Macrolide antibiotics are the drugs of choice for atypical pneumonia caused by intracellular pathogens (mycoplasma, chlamydia infections), as well as community-acquired pneumonia caused by St. pneumoniae and B. catarrhalis, especially in children with allergic symptoms and increased sensitivity to penicillin drugs. By origin macrolides are divided into natural and semisynthetic. By chemically isolated 14, 15 and 16-membered macrolides, depending on the number of carbon atoms in the lactone ring. In pediatric practice more widely used as drugs such as azithromycin, midecamycin and josamycin.
The introduction into clinical practice of new macrolide allowed to expand the application possibilities of oral antimicrobials, thereby reducing the need for parenteral methods of administration of antibiotics. In addition, macrolides are considered one of the safest groups of antibiotics. New macrolides compared with erythromycin have better sensory and pharmacokinetic properties, greater bioavailability, longer half-life with better tolerability, thereby reducing the number of daily dosing: midecamycin and josamycin to two or three times, azithromycin to once and increase the therapeutic efficiency.
- Azithromycin (Zithromax 500mg): Semisynthetic broad-spectrum antibiotic that is different from other macrolides in structure and pharmacological properties and long half-life of other macrolides. This allowed, due to the unique properties that distinguish it in a new group of antibiotics called “azalides.”
- Stability in acidic medium, the absolute bioavailability targeted transport to the site of infection, provide a longer half-life of its high efficiency in a short course of application (3-5 days) with a multiplicity of administration once daily. The range of actions that prolonged antibiotic much wider other macrolides.
- Suspension 100 mg / 5 ml syringe with the metering – children up to three years;
Fort suspension 200 mg / 5 ml – Children from 3 to 14 years;
Tablets 125 mg – Children from 14 to 16 years;
250 mg tablets – adults.
- During a five-day course of treatment is given on the first day 10 mg / kg per day, then the next 4 days at 5 mg / kg per day. When a three-day course of treatment – a daily 10 mg / kg per day. When pulsterapii single dose of 30 mg / kg per day.
- convenient dosage forms for early and older children;
- the drug once a day;
- comfortable short courses of three days, five days, pulsterapiya;
- the use of sequential therapy with the drug.
- An important feature is their ability to penetrate the maximum azithromycin and accumulate in the bronchial secretions and lung tissue, which contributes to the optimization of antibiotic therapy for respiratory diseases.
Azithromycin, like other macrolides, has bacterial activity against St. pneumoniae, St. pyogenes, metitsillinchuvstvitelnyh strains of S. aureus. It is also sensitive to azithromycin Gram M. catarrhalis, Neisseria gonorrhea, and Bordatella pertussis, Campylobacter spp. and others.
Azithromycin unlike other macrolides used in pediatric practice, is the only drug having bacterial activity against H. influenzae, including strains that produce beta-lactamase.
An important feature of azithromycin is high bactericidal activity against atypical intracellular pathogens.
The mechanism of antibacterial activity of azithromycin based on inhibition of protein synthesis in bacterial cells by binding to the 5OS subunit of the ribosome. The bioavailability of the drug is about 40%. The maximum concentration in serum is reached after 2.5-3 hours.
- Great importance is the rapid penetration of azithromycin in the inflammation with the creation of high concentrations in the tissues at the subcellular localization. With this level of antibiotic in the tonsils, adenoids, bronchial mucosa, alveolar fluid significantly exceeds its content in the blood plasma, thereby optimizing antibiotic therapy for respiratory diseases.
- A feature of azithromycin, in contrast to other macrolides, is a long half-life. In children it reaches 32-55 hours, with slow release of the tissue and slow its removal, which allows to use an antibiotic, once a day.
- The advantage of azithromycin is no interaction with theophylline and antihistamines, which justifies its use in children with allergic diseases, including bronchial asthma, if necessary, antibiotics.
- Macrolides in addition to bacteriological action the neantibakterialnymi properties, providing anti-inflammatory, immunomodulatory, mucoregulatory effect and can reduce bronchial hyperreactivity.
Check the reviews about Zithromax on this web-site. Here is the last review from 05/11/2015: “Bella, 33 y.o. Zithromax antibiotic has a very wide spectrum and people can use it with many deceases, I has chlamydia and after 10 days of treatment its gone. Thanks.”