Amoxiclav for pneumonia in adults dosage. Antibiotics for pneumonia. How long does therapy last

They are bacterial in nature, so antibiotics are the only effective method of dealing with them. All over the world, doctors adhere to a single scheme: for community-acquired forms of pathology, they prescribe drugs from the group of penicillins, macrolides and cephalosporins, and for hospital patients, cephalosporins and fluoroquinolones. All of these medicines have their own uses.

Penicillins

The oldest group of antibiotics with high activity and at the same time low toxicity to humans. Penicillins are effective against, including the most common pneumococcus (Streptococcus pneumoniae). All drugs of this class act bactericidal, i.e. cause the death of microbial cells. We have considered in detail the use of different groups of antibiotics in different groups of patients with pneumonia.

More often than others from the group are appointed:

1. Amoxicillin(trade names: Flemoxin Solutab, Hikoncil, Ospamox, Amoxicillin). It is administered orally in the form of capsules or suspensions. The frequency of administration is 2-3 times a day, depending on the dosage. The duration of treatment is from 10 to 14 days. In 10% of cases, amoxicillin is ineffective. This is due to the fact that some pathogens of pneumonia have learned to produce substances - beta-lactamases that destroy the antibiotic.

1. Amoxicillin + clavulanic acid combination(trade names: Augmentin, Amoxiclav, Flemoklav Solutab, Amoxicillin with clavulanic acid). Clavulanic acid protects amoxicillin from the effects of beta-lactamases, thereby increasing its effectiveness against bacteria. Preparations with it, as a rule, are prescribed to patients who have already been treated more than once. Combined drugs are used in the same way - 2-3 times a day for 10-14 days.

While taking penicillins, the following side effects may develop:

• allergic reactions (in comparison with other antibiotics, penicillins often cause urticaria, pruritus, Quincke's edema),
• disorders of the digestive tract (nausea, vomiting, diarrhea),

If any negative reaction occurs, the use of the drug should be discontinued and consult a doctor.

Due to the low toxicity of penicillins, they can be prescribed to young children and pregnant women. Dosages for these categories of patients are selected strictly individually.

macrolides

Another numerous and low-toxic class of antibiotics. Compared to penicillins, macrolides have a broader spectrum of action. Their use is effective, including in atypical pneumonia, the causative agents of which are mycoplasmas and chlamydia.

For adults, macrolides are available in the form of tablets and capsules, for children - in the form of suspensions. They act bacteriostatically, that is, they do not kill microbes, but inhibit their further reproduction. Of the side effects can cause:

• nausea, diarrhea, vomiting, abdominal pain,
• gum disease (stomatitis and gingivitis),
• allergic reactions (rare).

Doctors give preference from this group to several drugs, including:

1. Midecamycin(trade name Macropen). It is applied 3 times a day for 1-2 weeks. The drug is well tolerated. At the discretion of the doctor, it can be used during pregnancy. Contraindicated in children under 3 years of age.

1. Azithromycin(Sumamed, Zi-factor, Zitrolid). The frequency of admission is once a day. The duration of treatment is 3 days. Contraindicated in violations of the kidneys and liver.

1. Clarithromycin(Klabaks, Klacid). It is taken 2 times a day for 6-10 days. It is not prescribed for liver diseases and children under 6 months.

1. Roxithromycin(Rulid). It is recommended to take 2 times a day. The average duration of treatment is 5-10 days. Contraindicated during pregnancy, lactation and children weighing less than 40 kg.

Bacteria are able to quickly develop resistance to macrolides, so doctors try to avoid long-term therapy with these drugs (more than 10 days).

Cephalosporins

An extensive group of natural and semi-synthetic drugs, similar in structure to penicillins, but active against a larger number of pathogenic pathogens. For community-acquired pneumonia, patients are usually prescribed oral cephalosporins:

• cefixime (Suprax, Pancef),
• ceftibuten (Cedex).

In hospital forms, solutions for intramuscular and intravenous administration are more effective:

• cefuroxime (Zinacef),
• Cefotaxime (Cefabol, Talcef),
• ceftriaxone (Forcef, Tercef).

Common side effects of cephalosporins are digestive disorders and allergic reactions. Rarely, convulsions, fatigue, stomatitis, and blood clotting disorders can be observed. With caution, these drugs are prescribed in the elderly and patients with renal disease.

Cephalosporins can be used in children and, if necessary, in pregnant women (in the 2nd or 3rd trimester). The average duration of treatment is 7-10 days.

Fluoroquinolones

A group of powerful synthetic antibiotics that are prescribed for severe forms of pneumonia. Fluoroquinolones are available in the form of tablets, capsules and drip solutions. The specific form of the drug is selected by the doctor, taking into account the patient's condition.

