Pharmacy No. 84. Delivery of medicines to your home and office.

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Pensilina

The drug is administered intramuscularly or intravenously (drip, stream).

Standard dosage regimen

The following are the total doses of ampicillin and sulbactam (in a 2:1 ratio).

Adults:

from 1500 mg to 12000 mg per day. For mild infections - 1500-3000 mg/day in 2 doses; for moderate cases - 3000-6000 mg/day in 3-4 administrations; in severe cases - 12,000 mg/day in 3-4 administrations.

For children:

150 mg/kg body weight per day (equivalent to 100 mg/kg/day ampicillin and 50 mg/kg/day sulbactam) every 6-8 hours in accordance with usual practice for the use of ampicillin.

Newborns under 1 week of age (especially premature):

75 mg/kg body weight per day with an interval of 12 hours.

Elderly patients:

usual doses for adults, not adjusted for age.

Use in patients with impaired renal function (creatinine clearance

≤
30 ml/min):
In such patients, Pensilin should be administered less frequently in accordance with the usual practice of using ampicillin, increasing the interval between drug administrations.

Duration of treatment:

The duration of the course of therapy is 5-14 days, but in more severe cases it can be increased or ampicillin may be additionally prescribed. As always with antibiotic therapy, the administration of Pensilina should be continued in patients for at least 48 hours after the temperature has normalized and other pathological symptoms have disappeared.

Dosing in special cases:

Uncomplicated gonorrhea

single intramuscular injection of 1500 mg of Pensilina. In order to increase the duration of the content of sulbactam and ampicillin in plasma, probenecid should be prescribed simultaneously at a dose of 1000 mg orally.

Prevention of postoperative infections,

depending on the degree of infectious risk, 1500-3000 mg of Pensilina is administered during induction of anesthesia. The dose may be repeated every 6 to 8 hours; For most surgical procedures, the drug is usually discontinued 24 hours after surgery, unless administration of the drug for therapeutic purposes is indicated.

Method of preparing solutions

For intramuscular administration

: the contents of the bottle are dissolved as follows:

Contents of the bottle	Solvent (lidocaine hydrochloride solution 0.5%)
375 mg	1.0 ml
750 mg	1.8 ml
1500 mg	3.5 ml

As with other intramuscular injections, Pensilin is injected into a relatively large muscle (the gluteal muscle), and a test aspiration helps avoid inadvertent injection into a blood vessel. The drug diluted with lidocaine cannot be administered intravenously.

For intravenous administration

: for initial dilution, the contents of the bottle are diluted as follows:

Contents of the bottle	Solvent (water for injection)
375 mg	1.0 ml
750 mg	1.8 ml
1500 mg	3.5 ml

Then

- for intravenous infusion

: the solution prepared during the initial dilution, containing a single dose of the drug, is dissolved in 100-200 ml of 0.9% sodium chloride solution or 5-10% glucose solution. Inject at a rate of 60-80 drops per minute.

— for jet injection

: the solution prepared during the initial dilution, containing a single dose of the drug, is dissolved in 10-20 ml of 0.9% sodium chloride solution and administered slowly over 3-5 minutes.

Shake before use.

Duotsid (Ampisid) tablets 375 mg No. 10 - Instructions

Compound

The main active ingredient is sultamicillin.
Other Ingredients: Lactose anhydrous, dried corn starch, sodium starch glycolate, hydroxypropyl cellulose, magnesium stearate, pure water, polyethylene glycol 6000 (macrogol), hydroxypropyl methylcellulose, titanium oxide, talc.

Release form

The drug is in the form of tablets placed in packages of 10 pieces each.

pharmachologic effect

Sultamicillin is a combination of ampicillin and sulbactam.

Ampicillin has a bactericidal effect by binding to penicillin-binding proteins (transpeptidases), which are necessary for the synthesis of peptidoglycans, which are part of the bacterial cell wall. Blocking cell wall synthesis inhibits bacterial reproduction. Bacterial resistance to ampicillin may be associated with the formation of β-lactamases.

Sulbactam is a β-lactamase inhibitor that reduces bacterial resistance and increases the range of action of β-lactam antibiotics. The drug is effective against strains of Staphylococcus aureus and S. epidermidis, species of the genus Streptococcus (including Streptococcus pneumoniae, Streptococcus faecalis), Haemophilus influenzae and H. parainfluenzae, Moraxella catarrhalis, Bacteroides fragoteus species, bacteria of a related genus and related bacteria. Enterobacter, Citrobacter, Neisseria meningitidis, Neisseria gonorrhoeae and Morganella morganii.

Pharmacokinetics

Sultamicillin is a prodrug that is orally hydrolyzed by enzymes in the intestinal wall to ampicillin and sulbactam. The bioavailability of the drug when taken orally is 80% (regardless of whether the drug is administered on an empty stomach or after a meal), and after intramuscular administration the bioavailability is close to 100%.

Ampicillin and sulbactam are rapidly distributed into tissues, body fluids and secretions. Penetration of the drug into the brain and cerebrospinal fluid is small, unless the meninges are inflamed.

