Levomycetin alcohol solution. Scope of alcohol-based chloramphenicol. Application in childhood

Chloramphenicol* (Chloramphenicol*)

ATX

D06AX02 Chloramphenicol

Pharmacological group

Indications

For systemic use (parenterally and orally): typhoid fever, paratyphoid fever, salmonellosis (generalized forms), brucellosis, rickettsiosis (including typhus, Rocky Mountain spotted fever, Q fever), tularemia, dysentery, brain abscess, meningococcal infection, trachoma, inguinal lymphogranuloma, chlamydia, yersiniosis , ehrlichiosis, urinary tract infections, purulent wound infection, purulent peritonitis, biliary tract infections.

Contraindications

Hypersensitivity, diseases of the hematopoietic organs, acute intermittent porphyria, severe impairment of kidney and liver function, glucose-6-phosphate dehydrogenase deficiency, psoriasis, eczema, fungal skin diseases, neonatal period (up to 4 weeks) and early childhood.

Use during pregnancy and lactation

In pregnancy, it is likely that the expected result of therapy outweighs the potential risk to the fetus (adequate and strictly controlled studies on the use during pregnancy have not been conducted, the possibility of chloramphenicol to cross the placenta should be taken into account).

Side effects

System effects

Precautionary measures

In the process of treatment, it is necessary to regularly monitor the pattern of peripheral blood.

In the treatment of nipple cracks in nursing mothers, it is not necessary to stop breastfeeding newborns.

Storage conditions of the drug

In a cool, dark place.

Keep out of the reach of children.

The drug Levomycetin is an antibacterial drug based on chloramphenicol. The drug exhibits the action of an antibiotic, has a wide range of applications. The drug is produced by Russian, Belarusian, Ukrainian pharmaceutical companies. Read the instructions for use of the product to know about its method of use, indications.

Composition and form of release

Levomycetin (Levomycetin) is presented in the form of tablets, liniment, eye drops and an alcohol solution. Their composition:

Properties of Levomycetin

Bacterial resistance to chloramphenicol develops very slowly. The active substance of the drug blocks the polymerization of activated amino acid residues associated with mRNA. When applied topically, the agent reaches the desired concentration in the secretion of the eyes, vitreous body fibers, iris and cornea, does not penetrate into the lens. The drug passes through the barrier of the placenta, is found in breast milk.

After oral administration, the drug is rapidly absorbed, has 80% bioavailability, binds to plasma proteins by 55%. Metabolism of the drug occurs in the liver, intestines, the half-life is 1.5-3.5 hours, excreted in the urine, feces and bile. Therapeutic concentration of chloramphenicol in the blood persists for 4-5 hours after ingestion, up to a third of the dose taken enters the bile. The highest concentration of Levomycetin was found in the kidneys and liver. The drug is poorly exposed to hemodialysis.

Levomycetin - an antibiotic or not

The active substance of the composition of Levomycetin is an antibiotic, its action is associated with a violation of the synthesis of proteins of gram-positive and gram-negative bacteria. The drug shows activity against staphylococci, streptococci, E. coli, salmonella, shigella, klebsiella, proteus, spirochetes, some large viruses.

The drug kills microflora resistant to streptomycins, penicillins and sulfonamides. The antibiotic Levomycetin stops inflammation, treats infections of any tissues and organs, subject to the sensitivity of the microflora. The drug belongs to antibacterial agents of synthetic origin, it is identical to the product that streptomycetes microbes produce in the process of life.

Indications for use

Levomycetin is actively used to treat various diseases. The instruction highlights the following indications:

• typhoid fever, paratyphoid;
• dysentery;
• bronchopneumonia;
• sinusitis;
• brucellosis;
• coccidosis;
• laryngotracheitis;
• mycoplasmosis;
• osteomyelitis;
• tularemia;
• whooping cough;
• typhus;
• rickettsiosis, yersiniosis;
• brain abscess;
• chlamydia, inguinal lymphogranuloma;
• purulent peritonitis, ehrlichiosis;
• sepsis, meningitis;
• trachoma, pneumonia;
• purulent skin lesions, bedsores, wounds;
• boils, burns 2 and 3 degrees;
• cracked nipples when breastfeeding;
• scleritis, blepharitis, keratitis, conjunctivitis, episcleritis, keratoconjunctivitis;
• purulent otitis.

