Amoxiclav is a popular drug from the category of antibiotics. It is often appointed with therapists and pediatricians in the treatment of chronic infectious diseases. What are the medical features of Amoxiclava, what are his contraindications, and how to apply it correctly?

Composition and pharmacological action Amoxiclava

Amoxiclav consists of two main components. First of all, it is a semi-synthetic penicillin - amoxicillin, as well as clavulanic acid. Each component has its own function. Amoxicillin refers to the number of antibiotics, but clavulanic acid does not have a noticeable antibacterial effect. What then is her appointment?

As you know, it is one of the first antibiotics, obtained in the middle of the last century. During its use, they showed their high efficiency. But at the same time, many bacteria managed to develop resistance to them. What way does the protection of bacteria against antibacterial drugs work?

Amoxicill affects cell shell Bacteria tying one of the enzymes included in its composition. As a result, the cell wall loses its strength, and the bacterium is destroyed. However, many types of bacteria began to produce special substances - beta lactamases that block the effect of antibacterial agents. Thus, amoxicillin has become displaced for most bacteria.

Clawulanic acid is designed just to combat beta lactamases. Binding to amoxiciline, it makes its molecules immune to beta lactamases. This effect is manifested in relation to most types of beta lactamas produced by bacteria.

Thus, the use of a combination of amoxicillin and clavulanic acid allows you to expand the spectrum of antibacterial activity, compared with pure amoxicillin. If amoxicillin can only affect a limited number of bacteria that are not capable of producing beta-lactamases, then amoxicillin, connected to clavulanic acid, is active against most bacteria causing infectious diseases. Among bacteria that can destroy the drug, both gram-positive and gram-negative bacteria.

The main types of amoxiclava sensitive bacteria:

• streptococci
• staphylococci
• shigella
• klebsiella
• brucella
• echinococci,
• helicobacter
• klostridia,
• hemophilic stick
• salmonella
• proteus.

Bacteria resistant to amoxiclava:

• enterobacter
• pseudomonada
• chlamydia
• mycoplasma,
• legionella,
• iracinia

and some others.

Pharmacokinetics

Amoxiclava components are well absorbed into the blood and are evenly distributed in the main tissues and liquid media of the body, which ensures the universal therapeutic effect of the drug. In this case, the components do not penetrate through the hematostephalic barrier. However, the substances included in the amoxiclava can penetrate the placental barrier during pregnancy and in small quantities go into breast milk in nursing women. Amoxicillin is weakly metabolized and excreted almost unchanged through the kidneys. In contrast, clavulanic acid turns into metabolites, which are derived from the body with urine. The period of removal of half of the components with healthy kidneys is 1-1.5 hours. The drug can also be output from the body with hemodialysis.

Medium pharmacokinetic indicators

Form release

Amoxiclav is mainly produced in tablet form. There are two varieties of this form. The main is tablets coated with film shell, intended for swallowing and dissolving in the intestine. There are also instant tablets, resolved in the mouth. You can also purchase a preparation in the form of a suspension (powder requiring dilution), and in bottles containing a powder from which a solution can be prepared for intravenous administration.
Amoxiclava tablets may have the following dosage:

• 250 mg +125 mg,
• 500 mg +125 mg,
• 875 mg +125 mg.

The first figure denotes the dosage of amaxicillin, and the second - clavulanic acid. The drug is produced by the Slovenian pharmaceutical company LEK.

A 500/1000 mg of amoxicillin (100/200 mg of clavulanic acid, respectively) can be in powder for preparing a solution of amoxiclava for intravenous administration (100/200 mg of clavulanic acid, respectively). Powder dosage options for the preparation of amoxiclava suspension - 125, 250 and 400 mg (amoxicillin). The suspension medicine is recommended to use for the treatment of children under 12, although its use and adults are not excluded. Assembly, instant pills amoxyclav Kviktab 875 mg +125 mg are also available.

Indications of the drug Amoxiclav.

The sphere of use of amoxicillin and clavulanic acid includes the treatment of various infectious diseases, whose causative agents are bacteria. But most often this combination is prescribed in the treatment of sharp respiratory diseases. Amoxiclav reduces the severity of the symptoms of the disease and reduces its duration.

Under which infections are the use of the drug:

• top and lower diseases respiratory tractlungs;
• urological, andrological and gynecological diseases;
• skin diseases caused by bacterial infection;
• infection connecting I. bone tissue;
• infectious cholecystitis and cholangitis.

Bacterial diseases of the respiratory organs in which the drug can be appointed:

• pharyngitis,
• tonsillitis,
• laryngitis,
• rhinitis,
• hymorite
• sinusitis,
• pneumonia,
• pleurisy,
• bronchitis,
• tracheitis.

Bacterial infections of urination and genital organs, in which the use of the drug is possible:

• pyelonephritis
• urethritis,
• prostatitis,
• adnexitis
• endometritis,
• salpingitis.

