In / in or in / m. The following dilutions can be used:
For iv administration, sulbactam / ampicillin is diluted with sterile water for injection or any other compatible solution. To make sure that the drug is completely dissolved, you should wait for the disappearance of the formed foam and evaluate visually the complete dissolution. The dose can be administered as a bolus for at least 3 minutes. It can also be diluted and administered as an intravenous infusion over 15–30 minutes.
When i / m administration, sulbactam / ampicillin should be injected deep into the muscle, if pain occurs, 0.5% sterile lidocaine hydrochloride solution for injection can be used to dissolve the powder.
Usually, the dose of sulbactam / ampicillin varies from 1.5 to 12 g / day in several doses every 6 or 8 hours, the maximum daily dose of sulbactam is 4 g.
For less severe infections, the drug can be used every 12 hours.
The frequency of administration and dosage of the drug depends on the severity of the disease and the kidney function of the patient. Treatment is usually continued for another 48 hours after normalization of body temperature and the disappearance of other pathological signs. The duration of therapy is 5-14 days, but in more severe cases it can be increased or additionally prescribed ampicillin.
For the prevention of surgical infections, 1.5–3 g of sulbactam / ampicillin should be administered during induction of anesthesia, which provides sufficient time to achieve effective concentrations in serum and tissues during surgery. The dose can be re-administered every 6–8 hours; with most surgical interventions, the use of the drug is usually stopped 24 hours after the operation, if administration of sulbactam / ampicillin for therapeutic purposes is not indicated.
For the treatment of uncomplicated gonorrhea, sulbactam / ampicillin can be administered once at a dose of 1.5 g. In order to increase the duration of the content of sulbactam and ampicillin in plasma, one should simultaneously apply probenecid at a dose of 1 g orally.
Children, infants and newborns. In the treatment of most infections in newborns and children, the daily dose of sulbactam / ampicillin is 150 mg / kg / day (which corresponds to 50 mg / kg / day of sulbactam and 100 mg / kg / day of ampicillin).
In children, infants and newborns, the drug is usually administered every 6–8 hours in accordance with the usual practice of ampicillin.
In newborns in the first week of life (especially premature), it is recommended to administer in a dose of 75 mg / kg / day in separate doses with an interval of 12 hours.
Patients with impaired renal function. In patients with severe renal insufficiency (Cl creatinine ≤ 30 ml / min), the elimination of sulbactam and ampicillin is disturbed to the same extent, therefore the ratio of their concentrations in plasma does not change. In such patients, sulbactam / ampicillin should be administered less frequently in accordance with the usual practice of ampicillin.
An antibacterial drug exhibits properties that are due to its constituent parts. Sulbactam does not possess antibacterial activity, gives ampicillin the ability to act on resistant strains that produce beta-lactamase, blocking them and preventing the destruction of the antibiotic.
Ampicillin inhibits the biosynthesis of the mucopeptide and peptidoglycan of the cell wall; it refers to semi-synthetic bactericidal, acid-resistant antibiotics. The drug is effective against gram-positive and gram-negative staphylococci, streptococci, neisseria, Escherichia coli, Klebsiella, Proteus, cytobacteria, peptostreptokokk, bacteroids. It is ineffective against enterobacteria, Pseudomonas aeruginosa, staphylococcus, which produce penicillinase.
Indications for use
Instructions for use Unazin indicates its indications for use:
- otitis media,
- intraperitoneal, gonococcal infections,
- infections of the urinary tract, bones, skin, joints, soft tissue,
- infection prevention during operations.
Dosing and Administration
Instructions for use Unazin states that the powder is diluted with a solvent and administered intravenously or intramuscularly. For intravenous administration, it is diluted with sterile water until the lumps and foam are removed. The dose is administered bolus for 3 minutes. Intravenous infusions last 15–30 minutes.
For intramuscular injection, injections are made deeply, when pain appears, use 0.5% lidocaine hydrochloride solution. The maximum daily dose of medication does not exceed 4 g, a single dose - 1.5 every 6-8 hours. For less severe infections, the drug is administered every 12 hours. The treatment continues until the temperature normalizes and the symptoms of the disease disappear +2 days. Therapy lasts about 5-14 days, but may increase under the supervision of a physician.
For the prevention of surgical infections, 1.5-3 g of Unazin are administered during anesthesia, the dose is repeated every 6-8 hours, and one day after surgery the treatment is stopped. For the treatment of uncomplicated gonorrhea, 1.5 g of solution is injected once, and at the same time, 1 g of Probenecid can be taken orally.
In newborns and children, the daily dose is 150 mg / kg of body weight, divided into 3-4 doses. Premature newborns in the first week of life show 75 mg / kg of body weight per day with an interval of 12 hours. In case of impaired renal function, the frequency of administration is reduced.