1. Ofloxacin(Tarivid, Zoflox). It is administered orally or intravenously. In the first case, the drug is taken 2 times a day for 7-10 days. In the second, droppers are placed 1-2 times a day until the condition improves, then the patient is transferred to oral therapy.

1. Ciprofloxacin(Cifran, Tsiprobay). Forms of release and the scheme of administration are similar to ofloxacin.

Frequent negative reactions:

• nausea, vomiting, flatulence,
• headaches, dizziness,
• joint and muscle pain,
• blood clotting disorders,
• allergic reactions.

A significant disadvantage of fluoroquinolones is their ability to inhibit bone growth, and therefore they are not used in pregnant women and children under 18 years of age.

The program "School of Dr. Komarovsky" tells about the use of antibiotics in the treatment and even in the prevention of pneumonia:

In this article, you can read the instructions for using the drug Amoxiclav. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Amoxiclav in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Amoxiclav in the presence of existing structural analogues. Use for the treatment of various infectious diseases in adults, children, as well as during pregnancy and lactation. Alcohol use and possible consequences after taking Amoxiclav.

Amoxiclav- is a combination of amoxicillin - a semi-synthetic penicillin with a wide spectrum of antibacterial activity and clavulanic acid - an irreversible beta-lactamase inhibitor. Clavulanic acid forms a stable inactivated complex with these enzymes and provides amoxicillin resistance to the effects of beta-lactamases produced by microorganisms.

Clavulanic acid, similar in structure to beta-lactam antibiotics, has a weak intrinsic antibacterial activity.

Amoxiclav has a wide spectrum of antibacterial action.

Active against amoxicillin-sensitive strains, including strains producing beta-lactamase, incl. aerobic gram-positive bacteria, aerobic gram-negative bacteria, anaerobic gram-positive bacteria, gram-negative anaerobes.

Pharmacokinetics

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Both components are well absorbed after oral administration, food intake does not affect the degree of absorption. Both components are characterized by a good volume of distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries, etc.). Amoxicillin also penetrates into the synovial fluid, liver, prostate gland, palatine tonsils, muscle tissue, gallbladder, sinus secretions, saliva, bronchial secretions. Amoxicillin and clavulanic acid do not penetrate the BBB in non-inflamed meninges. Amoxicillin and clavulanic acid cross the placental barrier and are excreted in breast milk in trace concentrations. Amoxicillin and clavulanic acid are characterized by low plasma protein binding. Amoxicillin is partially metabolized, clavulanic acid appears to be extensively metabolized. Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly as metabolites.

Indications

Infections caused by susceptible strains of microorganisms:

• infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis);
• infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
• urinary tract infections;
• gynecological infections;
• skin and soft tissue infections, including animal and human bites;
• bone and connective tissue infections;
• biliary tract infections (cholecystitis, cholangitis);
• odontogenic infections.

Release form

Powder for the preparation of an injection solution for intravenous administration (4) 500 mg, 1000 mg.

Powder for suspension for oral administration 125 mg, 250 mg, 400 mg (a convenient children's form of the drug).

Film-coated tablets 250 mg, 500 mg, 875 mg.

Instructions for use and dosage

Adults and children over 12 years of age (or over 40 kg body weight): The usual dose for mild to moderate infections is 1 tablet 250 + 125 mg every 8 hours or 1 tablet 500 + 125 mg every 12 hours for severe infections. and respiratory tract infections - 1 tablet 500 + 125 mg every 8 hours or 1 tab. 875 + 125 mg every 12 hours. Tablets are not prescribed for children under 12 years of age (less than 40 kg of body weight).

The maximum daily dose of clavulanic acid (in the form of potassium salt) is 600 mg for adults and 10 mg/kg of body weight for children. The maximum daily dose of amoxicillin is 6 g for adults and 45 mg/kg of body weight for children.

The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not continue for more than 14 days without a second medical examination.

Dosage for odontogenic infections: 1 tab. 250 +125 mg every 8 hours or 1 tab. 500 + 125 mg every 12 hours for 5 days.

Dosage for renal insufficiency: for patients with moderate renal insufficiency (Cl creatinine - 10-30 ml / min), the dose is 1 table. 500 + 125 mg every 12 hours; for patients with severe renal insufficiency (Cl creatinine less than 10 ml / min), the dose is 1 table. 500 + 125 mg every 24 hours

Side effect

Side effects in most cases are mild and transient.

