Antibiotic usage and dosage

Some type antibiotics and explanation ( Part. 1 )
Here are some examples of Antibiotic medications :
1 . amoxicillin
- Indication :
Amoxicillin is effective against the disease :
Chronic respiratory tract infections and acute : pneumonia , pharyngitis ( not for gonorrhea pharyngitis ) , bronchitis , langritis .
Sluran gastrointestinal infections : bacillary dysentery .
Urinary tract infections : Uncomplicated gonorrhea , urethritis , cystitis , pyelonephritis .
Other infections : septicemia , endocarditis .

- Contra Indications :
Patients with allergic reactions to penisilina .

- Composition :
Each teaspoon ( 5 ml ) suspension containing amoksisilina trihydrate equivalent to 125 mg anhydrous amoksisilina .
Each capsule contains amoksisilina trihydrate equivalent to 250 mg anhydrous amoksisilina .
Each kaptab containing amoksisilina trihydrate equivalent to 500 mg anhydrous amoksisilina .

- How Drugs Work :
Amoksisilina penisilina a semi synthetic compound with broad-spectrum anti-bacterial activity that is bactericidal . Activity similar to ampisilina , effective against most gram - positive bacteria and some gram - negative pathogens .
Pathogenic bacteria are sensitive to amoksisilina Staphylococci , Streptococci , Enterococci , S. pneumoniae , N. gonorrhoeae , H. influenzae , E. coli and P. mirabilis .
Amoksisilina spesias less effective against Shigella and beta - lactamase -producing bacteria .

- Posology :
Amoksisilina dose adjusted to the type and severity of infection .
Children weighing less than 20 kg : 20-40 mm / kg of body weight a day , divided into 3 doses .
Adults or children weighing more than 20 kg : 250-500 mg daily , before meals .
Gonorrhea were not compiled : amoksisilina 3 grams with probenecid 1 g as a single dose .

- Side Effects :
In patients who are hypersensitive allergic reactions may occur such as hives , skin rash , pruritus , angioedema and gastrointestinal disorders such as diarrhea , nausea , vomiting , glossitis and stomatitis .

- Drug interactions :
Probenecid slows excretion amoksisilina .

2 . cefixime Capsules
- Indication :
Cefixime is indicated for the treatment of infections caused by susceptible microorganisms , among others :
Uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis .

Otitis media caused by Haemophilus influenzae ( strain ? - Lactamase positive ) and Streptococcus pyogenes .

Pharyngitis and tonsillitis caused by Streptococcus pyogenes .

Acute bronchitis and chronic bronchitis with acute exacerbation caused by Streptococcus pneumoniae and Haemophilus influenzae ( beta - lactamase positive strains and negative ) .

- Contra Indications :
Patients with a history of hypersensitivity due to shock or some of the ingredients of this preparation .

- Composition :
Each capsule contains Cefixime 50 :
Cefixime 50 mg

Each capsule contains Cefixime 100 :
Cefixime 100 mg

- Pharmacology :
antibacterial activity

Cefixime is a broad-spectrum bactericidal against microorganisms and gram-positive and gram-negative , like other oral cephalosporins , cefixime has potent activity against gram-positive microorganisms such as Streptococcus sp . , Streptococcus pneumoniae , and gram-negative as Branhamella catarrhalis , Escherichia coli , Proteus sp . , Haemophilus influenzae .

Its mechanism of action that inhibits cell wall synthesis . Cefixime has a high affinity for " penicillin -binding - protein " ( PBP ) 1 ( 1a , 1b , and 1c ) and 3 , with an activity that varies depending on the type of organism .

Cefixime is stable against ? - Lactamase produced by several organisms , and has good activity against organisms producing ? - Lactamase .

- Pharmacokinetics :
Concentration in the serum .

Single-dose oral administration 50,100 or 200 mg ( potency ) of cefixime in healthy adults in the fasting state , peak serum levels achieved after 4 hours of administration respectively 0.69; 1.13 , and 1.95 ? G / ml . Serum half-life is 2.3-2.5 hours . Oral administration a single dose of 1.5, 3.0 , or 6.0 mg ( potency ) / kg cefixime in pediatric patients with normal renal function , peak serum levels reached after 3-4 hours of administration respectively 1.14 ; 2.01 , and 3.97 ? g / ml . Serum half-life is 3.2 to 3.7 hours .
Distribution ( penetration into the tissue )
Penetration into sputum , tonsils , maxillary sinus mucosal tissue , otorrhea , bile and gallbladder tissue is good .

metabolism
There were no active metabolites as an antibacterial in the serum or urine .

elimination
Cefixime is excreted primarily through the kidneys . The amount of urine excretion ( up to 12 hours ) after oral administration of 50,100 or 200 mg ( potency ) in healthy adults in the fasting state approximately 20-25 % of the administered dose . Peak urine levels respectively 42.9 ; 62.2 and 82.7 ? G / ml achieved in 4-6 hours after administration . The amount of urine excretion ( up to 12 hours ) after oral administration of 1.5, 3.0 , or 6.0 mg ( potency ) / kg in pediatric patients with normal renal function approximately 13-20 % .

