Why is the antibiotic Macropen good? Its main characteristics
The discovery of antibiotics literally opened a new era in medicine and saved many lives that would otherwise have been doomed. But over time, pathogenic microflora adapted to antibiotics and began to mutate, becoming resistant to various drugs.
To avoid this and maintain the effectiveness of medications, the pharmaceutical industry has to resort to regularly updating formulations and inventing new drugs. With their help, you can treat many dangerous and extremely unpleasant diseases. Similar means include.
Macropen tablets are a broad-spectrum antibacterial drug classified as macrolides. This is a large group of antibiotics of natural or semi-synthetic origin, which have the least toxicity of all currently available types of drugs with similar properties.
The main active ingredient is midecamycin, a natural antibiotic, which in small dosages has a bacteriostatic effect, that is, inhibiting their growth and reproduction, and in high doses it has a bactericidal effect, that is, destroying pathogenic microflora.
Available in the form of smooth-coated tablets or as granules used to prepare a suspension, which is most often used to treat children.Long-term use of the drug requires monitoring the condition of the liver, especially if the patient has problems with the functioning of this organ or is chronically ill.
Macropen can interact with a number of drugs, for example, Warfarin, Carbamazepine and other drugs.
When used in parallel with other medications, medical advice is required.
The drug must be stored in a dry place, out of direct sunlight, with a temperature not exceeding 25 degrees Celsius. The shelf life of the drug is 3 years. Keep out of reach of children, especially the prepared suspension stored in the refrigerator, which has a sweetish taste and may be mistaken for a drink.
The drug Macropen tablets is active against a wide range of bacterial infections and can be effective in the presence of the following diseases:
- Respiratory diseases: pneumonia, including atypical pneumonia (angina), Legionnaires' disease (legionellosis), diphtheria.
- Stomatitis.
- Enteritis.
- Lesions of soft tissues and skin, erysipelas.
- Trachoma.
- Brucellosis.
Infectious diseases of the genitourinary area: urethritis, including nonspecific, gonorrhea and syphilis.
Such widespread use and pronounced effectiveness of the drug determined its popularity and frequency of prescription in sick adults and children. Macropen can be used as a backup remedy if a patient is allergic to beta-lactam drugs.
Dosage and rules of use
Macropen tablets are not prescribed for young children (under 3 years of age), replacing them with a suspension. The dosage of the drug depends on the child’s body weight:
- Up to 5 kg - 3.75 ml of mixture.
- Weighing from 5 to 10 kg - 7.5 ml of suspension.
- Weight from 10 to 15 kg - 10 ml.
- If the child weighs from 15 to 20 kg - 15 ml.
- For children weighing from 20 to 30 kg - 22.5 ml.
The suspension is given to babies twice a day, before meals. To obtain the finished product, add 100 ml of distilled water to a bottle of dry powder and stir thoroughly. Before each use of the drug, it must be shaken gently until smooth. Store the prepared solution in the refrigerator, warming it to room temperature before each use. Shelf life in the refrigerator is no more than two weeks (in a tightly closed bottle).
Older children and adults are prescribed Macropen in tablet form.The dosage for children is from 30 to 50 mg per kilogram of weight. This is a daily dose of the drug, which should be divided into three doses if the existing infectious disease is severe or moderate.
If the disease is relatively mild, it is allowed to divide the daily dose of the drug into two doses.
Adult patients are prescribed 400 mg of the drug three times a day. Take the medicine before meals with plenty of water. Do not use milk or other dairy products or juices. When treating with antibiotics, it is necessary to exclude alcohol from the menu - even minimal doses can cause negative reactions, especially in people with a tendency to allergies. The patient may feel dizzy, a flush of heat to the face, redness of the skin, and lightheadedness.
The duration of treatment with the drug is a week - 10 days, in the presence of chlamydial infections - up to 2 weeks. You cannot shorten or extend the time you take the medicine on your own. In the first case, this can lead to undertreatment of the disease, its resumption or its transition to a chronic state. In the second case, there may be negative reactions from the liver, kidneys, digestive system, changes in the blood picture and the development of fungal infections against the background of suppression of the intestinal microflora (candidiasis - thrush).
Contraindications and side effects
Macropen tablets are contraindicated in the following cases:
- Hypersensitivity to the components of the drug, allergic reaction to the drug.
- The presence of severe or complicated forms of renal and/or liver failure.
