Universal reference book for medicines
Product name: OXAMSAR (OXAMSAR)

Active substance: ampicillin, oxacillin

Type: The broad-spectrum penicillin antibiotic, resistant to penicillinase

Manufacturer: BIOCHEMIK (Russia)
A typical clinical and pharmacological article
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Combined antibiotic, combining the spectrum of action of ampicillin and oxacillin.


Ampicillin - semi-synthetic penicillin, acts bactericidal, acid-fast.
It is active against Gram-positive, non-forming penicillinase (Staphylococcus spp., Streptococcus spp., Streptococcus pneumoniae), and Gram-negative (Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Salmonella spp., Shigella spp., Proteus mirabilis, Haemophilus influenzae) microorganisms.
Oxacillin is a penicillin-resistant semisynthetic antibiotic from the penicillin group, acid-fast;
has bactericidal action against gram-positive microorganisms (Staphylococcus spp., Streptococcus spp., including Streptococcus pneumoniae, Actinimyces spp., Bacillus anthracis, Corynebacterium diphtheriae, anaerobic spore-forming rods, including Clostridium), Gram-negative cocci (Neisseria gonorrhoeae, Neisseria meningitidis), Escherichia coli, Proteus mirabilis, Haemophilus influenzae, Klebsiella pneumoniae, Actinomyces spp., Treponema spp.

Pseudomonas aeruginosa and other non-fermenting gram-negative bacteria are resistant to the action of the combination, most strains of Proteus vulgaris, Providencia rettgeri, Morganella morganii.

PHARMACOKINETICS
T Cmax of both antibiotics in the blood - 0.5-1 h after IM.
With intravenous administration in the blood, drug concentrations that are faster than those with a / m injection are quickly created.

Both antibiotics are excreted by the kidneys, in part - with bile.
When repeated injections are not cumulated.
INDICATIONS
Bacterial infections caused by susceptible pathogens: sinusitis, tonsillitis, otitis media;
bronchitis, pneumonia; cholangitis, cholecystitis; pyelonephritis, pyelitis, cystitis, urethritis, gonorrhea, cervicitis; infections of the skin and soft tissues: erysipelas, impetigo, secondarily infected dermatoses, etc.

Prevention of postoperative complications during surgical interventions (including against the background of immunodeficiency), infections in newborns (infection of the amniotic fluid, impaired breathing of the newborn, requiring the use of resuscitative measures, the risk of aspiration pneumonia).


Severely leaking infections (sepsis, endocarditis, meningitis, postpartum infection).

DOSING MODE
Inside, a single dose for adults and children over 14 years is 0.5-1 g, daily - 2-4 g. Children 3-7 years - 100 mg / kg / day, 7-14 years - 50 mg / kg / day.
Duration of treatment - from 5-7 days to 2 weeks. The daily dose is divided into 4-6 receptions.

In / m and / in (struyno, drip), daily intake for adults and children over 14 years old - 3-6 g;
for newborns , prematurity and children under 1 year - 100-200 mg / kg / day; 1-6 years - 100 mg / kg / day; 7-14 years - 100 mg / kg / day. The daily dose is administered in 3-4 doses, with an interval of 6-8 hours. If necessary, these doses can be increased by 1.5-2 times.

For the / m introduction, the contents of the vial (0.2 and 0.5 g) are dissolved respectively into 2 and 5 ml of water for injection.


For IV injection (for 2-3 minutes) a single dose is dissolved in 10-15 ml of water for injection or 0.9% NaCl solution.


For intravenous administration of adults, a single dose is dissolved in 100-200 ml of 0.9% NaCl solution or 5% dextrose solution and injected at a rate of 60-80 cap / min;
Children as a solvent use 30-100 ml of a 5-10% solution of dextrose. In / in the drug administered 5-7 days, followed by a transition to the / m or oral reception.

The solutions are used immediately after preparation.

SIDE EFFECT
Allergic reactions: urticaria, skin hyperemia, angioedema, rhinitis, conjunctivitis;
fever, arthralgia, eosinophilia, in rare cases - anaphylactic shock; superinfection, dysbacteriosis, taste change, vomiting, nausea, diarrhea, rarely - pseudomembranous enterocolitis, leukopenia, neutropenia, anemia.

Phlebitis and periphlebitis (with iv introduction);
with a / m - at the injection site infiltration, soreness.

At the appearance of signs of anaphylactic shock, urgent measures should be taken to remove the patient from this condition: the introduction of epinephrine, GCS (hydrocortisone or prednisolone) and antihistamines, if necessary, carry out mechanical ventilation.

CONTRAINDICATIONS
hypersensitivity;

- Infectious mononucleosis;

- lymphocytic leukemia.

With caution: chronic renal failure, children born to mothers with hypersensitivity to penicillins.

PREGNANCY AND LACTATION
Possible use in pregnancy according to indications.


It is excreted in breast milk in low concentrations.
If you need to use the drug during lactation, you should decide whether to stop breastfeeding.
APPLICATION FOR FUNCTIONS OF THE LIVER
When used in high doses in patients with renal insufficiency, a toxic effect on the central nervous system is possible.
At course treatment it is necessary to monitor the state of kidney function.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
At course treatment it is necessary to monitor the liver function.

APPLICATION FOR CHILDREN
Use with caution in children born to mothers with hypersensitivity to penicillins.
Apply on indications.
SPECIAL INSTRUCTIONS
In course treatment it is necessary to monitor the status of the functions of the organs of hematopoiesis, liver and kidneys.


The possibility of developing superinfection (due to the growth of insensitive microflora) requires a corresponding change in antibacterial therapy.


In patients who are hypersensitive to penicillins, there may be cross-allergic reactions with cephalosporin antibiotics.


When used in high doses in patients with renal insufficiency, a toxic effect on the central nervous system is possible.

DRUG INTERACTION
Antacids, glucosamine, laxatives, food, aminoglycosides (for enteral administration) slow down and decrease absorption;
ascorbic acid increases absorption.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, vancomycin, rifampicin) have a synergistic effect;
bacteriostatic medicinal agents (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic.

Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index);
reduces the effectiveness of oral contraceptives, drugs, in the process of metabolism which forms PABC, ethinyl estradiol - the risk of bleeding "breakthrough".

Diuretics, allopurinol, tubular secretion blockers, phenylbutazone, NSAIDs, and other drugs that block tubular secretion increase the concentration of the drug in the plasma, which increases the risk of developing toxic effects.


Allopurinol increases the risk of skin rash.

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