Dzhozamitsin

When ATH:
J01FA07

Characteristic.

Macrolide antibiotics. Producing actinomycetes Streptomyces Narbonne var. josamyceticus. It is soluble in methanol and ethanol, soluble in ether and very little water.

Pharmacological action.
Antibacterial.

Application.

Acute and chronic infections, caused by susceptible pathogens - infections of the upper respiratory tract and upper respiratory tract (sore throat, pharyngitis, paratonzillit, laringit, otitis media, sinusitis, Diphtheria - in addition to the treatment of diphtheria toxoid, scarlet fever in the case of hypersensitivity to penicillin); lower respiratory tract infections (acute bronchitis, exacerbation of chronic bronchitis, pneumonia, incl. caused by atypical pathogens, pertussis, psittacosis); dental infections (gingivitis and periodontal disease); infection in ophthalmology (dakriocistit, .Aloe); infections of skin and soft tissue (pyoderma, furunculosis, anthrax, erysipelas - if you are sensitive to penicillin, acne, limfangit, lymphadenitis, lymphogranuloma venereum); infections of the genitourinary system (prostatitis, uretrit, gonorrhea, Syphilis - in case of hypersensitivity to penicillin, khlamidiinyye, mycoplasma, incl. ureaplazmennogo, and mixed infections).

Contraindications.

Hypersensitivity (incl. to other macrolides), severe liver, premature babies.

Pregnancy and breast-feeding.

Permitted use during pregnancy and lactation on the testimony. The European branch of the WHO recommends josamycin as the drug of choice for treatment of chlamydial infection in pregnant women.

Category actions result in FDA - not determined.

Side effects.

From the digestive tract: anorexia, nausea, heartburn, vomiting, dysbacteriosis and diarrhea, flatulence, coated tongue, stomach cramps, abnormal liver function, transient increase in liver transaminases (IS, GOLD), violation of the outflow of bile, and jaundice.

Other: swelling of the feet, dose dependent transient hearing loss, candidiasis, allergic skin reactions (hives, rash), very rare - fever, general malaise.

Cooperation.

Josamycin slows excretion of theophylline (increasing side effects). When co-administered with such josamycin antihistamines, astemizole and terfenadine like, may slow excretion last, that can lead to life-threatening ventricular arrhythmias. In an application josamycin and digoxin may increase the concentration of digoxin in the blood plasma. There are some reports on strengthening the vasoconstrictor action after co-administration with ergot alkaloids and macrolide antibiotics,. Perhaps the weakening effect of hormonal contraceptives. Josamycin may reduce the bactericidal effect of other antibiotics, such as penicillins and cephalosporins (Avoid joint appointment). In a joint application josamycin and possibly lincomycin mutual reduction of their effectiveness. Josamycin increases the concentration of cyclosporine in the blood and increases the risk of nephrotoxicity (requires regular monitoring of the concentration of cyclosporine in the blood). Perhaps the increase in the concentration of midazolam, triazolam and bromocriptine plasma. Josamycin inhibits the metabolism of disopyramide, deduction (increases T_1/2) karʙamazepina.

Overdose.

Symptoms: increased severity of side effects.

Treatment: simptomaticheskaya therapy.

Dosing and Administration.

Inside, between meals. The coated tablets should be swallowed whole, with a little water. Dispersible tablets can be taken two ways: swallowed whole, drinking water, or pre-pre-diluted with water (no less 20 ml), the resulting slurry is thoroughly mixed. Adults and children over 14 years - 1-2 g / day in 2-3 hours, Initial recommended dose - 1 g. The daily dose for children is set from calculating the 40-50 mg / kg, divided by 3 admission.

When, If you omit a time, you should immediately take the dose. If it's time for your next dose, it is not necessary to make a previous dose, Do not increase or double the dose. A break in the treatment or premature discontinuation of treatment reduces the probability of success.

Typically, the duration of treatment is determined by a physician. In accordance with WHO recommendations on the use of antibiotic treatment of streptococcal infections the duration should be at least 10 days.

The treatment of common acne and spherical - for 500 mg 2 twice a day for 2-4 weeks, further - 500 mg 1 once a day for 8 Sun.

Precautions.

In appointing josamycin should consider the possibility of cross-resistance to various antibiotics, macrolides (organisms, resistant to treatment related in chemical structure Antibiotic, They may also be resistant to josamycin).

During treatment requires monitoring of ECG (especially in patients, while receiving digoxin). Precautions under the control of renal function should be used in patients with renal insufficiency.

In case of persistent severe diarrhea should be borne in mind the possibility of antibiotics against the backdrop of a life-threatening pseudomembranous colitis.

People older designate smaller doses and provide treatment under medical supervision.

Cooperation