AMOKLAVIN BID

Indications for use

Bacterial infections caused by susceptible pathogens: Upper respiratory tract infections (bronchitis, pneumonia, pleural empyema, lung abscess), ENT organ infections (sinusitis, tonsillitis, otitis media), biliary tract infections (cholangitis, Cholecystitis), intestinal infections (dysentery, salmonellosis, salmonella carrier), infections of the urogenital system and the pelvic organs (pyelonephritis, pyelitis, cystitis, Urethritis, prostatitis, cervicitis, salpingitis, salpingo-oophoritis, tuboovarian abscess, endometritis, bacterial vaginitis, septic abortion, postnatal sepsis, penile peritonitis, soft chancre, gonorrhea), skin and soft tissue infections (rye, impetigo, secondary infected dermatoses, abscess, phlegmon, wound infection), osteomyelitis, endocarditis, meningitis, sepsis; peritonitis, postoperative infections, prevention of infections in surgery. Amoklavin Bid indications. An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol.

Active ingredient, group

Amoxicillin+Clavulanic acid, Antibiotic, semisynthetic penicillin+beta-lactamase inhibitor

Dosage form

Lyophilisate for preparation of solution for intravenous injection, powder for preparation of drops for oral administration [for children] with concentration, powder for preparation of solution for intravenous injection, powder for preparation of suspension for p.

Contraindications

Hypersensitivity (including to cephalosporins and other beta-lactam antibiotics), infectious mononucleosis (including the appearance of a skin-like rash). Pregnancy, lactation, severe hepatic insufficiency, gastrointestinal diseases (including colitis in the history associated with the use of penicillins), CPP.

How to use: dosage and course of treatment

Oral (doses are given in terms of amoxicillin), the dosing regimen is established individually depending on the severity of the course and localization of the infection, the sensitivity of the pathogen. Adults and adolescents over 12 years are prescribed 250 mg three times a day. In severe course of infections, 500 mg 3 times a day or 1 g 2 times a day.

Children under 12 years of age are prescribed in the form of suspension, syrup or drops for oral administration 3 times a day. The single dose is adjusted according to age: for children aged 7-12 years – 250 mg, 2-7 years – 125 mg, 9 months-2 years – 62.5 mg, the frequency of prescription – 3 times a day. In severe cases, doses may be doubled. Oral doses for children 9 months-2 years of age – 20-40 mg/kg/day in 3 doses, for children 2-12 years – 20-50 mg/kg/day in 3 doses, depending on the severity of the infection.

For children under 9 months of age, the dosage for oral administration has not been established. When preparing suspension, syrup and drops, water should be used as a solvent.

When administered by injection in adults and adolescents over 12 years old 1.2 g 3 times daily, if necessary – 4 times daily. Maximum daily dose is 6 g. For children aged 3 months to 12 years, 25 mg/kg (30 mg/kg for the entire drug) 3 times a day; in severe cases – 4 times a day; for children under 3 months: premature and in the perinatal period – 30 mg/kg 2 times a day, in the post-perinatal period – 25 mg/kg 3 times a day.

The duration of treatment is up to 14 days.

For prevention of postoperative infections during surgeries lasting less than 1 hour, during anesthesia a dose of 1.2 g is administered v/v. In case of longer operations 1.2 g every 6 hours during the day. If there is a high risk of infection, administration may be continued for several days.

In CKD, the number of injections is reduced depending on the CK rate. In case of CKD more than 30 ml/min there is no need to reduce the dose; in case of 10-30 ml/min the treatment is started with 1.2 g by IV, then 600 mg by IV or 250-500 mg orally twice a day; in case of KKD less than 10 ml/min – 1.2 g, then 600 mg/day by IV or 250-500 mg/day orally in one course. For children, doses should be reduced in the same manner.

Hemodialysis reduces serum concentrations; therefore, during and at the end of dialysis, an additional 500 mg v/v is administered.

Pharmacological action

Amoklavin Bid indications. An indication is a term used for the list
Amoklavin Bid indications. An indication is a term used for the list

Pharmacological deaCombination of amoxicillin and clavulanic acid – beta-lactamase inhibitor. It acts bactericidally, inhibits the synthesis of the bacterial wall.

Active against aerobic gram-positive bacteria (including strains producing beta-lactamases): 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 beta-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 (previously Pasteurella), Campylobacter jejuni;

anaerobic gram-negative bacteria (including beta-lactamase-producing strains): Bacteroides spp.

Clavulanic acid inhibits types II, III, IV and V beta-lactamases, it is inactive against type I beta-lactamases produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has a high tropism to penicillinases, due to which it forms a stable complex with the enzyme, which prevents enzymatic degradation of amoxicillin under the influence of beta-lactamases.

Side effects

Digestive system: nausea, vomiting, diarrhea, liver dysfunction, increased liver transaminase activity, in single cases – cholestatic jaundice, hepatitis, pseudomembranous colitis.

Allergic reactions: urticaria, erythematous rash, rarely – erythema multiforme, anaphylactic shock, angioedema, very rare – exfoliative dermatitis, erythema malignant exudative (Stevens-Johnson syndrome).

Local reactions: in some cases – phlebitis at the site of intravenous injection.

Others: candidiasis, development of superinfection, reversible increase in prothrombin time. Symptoms: abnormal gastrointestinal function and water-electrolyte balance.

Treatment: symptomatic. Hemodialysis is effective.

Special Directions

During the course of treatment it is necessary to monitor the hematopoietic, hepatic and renal function.

In order to reduce the risk of gastrointestinal side effects, the drug should be taken with food.

Superinfection may develop due to growth of microflora insensitive to it, which requires appropriate changes in antibiotic therapy.

When administered to patients with sepsis, bacteriolysis reaction (Jarisch-Herxheimer reaction) may develop.

In patients with hypersensitivity to penicillins, cross-allergic reactions with cephalosporin antibiotics are possible.

Since tablets – combinations of amoxicillin and clavulanic acid of 250 and 500 mg contain the same amount of clavulanic acid (125 mg), 2 tablets of 250 mg are not equivalent to 1 tablet of 500 mg.

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