• loss of appetite;
• nausea, vomiting;
• diarrhea;
• stomach ache;
• itching, urticaria, erythematous rash;
• angioedema;
• anaphylactic shock;
• allergic vasculitis;
• exfoliative dermatitis;
• Stevens-Johnson syndrome;
• reversible leukopenia (including neutropenia);
• thrombocytopenia;
• hemolytic anemia;
• eosinophilia;
• dizziness, headache;
• convulsions (may occur in patients with impaired renal function when taking the drug in high doses);
• sense of anxiety;
• insomnia;
• interstitial nephritis;
• crystalluria;
• development of superinfection (including candidiasis).

Contraindications

• hypersensitivity to any of the components of the drug;
• a history of hypersensitivity to penicillins, cephalosporins and other beta-lactam antibiotics;
• a history of indications of cholestatic jaundice and / or other abnormal liver function caused by taking amoxicillin / clavulanic acid;
• infectious mononucleosis and lymphocytic leukemia.

Use during pregnancy and lactation

Amoxiclav can be prescribed during pregnancy if there are clear indications.

Amoxicillin and clavulanic acid are excreted in breast milk in small amounts.

special instructions

During the course of treatment, the functions of the hematopoietic organs, liver and kidneys should be monitored.

In patients with severely impaired renal function, an adequate correction of the dosing regimen or an increase in the intervals between dosing is required.

In order to reduce the risk of developing adverse reactions from the gastrointestinal tract, the drug should be taken with food.

Laboratory tests: High concentrations of amoxicillin give a false positive reaction to urine glucose when using Benedict's reagent or Felling's solution. Enzymatic reactions with glucosidase are recommended.

It is forbidden to use Amoxiclav with the simultaneous use of alcohol in any form, since the risk of hepatic disorders is seriously increased when they are taken simultaneously.

Influence on the ability to drive vehicles and control mechanisms

There are no data on the negative effect of Amoxiclav in recommended doses on the ability to drive a car or work with mechanisms.

drug interaction

With the simultaneous use of the drug Amoxiclav with antacids, glucosamine, laxatives, aminoglycosides, absorption slows down, with ascorbic acid it increases.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration).

With the simultaneous use of Amoxiclav increases the toxicity of methotrexate.

With the simultaneous use of Amoxiclav with allopurinol, the incidence of exanthema increases.

Co-administration with disulfiram should be avoided.

In some cases, taking the drug may lengthen the prothrombin time, in this regard, care should be taken when prescribing anticoagulants and the drug Amoxiclav.

The combination of amoxicillin with rifampicin is antagonistic (there is a mutual weakening of the antibacterial action).

Amoxiclav should not be used simultaneously with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of Amoxiclav.

Probenecid reduces the excretion of amoxicillin by increasing its serum concentration.

Antibiotics reduce the effectiveness of oral contraceptives.

Antibiotic analogs Amoksiklav

Structural analogues for the active substance:

• Amovicomb;
• Amoxiclav Quiktab;
• Arlet;
• Augmentin;
• Bactoclav;
• Verclave;
• Klamosar;
• Liklav;
• Medoklav;
• Panklav;
• ranclave;
• Rapiclav;
• Taromentin;
• Flemoklav Solutab;
• Ecoclave.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Good afternoon to all my readers!

I rarely get sick, but aptly, that is, I’m unlikely to get off with the usual SARS, but what’s more serious is that I love, for example, chickenpox, tonsillitis or bronchitis. By the way, antibiotics were not often prescribed to me, and this time the situation, apparently, was clearly from the category of an emergency, because from the first day I was prescribed a lot of serious drugs, one of them was Amoxiclav. Before that, we did not know him, so this was my first experience of taking this drug ..

Disease history

First, the child got sick, it all started with a slight cough, and then the temperature and sore throat increased, the doctor immediately sent her for an x-ray in order to exclude the version with pneumonia, and it turned out to be a normal cough, which was cured in a week. I was next in line, it all started with the usual khe-khe, and then such a horror began with a dry cough that at night you could only sleep while sitting. Then it became difficult for me to breathe, it was very bad, while I did not go to the doctor for a whole week and did not sit on sick leave. I went to the hospital only after I started wheezing when breathing, that is, you breathe, and inside you it’s like someone is rubbing your lungs on a grater.

The doctor listened to me and sent me for an X-ray, having previously diagnosed bronchitis with suspected pneumonia, since breathing was really very heavy. I did an X-ray only after 4 days, since there was no recording, which is not surprising, and all this time I drank Amoxiclav and Lazolvan + drink plenty of water.

My dosage: 500 mg + 125 mg 3 tablets per day for 5 days.

