Azithromycin is combined with what antibiotics. Azithromycin dosage regimens for various STIs

For oral administration: infections of the upper (streptococcal pharyngitis/tonsillitis) and lower (bacterial bronchitis, interstitial and alveolar pneumonia, exacerbation of chronic bronchitis) respiratory tract, ENT organs (otitis media, laryngitis and sinusitis), genitourinary system (urethritis and cervicitis) , skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses), chronic stage of erythema migrans (Lyme disease), stomach diseases and duodenum, associated with Helicobacter pylori. For infusions: severe infections caused by sensitive strains of microorganisms: community-acquired pneumonia, infectious inflammatory diseases pelvic organs.

Release form of the drug Azithromycin

powder substance; two-layer polyethylene bag (pouch) 1 kg; powder substance; two-layer polyethylene bag (bag) 2 kg; powder substance; polyethylene bag (bag) 5 kg drum 1; powder substance; polyethylene bag (bag) 15 kg drum 1; powder substance; polyethylene bag (bag) 25 kg drum 1; powder substance; polyethylene bag (bag) 50 kg drum 1; powder substance; two-layer polyethylene bag (bag) 3 kg; powder substance; two-layer polyethylene bag (bag) 4 kg; powder substance; two-layer polyethylene bag (bag) 5 kg; powder substance; two-layer polyethylene bag (bag) 6 kg; powder substance; two-layer polyethylene bag (bag) 7 kg; powder substance; two-layer polyethylene bag (bag) 8 kg; powder substance; two-layer polyethylene bag (bag) 9 kg; powder substance; two-layer polyethylene bag (pouch) 10 kg; powder substance; two-layer polyethylene bag (bag) 15 kg; powder substance; two-layer polyethylene bag (bag) 20 kg; powder substance; two-layer polyethylene bag (pouch) 25 kg; powder substance; two-layer polyethylene bag (bag) 50 kg; powder substance; two-layer polyethylene bag (bag) 5 kg polyethylene drum 1; powder substance; two-layer polyethylene bag (bag) 10 kg polyethylene drum 1; powder substance; two-layer polyethylene bag (bag) 25 kg polyethylene drum 1;

Pharmacodynamics of the drug Azithromycin

It binds to the 50S subunit of ribosomes, inhibits peptide translocase at the translation stage and suppresses protein biosynthesis, slowing down the growth and reproduction of bacteria; at high concentrations, a bactericidal effect is possible. The spectrum of action is wide and includes gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, streptococci of groups C, F, G, Streptococcus viridans), except those resistant to erythromycin, and gram-negative (Haemophilus influenzae, Moraxella catarrhalis, tella pertussis , Bordetella parapertussis, Campylobacter jejuni, Legionella pneumophila, Neisseria gonorrhoeae, Gardnerella vaginalis) microorganisms, anaerobes (Bacteroides bivius, Peptostreptococcus spp., Peptococcus, Clostridium perfringens), chlamydia ( Chlamydia trachomatis, Chlamydia pneumoniae), mycobacteria (Mycobacteria avium complex), mycoplasma (Mycoplasma pneumoniae), ureoplasma (Ureaplasma urealyticum), spirochetes (Treponema pallidum, Borrelia burgdorferi).

Pharmacokinetics of the drug Azithromycin

Stable in an acidic environment, lipophilic, when taken orally, it is quickly absorbed from the gastrointestinal tract. After a single oral dose of 500 mg, bioavailability is 37% (the “first pass” effect), Cmax (0.4 mg/l) is created in 2–3 hours, the apparent volume of distribution is 31.1 l/kg, protein binding is inversely proportional concentration in the blood is 7–50%, T1/2 is 68 hours. A stable plasma level is achieved after 5–7 days. Easily passes histohematic barriers and enters tissues. It is also transported by phagocytes, polymorphonuclear leukocytes and macrophages to the site of infection, where it is released in the presence of bacteria. Penetrates through cell membranes (effective against infections caused by intracellular pathogens). Concentrations in tissues and cells are 10–50 times higher than in plasma, and at the site of infection they are 24–34% higher than in healthy tissues. High levels (antibacterial) remain in tissues for 5–7 days after the last injection. Food intake significantly changes pharmacokinetics (depending on dosage form): capsules - decreases Cmax (by 52%) and AUC (by 43%); suspension - increases Cmax (by 46%) and AUC (by 14%); tablets - Cmax increases (by 31%), AUC does not change. In the liver it is demethylated, losing activity. Plasma clearance - 630 ml/min. 50% is excreted unchanged in bile, 6% in urine. In elderly men (65–85 years), the pharmacokinetic parameters do not change; in women, Cmax increases (by 30–50%), in children aged 1–5 years, Cmax, T1/2, and AUC decrease.