How to take Levomycetin

Instructions for use Levomycetin indicates that the drug should be used when the disease is caused by microbes sensitive to chloramphenicol. The medicine is ineffective against fungi, viruses. The dosage, method of use and duration of the course of treatment with the drug depend on the type of disease, the age of the patient and his individual characteristics, the severity of the disease.

For oral administration, Levomycetin tablets and capsules are intended. The dosage for adults is 500 mg 3-4 times a day. According to the instructions, a single dose for children under three years old is 15 mg / kg of body weight, 3-8 years old - 150-200 mg, over 8 years old - 200-400 mg. All doses are taken 3-4 times a day for a course of 7-10 days. The maximum dose for adults is 2000 mg per day.

In severe cases (peritonitis, typhoid fever), the daily dosage can be increased to 3-4 g in a course of up to 10 days. For diarrhea caused by food poisoning or a bacterial infection, take 1 tablet before meals. every 4-6 hours. If after taking the first tablet of 500 mg the symptoms of diarrhea have disappeared, the second and subsequent tablets should not be taken. With cystitis, the drug is taken in the usual dosage every 3-4 hours.

Levomycetin solution

According to the instructions, Levomycetin in ampoules is applied externally to lubricate damaged skin. An occlusive dressing can be used on top. With purulent otitis, it is allowed to instill the solution into the ears at a dosage of 1-2 ml per day. Cracks in the nipples are treated with a solution diluted in a ratio of 1: 4 with water after each feeding. Treatment should not last longer than five days in a row. Do not use injection solution.

The drug can be used for acne, because chloramphenicol suppresses the processes of infection and inflammation. For skin treatment, a 1% solution is used, which is applied pointwise to avoid overdrying of the skin and the appearance of purulent areas. The tool is used from the moment the pimple appears until it disappears, it is not recommended to use it prophylactically. It is allowed to combine the solution with Aspirin, calendula tincture, boric acid, salicylic acid, streptocide, camphor alcohol and ethanol. Talkers are made of them.

Drops

Levomycetin in the form of eye drops is introduced into the conjunctival sac at a dose of 0.1 ml 3-4 times a day for a course of 5-15 days. When applying, you must follow the instructions: tilt your head back, pull the lower eyelid towards the cheek, without touching the eyelid with the tip of the bottle, put a drop of medicine into the resulting cavity. After instillation, the outer corner of the eye should be pressed with a finger and try not to blink for half a minute. In the first 28 days of a newborn's life, it is allowed to use the drug for vital indications.

According to the instructions, with purulent otitis media, the solution is instilled 2-3 drops 1-2 times a day. If a lot of exudate is released from the ear canal, which washes away the medicine, the frequency of use can be increased up to 4 times per day. With barley, the use of drops can accelerate the ripening of barley, relieve redness and pain, and shorten the recovery time by 2-3 days. 1-2 drops are instilled into each eye 2-6 times a day. If severe pain is felt, Levomycetin can be used every hour.

Liniment

According to the instructions, the use of Levomycetin liniment is indicated for infectious lesions of the skin and soft tissues. The ointment is applied to a gauze swab or directly to the skin, a bandage is applied on top, compress or parchment paper can be used for laying. The dressing is repeated every 1-5 days, depending on the patient's condition. Liniment should be applied after cleansing the wound or burn from pus, dead tissue, treating with an antiseptic (it is allowed to use Miramistin, chlorhexidine, hydrogen peroxide or furacilin solution).

