Azithromycin 250 - instructions for use for children

Has restrictions during pregnancy

Prohibited during breastfeeding

Has restrictions for children

Has restrictions for older people

Has limitations for liver problems

Has limitations for kidney problems

Azithromycin is a broad-spectrum antibacterial drug from the macrolide group, used to treat infectious (bacterial) diseases of the skin, mucous membranes of the respiratory tract and nasopharynx, as well as pathologies of the urinary and reproductive systems. The medicine is dispensed only in the form of tablets or children's suspension for systemic use.

The medicine is contraindicated in patients with acute or exacerbated chronic gastrointestinal diseases, individual intolerance to the active component of azithromycin or excipients, kidney or liver diseases.

The drug can be prescribed to pregnant women and nursing mothers, but treatment must be carefully monitored by a doctor. The medicine can be used to treat children (less than 45 kg, Azithromycin oral suspension is prescribed, more than 45 kg, tablets).

The drug is generally well tolerated by patients, but in some cases it requires replacement, so you need to familiarize yourself with the list of the most effective Azithromycin analogs based on the active component and effect on the body.

Azibiote

Another complete analogue of Azithromycin can be considered the drug Azibiot, which has all the properties of the described drug. The drug is produced in Slovenia and Poland by the pharmaceutical company KRKA.

Azitrox and Azibiot are produced in the form of tablets and capsules containing the active substance (Azithromycin dihydrate) in an amount of 500 mg. Both drugs can be used as an analogue of Azithromycin 500.

What is

Macrolide containing the active ingredient of the same name.
The drug is indicated for use in cases of infection of the following areas:

• respiratory organs, nasopharynx;
• epidemic;
• genitourinary tract.

The price is 80-276 rubles. Azithromycin is a medicine of the latest generation and does not require a prescription to purchase. Domestic manufacturer. Release form: capsules, tablets, lyophilisate for preparing a solution for infusion.

Find the answer

Are you having any problem? Enter “Symptom” or “Name of the disease” into the form, press Enter and you will find out all the treatment for this problem or disease.

Sumamed

A long-established and well-proven drug with the main active ingredient - Azithromycin. Available in the form of tablets (regular and soluble), as well as powders for the preparation of oral suspension and solution for parenteral administration. Sumamed's analogue, Azithromycin, does not have a soluble tablet form, so in some situations Sumamed will be much more convenient to use. Soluble tablets are approved for use in adult patients and children over 3 years of age.

The dosage of the dispersible analogue for children is as follows:

• with a weight from 18 to 30 kg - 250 mg of the drug;
• with a weight from 30 to 45 kg - 375 mg of the drug.

The drug Sumamed is produced by Teva (joint ventures Croatia - Russia or Croatia - Israel).

Prices for the drug and its main analogues, average in Russia

Sumamed Fautre

The drug is produced in the form of a powder for the preparation of a suspension. Especially for children, the medicine is flavored and can taste like strawberries, bananas and raspberries. Sumamed Fotre can be classified as a group: analogues of Azithromycin in suspension.

To prepare the suspension, add water to the powder (based on the amount of powder) and shake until smooth.

The daily dosage of the analogue product is:

• with a weight from 15 to 24 kg - 5 ml;
• with a weight from 24 to 34 kg - 7.5 ml;
• with a weight from 35 to 44 kg - 10 ml;
• with a weight of 45 kg (for adult patients) 12.5 ml.

Reviews

Kozhevnikova Anastasia Viktorovna City: Budennovsk Pneumonia, Clarithromycin

She coughed for a long time, then developed a high temperature. X-ray showed pneumonia. With the help of research, the right medicine was identified, improvements began after 4 days of use.

Borisov Oleg Nikolaevich City: Ivanovo Bacterial tracheitis, Amoxicillin

I had a severe productive cough producing green phlegm. The doctor said that we couldn’t do without antibiotics. With their help, I was cured in 5 days.

Anisimova Irina Evgenievna City: Vladikavkaz Furunculosis, Suprax

Abundant ulcers appeared on the skin. But the use of medicine prescribed by an infectious disease specialist gave results in 1 week. Gradually the affected areas recovered and the fever ended.

Hemomycin, 10. Azicide and 11. Zithrocin

The drugs are complete analogs of Azithromycin. Hemomycin is produced by the Yugoslav company Hemofarm. Acid is manufactured in Czechoslovakia, at Zentiva production facilities. Zitrocin - in India, Unique Pharmaceutical Laboratories Ltd. Despite the identical active ingredient, these drugs are quite expensive analogues of Azithromycin. However, these drugs are also quite successfully used for the treatment of infectious and inflammatory processes of the respiratory tract, skin, soft tissues and genitourinary system.