Use of Azithromycin during pregnancy

During pregnancy, it is possible if the expected effect of therapy exceeds the potential risk to the fetus. FDA category of effect on the fetus is B. Breastfeeding should be discontinued during treatment.

Contraindications to the use of Azithromycin

Hypersensitivity (including to other macrolides), severe impairment of liver and/or kidney function, age up to 16 years (infusion), up to 12 years with body weight less than 45 kg (capsules, tablets), up to 6 months (suspension for ingestion).

Side effects of the drug Azithromycin

From the outside nervous system and sensory organs: dizziness, vertigo, headache, paresthesia, agitation, fatigue, drowsiness; rarely - tinnitus, reversible hearing loss up to deafness (when taken in high doses for a long time); in children - headache (during treatment of otitis media), hyperkinesia, nervousness, anxiety, sleep disturbance, conjunctivitis. From the cardiovascular system and blood (hematopoiesis, hemostasis): chest pain, palpitations. From the gastrointestinal tract: nausea, vomiting, diarrhea, flatulence, abdominal pain, increased ALT and AST activity, bilirubin levels, cholestasis, jaundice; rarely - constipation, discoloration of the tongue, pseudomembranous colitis, pancreatitis, liver necrosis, liver failure (possibly fatal); in children - loss of appetite, gastritis, candidomycosis of the oral mucosa. From the genitourinary system: vaginal candidiasis, nephritis. Allergic reactions: rash, itching, urticaria; rarely - angioedema, anaphylactic shock. Other: photosensitivity, eosinophilia, transient neutrophilia; with intravenous administration (optional) - bronchospasm, pain and inflammation at the injection site.

Method of administration and dosage of the drug Azithromycin

Orally, 1 hour before meals or 2 hours after meals, 1 time per day. For infections of the upper and lower respiratory tract, infections of the skin and soft tissues - 500 mg/day for 3 days (course dose - 1.5 g). For uncomplicated urethritis and/or cervicitis - 1 g (4 capsules of 250 mg each) once. For Lyme disease (borreliosis) for the treatment of stage I (erythema migrans) - 1 g (4 capsules of 250 mg each) on the 1st day and 500 mg daily from the 2nd to the 5th day (course dose - 3 G). For gastric and duodenal ulcers associated with Helicobacter pylori - 1 g (4 capsules of 250 mg) per day for 3 days as part of combination therapy. Children are prescribed at the rate of 10 mg/kg 1 time per day for 3 days or on the first day - 10 mg/kg, then 4 days - 5-10 mg/kg/day for 3 days (course dose - 30 mg/kg). kg). If you miss 1 dose of the drug, the missed dose should be taken as soon as possible, and subsequent doses should be taken 24 hours apart.

Overdose of Azithromycin

Symptoms: nausea, vomiting, diarrhea, temporary hearing loss. Treatment: gastric lavage (if taken orally), symptomatic therapy.

Interactions of Azithromycin with other drugs

Antacids, ethanol, and food slow down and reduce absorption (azithromycin should be taken 1 hour before or 2 hours after taking antacids and food). Tetracycline and chloramphenicol enhance the effectiveness of azithromycin, while lincosamides weaken it. When used in therapeutic doses, azithromycin has a weak effect on the pharmacokinetics of atorvastatin, carbamazepine, cetirizine, didanosine, efavirenz, fluconazole, indinavir sulfate, midazolam, rifabutin, sildenafil, theophylline (iv and orally), triazolam, co-trimoxazole, zidovudine. Efavirenz and fluconazole have little effect on the pharmacokinetics of azithromycin. Nelfinavir significantly increases the Cmax and AUC of azithromycin (when taken together, strict monitoring is necessary with regard to side effects of azithromycin such as impaired liver function and hearing impairment). It is necessary to conduct careful monitoring while taking azithromycin with digoxin (possible increase in the concentration of digoxin in the blood), with ergot alkaloids (possible manifestation of their toxic effect - vasospasm, dysesthesia), with cyclosporine and phenytoin (monitoring of their concentration in the blood is necessary). If it is necessary to take it together with warfarin, it is recommended to carefully monitor the PT (there may be an increase in PT and the incidence of hemorrhages). Pharmaceutically incompatible with heparin.

Precautions when taking Azithromycin

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Storage conditions for the drug Azithromycin

List B: In a dry place, protected from light, at a temperature not exceeding 25 °C.

Shelf life of Azithromycin

The drug Azithromycin belongs to the ATX classification:

J Antimicrobials for systemic use

J01 Antimicrobials for systemic use

J01F Macrolides and lincosamides

Sexually transmitted infections are the scourge of our time. Almost 50% of adults are carriers of dangerous infections. Azithromycin - effective remedy for their destruction.

Azithromycin is an antibiotic with a broad spectrum of action, which belongs to the group of macrolides. The main active ingredient is the substance of the same name - a semi-synthetic antibiotic, the first of the azalide subclass.

