The discovery of antibiotics once became an event akin to revolutionary. Many saved lives put a group of drugs on the leading edge, the funds gained fame. Sumamed is a relatively “young” drug, but its predecessor, erythromycin, is familiar to several generations. The fame of antibiotics has been surging and falling. Either they were almost declared a panacea, then a national disaster.
Many patients were confused, confused: are they good or harmful? Why is cheap erythromycin bad? Why has it often been replaced by sumamed, which is many times higher than the old antibiotic in cost?
Sumamed: a detailed description of the properties, instructions for use
The medicine is relatively new, it is part of the marolide group. They began to actively appoint him in the nineties of the last century.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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History of Sumamed
Sumamed is a trade name. Its active substance: azithromycin, an analog of erythromycin and its “neighbor” in the group. These are macrolides. This group is called “last generation” antibiotics. The name is not entirely accurate, pharmacists work, and over time they will improve this group. Generations tend to change. But for now, the “last” in medicine means the best, such an official verbal paradox. The attribution of sumamed to the latter did not damage the reputation of the drug.
Macrolides are famous for the gentle effect on the body of the patient receiving them. True, not all. Erythromycin is also a macrolide. It was he, the biomass product of soil bacteria, which in structure and development resembled mushrooms (bacteria with filaments similar to mycelium), served as the founder of the group. This macrolide was stronger in action than traditional penicillin, streptomycin, tetracycline. The spectrum of stopping pathogens in erythromycin is high. But the drug is tough.
Allergies, up to a shock reaction, candidiasis, hearing loss, negative effects on the gastrointestinal tract, other side effects, are not uncommon when using the old drug. Therefore, scientists worked with derivatives of the group, looking for a way to get a drug that preserves the effect on the pathogenic flora, but – sparing the person.
So it turned out sumamed. His and it’s convenient to use: if you had to use erythromycin four times a day for the desired effect, and even the course of treatment took two weeks or more, then sumamed will have the same effect for three days with a single application per day. Side effects are also minimal. The drug of the last, new, generation spares the body to the maximum with enhanced therapeutic effect compared to previous macrolides.
Form of issue
An antibiotic is released in the form of capsules, powder and tablets. Capsules made of gelatin are filled with a white or yellowish powder of azithromycin in a stable form before use (dihydrate). To give the active substance the desired properties: better metabolism, preservation, non-stickiness, pleasant taste and proper distribution, transportation to organs after use, use excipients. In the composition of sumamed tablets, these are:
- Corn starch;
- Dye E-132;
- Microcrystalline cellulose (stabilizer);
- Sodium salt – lauryl sulfate;
- Magnesium stearate;
- Disubstituted anhydrous calcium phosphate;
- Pregelatinized starch;
- Polysorbate 80.
Capsules, in addition to the active component azithromycin dihydrate, excipients contain a minimum of:
- Magnesium stearate;
- Microcrystalline cellulose;
- Sodium laryl sulfate.
The capsule itself is soluble by the juices produced by the digestive system.
A suspension is prepared from the powder before use, and therefore its composition of excipients is different. It is designed to give taste and ease of use, assimilation. Auxiliary components are also called for to hold the substance in the form of a suspension – suspension. The powder includes:
- Azithromycin dihydrate – active substance;
- Colloidal silicon dioxide;
- Flavors: apple, more often strawberry (predominant taste), sometimes mint;
- Tragacanth (dry ground stone fruit gum);
- Sodium benzoate (preservative);
- Titanium dioxide (dye);
- Sucrose is a sweetener;
- Sodium carbonate anhydrous.
Dosage of tablets: 500 mg (elongated tablets – Sumamed 500), 125 mg (round).
Group in pharmacology: antibiotic.
In the presence of sumamed, the pathogenic flora of most species harmful to humans loses activity. The drug blocks the biosynthesis of protein components of harmful microflora. The therapeutic activity of the drug is proportional to its concentration. Dependence is direct. Those pathogenic forms that are not amenable to erythromycin, azithromycin (sumamed) also does not destroy. These are gram-positive microorganisms. Sumamed works well against gram-negative and anaerobic bacteria. Even those microorganisms that parasitize at the intracellular level cannot resist the antibiotic azithromycin.
Drug absorption high. The distribution is uniform, fast. The ability to intracellular penetration increases the effectiveness of sumamed. It enters all cells, does not pass and the phagocytes protecting the body. These are guardians of the immune system, mobilizing in problem foci to kill the infection.
A double blow is created: the phagocytes themselves and the intracellular azithromycin located in them act. This presence only helps phagocytes. They are concentrated in large numbers in places affected by alien flora. Sumamed is there with them. Also in an amount exceeding its total distribution throughout the body. Since its effect is dose-dependent, the resulting dose in the focus of inflammation is many times higher. A pronounced therapeutic effect of the drug is manifested.