In the treatment of wounds, liniment is applied once a day, burns - 2-3 times a week, bacterial lesions - 1-2 times a day with a thin layer. If possible, the ointment should be rubbed until completely absorbed, to capture the treatment site and healthy skin around. Moist areas can be pre-wet with a sterile gauze pad. A single dose of liniment is 250-750 mg, daily - 1-2 g. On nipple cracks during breastfeeding, the ointment is applied in a thick layer over a sterile napkin.

special instructions

The drug is used with caution in patients previously treated with cytostatics or undergoing radiation therapy. Other special instructions from the instructions:

1. The combination of Levomycetin with alcohol intake can lead to disulfiram-like reactions. Symptoms are manifested by convulsions, redness of the skin, reflex cough, tachycardia, vomiting, nausea.
2. During treatment, you need to regularly donate blood for analysis.
3. The drug can be used in veterinary practice. The agent is prescribed for salmonellosis, colibacillosis, colienteritis, leptospirosis and urinary tract infections, lungs in birds, cats, dogs. Tablets are added to feed and given to animals.

During pregnancy

The use of chloramphenicol is contraindicated during pregnancy and lactation (breastfeeding). If the drug is prescribed according to the vital indications of a nursing mother, then the child is transferred to artificial feeding. If indicated, eye drops can be used during pregnancy and lactation, but on condition that the dosages do not exceed those indicated in the instructions.

children

The use of chloramphenicol is used with caution in newborns, because the development of gray cardiovascular syndrome is possible. It is manifested by gray-blue skin color, flatulence, cardiovascular insufficiency, nausea, dyspnea, hypothermia, cyanosis. Children's dosage of tablets will be 25-100 mg / kg per day, for children under one year old, the dose is calculated at 6.25 mg / kg up to 4 times a day. Infants older than 14 days can be prescribed 12.5 mg / kg of body weight per reception every 6 hours.

In severe infections, meningitis, the dosage is increased to 75-100 mg / kg per day. Children can be given Levomycetin to relieve intestinal disorders. According to the instructions, the dose at the age of 3-8 years will be 375-500 mg per day, over eight years - 750-1000 mg. Eye drops are instilled drop by drop into the conjunctival sac every 6-8 hours. With barley, drops are contraindicated up to 10 years. The solution is not used in children under one year old, liniment - in premature and newborn babies.

drug interaction

The combination of Levomycetin with oral hypoglycemic drugs leads to an increase in their action due to the suppression of their metabolism in the liver and an increase in plasma levels. Other drug interactions from the instructions:

1. Simultaneous use of the drug with drugs that inhibit bone marrow hematopoiesis enhances their effect.
2. The combination of chloramphenicol with Lincomycin, Clindamycin, Erythromycin leads to a mutual weakening of the effect due to the first displacement of the active components of antibiotics from the bound state.
3. Levomycetin prevents the manifestation of the bactericidal effect of penicillins.
4. The active substance of the composition weakens the metabolism of Warfarin, Phenobarbital, Phenytoin.
5. It is not recommended to combine the drug with sulfonamides, as the inhibitory effect on hematopoiesis is enhanced.

Side effects of Levomycetin

The use of the medication may cause side effects. The pages of the instructions indicate negative reactions:

• aplastic anemia, thrombocytopenia, agranulocytosis, leukopenia;
• flatulence, nausea, diarrhea, vomiting, dyspepsia;
• auditory and visual hallucinations, peripheral neuritis, delirium, confusion, headache, depression;
• rhinitis;
• intestinal dysbacteriosis (increase in the number of pathogenic microorganisms);
• angioedema, skin rash, urticaria;
• skin irritation, dermatitis.

The use of doses over 3 g per day for a long time leads to an overdose of Levomycetin, which is manifested by complications from hematopoiesis, skin pallor, weakness, hyperthermia, fatigue, sore throat, bleeding, hemorrhage. An overdose in newborns leads to the appearance of a cardiovascular (gray) syndrome, manifested by bloating, vomiting, acidosis, collapse, coma.

40% of cases of intoxication end in death. The reason is the accumulation of the active substance and the toxicity of the action of chloramphenicol on the myocardium. Overdose treatment consists in gastric lavage, the use of saline laxatives, cleansing enemas, enterosorbents. Severe cases suggest hemosorption. If the dose of eye drops is exceeded, vision temporarily deteriorates, to eliminate symptoms, you need to rinse your eyes with water.

Contraindications

Some groups of patients are prohibited from using the drug. The instruction highlights the following contraindications.