Azithromycin is actively used to treat various infectious diseases, since the drug has a pronounced bactericidal effect. The main areas of therapy: colds, skin and genital infections. The advantage of the drug is a short list of possible side effects.

Usually the drug is prescribed for a short course and in small doses, which allows it to be classified as a new generation of antibiotics.

pharmachologic effect

Azithromycin is capable of destroying colonies of streptococci (G, CF), gram-positive cocci, anaerobic microbes and gram-negative microorganisms. The bactericidal properties of the drug are well revealed in the treatment of diseases caused by Treponema pallidum, chlamydia, mycoplasmas, ureaplasmas and the spirochete Borrelia.

The drug can be prescribed only after laboratory tests. In cases where the disease is caused by different bacteria, it is often necessary to combine Azithromycin with antibiotics from other groups.

The active substances of the drug are quickly absorbed into the blood, and in full, since azithromycin is resistant to the acidic environment of the stomach. The maximum concentration of components in plasma is achieved 2-3 hours after administration.

The drug is able to penetrate any tissue and liquid, so it continues to fight pathogenic microorganisms for a long time (about a week). This property of the drug makes it possible to treat many diseases with Azithromycin, excluding relapses. The active substances do not disrupt the natural microflora, which makes the drug safe for different categories of patients.

Advantages

The antibiotic has the most pronounced accumulative ability among all antibacterial drugs. During microbial inflammation, active substances settle in the organs of the reproductive system, gastrointestinal mucosa and lungs, prostate gland and urethra.

Macrolides persistently accumulate in the cytoplasm and phagolysosomes - the habitat of chlamydia, mycoplasma and legionella. Namely, these microorganisms in Lately increasingly becoming the cause of urethritis and prostatitis.

The great advantage of Azithromycin is its ability to suppress the proliferation of atypical and intracellular pathogens, which are insensitive to most antibiotics. The drug is also widely used in the treatment of sexually transmitted infections.

Among all macrolides, Azithromycin has the highest degree of penetration into leukocytes, which increases anti-infective protection. Anti-inflammatory, immunomodulatory and mucoregulatory abilities of the drugs have been proven clinically and experimentally.

Due to its unique ability to accumulate in tissues, short courses of Azithromycin are most often prescribed for sexually transmitted infections.

Indications

Azithromycin is one of the few antibiotics approved for children and pregnant women (due to low toxicity). It is widely used to prevent inflammation of the pelvic organs.

Often prescribed for the following diseases:

  • inflammatory processes in the upper and lower respiratory tract, as well as diseases of the ENT organs (sinusitis, tonsillitis, sinusitis, tonsillitis, pneumonia, bronchitis);
  • infections of soft tissues and skin (erysipelas, dermatosis, impetigo);
  • acute infections that most often occur in children (measles, scarlet fever);
  • inflammatory diseases of the genitourinary system;
  • Lyme disease.

Sometimes this antibiotic is prescribed for chancroid, nongonococcal urethritis and granuloma inguinale. In severe forms of infection it is possible intravenous administration drug.

Standard dosage regimen

The drug should be taken once a day. You need to choose a time an hour before or after a meal. The medicine does not cause side effects from the digestive system, but the doctor should be warned about the presence of gastrointestinal diseases.

Standard regimen for taking Azithromycin for infection:

  1. One tablet (500 mg) or two tablets (250 mg each) once on the first day.
  2. 250 mg daily from the second to the fifth/seventh days.
  3. Certain pathologies are treated with a single dose of 500 mg of antibiotic ().
  4. Three days, 500 mg per day for intestinal infections.

Azithromycin should not be taken uncontrollably for sexually transmitted infections and colds.

IN last years complications (prostatitis, urethritis, epididymitis) are treated with a course of 1-7-14, 1 g per day. Typically, the cause of urogenital infection is chlamydia combined with other microorganisms. This treatment regimen (pulse therapy) can reduce the number of relapses to 1.2% in men and 2.5% in women. A similar effect cannot be achieved by any other macrolides or tetracyclines.

Only laboratory diagnostics can determine the correct dosage, otherwise the treatment will be ineffective or even destructive. Incorrect self-medication leads to the fact that the symptoms are “blurred” and complicates the diagnosis of the true cause of the disease.

Azithromycin for chlamydia

Treatment for chlamydia may include various drugs. The main ones are macrolides, fluoroquinolones and tetracyclines. Azithromycin is a leader in the treatment of chlamydial infection.

When treating chlamydia, monotherapy is assumed. This is due to the fact that, accumulating in the affected tissues, the active substances do not always adequately interact with other drugs (antimicrobial agents are acceptable). However, it should be remembered that taking Azithromycin exclusively is permissible only at the initial stage of chlamydia development.

Even the standard dosage regimen and dosage indicated in the instructions can be dangerous. If chlamydia is not treated correctly, the disease becomes chronic. Often, self-treatment of infections with antibiotics leads to the development of complications.

