Can Biseptol be used? Biseptol - a modern look at a long-familiar antibacterial drug

Photo of the drug

Latin name: Biseptol

ATX Code: J01EE01

Active substance: Co-trimoxazole [Sulfamethoxazole + Trimethoprim]

Manufacturer: abianice Pharmaceutical Works Polfa (Poland), Medana Pharma TERPOL Group J.S., Co. (Poland)

The description applies to: 02.11.17

A combined bactericidal preparation containing sulfamethoxazole, a medium-acting sulfonamide that inhibits the synthesis of folic acid by competitive antagonism with PABA, and trimethoprim, an inhibitor of bacterial dehydrofolic acid reductase, which is responsible for the synthesis of biologically active tetrahydrofolic acid. The combination of active ingredients that affect one chain of biochemical transformations provides synergism of antibacterial action and contributes to a slower development of bacterial resistance to the drug.
Biseptol is active in vitro in a relationship E. coli(including enteropathogenic strains), indole-positive strains Proteus spp.(including P. vulgaris), Morganella morganii, Klebsiella spp., Proteus mirabilis, Enterobacter spp., Haemophilus influenzae, Str. pneumoniae, Shigella flexneri, Shigella sonnei.
Both components of the drug are rapidly absorbed into the blood in the digestive tract. The maximum concentration of both components in the blood serum is reached 1-4 hours after oral administration. Trimethoprim binds to plasma proteins by 70%, sulfamethoxazole - by 44-62%. The distribution of both components is different: sulfamethoxazole is distributed exclusively in the extracellular environment, trimethoprim - in all body fluids. A high concentration of trimethoprim is determined in the secret of the bronchial glands, the prostate gland and bile. The concentration of sulfamethoxazole in body fluids is somewhat lower. Both components are found in high concentrations in sputum, vaginal secretions, and middle ear fluid. The volume of distribution of sulfamethoxazole is 360 ml/kg body weight, trimethoprim - 2000 ml/kg. Both components are metabolized in the liver: sulfamethoxazole - by acetylation and binding to glucuronic acid, trimethoprim - by oxidation and hydroxylation.
They are excreted mainly by the kidneys by filtration and active tubular secretion. The concentration of active compounds in the urine is much higher than in the blood. Within 72 hours, 84.5% of the accepted dose of sulfamethoxazole and 66.8% of trimethoprim are excreted in the urine. The half-life is 10 hours for sulfamethoxazole and 8-10 hours for trimethoprim. In renal insufficiency, the half-life of both components is prolonged. Sulfamethoxazole and trimethoprim pass into breast milk and enter the fetal circulation.

Indications for the use of the drug Biseptol

Urinary tract infections due to drug-susceptible strains E. coli, Klebsiella spp., Enterobacter spp., Morganella morganii, Proteus mirabilis, Proteus vulgaris; acute otitis media caused by drug sensitive exacerbation of chronic bronchitis caused by drug sensitive H. influenzae, Str. pneumoniae; bacteriologically confirmed pneumonia caused by Pneumocystis carinii, and prevention of infection with this microorganism in patients at risk (for example, HIV-infected); digestive tract infections caused by drug-sensitive Shigella flexneri, Shigella sonnei; traveler's diarrhea caused by enterotoxigenic strains E. colli; toxoplasmosis; nocardiosis.

The use of the drug Biseptol

urinary tract infections of the digestive tract caused by Shigella, and exacerbation of chronic bronchitis in adults, the average dose is 960 mg (2 tablets of Biseptol 400/80 mg, 8 tablets of Biseptol 100/20 mg) orally 2 times a day. In inflammatory diseases of the urinary tract, the drug is taken for 10-14 days, with exacerbation of chronic bronchitis - 14 days, with infections of the digestive tract caused by Shigella- 5 days.
In patients with a creatinine clearance of 15-30 ml / min, the dose should be reduced by half. With creatinine clearance ≤15 ml / min, the drug is not used.
In inflammatory diseases of the urinary tract, Shigella infections of the digestive tract, and acute otitis media in children prescribed at a dose of 48 mg / kg (40/8 mg / kg) of body weight per day in 2 doses with an interval of 12 hours. The dose for children should not exceed the dose for adults.
With inflammation of the urinary tract and acute otitis media, the drug is taken for 10 days, with infections of the digestive tract caused by Shigella- 5 days. With diarrhea travelers are prescribed at a dose of 960 mg (2 tablets of Biseptol 400/80 mg, 8 tablets of Biseptol 100/20 mg) with an interval of 12 hours.
For pneumonia caused by Pneumocystis carinii in adults and children the recommended dose of the drug is 90-120 mg / kg (75/15 mg / kg - 100/20 mg / kg) of body weight per day in divided doses, which are taken every 6 hours for 14-21 days.
For the prevention of pneumonia caused by Pneumocystis carinii, adults are prescribed - 900/60 mg of the drug 1 time per day. The daily dose should not exceed 1920 mg (16 tablets of 100/20 mg, 4 tablets of 400/80 mg).

Contraindications to the use of the drug Biseptol

Hypersensitivity to sulfamethoxazole or trimethoprim, megaloblastic anemia caused by folic acid deficiency; period of pregnancy and lactation, age up to 2 months, severe renal and hepatic insufficiency.

