Ery Children Enfants 250mg Bouchara Treatment of infection (24 packs)

Dosage form 24 package box
Specifications Erythromycin

Ingredient

Composition information	Content
Erythromycin	250mg

Uses

indications

24 -pack ery 250mg drugs are indicated in the following cases:

Indications based on antibacterial activity and dynamic properties of erythromycin, and base on clinical trials and its position within the current antibacterial agents.

Indications are limited to treatment with drugs that are sensitive to drugs such as:

Sore throat, due to Beta A's streptococcus streptococcus, replaced with beta-lactam treatment, especially when the patient cannot use beta-lactam.

using penicillin for 10 days is still treated for acute sore throat due to streptococcus.

Acute sinusitis. Consider the microbiological records of this type of infection, the macrolids are indicated when they cannot be treated with beta-lactam.

Infectious bronchitis.

The play of chronic bronchitis.

Community pneumonia in subjects: No risk factors; There are no heavy clinical signs; There are no clinical data suggesting the whole disease is pneumococcal.

In case of not typical pneumonia, macrolid is indicated regardless of severe and location.

Benignly skin infections: impetigo, impetigo, ulcerative, dermatitis and subcutaneous tissue due to bacterial infections (especially circles inflammation), fungal disease, acne that causes inflammation from mild to medium level (replacing cyclin treatment, when the patient cannot be used).

Dental infections.

Genital infections are not due to gonorrhea.

Preventive treatment for recurrence of rheumatism in the case of patients allergies to beta-lactam.

It is necessary to consider the official guidelines related to the rational use of antibiotics.

Pharmacokology

erythromycin is an antibiotic family of macrolid family.

erythromycin inhibits bacterial protein synthesis by attaching to the subunit of 50S of ribosom and preventing the formation of peptide chains.

antibacterial spectrum

Critical concentration to distinguish sensitive strains from intermediate sensitive strains and intermediate sensitive strains from resistance strains:

Sensitive concentration (s) ≤ 1 mg/l and resistance concentration (R)> 4 mg/l.

In some species, the obtained resistance level may vary by geographical and time position. Therefore, it is necessary to know the sensitivity of local bacteria, especially if the infection is severe. Sensitivity information only aims to guide the sensitivity of a bacterial line with this antibiotic.

The change in the anti -drug rate in France of the bacteria presented below:

sensitive strains

Gram (+) aerobic bacteria: Bacillus Cereus, Corynebacterium diphteriae, intestinal bacteria (50 - 70%), Rhodococcus Equi, Streptococcus B, Staphylococcus sensitive methicillin, Staphylococcus Methicillin resistance Group (30 ~ 40%), Streptococcus Pneumonia (35 - 70%), Streptococcus Pyogenes (16 - 31%).

Gram aerobic bacteria (-): Bordetella Pertussis, Branhamella CatVrhalis, Campylobacter, Legionella, Moraxella.

Anaerobic bacteria: Actinomyces, Eubacterium, Mobiluncus, Fusobacterium, Prevotella, Porphyromonas, Prevoteila, Propionibatcerium Acnes, Bacteroides (30 - 60%), Peptostreptococcus (30 - 40%).

Other strains

Borrelia Burgdorferi, Chlamydia, Coxiella, Mycoplasma Pneumonia, Treponema Pallidum, Leptospira.

average sensitive strain (intermediate sensitivity in test tubes)

Gram aerobic bacteria (-): Haemophilus, Neisseria gonorrhoeae.

Anaerobic bacteria: Clostridium perfringens.

Other: Ureaplasma Urealyticum.

Strain of resistance

Gram aerobic bacteria (+): Corynebacterium jeikeium, Nocardia asteroids.

Gram aerobic bacteria (-): acinetobacter, pseudomonas, bacteria.

Anaerobic bacteria: Fusobacterium

Other: Mycoplasma Hominis

*The ratio of methicillin resistance is about 30-50% between staphylococci staphylococcus aureus more common in hospitals.

Pharmacokinetics

absorption

Take the drug before meals (about 1 hour), the concentration of drugs is achieved in the highest serum. After drinking, Erythromycin is absorbed on the upper segment of the small intestine. The birth rate of drugs is from 60% to 80%.

Distribution

Semi -destructed time in plasma is nearly 2 hours. Take 500 mg of erythromycin to the maximum concentration in serum is 2.5 g/ml after 1 hour. Erythromycin is widely distributed in all tissues in the body, especially in the lungs and in the tonsils. Erythromycin is poorly distributed in cerebrospinal fluid. Erythromycin passed the placenta fence.

Macrolids come in and accumulate in phagocytic cells (neutral leukocytes, single -person leukocytes, peritoneal and alveoli). Therefore, the concentration of macrolid antibiotics in phagocytic cells is quite high in humans. Similar to other macrolids, this feature explains the activity of erythromycin for intracellular bacteria.

Metabolism

Erythromycin is partially metabolized in the liver to form an inactive form, this metabolic has not been determined.

Elimination

erythromycin is excreted mainly in constant form in bile and urine.

erythromycin is biological changes mainly in the liver by the reducing N-methyl reaction. Elimination mainly through bile. There is also a small amount of drugs eliminated in the urine.

