Amoxiclav for pneumonia in adults. Medicines for pneumonia - how to treat adults and children Amoxiclav with pneumonia

Compound

Release form

Available in the form:

• film-coated tablets;
• powder for suspensions;
• lyophilized powder for injection.

One 375 mg tablet contains 250 mg of amoxicillin and 125 mg of clavulanic acid.

The 625 mg tablet contains 500 mg of amoxicillin, 125 mg of clavulonic acid.

Auxiliary substances are:

• silicon dioxide (colloidal);
• croscarmellose (sodium salt);
• magnesium stearate;
• talc;
• hypromellose;
• ethylcellulose;
• polysorbate;
• titanium dioxide;
• triethyl citrate.

Tablets are packed into bottles, 15 pieces in everyone. One box contains one bottle of medicine.

Powder for suspension is available in dark glass bottles, one per box. There is also a measuring spoon. The composition of the usual ready-made suspension includes 125 and 31.25 mg active ingredients respectively. When preparing the suspension "Amoxiclav Forte", 5 ml of it contains twice as much active ingredients - 250 and 62.5 mg, respectively. Auxiliary substances are:

• lemon acid;
• sodium citrate;
• sodium benzoate;
• carmellose sodium;
• silica colloid;
• sodium saccharin;
• mannitol;
• strawberry and wild cherry flavors.

For injection, a lyophilized powder is produced in vials of 0.6 and 1.2 g. The content of amoxicillin sodium salt in the solution is 500 or 1000 mg, and the potassium salt of clavulanic acid is 100 and 200 mg, respectively. One box contains 5 vials.

pharmachologic effect

Indications

Amoxiclav tablets and powder - instructions for use

For children under 12- 40 mg per kilogram of body weight per day.
For children whose weight exceeds 40 kg, the drug is prescribed as adults.

Adults are prescribed: 375 mg tablets are taken every 8 hours around the clock, 625 mg tablets every 12 hours. When prescribing a drug for the treatment of severe infections, doses of 625 mg every 8 hours, or 1000 mg every 12 hours, are used.

It should be noted that tablets may differ in the proportions of active ingredients. Therefore, you cannot replace a 625 mg tablet (500 g amoxicillin and 125 g clavulanic acid) with two 375 mg tablets (250 g amoxicillin and 125 g clavulanic acid).

For the treatment of odontogenic infections, the following scheme is used. The 375 mg tablets are taken every 8 hours, around the clock. Tablets 625 mg every 12 hours.

If it is necessary to use a drug for the treatment of patients with kidney disease, the content of creatinine in the urine must be taken into account. In patients with liver disease, constant monitoring of its function is necessary.

Powder for the preparation of suspensions is used for newborns and children up to 3 months. Dosing is carried out using a special measuring pipette or spoon. Dosage - 30 mg of amoxicillin per kilogram of body weight, twice a day.

For children over three months old for mild and moderate infections - 20 mg / kg of body weight, and for severe infections - 40 mg / kg. The second dose is also used in the treatment of deep infections - inflammation of the middle ear, sinusitis, bronchitis, pneumonia. Instructions are attached to this medicine, in which there are special tables that allow you to calculate the doses of the drug necessary for children as accurately as possible.

The maximum allowable daily dose of amoxicillin for children is 45 mg / kg of body weight, for adults - 6 grams. Clavulanic acid can be taken per day no more than 600 mg for adults and 10 mg/kg for children.

Description of release forms

Suspension

Pills

This medicine is available in the form of film-coated tablets that are white or beige-white in color. Tablets have an oval biconvex shape.

One 625 mg tablet contains 500 mg of amoxicillin trihydrate with 125 mg of clavulanic acid (potassium salt).

Tablets can be produced in plastic jars (15 tablets each) or in aluminum blisters of 5 or 7 pieces.

Tablets of 1000 mg are also coated, have an oblong shape with beveled edges. They are imprinted with "AMS" on one side, and "875/125" on the other. They contain 875 mg of the antibiotic and 125 mg of clavulanic acid.

Amoxiclav 125

Amoxiclav 250 ("Amoxiclav Forte")

Amoxiclav 500

Amoxiclav 875

Amoxiclav 625

Amoxiclav 1000

Amoxiclav Quiktab

Contraindications

When taking the drug, liver dysfunction and jaundice (cholestatic) may occur if this drug has already been used before and the patient has an increased sensitivity to the components of the drug, or to all penicillins.

In patients who are allergic to cephalosporins, or in the presence of pseudomembranous colitis, insufficiency of liver function or severe renal dysfunction, the drug is administered with caution.

Patients with mononucleosis or lymphocytic leukemia who have previously been prescribed ampicillin may develop an erythematous rash. In this case, the antibiotic should be discontinued.

Side effects

Usually they pass easily and are easily tolerated by patients. Side effects are more common in elderly patients, as well as in those patients who use Amoxiclav for a long time. Most often, side effects appear either during or after the completion of treatment, but sometimes their development occurs several weeks after the end of the drug.

Digestive system. As a rule, it is diarrhea, nausea, vomiting, and dyspepsia. Less common are flatulence, stomatitis or gastritis, discoloration of the tongue or glossitis, enterocolitis. During or after treatment with this medicine, pseudomembranous colitis, a disease caused by one of the bacteria of the Clostridium genus, may occur.

The blood system. Anemia (including hemolytic), eosinophilia, a decrease in the number of platelets and / or leukocytes, and agranulocytosis may also occur.

Nervous system may respond to the drug with headaches, dizziness, agitation, insomnia, convulsions, inappropriate behavior or hyperactivity.

Liver. Increased liver function tests, including asymptomatic increases in the activity of AST and / or ALT, alkaline phosphatase and serum bilirubin levels.

Leather. The skin can react to taking amoxiclav with a rash, urticaria, angioedema, rarely develops erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis, Stevens-Johnson syndrome.

urinary system- there is the appearance of blood in the urine and interstitial nephritis.
With prolonged use of the drug, fever, oral candidiasis, and candidal vaginitis may occur.

Amoxiclav during pregnancy

Amoxiclav for children

Amoxiclav with angina

It must be remembered that antibiotics should not be used for a long time, as this increases the resistance of pathogenic microflora to them.
More about angina

Compatibility with other medicines

• It is undesirable to simultaneously use Amoxiclav and preparations of indirect anticoagulants. This may cause an increase in prothrombin time.
• The interaction of Amoxiclav and allopurinol causes the risk of exanthema.
• Amoxiclav enhances the toxicity of methotrexate.
• You can not use amoxicillin and rifampicin at the same time - these are antagonist drugs, the combined use weakens the antibacterial effect of both.
• You can not prescribe amoxiclav together with tetracyclines or macrolides (these are bacteriostatic antibiotics), as well as with sulfonamides due to a decrease in the effectiveness of this medication.
• Taking Amoxiclav reduces the effectiveness of contraceptive pills.

Comparison with other drugs

What is better than Amoxiclav?

Amoxiclav or amoxicillin?

Amoxiclav or Augmentin?

Amoxiclav or Flemoxin?

Amoxiclav or Sumamed?

Alcohol compatibility

Synonyms and analogues

Reviews

Reviews of doctors

Anna Leonidovna, therapist, Vitebsk. Amoxiclav is much more effective in the treatment of various diseases respiratory tract than its counterpart, amoxicillin. I prescribe a course of 5 days, after which it is obligatory to take drugs that restore the microflora.

Veronika Pavlovna, urologist. city ​​of Krivoy Rog. This drug is excellent for bacterial infections of the genital tract. Rarely gives side effects, I prescribe in parallel antifungal drugs, after taking - probiotics to restore normal microflora.

Andrey Evgenievich, ENT doctor, Polotsk. The use of this drug by injection allows you to quickly stop the manifestations of severe and moderate diseases of the upper respiratory tract. The drug well treats inflammation of the middle ear. In addition, patients take the sweet fruit suspension well.

Patient reviews

Victoria, Dnepropetrovsk. Used as prescribed by a doctor for the treatment of angina. Drink for 5 days. Antibiotics started on the 3rd day of illness. The disease subsided on the third. My throat stopped hurting. I had diarrhea, it went away in two days, after which I started taking probiotics to restore the microflora.

Alexandra, Lugansk. This drug was prescribed by a doctor for the treatment of pyelonephritis. The course was 7 days. First 3 days of injections - then pills. The injections are quite painful. However, improvement began around the fourth day. There were no side effects. Just dry mouth.

Tamara, Boyarka. Give me this medicine to treat a gynecological infection. It was very painful, there were bruises at the injection site. However, after a week, there was no trace of the pathogen in the smears.

