Sumakin 1g Mekophar medicine for infection treatment (2 blisters x 7 tablets)

Abdominal infections, gynecological infections.

Urinary tract infections: Especially in cases of recurrent or complicated cystitis.

Skin infections and soft tissue: lymphatic vasculitis, cellular inflammation, open wounds or tissue loss, tooth abscess and mouth due to staphylococcus aureus.

Infections combined by bacteria sensitive to amoxicillin and bacteria produced by beta - lactamase sensitive to amoxicillin preparations combined with sulbactam can be treated with single Sumakin without having to use any other antibiotic preparations.

Should conduct appropriate bacterial tests (isolation and sensitivity of bacteria) before starting treatment to identify pathogenic bacteria and bacterial sensitivity to Sumin.

It is advisable to start treatment before the results of bacterial testing if there is a reason suspected of infection caused by beta -lactamase bacteria. Once the test results have been tested, it is possible to adjust the necessary treatment regimen.

Pharmacokology

Pharmacological group: antibacterial drugs (systemic sugar).

ATC code: J01CR02.

Suminin is a drug that has a bactericidal effect on amoxicillin sensitive bacteria, amoxicillin combination with sulbactam helps to prevent amoxicillin from being destroyed by beta - lactamase.

The bactericidal effect of amoxicillin is similar to other antibiotics of the beta - lactam or penicillin group: inhibits the protein biosynthesis process of bacterial cell walls, leading to killing bacteria. The drug has a bactericidal effect during the division of sensitive bacteria. Its effect depends on the ability to find and cohesive with proteins associated with penicillin (Pbps) found in the inner layer of the bacterial cell wall.

Proteins associated with penicillin, including transpeptidase, carboxypeptidase and endopeptidase, enzymes that are related to the final stage of the process of cell walls and to the re -organization stage of cell walls during growth and division. Penicilin connects and inactivates the Pbps will make the cell wall of bacteria weaken last will be destroyed.

Amoxicilin, a semi -semi -synthetic antibiotic, the beta - lactam group, has a broad spectrum bactericidal effect against a variety of gram -positive and gram -negative bacteria, both aerobic and anaerobic bacteria. However, its sensitivity is reduced by beta - lactamase so the sensitivity of the drug usually does not include bacterial strains capable of producing beta - lactamase.

Sulbactam, a strong Beta - Lactamase competitive inhibitor, shows that its bactericidal effect is limited except for neisseriaceae and acinetobacter. However, it has the ability to inhibit the beta - lactamase enzymes that are found in the strains of bacteria against penicillin and cephalosporins. Therefore sulbactam can restore the bactericidal effect of amoxicillin for anti -drug bacteria due to the ability to produce beta - lactamase. Especially, it can manifest the effect of inhibiting the beta - lactamase enzyme, which is the cause of the anti -drug -resistant bacteria strains that can be converted and have a very good response. Sulbactam does not change the effects of amoxicillin on sensitive strains. The presence of sulbactam in Suminum increases the effects of amoxicillin on anti -drug bacteria when treating alone amoxicillin or in combination with antibiotics of other beta - lactam groups.

This combination has a force that increases the effects and expansion of amoxicillin antibacterial spectrum with beta -lactamase bacteria:

sensitive bacteria

Gram -positive bacteria

Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus Faecalis (intestinal bacteria), Streptococcus Viridans, Staphylococcus aureus (including Beta - lactamase bacteria), Staphylococcus Epidermidis (blood -tibia penicilinase), Staphylococcus Saprophyticus, Streptococci group A, B, C and G, Streptococci Viridans and some strains of Enterococci, Corynebacterium diptheriae, Listeria monocytogenes, Bacillus anthracis, Erysipelothrix Rhusiopathia (Although the majority is resistant).

Gram -negative bacteria

Neisseria gonorrhoeae, and N. Gonorrhoeae (not creating penicilinase), Haemophilus influenzae and some H. parainfluenzae and H. Ducreyi strains, some Enterobacteriaceae, Proteus Mirabilis, Salmonella and Shigella, VuLaris, P. Aerogenes, Citrobacter Freundii, Vibrio Cholerae, Helicobacter Pylori, Bordetella Pertussis, Acinobacillus, Pasteurella Multocida, Gardnerella Vaginalis (Haemophilus Vaginalis), Moraxella Catacrhalis (Brahamella Catarrhalis) - Lactamase, acinetobacter strains, E.coli, Proteus Mirabilis, Klebsiella strains include Klebsiella Pneumoniae.

Anaerobic bacteria

Bacteroides strains including B. Fragilis, Actinomyces, Arachnia, Bifidobacterium, Clostridium Tetani, C. Perfringens, Eubacterium, Lactobacillus, peptocccus, peptoccus and propionibacterium, fusobacterium.

Bacteria

Treponema Pallidum, Borelia Burgdoferi causes Lyme disease.

sensitive bacteria

Gram -positive air -loving bacteria: Enterococcus fast.

anti -drug bacteria

Gram -positive bacteria

Staphylococcus (staphylococcus aureus).

Gram -negative bacteria

Acinobacter Alcaligenes, Moraxella Catnrhalis creates beta - lactamase, campylobacter, citrobacter Freundii, Citrobacter Koseri, Entobacter, Klebsiella Oxytoca, Klebsiella Pneumoniae, Legionella, Morganella Morganii, Morganiii, Prot Rettgeri, Proteus Vulgaris, Providencia, Pseudomonas, Serratia, Yersinia Enterocolitica.

Anaerobic bacteria

bacteroides fragilis.

Other bacteria

Mycobacterium, Mycoplasma, Rickettsia.

Completely diagonal resistance often occurs between amoxicillin and ampicillin.

Dynamic pharmacokinetics

Amoxicillin amount absorbed when taken is approximately 80% and is not affected by food. The average peak concentration in serum is about 1-2 hours after drinking. In people with normal kidney function, the average half -life in serum is approximately 1 hour. Amoxicillin is distributed most of the tissue in the body and biological fluids, the concentration of treatment is achieved in bronchial secretions, sinus nose and amniotic fluid, saliva, fluid, cerebrospinal fluid, secretion in the membranes and middle ears. About 20% of the drug is connected to the protein of plasma.

The drug is excreted mainly in urine in the form of activity (70 - 80%) and into bile fluid (5 - 10%). Amoxicillin passes the placenta and is excreted into breast milk.

When using sulbactam on the gastrointestinal tract, the bioavailability of the drug is almost 100%, but if used by oral absorption of the digestive tract is incomplete. To improve the absorption ability, some of the synthesized precursors, among them Sulbactam Pivoxil has the best absorption ability.

Sulbactam pharmacokinetics similar to amoxicillin and when used at the same time there is no dynamic interaction between drugs.

Serum concentration of Sulbactam also achieved the same time as amoxicillin and the peak concentration values ​​also depend on the dose.

The ratio of cohesion to protein in plasma is approximately 40%. It is also mainly excreted in the urine in the form of unchanged (75 - 85%).

The semi -cancellation time of serum is approximately 1 hour, for patients with severe renal impairment, the excretion of the drug will slow down.

The drug also passes through the placenta and is excreted into breast milk.

Skin and subcutaneous tissue: skin rash.

Uncommon, 1/1000

Rare, 1/10000 ≤ ADR

Single -nucleus infections.