- The child's age is under 36 months (in case of using a tablet drug).
- Restrictions exist for use during pregnancy and breastfeeding, as well as if the patient has an allergic reaction to aspirin (acetylsalicylic acid).
Side effects that may occur with this drug include:
- Lack of appetite up to complete refusal to eat.
- Nausea.
- Vomit.
- Digestive disorder.
- Feelings of heaviness in the stomach and abdominal area.
- Diarrhea.
- Jaundice.
- Changes in the blood picture in the area of liver enzymes.
- Eosinophilia.
- General weakness.
- Bronchospasm.
- Manifestations of an allergic reaction in the form of rashes, urticaria, severe itching, swelling of the mucous membrane.
Side effects may be clustered, less severe, or very noticeable. It all depends on the individual susceptibility of the patient and the degree of damage.
During pregnancy and lactation, the instructions allow the use of the drug with caution. This means that the decision to prescribe is made by the attending physician, taking into account the potential threat to the patient’s health and the viability of the fetus.
Such a decision is made only if the expected benefit from the use of the drug far outweighs the potential harm to the fetus.
The main active ingredient Midecamycin actively penetrates into breast milk and can cause serious harm to the body of a breastfed baby. Women who are prescribed for health reasons need to stop breastfeeding and switch the baby to special formulas suitable for his age.
There is no complete, exact analogue of this drug, but there are a number of drugs that belong to the so-called group analogues, that is, they correspond to Macropen in their properties and main actions. In principle, the result of using analogues is very similar to the effect of the described product, but has a number of nuances.
Among the drugs that can act as analogues of Macropen, there is the old, tested, but not effective in all cases, Erythromycin, as well as relatively new drugs Clarithromycin, Clarithromycin-Verde, Clerimed, Clarbakt and many others.
Among those often prescribed as a replacement, we can mention drugs from the same group of macrolides as Macropen - Zetamax Retard, Oleandomycin, Rovamycin, and Sumamed forte, Ecomed and others.
The use of these drugs, their selection and prescription are entirely within the competence of the attending physician and depend on the severity of the disease, its type, the patient’s age and the presence of other health problems, taking into account existing general contraindications.
Approved
By order of the chairman
Committee for Control of Medical and
pharmaceutical activities
Ministry of Health
Republic of Kazakhstan
From "__"_______ 201__
Instructions for medical use
Medicine
MACROPENE®
Tradename
Macropen®
International nonproprietary name
Midecamycin
Dosage form
Film-coated tablets, 400 mg
Compound
One tablet contains
active substance- midecamycin 421.0 mg (in terms of midecamycin content 950 mcg/mg),
Excipients: potassium polacrilin, talc, microcrystalline cellulose, magnesium stearate,
Film shell: copolymer of basic bottled methacrylate, polyethylene glycol, titanium dioxide E 171, talc.
Description
Round, slightly biconvex, white film-coated tablets with a bevel and a score on one side.
Pharmacotherapeutic group
Antimicrobial drugs for systemic use. Macrolides.
PBX code JO1FAO3
Pharmacological properties
Pharmacokinetics
Suction
Medicamycin and mediamycin acetate are rapidly and relatively well absorbed and reach maximum serum concentrations of 0.5 mcg/ml to 2.5 mcg/ml and 1.31 mcg/ml to 3.3 mcg/ml, respectively, within 1 to 2 hours. Eating slightly reduces maximum concentrations, especially in children (4 to 16 years). Therefore, it is recommended to take midecamycin before meals.
Distribution
Midecamycin penetrates well into tissues, where it reaches more than 100% concentration than in the blood. High concentrations were found in bronchial secretions and in the skin. The volume of distribution of midecamycin acetate is large: 228 - 329 liters in healthy volunteers.
47% of midecamycin and 3 - 29% of metabolites are protein bound. Midecamycin acetate is excreted into breast milk. After a dose of 1200 mg/day, 0.4 mcg/ml - 1.7 mcg/ml midecamycin acetate is detected in breast milk.
Metabolism and removal
Midecamycin is primarily metabolized into active metabolites in the liver. It is excreted primarily in bile, and only about 5% in urine.
Significant increases in maximum serum concentrations, area under the curve, and half-life may be observed in patients with cirrhosis.
Pharmacodynamics
Antibacterial action
Midecamycin is a broad-spectrum macrolide antibiotic whose activity is similar to that of erythromycin.