Amoxiclav for children

Additional Information

If the drug is used for a long time, it is necessary to monitor the work of the liver, hematopoietic organs and kidneys of the patient. If the patient has impaired renal function, it is necessary to adjust the dose or increase the interval between doses of the drug. It is best to take the medicine with food. In the event of superinfection (the appearance of microflora that is insensitive to this antibiotic) you need to change the medicine. Due to the possibility of cross-allergic reactions with cephalosporins in patients sensitive to penicillins, it is undesirable to use these antibiotics simultaneously.

While taking the medicine, you must drink plenty of fluids to avoid the formation of amoxicillin crystals in the urine.

You should be aware that the presence in the body of high doses of an antibiotic can provoke a false positive reaction to urine glucose (if Benedict's reagent or Fleming's solution is used to determine it). Reliable results in this case will give the use of an enzymatic reaction with glucosidase.

Since the use of the drug may cause side effects from nervous system must be handled very carefully vehicles(car) or engage in activities that require increased concentration, reaction time and attention.

Amoxiclav - instructions for use, reviews, analogs and formulations (tablets 125 mg, 250 mg, 500 mg, 875 mg, 1000 mg, suspension) of a drug for the treatment of infectious diseases in adults, children and pregnancy

In this article, you can read the instructions for use medicinal product Amoxiclav. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Amoxiclav in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Amoxiclav in the presence of existing structural analogues. Use for the treatment of various infectious diseases in adults, children, as well as during pregnancy and lactation. Alcohol use and possible consequences after taking Amoxiclav.

Amoxiclav- is a combination of amoxicillin - a semi-synthetic penicillin with a wide spectrum of antibacterial activity and clavulanic acid - an irreversible beta-lactamase inhibitor. Clavulanic acid forms a stable inactivated complex with these enzymes and provides amoxicillin resistance to the effects of beta-lactamases produced by microorganisms.

Clavulanic acid, similar in structure to beta-lactam antibiotics, has a weak intrinsic antibacterial activity.

Amoxiclav has a wide spectrum of antibacterial action.

Active against amoxicillin-sensitive strains, including strains producing beta-lactamase, incl. aerobic gram-positive bacteria, aerobic gram-negative bacteria, anaerobic gram-positive bacteria, gram-negative anaerobes.

Pharmacokinetics

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Both components are well absorbed after oral administration, food intake does not affect the degree of absorption. Both components are characterized by a good volume of distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries, etc.). Amoxicillin also penetrates into the synovial fluid, liver, prostate gland, palatine tonsils, muscle tissue, gallbladder, the secret of the paranasal sinuses, saliva, bronchial secret. Amoxicillin and clavulanic acid do not penetrate the BBB in non-inflamed meninges. Amoxicillin and clavulanic acid cross the placental barrier and are excreted in breast milk in trace concentrations. Amoxicillin and clavulanic acid are characterized by low plasma protein binding. Amoxicillin is partially metabolized, clavulanic acid appears to be extensively metabolized. Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly as metabolites.

Indications

• infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsillitis, pharyngitis);
• infections of the lower respiratory tract (incl. acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
• urinary tract infections;
• gynecological infections;
• skin and soft tissue infections, including animal and human bites;
• bone and connective tissue infections;
• biliary tract infections (cholecystitis, cholangitis);
• odontogenic infections.

Release form

Powder for the preparation of an injection solution for intravenous administration(4) 500 mg, 1000 mg.

Powder for suspension for oral administration 125 mg, 250 mg, 400 mg (a convenient children's form of the drug).

Film-coated tablets 250 mg, 500 mg, 875 mg.

Instructions for use and dosage

Adults and children over 12 years of age (or over 40 kg body weight): The usual dose for mild to moderate infections is 1 tablet 250 + 125 mg every 8 hours or 1 tablet 500 + 125 mg every 12 hours for severe infections. and respiratory tract infections - 1 tablet 500 + 125 mg every 8 hours or 1 tab. 875 + 125 mg every 12 hours. Tablets are not prescribed for children under 12 years of age (less than 40 kg of body weight).

Maximum daily dose clavulanic acid (in the form of potassium salt) is for adults - 600 mg, for children - 10 mg / kg of body weight. The maximum daily dose of amoxicillin is 6 g for adults and 45 mg/kg of body weight for children.

The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not continue for more than 14 days without a second medical examination.

Dosage for odontogenic infections: 1 tab. 250 +125 mg every 8 hours or 1 tab. 500 + 125 mg every 12 hours for 5 days.

Dosage for renal insufficiency: for patients with moderate renal insufficiency (Cl creatinine - 10-30 ml / min), the dose is 1 table. 500 + 125 mg every 12 hours; for patients with severe renal insufficiency (Cl creatinine less than 10 ml / min), the dose is 1 table. 500 + 125 mg every 24 hours

Side effect

Side effects in most cases are mild and transient.

• loss of appetite;
• nausea, vomiting;
• diarrhea;
• stomach ache;
• itching, urticaria, erythematous rash;
• angioedema;
• anaphylactic shock;
• allergic vasculitis;
• exfoliative dermatitis;
• Stevens-Johnson syndrome;
• reversible leukopenia (including neutropenia);
• thrombocytopenia;
• hemolytic anemia;
• eosinophilia;
• dizziness, headache;
• convulsions (may occur in patients with impaired renal function when taking the drug in high doses);
• sense of anxiety;
• insomnia;
• interstitial nephritis;
• crystalluria;
• development of superinfection (including candidiasis).

Contraindications

• hypersensitivity to any of the components of the drug;
• a history of hypersensitivity to penicillins, cephalosporins and other beta-lactam antibiotics;
• a history of indications of cholestatic jaundice and / or other abnormal liver function caused by taking amoxicillin / clavulanic acid;
• infectious mononucleosis and lymphocytic leukemia.

Use during pregnancy and lactation

Amoxiclav can be prescribed during pregnancy if there are clear indications.

Amoxicillin and clavulanic acid are excreted in breast milk in small amounts.

special instructions

During the course of treatment, the functions of the hematopoietic organs, liver and kidneys should be monitored.

In patients with severely impaired renal function, an adequate correction of the dosing regimen or an increase in the intervals between dosing is required.

In order to reduce the risk of developing adverse reactions on the part of the gastrointestinal tract, the drug should be taken with food.

Laboratory tests: High concentrations of amoxicillin give a false positive reaction to urine glucose when using Benedict's reagent or Felling's solution. Enzymatic reactions with glucosidase are recommended.

It is forbidden to use Amoxiclav with the simultaneous use of alcohol in any form, since the risk of hepatic disorders is seriously increased when they are taken simultaneously.

Influence on the ability to drive vehicles and control mechanisms

There are no data on the negative effect of Amoxiclav in recommended doses on the ability to drive a car or work with mechanisms.

drug interaction

With the simultaneous use of the drug Amoxiclav with antacids, glucosamine, laxatives, aminoglycosides, absorption slows down, with ascorbic acid it increases.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration).

With the simultaneous use of Amoxiclav increases the toxicity of methotrexate.

With the simultaneous use of Amoxiclav with allopurinol, the incidence of exanthema increases.

Co-administration with disulfiram should be avoided.

In some cases, taking the drug may lengthen the prothrombin time, in this regard, care should be taken when prescribing anticoagulants and the drug Amoxiclav.

The combination of amoxicillin with rifampicin is antagonistic (there is a mutual weakening of the antibacterial action).

Amoxiclav should not be used simultaneously with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of Amoxiclav.

Probenecid reduces the excretion of amoxicillin by increasing its serum concentration.

Antibiotics reduce the effectiveness of oral contraceptives.

Antibiotic analogs Amoksiklav

Structural analogues for the active substance:

• Amovicomb;
• Amoxiclav Quiktab;
• Arlet;
• Augmentin;
• Bactoclav;
• Verclave;
• Klamosar;
• Liklav;
• Medoklav;
• Panklav;
• ranclave;
• Rapiclav;
• Taromentin;
• Flemoklav Solutab;
• Ecoclave.

Amoxiclav: instructions for use

Before buying an antibiotic Amoxiclav, you must carefully read the instructions for use, methods of application and dosage, as well as other useful information on the drug Amoxiclav. On the site "Encyclopedia of Diseases" you will find all the necessary information: instructions for proper use, recommended dosage, contraindications, as well as reviews of patients who have already used this drug.

Amoxiclav It is a broad-spectrum penicillin antibiotic with a beta-lactamase inhibitor.