Side effects of the drug Biseptol

Most often during treatment with Biseptol, side effects from the digestive tract (nausea, vomiting, anorexia) and skin-allergic reactions (rash, urticaria) are noted. Rarely, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome), acute liver necrosis, aplastic anemia can occur. In addition, hemolytic, megaloblastic anemia, eosinophilia, methemoglobinemia, hypoprothrombinemia can develop; allergic myocarditis; chills, fever, photophobia, anaphylactic reactions, vascular edema, skin itching, Shenlein-Genoch disease, urticaria, polymorphic erythema, allergic rashes, desquamation dermatitis, serum sickness, rarely - nodular periarteritis, lupus syndrome. From the digestive tract - diarrhea, abdominal pain, anorexia, nausea, pseudomembranous colitis, vomiting, increased activity of liver enzymes and serum creatinine levels, stomatitis, glossitis, pancreatitis, hepatitis (sometimes with cholestatic jaundice).
From the genitourinary system: renal failure, interstitial nephritis, nephrotoxic syndrome, anuria, increased levels of non-protein nitrogen and creatinine in the blood serum. Possible metabolic disorders - hyperkalemia, hyponatremia.
From the side of the nervous system: apathy, meningitis, ataxia, headache, depression, convulsions, hallucinations, irritability, tinnitus, peripheral neuritis. Sulfonamides are similar in chemical structure to some antithyroid drugs, diuretics (acetazolamide and thiazides), as well as to oral antidiabetic drugs, which may be the cause of cross-allergy. Rarely noted hypoglycemia, increased diuresis.
From the side of the musculoskeletal system: arthralgia, myalgia.
From the respiratory system: shortness of breath, cough, formation of infiltrates in the lungs. Weakness, fatigue, insomnia are possible.

Special instructions for the use of the drug Biseptol

Biseptol should be used with caution in patients with hepatic or renal insufficiency, folic acid deficiency (for example, in the elderly, alcoholics, patients receiving anticonvulsants, in people with malabsorption syndrome or malnutrition), with severe allergic diseases, asthma and impaired hematopoiesis.
Patients should drink sufficient fluids to prevent crystalluria and blockage of the renal tubules.
With prolonged treatment, it is necessary to regularly monitor the blood picture, liver and kidney function.
In elderly patients, Biseptol treatment increases the risk of kidney or liver damage, the development of severe skin reactions, and inhibition of erythropoiesis.
Patients with AIDS who use Biseptol in connection with pneumocystis infection often develop symptoms such as rash, fever, leukopenia, increased activity of aminotransferases, hyperkalemia and hyponatremia.
During treatment, direct solar exposure should be avoided (due to the risk of photosensitivity).
Do not use the drug for tonsillitis caused by β-hemolytic streptococci.
Trimethoprim may affect the results of determining the concentration of methotrexate in the blood serum by the enzymatic method, but does not affect the results when using the radioimmunological method.
Biseptol can increase the results of the Yaffe test for creatinine by approximately 10% using the main picrate.

Interactions of the drug Biseptol

NSAIDs, antidiabetic agents of the group of sulfonylurea derivatives, difenin, indirect anticoagulants, barbiturates increase the risk of side effects. Ascorbic acid increases the risk of developing crystalluria.
In elderly patients, the combined use of Biseptol with some diuretics, especially thiazides, increases the risk of developing thrombocytopenia.
Biseptol may increase the concentration of digoxin in the blood serum, especially in elderly patients.
With the simultaneous use of the drug with tricyclic antidepressants, the effectiveness of the latter is reduced. The drug reduces the reliability of oral contraception. Biseptol may enhance the effect of anticoagulants, which requires a dose reduction of these drugs.
Biseptol inhibits the metabolism of phenytoin: in persons taking both drugs at the same time, the half-life of phenytoin increases by approximately 39%, and its clearance decreases by approximately 27%.
Biseptol increases the concentration of the free fraction of methotrexate in the blood serum due to its displacement from protein binding. With the simultaneous use of the drug by patients who take pyrimitamine at a dose higher than 25 mg / week for the prevention of malaria, megaloblastic anemia may develop.

Overdose of the drug Biseptol

The life-threatening dose of Biseptol is unknown. With an overdose of sulfonamides, anorexia, colic-like pain, nausea, vomiting, dizziness, headache, drowsiness, loss of consciousness are noted. Possible fever, hematuria, crystalluria, depression of bone marrow function, hepatitis. In acute overdose of trimethoprim, nausea, vomiting, dizziness, headache, depression, confusion, depression of bone marrow function may occur.
If symptoms of an overdose appear, it is necessary to stop using the drug, induce vomiting, prescribe a large amount of fluid with insufficient diuresis and normal kidney function. Acidification of the urine accelerates the excretion of trimethoprim, but may increase the risk of sulfanilamide crystallization in the kidneys. The blood picture, the level of electrolytes in the blood serum and other biochemical parameters should be monitored. If symptoms of bone marrow depression or hepatitis appear, appropriate therapy is prescribed. Hemodialysis is ineffective.
With chronic intoxication, thrombocytopenia, leukopenia, or megaloblastic anemia develop. In this case, calcium folinate should be prescribed at a dose of 5-15 mg / day.

Storage conditions of the drug Biseptol

At temperatures up to 25 °C.

List of pharmacies where you can buy Biseptol:

• St. Petersburg

Biseptol is active against the following pathogens: staphylococci, streptococci, pneumococci, dysentery bacillus, typhoid bacillus, proteus, E. coli, salmonella, pneumocystis, plasmodium, causative agent of leishmaniasis, meningococcus, vibrio cholerae, actinomycetes, klebsiella, chlamydia, causative agent of diphtheria and some types of diphtheria mushrooms.

The drug is ineffective against Pseudomonas aeruginosa, the causative agent of leptospirosis, the causative agent of tuberculosis, spirochetes and viruses.
Biseptol also has an effect on microorganisms that are resistant to other sulfanilamide drugs.

Biseptol is rapidly and well absorbed from the stomach and reaches its maximum concentration in the blood 1-3 hours after ingestion. Therapeutic concentration of the drug is maintained up to 7 hours.

The drug penetrates well into biological fluids and tissues of the body: bile, saliva, cerebrospinal fluid, sputum, prostate, kidneys, lungs. It is excreted from the body mainly with urine.

