Health, Preparations
Antibiotic "Zivox": instructions for use, analogues
In the treatment of diseases of bacterial nature, the doctor usually prescribes antibiotics. These drugs have a huge number of varieties. Of course, it is impossible to know all kinds of antiseptic pharmaceutical products, but some medicines against bacterial infection are of particular interest.
One of the modern antibiotics, which is represented in our drug market - is Zivox. Instructions for use of this drug indicates that it is an antimicrobial agent of synthetic origin. He belongs to a special group - oxazolidinones. The main active ingredient is linezolid.
In what form is it produced?
This drug is available in two dosage forms:
- In the form of granules, painted in white or yellowish color and having the aroma of orange. Of these, a reagent solution is prepared, with the expectation that 100 mg of linezolid will be contained in 5 ml of the finished suspension. The granules are placed in a 150 ml sterile container. Also in the package there is a measuring spoon with divisions (2.5 and 5 ml of suspension).
- In the form of tablets containing 600 mg of linezolid. In the package there is one blister with 10 tablets inside.
- Infusion solution containing 2 mg of linezolid / 1 ml, in packs of 100, 200, 300 ml.
What is the pharmacological effect of the drug?
Active substance linezolid has the ability to penetrate into bacterial cells, bind to their ribosomes and suppress protein synthesis. As a result, microorganisms die.
Against which microorganisms does the drug help?
The drug "Zivox", the instruction for its use accompanies each package containing the medicine, effectively affects the following microorganisms:
- Gram-positive aerobic bacteria: enterococci, corynebacter, staphylococci, streptococci;
- Gram-negative aerobic bacteria of the genus Pasteurella;
- Gram-positive anaerobic bacteria: clostridium and peptostreptococci;
- Gram-negative anaerobic bacteria of the genera prevotella, bacteroides, chlamydia.
To linezolid, the bacteria of the genera moraxella, legionella, mycoplasma are moderately sensitive.
There are also microorganisms that show resistance to the linezolid included in the Zivox preparation.
At what diseases is this medicine shown?
Antibiotic "Zivox" is prescribed for the following diseases:
- Infectious and inflammatory diseases that are caused by bacteria that show sensitivity to this drug.
- In cases of hospital or community-acquired pneumonia.
- With infectious lesions of the skin and soft tissues of the human body.
- In the presence of diseases, the causative agents of which are enterococci, showing resistance to vancomycin.
Also, the antibiotic "Zivox" can be used as a component of combination therapy for infection caused by gram-negative bacteria.
Pharmacokinetics
Linezolid is characterized by a fairly rapid absorption from the digestive tract into the blood, regardless of the form of release of the agent. Already after 2 hours from the time of taking the drug, its concentration in the plasma reaches its maximum values. Linezolid is characterized by complete bioavailability, and its distribution to organs and tissues is fairly rapid. Regardless of what the concentration of antibiotic in the blood, 31% is associated with plasma proteins.
In the human body, linezolid is metabolized by oxidation to two products that do not have an antimicrobial effect. They are excreted by the kidneys (about 50%) and the intestines (up to 6%). Up to 35% of nonmetabolized antibiotic is excreted together with urine.
Stable pharmacokinetics, characterized by Zivox, is noted. Instruction for use notes the lack of dependence of this criterion of the drug on the patient's age. In this regard, older people do not need to adjust the dosage of this pharmaceutical product.
Dosage of the drug
The Zyvox drug can be prescribed by a doctor to a patient for oral use or as an intravenous infusion. And the patient can be transferred from one type of drug administration to another without losing the effectiveness of treatment.
Dosage of the drug, the duration of the course is prescribed by the attending physician, and these circumstances of therapy are determined by the following factors:
- What kind of bacteria the disease was caused by;
- Localization of infection;
- Severity of the disease;
- Clinical effect of therapy.
In case of streptococcal pneumonia of the out-of-hospital and hospital type in adults and children over 12 years of age, 600 mg of Zivox are prescribed. The instruction indicates that the dose of the drug should be taken every 12 hours, and the duration of the course is 10-14 days.