Contraindications

The drug has few contraindications. Amoxiclave can be treated for children, including both breasts. For infants, you can use a suspension and a solution for intravenous administration. Can use preparation and pregnant women (under the control of the doctor). The main contraindication for the reception of amoxiclava is the intolerance to the preparations of the penicillin group, as well as cephalosporins and other betelactam antibacterial agents. Also, it is impossible to take amoxiclave to persons suffering from severe forms of hepatic insufficiency, infectious mononucleosis and lympholoicosis, those who have previously led amoxicaline to the development of cholestatic jaundice.

Reception of the drug also depends on the patient's kidney condition. People with renal failure (having creatinine clearance below the norm) should be prescribed smaller doses of amoxiclava compared to the usual.

Correction of doses for renal failure

Patients located on hemodialysis are assigned a tablet 500 + 125 mg 1 time per day or 2 tablets 250 + 125 mg 1 time per day. In addition, it is accepted on a tablet 500 + 125 or 2 tablets 250 + 125 mg mg during dialysis.

Children under 12 do not prescribe the tableted forms of amoxiclava. For them, it is preferable to use a suspension.

The use of amoxiclava during pregnancy and breastfeeding

Amoxiclav is prescribed with caution during pregnancy. Its use is possible in cases where the potential benefit for the mother is higher than that harm, which can be applied to a developing fetus. When lactation, the drug can also be used. However, if it becomes necessary to use amoxiclav at breastfeeding, it is recommended to pre-consult with your doctor.

Side Effects Amoxiclava

The drug is good tolerability, and side effects When receiving amoxiclava, infrequently appear. The most common side effects associated with the gastrointestinal tract. Like any antibiotic, amoxiclav destroys not only pathogenic organisms, but also the normal intestinal microflora. Therefore, with a long-term course of treatment with amoxiclav, phenomena associated with dysbacteriosis - dyspepsia, nausea, abdominal pain.

Candidosis can develop on the skin, mucous membranes and in the oral cavity - the damage to the fungi of the genus candidate. Side effects associated with dysbacteriosis are the most common when receiving amoxiclava. Also, against the background of the amoxiclava, many women may have candidomic colpit (thrush).
Another group of amoxiclary side effects - allergic reactions. They can manifest, for example, in the form of rash on the skin, urticaria, dermatitis. In this case, it is recommended to stop taking the drug and consult with the doctor. It is extremely rare due to amoxiclava taking, anaphyactic shock may appear.

When using amoxiclava, the side effects associated with violation of the liver functions can appear - cholestatic jaundice and hepatitis. These phenomena were most often observed in the elderly and men, especially with a long-lasting course of treatment.

There may also be other side effects: headaches, dizziness, insomnia, changes in the composition of blood (leukopenia, neutropenia, thrombocytopenia, agranulocytosis), anemia, changes in the urine (crystalluria, blood appearance), pseudomambranous colitis.

Overdose by amoxiclav

In clinical practice, it is not known an overdose cases that led to death. When taking the drug in doses, noticeably exceeding the instructions prescribed, may be observed:

• abdominal pain,
• diarrhea,
• vomiting
• excitation,
• anxiety,
• insomnia,
• dizziness.

Treatment with the overdose of amoxiclava is symptomatic, the reception of activated carbon, washing the stomach is shown.

Instructions for use

The dosage of amoxiclava may depend on many factors - the type of disease, its gravity, the age of the patient, the functionality of its kidneys, etc. Therefore, an infectious physicist or therapist should be appointed an accurate dose. Too low dose of amoxiclava can lead to the fact that bacteria will be immune to it and it will be able to develop resistance, and too high entails the risk of adverse events.

In case of infections leaking with low intensity, one pill is assigned to amoxiclava 250 + 125 mg three times a day or a tablet 500 + 125 twice a day. With severe diseases, 3 amoxiclava 500 + 125 mg per day or 2 tablets 875 + 125 mg per day can be assigned.

In one-hydrogen infections, it is usually assigned to a tablet 250 + 125 mg every 8 hours or a tablet 500 + 125 mg every 12 hours. The course of treatment is 5 days.

Children dose are prescribed, based on their weight. It should be remembered that for children it is preferable to use a suspension, not a pill. In case of infections occurring in light and medium form, it is recommended to apply a dose of 20 mg / kg of weight, with severe infections should be enlarged. Amoxiclava packaging is equipped with a special instruction that allows you to calculate the dose for children in various cases.

Powder for the preparation of suspension is produced in three versions.

Doses of active substances on 5 ml powder for suspension

Doses of suspension 125 + 31.25 mg for children

Doses of suspension 250 + 62.5 mg for children

Specified in the tables the volume of the drug needs to give a child 3 times a day

Doses of suspension 400 mg + 57 mg for children

The volume specified in the table must be given to the child 2 times a day

When selecting the desired dose, it is necessary to proceed from the mass of the body of the child, and not from age.

With insufficient kidney functionality, the dose should be adjusted. With a reduced clearance of creatinine (10-30 ml / min), the maximum dose of amoxiclava is one tablet 500 + 125 mg twice a day after 12 hours, with a clearance of less than 10 ml - this tablet can be taken no more than once every 24 hours.

The medicine should be taken through strictly certain intervals. Thus, if a reception of three tablets per day is assigned, they should be taken exactly after 8 hours, for example, at 8, 16 and 24 hours. If the drug is appointed twice a day, then the tablets should be taken after 12 hours. This method allows to maintain a constant concentration of the drug in the blood, as a result of which the efficiency of amoxiclava will be maximum.