Before taking Ery Children Enfants 250mg Bouchara Treatment of infection (24 packs)

How to use

The best is to take medicine before meals.

Dosage

This drug is suitable for children from 10 to 25 kg (about 1 to 8 years old).

Children: 30 - 50 mg/kg/day.

from 10 to 15 kg (equivalent to 1-4 years): 1 pack, 2 times daily.

from 15 to 25 kg (equivalent to 4-8 years old): 1 pack, 3 times daily.

Treatment time

Sore throat treatment time is usually 10 days. The usual treatment time for bronchitis and lung disease is 2 weeks.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when overdose? Stomach douche to eliminate unprocessed drugs from the body; And when you need to use supportive measures.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using Ery 250mg, you may experience unwanted effects (ADR).

Manifestations on the digestive system: nausea, vomiting, stomach pain, diarrhea.

There are rare cases of fake colitis reported.

Rarely pancreatitis appears right after the beginning of treatment or after high doses or overdose is reported.

Rare skin all -skin expressions: Very rare rare rare ban, Stevens Johnson and Lyell syndrome.

There are rare cases of hepatitis or liver damage accompanied by an increase in alkalin phosphatase and/ or transaminase increased that has been reported sometimes with clinical manifestations (jaundice, fever, sometimes accompanied by acute abdominal pain.

Notify the doctor with unwanted effects when using the drug.

Instructions on how to handle ADR

Some unwanted effects can recover, the treatment is stopped.

Avoid using erythromycin estolat or erythromycin ethylsuccin for patients with hepatitis fibrosis caused by erythromycin. To avoid pain and irritation, continuous venous dilution or slow interruption for 20-60 minutes. Only use intravenous injection when really necessary to avoid cardiovascular events.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Ery 250mg drug contraindicated in the following cases:

allergies to erythromycin.

Patients who used to use erythromycin that had liver disorders.

Patients with a history of deafness.

Combined with: Chicken mushroom alkaloid causes vasoconstriction (dihydroergotamine and ergotamine), Cisaprid, Mizolastin, Pimozid, Bepridil, Terfenadin, Astermizol.

Should not use this drug in combination with: Dopamine owner (Bromocriptin, Cabergolin, Pergolid), Bospiron, Carbamazepin, Cyclosporin and Tacrolimus, Ebastin (H1 antihistamine resistance), Theophylllin (Base and Salt form) and Aminophyllin, Triazolam, Triazolam, Triazolam, Triazolam, Triazolam, Triazolam, Tria Tolterodin, Halofantrin, Lumefantrin combined with Artemether, Disopyramid.

Do not recommend the use of erythromycin for patients with acute porphyrin metabolism disorders, for causing acute batches.

Be cautious when using

Cases of severe diarrhea during or after treatment with erythromycin suggest patients who are likely to have fake colitis as some rare cases have been reported when using erythromycin, as well as all antibiotics.

In the case of liver failure, it is not recommended to use erythromycin. If necessary, regular monitoring of liver function tests and can reduce the dose.

Rarely occurs the typical non -typical ventricular rhythm (torsion) when using erythromycin oral or intravenously; However, Erythromycin is needed to be careful in patients with prolonged QT.

Due to containing saccharose, contraindicating this drug in fructose intolerant patients, glucose and galactose malabsorption syndrome, or Sucrase-Isomaltase deficiency.

Each pack contains 2 g of sugar; Should be calculated in daily diets.

Each pack contains 5.5 g of salt; Should be calculated in the diet in people who abstain from salt.

Interactions in subclinical research: Similar to other antibiotics, erythromycin can hinder the testcholamine dosage test with fluorescent in urine. This intervention can be observed mainly by non -chromatographic techniques, and at lower concentrations after chromatography.

The ability to drive and operate machinery

There is no report showing the effect of the drug.

pregnancy

erythromycin passes through the placenta. Although there is no evidence of pregnancy and teratogenic poisoning in animal studies, there is no satisfactory studies and are closely checked for the use of erythromycin for pregnant women or during birth, so do not use erythromycin for pregnant women, unless there are no replacement therapy and must be monitored carefully. Do not use erythromycin estolat due to increasing the risk of toxicity to the liver and increasing side effects for the mother and fetus.

Breastfeeding period

erythromycin secreted into breast milk, drugs need to be cautious for breastfeeding women.

Drug interaction

Contraindicated combination

The fungal mushroom alkaloids cause vascular spasm (Ergotamine): Ergotin poisoning can cause head necrosis (reducing the elimination of chicken fungus through the liver).

cisaprid: increased risk of ventricular arrhythmia, sometimes causing torsion.

mizolastin: Increased risk of ventricular arrhythmia, sometimes causes vertex (erythromycin that reduces the metabolism of antihistamine drugs in the liver).

Pimozid, Bepridil: Increased risk of ventricular arrhythmia, sometimes causing torsion.

Terfenadin and Astemizol, especially in the case of heart disease, arrhythmia, bradycardia, prolonged QT interval, myocardial ischemia or patients with electrolytes. Increases the risk of heart poisoning such as torsion, ventricular fastness and death.