It is active against gram-positive bacteria (staphylococci, streptococci, pneumococci, Bacillus anthracis, Corynebacterium diphtheriae, and Listeria monocytogenes), against some gram-negative bacteria (Bordetella pertussis, Campylobacter, Moraxella catarrhalis and Neisseria spp.), anaerobes (Clostridium spp. and Bacteroides spp.) and other bacteria such as mycoplasma, ureaplasma, chlamydia and legionella.
In vitro bacterial susceptibility to midecamycin acetate (MDM-acetate) and midecamycin (MDM)
Average MIC90 (µg/ml)
BacteriaMDM-acetateMDM
Streptococcus pneumoniae0.50.10
Streptococcus pyogenes0.670.20
Streptococcus viridans0.280.39
Staphylococcus aureus1.51.5
Listeria monocytogenes21.5
Bordetella pertussis0.250.20
Legionella pneumophila0.10.12 - 1
Moraxella catarrhalis2-
Helicobacter pylori0.5-
Propionibacterium acnes0.12-
Bacteroides fragilis5.53.13
Mycoplasma pneumoniae0.0240.0078
Ureaplasma urealyticum0.341.56
Mycoplasma hominis2.3-
Gardnerella vaginalis0.08-
Chlamydia trachomatis0.06-
Chlamydia pneumoniae0.5-
The criteria for midecamycin regarding MIC interpretation are the same as for other macrolides according to NCCLS (National Clinical Laboratory Standards Committee) standards. Bacteria are defined as sensitive if their MIC90 is ≤ 2 μg/ml, and as resistant if their MIC90 is ≥ 8 μg/ml.
Antimicrobial effectiveness of metabolites
Metabolites of midecamycin have a similar antibacterial spectrum as midecamycin, but their effect is somewhat weaker. Results from some animal trials have demonstrated that the efficacy of midecamycin and midecamycin acetate is better in vivo than in vitro. This is partly due to high concentrations of active metabolites in tissues.
Mechanism of action
Midecamycin inhibits RNA-dependent protein synthesis at the stage of protein chain elongation. Midecamycin reversibly binds to the 50S subgroup and blocks the transpeptidation and/or translocation reaction. Due to the different structure of ribosomes, communication with the ribosomes of a eukaryotic cell does not occur. This is why the toxicity of macrolides to human cells is low.
Like other macrolide antibiotics, midecamycin has a primarily bacteriostatic effect. However, it may also have a bactericidal effect, which depends on the type of bacterium, the drug concentration at the site of action, the size of the inoculum and the reproductive stage of the microorganism. In vitro activity is reduced in acidic conditions. If the pH value in the culture medium of Staphylococcus aureus or Streptococcus pyogenes increases from 7.2 to 8.0, the MIC for midecamycin is two times lower. If the pH drops, the situation is reversed.
High intracellular concentrations of macrolides are achieved as a result of their good lipid solubility. This is especially important when treating infections caused by microorganisms with an intracellular development cycle, such as chlamydia, legionella and listeria. Midecamycin has been shown to accumulate in human alveolar macrophages. Macrolides also accumulate in neutrophils. While the ratio between extracellular and intracellular concentrations ranges from 1 to 10 for erythromycin, it is over 10 for newer macrolides, including midecamycin. The accumulation of neutrophils at the site of infection may further increase the concentration of macrolides in infected tissues.
In vitro studies have shown that midecamycin also affects immune functions. Thus, increased chemotaxis has been established in comparison with erythromycin. Medicamycin appears to stimulate natural killer cell activity in vivo. All of these studies indicate that midecamycin affects the immune system, which may be important for the in vivo antibiotic action of midecamycin.
Sustainability
Resistance to macrolides develops due to the following reasons: reduced permeability of the outer cell membrane (Enterobacter), drug inactivation (S. aureus, E. coli) and, most importantly, an altered site of action.
From a geographic perspective, the prevalence of bacterial resistance to macrolides is highly variable. Resistance of methicillin-susceptible S. aureus ranges from 1% to 50%, while most methicillin-resistant S. aureus strains are also macrolide resistant. Resistance of pneumococci is mostly below 5%, but in some parts of the world it is over 50% (Japan). Resistance of Streptococcus pyogenes to macrolides ranges from 1% to 40% in Europe. Resistance develops very rarely in Mycoplasmas, Legionella and C. diphteriae.