Amoxiclav - composition and form of release

Amoxicillin (as trihydrate) 250 mg

→ Tablets, film-coated white or almost white, oval, biconvex.

Amoxicillin (as trihydrate) 500 mg

Clavulanic acid (as potassium clavulanate) 125 mg

Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose.

The composition of the film shell: hypromellose, ethylcellulose, diethyl phthalate, macrogol 6000, titanium dioxide.

→ Tablets, film-coated, white or almost white, oblong, biconvex, with an imprint of "AMC" on one side, with a notch and an imprint of "875" and "125" on the other.

Amoxicillin (as trihydrate) 875 mg

clavulanic acid (as potassium clavulanate) 125 mg

Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose.

The composition of the film shell: hypromellose, ethyl cellulose, povidone, triethyl citrate, titanium dioxide, talc.

Amoxiclav - Pharmacological action

Pharmacological action of the drug is bactericidal, broad spectrum antibacterial.

Amoxiclav is a combination of amoxicillin and clavulanic acid.

Amoxicillin is a semi-synthetic penicillin (beta-lactam antibiotic) that inhibits one or more enzymes (often referred to as penicillin-binding proteins, PBPs) in the biosynthesis pathway of peptidoglycan, which is an integral structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to a loss of cell wall strength, which usually leads to lysis and death of microorganism cells.

Amoxicillin is destroyed by the action of beta-lactamases produced by resistant bacteria, so the spectrum of activity of amoxicillin does not include microorganisms that produce these enzymes.

Clavulanic acid is a beta-lactam structurally related to penicillins. It inhibits some beta-lactamases, thereby preventing the inactivation of amoxicillin and extending its spectrum of activity to include bacteria normally resistant to amoxicillin as well as to other penicillins and cephalosporins. By itself, clavulanic acid does not have a clinically significant antibacterial effect.

The drug Amoxiclav has a bactericidal effect in vivo on the following microorganisms:

Gram-positive aerobes - Staphylococcus aureus *, Streptococcus pneumoniae, Streptococcus pyogenes;

Gram-negative aerobes - Enterobacter spp.**, Escherichia coli*, Haemophilus influenzae*, species of the genus Klebsiella*, Moraxella catarrhalis* (Branhamella catarrhalis).

The drug Amoxiclav has a bactericidal effect in vitro on the following microorganisms (however, the clinical significance is still unknown):

Gram-positive aerobes - Bacillis anthracis*, species of the genus Corynebacterium, Enterococcus faecalis*, Enterococcus faecium*, Listeria monocytogenes, Nocardia asteroides, coagulase-negative staphylococci* (including Staphylococcus epidermidis), Streptococcus agalactiae, other species of the genus Streptococcus, Streptococcus viridans;

Gram-positive anaerobes - species of the genus Clostridium, species of the genus Peptococcus, species of the genus Peptostreptococcus;

Gram-negative aerobes - Bordetella pertussis, species of the genus Brucella, Gardnerella vaginalis, Helicobacter pylori, species of the genus Legionella, Neisseria gonorrhoeae*, Neisseria meningitidis*, Pasteurella multocida, Proteus mirabilis*, Proteus vulgaris*, species of the genus Salmonella*, species of the genus Shigella*, Vibrio cholerae, Yersinia enterocolitica*;

Gram-negative anaerobes - species of the genus Bacteroides* (including Bacteroides fragilis), species of the genus Fusobacterium*;

Others - Borrelia burgdorferi, Chlamydia spp., Leptospira icterohaemorrhagiae, Treponema pallidum.

* Some strains of these bacterial species produce beta-lactamase, which contributes to their insensitivity to amoxicillin monotherapy.

** Most strains of these bacteria are resistant to the amoxicillin/clavulanic acid combination in vitro, but this combination has been shown to be clinically effective in the treatment of urinary tract infections caused by these strains.

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Amoxicillin and clavulanic acid dissolve well in aqueous solutions with a physiological pH value and, after taking the drug Amoxiclav, are quickly and completely absorbed from the gastrointestinal tract. The absorption of active substances - amoxicillin and clavulanic acid - is optimal if the drug is taken at the beginning of a meal.

The bioavailability of amoxicillin and clavulanic acid after oral administration is about 70%.

Peak plasma concentrations are reached approximately 1 hour after ingestion. Cmax values ​​​​are for amoxicillin (depending on the dose) 3–12 μg / ml, for clavulanic acid - about 2 μg / ml.

Cmax in plasma after a bolus injection at a dose of 1.2 g (1000 + 200 mg) of the drug is 105.4 mg / l for amoxicillin and 28.5 mg / l for clavulanic acid.

When using the drug Amoxiclav, plasma concentrations of amoxicillin / clavulanic acid are similar to those with oral administration of the corresponding doses of amoxicillin or clavulanic acid separately in equivalent doses.

Both components are characterized by sufficient Vd in various bodies, tissues and body fluids (including in the lungs, organs abdominal cavity; fat, bone and muscle tissue; pleural, synovial and peritoneal fluids; in skin, bile, urine, purulent discharge, sputum, interstitial fluid).

Plasma protein binding is moderate - 25% for clavulanic acid and 18% for amoxicillin.

Vd is about 0.3-0.4 l/kg for amoxicillin and about 0.2 l/kg for clavulanic acid.

Amoxicillin and clavulanic acid do not cross the blood-brain barrier in non-inflamed meninges.

Amoxicillin (like most penicillins) is excreted in breast milk. Trace amounts of clavulanic acid have also been found in breast milk. Amoxicillin and clavulanic acid cross the placental barrier.

Amoxicillin is excreted primarily by the kidneys, while clavulanic acid is eliminated via both renal and extrarenal mechanisms. After a single oral administration of one tablet of 250 + 125 mg or 500 + 125 mg, approximately 60–70% of amoxicillin and 40–65% of clavulanic acid are excreted unchanged in the urine during the first 6 hours. About 10-25% of the initial dose of amoxicillin is excreted in the urine as inactive penicillic acid. Clavulanic acid in the human body undergoes intensive metabolism with the formation of 2,5-dihydro-4-(2-hydroxyethyl)-5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butan-2-one and is excreted in urine and feces.

The average T1 / 2 of amoxicillin / clavulanic acid is approximately 1 hour, the average total clearance is approximately 25 l / h in healthy patients. In the course of various studies, it was found that the excretion of amoxicillin in the urine within 24 hours is approximately 50-85%, clavulanic acid - 27-60%. The greatest amount of clavulanic acid is excreted during the first 2 hours after ingestion.

Amoxiclav - Indications for use

For all dosage forms

Infections caused by susceptible strains of microorganisms:

Upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis);

Lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);

urinary tract (eg cystitis, urethritis, pyelonephritis);

Skin and soft tissue, including human and animal bites;

Bone and connective tissue;

Biliary tract (cholecystitis, cholangitis);

Amoxiclav for powder for the preparation of a solution for intravenous administration additionally

abdominal infections;

Sexually transmitted infections (gonorrhea, chancre);

Prevention of infections after surgical interventions.

Amoxiclav - Dosage

Adults and children over 12 years of age (or those weighing >

The drug in the form of tablets is not prescribed to children under 12 years of age (with a body weight of 40 kg of body weight)

The usual dose in the case of mild and moderate infection is 1 table. 250+125 mg every 8 hours or 1 tab. 500 + 125 mg every 12 hours, in case of severe infection and respiratory tract infections - 1 table. 500+125 mg every 8 hours or 1 tab. 875+125 mg every 12 hours

Since the tablets of the combination of amoxicillin and clavulanic acid 250 + 125 mg and 500 + 125 mg each contain the same amount of clavulanic acid - 125 mg, then 2 tables. 250 + 125 mg are not equivalent to 1 table. 500+125 mg.

Dosage for odontogenic infections

1 tab. 250+125 mg every 8 hours or 1 tab. 500+125 mg every 12 hours for 5 days.

Patients with impaired renal function

Adults and children over 12 years of age (or ≥40 kg body weight) (Table 2);

With anuria, the interval between dosing should be increased to 48 hours or more;

Tablets 875 + 125 mg should only be used in patients with Cl creatinine> 30 ml / min.

Patients with impaired liver function

Amoxiclav should be taken with caution. It is necessary to conduct regular monitoring of liver function.

Adults and children over 12 years of age (or weighing >40 kg) with mild or moderate infection are prescribed 1 tab. (250 mg + 125 mg) every 8 hours or 1 tab. (500 mg + 125 mg) every 12 hours, in case of severe infection and respiratory tract infections - 1 tab. (500 mg + 125 mg) every 8 hours or 1 tab. (875 mg + 125 mg) every 12 hours.