The absorption of active substances into the blood is occurring regardless of meals, so amoxiclav can be taken before, after, and during meals, its effectiveness will not decrease. However, doctors still recommend taking tablets at the beginning of food. This will be reduced the likelihood of the emergence of unpleasant side effects associated with the gastrointestinal tract.

Patients over 12 years old and having a body weight more than 40 kg take the adult dose of suspension or tablets. Persons having kidney dysfunction associated with a decrease in creatinine clearance requires a dose correction.

The duration of treatment is 5-14 days. Exceeding this period requires special instructions of the attending physician. In the event of the ineffectiveness of treatment with the drug, it should be replaced. If the drug was prescribed, and the improvement of the state happened earlier than the course was completed, it should still be completed to the avoidance of relapses.

When using amoxiclav Kviktab, the tablet must be dissolved in water before use, or dissipate in the mouth.

Preparation of suspension

For the preparation of the suspension, you must vigorously shake the bottle with a powder and then add water to the label in two receptions. Each time the water is added, it is necessary to shake the bottle, in order for the suspension to have a homogeneous consistency.

Required water volume for the preparation of suspension of powder 400 / 57.5 mg

Analogs of the drug

The full structural analogues of amoxiclava include preparations containing amoxicillin and clavulanic acid, for example, Augmentin, Flemoclav Soluteab. Preparations containing alone amoxicillin will not be adequate replacement due to the fact that the list of microorganisms sensitive to pure amoxicillin is much less than that of amoxiclava. The same can be said about other preparations of the penicillin group - the sphere of their use may not coincide with the scope of amoxiclava.

Amoxiclava interaction with other substances and drugs

Amoxiclava efficiency is usually increased by simultaneously use with other bactericidal preparations. However, macrolides, tetracyclines, sulfonamides and other bacteriostatic means reduce the efficiency of the drug. Therefore, it is necessary to avoid simultaneous reception of the drug and bacteriostatic agents. It should also be remembered that the simultaneous reception of amoxiclava with hormonal contraceptives weakens the effect of the latter.

It is prohibited simultaneous admission of alcohol and amoxiclava, since it is possible negative impact on the liver and decrease in the effect of the drug.

Simultaneous reception of amoxyclava and methotrexate is also prohibited, since amoxiclav strengthens the toxicity of the latter. It is impossible to prescribe a drug simultaneously with disulfiram, as it increases the likelihood of allergic reactions. With simultaneous reception with Allopurinol, the risk of exploration is increased.

When taking a suspension or tablets in combination with oral anticoagulants, caution should be taken, since the drug is able to increase the prothrombin time.

Amoxiclav - antibacterial preparation of the penicillin group. This is a comprehensive means of a new generation, which has a powerful antimicrobial activity in relation to most pathogenic bacteria. Due to this, the medicine has an extensive scope of use, and is successfully used to treat many diseases. Read further about Amoxiclava, the forms of its release, from which it helps, side effects and contraindications.

Composition and action

Basic active ingredients - amoxicillin and clavulanic acid. The combination of these active substances ensures the pronounced therapeutic effect of the antibiotic. Thanks to clavulanic acid, amoxiclav can be assigned in infections resistant to amoxicillin.

The antibacterial drug has a pronounced bactericidal and bacteriostatic action for almost all types of streptococci (the exception is meticillin-resistant strains), sheets, echinococci. Sensitive to the drug and gram-negative bacteria: Klebseyella, Brucella, Moraxella, Salmonella, Gardnernella, Protoney, Clostridium and others.

The maximum antibiotic concentration is achieved after 1 hour after receiving the drug. Active substances, regardless of the introduction method, are rapidly distributed in the tissues and body fluids (middle ear, lungs, uterus, ovaries, peritoneal and pleural liquids, fat and muscle tissues, nasal sinuses, almonds, and so on).

The drug is excreted from the body through the kidneys (half-life during healthy kidneys - 1-1.5 hours). A small amount of Clavulanic acid metabolites is highlighted with exhaled air and cartoons.

The medicine does not penetrate through the shell of the brain and the cerebrospinal fluid, this feature significantly reduces the risk of unpleasant adverse reactions from the CNS.

Forms of release

• Amoxiclav tablets - 250 mm amoxicillin / 125 milligrams of clavulanic acid, 500 milligrams / 125 milligrams and 875 milligrams / 125 milligrams, respectively;
• tablets Amoxiclav Kviktab - 500 milligrams / 125 milligrams, 875 milligrams / 125 milligrams, dispersed pills;
• Amoxiclav for parenteral administration - powder for the preparation of a solution for administration to Vienna 600 milligrams (500 milligrams of amoxicillin and 100 milligrams of clavulanic acid) or 1.2 grams in a bottle (1000 milligrams of amoxicillin and 200 milligrams of clavulanic acid);
• powder for preparing the suspension - 125 milligrams of amoxicillin and 31.25 milligrams of clavulanic acid per 5 milliliters and 250 milligrams of amoxicillin and 62.5 milligrams of clavulanic acid per 5 milliliters.