Release forms

• 120 mg tablets (100 mg sulfamethoxazole and 20 mg trimethoprim);
• 480 mg tablets (400 mg sulfamethoxazole and 80 mg trimethoprim);
• Tablets "Bactrim forte" 960 mg (800 mg of sulfamethoxazole and 160 mg of trimethoprim);
• Syrup (or suspension) - for oral administration 100 ml (in 1 ml - 40 mg of sulfamethoxazole and 8 mg of trimethoprim);
• Concentrate for solution for injection 480 mg (in 1 ml of concentrate - 80 mg of sulfamethoxazole and 16 mg of trimethoprim).

Instructions for use Biseptol

Indications for use

• respiratory diseases (bronchitis in acute and chronic form; pneumonia; pleural empyema - purulent inflammation of the membranes of the lungs; abscess or abscess of the lung; bronchiectasis - expansion of the lumen of the bronchi due to the disease);
• ENT pathology (otitis media, or inflammation of the ear; sinusitis, or inflammation of the paranasal sinuses);
• intestinal infections (dysentery, paratyphoid A and B, cholera, typhoid fever);
• urinary tract infections (urethritis - inflammation of the urethra; prostatitis - inflammation of the prostate gland; pyelonephritis - inflammation of the renal pelvis and the kidney tissue itself; salpingitis - inflammation of the uterine appendages);
• gonorrhea (venereal disease);
• soft tissue and skin infections (pyoderma, or pustular skin lesions; acne; furuncle, or boil);
• meningitis (inflammation of the meninges) and abscess (abscess) of the brain;
• septicemia (a form of "infection" of the blood);
• infectious diseases: brucellosis, malaria, toxoplasmosis, borreliosis, scarlet fever;
• wound infections and osteomyelitis;
• prevention and treatment of pneumocystis pneumonia in HIV-infected patients.

Contraindications

• with severe cardiovascular insufficiency;
• with diseases of the hematopoietic organs;
• with severe renal failure;
• mothers when breastfeeding;
• with deficiency of glucose-6-phosphate dehydrogenase (hereditary disease);
• children under the age of 3 months and premature babies;
• with an increased level of bilirubin in children;
• with hypersensitivity to the components that make up the drug, or to other sulfanilamide drugs.

With caution, Biseptol can be used if the patient has previously been allergic to other drugs; with bronchial asthma; patients with folic acid deficiency; with diseases of the thyroid gland; in early childhood and old age.

Treatment with Biseptol should be carried out under medical supervision and blood tests should be carefully monitored.

Side effects

• From the side of the digestive system: in rare cases - diarrhea, abdominal pain, loss of appetite, nausea, vomiting; in isolated cases - colitis (inflammation of the intestine); reactive inflammation of the liver with bile stasis - cholestatic hepatitis; glossitis - inflammation of the tongue; stomatitis - inflammation of the oral mucosa; pancreatitis - inflammation of the pancreas.
• From the nervous system in some cases: dizziness, headache, depression, fine trembling of the fingers of the extremities.
• From the side of the kidneys in rare cases: an increase in the volume of urine, inflammation of the kidneys (nephritis), excretion of blood in the urine.
• On the part of the respiratory system: bronchospasm, cough, choking or a feeling of lack of air.
• On the part of the hematopoietic organs in isolated cases: a decrease in the number of leukocytes in the blood, a decrease in the number of neutrophils (a type of leukocyte that protects the body from infections), a decrease in platelets (platelets involved in blood clotting), folic acid deficiency anemia.
• On the part of the skin: rashes on the skin in the form of urticaria; itching; in isolated cases - Lyell's syndrome and Stevens-Johnson syndrome (the most severe variants of allergic manifestations on the skin and mucous membranes with necrosis and rejection); angioedema (local or diffuse swelling of the subcutaneous tissue and mucous membranes); hypersensitivity to ultraviolet rays.
• There have been isolated cases of chills and fever after taking Biseptol (drug fever).
• Pain in joints and muscles.
• Thrombophlebitis (at the injection site).
• Decreased levels of potassium, sodium and blood sugar.

With prolonged use (more than 5 days) and with the use of higher dosages, as well as with the appearance of changes in the blood test during treatment, folic acid should be taken at 5-10 mg per day.

drug interaction
Biseptol should not be taken simultaneously with Aspirin, Butadion, Naproxen.

Biseptol enhances the effect of drugs that reduce blood clotting, such as Warfarin.

Biseptol enhances the effect of some antidiabetic drugs (Gliquidone, Glibenclamide, Glipizide, Chlorpropamide, Gliclazide).

Biseptol increases the activity of the antitumor drug Methotrexate and the anticonvulsant drug Phenytoin.

Biseptol is not recommended to be administered simultaneously with thiazide diuretics (Chlorothiazid, Diuril, Naturetin, Metolazone, Diukardin, Furosemide, etc.) - this increases bleeding.

Biseptol in combination with diuretics, as well as with the antidiabetic agents listed above, can cause an allergic cross reaction.

Hexamethylenetetramine, ascorbic acid and other drugs that acidify urine increase the risk of "sand" in the urine when used simultaneously with Biseptol.

Biseptol may increase the concentration of digoxin in the blood in elderly patients.

The simultaneous use of Biseptol and Pyrimethamine (an antimalarial drug) increases the risk of anemia.

Benzocaine, Procaine (drugs for local anesthesia) reduce the effectiveness of Biseptol.

Dosage of Biseptol
The dose of the drug and the duration of administration is prescribed by the doctor individually, depending on the severity of the condition and concomitant diseases.

Adult patients are usually prescribed 960 mg 2 times a day (2 tablets of 480 mg or 1 tablet forte 2 times) every 12 hours for 5-14 days.

If long-term treatment is necessary, 480 mg is prescribed 2 times a day (1 tablet 480 mg 2 times).