The drug in the form of tablets is not prescribed for children under 12 years of age (with body weight

For odontogenic infections, 1 tab. (250 mg + 125 mg) every 8 hours or 1 tab. (500 mg + 125 mg) every 12 hours for 5 days.

In case of moderate renal failure (CC 10-30 ml / min), 1 tab. (500 mg + 125 mg) every 12 hours, with severe renal failure (QC

Despite having a large number modern antibiotics, each attending physician is always faced with the problem of choosing the optimal drug. When choosing an antibacterial drug for the treatment of pneumonia and exacerbations of chronic bronchitis, it is necessary to take into account the age, severity of the patient's condition, the presence of concomitant diseases, and the conditions for the development of the disease. One of the groups antibacterial drugs, well established for the treatment of organ infections respiratory system, are semi-synthetic protected penicillins. Representatives of this group include Amoxiclav® (amoxicillin / clavulant, Lek, Slovenia), high efficiency and the safety of which has been proven by numerous studies.
Amoxiclav is a broad-spectrum antibiotic that is a combination of the semi-synthetic penicillin amoxicillin and the b-lactamase inhibitor clavulanic acid. The ratio of the components of the drug for oral administration is 2:1, 4:1, 7:1, for the parenteral form - 5:1.
Amoxiclav has a high bactericidal activity, including against strains of microorganisms resistant to amoxicillin alone.
The activity of this drug is observed in relation to:
aerobic gram-positive bacteria (including strains producing b-lactamase): Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus anthracis, Streptococcus pneumoniae, Streptococcus viridans, Enterococcus faecalis, Corynebacterium spp., Listeria monocytogenes;
anaerobic Gram-positive bacteria: Clostridium spp., Peptococcus spp., Peptostreptococcus spp.;
aerobic gram-negative bacteria (including b-lactamase producing strains): Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella spp., Salmonella spp., Shigella spp., Bordetella pertussis, Yersinia enterocolitica, Gardnerella vaginalis, Neisseria meningitidis, Neisseria gonorrhoeae, Moraxella catarrhalis, Haemophilus influenzae, Haemophilus ducreyi, Yersinia multocida (formerly Pasteurella), Campylobacter jejuni;
* anaerobic gram-negative bacteria (including b-lactamase producing strains): Bacteroides spp., including Bacteroides fragilis.
Clavulanic acid inhibits types II, III, IV and V b-lactamases, is inactive against type I b-lactamases produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has a high tropism for penicillinases, due to which it forms a stable complex with the enzyme, which prevents the enzymatic degradation of amoxicillin under the influence of b-lactamases.
A wide range of antimicrobial activity and activity against amoxicillin-resistant strains make Amoxiclav indispensable in the treatment of bronchopulmonary infections, especially at high risk of b-lactamase producing pathogens, mainly in immunocompromised patients, with nosocomial infections.
The pharmacological characteristics of amoxicillin and clavulanic acid are very similar. When administered intravenously, the serum concentrations of both substances are many times higher than the required therapeutic concentrations. When taken orally, they are rapidly absorbed into the blood. Peak serum levels of both compounds are reached approximately one hour after dosing. The simultaneous use of food does not affect absorption. The drug is well distributed in organs and tissues, creating sufficient concentrations to destroy strains of sensitive bacteria.
In addition to blood plasma, a high concentration of Amoxiclav is observed in sputum, bronchial secretions, lung tissue, and pleural fluid. In terms of penetration into the lung tissue, amoxicillin / clavulanate is superior to ampicillin. Amoxicillin concentrations in sputum are twice the concentrations of ampicillin when taking the same doses of the drug. Moreover, the concentrations of the first agent remain much longer in sputum at a therapeutic level.
Both components of the drug are metabolized in the liver: amoxicillin - 10% of the administered dose, clavulanic acid - 50%.
The drug is excreted mainly by the kidneys (glomerular filtration and tubular secretion): 50-78% of the dose of amoxicillin and 25-40% of clavulanic acid are excreted unchanged during the first 6 hours after administration.
Side effects when using the drug in most cases are mild and transient. They are mainly represented by changes in the digestive tract and allergic reactions.
Amoxiclav is approved for use in all trimesters of pregnancy.
The drug has several dosage forms: for oral administration: Amoxiclav in tablets at doses of 375 mg, 625 mg and 1000 mg, which allows it to be used in outpatient practice, and for parenteral administration - 600 mg and 1200 mg vials (Table 1).
Amoxiclav can be combined with antibacterial drugs of other groups.
The presence of various forms of Amoxiclav implies the possibility of both parenteral therapy and oral administration. In the treatment of non-severe (outpatient) forms of community-acquired pneumonia and exacerbations of chronic bronchitis, preference should be given to oral forms of the antibiotic. In severe infections, the antibiotic must be administered parenterally. Stepwise therapy is also highly effective, which involves a transition from the parenteral route of administration of the drug to the oral one, provided that the patient's condition stabilizes or the course of the disease improves. This is usually carried out on the 2-3rd day from the start of treatment.
Stepwise antibiotic therapy can provide effective therapy for pneumonia and exacerbations of chronic bronchitis. The average duration of parenteral antibiotics is 2-3 days, and oral therapy is 5-7 days.
We have studied the effectiveness of Amoxiclav. The observation group consisted of 20 patients with radiologically confirmed pneumonia, average age patients - 60.7 years. The condition of 6 patients was regarded as moderate, the rest - as satisfactory. Treatment of all patients started with intravenous drip of the drug 1.2 g every 8 hours for 2-3 days. After the achieved clinical improvement, intravenous therapy was replaced by oral therapy. Amoxiclav was administered at a dose of 625 mg every 8 hours orally with meals. The total duration of drug treatment averaged 9 days. The clinical efficacy of Amoxiclav was high (100%), recovery was noted in all 20 patients. Bacteriological eradication was achieved in 16 patients (80%). The comparison group consisted of 20 patients with pneumonia who received cefotaxime parenterally according to the traditional scheme: 1 g intramuscularly every 8 hours for an average of 8 days. Recovery in this group was noted in 80% of cases, in 10% of patients - a decrease in infiltrative changes with complete relief of signs of a bacterial infection. Bacteriological efficiency was 82.6%. Thus, the clinical efficacy of Amoxiclav was higher, and the bacteriological efficacy was comparable to that of cefotaxime. The cost of a 7-day course of therapy with Amoxiclav according to a stepwise scheme is 42.51 USD. The cost of a 7-day course of intramuscular cefotaxime therapy (including consumables) is 49.77 USD. (with intravenous infusions, the cost increases by 1.3 times).
Ease of use and improved economics are among the most important advantages of stepwise therapy over parenteral therapy. They consist of lower costs due to the lower cost of oral antibiotic formulations compared to parenteral formulations, lower costs for short-course parenteral antibiotics, reduced costs for syringes, intravenous solutions, reduced staff time and reduced risk and the number of post-injection complications. Step therapy is a cost-effective regimen that provides benefits for both the patient and the hospital. When using it, the cost of treatment is reduced by 30-60%.
The severe course of pneumonia requires the use of the parenteral route of drug administration, and in some cases, combination therapy using antibiotics of other groups.

Literature
1. Avdeev S.N., Chuchalin A.G. "The role of bacterial infection and the choice of antibiotics in exacerbations of chronic bronchitis". // Consilium, No. 2, 2000
2. “Antibacterial drugs. Methods for standardization of preparations, edited by R.U. Khabriev. // Medicine, 2004
3. Budanov S. V. “Stepwise antibiotic therapy of infections”. // Clinical Bulletin, No. 4, 1996
4. State register medicines, 2004
5. Ioffe L.Ts., Beisebaev N.A., Shatskikh V.V., Salimova S.S., Auelbekova G.A., Esetova G.U. "Amoxiclav in the treatment of lower respiratory tract infections". // 12th National Congress on Respiratory Diseases, 2002
6. Krivtsiov E.V., Prokhorovich E.A., Aleksanyan A.A., Makaryan A.S., Chibikova A.A. " Comparative characteristics semi-synthetic penicillins (ampicillin and amoxicillin / clavulanic acid) and fluoroquinolones (pefloxacin and ciprofloxacin) in the treatment of patients community-acquired pneumonia". // Medical file cabinet, No. 2, 1999
7. Nonikov V.E., Konstantinova T.D., Lenkova N.I., Argetkina I.N. "Pharmacoeconomic aspects antibiotic therapy pneumonia." // Infection and antimicrobial therapy, No. 2, 1999
8. Nonikov V. E., Konstantinova T. D., Lenkova N. I., Minaev V. I., Ritchik L. A. “Effectiveness of amoxicillin/clavulanate potassium in the treatment of bronchopulmonary infections in hospital”. // Antibiotics and chemotherapy, No. 10, 1997
9. Vidal Handbook, 2003
10. Strachunsky L.S., Kozlov S.N. "Penicillins, part 2. Inhibitor-protected and combined penicillins". // Russian Medical Journal, No. 2, 2000
11. Strachunsky L.S., Belousov Yu.B., Kozlov S.N. “Antibacterial therapy. Practical guide. // RC "Pharmedininfo", 2000

The main direction in the treatment of infections of the upper and lower respiratory tract is the use of various antibacterial drugs that can suppress the vital activity of pathogens. Among the most effective drugs allocate the drug Amoxiclav, which managed to establish itself as really effective remedy with pneumonia and other respiratory diseases.