Indications for use
Infections of the respiratory tract and genitourinary tract caused by mycoplasmas, legionella, chlamydia and Ureaplasma urealyticum;
Infections of the respiratory tract, skin and subcutaneous tissue and all other infections caused by bacteria sensitive to midecamycin and penicillin in patients with hypersensitivity to penicillin;
Enteritis caused by bacteria of the genus Campylobacter;
Treatment and prevention of diphtheria and whooping cough.
Directions for use and doses
Macropen should be taken before meals.
Adults and children weighing more than 30 kg: one 400 mg tablet 3 times a day. The maximum daily dose of midecamycin for adults is 1600 mg.
The duration of treatment is usually from 7 to 14 days. Chlamydial infections are treated for 14 days.
Side effects
During treatment with Macropen, mild gastrointestinal disturbances (decreased appetite, stomatitis, nausea, vomiting and diarrhea) may occur. In rare cases, severe and prolonged diarrhea may occur, which may indicate the development of pseudomembranous colitis. Allergic reactions (skin rash, urticaria, itching, eosinophilia), increased transaminase activity and jaundice are also possible.
Contraindications
Hypersensitivity to the active substance or auxiliary components of the drug
Severe liver failure
Children's age up to 6 years.
"Macropen" is an antibiotic from the macrolide series, which is widely used in clinical practice for the treatment of bacterial infections of the ENT organs and respiratory system in children. It contains midecamycin acetate.
The big advantage of Macropen is its convenient dosage regimen for children, which allows you to take the required amount of the drug depending on the age of the child.
This antibiotic also has a low rate of antibiotic resistance among bacterial flora.
It also has a low incidence of side effects (even when compared with penicillins). All these factors influence the fact that Macropen for children is very often used and prescribed by many pediatricians.
Pharmacological features of the drug
Midecamycin has all the features of macrolide antibiotics. They are available only in oral form. In this case, the drug molecules are absorbed almost completely in the intestine. Midecamycin is a precursor to the active agent. This means that in order for the drug to enter its active form, it must first go through a metabolic stage in the body.
The mechanism of action of Macropen is its ability to inhibit the S50 ribosomal subunit of bacterial cells. This leads to the suppression of protein synthesis by pathogenic microorganisms, which undermines their metabolism and ability to further reproduce.
At the same time, the resistance of bacteria to the action of the body’s protective immune mechanisms decreases. The combination of these mechanisms leads to a decrease in the activity of inflammatory processes and the elimination of pathogenic agents from the body. This effect in pharmacology is called bacteriostatic.
The unique features of macrolides are their long-term presence in the body in therapeutic concentrations.
Many studies have shown that they have the ability to accumulate in body tissues (especially in the respiratory epithelium at the source of inflammation). Also, antibiotic molecules pass into the cells of the immune system, with which they are transported to the site of the pathological process in the body.
After taking the drug, the concentration of midecamycin in tissues may exceed the amount of antibacterial agent in the blood by 20-30 times. Moreover, the effect of the drug lasts 72 hours after the time of its administration, which makes it possible to reduce the duration of the course of treatment.
Macropen tablets are excreted from the body primarily by the liver, where they are converted into inactive metabolites and secreted into bile. A small proportion of midecamycin passes through the kidneys into the urine.
"Macropen" is effective against pathogens that cause the vast majority of bacterial pathologies of the respiratory system - streptococci, staphylococci, listeria, mycobacteria, corynebacteria, clostridia, moraxella, neisseria, helicobacteria and bacteroides.
Rules for prescribing antibacterial agents
Macropen contains an antibiotic, which, like other antibacterial drugs, has a systemic effect on the patient’s body. Therefore, it should only be used when prescribed by a qualified physician.
Self-administration of an antibiotic may not only not give the expected positive effect, but also lead to the development of side effects.
In addition, there are a number of conditions in which the use of drugs from a number of macrolides is strictly prohibited.
It is also necessary to make sure that the child has a bacterial infection before prescribing Macropen. Quite often, antibacterial agents are mistakenly used for viral or fungal pathologies, and then they are ineffective.