Medicines of the same name

Various pharmaceutical companies produce the drug under the same name. These products have different prices, but the same indications and restrictions on use. Of course, all these drugs can be presented as generics of Azithromycin or its analogues.

For example, Azithromycin Grindeks, produced by the Portuguese-Latvian joint venture Blupharma-Industry Pharmaceuticals, or Azithromycin-Zentiva, which is produced in Czechoslovakia.

Use in young children

Quite often the drug is prescribed in pediatrics for the treatment of various inflammatory processes of infectious etiology. And of course, it is very important for parents to know what analogues of Azithromycin for children exist.

The drugs AzitRus, Zetamax, Azitro Sandoz and Azimed are available in the form of a suspension for oral administration. All of these medications are approved for use in young children and are analogues of Azithromycin.

Contraindications

The drug Azithromycin is contraindicated in the following situations:

• with hypersensitivity to the components of the drug;
• in cases of severe impairment of the functional activity of the kidneys and liver.

How can Azithromycin be replaced if the patient cannot tolerate the active substance of the drug or has severe kidney and liver disorders? To find an analogue, you need to understand what pathologies the medicine is used to treat.

Indications for use of Azithromycin and its analogues

Azithromycin has a wide spectrum of effects against some gram-positive, gram-negative, anaerobic microorganisms, as well as intracellular infectious agents and is used to treat the following pathologies:

• infections of the respiratory system and hearing aid;
• infectious and inflammatory processes localized on the skin and soft tissues;
• inflammatory processes caused by microbes sensitive to macrolides, localized in the genitourinary system;
• diseases of the digestive system caused by Helicobacter pylori.

Full analogues of the drug will have the same indications for use.

Let's look at the following drug analogs that can replace it if you have hypersensitivity to the active substance.

Indications for use of azithromycin

The drug is prescribed for the following pathological processes:

• sinusitis (damages of the sinuses);
• tonsillitis (acute and recurrent forms);
• tonsillitis;
• otitis media;
• pharyngitis;
• bronchitis;
• tracheitis;
• pleurisy (in the initial stages of the disease);
• pneumonia;
• erysipelas;
• infectious dermatoses;
• furunculosis;
• scarlet fever;
• infections of the genitourinary organs;
• impetigo;
• in complex treatment regimens for the gastrointestinal tract;
• Lyme disease (tick-borne borreliosis).

For treatment to be effective, bacterial culture for microflora with an antibiogram should be performed. This analysis will identify the causative agent of the disease and help determine whether azithromycin is appropriate in a particular case. For example, for a sore throat, a smear is taken from the area of ​​the affected tonsils.

Children very often suffer from herpetic sore throat; we recommend reading an article on how to treat this type of sore throat.

The negative point is that it takes 5-10 days for the bacteria to be prepared, but the disease is an insidious thing and will not wait long. Therefore, in most cases, cultures are performed, but treatment is prescribed blindly. If the antibiotic is not suitable, then when the smear results are received, it will be possible to accurately apply a drug sensitive to pathogenic microflora.

You can check out other effective remedies for runny nose here.

Amoxiclav

An antibacterial agent that can act as an analogue of Azithromycin for the treatment of infectious and inflammatory diseases of the respiratory system. The drug contains two active ingredients: amoxicillin and clavulanic acid. Amoxiclav is approved for use in patients aged two years and older and is usually very well tolerated by children. This analogue of Azithromycin is sold without a prescription in the pharmacy chain of any city.

Indications for use:

• infections of the upper and lower respiratory tract, as well as infections of the ENT organs;
• infectious and inflammatory processes of the genitourinary system;
• infectious and inflammatory diseases of the skin and soft tissues;
• infections of bone and connective tissues;
• biliary tract infections.

Contraindications to the use of the analogue:

• hypersensitivity to substances included in the drug;
• pathologies of liver function caused by the use of amoxiclav;
• mononucleosis and lymphocytic leukemia.

special instructions

The use of an antibiotic during pregnancy is not recommended, unless the expected benefit to the mother outweighs the potential risk to the child.

During treatment with the drug, breastfeeding should be stopped.

Impact on the ability to drive vehicles and complex mechanisms

The use of azithromycin can lead to the development of undesirable effects on the organ of vision and nervous system, so patients should be careful when performing work that requires increased concentration and concentration.

Ceftriaxone

A third generation antibiotic, part of the cephalosporin group. Ceftriaxone is a modern antibacterial agent that affects a wider range of pathogens. The medicine is approved for use in young children and is an analogue of Azithromycin according to indications. Patients should be aware that the drug is available only in powder form for the preparation of a solution administered parenterally. This is due to the fact that the drug has rather low absorption characteristics from the gastrointestinal tract.

Prices for Azithromycin analogues, which are part of the group of cephalosporins, are quite affordable and this drug is available to the general population.