This drug contains two components, namely: amoxicillin - half synthetic penicillin and clavulanic acid. The substance amoxicillin acts on the bacterial membrane and binds the enzymes that make up its composition. After that, the destruction of the cell and the death of the bacterium occurs.

As you know, many pathogenic microorganisms are already immune to such drugs, they began to produce new protective substances, namely, beta-lactamases. It is to combat beta-lactamases that clavulanic acid is needed. It helps to destroy all bacteria, making the antibiotic stronger and more effective.

In addition, clavulanic acid is effective in cases where the patient has already used various antibiotics to eliminate pneumonia. A lung infection is often caused by specific microorganisms, and the use of Amoxiclav allows you to completely get rid of them.

IMPORTANT! It is necessary to prescribe the drug after laboratory research and determining the type of infection.

The drug Amoxiclav is able to have a good antimicrobial effect in pneumonia. Moreover, it is also able to eliminate many infections, including: staphylococcus aureus, streptococcus, salmonella.

Application scheme

In adults

Dosage for adults in the treatment of pneumonia is determined in each individual case. Only an infectious disease doctor or therapist can prescribe such a drug.

If symptoms of pneumonia occur, the patient is hospitalized and rescue measures are taken, including the use of drugs intramuscularly or intravenously.

The medicine has the following forms of release:

• Tablets of 250 mg + 125 mg.
• Tablets of 500 mg + 125 mg.
• Tableted remedy 875 mg + 125 mg.
• Powder for further dissolution of 125 mg + 31.25 mg / 5 ml or 250 mg + 62.5 mg / 5 ml;
• Mixture for oral suspension, 400 mg + 57 mg/5 ml.
• Mixture to prepare a solution for intravenous administration, 500 mg + 100 mg or 1000 mg + 200 mg.

The dosage may depend on the type and form of pneumonia, as well as the patient's condition and the functionality of his kidneys, because the drug is excreted through them. The severe stage of pneumonia requires the administration of the drug intravenously.

At earlier stages, it is enough to use tablets according to the following scheme:

• 250 + 125 mg. three times a day;
• 500 + 125 mg. twice a day;
• 875 +125 mg. twice a day, if the disease is severe.

Strictly observe the dosage, according to the recommendations of the doctor. If the dose was too small, this can cause the drug to be ineffective, because even in a short time of taking the bacteria can develop immunity. If the dosage is exceeded, this often causes side effects.

Maximum dosage: 6 g of amoxicillin and 0.6 g of clavulanic acid. In some cases, the dosage and amount of the drug is reduced to 1 dose. This applies to those who have various pathologies or chronic kidney diseases.

IMPORTANT! The drug should be taken at a strictly allotted time, if Amoxiclav is prescribed for the treatment of pneumonia three times a day, the intervals between doses should be eight hours. Thus, the substance will act effectively, and you will not break the dosage.

In children

In children, the dosage for the treatment of pneumonia is selected based on weight. In treatment, they prefer to use a suspension and only occasionally tablets.

If the infection is in mild form, the doctor prescribes 20 mg per 1 kg. weight. If the infection causes complications, the dosage is doubled.

Manufacturers have created special packaging so that the portion for admission can be calculated as quickly as possible, without exceeding the daily allowance.

There are two types of mixing:

1. In 5 ml. The powder contains a dose of amoxicillin (125 mg) and clavulanic acid (30.5 mg).
2. In 5 ml. ratio 250 mg. to 62.5 mg.

The maximum daily allowance: amoxicillin - 45 mg per 1 kg. weight and 10 mg of acid per 1 kg. body weight.
Children over 12 years of age with a weight of more than 40 kilograms should take adult dosage drug, in tablets. If there is kidney dysfunction, the doctor adjusts the dosage.

Peculiarities

Treatment of pneumonia with Amoxiclav takes from 5 to 14 days. Only the attending physician can extend the period of admission. If positive action not observed - it is necessary to change the medicine.
In order to avoid relapses, it is worth undergoing a course of treatment, even if there is a clear relief and the condition has improved. Amoxiclav instant tablets should be dissolved in a glass of water before use or carefully dissolved in the mouth.

During pregnancy and lactation

In case of emergency, pregnant women are prescribed Amoxiclav for the treatment of pneumonia, but only after careful examination and analysis possible risk for fetus.
The instructions for the drug indicate that the treatment of pneumonia in pregnant women can be carried out only on the recommendation of a doctor.

In women in position while taking the drug, unpleasant side effects in the form of nausea, diarrhea, and headache are more likely to occur. Treatment may be contraindicated if a woman has previously had various kidney and liver diseases, as well as with severe allergic reactions.

Nursing mothers should be treated with Amoxiclav only under the supervision of a doctor. If a child has a reaction to the drug, it is worth stopping taking and changing the treatment regimen.

Contraindications

The main contraindications are:

• intolerance to the penicillin group;
• liver pathology;
• mononucleosis.

Side effects and overdose

Side effects: nausea, diarrhea, strong pain in a stomach. The occurrence of candidiasis in the oral cavity, in women the occurrence of thrush. If there allergic reactions, possible skin rashes, Quincke's edema.

An overdose may cause severe dizziness, insomnia, development of anemia.

Analogues

The most suitable in composition are: Augmentin, Flemoklav, Summamed,.

Useful video

Familiarize yourself visually with the drug amoxiclav and the treatment of pneumonia, in the video below:

Summing up

Pneumonia and its symptoms require immediate treatment. Before taking this or that drug, you need to consult a doctor. If there are no contraindications, Amoxiclav can be prescribed - a remedy that can cope with various bacteria and is safe for children and pregnant women.

Inflammation of the lung tissue (pneumonia) is popularly called "pneumonia". Having heard such a diagnosis, even the patient who is farthest from medicine understands that the matter is serious, and ordinary raspberries and honey cannot be dispensed with.

Inflammation of the lungs develops against the background of a weakened immune system (in the elderly, with chronic diseases etc.). The level of treatment of pulmonological patients today is quite high. The main success in the treatment of pneumonia is timely therapy, when the pathological focus has affected the smallest area.

The most common causes of pneumonia are:

• staphylococcus,
• streptococcus,
• moraxella,
• Pneumococcus,
• haemophilus influenzae.

Pneumonia can proceed classically or have erased symptoms. Typical (classic) symptoms include:

• increased body temperature (sometimes up to 40 ° C);
• lack of appetite or its decrease;
• general malaise;
• muscle pain;
• cough;
• chest or back pain;
• sweating;
• other.

Sometimes a cough heat and there are no other significant symptoms. Therefore, if fatigue, sweating and slight coughing do not go away for a long time, this is a reason to consult a doctor. The first steps to treatment are x-rays of the lungs and general analysis blood (necessarily with the formula). These studies will help clarify the diagnosis, and determine the localization inflammatory process in lung tissue.

Which doctor treats pneumonia?

Residents of small towns and villages do not always immediately have the opportunity to visit a specialized specialist - a pulmonologist. In this case, you should consult a therapist. Often, with mild forms of pneumonia (focal), it is enough to conduct an antibacterial course in tablets at home.

If pneumonia has already “gained momentum”, treatment should be carried out only in a hospital setting. To quickly eliminate pneumonia, injectable antibacterial agents are used (injections are performed intramuscularly or intravenously). The tactics of treatment is determined by the doctor, depending on the severity of the inflammation.

What medicines are used to treat pneumonia?

The drugs of choice number 1 are antibacterial agents. The following drugs are considered the most popular:

Antibacterial therapy for pneumonia is 10-14 days (depending on the severity of the inflammatory process). After the course of treatment, a control x-ray of the lungs is performed. And now, let's look at the most popular tools from this list.

