Лечение инфекционно-воспалительных заболеваний, вызванных чувствительными к препарату микроорганизмами: Инфекции верхних отделов дыхательных путей и ЛОР-органов, в т.ч.: Острый и хронический синусит. Острый и хронический средний отит. Заглоточный абсцесс. Тонзиллит. Фарингит. Инфекции нижних отделов дыхательных путей, в т.ч.: Острый бронхит с бактериальной ...
Амоксициллин (в форме натриевой соли) 500 мг клавулановая кислота (в форме калиевой соли) 100 мг
Фармакологические свойства
Антибиотик широкого спектра действия . содержит полусинтетический пенициллин амоксициллин и ингибитор β .-лактамаз клавулановую кислоту. Клавулановая кислота образует стойкий инактивированный комплекс с β .-лактамазами и обеспечивает устойчивость амоксициллина к их воздействию. Клавулановая кислота, подобная по структуре бета-лактамным антибиотикам, обладает слабой собственной антибактериальной активностью. Таким образом, Амоксиклав . действует бактерицидно на широкий спектр грамположительных и грамотрицательных бактерий (в т.ч. на штаммы, которые приобрели устойчивость к бета-лактамным антибиотикам вследствие продукции β .-лактамаз). Амоксиклав . активен в отношении аэробных грамположительных бактерий: Streptococcus spp. (в т.ч. Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Streptococcus bovis), Enterococcus spp., Staphylococcus aureus (кроме метициллин-резистентных штаммов), Staphylococcus epidermidis (кроме метициллин-резистентных штаммов), Staphylococcus saprophyticus, Listeria spp. . аэробных грамотрицательных бактерий: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp., Providencia spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica, Eikenella corrodens . анаэробных грамположительных бактерий: Peptococcus spp., Actinomyces israelii, Prevotella spp., Clostridium spp., Peptostreptococcus spp., Fusobacterium spp. . анаэробных грамотрицательных бактерий: Bacteroides spp.
Показания к применению
Лечение инфекционно-воспалительных заболеваний, вызванных чувствительными к препарату микроорганизмами: Инфекции верхних отделов дыхательных путей и ЛОР-органов, в т.ч.: Острый и хронический синусит. Острый и хронический средний отит. Заглоточный абсцесс. Тонзиллит. Фарингит. Инфекции нижних отделов дыхательных путей, в т.ч.: Острый бронхит с бактериальной суперинфекцией. Хронический бронхит. Пневмония . Инфекции мочевыводящих путей. Гинекологические инфекции. Инфекции кожи и мягких тканей, включая укусы человека и животных. Инфекции костей и суставов. Инфекции брюшной полости, в т.ч. желчных путей ( холецистит , холангит ). Одонтогенные инфекции. Инфекции передаваемые половым путем (гонорея, шанкроид). Профилактика инфекций после хирургических вмешательств.
Способ применения и дозы
Препарат вводят в/в. Курс лечения составляет 5-14 дней. Продолжительность курса лечения определяется индивидуально. При уменьшении степени тяжести симптомов для продолжения терапии рекомендуется переход на пероральные формы препарата Амоксиклав. Каждые 30 мг препарата Амоксиклав содержат 25 мг амоксициллина и 5 мг клавулановой кислоты. Взрослым и детям старше 12 лет (с массой тела > 40 кг): препарат назначают в дозе 1.2 г (1000 мг + 200 мг) с интервалом 8 ч, в случае тяжелого течения инфекции - с интервалом 6 ч. Детям в возрасте от 3 мес до 12 лет: препарат назначают в дозе 30 мг/кг массы тела (в пересчете на весь Амоксиклав) с интервалом 8 ч, в случае тяжелого течения инфекции - с интервалом 6 ч. Детям в возрасте до 3 мес: Недоношенным и в перинатальный период - в дозе 30 мг/кг массы тела (в пересчете на весь Амоксиклав) каждые 12 ч. В постперинатальном периоде - в дозе 30 мг/кг массы тела (в пересчете на весь Амоксиклав) каждые 8 ч. При хирургических вмешательствах Профилактическая доза при хирургических вмешательствах составляет 1.2 г при вводном наркозе (при продолжительности операции менее 2 ч) . при более продолжительных операциях - по 1.2 г до 4 раз/сут. Применение при нарушении функции почек Для пациентов с почечной недостаточностью доза и/или интервал между введениями препарата должны быть скорректированы в зависимости от клиренса креатинина (см.