Therefore, it is first necessary to conduct a thorough interview with the parents and a physical examination of the child. Additionally, the following examinations are prescribed:
- general blood test (for bacterial pathology - leukocytosis, neutrophilia, increased number of young cell forms and erythrocyte sedimentation rate, monocytosis is possible);
- general urine analysis;
- biochemical blood test (appearance of inflammatory proteins);
- X-ray examination of the chest cavity and skull (if sinusitis, bronchitis and pneumonia are suspected) and computed tomography.
The key study to determine the cause of the pathological process is bacteriological. To carry it out, it is necessary to collect sputum, pleural fluid, blood or a smear from the posterior wall of the nasopharynx.
It allows you to reliably determine which microorganism caused the disease, as well as what drugs it is sensitive to. This research method is the gold standard for diagnosis.
Its only drawback is the fact that the results of the bacteriological analysis are received by the doctor only on the 3-4th day. Therefore, initial antibiotic therapy should be empirical and based on the recommendations of domestic and European pediatricians.
How to properly treat with antibiotics
Antibacterial drugs must be taken regularly without skipping to create a therapeutic dose in the body.
If you miss an appointment, there is no need to panic. It is enough to take the missed dose of Macropen as quickly as possible, and then continue therapy as usual.
If side effects occur, you should report them to your doctor. Most of them are not too serious (headache, diarrhea, feeling of heaviness in the stomach), for which treatment can be continued. But the decision about this should be made only by the attending physician.
The effectiveness of therapy is assessed 2-3 days after initiation. For this purpose, repeated analyzes are carried out. If there are good dynamics of their results, as well as the clinical picture of the disease, therapy continues.
If there is no effect, then it is necessary to change the antibacterial drug, based on the results of a bacteriological study.
Contraindications for taking Macropen
Macropen should not be prescribed if the child has the following conditions:
- allergic reactions in the past when using macrolide antibiotics;
- chronic or acute liver pathologies, which are accompanied by dysfunction of organs;
- acute or chronic renal failure;
- if there is evidence of the presence of a pathogen that is not sensitive to the action of this antibiotic;
- congenital cardiac conduction disorder (risk of developing reciprocal tachycardia).
It is necessary to use the medicine "Macropen" with caution in the first months of a child's life, since there is not enough information about the safety of the drug's composition during this period.
Side effects of the drug
Macrolide preparations are among the safest antibacterial agents.
But since the Macropen composition has a systemic effect, side effects sometimes develop when taking it.
Among them, the most common are the following:
- functional disorders of the digestive tract (feeling of heaviness in the abdomen, nausea, vomiting, diarrhea, flatulence);
- hypersensitivity reactions (allergic rash, redness of the skin with severe itching, anaphylactic shock, Quincke's edema);
- pseudomembranous colitis of varying severity;
- addition of superinfection;
- transient increase in liver enzyme levels;
- jaundice (if the child has congenital disorders of bilirubin metabolism);
- general weakness and/or headache.
Indications for taking Macropen
Macropen can be taken for bacterial pathologies of the respiratory, genitourinary and digestive systems:
Macropen is often prescribed in situations where the patient has hypersensitivity to beta-lactam antibiotics, as well as when protected penicillins are ineffective.
Principles of using Macropen
Macropen is available for children in the form of 400 mg tablets and powder for preparing a suspension with a special spoon for the exact dosage of the drug. Usually she is given priority when the child is under 8 years old.
When determining the daily dose of the drug, it is necessary to proceed from the calculation of 50 mg per 1 kg. It should be borne in mind that after preparing the syrup (for which you need to add 100 ml of water), 1 ml of it contains 35 mg of midecamycin.
For children weighing more than 30 kg, you need to take 1 tablet (400 mg) 3 times a day. The duration of therapy for respiratory infections is 3-7 days. For pathologies of the genitourinary system and intestines, the course of taking Macropen can reach 7-14 days.
Video
The video talks about how to quickly cure a cold, flu or acute respiratory viral infection. Opinion of an experienced doctor.
"Macropen" is an antibiotic from the macrolide series, which is widely used in clinical practice for the treatment of bacterial infections of the ENT organs and respiratory system in children. It contains midecamycin acetate.
The big advantage of Macropen is its convenient dosage regimen for children, which allows you to take the required amount of the drug depending on the age of the child.
This antibiotic also has a low rate of antibiotic resistance among bacterial flora.
It also has a low incidence of side effects (even when compared with penicillins). All these factors influence the fact that Macropen for children is very often used and prescribed by many pediatricians.