Amoxiclav

This tool consists of two active ingredients - amoxicillin and clavulanic acid. Amoxiclav has moderate toxicity compared to antibiotics of other pharmacological series.

Clavulanic acid is a kind of assistant to amoxicillin. It inhibits the action of beta-lactamases (a group of bacterial enzymes), which have learned to resist antibiotics quite well.

• In addition to pneumonia, amoxiclav is used for sinusitis, cholecystitis, tonsillitis, otitis media, pyelonephritis and other infections.
• Amoxiclav is contraindicated in case of intolerance to the two main substances of which it consists, as well as pseudomembranous colitis, severe pathologies of the kidneys and liver. With prolonged use and the use of high doses, side reactions such as dyspepsia, allergic rash, fungal lesions of the mucous membrane, and others are sometimes observed.
• The dosage of the drug depends on the form of application, therefore it is prescribed strictly individually. Also taken into account general state patient and comorbidities.

For ease of use, the manufacturer suggested the following dosage forms: tablets, suspension (powder), solution (powder). Pharmacy prices fluctuate. For example, a powder for the preparation of a solution for injection and tablets in a dose of 500 mg cost about 400 rubles. Powder for the preparation of a suspension (400 mg) - 200 rubles.

Sumamed

Currently, sumamed (azithromycin) has gained particular popularity. Firstly, it has a wide spectrum of antibacterial activity, and secondly, it is convenient to use (tablets are taken once a day for 3-5 days in a row). Azithromycin dihydrate (the main substance of sumamed) is used not only in the form of tablets, but also in powder, capsules, suspensions. And that is not all. Sumamed has a liquid form (infusion bottles).

Sumamed is effective in many infectious processes caused by the reproduction of pathogenic microflora. I often prescribe it for bronchitis, pleurisy, pneumonia, as well as ENT infections: sinusitis, otitis, tonsillitis. Infectious diseases of the genitourinary system and skin no less need such a drug as sumamed.

• The drug is approved for use from the infancy period, starting from the age of six months (for suspension). If the weight of the baby is 5 kg, the dose of the suspension will be 2.5 ml. Solid forms of sumamed are allowed to be taken only from the age of three, when the child is able to take a pill and drink the medicine as it should. In pediatrics, lower dosages are used - 125 mg of sumamed.
• It is undesirable to take sumamed in case of impaired glucose tolerance (only for suspension), interruptions in heart rate, myasthenia gravis, low potassium in the blood.

The price of sumamed depends on the manufacturer - Israel or Croatia. For example, capsules and tablets from the Israeli company Teva cost about 450 rubles. The packages contain 6 capsules or tablets, which is enough for the entire course of treatment. Lyophilized powder for the preparation of an injection solution of 500 mg No. 5 costs 1500–1800 rubles. A suspension of 200 mg costs about 450-500 rubles.

Ceftriaxone

This drug belongs to powerful antibacterial agents, toxic. Shows high antibacterial activity, resistant to beta-lactamases. Ceftriaxone is used only for complicated infections, when its other "colleagues" could not overcome the bacterium that caused the disease.

The drug is used only for intramuscular and intravenous administration. The drug is produced in vials (0.5, 1.0 and 2.0 grams), where ceftriaxone is placed in the form of sodium salt.

• The spectrum of application of ceftriaxone completely covers infectious diseases all organs and systems. These are pneumonia, sepsis, meningitis, severe tonsillitis, syphilis, peritonitis, otitis media and other pathologies.
• Do not use ceftriaxone with individual intolerance to the composition, renal and hepatic insufficiency, elevated bilirubin to high numbers, during the neonatal period, as well as in premature babies.
• Unfortunately, even when the right doses are observed, ceftriaxone often causes adverse reactions. Literally 3-4 days after the start of the injection, skin rashes with severe redness can be observed. In children, such rashes “love” the buttocks area.

The addition of candidiasis is also noted, the liver indicators of ALT and AST are often increased in biochemical analysis blood. For a detailed list of possible adverse reactions, please read official instructions to the medium in question.

Important! Intramuscular injections of ceftriaxone are performed on lidocaine, because. the drug causes severe pain when administered. Before the first injection, it is necessary to conduct an allergy test for lidocaine, so that, God forbid, the patient does not experience severe complications in the form of Quincke's edema during the administration of the drug. If the patient is allergic, the drug can be administered intravenously, then pain will not be felt, and lidocaine will not be needed.

Ceftriaxone is produced both in the post-Soviet space and abroad, so price fluctuations will depend on the brand. Russian ceftriaxone (1 bottle) costs about 25 rubles. Russian pharmacies have Ukrainian, Indian, Portuguese and Chinese ceftriaxone.

The success of the treatment of pneumonia depends on the timely detection of the bacterium or virus that caused it. But, unfortunately, this is not always easy to do. The absence of sputum does not reveal the infection, i.e. there is no material for bakposev.

Viral and fungal pneumonia are more difficult to determine, and it all depends on the experience of the doctor. As antiviral therapy for pneumonia, drugs such as zanamivir, arbidol, oseltamivir can be used.

Medicines for pneumonia that do not contain antibacterial agents

As we already know, the lion's share of treatment for pneumonia falls on antibiotics (prescribe injections or pills). It is antibacterial agents that destroy the negative microflora that violates the imbalance in the body. Against the background of the development of pneumonia, the patient has a lot of concomitant symptoms - a cough, chest pain, sputum, increased heart rate, fever, and others.

To alleviate the patient's condition during illness, one has to resort to antibiotic therapy and add drugs that, in combination, will help get rid of pneumonia faster (that is, an individual treatment regimen is selected).

1. As expectorants, lazolvan, ACC, bromhexine, broncholithin, pertussin, licorice root (syrup) are suitable.
2. Bifido and lactobacilli, such as bifidumbacterin, hilak, Canadian yogurt and others, are used to maintain the intestinal microflora.
3. Antibacterial agents are always prescribed under the guise of antihistamines (loratadine, claritin, tavegil, fenistil, zodak).
4. To reduce body temperature, antipyretic drugs should be used: panadol, nurofen, acetylsalicylic acid, analgin.

To raise the body's defenses, immunomodulators and vitamins are recommended. For their appointment, you need to consult an immunologist. According to patients, homeopathic therapy gives good results in restoring strength during the rehabilitation period.

After a decrease in body temperature below 37.3 degrees, inhalations can be carried out with anti-inflammatory, bronchodilator and expectorant drugs:

• decasan,
• salbutamol,
• ambroxol.

During the rehabilitation period, physiotherapy is indicated. Oxygen therapy and special exercises for the lungs will help improve breathing function and relieve shortness of breath.

Diet therapy remains an important factor in recovery. Patients should limit all non-natural foods, as well as foods high in fat, acids, spices and sugar. The diet must include dairy products, vegetables, fruits, lean meats, fish, cereals, fortified drinks.

To cleanse the liver and kidneys from drug toxins, it is recommended to increase the drinking regimen (at least 1.5–2 liters per day).

Folk remedies for pneumonia

Of course, home treatments are only an addition to the main therapy, or are used in cases where for some reason there is no access to pharmaceutical preparations. Despite its safety and availability, any combination of folk and chemical remedies should be agreed with the doctor.

Decoction for bronchitis and pneumonia

• coltsfoot;
• dried raspberries;
• oregano.

All components are taken in equal proportions. For 3 tablespoons of the mixture, you need to take 300 ml of boiling water, leave for 40 minutes. Strain, divide the infusion into six doses and drink during the day.

Figs with milk

Compound:

• figs (yellow or green fruits) - 4 pieces;
• milk - a large mug (250-300 ml).

Pour milk over figs and cook over low heat for 10 minutes. If fresh fruits are not available, use dried figs of any variety. After cooking, the mixture should cool down to about 35-40 degrees. The resulting broth does not need to be filtered. We divide it into two parts and drink between meals.

Oats + raisins + honey

• raisins and oats - 20 grams each;
• water - 1000 ml;
• honey - 10 ml.

Pour raisins and oats with a liter of boiling water. When the water in the saucepan becomes half as much, turn off the fire. Let the broth cool, then strain. In the resulting broth, add a tablespoon of honey (10 ml). We take 10-20 ml up to five times a day, so for 20 days.

Propolis tincture

Propolis is an effective bactericidal and anti-inflammatory agent. It enhances the action of antibacterial agents and anti-tuberculosis drugs. You can take propolis tincture in cases where the patient is not allergic to bee products.