таблицу). Клиренс креатинина Режим дозирования > 0.5 мл/с (> 30 мл/мин) коррекции дозы не требуется 0.166-0.5 мл/с (10-30 мл/мин) первая доза - 1.2 г (1000 мг + 200 мг), а затем по 600 мг (500 мг + 100 мг) в/в каждые12 ч < 0.166 мл/с (< 10 мл/мин) первая доза - 1.2 г (1000 мг + 200 мг), а затем по 600 мг (500 мг + 100 мг) в/в каждые 24 ч анурия интервал между введениями следует увеличить до 48 ч или больше Поскольку 85% Амоксиклава удаляется гемодиализом, введение препарата проводят по окончании процедуры гемодиализа. При перитонеальном диализе не требуется коррекции режима дозирования. Правила приготовления и введения растворов для в/в инъекций Следует растворить содержимое флакона 1.2 г (1000 мг+200 мг) в 20 мл воды для инъекций . В/в вводить медленно (в течение 3-4 мин.). Правила приготовления и введения растворов для в/в инфузий Для инфузионного введения Амоксиклава необходимо дальнейшее разведение: приготовленный раствор, содержащий 1.2 г (1000 мг+200 мг) препарата, должен быть разведен в 100 мл инфузионного раствора. Продолжительность инфузии 30-40 мин. При использовании перечисленных ниже инфузионных растворов в рекомендованных объемах в них сохраняются необходимые концентрации антибиотика. В качестве растворителя для в/в инфузий могут использоваться следующие инфузионные растворы. Инфузионный раствор Стабильность при 25°С Стабильность при 5°С Вода для инъекций 4 ч 8 ч Инфузионный раствор натрия хлорида (0.9%) 4 ч 8 ч Инфузионный раствор Рингера лактата 3 ч - Инфузионный раствор калия хлорида или натрия хлорида 3 ч - Амоксиклав менее стабилен в инфузионных растворах, содержащих декстрозу (глюкозу), декстран или бикарбонат. Амоксиклав следует вводить в течение 20 мин после приготовления растворов для в/в введения. Следует использовать только прозрачные растворы. Приготовленные растворы не замораживать.
Побочное действие
Со стороны пищеварительной системы Потеря аппетита, тошнота, рвота , диарея. Редко - нарушения функции печени, повышение активности АЛТ и АСТ . в единичных случаях - холестатическая желтуха , гепатит, псевдомембранозный колит . Аллергические реакции Зуд, крапивница, эритематозные высыпания . редко - многоформная экссудативная эритема, ангионевротический отек, анафилактический шок. В единичных случаях - эксфолиативный дерматит, синдром Стивенса-Джонсона. Прочие Обратимое увеличение протромбинового времени (при совместном применении с антикоагулянтами). Редко - кандидоз и другие виды суперинфекции.
Особые указания
Со стороны пищеварительной системы Потеря аппетита, тошнота, рвота , диарея. Редко - нарушения функции печени, повышение активности АЛТ и АСТ . в единичных случаях - холестатическая желтуха , гепатит, псевдомембранозный колит . Аллергические реакции Зуд, крапивница, эритематозные высыпания . редко - многоформная экссудативная эритема, ангионевротический отек, анафилактический шок. В единичных случаях - эксфолиативный дерматит, синдром Стивенса-Джонсона. Прочие Обратимое увеличение протромбинового времени (при совместном применении с антикоагулянтами). Редко - кандидоз и другие виды суперинфекции.