Unknown combination

Dopamine homogeneous substances (bromocriptin, Cabergolin, pergolid): Increases the concentration of dopamine owners in plasma and can increase its activity or onset of overdose signs.

Bospiron: Increases the concentration of anxiety antidote in plasma due to decreased liver metabolism.

Carbamazepin: Increasing carbamazepine levels in plasma and showing signs of overdose due to inhibition of drug metabolism through the liver. Other macrolids can be used, which should be considered for minimum or non -clinical intervention. However, in Legionella infection pneumonia, Erythromycin is still an antibiotic for exploration: In the case of this antibiotic use, it is recommended that clinical monitoring with specialized equipment to control carbamazepine levels in plasma.

Cyclosporin and tacrolimus: Increases the concentration of immunosuppressants and plasma creatinins due to inhibition of metabolism of immune inhibitors in the liver.

Ebastin (antihistamine H1): increases the risk of ventricular arrhythmia, especially on sensitive objects (congenital persistent syndrome), sometimes causing torsion (decreased metabolism of antihistamine drugs in the liver due to macrolids).

Theophylllin (base and salt) and aminophyllin: Theophylllin overdose (reducing the excretion of liver), especially dangerous in children. Other macrolids may be used, including minimum reduction or clinical intervention. However, in Legionella infection pneumonia, Erythromycin is still an antibiotic for exploration and can be used, combined with strict clinical monitoring to control theophyllin concentration in plasma.

triazolam: There are rare cases that worsen the side effects of triazolam (behavioral disorders) reported.

Tolterodin: Increased plasma tolterodine levels in people with low metabolic, risk of overdose.

halofantrin: increases the risk of ventricular arrhythmia, sometimes causing torsion. If possible, stop using macrolid. If this combination cannot be avoided, it is advisable to control QT first and monitor the electrocardiogram.

Disopyramid: Increased risk of side effects of this compound: severe hypoglycemia, increased QT interval and severe ventricular arrhythmia, sometimes causing torsion. Clinical monitoring, microorganisms and electrocardiograms regularly.

lumefantrin and combined with Artemether: increases the risk of ventricular arrhythmia, sometimes causing torsion.

If possible, stop taking the peak. If this combination cannot be avoided, it is advisable to control QT first and monitor the electrocardiogram.

Valproic acid: erythromycin can inhibit the metabolism of Valproic acid, increasing the concentration of this drug in plasma and increasing toxicity.

Ear poisoning: high doses of erythromycin with drugs that are toxic to people in kidney failure can increase the potential of toxicity to the ears of these drugs.

penicillin: Bacterial pliers may affect the bactericidal effect of penicillin in the treatment of meningitis or cases that need to have a fast bactericidal effect. It is best to avoid coordination.

Combining carefully

Alfentanil: Increases the respiratory inhibiting effects of opiat painkillers due to reducing liver chemistry. The dose of an analgesics of opiat groups should be adjusted in the case of erythromycin treatment.

Oral anticoagulants: Increases the effects of oral anticoagulants and increases the risk of bleeding. Need to control the Inr more often. The dose of oral anticoagulants can be adjusted during and after treatment with erythromycin.

Atorvastatin, Simvastatin, Lovastatin: Increasing the risk of side effects (depending on concentration), such as muscle pattern (reducing metabolism through liver cholesterol). Use lower doses. If not reaching the treatment goals, using another statin is not affected by this interaction.

Digoxin: Increases the concentration of blood in the blood due to increased absorption (erythromycin that destroys the effect of converting digoxin into non -active metabolites of the intestinal microorganism).

lisurid: Increased lisurid concentration in plasma with signs of dopamine overdose (nausea, vomiting, drowsiness, weakness). Clinical monitoring and lisurid dose should be corrected during erythromycin treatment.

Midazolam: Increased plasma midazolam concentration due to decrease in liver metabolism, increasing sedative effects, especially in children. Clinical monitoring and Midazolam dose adjustment during treatment with erythromycin.

Sildenafil: Increasing plasma Sildenafil levels in the risk of arterial hypotension. Starting Sildenafil treatment at a dose of 25 mg/day.

verapamil: slow heart rate and/or atrial-transmission disorders, due to the liver's metabolism of metabolism through the liver. Clinical monitoring and electrocardiogram. In case of necessity, adjust the Verapamil dose during treatment with erythromycin and after the drug stopped.

Chloramphenicol and Lincomycin: Erythromycin can push or prevent chloramphenicol or lincomycin attached to the subunit of 50S of the bacterial ribosom, so the anti -effect of these drugs.

The drugs with liver toxicity: increase the potential toxic to the liver.

Special problem when the Inr index is unstable

In many cases, the activity of oral anticoagulants increased, reported in patients with antibiotics. When suffering from severe inflammation and infection, the patient's age and total condition are considered risk factors. In these cases, it is difficult to recognize how to infect from treatment when the Inr appears unstable. However, some antibiotic groups may be related: fluoroquinolon, macrolide, cyclin, co-trimoxazol and a few cephalosporins.

Storage

Store at temperatures below 30 ° C. To be out of reach of children.

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