  1. On early stage Take one tablet (1 g) per day two hours before meals.
  2. For mild symptoms, take one tablet on the first day, then 0.5 g for another two to three days. From the fourth to the seventh days, 0.25 g is prescribed.

The patient should receive approximately 3 g of Azithromycin per week. Often this is enough to adequately affect chlamydia. The regimen is acceptable for both women and men, but you should also consult your doctor on this issue. When treating chlamydia with Azithromycin, some side effects may occur: diarrhea, allergic rash, drowsiness, tinnitus, and rarely chest pain.

Treatment of ureaplasmosis

It begins only after testing for Trichomonas. The causative agent of the disease, ureaplasma, is able to live inside these microorganisms, using them as protection against antibiotics. The results of the analysis help you choose the right treatment regimen.

Possible dosages of Azithromycin for ureaplasmosis:

  1. Before treatment with antibiotics, an injection course of immunomodulators should be started. Cycloferon is usually prescribed (every two days intramuscularly). Injections should be continued during antibiotic therapy.
  2. The second stage is bactericidal antibiotics. For these purposes, Oflox is prescribed (400 mg in the first two days in the morning and evening, the remaining days 200 mg).
  3. After a course of bactericidal agents, Azithromycin is prescribed (in the first six days, an hour and a half before breakfast, 1 g of the drug, a break of five days, again 1 g, break, third dose of 1 g).

Treatment of ureaplasmosis with Azithromycin takes 15-16 days. Often, along with an antibiotic, antifungal agents are prescribed at a dose of 150-400 mg two to three times a day. After a course of antibiotics, restorative therapy should be carried out to normalize the functioning of the gastrointestinal tract and liver. It usually lasts two weeks and includes one tablet per day. Medicines to strengthen the liver are prescribed three times a day before meals.

Treatment of urethritis with antibiotics

For inflammation of the urethra, antibiotics are most effective. Azithromycin is considered one of the best for therapy.

Advantages of this antibiotic:

  • ability to overcome cell membranes;
  • rapid absorption and accumulation in tissues;
  • prolonged effect (long-lasting);
  • resistance to acidic environments.

For urethritis, this antibiotic is effective due to its ability to suppress protein synthesis in pathogenic microorganisms. Small doses of the antibiotic can slow down the growth and reproduction of bacteria, and high doses can destroy colonies and prevent relapse of urethral inflammation.

Azithromycin is the best choice for urethritis, which is caused by microplasmas, chlamydia, spirochetes, treponema and ureaplasmas. If the cause is streptococci, staphylococci or enterococci, you should take Erythromycin.

For urethritis, the drug is usually prescribed at an early stage. The standard course includes taking one 0.5 g tablet daily for three days. A course is possible that includes taking two tablets of 0.5 g once a day, maintaining an interval.

It is better to take the antibiotic before meals, preferably an hour or two hours after. However, for gastrointestinal disorders, the drug can be taken with meals. This reduces the rate of absorption, which, however, does not affect the effectiveness.

When treating with Azithromycin, all citrus fruits are excluded from the diet: their components, in combination with the active substances of the drug, can impair the functioning of the heart muscle.

Azithromycin for ovarian inflammation

– inflammation of the fallopian tubes and ovaries, which is infectious in nature. It is most common among women 20-30 years old, and poses a serious danger to reproductive function.

For adnexitis, Azithromycin is indicated for initial stage development of the disease, followed by switching to other antibacterial agents (Amoxiclav). To preserve reproductive function, treatment of adnexitis should be started in a timely manner.

The high effectiveness of the drug against various infections allows the treatment of acute adnexitis without test results. The effectiveness of the drug makes it possible to avoid tubal infertility.

Treatment regimen for adnexitis with Azithromycin:

  1. 500 mg once a week, combined with Amoxiclav.
  2. Combination of different drugs: Azithromycin, Metronidazole, Ceftriaxone.

Acute inflammation requires a short course of antibiotics. The drug combines well with antimicrobial drugs; it is ineffective only against certain types of microbes.

Azithromycin after abortion

After termination of pregnancy, restorative therapy is prescribed.

Recovery after a miscarriage includes:

  • antibiotics to prevent inflammation;
  • combined oral contraceptives, restoring hormonal levels;
  • vitamin supplements that strengthen the immune system.

Antibiotics should be taken in any case. They protect the body from infections, so doctors prescribe strong drugs (Metronidazole). Azithromycin is indicated on the day of abortion (1 g). Thus, the risk of infectious post-abortion complications is reduced by 88%.

Can it be given to children?

Children over 3 years of age should take Azithromycin according to an individual regimen, which is based on the baby’s weight. For children under 10 kg, the drug is prescribed extremely rarely (in case of danger to life); it is replaced with gentle analogues.