Suspension of Biseptol is prescribed to adults at 20 ml every 12 hours.

In the case of a severe course of the disease (sometimes with a chronic disease), the dose may be increased up to 50%.

And with a duration of treatment over 5 days, and with an increase in the dose of Biseptol, it is necessary to control the complete blood count.

But microbes adapt to drugs that are often used, and over time lose their sensitivity to these drugs; medicines stop working. So it happened with Biseptol. Therefore, the attitude towards the appointment of Biseptol for cystitis is very restrained at the present time.

The correct tactic in relation to the treatment of cystitis is the selection of medications in accordance with their sensitivity. For this purpose, urine culture is prescribed for microflora and its sensitivity to drugs. The doctor will receive the result 3-4 days after the test and select the correct treatment.

In some cases, the doctor initially prescribes Biseptol, and after receiving the result of the sensitivity of the flora to drugs, if necessary, changes the treatment. Sometimes Biseptol is prescribed due to intolerance to antibiotics or other drugs. Assign Biseptol in the usual dosage (2 tablets 2 times a day) for 5-10 days.

Biseptol's analogs and synonyms

Analogues are called drugs that have different active ingredients in their composition, differ in names, but are used in the treatment of the same diseases, because. have the same effect. Analogues may differ in strength of action, tolerability of the drug, contraindications, side effects.

Analogues of Biseptol are antibiotics of different groups, tk. they also have antimicrobial activity. Depending on the sensitivity of the pathogen and the spectrum of action, antibiotics are used to treat the same diseases as Biseptol.

Analogues of Biseptol are other sulfanilamide preparations:

• Asacol (active ingredient: mesalazine);
• Dermazin (active ingredient: sulfadiazine);
• Ingalipt (active ingredients: streptocide, sodium sulfathiazole);
• Ingaflu (active ingredient: streptocide) and other sulfa drugs.

Preparations-synonyms of Biseptol: Bactrim, Bacterial, Bactramin, Abatsin, Andoprim, Bactifer, Abactrim, Bactramel, Hemitrin, Bactrizol, Ectapprim, Berlocid, Bacticel, Doctonil, Ekspektrin, Gantrin, Falprin, Methomide, Infectrim, Primazol, Microcetim, Oradin, Potesept, Oribact, Resprim, Sumetrolim, Septocid, Uroxen, Bactecod, Trixazole, Trimexazole, Blackson, Vanadil, Aposulfatrin, Bactreduct, Groseptol, Cotrimol, Cotribene, Eriprim, Primotren, Sulfatrim, Rancotrim, Expazol, Novotrimed, Oriprim, Cotrimaxol, Cotrimaxazole, Sinersul, Sulotrim, Trimosul.

One of the most famous and controversial antibacterial drugs sold in Russia is Biseptol. In the 80-90s of the last century, Biseptol was at the peak of popularity. The drug was prescribed by doctors of all specializations, from the district pediatrician to the narrow-profile urologist. Patients, having felt the effectiveness of the remedy, perceived it as a panacea for all ills. If at first we still did not risk buying Biseptol without a doctor's prescription, then soon such a "trifle" as a specialist's recommendation began to seem redundant. In Biseptol, they saw a panacea for any infection and took it almost uncontrollably for any reason, not excluding the common cold.

Meanwhile, any antibacterial medicine is not at all so harmless. And many ardent fans of Biseptol were convinced of this, unfortunately, already from their own experience.

The modern pharmaceutical market offers a large number of safer and more effective antibacterial drugs. Sales and popularity of Biseptol faltered. However, until now, therapists and pediatricians write the long-learned words “Tab. Biseptoli” in recipes. And until now, Biseptol can be sold in our pharmacies on the recommendation not of a doctor, but of a friend, neighbor or a complete stranger who gave advice in line for bread.

Before continuing reading: If you are looking for an effective method of getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to check out site section Book after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

In this article, we will try to highlight the positive and negative aspects of the drug and answer the main questions: is Biseptol safe? Is it worth taking this medicine uncontrollably and what is the risk?

The composition and form of release of Biseptol

Few people know that the name hides both the composition and the action of Biseptol. The particle "bi" comes from the Latin prefix "bis" - twice - and means that the composition includes two components. The second part of the name - "septol" - apparently comes from the Latin "septicus", literally meaning "rotting". In pharmaceuticals, drugs that have the root "septol" in their name belong to the group of antiseptics.

So, what are the active ingredients in Biseptol? In the instructions for use for the drug, it is noted that Biseptol tablets are a combined remedy consisting of two components: sulfamethoxazole at a dose of 400 mg and trimethoprim at a dose of 80 mg. The number indicated in the patented name "Biseptol 480" means nothing more than the total mass of the active ingredients of the drug.

The pharmaceutical industry produces four main forms of release:

• Biseptol 480 mg - tablets for adults;
• Biseptol 120 mg - tablets for children;
• Biseptol 240 mg - suspension for children. 5 ml of the drug contains 240 mg of a combination of sulfamethoxazole and trimethoprim;
• Option 480 mg - ampoules containing a concentrate from which solutions for infusions are prepared - intravenous drip injections, or, more simply, droppers. Biseptol in ampoules is indicated for use in a hospital setting.

Some manufacturers have developed the release of Biseptol syrup for children containing 240 mg of active ingredients.

The most popular forms of release that doctors and their patients most often deal with are Biseptol 480 mg in the form of tablets and Biseptol 240 mg suspension for children.

How Biseptol works - pharmacological action

Sulfamethoxazole is the main component of Biseptol, which has a fairly strong bactericidal effect. It disrupts the synthesis of dihydrofolic acid, necessary for microorganisms to live. Trimethoprim enhances the effect of sulfamethoxazole. Synergy, that is, the summation of the effects of Biseptol components, was first described in the late 60s.