Valuable property: azithromycin is a prolonged preparation. It is excreted longer than conventional antibiotics. According to medical standards, the elimination rate is usually measured by the half-life. For sumamed, this period is three days.
Very convenient: a single dose, only three days in a single dose. And the action is stretched to one and a half weeks. All this time, azithromycin has been working to neutralize pathogenic microflora. Metabolism passes in the liver, inactivated metabolites are formed. It is excreted with bile, spares the kidneys, almost without getting into them.
Sumamed is used, guided by the instructions for use, there are tablets for children that differ in the dose of the drug from those prescribed for adults.
Sumamed is indicated for bacteria caused by:
- Infectious lesions of the respiratory tract, both upper (sinusitis, laryngitis, otitis media, tonsillitis, pharyngitis), and lower (pneumonia of various etiologies and forms – alveolar, interstitial, chronic bronchitis, whooping cough);
- Skin and tissue infections of a bacterial nature (recurrent course of migratory erythema, developing borreliosis – Lyme disease, pyodermatosis, impetigo, skin disease – erysipelas);
- Contact infections characteristic of the genital area (chlamydia, cervicitis, inflammation of the urethra, mycoplasmosis, vaginitis and other bacterial);
- The presence of Helicobacter pylori in the corresponding sections of the digestive tract with diagnosed problems of the duodenum, gastric diseases.
- Intolerance to any drug from macrol >
- Various pathologies, kidney disease;
- Impaired liver function;
- Cardiac arrhythmia;
- Predisposition to rhythm malfunctions;
- Pathological cardiogram.
Pregnancy and Feeding
Sumamed is used for pregnant women only according to indications important for saving life. Compare the risks of the mother and her fetus, make a conclusion and choice. It is better when there is an opportunity to abstain from pregnancy drugs. But if an antibiotic is needed, sumamed is tolerated easier than many others, and it is prescribed for children in suspension (especially for children).
When a mother is sick, her fetus suffers. The antibiotic sumamed can be a salvation for both. The doctor should think about the appropriateness of the application, do not allow amateur performances.
Nursing mothers definitely you must refuse either feeding or medication. Azithromycin penetrates into milk, the antibiotic also affects beneficial flora. This is dangerous for the baby, its metabolism is just beginning to form, it can be harmed for life.
Method of application, dosage
The method is simple. Once a day – a daily dose. If this is a pill, we don’t take into account the meal; food does not interfere with the absorption of the tablet sumamed.
Suspension and capsules are vulnerable, they must be diluted in time with any food. Either take on an empty stomach and wait an hour, then take food, or wait two hours after eating. And only after – sumamed.
For half a year, children have been given sumamed: according to the instructions for use for children, a dose of 125 mg (tablet). But it is better to give Sumamed to the children in the form of a special suspension with a dosage for children, although the price is more than conventional antibiotics, the effect is greater. Allergies to it almost never happen, there are a lot of children with allergies. The instructions for Sumamed suspension for children emphasize: the use is safe, the drug is well tolerated.
For adults, a different dosage of sumamed tablets, the instructions for use recommend 500 mg: this is a single daily dose, the price of the drug is 400 rubles with slight fluctuations. The course is short: three days. Treatment lasts longer due to the prolonged action of the drug. Sumamed will work in the body for up to one and a half weeks. For all diseases of bacterial etiology that affected the respiratory system, tonsillitis, soft tissue lesions (excluding migratory erythema) and skin bacterial diseases, such a course and dosage of sumamed are sufficient.
Chronic migratory erythema for effective treatment requires a different scheme. The course is longer: five days. The first day, the reception is also single, but the dose is shock: double. Two tablets at once in an adult dosage (500 mg each). The remaining four days, the usual dose, 500 mg. In children, erythema is also treated, starting with a loading dose: 20 mg per kilogram of a child’s weight. The remaining four days, the dose is half.
In gastric diseases, the classical scheme adopted for azithromycin is used. The course is three days, 500 mg daily, a single dose.
For the treatment of genital infections – its own scheme. If the course is mild, uncomplicated, two tablets of an adult dosage, and sumamed will help at one time. But if the infection is complicated, for a long time, you will need six tablets. And there are three receptions. But not daily, the scheme is different. The prolonged effect of the drug is taken into account here, so weekly intervals are made between doses. They drink sumamed once a week, two tablets. The infection will give up after three weeks.
Sumamed and alcohol
Alcohol drinkers susceptible to diseases even more often, they need to know whether sumamed is compatible with this. Alcohol causes intoxication. This is a blow to the liver, kidneys. After reading the annotation to the drug sumamed, the patient will see: with the medicine one should be careful for those whose organs are not normal. Conclusion: azithromycin loads the liver, kidneys. And along with alcohol, the negative effect will inevitably increase.