Indications for use

• ENT infections and infectious diseases of the upper respiratory tract (cap abscess, pharyngitis, scarletin, medium otitis, tonsillitis, sinusitis, chronic and sharp sinusitis, laryngitis, tracheit, angina).
• Infection lower departments respiratory tract (bronchitis chronic and sharp, pneumonia).
• Biliary tract infections (cholangitis, cholecystitis).
• Urinary tract infections (cystitis, prostatitis, pyelonephritis, urethritis and others).
• Gynecological diseases of infectious origin (adnexitis, inflammation of appendages, endometritis and others).
• Ondogenic infections, including periodontitis.
• Venereological infections (syphilis, ureaplasm, gonorrhea, including provoked by gonococci).
• Shankroid.
• Infections of soft tissues and skin cover, including wound infections (furunculese and so on).
• Infections of joints and bones.
• Orthopedic practice.
• Infection lymphatic system (lymphadenitis and others).
• Mixed infections caused by gram-negative and gram-positive microorganisms, anaerobic pathogens (missile abscess, mastitis, postoperative abdominal infections, aspiration pneumonia).

Also, amoxiclav is used in dentistry (with flux, stomatitis, and so on) and for the prevention of purulent-septic complications surgical interventions on organs abdominal cavity, small pelvis, kidneys, bile ducts, heart muscle.

How to use

The exact meter mode is set by a doctor individually depending on the severity of the disease and the therapeutic effect. The duration of treatment with an antibiotic ranges from 5 to 14 days.

Pills

Take inside immediately before meal, swallowed by integer, not chewing and drinking water.

According to the instructions, adults and children with a body weight above 40 kilograms pathologies easy and medium gravity are prescribed 1 tablet (250 milligrams / 125 milligrams) every 8 hours (3 times a day) or 1 tablet (500/125 milligrams) every 12 hours (2 times a day); In case of severe, the disease is prescribed - 1 tablet 500 milligrams / 125 milligrams every 8 hours (three times a day) or 1 tablet 875 milligrams / 125 milligrams every 12 hours (twice a day).

Tablets Amoxiclav Kviktab

Before use, the tablet must be dissolved in 100-150 milliliters of water and stir well. Adults and children from 12 years old are prescribed 1 tablet (500 milligrams / 125 milligrams) 2-3 times a day; With severe conditions - 1 tablet (875 milligrams / 125 milligrams) twice a day.

Powder for parenteral use

To prepare a solution for intravenous administration, the contents of the bottle are dissolved in water for injection (for amoxiclava 600 milligrams - 10 milliliters; for amoxiclava 1.2 grams - 20 milliliters). Next, the resulting solution is administered intravenously slowly for 4-5 minutes.

If the medication needs to be introduced in the form of intravenous infusion, then 600 milligrams of drugs are dissolved in 10 milliliters of water for injections and add it to an infusion solution (50 milliliters). The antibiotic 1.2 grams is dissolved in 20 milliliters of water for injections and added to 100 milliliters of the infusion solution. Dripping drug is injected for 30-40 minutes. Does freeze funds.

Suspension

The bottle with a powder shake well, add warm boiled water (up to the label) in 2 clips, every time scattering until the powder is completely dissolved.

In pediatrics, newborn and infants up to 3 months prescribe a medicine at the rate of 30 milligrams per 1 kilogram of weight (daily dose), this quantity should be divided and given in 2 receptions at equal intervals.

From 3 months, the antibiotic is prescribed at a dose at the rate of 25 milligrams per 1 kilogram of body weight, it is also divided into 2 receptions. In case of infectious diseases of medium gravity, 20 milligrams per 1 kilogram of body weight are prescribed and divided it into 3 administration. In severe conditions, the dose increases - 45 milligrams per 1 kilogram of weight and divide it into 2 introductions per day.

Contraindications

• Lympholoicosis;
• infectious mononucleosis;
• cholestatic jaundice or hepatitis, resulting from the reception of antibacterial drugs of a group of penicillins;
• hypersensitivity to antibiotics of a group of cephalosporins, penicillins and other beta-lactam drugs;
• increased sensitivity to clavulanic acid or amoxicillin.

With caution, the medicine is prescribed with severe disorders of the renal function, renal failure and patients with pseudommabranous colitis in an anamnesis.

Side effects

• Allergic reactions: urticaria, itching, erythematous rash; In rare cases - angioedema edema, allergic vasculitis, anaphylactic shock, Stevens-Johnson syndrome, exfoliative dermatitis.
• From side digestive tract : Possible nausea, loss of appetite, diarrhea, vomiting; seldom - painfulness in the abdomen area, liver function disorders; In isolated cases, hepatitis, cholestatic jaundice can develop, pseudomembranous colitis.
• From side nervous system : headache, dizziness; Rarely - hyperactivity, insomnia, anxiety, convulsions (may be observed in patients with impaired kidney function when using medication in high doses).
• From the hematopoietic system: rare cases of reversible leukopenia (including neutropenia), thrombocytopenia; In isolated cases, hemolytic anemia, pancytopenia, eosinophilia, reversible increase in prothrombin time (while using anticoagulants simultaneously).
• From the urinary system: Rarely - crystalluria, interstitial jade.
• Others: Candidiasis.