• For pneumonia, 20% propolis tincture is used (purchased from beekeepers or at a pharmacy). Take 25 drops of tincture three times a day. Before use, dilute the drops in 10–20 ml of boiled water or milk. Drink only before meals for 30 minutes.
• The course of propolis treatment is long, about 45 days. Even if the pneumonia receded quickly, continue the course of treatment anyway. This will enable immune system recover and reduce the risk of recurrence of the disease.

The dose of propolis in pediatrics is calculated as follows: 1 year - 1 drop of propolis per 100 ml of liquid (water or milk).

Propolis tincture is recommended to be used as a rubbing agent before going to bed. The back and chest in the region of the bronchi are rubbed for one minute, a natural shirt is put on, and then immediately to bed and under the covers.

Hazelnuts with red wine

Peeled nuts (20-30 grams) pour 200 ml of dry red wine (it is better to take homemade). Mix the mixture over low heat for no more than 20 minutes. Take 20 minutes before meals.

Conclusion

Manifold medications sometimes leads to a dead end even doctors. It should be noted that pulmonology hospitals have vast experience in the treatment various kinds pneumonia. Apply modern medicines from pneumonia and developed methods. The patient is around the clock under the attention of doctors. Treatment is carried out under the control of diagnostic methods.

You should not treat pneumonia on your own, there is a high risk of not curing the disease, and becoming a hostage chronic forms this pathology. Remember, you can quickly get rid of pneumonia, literally within 5-7 days, with a competent and professional approach. If you are offered to go to the hospital and be treated, do not refuse, a week in a hospital bed, and you are healthy! Take care of yourself and your loved ones!

Content

Inflammation of the lungs or pneumonia is most dangerous disease during which inflammation of the lung tissue occurs. The process leads to an imbalance of oxygen metabolism in the body, which in a neglected form dramatically increases the risk of developing blood poisoning and other life-threatening conditions. Pneumonia is caused by pathogenic microbes. This reason necessitates drug therapy that can kill the infection.

What are antibiotics for pneumonia in adults

A fundamental part of the fight against pneumonia are antibiotics that can destroy the pathogen and suppress its ability to reproduce. Otherwise, the disease can cause irreparable damage to the body in the form of complications and even cause death. The duration of treatment depends on the stage of neglect of pneumonia and the patient's immunity. The extracellular form of the pathogen can be killed in 7 days, the intracellular form in 14, and it can take 50 days to treat a lung abscess.

General principles of appointment

Antibiotics are the main means of treatment aimed at eliminating the cause of the disease, which is the presence of pathogenic microflora. The main principle of their treatment is the correct selection of the form, which determines the method and the factor of the continuity of the drug in the blood and sputum. in a good way Injections are considered, as the antibiotic is delivered directly to the location of pathogens, which minimizes the impact on the gastrointestinal tract.

In this case, oral administration is more accessible. Rules for the use of antibacterial agents:

• after the diagnosis is made, medication should be started immediately;
• first-line antibiotics are those that belong to the penicillin group;
• if the disease is severe, then more than effective remedy(when a pathogen is detected);
• in initially severe cases, therapy with two drugs begins immediately - it is recommended to use penicillin with erythromycin, monomycin or streptomycin, as well as tetracycline with oleandomycin and monomycin;
• more than two drugs on an outpatient basis at the same time is not recommended;
• small doses are not recommended so that microbes do not develop resistance;
• long-term use of antibiotics (more than 6-10 days) leads to the development of dysbacteriosis, which necessitates the use of probiotics;
• if treatment requires taking medications for more than three weeks, then it is necessary to provide for a 7-day break and further use of nitrofuran preparations or sulfonamides;
• the course is important to complete even with the disappearance of negative symptoms.

What antibiotics to take for pneumonia

More often, doctors prescribe antibiotics for pneumonia in adults from the following effective drug groups:

1. Penicillins: Carbenicillin, Augmentin, Amoxiclav, Ampicillin, Piperacillin.
2. Cephalosporins: Ceftriaxone, Cephalexin, Cefuroxime.
3. Macrolides: Clarithromycin, Erythromycin, Azithromycin.
4. Aminoglycosides: Streptomycin, Gentamicin, Tobramycin.
5. Fluoroquinolones: Ciprofloxacin, Ofloxacin.

Each of these groups differs from others in the breadth of the spectrum of application, duration and strength of exposure, side effects. To compare drugs, study the table:

When prescribing antibiotics to treat pneumonia in adults, physicians should pay attention to drug compatibility. So, for example, you can not simultaneously take medications of the same group or combine Neomycin with Monomycin and Streptomycin. At the initial stage, until the results of the bacteriology study are obtained, broad-spectrum drugs are used, they are taken in the form of continuous therapy for three days. Further, the pulmonologist may decide to change the medication.

In severe cases, a combination of Levofloxacin and Tavanic, Ceftriaxone and Fortum, Sumamed and Fortum is recommended for adults. If patients are under 60 years old and have a mild degree of pneumonia, then for five days they take Tavanic or Avelox, up to two weeks - Doxycycline, for 14 days - Amoxiclav, Augmentin. It is impossible to prescribe antibacterial agents on your own, especially for the elderly.

Community form

Community-acquired pneumonia in adults is treated with macrolides. Sometimes drugs based on clavulanic acid, sulbactam, penicillins, cephalosporins of 2-3 generations in combination with macrolides are prescribed. In severe cases, carbapenems are indicated. Description of several drugs:

1. Amoxicillin - capsules and suspension based on the component of the same name from the group of semi-synthetic penicillins. Principle of action: inhibition of the synthesis of the cell wall of the flora. Reception is contraindicated in case of intolerance to the components and infectious mononucleosis high gravity. Dosage: 500 mg three times / day.
2. Levofloxacin - tablets based on levofloxacin hemihydrate, which blocks the synthesis of DNA in microbial cells and disrupts their cytoplasmic and cellular membrane barriers. They are contraindicated in tendon lesions, under the age of 18, during pregnancy and lactation. Dosage: 500 mg 1-2 times / day for 7-14 days.
3. Imipenem is a beta-lactam carbapenem available as an injectable solution. It is used in the form of droppers or intramuscular injections. Dosage: 1-1.5 g per day in two divided doses. The duration of the droppers is 20-40 minutes. Contraindications: pregnancy, age up to three months for intravenous and up to 12 years for intramuscular injection, severe renal failure.

Aspiration

Antibacterial agents for the treatment of aspiration-type pneumonia should include clavulanic acid, amoxicillin, vancomycin-based aminoglycosides. In severe cases, third-generation cephalosporins are indicated in combination with aminoglycosides, metronidazole. Description of medicines:

1. Augmentin - tablets based on amoxicillin trihydrate and clavulanic acid in the format of a potassium salt. Included in the group of penicillins, inhibits beta-lactamase. Reception: 1 tablet 875 + 125 mg twice / day or tablet 500 + 125 mg three times / day. For children, the suspension format is shown (tablet dissolves in water). Contraindications: jaundice.
2. Moxifloxacin is an antimicrobial solution and tablets from the fluoroquinolone group. Contain moxifloxacin hydrochloride, contraindicated in pregnancy, lactation, under the age of 18 years. Dosage method: once / day intravenously 250 ml for an hour or orally 400 mg / day for 10 days.
3. Metronidazole is a solution for infusions or tablets based on the component of the same name. The 5-nitroimidazole derivative inhibits the synthesis of bacterial nucleic acids. Contraindications: leukopenia, impaired coordination, epilepsy, liver failure. Dosage: 1.5 g/day in three weekly doses as tablets.

Nosocomial

Pneumonia of the nosomial type is treated with the use of 3-4 generation cephalosporins, Augmentin. In severe cases, the use of carboxypenicillins in combination with aminoglycosides, 3rd generation cephalosporins or 4th generation in combination with aminoglycosides is indicated. Popular drugs:

1. Ampicillin tablets and capsules contain ampicillin trihydrate, which inhibits bacterial cell wall synthesis. Contraindicated in mononucleosis, lymphocytic leukemia, liver dysfunction. It is indicated to use 250-500 mg 4 times / day orally or 250-500 mg every 4-6 hours intramuscularly or intravenously.
2. Ceftriaxone powder for injection contains ceftriaxone disodium salt. Inhibits the synthesis of the cell membrane of microorganisms. Contraindicated for use in the first three months of pregnancy. Average daily dose: 1-2 g once/day or 0.5-1 g every 12 hours. It is used intramuscularly and intravenously in a hospital.
3. Tavanic - tablets and solution for infusions based on levofloxacin. Included in the group of fluoroquinolones, have a broad antimicrobial effect. Contraindicated in epilepsy, tendon disorders, lactation, childbearing, under 18 years of age, with heart disease. Method of application: 250-500 mg tablets 1-2 times / day or in the early stages intravenously 250-500 mg 1-2 times a day.