The ratio in which the components are dosed is precisely verified. If in a Biseptol tablet it is approximately one to five, then when absorbed into the blood, the ratio of sulfamethoxazole and trimethoprim drops to one to twenty. These concentrations are necessary for the peak, maximum synergistic effect of the components.

Does Biseptol still have anything to do with antibiotics or not?

This question worries patients so often that it is simply necessary to dot the i's. So, an antibiotic is a medicinal substance of natural (animal, plant or microbial) origin, which has an antibacterial effect, completely suppressing both the growth and reproduction of bacteria. The modern pharmaceutical industry also produces semi-synthetic antibiotics.

Upon careful study of the instructions for Biseptol, it becomes obvious that its components have nothing to do with antibiotics. Both substances that make up the drug are synthesized in the laboratory. Sulfamethoxazole belongs to the group of sulfa drugs, and trimethoprim is used exclusively to enhance the effect of the main component.

So, the answer to the question whether Biseptol belongs to antibiotics or not is unambiguous and beyond doubt. Biseptol is a medicine from the group of sulfonamides with antibacterial action. But not an antibiotic.

However, it is naive to believe that a remedy that is not related to the notorious “harmful” antibiotics is as safe as multi-colored sweet vitamins. Sulfonamides are also serious drugs that should be taken exclusively under the supervision of a doctor. Otherwise, you may expect not very pleasant consequences, including the formation of drug-resistant microorganisms. After all, it is not for nothing that all antibacterial agents - antibiotics, sulfonamides, and representatives of other pharmacological groups - are prescription drugs. And you shouldn't forget about it.

Biseptol: indications for use

The answer to a common and seemingly simple question, what does Biseptol help with, cannot be unambiguous. After all, the combination of sulfamethoxazole and trimetroprim is a serious drug, the selection of which requires careful collection of information. Ideally, if this is done by a specialist. Let's try to figure out in which cases Biseptol is the drug of choice and when it is better to prefer another medicine to it.

The main indications for the use of Biseptol are, of course, diseases caused by pathogenic microorganisms. The spectrum of action of the sulfamethoxazole-trimethoprim complex is quite wide and includes a wide variety of gram-positive, gram-negative bacteria, protozoa and even pathogenic fungi. Streptococci, staphylococci, Escherichia coli, Salmonella, Chlamydia, Toxoplasma and other microorganisms are exposed to the bactericidal action of the drug. Tuberculosis bacillus, treponema, leptospira, pathogenic viruses are resistant to Biseptol.

A fairly wide range of microorganisms sensitive to Biseptol determines the same extensive list of diseases for which the drug is used. Let's try to figure out in what cases this drug is prescribed.

The most common gram-positive bacteria that commonly cause upper and lower respiratory infections are staphylococci and streptococci. The high efficiency of Biseptol against these microorganisms allows it to be successfully used in bacterial pharyngitis and tonsillitis - tonsillitis.

Biseptol also gives positive results with bacterial bronchitis. However, I would like to note that inflammation of the bronchi is often caused by viruses that are resistant to the action of antibacterial drugs. Therefore, be prudent: when a cough appears, you should not drink such drugs without the recommendation of a doctor.

Inflammation of the maxillary sinuses - sinusitis - most often caused by all the same cocci, less often - chlamydia, mycoplasmas and viruses. Despite the fact that antibiotics are the drugs of choice for sinusitis, Biseptol is sometimes prescribed.

Is the treatment of intestinal infections justified?

The activity of the drug against Escherichia coli allows the use of Biseptol in acute intestinal infections. It is important that the effect of the drug extends to enterotoxigenic strains of the pathogen. Enterotoxigenic E. coli is responsible for severe bloody diarrhea that is accompanied by general intoxication of the body. In addition, there is experience with the use of the drug in salmonellosis.

However, before deciding to use any antibacterial agent for intestinal infections, one important nuance should be remembered. All pathogens of these diseases are eliminated on their own within a week. In plain language, a week after infection, the disease will stop without any treatment. This also applies to the notorious salmonellosis, one diagnosis of which sometimes leads the patient and his relatives into a state of panic.

Standard protocols for the treatment of acute intestinal infections do not include the use of any antibacterial drugs. The basis of the treatment of such diseases is to ensure sufficient fluid intake.

In severe cases (for example, with the development of infection in young children or the elderly, in immunocompromised patients), it is still possible to prescribe antibacterial drugs. And again, Biseptol is not the gold standard in such cases - there are many other, safer drugs. For example, funds from the group of nitrofurans are not absorbed into the blood at all. The effectiveness and safety of these drugs is based on the fact that they work only in the intestinal lumen.

Therefore, in the vast majority of cases, Biseptol treatment of intestinal infections is absolutely unjustified.

Urinary tract infections

Escherichia coli is recognized as the most common cause of urinary tract infections. Approximately 80% of all inflammatory processes of the bladder are caused by this pathogen. Therefore, Biseptol, which is active against Escherichia coli, in some cases gives good results with cystitis.

However, it should be remembered that the antibiotic of the fluoroquinolone series is still the drug of choice for diseases of the urinary tract. It is impossible to approach the treatment of these pathologies negligently: with inadequate therapy, there is a rather high risk of chronicity of the pathological process. Untreated cystitis threatens with chronic inflammation of the bladder, which is difficult to treat.

Why is the uncontrolled use of Biseptol dangerous for cystitis? In fact, everything is very simple: the frequent use of Biseptol for a long time led to the gradual emergence of resistance to the components of the drug. As a result, the effectiveness of the drug has decreased significantly.

In the treatment of many infections, the relief received at the beginning is taken by the patient for a complete cure. In fact, with the uncontrolled use of Biseptol, and other antibacterial drugs, there is a possibility that some particularly resistant microorganisms survived. With this development of events, the disease passes into a latent chronic phase. Chronic cystitis may not appear for some time, and this is its particular danger.