- Dose :

Adults and children with weight? 30 kg , the recommended daily dose is 50-100 mg ( potency ) of cefixime orally twice daily .

The dose should be adjusted to patient age , weight and condition of the patient. For severe infections the dose may be increased to 200 mg ( potency ) given twice daily .

In the case of overdose :

Gastric lavage can be done when there is no specific antidote . Cefixime is not removed within a specific amount . Cefixime is not removed in significant quantities from the circulation by hemodialysis or peritoneal dialysis .


- Side effects :
shock
Considerable attention should be done because the symptoms can sometimes shock occurs . If some of the signs or symptoms such as feeling bad , bad taste in the mouth cavity , stridor , dizziness , abnormal defecation , tinnitus or diaphoresis ; hence the use of these preparations should be discontinued .

hypersensitivity
If signs of hypersensitivity reactions such as rash, urticaria , erythema , pruritus or fever, then the use of these preparations should be discontinued and other treatment should be made more precise .

hematologic
Granulocytopenia or eosinophilia are rare. Sometimes thrombocytopenia may occur . The use of these preparations should be discontinued if any abnormalities found this .

Hemolytic anemia was reported that occurred in the use of cefixime other preparations .

hepatic
Rarely an increase in GOT , GPT or alkaline phosphatase .

renal
Periodic monitoring of renal function is recommended because of impaired renal function such as renal insufficiency can sometimes occur . If any abnormalities are found these , stop using this drug and do another, more precise handling .

Digestive
Sometimes it happens like colitis pseudomembranous colitis , as indicated by the presence of blood in the stool . Stomach pain or diarrhea continue to require proper handling , infrequent vomiting , diarrhea , stomach pain , discomfort in the stomach , heartburn or anorexia , nausea , feeling of fullness in the stomach or constipation .

breathing
It sometimes happens interstitial pneumonia or PIE syndrome , as indicated by the presence of symptoms of fever , cough , dyspnea , chest x-rays are not normal and eosinophilia , it should refrain from treatment with these drugs and doing other proper handling of such provision adrenocortical hormones .

Changes in bacterial flora
Rare stomatitis or thrush .

deficiency of vitamin
Vitamin K deficiency is rare ( like hipoprotrombinemia or bleeding tendency ) or a deficiency of vitamin B group ( such as glossitis , stomatitis , anorexia or neuritis ) .

Others
Infrequent headaches or dizziness .

In a study of young rats given 1,000 mg / kgBB.hari orally , reported a decrease in spermatogenesis .

Effect on laboratory tests
False positive results can occur in the determination of urine glucose using Benedict's solution , Fehling's solution and Clinitest . But the test - tape does not occur false positive .

Can occur positive direct Coombs test .

3.Cefadroxil 500 mg
- Indication :
Cefadroxil is indicated for the treatment of infections caused by sensitive microorganisms such as :
- Respiratory tract infections : tonsillitis , pharyngitis , pneumonia , otitis media .
- Skin and soft tissue infections .
- Urinary and genital tract infections .
- Other infections : osteomyelitis and septicemia .

- Contra Indications :
Patients who are hypersensitive to cephalosporins .

- Composition :
Cefadroxil 500 , each capsule contains Cefadroxil Cefadroxil monohydrate equivalent to 500 mg .

- How it Works :
Cefadroxil is a semisynthetic antibiotic class sefalosforin for oral administration .
Cefadroxil is bactericidal by inhibiting the synthesis of bacterial cell walls . Cefadroxil is active against beta - hemolytic Streptococcus , Staphylococcus aureus ( including penicillinase -producing enzyme ) , Streptococcus pneumoniae , Escherichia coli , Proteus mirabilis , Klebsiella sp , Moraxella catarrhalis .

- Dose :
adult :
Urinary tract infections :
Lower urinary tract infections , such as cystitis : 1-2 g daily in a single dose or two divided doses , other urinary tract infections 2 g daily in divided doses .

Skin and soft tissue infections : 1 g per day in a single dose or two divided doses .

Respiratory tract infections :
Mild infection , usual dose of 1 gram daily in two divided doses .

Moderate to severe infections , 1-2 grams daily in two divided doses . For pharyngitis and tonsillitis caused by beta - hemolytic Streptococcus : 1 g per day in a single dose or two divided doses , the treatment given at least 10 days .

Children :
Urinary tract infections , skin and soft tissue infections : 25-50 mg / kg daily in two divided doses .
Pharyngitis , tonsillitis , impetigo : 25-50 mg / kg in a single dose or two divided doses . For infections caused by beta - hemolytic Streptococcus , treatment given at least 10 days .