Mycoplasma

This form of the disease is atypical, manifested by nasal congestion, myalgia, sore throat, headache, paroxysmal cough, general weakness. The disease is treated for at least 14 days, during the first 48-72 hours intravenous solutions are used. Apply drugs from the group of macrolides:

1. Clarithromycin is a semi-synthetic macrolide tablet based on clarithromycin. Suppresses protein synthesis of the bacterial ribosome, leading to the death of the pathogen. Contraindicated in pregnancy, lactation, up to 12 years, in combination with ergot preparations. Dosage: 250 mg twice a day for a week.
2. Sumamed is a solution for infusions, tablets, capsules and powder for oral administration from the group of azalide macrolides. They inhibit protein synthesis by bacteria, have a bactericidal effect. Contraindications: disorders of the liver and kidneys. Method of use: once a day, 500 mg once a day for a course of three days.
3. Rovamycin - tablets based on spiramycin, are included in the group of macrolides. They act bacteriostatically, disrupting protein synthesis inside the cell. Contraindicated in lactation. Dosage: 2-3 tablets in 2-3 doses/day

Treatment of pneumonia caused by Klebsiella

The disease caused by Klebsiella (microorganisms found in the human intestine) develops against the background of impaired immunity and leads to the development of a pulmonary infection. On initial stage in adults, aminoglycosides, 3rd generation cephalosporins are used for 14-21 days. Medicines are used:

1. Amikacin - powder for the manufacture of a solution administered intravenously and intramuscularly, contains amikacin sulfate. The semi-synthetic antibiotic aminoglycoside acts bactericidal, destroying the cytoplasmic barrier of the cell. Contraindicated in severe renal chronic insufficiency, acoustic neuritis, pregnancy. Dosage: 5 mg/kg body weight every 8 hours. In uncomplicated infections, the administration of 250 mg every 12 hours is indicated.
2. Gentamicin is an aminoglycoside in the form of an injection solution containing gentamicin sulfate. Violates protein synthesis of the cell membrane of microorganisms. Contraindicated in case of hypersensitivity to components. Method of application: 1-1.7 mg/kg of body weight 2-4 times/day intravenously or intramuscularly. The course of treatment lasts 7-10 days.
3. Cephalotin is a first-generation cephalosporin antibiotic that acts by destroying the cell walls of bacteria. Solution for parenteral administration based on cephalothin. Contraindications: hypersensitivity to ingredients, beta-lactam antibiotics. Dosage: intravenously or intramuscularly, 0.5-2 g every 6 hours. With complications, the introduction of 2 g every 4 hours is indicated.

For congestive pneumonia

Antibiotics for inflammation of the lungs of a congestive type are prescribed from the group of cephalosporins, sometimes macrolides are prescribed. Congestive pneumonia in adults is a secondary inflammation of the lungs that occurs due to stagnation in the pulmonary circulation. In the risk group for its development, patients with atherosclerosis, hypertension, ischemia, emphysema, somatic diseases. Medicines are used for 14-21 days:

1. Tsifran - antimicrobial tablets from the group of fluoroquinolones based on ciprofloxacin hydrochloride monohydrate and tinidazole. Penetrates through the bacterial wall, acting bactericidal. Contraindications: pregnancy, lactation, age up to 12 years. Dosage: 500-750 mg every 12 hours before meals.
2. Cefazolin is a powder for the preparation of a parenteral solution. Contains sodium salt of cefazolin, a first-generation semi-synthetic cephalosporin antibiotic. The drug acts bactericidal, contraindicated in pregnancy, under the age of 1 month. Method of use: intramuscularly or intravenously 0.25-1 g every 8-12 hours. In severe cases, the introduction of 0.5-1 g every 6-8 hours is indicated.
3. Targocid - lyophilized powder for injection, contains teicoplanin, which has antimicrobial and bactericidal effects. Blocks the synthesis of the cell wall and inhibits the growth of bacteria, their reproduction. Contraindications: hypersensitivity to beta-lactam antibiotics. Dosage: intramuscularly or intravenously on the first day, 400 mg, then 200 mg once a day.

Antibiotics in tablets

The most popular format for taking medications are tablets. They should be taken during or after meals, washed down with water. Popular drugs:

1. Erythromycin is a macrolide antibiotic containing erythromycin. Violates the formation of peptide bonds between the amino acids of bacteria, causing their death. Contraindicated in hearing loss, lactation, up to 14 years. Dosage: 0.25-0.5 g every 4-6 hours.
2. Moxifloxacin is a bactericidal tablet from the group of fluoroquinolones based on moxifloxacin hydrochloride. They block the enzymes responsible for the reproduction of bacterial DNA. Contraindications: age under 18, pregnancy, lactation. Method of use: 400 mg once / day for 10 days.

dropper

In the early days of an exacerbation of pneumonia in adults, doctors advise administering antimicrobial agents parenterally (intravenous drip or jet), and after relief, transfer the patient to tablets. Popular solutions for droppers are:

1. Amoxiclav - contains potassium clavulanate and amoxicillin trihydrate, is available in powder format for the preparation of an intravenously administered solution. The combination of active substances of the drug provides bactericidal activity. Jaundice, liver dysfunction become contraindications for taking the solution. Dosage: 30 mg/kg in two divided doses for 5-14 days.
2. Meropenem - antibacterial agent from the group of carbapenems, has a bactericidal effect by inhibiting the synthesis of the bacterial cell wall. Contraindicated in hypersensitivity to beta-lactams, under the age of three months. Dosage: 500 mg every 8 hours (intravenous bolus 5 minutes or intravenous infusion 15-30 minutes).

Strong antibacterial agents

In severe pneumonia in adults, doctors prescribe strong antimicrobial agents to patients. The most requested are:

1. Avelox - tablets based on moxifloxacin hydrochloride, are included in the group of fluoroquinolones, act bactericidal. Contraindications: severe diarrhea. Dosage: 400 mg once/day for 10 days.
2. Ospamox is a powder for the preparation of a suspension based on amoxicillin. Included in the group of penicillins, has a quick effect. Contraindicated in infectious mononucleosis, individual lymphocytic leukemia. Dosage: 1.5-2 g / day in 3-4 doses for a course of 2-5 days.

New generation

The latest generation of antibiotics for pneumonia in adults is characterized by broad activity, a minimum side effects and fast effect, maximum safe action. Popular medicines:

1. Furazolidone - antimicrobial tablets from the group of nitrofurans, contain destructive furazolidone, which suppresses the Krebs cycle in bacteria - this leads to their death due to suppression of the respiratory process. Contraindications: age up to 3 years. Dosage: inside after eating tablets with a concentration of 110-150 mg 4 times / day for a course of 5-10 days. At the time of treatment, monitoring of vital signs is necessary.
2. Remedia - tablets based on levofloxacin hemihydrate from the fluoroquinolone group, block the DNA of a microbial cell. Contraindications: epilepsy, history of tendon damage, pregnancy, lactation, allergic reactions. 500 mg are taken 1-2 times / day for a course of 2 weeks.

Treatment regimen

When prescribing therapeutic therapy, the belonging of pathogens to one or another classification series is taken into account. General principle is that the antibiotic should be effective against staphylococcus aureus, pneumococcus, Haemophilus influenzae. When prescribing a treatment regimen for children, a group of aminopenicillins (ampicillin, amoxicillin) is taken as the basis.

If there is a suspicion that bacterial strains producing beta-lactamases are the cause of the inflammatory process, then inhibitor-protected penicillins (drugs with a complex of clavulanic acid and amoxicillin) are used as treatment. Augmentin is acceptable for use, both for adults and for children. If patients (children and adults) used ampicillin or amoxicillin for treatment, then Augmentin, Amoxiclav, Flemoklav, Klaforan are often prescribed.

Antibiotics for pneumonia for adults from the group of macrolides (spiramycin, azithromycin, lincomycin and clarithromycin) are prescribed when a patient is allergic to cephalosporins and penicillins, when diagnosing atypical pneumonia (mycoplasmal, chlamydial, legionella). In addition, for the treatment of SARS, doxycycline (a new generation drug) has good efficacy. Prolonged bronchopneumonia is successfully treated with beta-lactam antibiotics (cephalosporins and penicillins)

Price

You can buy antibiotics for pneumonia in adults by prescription from a doctor. You should not prescribe them on your own, only after outpatient tests. You can order drugs in the pharmacy catalog or buy inexpensively in the online store. The cost of the most popular drugs in Moscow pharmacies is shown in the table:

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