Indications for use:

• infectious and inflammatory processes of the fight (including lesions of the stomach, intestines and peritonitis);
• respiratory system infections (pneumonia, bronchitis, abscess);
• infections of bone and connective tissues;
• meningitis;
• infectious and inflammatory lesions of the skin;
• bacterial infections of the genitourinary system;
• endocarditis;
• blood poisoning (sepsis);
• preventive therapy for the occurrence of infectious and inflammatory processes after surgical operations.

A contraindication for the use of this analogue is hypersensitivity to the substances included in the drug.

Drug interactions

The antibiotic reacts with the following substances and drugs:

• antacids - reduce the plasma level of the active substance by 25-30%;
• Triazole, Indinavir, Cotrimoxazole, Cimetidine - there is a risk of a decrease in their effect;
• Cyclosporine, Digoxin - there is a possibility of reducing their absorption;
• Warfarin – it is necessary to monitor the prothrombin period with such a combination;
• Terfenadine – arrhythmia appears;
• Rifabutin – increases the risk of leukopenia and neutropenia;
• ergot alkaloids – ergotism (poisoning) develops.

Clarithromycin

The drug is an analogue of Azithromycin and belongs to the group of macrolide antibiotics.

Indications for use:

• infections of the respiratory system and hearing aid;
• soft tissue and skin infections;
• infections localized in the genitourinary system;
• diseases of the digestive system caused by Helicobacter pylori.

Contraindications for the use of this analogue is the presence of hypersensitivity to the substances included in the composition of the product.

Side effects

During the therapeutic course of Azithromycin and its full analogues, the following side effects may develop:

• state of dizziness and increased fatigue, headache, hyperexcitability and drowsiness;
• increased heart rate;
• state of nausea, vomiting, pain in the abdomen, increased concentration of liver enzymes and bilirubin, decreased appetite, the occurrence of fungal diseases of the oral cavity;
• allergic reactions, expressed in the form of rashes and redness of the skin.

If you are using a domestic or imported analogue of Azithromycin, then if any negative manifestations occur, you must interrupt therapy and consult your doctor for advice.

Overdose

If the therapeutic dosage of Azithromycin and its analogues is exceeded, the following negative symptoms may occur:

• hearing aid dysfunction;
• states of nausea;
• gagging;
• diarrhea.

There is no specific antidote for the active substance, so in case of overdose it is necessary to rinse the stomach and induce vomiting. If necessary, symptomatic treatment should be carried out.

Use of the drug during pregnancy and lactation

The use of Azithromycin and its full analogues in pregnant women is possible only if absolutely necessary. In this case, therapy is carried out under the strict supervision of the attending physician.

To use antibiotic analogues during lactation, it is necessary to stop breastfeeding for the period of the therapeutic course.

Drug interactions

Before starting therapy with Azithromycin and its analogues, you must inform your doctor about the medications you are taking.

According to the instructions, simultaneous use of the drug with Warfarin and Digoxin is not recommended. If complex therapy is necessary, regular blood tests should be performed using analogues.

Pharmacological properties

Pharmacodynamics

Azithromycin belongs to the group of azalides - macrolide derivatives - and has a bacteriostatic effect. It binds to the 50S subunit of ribosomes, which leads to inhibition of peptide translocase at the translation stage, suppression of protein production, inhibition of growth and reproduction of bacterial microorganisms. When used in high concentrations, the drug has a bactericidal effect.

Azithromycin acts on intra- and extracellular pathogens. It is active against the following microorganisms:

• gram-positive bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus viridians, Streptococcus agalactiae, Streptococcus spp. (groups C, F and G, except for strains demonstrating resistance to erythromycin), Streptococcus pyogenes;
• gram-negative bacteria: Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Neisseria gonorrhoeae, Legionella pneumophila, Moraxella catarrhalis, Campylobacter jejuni, Bordetella pertussis, Bordetella parapertussis;
• some anaerobic bacteria: Peptostreptococcus spp., Clostridium perfringens, Bacteroides bivius;
• others: Borrelia burgdorferi, Chlamydia pneumoniae, Chlamydia trachomatis, Treponema pallidum, Mycoplasma pneumoniae, Ureaplasma urealyticum, Mycobacterium avium complex.

Does not show activity against gram-positive microorganisms resistant to erythromycin.

Pharmacokinetics

The degree of absorption of azithromycin is quite high, it is acid-stable and lipophilic. After a single dose of 500 mg, the bioavailability of the drug, due to the effect of the first passage through the liver, is 37%, and the maximum concentration in the blood serum is 0.4 mg/l (it is achieved in approximately 2.5–2.9 hours). In cells and tissues, the concentration of azithromycin is 10–50 times higher than in blood plasma. The volume of distribution is approximately 31.1 l/kg.