I started taking antibiotics right away, because this is not the case when you can say: "Damn, antibiotics, why poison yourself, and everything will pass. I'll go drink tea with lemon ...". It’s better not to do this, because a complication can overtake at any moment, especially then I still didn’t rule out pneumonia.

I felt relief already on the first day, when I slept normally all night, that is, I no longer jumped out of bed every 5 minutes to clear my throat. There were still wheezing, of course, and heavy breathing remained, but the cough began to subside. After 4 days, I began to clear my throat completely, the sputum was leaving at a frantic speed, there were no more wheezing, my breathing became perfect.

Every day I felt better and better, by the way, I didn’t drink any syrups as prescribed by the doctor, I only drank a dose of Pertusin at night once a day in order to sleep better. It is absolutely impossible to skip pills, so I advise you to set a reminder on your phone.

Side effect

Already on the 4th day I had a terrible nausea, it seemed to me that I was poisoned by something, I felt so bad that for 2 hours it was difficult for me to get out of bed. After lunch, I tried to shove something into myself to take a pill, and then wild stomach pains began, I drank Phosphalugel, but the pain did not recede, then it became clear that antibiotics were the cause of this condition. I could not master the last day, so I quit taking Amoxiclav. Then I was haunted by the obsessive thought that some one microbe remained and now multiplies. Fortunately, everyone died out, and already after 5 months I am not bothered by bronchitis and even the usual cough.

If I were a doctor, I would prescribe some probiotics for myself, even the same Linex, because because of the disease, the body is already so weak, and then there is a wild load on the stomach.

For kids

Bronchitis in our family went through everyone, so the child was also prescribed Amoxiclav, only with a dosage half as much. Here he also proved himself to be one hundred percent, all the symptoms disappeared after 3-4 days, but there were some side effects. Again, the gastrointestinal tract fell under the scope, the child had severe diarrhea and abdominal pain, the intake had to be stopped without finishing only 2 tablets. Then they were restored by Normobact.

In general, I liked Amoxiclav, he coped well with an infectious disease, he is inexpensive, but since it is an antibiotic, it was worth expecting such side effects from him in advance. I think he deserves a 5-.

My reviews of other medicines:

Most often, doctors prescribe Amoxiclav for pneumonia in adults and children. What are the benefits of this antibiotic?

Amoxiclav is a combined antibiotic from the penicillin group. It has a wide spectrum of activity. The drug is effective against Gram-positive and Gram-negative microbes, as well as most pathogens of pneumonia. Most often they are pneumococci, but other microbes can cause pneumonia.

The main disadvantage of antibiotics from the penicillin group is their vulnerability to the action of specific bacterial enzymes (penicillinases). They destroy drugs, causing the drugs to lose their effectiveness.

Amoxiclav is a combination of amoxicillin and clavulanic acid. The latter substance also has a certain antibacterial activity, but its main function is protection from the influence of penicillinase.

Due to its combined composition, Amoxiclav is resistant to the action of the enzyme, which allows doctors to widely use it to treat pneumonia.

The antibiotic has a bacteriostatic effect - it stops the growth and reproduction of bacteria, and in large doses it kills microbes.

This remedy is a first-line drug in the treatment of pneumonia, with which therapists, pediatricians and pulmonologists always begin the treatment of community-acquired pneumonia.

Release form

Amoxiclav is available in the form of tablets and suspensions for children. There is also an injectable form of this antibiotic, it is prescribed for severe forms of the disease. In such a situation, the drug is administered intravenously. For mild inflammation, oral medication is sufficient.

In pharmacies, Amoxiclav is sold under the following trade names:

• Augmentin.
• Flemoklav.
• Amoxiclav.
• Amoxi-Apo-Clav.
• Amoxicomb.
• Amoxil-K.
• A-Clave-Pharmex.
• Amoxiplus.
• Betaclav.
• Klavam.
• Medoklav.
• Bactoclav.

Amoxiclav tablets contain varying amounts of amoxicillin and clavulanic acid. That is why the right dosage for pneumonia is selected only by a doctor - depending on the following factors:

• The patient's age.
• His weight.
• The severity of the disease.
• Concomitant pathologies (renal or liver failure).

The duration of the course of treatment is determined by the dynamics of the disease and the data of laboratory and instrumental studies (complete blood count, chest X-ray).

Combination Therapy

Side effects

When taking antibiotics based on amoxicillin, patients often complain of loose stools. This side effect is called antibiotic-associated diarrhea, it is typical for drugs from the penicillin group. Some doctors make a diagnosis of dysbacteriosis when the first complaints appear and prescribe pro- and prebiotics to patients for treatment. However, such diarrhea is not associated with a change in the intestinal microflora and in most cases it does not require specific therapy, it disappears on its own after discontinuation of the drug.