- Side Effects :
Gastrointestinal disorders , such as nausea , vomiting , diarrhea , and symptoms of pseudomembranous colitis .
Hypersensitivity reactions , such as skin rash , hives and anaphylactic reactions .
Other side effects such as vaginitis , neutropenia and transaminase elevations .

- Drug Interactions :
Drugs that may increase the nephrotoxic cephalosporins against renal toxicity .
Probenecid inhibits the secretion of cephalosporins to extend and increase the concentration of drug in the body .
Alcohol can cause Disulfiram - like reactions , if given 48-72 hours after administration of cephalosporins .

- How Reconstitution Suspension :
Add 45 ml of water , shake until a homogeneous suspension .
After 7 days the suspension that has been reconstituted should not be used anymore .

- How Storage :
Store in tightly covered container at room temperature ( 15-30 º C ) .

4 . KALMICETINE Chloramphenicol Capsules
- Indication :
As the first choice therapy for the treatment of typhoid and paratifus .
For severe infections caused by :
- Salmonella sp .
- H. influenzae ( especially the meningeal infection )
- Rickettsa
- Limphogranuloma
- Psittachosis
- Gram - negative bacteremia that causes meningitis .

- Contra Indications :
- Patients who are hypersensitive to chloramphenicol
- Patients with severe liver dysfunction
- Patients with severe renal impairment

- Composition :
Each capsule contains :
Chloramphenicol ................................................ 250 mg
Each 5 ml of suspension contains :
Chloramphenicol Chloramphenicol Palmitate which is equivalent to 125 mg ..............
Ethanol ................................................. ................. 0.78 % v / v

- Pharmacology :
Chloramphenicol is a broad-spectrum antimicrobial effective against gram positive and gram negative bacteria . Its mechanism of action is to inhibit microbial cell protein synthesis .

- Dosage and Administration :
 - Adults , children and infants over the age of 2 weeks : 50 mg / kg body weight a day divided into 3-4 doses .
 - Infants under the age of 2 weeks : 25 mg / kg body weight a day divided into 4 doses .

- Warnings and Precautions:
 - Do not recommended the use for pregnant and lactating women because of their safety has not been established .
 - In the long-term use needs to be done hematologisecara periodic inspection .
 - Only used for infections of the obvious cause, except when there is the possibility of severe infection .
 - There needs to be oversight of the possibility of superinfection by bacteria and fungi .
 - Be careful when used in patients with impaired renal function and liver , premature infants and newborns ( first 2 weeks ) .
 - Not for the prevention of infection , treatment of influenza , coughs and colds .

- Side Effects :
 - Especially blood dyscrasias aplastic anemia can be serious and fatal .
 - Gastrointestinal Disorders such as : nausea , vomiting , diarrhea .
 - Hypersensitivity reactions , eg, urticaria and anaphylactic .
 - Grey syndrome in newborns , especially premature infants .

- Drug Interactions :
Chloramphenicol inhibits the biotransformation of other compounds that are metabolized by the liver microsomal enzymes such as dikumarol , phenytoin , tolbutamide and other sulfonylurea derivatives .

5 . clindamycin capsule
- Indication :
Effective for the treatment of serious infections disebabkanoleh anaerobic bacteria , streptococcus , pneumococcus and staphylococcus , such as :
Serious respiratory tract infections .
Bone and soft tissue infections are serious .
Septicemia .
Intra - abdominal abscess .
Infections of the female pelvis and genital tract .

- Contra Indications :
Hypersensitivity to clindamycin and lincomycin .

- Composition :
Each capsule contains 169.5 mg of clindamycin hydrochloride equivalent klindamissin dengan150 mg .
Each capsule contains 339 mg of clindamycin hydrochloride equivalent to 300 mg of clindamycin .

- How Drugs Work :
Clindamycin can work as a bacteriostatic or bactericidal depending on the concentration of drug at the site of infection and infecting organism .
clindamycin inhibits protein synthesis by binding organisms 50 S ribosomal subunit resulting terjhambatnya peptide bond formation .
Clindamycin quickly absorbed by the digestive tract .

- Dose
Adults : Serious infections 150-300 mg every 6 hours
More severe infections 300-450 mg every 6 hours
Children: Serious infections 8-16 mg / kg / day in 3-4 divided doses
More severe infections 16-20 mg / kg / day in 3-4 divided doses
To avoid the possibility of esophageal irritation , then the drug should be swallowed with a full glass of water .
In the beta hemolytic streptococcus infection , treatment should be continued for at least 10 days .

- Side Effects :
Gastrointestinal tract , such as nausea , vomiting and diarrhea .
Hypersensitivity reactions , such as rash and urticaria .
Liver : jaundice , abnormal liver function tests .
Kidney : Clindamycin is not straightforward to kidney damage .
Hematopoietic : neutropenia ( leukopenia and eosinophilia while ) .
Musculoskeletal : polyarthritis .

- Drug Interactions :
Neuromuscular inhibitory compounds , such as aminoglycosides and erythromycin .