The safety of the drug for adult patients does not guarantee an adequate response of the child’s body. Only the attending physician, based on test results, can prescribe Azithromycin to a child.

Complications, contraindications and side effects

There is an opinion that Azithromycin can be an indirect cause of infertility, like many other strong antibiotics. Improper use of such drugs leads to the fact that the patient weakens the symptoms, but does not cure the sexually transmitted disease.

The drug is not prescribed to patients who are allergic to macrolide antibiotics. At risk are people with kidney failure, pregnant and lactating women. When carrying a child, the drug is prescribed only as a last resort, so if you have symptoms of infection, you should definitely consult a doctor.

Side effects during treatment with Azithromycin are very rare. Sometimes patients complain of dizziness, headaches, nervousness and symptoms of indigestion, fatigue, vaginitis and nephritis.

Side effects are observed in only 1% of cases, 64% of which are mild. When Azithromycin is included in therapy for pregnant women, there is no risk of harm to the fetus. The drug does not have a toxic effect on the unborn child.

Ciprofloxacin is a well-known fluoroquinolone antibiotic that is actively used for diagnosing a number of acute and chronic pathologies.

Diseases cannot always be cured with just one antibiotic.

Doctors often prescribe combination antibacterial drugs or other drugs are added for treatment in order to enhance the bactericidal and bacteriostatic effect, as well as to avoid bacterial resistance or side effects.

Ciprofloxacin may easily combined with other drugs, but patients are most often interested in the specifics of such a combination, because enhanced antibacterial therapy does not benefit the body.

What medications are Ciprofloxacin prescribed with?

Ciprofloxacin is a fluoroquinolone antibiotic produced with the aim of extended action against pathogenic bacteria. The drug is suitable for the treatment of many diseases, and its effects are varied. Antibiotics are most often not prescribed alone, because the treatment of many pathologies requires individual and combined approach.


Photo 1. Ciprofloxacin, 20 tablets, 500 mg, manufacturer - Aliud Pharma.

Bacteria with an aggressive course of the disease acquire sustainability to the active components of the drug, which leads to incomplete recovery and increased frequency of relapses. Ciprofloxacin, like a fluoroquinolone, is not a highly effective antibiotic, which justifies the prescription of additional medications.

Most often it is combined with the following antibiotics and antimicrobials:

  • Doxycycline;
  • Levofloxacin;
  • Metronidazole;
  • Azithromycin;
  • Ciftriaxone;
  • Cephalosporin;
  • Fluconabosis;
  • Ibuprofen.

It has been proven that the effectiveness of Ciprofloxacin increases and intensifies when combining other antibacterial medications, but in some cases additional treatment is prescribed to relieve pain symptoms, as well as eliminate side effects.

Compatibility of Ciprofloxacin and Doxycycline

Both drugs are antibiotics, but Doxycycline belongs to the group tetracyclines, that is, he has a completely different chemical composition. These groups of antibacterial drugs do not have any contraindications for combination.

Thanks to the combination of Doxycycline and Ciprofloxacin, there is amplifying antibacterial effect, resistance to other antibiotics decreases.

Ciprofloxacin is a drug with a unique chemical formula, which means there is no cross-resistance with drugs of other antibacterial series. It goes well with Doxycycline.

The components of both drugs do not block or reduce pharmacological actions each other, but only complement (synergy).

Doxycycline itself is a very strong and toxic drug, so its simultaneous administration with Ciprofloxacin is a case exceptions, not rules. This combination is prescribed for the following pathologies:

  • acute inflammatory pelvic diseases among women;
  • specific urethritis caused by STIs;
  • infectious complications after operations, abortions;
  • pneumonia;
  • tuberculosis;
  • sepsis;
  • sinusitis, sinusitis, frontal sinusitis in acute form.

Most often, Ciprofloxacin + Doxycycline is used in obstetrics and gynecology, but the cases are different. Doxycycline has many dangerous side effects, and additional use of other antibiotics will only increase their manifestation. The doctor must monitor the patient's condition.

Important! Ciprofloxacin + Doxycycline can be taken together only for acute or complicated infections.

Sluggish and chronic pathologies do not imply the combined use of drugs, but this option is possible if other treatment is ineffective.

The dosage, as well as the combination of drugs, depends on the doctor’s recommendations and clinical diagnosis.

For acute, severe infections or severe foci of inflammation, Ciprofloxacin and Doxycycline are taken together or combined a week later in order to block resistance.

In cases of ineffectiveness of Ciprofloxacin, Doxycycline is prescribed, which is taken strictly as prescribed doctor

Ciprofloxacin and Levofloxacin: can they be taken at the same time?

Levofloxacin is a 3rd generation fluoroquinolone antibiotic that belongs to the same drug group as Cifprofloxacin. In clinical practice, such drug combinations can cause cross resistance, that is, the usual resistance of bacteria to the active components of all fluoroquinolones. Their joint purpose doesn't make sense and carries certain risks, but at the same time they are compatible and do not cause any negative manifestations from the body.