Also, a common complication is candidiasis of the mucous membranes - the oral cavity, genitals in women. This is due to the wide spectrum of action of Amoxiclav - it destroys not only pathogenic, but also beneficial microflora.

If there are complaints of itching, white cheesy plaque on the mucous membranes and abundant vaginal discharge in women, antifungal drugs are indicated - Fluconazole, Diflucan. Sometimes they are prescribed simultaneously with antibiotics - to prevent the development of candidiasis. This tactic is appropriate for chronic thrush, as well as in a situation where the patient has already had fungal diseases after antibiotic therapy.

When treating with antibiotics, allergic reactions often occur, therefore, when using injectable forms, doctors prescribe an allergy test to the patient.

If, after taking Amoxiclav, the patient notes itching of the skin, its redness, the appearance of a rash, swelling or difficulty breathing, this is an indication for discontinuing the antibiotic and prescribing a drug from another group.

Contraindications

Amoxiclav is generally well tolerated. However, in some situations it is contraindicated:

• With a confirmed allergy to amoxicillin or clavulanic acid.
• If previously noted hypersensitivity reactions to other beta-lactams (penicillins, cephalosporins, carbapenems).
• With severe violations of liver function.

Also, Amoxiclav should not be prescribed for infectious mononucleosis. This disease is caused by the Epstein-Barr virus, and antibiotics are ineffective against it. In addition, taking amoxicillin in this disease causes the appearance of a measles-like rash for 4–5 days. The manufacturer indicates this in the instructions. Such a side effect of the drug must be taken into account, since doctors often mistake infectious mononucleosis for streptococcal tonsillitis due to a similar clinical picture.

Amoxiclav is a broad-spectrum antibiotic, a first-line drug for pneumonia in adults and children. The medicine is usually easily tolerated, the list of contraindications is small. However, you need to know about them in order to prevent complications.

Pneumonia is one of the most common respiratory diseases. For treatment, a complex of effective means is selected, including antibiotics. Amoxicillin is often chosen for pneumonia. The course of antibiotic treatment causes an improvement in the condition and allows you to cope with the disease.

Purpose and principle of operation

Treatment of pneumonia with Amoxicillin allows you to cure a bacterial infection even out of the hospital, but with the obligatory observance of bed rest.

This drug has a wide spectrum of action against pathogenic bacteria. The active substance - amoxicillin trihydrate - acts on microorganisms, destroying their cell wall, as a result of which they die.
To correct therapy and evaluate its effectiveness, sputum culture is performed to determine whether the causative agent of the disease is present in it. Amoxicillin is effective against pneumococci and gram-negative bacteria, most often causing pneumonia. If the nature of the disease is viral or fungal, treatment with Amoxicillin will not work.

The drug is available in several forms:

• tablets;
• capsules;
• injection;
• powder for suspension for children.

The bactericidal and antibacterial action of the drug, its rapid absorption and good penetrating ability make it possible to use it for the treatment of children and adults with respiratory diseases. To enhance the effect of the drug, it is often combined with taking clavulanate.

Indications for use:

• pneumonia;
• bronchitis;
• pharyngitis;
• diseases of the urinary system, etc.

Treatment of pneumonia with amoxicillin

The selection of the dosage in each case should be made by a doctor. Amoxicillin for pneumonia in adults and children from 12 years of age is used in accordance with the instructions in the form of tablets, capsules or injections.

For children, the dosage of Amoxicillin for pneumonia or bronchitis depends on the age of the child. The medicine is easy to prepare, it should be done before use. The required dose of the suspension is measured with a measuring spoon attached to the package.

In addition to the antibiotic, other drugs are also prescribed:

• mucolytics;
• medicines for dilating the bronchi;
• bifidobacteria to restore intestinal microflora, etc.

As a rule, therapy is selected in such a way as to switch from injection of antibacterial drugs to oral administration. On average, the treatment time is from one to one and a half weeks. The duration of the course is specified by the doctor depending on the condition of the patient.

In cases where Amoxicillin cannot be used, an analogue is selected by the doctor:

• Flemoxin Solutab;
• Klamosar;
• Rapiclav;
• Augmentin and others.

Contraindications

Antibiotics from the penicillin group are prescribed only with regard to contraindications. Among the contraindications are the following conditions:

• allergic reaction;
• asthma;
• SARS;
• infectious mononucleosis;
• lymphocytic leukemia;
• hypersensitivity to components;
• kidney failure;
• pregnancy, etc.

It should also be borne in mind that while taking oral contraceptives, their effect is weakened.