Indications for use and dosage antibacterial funds in diseases of the respiratory organs
Penicillin. Penicillin highly effective for most cocci and grampolozhitelnyh bacteria, ampicillin - also against DTaP sticks, salmonella, shigella, proteya, coliform bacillus. They remain important means of antibacterial therapy with common infections such as pneumococcal, gemofilyusnaya, less ningokokkovaya, streptococcal. The dose of penicillin 50 000-100 000 ED / kg per day potassium salt - intramuscularly, sodium salt - intravenously; V-penicillin (smallpox, oratsillin, etc.) - inwards dose am pitsillina 100-300 mg / kg per day inside, intravenously and intramuscularly. Amoxicillin - analog-amp tsillina applies inside, is part of the preparations augmentin, amoksiklav in combination with cluster-vulavikovoy acid, overwhelmingly laktamazu; dose of 40-60 mg / kg per day.
Metitsimin, oksatsillin, dikloksatsillin, naftsillin resistant to action laktamaz, but inferior to penicillin on the Effects on sensitive flora. Their use for the treatment processes caused by sustained stafillokokkom, for other purposes their use impractical. Intravenously and intramuscularly impose 100-300 mg / kg per day, inside (oksatsillin and dikloksatsillin) 50-100 mg / kg per day, ampioks - 100-300 mg / kg per day.
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Karbenitsillin, tikartsillin have a range of activity, close to ampicillin se, but more effective against sinegnoynoy sticks and applied in a dose of 300-400 mg / kg per day.
Ureidopenitsilliny: piperatsillin (pipratsil), meelotsillin (mezlin), azlotsillin (azlin) - are active against sinegnoynoy sticks and some other intestinal bacteria groups, including klebsiell, tsitrobaktera, bakteroidov. Used as a reserve medication, including for the treatment of hospital infections; dose of 200-400 mg / kg per day.
Tsefalosporiny. The first generation tsefalosporinov effective against resistant Staphylococcus, in the rest of their range of action is similar to penicillin itself, so in paediatric practice them apply only if stafilokokkovoy infections (including alleged, in combination with Agent-tsin) or when intolerance of penicillin (5 - 15% patients has also increased sensitivity to tsefalosporinam). Tsefazolin (kefzol, tsefamezin) impose intravenously and intramuscularly at a dose of 75-100 mg / kg per day, tsefaklor (tseklor) and tsefaleksin (kefleks) - inwards in a dose of 50-75 mg / kg per day. Poor penetrate gematoenfetsalichesky barrier, with meningitis are not appointed.
The second generation tsefalosporinov less effective against cocci, but more actively against intestinal and DTaP sticks, klostridy, bakteroidov. Tsefmandol and tsefuroksim (tsinatsef) used intravenously and intramuscularly at a dose of 75 - 200 mg / kg per day, tsefuroksim-aksetil (tseftin, zinnat) - inwards in a dose of 125-200 mg twice a day after meals.
The third generation tsefalosporinov has a wide range of actions. Used with infections caused by gram bacteria, including the hospital, well-penetrate gematoentsefaliche ский barrier that allows their use with meningitis. It is advisable to limit their use in cases where other drugs are effective for preventing them from developing resistance to the flora. Tsefataksim (klaforan), tsefperazon (tsefobid), tseftizoksim (epotselIn, tsefizoks), ceftazidime (fortum, kefadim) impose intravenously or intramuscularly at a dose of 75-150 mg / kg per day 1 time, tseftriakson (fold-gotsef) - 1 injection in night, tsefiksim (tsefspan) in a dose of 3-9 mg / kg per day inside.
Aminoglikozidy. The group of drugs active against gram of bacteria, but often not an overwhelming growth of pneumococcus and streptokokkov. Not-and-fro ototoksichny.