Among antibacterial drugs, Levomycetin is well known - the instructions for use recommend the use of a tableted antibiotic for patients with stomach disorders, in ophthalmology the drug is in demand in the form of a liquid. It has a broad spectrum of activity and is effective against numerous strains of bacteria. The drug is not used to treat fungal diseases and postoperative infectious complications.

Antibiotic Levomycetin

In the pharmaceutical market, Levomycetin is well known and in demand for more than half a century. Chloramphenicol is the international name for an antibiotic. Its opening dates back to 1949. American professor David Gottlieb managed to isolate a substance unknown to science from strains of streptomycetes (bacteria that live in the soil). Studies have confirmed its antibacterial action.

Clinical trials were quickly carried out and Chloromycetin (Levomycetin) was introduced to the pharmaceutical market. In a short time, it became a very popular drug, so its artificial synthesis was launched. The World Health Organization has included the antibiotic in the list of essential medicines. The antibiotic is used in surgery, ophthalmology, dermatology, gastroenterology, otolaryngology and other branches of medicine. It is available and cheap.

Composition and form of release

Chloramphenicol is a crystalline powder, white or yellow in color. The substance is poorly soluble in water, but highly soluble in alcohol. A distinctive feature of the powder is its very bitter taste. A synthetic antibiotic is no different from natural chloramphenicol, which in its natural environment is a waste product of streptomycetes. Antibiotic Levomycetin is produced in various pharmacological forms, in which the main active ingredient is presented in different concentrations:

Medicinal action

Indications for use

Before starting treatment with Levomycetin, the instructions for use must be read. According to the annotation, the drug is prescribed for the treatment of infectious diseases caused by bacteria sensitive to chloramphenicol. The list of direct prescriptions of the drug begins with infections of the gastrointestinal tract, which are accompanied by vomiting, diarrhea and are associated with a violation of the intestinal microflora. The drug is a first-line antibiotic for intestinal infections, so it is prescribed for:

• typhoid fever;
• typhus;
• paratyphoid;
• dysentery;
• brucellosis;
• salmonellosis and other serious diseases.

In otolaryngology, levomycetin is prescribed for angina, purulent otitis media. Antibiotic for many years shows a high degree of activity against the three main bacterial pathogens of meningitis. The drug is widely used to treat purulent wounds, acne and other purulent skin infections. The bacteriostatic antibiotic is effective in diseases of the respiratory system: inflammation and abscess of the lungs. They resort to its use in the treatment of chlamydia, trachoma, tularemia. The drug is in demand for the treatment of conjunctivitis and other eye inflammations.

Method of application and dosage

Any antibiotics require strict adherence to the dosage and regimen, including Levomycetin - the instructions for use contain all the necessary information for the effective use of the drug. Only a doctor should prescribe an antibiotic, determine the pharmacological form and adjust the regimen, self-medication with the use of antibacterial drugs is unacceptable.

Levomycetin solution for eyes

Levomycetin eye drops are used to treat eye infections. The antibiotic does not penetrate into the lens. The solution is instilled 3-4 times a day, one drop in each eye. The conjunctival sac is the best place to inject the treatment solution. For the procedure, sterility must be observed. When instilling eyes, use a clean pipette. The duration of the therapeutic course should be determined by the attending physician. The standard duration of treatment is 2 weeks.

alcohol solution

For external use in the treatment of skin lesions (wounds, burns, bedsores), an alcohol solution of Levomycetin is used. To treat the skin, the solution is applied to a cotton pad, and the damaged areas are wiped with light movements. It should be borne in mind that the solution of the drug is alcohol and greatly dries the skin, so it is used until the inflammatory process on the skin stops.

An antibiotic solution is widely used to eliminate cosmetic problems on the face - the elimination of black spots, acne, acne. It is used as a drying agent. Microorganisms that cause such rashes are resistant to chloramphenicol. As part of therapeutic suspensions (for example, with salicylic acid) to solve problems with rashes on the face, this is an effective remedy. The composition of the suspension must be determined by a dermatologist.

Liniment

For purulent inflammations and skin diseases, boils, trachoma, a special pharmacological form of Levomycetin, liniment, is used. It is used by nursing women to treat cracked nipples. The drug is prescribed for severe purulent inflammation of the skin caused by microorganisms that are resistant to the antiseptic effect of penicillin.