So it's not worth the risk. Cystitis and other diseases of the urinary tract should be treated by a doctor, and uncontrolled intake of Biseptol in these pathologies can be fraught with complications.

Biseptol for colds: necessary, contraindicated or useless?

One of the most common misconceptions of Russian patients is blind faith in the mighty power of antibiotics for any disease. It is impossible to link this confidence with objective reasons. Our citizens stubbornly want to treat influenza, colds and SARS with antibiotics. The worst thing is that often caring mothers conduct these experiments with their children.

So, let's try to understand this, of course, an important issue. Do you need antibacterial drugs, which include Biseptol, for a cold or SARS?

To do this, first of all, it is necessary to remember that the common cold, the flu, and an acute viral disease - ARVI - are caused by various viruses. And from the instructions for the use of Biseptol, we know that this drug, like any other antibacterial agents, does not affect viruses. Absolutely. Thus, using it for a cold, we will not get any effect. Except for the side.

A common cold or SARS usually goes away on its own within a week or a little more. However, in debilitated patients, young children, elderly patients - all those who have malfunctions in the immune system - the disease can take a protracted course. This leads to a complication of the pathology and additional infection with bacteria. In such cases, as a rule, an antibacterial drug is needed. And the use of Biseptol tablets will be very appropriate.

How to notice this line between a viral and already complicated viral-bacterial infection? For a person far from medicine, this is indeed not so simple. One of the symptoms of a complicated viral disease is a sharp deterioration in the condition. For example, a significant increase in temperature after several days of illness and a period of relative calm. In this case, the fever either does not stop at all, or after taking antipyretics, the temperature drops very slowly and for a short time. The appearance of a strong cough, accompanied by sputum discharge, may indicate a complication of the infection. The treatment of a cold aggravated by a bacterial infection should be handled by a doctor who will select the correct antibacterial drug.

According to the instructions for Biseptol, the course of treatment is selected individually for each patient.

For children, the drug is prescribed starting from 6 weeks of age. Young children are usually prescribed a suspension or syrup. Most often, pharmacies sell a suspension of Biseptol, the instructions for which clearly describe the recommended treatment regimen, depending on the age of the child.

The standard dosage of Biseptol for children from six months to five years is 240 mg twice a day. 5 ml of suspension or syrup contains exactly 240 mg of sulfamethoxazole and trimethoprim, so it is very convenient to dose the drug. Even if you lose the measuring spoon that usually comes with the medicine, there will be no problem with taking it. After all, a standard teaspoon contains exactly 5 ml of solution. One teaspoon of Biseptol suspension or syrup in the morning and evening is enough for the child to receive a daily dose of sulfamethoxazole and trimethoprim.

If the child is able to swallow a pill, he is prescribed a tablet form of Biseptol at a dose of 120 mg. Children under 5 years old take 2 tablets at once twice a day.

Starting from the age of 6, the drug is prescribed at a dose of 480 mg twice a day, and it is most convenient to buy Biseptol tablets.

Starting from the age of 12, Biseptol is prescribed at a dose of 960 mg. Multiplicity of application - twice a day.

The course of treatment is selected depending on individual factors and can range from 5 days to two weeks. In severe cases, the doctor has the right to prescribe doses that exceed the standard recommended by 50%.

Features of the use of suspensions

I would like to draw attention to the features of taking Biseptol suspension. Usually, in the instructions for each suspension, the manufacturer tries to warn the patient about the need to shake the vial before using the medicine. And unfortunately, not everyone complies with this requirement. Why is it so important to read the annotation to Biseptol to the end and do not forget to shake the vial with the suspension?

Any suspension is a two-fraction system in which the active substance is present in an undissolved form. It is evenly distributed only after vigorous shaking. Otherwise, you run the risk of drinking a teaspoon of a suspension containing not 240 mg of Biseptol, but much less, and it is not possible to establish the exact mass.

If you bought Biseptol syrup, you can safely give it to your child without first manipulating the bottle - the syrup is absolutely homogeneous.

And finally. All children's forms of Biseptol - both syrup and suspension - have a pleasant taste. Children are usually happy to be treated with such "edible" medicines, so be careful and keep the drug out of reach.

Admission rules, or How to drink Biseptol?

Therapy with any medication should not be chaotic. If you have to drink antibiotics or sulfonamide antibacterial drugs, you should be especially attentive to treatment. Both the effectiveness of the drug and the likelihood of adverse events depend on compliance with the rules of admission.

So, how to drink Biseptol correctly? You just need to remember the following rules:

• it is necessary to observe a 12-hour interval between doses. For example, take the morning dose at 8 am and the evening dose at 8 pm. Non-compliance with the regimen threatens to reduce the antibacterial activity of Biseptol;
• you need to drink the drug (both tablets and suspension) only after meals. Otherwise, the medicine has an irritating effect on the walls of the stomach;
• the minimum course of therapy should be at least five days. All lovers of treatment in three days should arm themselves with patience. Otherwise, you risk getting a complication of the infection, which, moreover, will be difficult to respond to antibiotic therapy.

Side effect

If you carefully read the instructions for Biseptol, the abundance of information about the side effects of the drug can shock even the most sophisticated reader. But in practice, things are not so threatening.

As a rule, at the recommended doses, both tablets and Biseptol suspension are well tolerated. Side effects that are recorded most often do not usually require discontinuation of the drug. Among the most common adverse events, I would like to note:

• dermatological manifestations in the form of rash and urticaria. Allergic reactions are more common in sensitized (sensitive) patients;
• violation of the gastrointestinal tract: nausea, occasionally - diarrhea, loss of appetite, stomatitis.