During pregnancy

Antibacterial drug is not recommended to apply during pregnancy. Exceptions are cases where the benefits of treatment above are potentially harm to the fetus. Reception of amoxiclava during pregnancy increases the risk of developing necrotic colitis in newborns.

Undesirable to take the drug and lactation, since clavulanic acid and amoxicillin in small quantities stands out with breast milk. If the mother still prescribed treatment with medicine, it is worth canceting breastfeeding for a while. Otherwise, the child may appear diarrhea, allergic reactions, and so on.

For children

Children under 12 years and weighing less than 40 kilograms are prescribed an antibiotic in the form of a suspension. Recommended dosages are indicated above.

With alcohol

During medication therapy, alcoholic beverages are prohibited. Acceptance of alcohol significantly reduces the antibacterial effect of the drug and makes it difficult to eliminate through the kidneys.

Analogs

Substitutes for the active substance: amuoviclin, artlet, augmentin, amoxicillin + clavulanic acid, Bakoklav, Verklav, Claus, Liklav, Medoclaw, Panklaw, Ranclav, Rapiklav, Tomerentine, Flemoclav Solutab, Ecoclav.

Analogs of the mechanism of action:

Amoxicillin (Amoxicillin Sandoz, Amosin, Ecobol, Ranoxyl)

Release form - tablets, capsules, injection powder, suspension; Active substance - amoxicillin.

Bactericidal antibacterial preparation from a group of semi-synthetic penicillins. It has a wide range of action and is used for the treatment of bacterial infections: pneumonia, bronchitis, angina, urethritis, pyelonephritis, gonorrhea and other microorganisms caused by sensitive medicine.

The dosage is selected individually. For receiving inside adults and children from 12 years (or with a weight of more than 40 kilograms), 250-500 milligrams are prescribed, with a serious course of the disease - up to 1 gram; Children 5-10 years old - 250 milligrams; 2-5 years - 125 milligrams; Up to 2 years, the daily dose is 20 milligrams per kilogram of weight. There should be at least 8 hours between medication techniques. Children under 12 are recommended to use amoxicillin in the form of a suspension.

In parenteral use, adults intramuscularly introduced 1 gram twice a day; Children - 50 milligrams / kilogram / day, one-time - 500 milligrams, multiplicity of administration - 2 times a day.

Side effects: Erythema, Sweet Sweep, conjunctivitis, anaphyactic shock, joint pain, feverish state.

Contraindications: Hypersensitivity to penicillins, infectious mononucleosis. With caution, the antibiotic is prescribed by pregnant and patients prone to allergic reactions.

Ampioks (Oxampicin, Oxep)

Release form - capsules, powder for making a solution; Active substances - ampicillin sodium, oxacillin sodium.

The antibacterial drug refers to semi-synthetic penicillins and shows activity relative to gram-negative (meningococcus, intestinal wand, gonococcus, salmonella and so on) and gram-positive (streptococcus, pneumococcus, staphylococcus) microorganisms. Indications for use are: tonsillitis, pyelonephritis, sinusitis, tonsillitis, pneumonia, medium otitis, meningitis, cystitis, cervicitis, and so on.

Capsules are taken in front of food, swallowing entirely and drinking water. Adults and adolescents from 14 years are prescribed at 0.5-1.0 grams (2-4 capsules); 7-14 years old - 50 milligrams / kilogram / day; 3-7 years old - 100 milligrams / kilograms / day; The daily dose is divided by 4-6 receptions. The duration of treatment is 7-14 days.

Intravenously and intramuscularly (drip, inkjino) The daily dose for adults and adolescents from 14 years is 3-6 grams; children 7-14 years old - 100 milligrams / kilograms / day; 1-6 years old - 100 milligrams / kilogram / day; Newborn, premature and kids up to 1 year - 100-200milligrams / kilogram / day. The daily must be administered in 3-4 receptions, with an interval of 6-8 hours. According to dose indications can be increased 1.5-2 times.

Side effects: rhinitis, skin cover hyperemia, arthralgia, conjunctivitis, vomiting, diarrhea, nausea, leukopenia, enterocolitis, anemia, angioedema swelling.

Contraindications: lympholecosis, infectious mononucleosis, hypersensitivity. Use with caution when chronic insufficiency, in children who were born in mothers with the intolerance of penicillins.

Ampisid (Sulsin, Sulacillin, Libac Cyllain, Ampicillin + Sulbaktam, Sulbacin)

Release form - powder, pills; Active substances - ampicillin, sulbactam.

The combined antibiotic group of penicillins is assigned to patients of all age groups With infectious diseases caused by ampicillin and sulbactam, microorganisms sensitive. Among them are infections: respiratory organs (pleurrites, bronchitis, bacterial pneumonia), ENT organs (otitis, sinusitis, tonsillites), urinary and sexual organs (cystitis, pyelonephritis, adnexites, and so on), gastrointestinal bodies (cholangitis, pancreatitis, cholecystitis ), musculoskeletal system (myosites, arthritis, osteomyelitis), leather and subcutaneous fiber ( burning wounds, erysipelas, infected dermatoses), prevention of postoperative infections.

