Is a semisynthetic aminopenicillin belonging to the group of beta-lactam antibiotics possessing a broad spectrum of antibacterial activity against many Gram-positive and Gram-negative microorganisms
Amoxicillin degraded by microbial enzymes (beta lactamase) and has no effect on the microorganisms which produce these enzymes.
The presence of acid protects klavulanovoi amoxicillin from the destructive action of beta-lactamases and effectively broadens the spectrum of activity of amoxicillin which comprises many bacteria normally resistant to amoxicillin and other penicillins and cephalosporins. Thus deca durabolin combines a broad spectrum antimicrobial activity and the ability to inhibit beta-lactamases.
Medoklav bactericidal effect in vivo on the following microorganisms: Gram-positive aerobes: Staphylococcus aureus *, Streptococcus pneumoniae, Streptococcus pyogenes.
Gram-negative aerobes: .. Klebsiella spp, Enterobacter spp (most strains of bacteria resistant to in vitro, however, clinical efficacy has been demonstrated in the treatment of urinary tract infection caused by strains of the data), Escherichia coli *, Haemophilus influenzae, Moraxella catarrhalis * (Branhamella catarrhalis).
Medoklav has a bactericidal effect in vitro on the following microorganisms, however, the clinical significance of this action is still unknown: Gram-positive aerobes: Bacillis anthracis *, of Corynebacterium spp, of Enterococcus faecalis *, of Enterococcus faecium *, of Listeria monocytogenes, of Nocardia asteroides,. Coagulase-negative staphylococci * ( including Staphylococcus epidermidis *), Streptococcus agalactiae, Streptococcus spp., Streptococcus spp. group viridans.
Gram-positive anaerobes: of Clostridium spp, Peptococcus spp, Peptostreptococcus spp…
Gram-negative aerobes: Bordetella pertussis, Brucella spp, Gardnerella vaginalis, Helicobacter pylori, Legionella spp, Neisseria gonorrhoeae *, Neisseria meningitides *, Pasteurella multocida, Proteus mirabilis *, * Proteus vulgaris, Salmonella spp…. *, Shigella spp. *, Vibrio cholerae, Yersinia enterocolitica * .
Gram-negative anaerobes: of Bacteroides spp. * (Including Bacelroides fragilis), Fusobacterium spp. *
Other: Borrelia burgdorferi, Chlamydiae spp, Leptospira icterohaemorrhagiae, pallidum Treponema.. * Some strains of these bacteria produce beta-lactamase, which makes them insensitive to amoxicillin alone.
The pharmacokinetic parameters of amoxicillin and clavulanic acid are similar and have no effect on the pharmacokinetics of each other. For intravenous (i / v) in a dose of 1000 mg / 200 mg (1.2 g), maximum concentration (C max ) of amoxycillin of 105.4 ug / ml, and clavulanic acid – 28.5 ug / ml; half-life (T 1/2 ) is 0.9 hours to 0.9 hours and amoxicillin – clavulanic acid, for.
After the on / in therapeutic concentrations of amoxicillin and clavulanic acid are in the abdomen, fat and muscle tissue and interstitial fluid, skin, lung, and pleural fluid in the gallbladder as well as in synovial and peritoneal fluids, bile and pus.
Both the active component does not have a high ability to bind to plasma proteins, only 13-20% of each of the components of the drug in plasma is associated with proteins.
amoxicillin and clavulanic acid penetrate the placenta. Amoxicillin, like most penicillins, it passes into breast milk. Breast milk also found trace amounts of clavulanic acid. Both do not cumulate component.
Amoxicillin is derived mainly kidneys, while clavulanic acid by both renal and extrarenal mechanisms. Approximately 60-70% 40-65% amoxicillin and clavulanic acid in the kidneys unchanged during the first 6 hours after a single bolus injection of 1000 mg / 200mg.
Amoxicillin in an amount equivalent to 10-25% of the initial dose of amoxicillin, kidneys displayed in an inactive penitsilloevoy acid. Clavulanic acid in the human body is exposed to an intensive metabolism of 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butan-2-one and excreted by the kidneys.
Bacterial infections caused by susceptible to amoxicillin + clavulanic acid agents:
– lower respiratory tract infections (acute exacerbations of chronic bronchitis, pneumonia, empyema, lung abscess).
– Upper respiratory tract infections (sinusitis, otitis, tonsillitis).
– Urogenital system infections and pelvic organs (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, cervicitis, salpingitis, oophoritis, tubo-ovarian abscess, endometritis, bacterial vaginitis, septic abortion, puerperal sepsis, pelvioperitonit, gonorrhea).
– skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatoses, abscess, cellulitis, wound infection).
– osteomyelitis deca durabolin.
Prevention of infections in surgery.
Hypersensitivity to beta-lactam antibiotics (e.g. penicillin and cephalosporin) and clavulanic acid; with a history of episodes of jaundice or liver dysfunction associated with the intake of amoxicillin / clavulanic acid; infectious mononucleosis (including when a morbilliform rash).
- allergic history;
- children born to mothers with hypersensitivity to penicillin;
- abnormal liver function;
- impairment of renal function (creatinine clearance <30 mL / min);
- gastrointestinal (GI) tract (including the presence of a history of colitis associated with the reception of penicillin).
Application of pregnancy and during breastfeeding
During pregnancy, the drug used only in cases where the expected benefit to the mother outweighs the potential risk to the fetus.
If necessary, the appointment during lactation should decide the issue of the abolition of breastfeeding, because in lactating women have been found traces of amoxicillin and clavulanic acid in breast milk.
Dosing and Administration
B / in the introduction as a slow injection (3-4 minutes) or directly into the vein as an infusion over 30-40 min. The preparation is not intended for intramuscular administration! Administered bolus or infusion solution is prepared for injection. Doses are based on the amoxicillin and depend on the age, body weight, renal function and the severity of the infection process. The minimum antibiotic treatment was 5 days. The maximum duration of therapy could be 14 days, after which it should assess the efficacy and tolerability of Adults and children over 12 years old and weighing more than 40 kg: 1 g every 8 hours a day, in severe infections – every 4-6 hours.
Prophylaxis in Surgery:
When the operation of up to 1 hour – I / O, 1 g once during induction of anesthesia. When operating with a deca durabolin high risk of infection and the duration over 1 h Input 1 g during the induction of anesthesia in conjunction with the introduction of up to 4 doses of 1 g for a 24 hour period. These are usually prescribed dose at 0, 8, 16 and 24 hours. If the procedure is accompanied by an increased risk of infection, the therapeutic regimen may be maintained for several days. online anabolic steroids pharmacy
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