If a patient has kidney failure, then he does not need a dose adjustment. When carrying out the hemodialysis procedure, linezolid is removed during the time interval of 3 hours. In connection with this circumstance, the drug should be taken after the blood purification measure. Patients who are diagnosed with liver failure also do not need a dosage adjustment.
Patients under 12 years of age are prescribed only an infusion form of the Zivox. Instructions for use in newborns and children indicate that linezolid should be taken at a dosage of 10 mg / kg of the child's weight at a frequency of every 8 hours. The course of treatment is from 10 to 14 days. This dosage of the drug is relevant for therapy in the case of community and hospital pneumonia, infections of soft tissues and skin, as well as for the control of enterococcal infections.
The protective sheath made of foil is removed immediately before the infusion procedure. You should check the package for leaks, compressing it for 1 minute. Unsealed packaging is not suitable due to non-sterility. The infusion solution is administered during the time period of 30-120 minutes.
Application Features
There are some features of taking Zivox. The instruction indicates that if the infection is caused by gram-negative bacteria, then it is necessary to connect additional drugs with activity against this group of microorganisms.
When taking linezolid, some patients may experience a reversible myelosuppression. Depending on the duration of therapy, it is characterized by anemia, leukopenia, thrombocytopenia or pancytopenia. Based on these data, blood tests should be performed in patients who are at risk of bleeding. Also, these measures are appropriate if the patient has a history of myelosuppression or he takes medications that lower the level of hemoglobin and platelets or their activity. Evaluation of blood counts is also necessary for a long period of treatment (more than 14 days).
Diarrhea occurs in people who take antibiotics quite often. The extent of this side effect can range from mild to severe. When taking Zivox, a pill or suspension, the normal microflora of the intestine is suppressed and the bacterium of the genus Clostridium is overgrown. In the process of its life, this microorganism secretes toxins of groups A and B, and they provoke diarrhea. The increased content of these components can cause death in patients. All patients who have had a diarrhea of this type need to be closely monitored by physicians for a period of 2 months.
In some cases there is a worsening of vision when treated with Zivox. Instructions for use in children and adults indicate a possible change in the perception of colors, focus sharpness, field defects, fogging. In these cases, the patient needs urgent consultation of an oculist. If this medicine is taken by the patient for a long time period (more than 3 months), then it is necessary to perform visual control without fail. When the emergence and development of such phenomena as peripheral or optic nerve neuropathy, the question is raised about discontinuing drug treatment if the benefit from it is less than the damage to health.
There were also cases of lactic acidosis with Zivoks. It manifests itself in the form of nausea, vomiting, unreasonable acidosis, or a decrease in carbonate anions. This phenomenon should be carefully observed by a medical specialist.
If a patient has a need to take serotonin reuptake inhibitors together with Zyvox, then he must be taken under medical supervision in order to identify a serotonin syndrome: a cognitive function failure, hyperreflexia, hyperpyrexia, and coordination disorder. In the presence of the phenomena described, treatment is stopped by one or both drugs. In this case, a discoloration of the tooth enamel is observed, which is removed by professional cleaning.
There is one more caution to take Zivox. Instructions for use (tablets or granules for the preparation of a suspension - not the essence) says: in the treatment with linezolid, it is not recommended to drive vehicles, manage special equipment and activities that involve a risk to life and health.
What are the side effects of the drug?
Undesirable reactions that may occur in a patient when taking Zivox 600 mg are classified according to the frequency of manifestation: from very frequent (10%) to very rare (0.01%).
Usually, as side effects in the treatment with the drug "Zyvox" instructions for use, a solution or a tablet, calls the phenomenon of mild or moderate severity. The following features are particularly frequent:
- nausea;
- diarrhea;
- headache.
Adults may also experience constipation, vomiting, abdominal pain, flatulence, and candidal disease of the oral cavity.
Based on laboratory studies, it can be argued that during treatment with this antibiotic is often detected thrombocytopenia. The increase in the content of triglycerides in the blood, the anomalous activation of liver enzymes ALT, AST, FA, LDH, as well as lipase and amylase, are not as regular. There was also an increase in the concentration of total bilirubin, creatine and prolactin.