With prolonged use of high dosages of Biseptol, side effects may be more pronounced. Serious allergic reactions are occasionally recorded, candidiasis may develop due to changes in the composition of the intestinal microflora.

I would like to reassure those patients who, after reading the annotation to Biseptol to the section "Side Effects" and horrified, make a responsible decision to be treated with folk, and not "harmful" medicine.

The list of side effects includes all the symptoms that were recorded during the trials of the drug. The number of patients participating in clinical trials is usually several thousand people. Post-marketing trials last throughout the entire period of drug sales. Each patient is a potential participant in these studies, and the fact that he has a new side effect will be recorded in the annotation. Therefore, the likelihood of most side effects in the light of large numbers is extremely small. So, the instructions for Biseptol describe the possibility of hematopoietic disorders, but if the recommended doses are observed, this effect is observed only in one out of several hundred patients.

Contraindications

Biseptol is prescribed for the treatment of children, but it is not recommended to use the drug in infants under six weeks of age. In addition, Biseptol is categorically contraindicated during pregnancy and lactation. Sulfamethoxazole and trimethoprim perfectly penetrate the placental barrier. High doses of Biseptol components are also found in breast milk. Therefore, pregnant and lactating women will have to select other, safer antibacterial agents.

In addition, Biseptol is contraindicated in patients with severe diseases of internal organs: liver, kidneys, as well as hematopoietic disorders.

Separately, I would like to note individual sensitivity to sulfanilamide drugs as a contraindication. The likelihood of an individual reaction is usually extremely small and possible in sensitized patients. Be careful when taking Biseptol if you have ever had allergic reactions to medications (for example, an allergic rhinitis). For the same patients who have experienced any manifestations of sensitivity to streptocide, fthalazole, sulfadimethoxine, Biseptol is categorically contraindicated. The likelihood of an allergy in this case is very high!

If side effects occur during treatment, it is very important to inform your doctor immediately.

When does Biseptol not work?

I would especially like to note that with angina caused by beta-hemolytic streptococcus, Biseptol is not recommended for use. The fact is that strains of group A hemolytic streptococcus are almost completely resistant to sulfa drugs. For a long period of therapy with antibacterial drugs, microorganisms have formed on which sulfamethoxazole does not have a bactericidal effect.

An error in the selection of the drug for tonsillitis can lead to complications, especially in young children. That is why an examination and consultation of a doctor is necessary: ​​only a specialist can distinguish streptococcal tonsillitis from staphylococcal.

A question of choice, or how to replace Biseptol?

The pharmaceutical market is usually saturated with analogues that can fully replace the drug. Often it is difficult even for a doctor to understand the abundance of different drugs. And a person who is not related to medicine, an excessive abundance of analogues or generics can be confusing. Let's try to figure out what can replace Biseptol in Russia.

So, most often in pharmacies it is Biseptol that is sold in tablets and children's suspensions made in Poland. A fairly common drug from the French company Seneksi Bactrim is also not inferior in quality to the original remedy. The Russian company Pharmstandard produces a cheaper analogue of Biseptol in tablets and suspensions - Co-trimoxazole at a dose of 480 mg and 240 mg, respectively. Medicines under the same name are produced by other Russian pharmaceutical companies. All of them are democratically priced.

The remaining modern analogues of Biseptol are extremely rare. Sometimes pharmacies offer very high-quality Dutch Bi-septin tablets (manufacturer NaturProduct) and Septrin, produced by the world-famous English concern Glaxo.

The use of drugs that have a strong antibacterial effect makes it possible to eliminate diseases caused by pathogenic fungi, protozoa, gram-positive and gram-negative bacteria. Biseptol tablets are a drug with a bactericidal effect: it provokes the death of a microbial cell by blocking the synthesis of folic acid, without which it loses its ability to divide. This drug does not belong to the group of antibiotics. Biseptol is produced in the form of tablets, syrup and suspension. The last two forms mentioned are usually recommended for the treatment of children. Each dosage form has features of administration and dosage, therefore, before starting treatment, it is necessary to obtain an exhaustive consultation of a specialist. It should be noted: the drug is dispensed by prescription.

Biseptol - a drug with an extensive range of action, belongs to the group of bactericides. It is prescribed to eliminate microbes that cause infectious diseases.

Characteristics of the drug

Biseptol tablets are a combination drug that is characterized by a wide spectrum of action. It contains sulfamethoxazole, which disrupts the synthesis of the acid necessary for the development of bacteria, as well as trimethoprim, a substance that enhances the effect of the first active ingredient and prevents the reproduction of pathogenic microorganisms.

This medication is active against pathogens such as:

• gonococci;
• meningococci;
• chlamydia;
• salmonella;
• coli;
• some types of fungi.

Note! Biseptol does not act on viruses, so it is not used to treat viral diseases. The drug is also not active against pathogens and leptospirosis, Pseudomonas aeruginosa, spirochetes.

This medication is produced not only in the form of tablets - Biseptol suspension, syrup and ampoules containing a concentrate are also available. Biseptol suspension is suitable for children; the drug contained in ampoules is used exclusively during inpatient treatment under the supervision of medical personnel.

Tablets and other forms of the drug are rapidly absorbed from the stomach, and their active components have the ability to penetrate into the tissues and body fluids - into the kidneys, tonsils, lungs, bronchial secretions, cerebrospinal fluid.

The maximum concentration of the active components of the drug in the blood is observed 60 minutes after its administration.

Indications and contraindications for taking the drug

Treatment with Biseptol is effective in the treatment of acute infectious diseases of the respiratory tract, infections of the ENT organs and the gastrointestinal tract, diseases of the urinary tract and organs of the reproductive system. Also, the use of the drug is advisable for infections of the skin and soft tissues.