The side effects of each antibiotic are dangerous in any case. Levofloxacin is often prescribed after ineffectiveness or intolerance of Ciprofloxacin. They should not be taken together, but Cifprofloxacin can be combined with another fluoroquinolone in 7-10 days to reduce resistance.


Photo 2. Levofloxacin, 10 tablets, 250 and 500 mg, manufacturer - Vertex.

Ciprofloxacin + Levofloxacin are theoretically used for any infectious diseases, since they have a wide spectrum of action, but taking the drugs together leads to the risk of sustainability bacteria.

Ciprofloxacin and Metronidazole: their interaction

Metronidazole is not an antibiotic in its own right pharmacological group This antimicrobial a drug that is intended for auxiliary treatment during antibacterial therapy. Ciprofloxacin and Metronidazole can be taken either together or separately, but in the latter case Metronidazole is prescribed after the end of the reception Ciprofloxacin to maintain the therapeutic effect.

Ciprofloxacin + Metronidazole are effective against the following pathologies:

  • protozoal diseases: amebiasis, giardiasis, trichomonas urethritis/colpitis/vaginitis;
  • cystitis, caused STI;
  • endocarditis bacterial nature;
  • meningitis;
  • pneumonia;
  • sepsis;
  • infections caused Bacteroides spp, Peptostreptococcus spp, Clostridium spp, Peptococcus spp;
  • organ diseases pelvis;
  • skin diseases;
  • postoperative complications in gynecology/urology.

Reference! Metronidazole is also available under a different trade name. Trichopolum, which contains a similar pharmacological composition.

Metronidazole is ineffective when taken alone, so it is always prescribed with other medications or antibiotics. Concomitant use of drugs is not dangerous, but Metronidazole has many side effects, which usually occur when interacting with other antibiotics. Doctors either reduce the dose of Metronidazole or prescribe it after antibiotic therapy.

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How to combine Ciprofloxacin and Azithromycin

Azithromycin is a drug antibacterial group, which traditionally belongs to the azalide macrolides. There are no contraindications for combining Azithromycin with fluoroquinolones, since they are successfully combined in the treatment of a number of specific diseases.

First of all, such pathologies include:

  • pneumonia;
  • pleurisy;
  • COPD;
  • tuberculosis;
  • ENT pathologies(sinusitis, frontal sinusitis, otitis media, sinusitis).

Ciprofloxacin + Azithromycin are taken together for treatment pulmonary diseases. Their separate use in the above acute pathologies is impractical and ineffective. They combine well and are safe to use, but side effects and individual intolerance may occur.

Ciprofloxacin and Ceftriaxone

Ceftriaxone is an antibiotic belonging to the cephalosporin group, which can be combined with fluoroquinolones, enhancing the bactericidal and bacteriostatic effect. Both antibiotics have a broad spectrum of action, which indicates that they can treat any bacterial infection.

In clinical practice, they are combined for the treatment of various pathologies of a bacterial nature, and especially when the patient is resistant to groups of other antibiotics.

They are safe to use and can be consumed at the same time.

Most often, this combination is used for therapy ENT pathologies, and infections of the gastrointestinal tract, urogenital tract, skin ailments.

Ciprofloxacin and Cephalosporin: are they taken together?

Cephalosporin is an antibacterial agent from the group of β-lactams, which is known for the versatility of its pharmacological properties. Ciprofloxacin goes well with Cephalosporin, which complements and maintains the bactericidal effect.

In practice, doctors use this combination to treat a wide range of bacterial infections. First of all, this is Gastrointestinal diseases, and urogenital diseases. Both drugs destroy opportunistic bacteria at the cellular level, which is extremely effective when taken twice. This combination of drugs allows you to quickly stop foci of infection.

Most often, the drugs are used at the same time, as this helps prevent bacterial growth and block resistance. Cephalosporin completely destroys the DNA of the bacteria, stopping their division, and Ciprofloxacin consolidates the therapeutic effect.

Ciprofloxacin and Fluconazole

Most antibacterial agents cause side effects, the most common of which is candidiasis(thrush) caused by pathogenic fungi Candida spp.

Fluconazole is a proven antifungal agent, the pharmacokinetics of which inhibits the proliferation of Candida spp, as well as other representatives of fungal organisms.

Fluconazole can be taken simultaneously with any antibiotic to eliminate fungal manifestations.

But most often Fluconazole is used after undergoing antibacterial therapy or in last days taking Ciprofloxacin to avoid hepatotoxicity and blocking the active components of the antifungal agent.

Important! Simultaneous use of Ciprofloxacin and Fluconazole required with a significant weakening of the immune system after severe conditions (AIDS, radiation therapy).