Liniment is applied directly to the damaged skin or a gauze swab is impregnated with the drug, which is applied to the wound. To enhance the therapeutic effect of the liniment on the skin, a bandage is used, which ensures the tightness of the damaged area. To treat nipple cracks, they are treated with a solution of ammonia and a sterile bandage with a drug is applied. The procedure is carried out after feeding.

Levomycetin tablets

The main action of the antibiotic is aimed at combating numerous intestinal infections. The use of the drug for diarrhea, vomiting is effective only if it is caused by pathogenic intestinal bacteria sensitive to chloramphenicol. Levomycetin Aktitab is prescribed to combat strains of microorganisms resistant to penicillin, tetracycline, sulfonamides.

Tablets are taken orally, regardless of the meal. They should not be chewed. Drink plenty of water. Depending on the severity of the disease and the age of the patient, the dosage is prescribed by the doctor. The usual regimen for adult patients to suppress the activity of pathogenic E. coli involves taking 500 mg tablets 3-4 times a day, the duration of the course is 7-10 days.

With infections of the genitourinary system caused by streptococci and staphylococci, this drug may also be effective. An antibiotic in tablet form is prescribed by a doctor to treat cystitis (inflammation of the walls of the bladder), if the disease is caused by these groups of bacteria. Self-medication in this case is unacceptable and can lead to a chronic form of the disease.

special instructions

Taking an antibiotic provides for a number of special instructions:

• Pediatrics does not allow the use of the drug by newborns.
• Antibiotics are taken with caution by patients after radiation therapy.
• The simultaneous use of the drug and alcohol is contraindicated (if this rule is not observed, convulsions, cough, hyperemia, and vomiting may occur).
• Prolonged use of the drug requires control of peripheral blood, there may be a violation of hematopoiesis.
• The drug should be taken with caution in patients with reduced liver function - the antibiotic is processed by the liver and excreted through the kidneys.
• Levomycetin does not have a direct effect on the brain, but the development of side effects associated with a decrease in concentration and motor reactions is possible.

During pregnancy

Levomycetin is included in the list of drugs that are forbidden to be taken by pregnant women. Chloramphenicol inhibits the activity of the bone marrow, which leads to inhibition of hematopoiesis and the development of severe blood pathologies. As a result, vital organs are affected in the fetus, which leads to fatal consequences. In the event of severe infectious diseases in a pregnant woman, drug therapy is prescribed only by a doctor.

Levomycetin for children

In pediatric practice, the drug is prescribed in the form of tablets, intramuscular injections and eye drops. The regimen and dosage is prescribed only by a pediatrician. For children aged 3-8 years, the recommended daily dosage of antibiotic tablets is 125 mg 3-4 times. For children 8-16 years old - 250 mg 3-4 times. Eye drops are prescribed for children from 2 years of age. The duration of treatment and dosage is selected by the doctor individually.

drug interaction

The antibiotic is not prescribed to patients who are undergoing therapy with drugs that depress hematopoiesis, which include cytostatics, sulfonamides. Caution should be taken in patients with diabetes mellitus who use drugs that lower blood glucose levels. The antibacterial effect of the drug is reduced when it is used with other antibiotics.

Side effects and overdose

With an overdose of the drug, nausea and vomiting begin. In this case, the drug is canceled. Lavage of the stomach and intestines is carried out, sorbents are used. Adverse reactions can occur from the internal organs and systems:

• The digestive system reacts with nausea, vomiting, bloating, diarrhea.
• The reactions of the nervous system include headache, sleep disturbance, hallucinations, confusion.
• The bone marrow reacts with a violation of the process of hematopoiesis, which is manifested in a decrease in the number of blood cells.
• Allergic manifestations are possible in the form of a rash on the skin, Quincke's edema.

Contraindications

Certain pathological and physiological conditions of the body are a contraindication to taking Levomycetin, these include:

• intolerance to components;
• violation of the process of hematopoiesis;
• skin pathologies (psoriasis, fungal diseases, allergic eczema);
• pregnancy at any time;
• lactation;
• childhood.

