Karbenicillin
When ATH:
J01CA03
Characteristic.
Semisynthetic antibiotic penicillin group. Is acid, destroyed beta-lactamases.
Karbenicillin. Molecular weight 378,40.
Karbenicillina disodium salt. Powder or porous mass of white or nearly white. Hygroscopic. Easily soluble in water, slowly - in ethanol, practically insoluble in ether and chloroform. Molecular weight 422,36.
Pharmacological action.
Broad-spectrum antibacterial, bactericide.
Application.
Bacterial infections, caused by susceptible microorganisms, incl. pelvic infection, urine- and biliary tract, peritonitis, sepsis, septicemia, pneumonia, bone and joint infections, infectious and inflammatory diseases of the skin and soft tissues, meningitis, brain abscess, purulent complications after surgery and childbirth, infected burns, otitis media.
Contraindications.
Hypersensitivity, incl. other beta-lactam antibiotics, congestive heart failure, arterial hypertension, bronchial asthma, eczema, angioedema, bleeding (incl. history), yazvennыy colitis, enteritis, chronic renal failure.
Pregnancy and breast-feeding.
Safety of use in pregnancy and lactation has not been established.
Side effects.
Cardio-vascular system and blood (hematopoiesis, hemostasis): thrombocytopenia, neutropenia, leukopenia, hemorrhagic syndrome.
From the digestive tract: nausea, vomiting, abdominal pain, increase in liver transaminases, dysbiosis, psevdomembranoznыy colitis.
Allergic reactions: hives, эritema, angioedema, rhinitis, conjunctivitis, angioedema, anaphylactic shock, eozinofilija.
Other: interstitial nephritis, epileptiform seizures, gipovitaminozы, vaginal candidiasis; superimposed infection, caused by microorganisms resistant to carbenicillin, changing levels of sodium and potassium in the blood (when administered at high doses); Local reactions: When the/m introduction is soreness at the injection, at / in - phlebitis.
Cooperation.
It enhances the effects of direct and indirect anticoagulants, antiplatelet agents and fibrinolytic. It increases the likelihood of adverse events in combination with NSAIDs. Incompatible (bactericidal effect) with bacteriostatic (tetracycline antibiotics, makrolidы, chloramphenicol). You can not mix in the same syringe with aminoglycosides.
Dosing and Administration.
/ M, I / (bolus or infusion). Dosage regimen individual, route of administration and dose determined by the severity and site of infection, susceptibility to carbenicillin.
For the / m 1 g is dissolved in 2 ml water for injection; for / in the applied solution with a concentration of not more than 1 g / 10 ml 5% glucose solution or isotonic sodium chloride solution at a rate of introduction 60 drops / min (solutions were prepared immediately before administration).
/ M, adults - 4-8 g / day, children - 50-100 mg / kg / day in 4-6 injections.
B /, adults - 20-30 g / day, children - 250-400 mg / kg / day 6 introduced. The duration of treatment depends on the type and severity of the disease and is an average of 10-14 days. If the kidney function, reduce the dose and increase the interval between doses (when the level of residual nitrogen from above 100 mg% or less creatinine Cl 30 ml / min - for adults 2 g every 6-8 hours).
Precautions.
Before using the parenteral formulation is required is made in / to the sample in individual sensitivity to 0,1 ml of the product. The test results assessed 30 m. In case of allergic reactions during therapy should stop the drug and conduct desensitizing therapy. Carbenicillin can prolong bleeding time. For parenteral administration may take some time, bleeding and levels of K+ and Na+ serum.
Patients with impaired kidney function may need a reduced dose (should be monitored for signs of bleeding complications).
When i / m administration should not be administered in the same place more 2 g.