Ciprofloxacin and Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drugs that are designed to relieve pain and lower temperature. Often, pathological conditions are accompanied by extremely unpleasant and painful symptoms, which require action.

Ciprofloxacin + Ibuprofen is an ideal option for treatment antibacterial infections, and to eliminate associated symptoms.

Ibuprofen itself has no effect on bacteria, and its pharmacokinetics have no effect on the components of any antibiotic that fights the cause and not the effect.

This combination of drugs is often prescribed for arthritis, myositis and other musculoskeletal diseases. In terms of side effects and compatibility, these are safe medications.

Which combination of drugs is most suitable for treating tuberculosis?

Each combination of drugs has varying degrees of effectiveness and is intended to treat specific diseases. Tuberculosis cannot be stopped with a single antibiotic, which requires combination therapy.

Ciprofloxacin, like a fluoroquinolone, is a “reserve” drug in the treatment of tuberculosis of the lungs. It has relatively moderate effectiveness, which in practice means using Ciprofloxacin only in cases of resistance to the most powerful drugs.

The ideal option is a combination of Ciprofloxacin and Doxycycline, as well as Azithromycin. Other combinations of antibiotics will have little effect.

Important! The ideal combination of antibiotics is their simultaneous use in tableted And injection form (injections).

Ciprofloxacin combines well with other antibiotics and antimicrobials. Their double effect enhances bactericidal properties and speeds up overall recovery. But Ciprofloxacin does not combine well with others fluoroquinolones, as well as with some other groups of antibiotics. In other cases, combining drugs is an excellent treatment option, but there is a high probability of side effects.

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Azithromycin and Ceftriaxone are antibacterial agents that have a wide range of applications. It is worth figuring out whether a combination of these medications is possible.

Characteristics of Azithromycin

Azithromycin is an antibiotic belonging to the macrolide group. It is considered a derivative of Erythromycin. Its principle of action is that the production of proteins that ensure the vital activity of bacteria is blocked. After use, the medication is distributed throughout the tissues of the body. Part of the active substance is excreted in the urine.

The main advantage of the drug is its stability. This medication is not destroyed by gastric juice and acids. As for the indications for the use of such a drug, it is used for the following pathologies:

  • in case of meningitis;
  • for prostatitis and pneumonia;
  • when the patient has pulmonary or genitourinary infections;
  • with otitis media and sinusitis;
  • in case of skin damage.
  • This drug is also effective in the treatment of chlamydia.

This medicine is used to treat patients who have advanced stomach damage. A similar medication also helps with duodenal ulcers.

Characteristics of Ceftriaxone

Ceftriaxone is used to treat meningitis and gonorrhea. It is effective:

  1. With insufficient liver and kidney function.
  2. As a prophylactic after surgery.
  3. In case of infection of joints and bones.
  4. With pyelonephritis.

Separately, it is worth mentioning the pharmacokinetics of such a medication. An increased concentration of Ceftriaxone is achieved in the bile.

This medication is recommended to be used with caution if you are sensitive to individual components of the drug. It is undesirable to use it in cases of severe renal dysfunction. For newborns who have congenital hyperbilirubinemia(it occurs in premature babies), this drug can be used under the supervision of a doctor.

It is undesirable for such a drug to interact with medications that reduce platelet aggregation, for example, Sulfinpyrazone, because the likelihood of bleeding increases. The anticoagulant effect is enhanced when this medicine is used simultaneously with anticoagulants.

Which is better Azithromycin or Ceftriaxone

The difference between these medications is their side effects. Thus, when consuming Azithromycin, side effects from the sensory organs and nervous system are possible: dizziness and drowsiness may occur. Children may develop conjunctivitis and anxiety.

Also, when consuming Azithromycin, side effects from the cardiovascular system are possible. Palpitations and pain in the chest area often appear.

Concerning gastrointestinal tract, diarrhea and vomiting may occur. In addition, patients complain of abdominal pain, jaundice and increased bilirubin concentrations. Side effects from the urinary system include nephritis and candidiasis.

An allergic reaction also occurs. Its symptoms are urticaria, rash. Anaphylactic shock rarely develops. Neutrophilia and bronchospasm also rarely appear.

The use of Ceftriaxone can lead to such side effects, such as erythema and urticaria. From the gastrointestinal tract, diarrhea and nausea may occur. Taste sensations may be impaired.

Common by-effect- glossitis (inflammation of the tongue). Stomatitis and abdominal pain in the abdominal area may develop.

Is it possible to take Azithromycin and Ceftriaxone at the same time?

The combination of Azithromycin and Ceftriaxone is often used to treat tuberculosis. The double effect of such antibiotics enhances the bactericidal properties and allows the patient to recover faster.

When combining these medications, you should be careful because the likelihood of side effects increases.

To quickly get the effect of therapy, it is recommended to simultaneously use tablet and injection forms of antibiotics. It should also be remembered that it is undesirable to combine Ceftriaxone with fluoroquinolones.