The patient's nervous system can also respond to the drug with linezolid. Often this is expressed in dizziness and migraines, as well as in convulsions. Rare manifestations of side effects of the drug are cases of taste distortion.
Changes in the normal functioning of the central nervous system can cause "Zyvox" (tablets). The instruction indicates a fairly common insomnia in patients during the course of treatment with this pharmaceutical preparation.
On the functioning of the genitourinary system, therapy with the application of "Zyvox" can be reflected in the form of vaginal candidiasis.
Often there are skin manifestations of treatment with linezolid in the form of rash.
Among other side effects can be called fever and opportunistic fungal infection, which occurs infrequently.
Also, when examining Zivox, there were cases of increased blood pressure, itching and indigestion.
In the treatment of linezolid of adolescent patients from 12 to 17 years, the following undesirable manifestations are often encountered:
- Diarrhea, vomiting, nausea, abdominal pain;
- Vertigo, migraine;
- rash;
- Infectious diseases of the upper respiratory tract, cough, pharyngitis;
- fever;
- Pain, the localization of which is difficult to describe.
The following phenomena, characterized by a lower frequency, may also occur:
- Eosinophilia;
- Growth of triglycerides, ALT, creatine and lipase;
- Itching.
In the clinical trial, additional side effects were identified that characterize Zyvox (solution and tablets). These include:
- Myelosuppression is reversible;
- Optic nerve neuropathy;
- anaphylaxis;
- Angioedema edema;
- Lactic acidosis;
- Peripheral neuropathy;
- Change in the color of tooth enamel;
- chills;
- Increased fatigue;
- Serotonin syndrome.
How does Zivox work with other medicines?
When combined with cytochrome isoenzymes, there is no change in the activity of the latter.
If concurrently treated with linezolid and monoamine oxidase inhibitors, then the effect of the latter is enhanced. On this basis, dosages of adrenomimetics and dopaminomimetics should be reduced.
In the case of concomitant administration with "Aztreonam" or "Gentamicin" pharmacokinetics of linezolid was not observed.
Joint reception with "Rifampicin" entails a decrease in the maximum concentration of "Zivoks" - up to 32%.
Contraindications
The drug is unacceptable for use by patients with increased sensitivity to the main or additional components that make up its composition.
If the patient is taking phenelzine or isocarboxazide, then linezolid can not be taken during this therapy and 2 weeks after it.
If there is no way to control blood pressure, then Zyvox is unacceptable for treating patients with the following diseases:
- Unstable hypertension;
- Thyrotoxicosis;
- Pheochromocytoma;
- And also with joint admission with adrenomimetics and dopaminomimetics.
If you can not closely monitor patients at risk of serotonin syndrome, "Zyvox" can not be administered under the following circumstances:
- Presence of carcinoid disease;
- The use of drugs that inhibit the reuptake of serotonin, antidepressants of the tricyclic species, triptans, Miperedin and Buspirone.
The tablet form of "Zyvoks" is contraindicated for children under 12 years due to the impossibility of selecting an adequate dosage.
The drug is indicated for treatment in the event that the expected benefit from it exceeds the risk in the following cases:
- Renal and hepatic impairment;
- Systemic infections;
- Pregnancy and lactation.
Can an overdose of the drug occur?
In clinical trials, as well as with the further use of Zivox in hospital or out-of-hospital cases, no overdose has been detected. If such a situation arises, it is recommended to perform symptomatic therapy.
Conditions of storage and leave
The drug "Zivox" is sold in a pharmacy on the prescription of a doctor.
Analogues
In case of unacceptability of treatment with Zivox, its analogs may be assigned from the consideration of the similar effects of the action of the main active substance:
- With pneumonia and bronchitis - Doxycycline hydrochloride, Bronchorus, Arlet.
- With bacterial infections - "Levomycetin 0.25 g", "Vankomabol", "Lifaxon."
- With infections of the skin - "Benzatine benzylpenicillin", "Sulfadimetoksin."
- At not healing wounds - "Tsifaleksina sodium salt", "Lifuzol".
Appoint a drug on their list should only be the attending physician, since each medication has its own indications, features of reception and contraindications.
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