Tablets are prescribed inside before taking food, in 1-2 hours in a daily dose of 375-750 milligrams for adults and 25-50 milligrams per kilogram of body weight for children, whose weight does not exceed 30 kilograms. Daily dose of medication must be divided into 2 receptions.

Intramuscularly and intravenously (drip at a speed of 60-80 drops per minute, stove - slowly, for 3-4 minutes). It is intravenously introduced 5-7 days if you need to continue treatment, then go to intramuscular use. With an easy course of infection with adults - 1.5-3 grams per day in 2 administration; with an average course - 3-6 grams per day in 3-4 administration; Heavy current - 12 grams per day in 3-4 administration. For children, the daily dose is taken at the rate of 150 milligram per 1 kilogram of weight, the multiplicity of administration is 3-4 times; Newborn and premature babies - every 12 hours. Duration of therapy 5-14 days.

Side effects: Reducing appetite, nausea, vomiting, diarrhea, anemia, leukopenia, drowsiness, headache, skin hyperemia, urticaria, rhinitis, eosinophilia, candidiasis (long-term use).

Contraindications: Lactation period, infectious mononucleosis, hypersensitivity. With caution in hepatic and / or renal failure, pregnancy.

Clonak-H.

Release form - capsules; Active substances - amoxicillin trihydrate, Cloxacillin sodium.

The drug is active in respect of most gram-positive and gram-negative bacteria. It is assigned in the infections of the upper respiratory tract, pneumonia, bronchitis, the infections of the gastrointestinal tract, the blade, the skin and soft tissues, gonorrhea, and so on.

Capsules are taken before eating, drinking water, swallowing entirely, not chewing. Adults are prescribed 1 capsule every 6-8 hours, depending on the severity of the disease. If the kidney function is violated, the dose is reduced.

Side effects: nausea, diarrhea, skin rashesIn rare cases, pseudommbranous colitis (intestinal colic) can develop.

Contraindications: childhood, pregnancy, lactation period, infectious mononucleosis, hypersensitivity to active substances. With caution to take patients with allergic reactions.

Tazocin (Tazrobida, Piper Cyllain + Tazobaktam Teva)

Release form - lyophilisate for solution; Active substances - Piperotillalin, Tazobactam.

Bactericidal semi-synthetic antibacterial preparation of a wide range of action is effective in medium-heavy and severe infections: bacterial infections lower and upper respiratory tract, abdominal organs, complicated and uncomplicated leather and soft tissue pathologies, abscess, small pelvic organs, bacterial septicemia (blood infection by bacteria), infections of joints and bones.

The drug is injected intravenously drip (slowly for 30 minutes) or intramuscularly. The daily dose in adults and adolescents from 12 years with a normal kidney function is 2.25 grams every 6 hours or 4.5 grams every 8 hours; Children 2-12 years old - 90 milligram per 1 kilogram weight every 6 hours. For patients passing hemodialysis (blood purification method), the maximum dose is 2.25 grams every 8 hours. The duration of therapy is 7-10 days.

Side effects: vomiting, nausea, development of intestinal colic, itching, urticaria, rash, erythema, headache, cramps, hypoglycemia, phlebitis, hypotension, blood tides to the skin of the face, an increase in body temperature, rarely - arthralgia and others.

Contraindications: Hypersensitivity, age up to 2 years. With caution with strong bleeding (in history), pregnancy, lactation, fibrosis, hypokalemia, pseudo-membrane enterocolite.

Timenin

Release form - lyophilisate for the preparation of the solution; Active substances - ticarcillin, clavulanic acid.

The antibiotic has a wide range of action and is shown for the treatment of infections of connective and bone tissue, in gynecology, leather and subcutaneous fiber, urinary tract, and so on.

The drug is administered intravenously drip or stroke. Intervals between infusions should be at least 4 hours. Therapy needs to continue for 48-72 hours after the symptoms disappear.

Adults and adolescents with weight of more than 40 kilograms The average dose is 3 grams every 6 hours or 5 grams every 8 hours. Maximum dose - 3 grams every 4 hours. Children with weight of less than 40 kilograms are prescribed 75 milligrams / kilograms every 8 hours (maximum - 75 milligrams every 6 hours); Premature babies with weight of less than 2 kilograms - 75 milligrams every 12 hours, with weight of more than 2 kilograms - 75 milligrams every 8 hours. With violations of the kidney function, the dose is adjusted.

Side effects: diarrhea, nausea, vomiting, hepatitis, cholestatic jaundice, cramps, leukopenia, reduction of hemoglobin levels, eosinophilia, urticaria, rash, itching, anaphylactic reactions, redness of the skin, a feeling of burning and so on.

Contraindications: premature children with impaired kidney function, hypersensitivity to active substances, pregnancy, lactation.

Amoxiclave is a combined drug with antibacterial effect. It has a wide range of applications and has fast therapeutic effect In the treatment of many infectious diseases. Nevertheless, exist side effects Amoxiclava, which the doctor must consider when prescribing to the patient.

Description and composition of amoxiclava

The antibiotic consists of two main substances:

• amoxicillin;
• clawulanic acid.