The substance easily overcomes histohematic barriers and penetrates well into soft tissues, skin, respiratory tract, prostate gland, genitourinary tissues and organs. It accumulates in an environment with low pH and in lysosomes (which is of great importance for the eradication of pathogens located in the cell cavity). Azithromycin is also transported by macrophages, polymorphonuclear leukocytes and phagocytes. It also penetrates cell membranes.

The results of reliable studies confirm that the content of the drug in foci of infectious inflammation is 24–34% higher than in healthy tissues, and correlates with the intensity of inflammatory edema. Bactericidal concentrations of azithromycin remain in the body for 5–7 days after taking the last dose. The degree of binding to plasma proteins varies over a wide range (from 7 to 50%) and is inversely proportional to the concentration of the drug in the blood.

In the liver, azithromycin participates in demethylation processes with the formation of metabolites that do not have pharmacological activity. It has a relatively high plasma clearance (630 ml/min). Elimination from the blood serum occurs in two stages: between 8 and 24 hours after taking the drug, the half-life is 14–20 hours, and between 24 and 72 hours after taking the drug, the half-life is 41 hours. 50% of azithromycin is excreted unchanged in bile, and 6% of the dose taken in urine. Changes in pharmacokinetics when taking the drug with food are significant: the maximum concentration of the substance is reduced by 52%, and the area under the concentration-time curve (AUC) is reduced by 43%. In elderly men (65–85 years), the pharmacokinetic parameters remain unchanged, but in women, the maximum concentration of azithromycin increases by 30–50%.

Side effect

Determination of the frequency of adverse reactions: often (> 1/100 and < 1/10), sometimes (> 1/1000 and < 1/100), rarely (> 1/10,000 and < 1/1000), very rarely (< 1 /10 000).

From the hematopoietic system: rarely - thrombocytopenia, neutropenia, eosinophilia.

From the central nervous system and peripheral nervous system: sometimes - dizziness/vertigo, headache, drowsiness, convulsions; rarely - paresthesia, asthenia, insomnia, hyperactivity, aggressiveness, anxiety, nervousness.

From the senses: rarely - tinnitus, reversible hearing loss up to deafness (when taken in high doses for a long time), impaired perception of taste and smell.

From the cardiovascular system: rarely - palpitations, arrhythmia, including ventricular tachycardia, increased QT interval, bidirectional ventricular tachycardia.

From the digestive system: often - nausea, vomiting, diarrhea, abdominal pain and cramps; sometimes - diarrhea, flatulence, digestive disorders, anorexia; rarely - constipation, discoloration of the tongue, pseudomembranous colitis, cholestatic jaundice, hepatitis, changes in laboratory parameters of liver function; very rarely - liver dysfunction and liver necrosis (possibly fatal).

Allergic reactions: sometimes - itching, skin rashes; rarely - angioedema, urticaria, photosensitivity, anaphylactic reaction (in rare cases fatal), erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.

From the musculoskeletal system: sometimes - arthralgia.

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

Other: rarely - vaginitis, candidiasis.

How the drug works

Azithromycin belongs to macrolides , but differs from them structurally. It does not have a 14-atomic lactone ring, but a 15-atomic ring, as a result of which it ceases to be lactone.

Thanks to this rearrangement, the acid resistance of the active substance is 300 times greater than that of Erythromycin, the first macrolide antibiotic.

Once in the stomach, azithromycin is not destroyed by hydrochloric acid. In the body, the substance does not create high concentrations in the blood, is well distributed and penetrates into many organs.

It accumulates in tissues, creating large concentrations, and remains there for a long time. It has a wider spectrum of activity against pathogenic microbes.

Other advantages of Azithromycin compared to Erythromycin:

• better overcomes the cell membrane of gram-negative bacteria;
• penetrates better into the paranasal sinuses;
• active against Haemophilus influenzae Pfeiffer (H.influenzae) - the causative agent of pneumonia, meningitis, epiglottitis (inflammation of the pharynx);
• creates high intracellular concentrations;
• acts bactericidal on pathogens inside cells.

This superiority extends to spirochetes (Lyme disease), rickettsia (SARS), Toxoplasma gondii (toxoplasmosis), gram-negative rods, gram-negative cocci.

Azithromycin is excreted from the body along with feces.

Dosage at different ages

According to the instructions for use of Azithromycin 250 mg, children are prescribed a dosage depending on the sensitivity of the pathogen to the antibiotic and the severity of the disease. Standard doses are from 5 to 10 mg per 1 kg once a day . The duration of treatment is from 2 to 5 days.

For some diseases, adjustment or division of the dose into several doses is necessary.

If a dose is missed, take the next one as soon as possible, and then maintain an interval of 24 hours between doses of the medicine.