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Клавулановая кислота образует стойкий инактивированный комплекс с β .-лактамазами и обеспечивает устойчивость амоксициллина к их воздействию. Клавулановая кислота, подобная по структуре бета-лактамным антибиотикам, обладает слабой собственной антибактериальной активностью. Таким образом, Амоксиклав . действует бактерицидно на широкий спектр грамположительных и грамотрицательных бактерий (в т.ч. на штаммы, которые приобрели устойчивость к бета-лактамным антибиотикам вследствие продукции β .-лактамаз). Амоксиклав . активен в отношении аэробных грамположительных бактерий: Streptococcus spp. (в т.ч. 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Острый и хронический средний отит. Заглоточный абсцесс. Тонзиллит. Фарингит. Инфекции нижних отделов дыхательных путей, в т.ч.: Острый бронхит с бактериальной суперинфекцией. Хронический бронхит. Пневмония . Инфекции мочевыводящих путей. Гинекологические инфекции. Инфекции кожи и мягких тканей, включая укусы человека и животных. Инфекции костей и суставов. Инфекции брюшной полости, в т.ч. желчных путей ( холецистит , холангит ). Одонтогенные инфекции. Инфекции передаваемые половым путем (гонорея, шанкроид). Профилактика инфекций после хирургических вмешательств."}}]},{"id":4,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат вводят в/в. Курс лечения составляет 5-14 дней. Продолжительность курса лечения определяется индивидуально. При уменьшении степени тяжести симптомов для продолжения терапии рекомендуется переход на пероральные формы препарата Амоксиклав. Каждые 30 мг препарата Амоксиклав содержат 25 мг амоксициллина и 5 мг клавулановой кислоты. Взрослым и детям старше 12 лет (с массой тела \u003e 40 кг): препарат назначают в дозе 1.2 г (1000 мг + 200 мг) с интервалом 8 ч, в случае тяжелого течения инфекции - с интервалом 6 ч. Детям в возрасте от 3 мес до 12 лет: препарат назначают в дозе 30 мг/кг массы тела (в пересчете на весь Амоксиклав) с интервалом 8 ч, в случае тяжелого течения инфекции - с интервалом 6 ч. Детям в возрасте до 3 мес: Недоношенным и в перинатальный период - в дозе 30 мг/кг массы тела (в пересчете на весь Амоксиклав) каждые 12 ч. В постперинатальном периоде - в дозе 30 мг/кг массы тела (в пересчете на весь Амоксиклав) каждые 8 ч. При хирургических вмешательствах Профилактическая доза при хирургических вмешательствах составляет 1.2 г при вводном наркозе (при продолжительности операции менее 2 ч) . при более продолжительных операциях - по 1.2 г до 4 раз/сут. Применение при нарушении функции почек Для пациентов с почечной недостаточностью доза и/или интервал между введениями препарата должны быть скорректированы в зависимости от клиренса креатинина (см.таблицу). Клиренс креатинина Режим дозирования \u003e 0.5 мл/с (\u003e 30 мл/мин) коррекции дозы не требуется 0.166-0.5 мл/с (10-30 мл/мин) первая доза - 1.2 г (1000 мг + 200 мг), а затем по 600 мг (500 мг + 100 мг) в/в каждые12 ч \u003c 0.166 мл/с (\u003c 10 мл/мин) первая доза - 1.2 г (1000 мг + 200 мг), а затем по 600 мг (500 мг + 100 мг) в/в каждые 24 ч анурия интервал между введениями следует увеличить до 48 ч или больше Поскольку 85% Амоксиклава удаляется гемодиализом, введение препарата проводят по окончании процедуры гемодиализа. При перитонеальном диализе не требуется коррекции режима дозирования. Правила приготовления и введения растворов для в/в инъекций Следует растворить содержимое флакона 1.2 г (1000 мг+200 мг) в 20 мл воды для инъекций . В/в вводить медленно (в течение 3-4 мин.). Правила приготовления и введения растворов для в/в инфузий Для инфузионного введения Амоксиклава необходимо дальнейшее разведение: приготовленный раствор, содержащий 1.2 г (1000 мг+200 мг) препарата, должен быть разведен в 100 мл инфузионного раствора. Продолжительность инфузии 30-40 мин. При использовании перечисленных ниже инфузионных растворов в рекомендованных объемах в них сохраняются необходимые концентрации антибиотика. В качестве растворителя для в/в инфузий могут использоваться следующие инфузионные растворы. Инфузионный раствор Стабильность при 25°С Стабильность при 5°С Вода для инъекций 4 ч 8 ч Инфузионный раствор натрия хлорида (0.9%) 4 ч 8 ч Инфузионный раствор Рингера лактата 3 ч - Инфузионный раствор калия хлорида или натрия хлорида 3 ч - Амоксиклав менее стабилен в инфузионных растворах, содержащих декстрозу (глюкозу), декстран или бикарбонат. Амоксиклав следует вводить в течение 20 мин после приготовления растворов для в/в введения. Следует использовать только прозрачные растворы. Приготовленные растворы не замораживать."}}]},{"id":5,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы Потеря аппетита, тошнота, рвота , диарея. Редко - нарушения функции печени, повышение активности АЛТ и АСТ . в единичных случаях - холестатическая желтуха , гепатит, псевдомембранозный колит . Аллергические реакции Зуд, крапивница, эритематозные высыпания . редко - многоформная экссудативная эритема, ангионевротический отек, анафилактический шок. В единичных случаях - эксфолиативный дерматит, синдром Стивенса-Джонсона. Прочие Обратимое увеличение протромбинового времени (при совместном применении с антикоагулянтами). 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