Gentamicin - the main representative of the group, also is active against Staphylococcus, used in combination with penicillin or tsefalosporinami first generation to start therapy heavy infections unidentified etiology; his dose intravenously or intramuscularly, with the introduction of 4-8 mg / kg per day, while intratekalnom 1-2 mg, inside (not absorbed) 50-100 mg / kg per day. Sizamitsin (5-7 mg / kg / day) and amikacin (15-20 mg / kg in sugki) have a broader spectrum of action than gentamicin. Tobramitsin in a dose of 5-10 mg / kg per day especially active against psevdomonad. Streptomycin and kanamycin (20 - 30 mg / kg / day) are used to treat tuberculosis, in the treatment of non-tubercular disease concede gentamicin.
Makrolidy. It has high activity against cocci, pertussis, diphtheria sticks, mikoplazmy, brutsell, legionell, chlamydia, rikket session. Erythromycin, oleandomitsin isplzuyutsya in a dose of 30-50 mg / kg per day inside, erythromycin also intravenously in a dose of 15-20 mg / kg per day in the form of lengthy infusion. Azithromycin (sumamed) is wider than erythromycin, the range of actions, including shigella, salmonella, iersiny, intestinal stick. Dose on the first day of 10 mg / kg, then 5 mg / kg per day inside.
Tetracycline. Active against chlamydia, rickettsia, mikoplazm, brutsell. Many cocci become resistant to tetracycline. At the same time, tetracyclines destroy rudiments of teeth in children younger than 8 years. All this restricts the use of these drugs. Tetracycline, chlortetracycline, oksitetratsik-line inside take 20-40 mg / kg per day (zapivat not milk!), Doxycycline, minotsiklin - to 4 - 5 mg / kg per day; first dose redouble better.
Other drugs. Levomitsetin (chloramphenicol) has a broad spectrum of activity against cocci, bacterial anaerobe, chlamydia, rickettsiae; well penetrates through the blood-brain barrier. Provides mostly bacteriostatic effect against gemofilyusa - microbicides. Inside take on 50-75 mg / kg per day, intramuscularly and intravenously - up to 100 mg / kg per day (with heavy infections). Not applicable for children 4-6 first month of life because of the possibility of development vasomotor collapse (gray syndrome); can suppress haematopoiesis.
Lincomycin (linkotsin) is active against gram-positive cocci, including resistance to less titsillinu Staphylococcus, as well as mikoplazm; dose of 30 mg / kg per day intravenously or intramuscularly.
Clindamycin is used mostly with anaerobic infections in a dose of 10-20 mg / kg per day inside or 25-40 mg / kg per day intravenously. Contribute Development psevdomembranoznogo colitis.
Vancomycin (vankotsin) is applied at kokkovyh infections, including stafilokokkovoy, as well as psevdomembranoznom colitis caused by Clostridium dificile. Intravenous impose 40-60 mg / kg per day, the interior (not absorbed) - 20-40 mg / kg per day.
In polymyxin used to suppress the polished-zistentnoy intestinal flora, with heavy infections as a reserve in the drug dose 30 000-40 000 ED / kg in sugki intramuscularly. When intestinal infections give inwards in the same dose (not absorbed).
Imipinem (tienam) is active against a broad range of pathogens, is used in heavy infections, primarily caused by psevdomonadami, in a dose of 60 mg / kg per day intravenously, not more than 2 g per day.
Rifampicin - anti-drug active against resistant forms of cocci, gemofilyusa, salmonella, is used as a backup in a dose of 10 mg / kg in sugki inside.
Metronidazole (trihopol, flags, metragil) - antiprotozoyny drug active against anaerobe, including bakteroidov. Inside give 20-50 mg / kg per day, intravenously - 30-50 mg / kg in sugki.
Trimethoprim (sulfamethoxazole, biseptol, baktrim) suppresses growth of many cocci, bacteria, chlamydia, pnevmotsist. Dose 6-8 mg / kg per day trimethyl-Prima, with pnevmotsistoze to 20 mg / kg per day.
Tsiprofloksatsin (tsiprobay) is active on many cocci and bacteria, including psevdomonad. Vrgutr 250-750 mg dose 2 times per day, with long intravenous infusion - of 100-200 mg 2 times a day.
