolides, and lincosamides.

Spectrum of antimicrobial activity of azithromycin

sensitive

Staphylococcus aureus

Methicillin-sensitive

Streptococcus pneumoniae

Penicillin sensitive

Streptococcus pyogenes (gr. A)

Aerobic gram-negative bacteria

haemophilus influenzae

haemophilus parainfluenzae

Legionella pneumophila

Moraxella catarrhalis

Pasteurella multocida

anaerobic bacteria

Clostridium perfringens

Fusobacterium spp. (kinds)

Porphyromonas spp.

other bacteria

Chlamydia trachomatis

Species that acquire resistance in isolated cases

Aerobic gram-positive bacteria

Streptococcus pneumoniae

With intermediate sensitivity to penicillin

Penicillin-resistant

Birth resistant organisms

Aerobic gram-positive bacteria

Enterococcus faecalis

Staphylococci MRSA, MRSE (methicillin-resistant Staphylococcus aureus)

anaerobic bacteria

Bacteroides fragilis group of bacteroids

Pharmacokinetics.

Bioavailability after oral administration is approximately 37%. The maximum concentration in the blood serum is reached 2-3 hours after taking the drug.

When taken, azithromycin is distributed throughout the body. In pharmacokinetic studies, it was shown that the concentration of azithromycin in tissues is significantly higher (50 times) than in blood plasma, which indicates a strong binding of the drug to tissues.

Plasma protein binding varies with plasma concentrations and ranges from 12% at 0.5 µg/ml to 52% at 0.05 µg/ml in serum. The volume of distribution at steady state (VVss) was 31.1 l/kg.

The terminal plasma half-life fully reflects the tissue half-life of 2-4 days.

Approximately 12% of a dose of azithromycin is excreted unchanged in the urine over the next three days. Particularly high concentrations of unchanged azithromycin have been found in human bile. Ten metabolites were also identified in bile, which were formed by N- and O-demethylation, hydroxylation of the deosamine and aglycone rings, and cleavage of the cladinose conjugate. Comparison of the results of liquid chromatography and microbiological analyzes showed that azithromycin metabolites are not microbiologically active.