Indications for taking Biseptol are the following diseases and pathologies:

• acute and chronic;
• lung abscess;
• malaria;
• scarlet fever;
• brucellosis;
• toxoplasmosis;
• acne;
• brain abscess;
• pyoderma;
• cystitis;
• salmonellosis;
• typhoid fever;
• osteomyelitis;
• cholera.

Even having an idea of ​​​​what Biseptol helps from, you should not take it without a doctor's prescription. This drug has some absolute contraindications. These include:

• children's age up to 3 months (for taking a suspension) or 3 years (for taking tablets);
• impaired renal function;
• hypersensitivity to the active substances of the drug;
• the period of gestation and breastfeeding;
• hematopoietic disorders;
• deficiency of folic acid in the body;
• liver failure;
• cardiovascular failure.

Note! If the patient has previously experienced an allergic reaction to taking certain medications, Biseptol is prescribed with caution, and treatment in this case is carried out under the special supervision of a physician. Also, tablets are prescribed with caution in case of thyroid diseases, at an early and advanced age.

When a patient is recommended to drink Biseptol, he is necessarily warned about the likelihood of adverse reactions. Although in most cases this drug is well tolerated by patients, the following undesirable manifestations may occur:

• diarrhea;
• nausea;
• abdominal pain;
• apathy;
• depression;
• dizziness;
• trembling fingers;
• an increase in the volume of urine excreted;
• feeling short of breath;
• pain in muscles and joints;
• temperature rise;
• chills;
• skin itching.

Side effects, if they occur, are mild.

Note! Particular care in the treatment of Biseptol must be observed in the elderly, as well as in persons suffering from alcoholism or malabsorption of substances.

Biseptol tablets are available in dosages of 120 and 480 mg. The difference between them is that the first type of drug contains sulfamethoxazole in the amount of 100 mg and trimethoprim in the amount of 20 mg; in the preparation with a dosage of 480 mg - 400 mg and 80 mg of substances, respectively.

Each package contains 20 tablets.

Instructions for Biseptol tablets prescribe the following:

• reception is carried out after a meal;
• to prevent the formation of crystals in the urine that provoke urolithiasis, it is necessary to drink tablets with plenty of water, and throughout the course of treatment, drink at least 2 liters of pure water daily;
• during therapy, limit exposure to direct ultraviolet rays;
• when taking tablets, adults and children should limit the intake of protein foods, which reduces the effectiveness of the drug;
• it is important to stop drinking alcoholic beverages, which not only neutralize the effectiveness of the medication, but can also cause the development of allergic reactions.

Before starting treatment, the specialist should explain to the patient how to take Biseptol. The dosage of the drug depends on the existing disease:

• Biseptol for cystitis, other diseases of the urinary tract of an infectious nature, as well as chronic bronchitis in adults, is taken according to the following scheme: 960 mg of the drug per day, which is equal to 2 tablets at a dosage of 480 mg or 8 tablets at a dosage of 120 mg. You need to take the tablets 2 times a day. Biseptol is taken in the same way;
• with gonorrhea, 1920-2880 mg of the drug per day is indicated. The indicated dosage is divided into 3 doses per day;
• with diarrhea, it is recommended to take 960 mg of the drug, in two divided doses. Between each of them must pass 12 hours.

The minimum period of use of this medication is 4 days. It is not recommended to continue therapy for more than 2 weeks, since prolonged use of Biseptol provokes a violation of the synthesis of folic acid, and this, in turn, can lead to hematopoietic disorders.

When treating, it is important not to exceed the rate of the drug prescribed by the doctor. An overdose of Biseptol can cause the following symptoms:

• drowsiness;
• nausea and vomiting;
• fever;
• pre-fainting state;
• the appearance of blood in the urine;
• jaundice;
• depression;
• hematopoietic disorders.

If signs of an overdose appear, the patient is assisted in the form of gastric lavage, intramuscular injections of folinate, acidification of urine.

Can children take Biseptol tablets?

Can Biseptol be used in childhood? If it is necessary to take this drug, Biseptol for children is recommended in the form of a suspension. It can be given to a child from the age of 3 months. Biseptol syrup is recommended to be given from the age of 1 year. As for the medication in tablets, it can be used from the age of 3 years. Parents are often concerned about the question of whether Biseptol is an antibiotic or not. This remedy does not belong to the group of such drugs, but its use must be discussed with a doctor.

How many milligrams should the dose of the drug be? Instructions for the use of Biseptol for children provide for the following:

• at the age of 3 to 5 years, the daily dose of tablets will be 240 mg (2 tablets with a dosage of 120 mg);
• children from 6 to 12 years old are given 480 mg of the drug per day (4 tablets of 120 mg or 1 at a dosage of 480 mg);
• at the age of 12 years and older, the allowable daily dose can reach 960 mg per day. The daily intake is divided into 2 times.

When taking Biseptol by a child, it is important for parents to control his condition. If adverse reactions occur, you should immediately contact a specialist. On the advice of a doctor, you can supplement the treatment with vitamin and dietary supplements that mitigate the negative effect of the drug on the functioning of the intestines and kidneys.

Analogues

Analogues of the drug Biseptol 480 for the active substance are:

• Bactrim;
• Disepton;
• Intrim;
• Cotrimoxazole;
• Trimezol;
• Ziplin;
• Sumetrolim;
• Oriprim;
• Duo-Septol;
• Cotrifarm;
• Berlocid;
• Bisutrim.

The price of the drug Biseptol is from 27 to 40 rubles for a package of tablets with a dosage of 120 mg and from 80 to 110 rubles for a package of tablets with a dosage of 480 mg.

The drug is dispensed exclusively by prescription and is taken according to his instructions.

Attention everyone who uses Biseptol 480: instructions for use of this drug should be carefully studied! The dosage prescribed by the doctor should never be exceeded, otherwise there is a significant risk of side effects.