Intoxication is also present from infection, why strengthen it with ethanol?
Alcohol also reduces the effectiveness of sumamed. Having treated the course, “diluting” it with ethanol, the disease can not be cured, but translated into a chronicle. Because the bacteria will remain “unfinished”, they will survive and become resistant to the antibiotic. The medicine will have to be changed, the treatment renewed.
Side effects of azithromycin are infrequent. But in the presence of ethanol, they become more frequent, new, unpredictable ones appear. Sumamed does not have compatibility with alcohol, as does other antibiotics.
The combination of antibiotics and ethanol is dangerous provoking disulfiram-like reactions. This is a chain of quick reactions in the body. The person is sick, vomiting appears. He is thrown into the heat, panic occurs, and the fear of death is acute. This fear is not from scratch: due to respiratory failure, pressure drop, failure of the nervous system, a fatal outcome is possible.
So it makes no sense to take risks. It is necessary to be treated competently, refraining from dangerous hobbies.
The drug is cleaned and arranged in such a way that it integrates as organically as possible into the body processes without changing them. But side effects were found and indicated even in harmless activated carbon. In some people, they also occur when taking azithromycin. This rarely happens, but you need to know. Side effects are:
- Digestive disorders: vomiting, periodic or constant nausea, chronic constipation, flatulence, diarrhea, acute gastritis, anorexia;
- Allergic manifestations: skin rash, Quincke’s edema, reaction to solar insolation (photosensitivity);
- Vaginal cand >Conjunctivitis Cardiopalmus Vaginal cand />pyelonephritis
Exceeding the dose can cause hearing loss, more often – temporary. There is intoxication, manifested by the usual symptoms: diarrhea, vomiting. There is no specific treatment and antidote, treat symptoms.
Macrolides of previous generations reacted negatively to a number of drugs, distorting their own or their effect. It was impossible to combine them with drugs:
- Carbamazepine (antiepileptic);
- Theophylline (bronchodilating antispasmodic);
- Digoxin (cardiac glycoside);
- Terfenadine (antihistamine);
- Triazolam (a tranquilizer of benzodiazepines).
Sumamed is successfully used in combination with these funds, often necessary for different categories of patients. He does not come into conflict with them, does not react.
Macrolides have species with different chemical formulas. Ketolides and azalides. The difference is not so great: one fragment in the lactone rings. Ketolides have 14 components, azalides – 15. Azithromycin (sumamed) – azalide. In combination with a number of pharmaceuticals, ketolides increase their toxicity. Therefore, macrolides of this species are not used with:
- Sugar-lowering drugs;
- Derivatives of ergot.
But azalides do not produce such a negative effect, they can be combined with these drugs without fear. In this, azithromycin is superior to the parallel group of macrolides in safety of use.
If the patient is treated with warfarin, a combination of sumamed with him is allowed. But monitoring of blood coagulability indices (prothrombin index) is required. If they worsen, one of the drugs must be discontinued for a particular patient.
It is undesirable to combine azithromycin with dihydroergotamine and / or ergotamine. In the presence of sumamed, these drugs often cause intoxication. Sensitivity disorders (dysesthesia) and even acute circulatory failure in the brain may occur due to vasospasm mediated by the interaction of drugs.
Other types of drugs can enhance (chloramphenicol, tetracycline) or inhibit (lincosamine) the effect of sumamed. The dosage of the latter should be adjusted or such combinations avoided.
It can not be combined with heparin, medications are incompatible.
It is advisable not to miss the sumamed receptions. If this happens, take the usual dose without waiting for time right away. The rest is already counted from this reception a day, taken, adhering to the interval of 24 hours.
The main analogue, almost the twin, of sumamed is its active substance, azithromycin. This is the same sumamed, with the same dosage of tablets: 500, 250, 200, 125 mg. 250 mg or less – intended for children, children’s sumamed with the attached instructions. Sumamed tablets for adults have a dosage of 500 mg. The habit of thinking that by paying more, we get a product with better quality, encourages you to choose an expensive medicine. Many take (and doctors prescribe) sumamed, the price of which is four times higher than the cost of azithromycin. Which is better: affordable azithromycin, or expensive sumamed? They are the same. The buyer chooses the reputation of the manufacturer, usually justify the price with explanations about the degree of purification of excipients.
Everything is experienced. Both forms of the drug are good. Sumamed produces Croatia, azithromycin – Russia, it is a Russian analogue of the drug, it is much cheaper than foreign.
- Sumamycin. At a price close to the Croatian drug, similar in effect. Manufacturer – Russia.
- Erythromycin-AKOS, Russia. Erythromycin is a macrol .