The half-life of ampicillin and sulbactam is approximately 1 hour. About 80% of ampicillin and sulbactam are excreted unchanged in the urine. Small amounts of both substances were found in bile and feces. In the elderly and those with renal impairment, the clearance of both components may be reduced and the half-life may be prolonged.

Indications for use

Duocide is used for upper and lower respiratory tract infections, urinary tract infections, gynecological infections, intra-abdominal infections (including for prophylactic purposes after abdominal or pelvic surgery, and after childbirth or cesarean section) and infections of the skin and subcutaneous tissue.

Contraindications

A limitation to taking this antibiotic is an allergy to one of the constituent substances.

Side effects

Gastrointestinal disorders: The most common side effects are nausea, vomiting and diarrhea. You may see blood in the stool (dark stool).

Diseases of the skin and subcutaneous tissue: the most common side effects are skin rash and itching. In addition, other possible skin conditions may occur.

Diseases of the blood and lymphatic system: Changes in blood counts may occur. These changes are reversible after stopping treatment.

Nervous system disorders: dizziness.

Liver and biliary disorders: Transient laboratory findings suggestive of liver damage have been observed.

Compatibility with other medications

It is not recommended to combine Duacid with:

Allopurinol;
penicillins when taken together with anticoagulants;
antibiotics such as chloramphenicol, erythromycin, sulfonamides and tetracyclines;
oral contraceptives containing the hormone estrogen;
methotrexate;
probenecid.

Application and dosage

Unless your doctor recommends otherwise, the recommended daily dose of Duocide is 1-2 tablets (375-750 mg) every 12 hours. When treating gonorrhea, take 6 tablets (2.25 g) once a day.

When treating infections caused by group 5A beta-hemolytic streptococci, it is recommended to continue treatment for at least 10 days to prevent the formation of rheumatic fever or kidney inflammation.

Overdose

Intoxication is manifested by side effects that occur more often and with greater intensity.

special instructions

Prescribing the medication to people with suspected infectious mononucleosis should be avoided due to the risk of a pathological rash.

If diarrhea occurs during treatment, an examination should be performed to rule out inflammation of the colon, which can range from mild to life-threatening. When confirmed by a doctor, the drug should be discontinued.

Use during pregnancy and breastfeeding

Appointment is not recommended.

Impact on the ability to drive vehicles and operate machinery

No special precautions are required.

Terms of sale

As prescribed by a doctor.

Storage conditions

In a dry, cool place, with limited access for children.

Ampicillin + Sulbactam

Intravenously (stream and drip), intramuscularly.

The route of administration depends on the severity of the infection and the dose chosen.

The following are the total doses of ampicillin and sulbactam (in a 2:1 ratio).

In adults and children over 12 years of age and weighing more than 40 kg, for the treatment of moderate infections, 1.5 g is administered intramuscularly or intravenously every 6 hours.

For severe infections - 3 g every 6 hours. The maximum daily dose of sulbactam should not exceed 4 g, which corresponds to a daily dose of the drug equal to 12 g.

Treatment should be continued for at least another 2-3 days after the clinical symptoms of the disease disappear. The duration of treatment is 5-14 days, but in more severe cases it can be increased or additional ampicillin can be prescribed.

For uncomplicated gonorrhea - 1.5 g once.

To prevent postoperative infection - 1.5-3 g during anesthesia, then for 24 hours after surgery at the same dose every 6-8 hours.

In children over 1 month and up to 12 years (or weighing less than 40 kg), the drug is administered at a dose of 150 mg/kg per day, which is divided into 3-4 injections. In case of severe infection, the dose can be increased to 300 mg/kg/day. The duration of the course of therapy should not exceed 14 days.

In premature newborns and children in the first week of life, the daily dose of the drug is 75 mg/kg, which is divided into two injections.

In children aged 7 days to 28 days, the drug is prescribed at a dose of 150 mg/kg per day, divided into 3 intravenous administrations.

In patients with impaired renal function, the dosage regimen is adjusted depending on the values of creatinine clearance (CC).

Creatinine clearance, ml/min	T 1/2, h	Recommended administration mode
≥30	1	1.5-3 g every 6-8 hours
15-29	5	1.5-3 g every 12 hours
5-14	9	1.5-3 g every 24 hours

In children with renal failure (creatinine clearance less than 30 ml/min), the drug is administered in usual single doses (50-75 mg/kg), increasing the intervals between doses, as indicated in adults.

Preparation of solutions:

To prepare a solution for intramuscular administration, sterile water for injection, 0.5% procaine solution, and 0.5% lidocaine solution are used as a solvent. Add 4 ml of solvent to a bottle containing 1.5 g of the drug.

To prepare a solution for intravenous jet administration, add 12 ml of water for injection and 0.9% sodium chloride solution to a bottle containing 1.5 g of the drug. Inject slowly over 3-5 minutes.

To prepare a solution for intravenous drip administration, 1.5-3 g of the drug is dissolved in 15 ml of water for injection, then the resulting solution is added to 150-200 ml of 0.9% sodium chloride solution or 5% dextrose solution and injected at a speed of 60 -80 drops per minute.