Pharmacological features of the drug
Midecamycin has all the features of macrolide antibiotics. They are available only in oral form. In this case, the drug molecules are absorbed almost completely in the intestine. Midecamycin is a precursor to the active agent. This means that in order for the drug to enter its active form, it must first go through a metabolic stage in the body.
The mechanism of action of Macropen is its ability to inhibit the S50 ribosomal subunit of bacterial cells. This leads to the suppression of protein synthesis by pathogenic microorganisms, which undermines their metabolism and ability to further reproduce.
At the same time, the resistance of bacteria to the action of the body’s protective immune mechanisms decreases. The combination of these mechanisms leads to a decrease in the activity of inflammatory processes and the elimination of pathogenic agents from the body. This effect in pharmacology is called bacteriostatic.
The unique features of macrolides are their long-term presence in the body in therapeutic concentrations.
Many studies have shown that they have the ability to accumulate in body tissues (especially in the respiratory epithelium at the source of inflammation). Also, antibiotic molecules pass into the cells of the immune system, with which they are transported to the site of the pathological process in the body.
After taking the drug, the concentration of midecamycin in tissues may exceed the amount of antibacterial agent in the blood by 20-30 times. Moreover, the effect of the drug lasts 72 hours after the time of its administration, which makes it possible to reduce the duration of the course of treatment.
Macropen tablets are excreted from the body primarily by the liver, where they are converted into inactive metabolites and secreted into bile. A small proportion of midecamycin passes through the kidneys into the urine.
"Macropen" is effective against pathogens that cause the vast majority of bacterial pathologies of the respiratory system - streptococci, staphylococci, listeria, mycobacteria, corynebacteria, clostridia, moraxella, neisseria, helicobacteria and bacteroides.
Rules for prescribing antibacterial agents
Macropen contains an antibiotic, which, like other antibacterial drugs, has a systemic effect on the patient’s body. Therefore, it should only be used when prescribed by a qualified physician.
Self-administration of an antibiotic may not only not give the expected positive effect, but also lead to the development of side effects.
In addition, there are a number of conditions in which the use of drugs from a number of macrolides is strictly prohibited.
It is also necessary to make sure that the child has a bacterial infection before prescribing Macropen. Quite often, antibacterial agents are mistakenly used for viral or fungal pathologies, and then they are ineffective.
Therefore, it is first necessary to conduct a thorough interview with the parents and a physical examination of the child. Additionally, the following examinations are prescribed:
- general blood test (for bacterial pathology - leukocytosis, neutrophilia, increased number of young cell forms and erythrocyte sedimentation rate, monocytosis is possible);
- general urine analysis;
- biochemical blood test (appearance of inflammatory proteins);
- X-ray examination of the chest cavity and skull (if sinusitis, bronchitis and pneumonia are suspected) and computed tomography.
The key study to determine the cause of the pathological process is bacteriological. To carry it out, it is necessary to collect sputum, pleural fluid, blood or a smear from the posterior wall of the nasopharynx.
It allows you to reliably determine which microorganism caused the disease, as well as what drugs it is sensitive to. This research method is the gold standard for diagnosis.
Its only drawback is the fact that the results of the bacteriological analysis are received by the doctor only on the 3-4th day. Therefore, initial antibiotic therapy should be empirical and based on the recommendations of domestic and European pediatricians.
How to properly treat with antibiotics
Antibacterial drugs must be taken regularly without skipping to create a therapeutic dose in the body.
If you miss an appointment, there is no need to panic. It is enough to take the missed dose of Macropen as quickly as possible, and then continue therapy as usual.
If side effects occur, you should report them to your doctor. Most of them are not too serious (headache, diarrhea, feeling of heaviness in the stomach), for which treatment can be continued. But the decision about this should be made only by the attending physician.
The effectiveness of therapy is assessed 2-3 days after initiation. For this purpose, repeated analyzes are carried out. If there are good dynamics of their results, as well as the clinical picture of the disease, therapy continues.
If there is no effect, then it is necessary to change the antibacterial drug, based on the results of a bacteriological study.
Contraindications for taking Macropen
Macropen should not be prescribed if the child has the following conditions:
- allergic reactions in the past when using macrolide antibiotics;
- chronic or acute liver pathologies, which are accompanied by dysfunction of organs;
- acute or chronic renal failure;
- if there is evidence of the presence of a pathogen that is not sensitive to the action of this antibiotic;
- congenital cardiac conduction disorder (risk of developing reciprocal tachycardia).