The first struggles with the sensitive bacteria, and the acid, connecting with beta lactamases, forms strong complexes that protect the amoxicillin particles from destruction.

The pharmacological abilities of these two components are similar to each other, but do not muffle each other. Due to this property, this drug is considered one of the best in the treatment of a plurality of diseases of bacterial nature.

Indications for use

As a rule, amoxiclav is prescribed at:

• sinusitis of varying severity;
• plug abscess;
• otitis;
• bronchitis;
• inflammatory processes in the lungs;
• infectious lesions of urinary channels;
• periodontitis;
• genital infections;
• gonor;
• infectious inflammatory diseases of the skin and soft tissues;
• inflammatory processes of the bacterial nature of the bone-articular apparatus.

Also, the preparation is used to prevent postoperative complications.

Despite such a positive characteristic, the occurrence of side effects from amoxiclava is sufficient.

Contraindications for the use of amoxiclava

Since amoxiclav has a number of side effects, before its appointment, a specialist must make sure that the patient has no:

• any of the forms of hepatitis;
• cholestatic jaundice caused by the method of medication;
• allergic reaction to valid and additional components of amoxiclava components.

Side effects from the drug

Eliminate such side effects from Amoxiclava:

Digestive system

Stripping from feedback from patients, in 43 percent after amoxiclava, long-term nausea and vomiting began, about 3.7 percent complained about constipation and diarrhea. In rare cases (2.4 percent), development was observed:

• meteorism;
• gastritis;
• anorexia;
• stomatitis;
• enterocolitis;
• coloring language in another color.

When used and after the cessation of amoxiclava, the risk of colitis is possible.

Skin covering

On this side, the high possibility of developing side effects:

• angioedema edema;
• rash;
• urban.

In rare cases, the development is marked:

• multiform erythema;
• exfoliative dermatitis;
• stevens-Johnson syndrome;
• toxic epidermal necrolize.

Nervous system

Approximately 5 percent of cases in patients receiving amoxiclava provoked development:

• attachment;
• unfortunate anxiety;
• strong headaches;
• systematically repeated dizziness;
• inadequate behavior;
• long insomnia;
• sighup limbs;
• the nebula of consciousness;
• slow motion physical and mental reaction;
• hyperactivity;
• attacks of aggression;
• depression.

Circulation

In 31.2 percent of cases in patients after treatment, amoxica was diagnosed:

• thrombocytopenia;
• anemia (some even hemolytic);
• leukopenia;
• eosinophilia;
• agranulocytosis.

Hepatobiliary violations

13 percent of patients showed:

• high performance of hepatic samples, namely the increased activity of asate and alt and alkaline phosphatase;
• raising the serum concentration of bilirubin.

In the elderly patients after treatment, the amoxiclave diagnosed the disturbed functionality of the liver. In 1 patient out of 10 amoxiclav provoked the development of jaundice and hepatitis. As a rule, the signs of these diseases appear already during the reception of amoxiclava, but there are cases when the aralless "showed themselves" only a month after the end of treatment with the drug.

urinary system

Very rarely after receiving amoxiclava in patients were diagnosed with interstitial jade and hematuria.

Others (less than 1 percent of patients)

Rarely encountered side effects in adults from Amoxiclava:

• fever;
• vulvovaginal candidiasis;
• candidiasis oral cavity (with long-term reception of the drug).

Amoxiclav and pregnancy

In these experimental tests of the drug, there are no records of its negative impact on the future mother or fetus, so specialists allow the use of amoxiclava when carrying a child and breastfeeding.

In order to avoid the development of side effects, experts strongly recommend taking a drug strictly and not to use it as self-medication.

Article Verified
Anna Moschovis - family doctor.

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This article allows you to familiarize yourself with the instructions for use. medicinal preparation Amoxiclav.. The reviews of the site visitors - consumers of this medicine are presented, as well as the opinions of doctors of specialists in the use of amoxiclava in their practice. A big request to more actively add your reviews about the preparation: helped or did not help the medicine to get rid of the disease, which complications were observed and side effects, possibly not stated by the manufacturer in annotations. Amoxiclava analogues in the presence of available structural analogs. Use for the treatment of various infectious diseases in adults, children, as well as during pregnancy and breastfeeding. Alcohol use I. possible consequences After receiving amoxiclava.

Amoxiclav. - is a combination of amoxicillin - semi-synthetic penicillin with wide spectrum Antibacterial activity and clavulanic acid - an irreversible beta-lactamase inhibitor. Clawulanic acid forms a persistent inactivated complex with the specified enzymes and provides resistance to amoxicillin to the effects of beta-lactamas produced by microorganisms.

Clawulanic acid, similar to the structure of beta-lactam antibiotics, has weak its own antibacterial activity.

Amoxiclav has a wide range of antibacterial action.