Indications for joint use

Azithromycin and Ceftriaxone are taken together for tonsillitis and sinusitis. In addition, their combined use is possible in the case of erysipelas, dermatosis, when the patient is diagnosed with urethritis or Lyme disease.

Doctors prescribe a combination of these medications in case of stomach diseases caused by the Helicobacter bacteria. Their combination is also effective in the treatment of impetigo.

Broad-spectrum antibiotic of the azalide subgroup of the macrolide group. When a high concentration of the active substance is created at the site of inflammation, azithromycin has a bactericidal effect. Compared to other macrolide antibiotics, it has the most pronounced bactericidal effect, the ability to penetrate tissues, cells and body fluids, and the maximum half-life. To achieve a clinical effect, in most cases a 3-day course of therapy is sufficient. Like all erythromycin antibiotics, azithromycin is well tolerated; active against gram-positive aerobic microorganisms (including strains producing β-lactamases): Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus viridans, streptococci of groups C, F and G. Gram-positive microorganisms resistant to erythromycin are cross-resistant to azithromycin. Most strains Enterococcus faecalis and methicillin-resistant staphylococci are resistant to azithromycin.
Of the gram-negative aerobic microorganisms that are sensitive to azithromycin: Bordetella pertussis, Bordetella parapertussis, Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus parainfluenzae, Haemophilus ducreyi, Legionella pneumophila, Moraxella catarrhalis, Neisseria gonorrhoeae, Shigella spp., Salmonella spp., Yersinia spp. From anaerobes - Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp.
The following are sensitive to azithromycin: Borrelia burgdorferi, Chlamydia trachomatis, Mycoplasma pneumoniae, Treponema pallidum, Ureaplasma urealyticum.
When administered orally, azithromycin is well absorbed and rapidly distributed in the tissues of the body, reaching high concentrations many times higher than the concentration in the blood plasma. High antimicrobial activity is also ensured due to the ability of azithromycin to penetrate and accumulate intracellularly in leukocytes (granulocytes and monocytes/macrophages), with which it is transported to sites of inflammation, as a result of which the concentration of the antibiotic is 6 times higher in the site of inflammation compared to intact tissues. Azithromycin is slowly eliminated from the body, which makes it possible to take it once a day and reduce the duration of treatment to 5 days; in tissues high concentrations the active substance remains for another 5-7 days after taking the last dose of azithromycin.

Indications for use of the drug Azithromycin

Infections caused by microorganisms sensitive to azithromycin, including infections of the respiratory tract and ENT organs (acute pharyngitis and tonsillitis; scarlet fever; acute otitis media; acute sinusitis; acute bronchitis, exacerbation of chronic bronchitis, pneumonia); infections of the skin and subcutaneous fat (erysipelas, impetigo, secondary infected dermatoses); infections of the urinary tract and genital organs (acute nonspecific (chlamydial) or gonococcal urethritis, cervicitis, colpitis).

Use of the drug Azithromycin

Orally 1 hour before or 2 hours after meals. For adults with infections of the upper and lower respiratory tract, skin and subcutaneous fat, 500 mg per dose is prescribed on the 1st day of treatment, from the 2nd to 5th day - 250 mg once a day; for acute sexually transmitted infections, taking 1 g of azithromycin once is most often sufficient.
For children over 1 year of age, azithromycin is prescribed on the 1st day at the rate of 10 mg per 1 kg of body weight, and in the next 4 days - 5 mg/kg 1 time per day.
Pharmacokinetic properties allow the use of azithromycin for a short time, from 3 to 5 days, maximum - 7 days. Only in rare cases of chronic infectious and inflammatory diseases when other antibiotics are ineffective, longer treatment in combination with various antimicrobial agents is required. Sometimes a combination with immunomodulatory therapy is recommended.

Contraindications to the use of the drug Azithromycin

Hypersensitivity to macrolide antibiotics.

Side effects of the drug Azithromycin

Possible nausea, vomiting, lack of appetite, diarrhea; transient increase in the activity of liver enzymes, allergic reactions (may occur 2-3 weeks after taking the last dose of the antibiotic).

Special instructions for the use of Azithromycin

Caution is required when prescribing azithromycin to patients with severely impaired liver and kidney function. Experimental studies have not revealed a negative effect of azithromycin on animals and their offspring, but since clinical experience is insufficient, caution should be exercised when prescribing azithromycin during pregnancy and lactation.

Drug interactions Azithromycin

The absorption of azithromycin does not change significantly with the simultaneous use of antacids or H2-histamine receptor blockers, however, it is recommended that the interval between taking the above drugs be at least 2 hours. There is no interaction of azithromycin with digoxin, ergotamine, cyclosporine, carbamazepine, theophylline, phenytoin or oral anticoagulants.

List of pharmacies where you can buy Azithromycin:

  • Saint Petersburg