Terms of sale and storage

All dosage forms of chloramphenicol are recommended to be stored in a place protected from light and out of the reach of children. The drug should be stored at a temperature not exceeding + 25 ° C. The shelf life of the powder is no more than 4 years, tablets - 3 years, eye drops - 2 years. Released by prescription.

Analogue of Levomycetin

In severe bacterial infections, the drug can be replaced by analogues. Eye drops Levomycetin-DIA, AKOS, Akri are analogues of Levomycetin eye drops. The same active ingredient is contained in the preparations Levomycetin Aktitab and Levomycetin sodium succinate. According to the mechanism of action, the antibiotic can be replaced:

• tablet form of the drug - Fluimucil;
• solution and ointment - aerosol Levovinizol, Baktoban, Gentamicin, Synthomycin, Fusiderm, Neomycion, Baneocin, Lincomycin.

The price of Levomycetin

The cost of the drug is low. Not all dosage forms are freely available in pharmacies. Of the available offers, prices for the drug are presented in the table:

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Producer: CJSC "Yaroslavl Pharmaceutical Factory" Russia

ATC code: D06AX02

Farm group:

Release form: Liquid dosage forms. Solution for external use.

General characteristics. Compound:

Pharmacological properties:

Indications for use:

Important! Get to know the treatment

Dosage and administration:

Application Features:

Side effects:

Overdose:

Storage conditions:

List B. In a cool, dark place, out of the reach of children.

Leave conditions:

On prescription

Package:

Solution for external use (alcohol) 1%, 3%, 5% in dark glass bottles of 25 and 40 ml. Each vial with instructions is placed in a pack.

Levomycetin alcohol solution 1%- instructions for the medical use of the drug

(Laevomycetin alcohol solution 1%)

international and chemical names: chloramphenicol; D-(-)-threo-1-para-nitrophenyl-2-

dichloroacetylamino-propanediol-1, 3;

Basic physical and chemical characteristics: clear, colorless liquid with an odor of alcohol;

Compound. 100 ml of the preparation contain chloramphenicol -1g;

other components: ethyl alcohol 70%.

Release form of the medicinal product. Solution for external use, alcohol.

Pharmacotherapeutic group. Antibiotics for topical use. ATC code D06AX02.

The action of the drug.

Pharmacodynamics. The drug exhibits antimicrobial activity when applied topically against most gram-positive and gram-negative bacteria. Affects pathogens resistant to antibiotics of the penicillin group, streptomycin, sulfonamides. Resistance to levomycetin itself develops slowly. The mechanism of antimicrobial action is due to the ability to disrupt the processes of protein synthesis. The effect of the antibiotic is mainly bacteriostatic.

Pharmacokinetics. With external use, the drug does not penetrate well through intact skin and mucous membranes, so the resorptive effect is light. The bacteriostatic effect when applied to the surface depends on the size of the damaged area, the amount of pus, mechanical obstacles. On average, the antimicrobial effect persists for 6-12 hours, after which the application of the drug should be repeated.

Indications for use. The drug is prescribed externally for burns, cuts, skin cracks, otitis and other diseases complicated by purulent pathology.

Method of use and dosage. Lubricate the affected skin surfaces (can be used under an occlusive dressing). The duration of use depends on the nature of the pathological process, its severity, the effect achieved. With purulent otitis, the drug is instilled into the ear canal (2-3 drops). The procedure is repeated 1 - 2 times a day, and in case of severe discharge, which wash off the applied solution - up to 3 - 4 times a day.

Side effect. With prolonged use, there may be a violation of the blood picture, the functions of the liver and kidneys, the development of dysbacteriosis. In case of an overdose of the drug, irritation of the skin and mucous membranes, local allergic reactions in the form of rashes, itching, redness and swelling of tissues are possible.

Contraindications. Increased individual sensitivity to the components of the drug, deficiency of the enzyme glucose-6-phosphate dehydrogenase, acute intermittent porphyria, skin diseases (, fungal infections).

Features of use. Do not use in newborns.

Interaction with other drugs. Interaction not known.

Terms and conditions of storage. Store in a cool (8-15°C), protected from light and out of the reach of children. Shelf life - 2 years.