Active in relation to amoxicillin-sensitive strains, including strains producing beta lactamases, 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 taking the drug inside, food intake does not affect the degree of suction. Both components are characterized by a good volume of distribution in liquids and tissues of the body (light, medium ear, pleural and peritoneal liquid, uterus, ovaries, etc.). Amoxicillin also penetrates into synovial fluid, liver, prostate gland, sky almonds, muscular fabric, gall-bubble, the secret of the apparent sinuses, saliva, bronchial secret. Amoxicillin and clavulanic acid do not penetrate the BC with unrevennt brain shells. Amoxicillin and clavulanic acid penetrate the placental barrier and in trace concentrations are distinguished with breast milk. Amoxicillin and clavulanic acid are characterized by low binding to plasma proteins. Amoxicillin is partially metabolized, clavulanic acid is subjected to intensive metabolism. Amoxicillin is excreted by the kidneys in virtually unchanged form by tubular secretion and glomerular filtration. Clawulanic acid is output by glomerular filtration, partly in the form of metabolites.

Indications

Infections caused by sensitive strains of microorganisms:

• infections of the upper respiratory tract and LOR organs (incl. acute and chronic sinusitis, acute and chronic average otitis, cap abscess, tonsillitis, pharyngitis);
• infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronical bronchitis, pneumonia);
• urinary tract infections;
• gynecological infections;
• skin infections and soft tissues, including animal bites and humans;
• bone and connective tissue infections;
• biliary tract infections (cholecystitis, cholangitis);
• thindogenous infections.

Forms of release

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

Powder for preparing a suspension for intake of 125 mg, 250 mg, 400 mg (comfortable children's form of the drug).

Tablets coated with film shell 250 mg, 500 mg, 875 mg.

Instructions for use and dosage

Adults and children older than 12 years (or more than 40 kg of body weight): The usual dose in the event of a light and medium-free flow of infection is 1 tablet 250 + 125 mg every 8 hours or 1 tablet 500 + 125 mg every 12 hours, in case of severe infection and respiratory tract infections - 1 tablet 500 + 125 mg every 8 h or 1 tab. 875 + 125 mg every 12 hours. Tablets are not prescribed to children under 12 years old (less than 40 kg of body weight).

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

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

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

Dosage in renal failure: for patients with renal failure of a moderate degree (CL creatinine - 10-30 ml / min) dose is 1 table. 500 + 125 mg every 12 hours; For patients with severe renal failure (CL creatinine less than 10 ml / min) dose is 1 tab. 500 + 125 mg every 24 hours.

Side effect

Side effects in most cases weakly pronounced and transient.

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

Contraindications

• increased sensitivity to any of the components of the drug;
• increased sensitivity as a history of penicillins, cephalosporins and other beta-lactam antibiotics;
• a history of indications of cholestatic jaundice and / or other disorders of the liver function caused by amoxicillin / clavulanic acid intake;
• infectious mononucleosis and lympholecosis.

Application in pregnancy and breastfeeding

Amoxiclav can be prescribed during pregnancy with clear indications.

Amoxicillin and clavulanic acid in small quantities are highlighted with breast milk.

special instructions

During course treatment, the functions of the blood formation, liver and kidney organs should be controlled.

In patients with severe disorders, the kidney function requires an adequate correction of the dosing mode or an increase in intervals between dosing.

In order to reduce the risk of developing adverse reactions by the gastrointestinal tract, the drug should take during meals.

Laboratory tests: High concentrations of amoxicillin give a false-positive reaction to urine glucose when using the Benedict reagent or fending solution. It is recommended to use enzymatic reactions with glucosidase.

It is forbidden to use amoxiclava with simultaneous use of alcohol in any forms, as the risk of hepatic disorders is seriously increasing when they are simultaneously intake.

Impact on the ability to driving vehicles and control mechanisms

Data on the negative impact of amoxiclava in recommended doses on the ability to control the car or working with mechanisms is not.

Medicinal interaction

With the simultaneous use of the drug amoxiclav with antacids, glucosamine, laxatives, aminoglycosides, absorption slows down, with ascorbic acid - rises.

Diuretics, Allopurinol, Phenylbutazone, NSAIDs and others medicinal productsblocking channel secretions increase the concentration of amoxicillin (clavulanic acid is output mainly by glomerular filtration).

With simultaneous use, amoxiclav increases the toxicity of methotrexate.

With the simultaneous use of amoxiclava with allopurinol, the frequency of the development of the examination increases.

Avoid simultaneous destination with disulfiram.

In some cases, the drug can lengthen the prothrombin time, in connection with this, caution should be taken at the simultaneous purpose of anticoagulant and amoxiclav drug.

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

Amoxiclav should not be used simultaneously with bacteriostatic antibiotics (macrolides, tetracyclines), sulfanimamides due to a possible decrease in amoxiclava efficiency.

The probilecid reduces the removal of amoxicillin, increasing its serum concentration.

Antibiotics reduce the effectiveness of oral contraceptives.

Analogs of antibiotic amoxiclav.

Structural analogues for the acting substance:

• AmoVikom;
• Amoxiclav Kviktab;
• Artilet;
• Augmentin;
• Bortoklav;
• Verklav;
• Clamor;
• Liklav;
• Medoclav;
• Panklav;
• Ranxlav;
• Rapiklav;
• Tomerentine;
• Flemoclav Soluteab;
• Ekoclav.

In the absence of analogues of drugs on the active substance, you can follow the links below on the disease, which helps the appropriate drug, and see the analogues on therapeutic effects.