It is necessary to use the medicine "Macropen" with caution in the first months of a child's life, since there is not enough information about the safety of the drug's composition during this period.
Side effects of the drug
Macrolide preparations are among the safest antibacterial agents.
But since the Macropen composition has a systemic effect, side effects sometimes develop when taking it.
Among them, the most common are the following:
- functional disorders of the digestive tract (feeling of heaviness in the abdomen, nausea, vomiting, diarrhea, flatulence);
- hypersensitivity reactions (allergic rash, redness of the skin with severe itching, anaphylactic shock, Quincke's edema);
- pseudomembranous colitis of varying severity;
- addition of superinfection;
- transient increase in liver enzyme levels;
- jaundice (if the child has congenital disorders of bilirubin metabolism);
- general weakness and/or headache.
Indications for taking Macropen
Macropen can be taken for bacterial pathologies of the respiratory, genitourinary and digestive systems:
Macropen is often prescribed in situations where the patient has hypersensitivity to beta-lactam antibiotics, as well as when protected penicillins are ineffective.
Principles of using Macropen
Macropen is available for children in the form of 400 mg tablets and powder for preparing a suspension with a special spoon for the exact dosage of the drug. Usually she is given priority when the child is under 8 years old.
When determining the daily dose of the drug, it is necessary to proceed from the calculation of 50 mg per 1 kg. It should be borne in mind that after preparing the syrup (for which you need to add 100 ml of water), 1 ml of it contains 35 mg of midecamycin.
For children weighing more than 30 kg, you need to take 1 tablet (400 mg) 3 times a day. The duration of therapy for respiratory infections is 3-7 days. For pathologies of the genitourinary system and intestines, the course of taking Macropen can reach 7-14 days.
Video
The video talks about how to quickly cure a cold, flu or acute respiratory viral infection. Opinion of an experienced doctor.
Excipients: potassium polacrilin, magnesium stearate, talc, microcrystalline cellulose.
Shell composition: methacrylic acid copolymer, macrogol, titanium dioxide, talc.
8 pcs. - blisters (2) - cardboard packs.
pharmachologic effect
Antibiotic of the macrolide group. The mechanism of action is associated with inhibition of protein synthesis in bacterial cells. In low doses it has a bacteriostatic effect, in high doses it has a bactericidal effect.
Active against gram-positive bacteria: Staphylococcus spp., Streptococcus spp., Corynebacterium diphtheriae; gram-negative bacteria: Listeria monocytogenes, Neisseria gonorrhoeae, Neisseria meningitidis, Bordetella pertussis, some strains of Haemophilus influenzae, Legionella pneumophila; anaerobic bacteria: Clostridium spp.
Active against Mycoplasma pneumoniae, Erysipelothrix spp., Ureaplasma urealyticum, Chlamydia (including Chlamydia trachomatis), Mycoplasma hominis.
Pharmacokinetics
After oral administration, it is quickly and fairly completely absorbed from the gastrointestinal tract. Concentrations exceeding those found in serum are created in the internal organs (especially in the lungs, parotid and submandibular glands) and skin after 1-2 hours. In therapeutic concentrations in the blood and tissues it persists for 6 hours. Metabolized in the liver to form two pharmacologically active metabolites. Excreted mainly through bile, a small part through the kidneys (<5%).
Indications
Infectious and inflammatory diseases caused by pathogens sensitive to midecamycin (especially if there are contraindications to the use of penicillin antibiotics), incl. diseases of the upper and lower respiratory tract, oral cavity, skin and soft tissues, genitourinary tract, scarlet fever, erysipelas, diphtheria, whooping cough.
Contraindications
Dosage
Individual. Orally for adults - an average of 400 mg 3 times a day; maximum daily dose- 1.6 g; children - 30-50 mg/kg/day in 2 divided doses. For severe infections, the frequency of administration can be increased to 3 times a day. Duration of treatment is 7-14 days.
Side effects
Rarely: anorexia, feeling of heaviness in the epigastrium, nausea, vomiting, diarrhea, transient increase in the activity of liver transaminases and bilirubin concentration in the blood serum (in predisposed patients).
Drug interactions
When used simultaneously with warfarin, their excretion is reduced; with ergot alkaloids, carbamazepine - the intensity of their metabolism in the liver decreases.