During treatment Unazin may develop adverse reactions. The instruction indicates the following:
- nausea, diarrhea, vomiting,
- anemia, leukopenia, thrombocytopenia,
- increased activity of liver enzymes, creatinine levels,
- pain at the injection site, phlebitis,
- rash, itching, allergies, anaphylactoid reactions.
Terms of sale and storage
Unazin refers to prescription drugs that are stored at a temperature of up to 30 degrees for no longer than 3 years, away from children.
You can replace the drug with antibacterial drugs, the same or a different composition. Unazin analogues:
- Ampisulbin, Bactamed - powder based on ampicillin, sulbactam.
- Amoxiclav, Augmentin - tablets containing amoxicillin, clavulanic acid.
- Ecoclav, Clavomed, Medoclav - powder for the preparation of suspensions based on amoxicillin, sodium clavulanate.
- Tazpen - lyophilized powder containing piperacillin, tazobactam.
- Amoksil - tablets on the basis of amoxicillin.
Approximate cost of funds in pharmacies in Moscow:
Bactericidal broad-spectrum antibiotic, acid-resistant. Blocks the synthesis of peptidoglycan cell walls of microorganisms. The active principle is ampicillin, a broad spectrum semisynthetic penicillin antibiotic that is broken down by beta-lactamases.
The second component (sulbactam), not possessing antibacterial activity, inhibits beta-lactamase and in this connection, ampicillin acquires the ability to act on resistant (beta-lactamase-producing) strains.
It is active against most Gram-positive and Gram-negative microorganisms (Staphylococcus spp., Streptococcus spp., Haemophilus influenzae and Haemophilus parainfluenzae, Neisseria meningitidis, Neisseria gonorrhoeae, Escherichia coli, Klebsiella crypt, Nesseria meningiidis, Neisseria gonorrhoeae, Escherichia coli, Klebsiella sf. Peptococcus spp., Peptostreptococcus spp., Bacteroides spp., including Bacteroides fragilis. Ineffective against penicillin-producing strains of staphylococci, all strains of Pseudomonas aeruginosa, most strains of Klebsiella and enterobacteria.
Activity against pathogens that do not produce beta-lactamase does not exceed the activity of ampicillin alone.
Bacterial infections of various localization caused by susceptible pathogens:
respiratory infections (including pneumonia, lung abscess, chronic bronchitis, pleural empyema),
infections of upper respiratory tract (including sinusitis, tonsillitis, otitis media),
infections of the urinary tract and genital organs (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, endometritis),
biliary tract infections (cholecystitis, cholangitis),
infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatitis),
gastrointestinal tract infections (dysentery, salmonellosis, salmonellosis),
infections of bones and joints,
septic endocarditis, meningitis, sepsis, peritonitis, scarlet fever, gonococcal infection.
Prevention of postoperative complications during operations on the abdominal organs and small pelvis.
Application and dosage
V / m, v / v (drip with a speed of 60-80 drops / min, jet - slowly, within 3-5 minutes). In / in injected 5-7 days, then, if necessary, continue treatment, move on to the / m application.
The following are the total doses of ampicillin and sulbactam (in a 2: 1 ratio).
With a mild infection course, 1.5–3 g / day in 2 administrations, with a moderate course — 3–6 g / day in 3–4 administrations, with a severe course — 12 g / day in 3–4 administrations.
With uncomplicated gonorrhea - 1.5 g, once.
For the prevention of surgical infections - 1.5-3 g, during anesthesia, then within 24 hours after surgery - in the same dose every 6-8 hours.
Children - in a daily dose at the rate of 150 mg / kg (100 mg / kg of ampicillin and 50 mg / kg of sulbactam), the multiplicity - 3-4 times a day.
Newborns under 1 week old and premature babies every 12 hours.
The course of treatment is 5-14 days (if necessary, it can be extended). After normalization of temperature and disappearance of other pathological symptoms, treatment is continued for another 48 hours.
With CRF (CK less than 30 ml / min), it is necessary to increase the intervals between injections.
The solution for parenteral use is prepared ex tempore. To the contents of the vial add 2 or 4 ml of water for injection, 0.5% solution of procaine or 0.9% NaCl solution. For i / m injection is acceptable dilution of 0.5% lidocaine solution. For iv administration, a single dose is dissolved in a 0.9% NaCl solution or 5% dextrose solution in a volume from 10 to 200 ml.
In patients with hypersensitivity to penicillins, allergic cross-reactions with cephalosporin antibiotics are possible.
In the course of treatment, it is necessary to monitor the state of the function of the blood-forming organs, liver and kidneys.
The development of superinfection is possible due to the growth of microflora insensitive to it, which requires a corresponding change in antibacterial therapy.
When treating patients with sepsis, a bacteriolysis reaction may be developed (the Jarish-Herxheimer reaction).
Pharmaceutically incompatible with blood products or protein hydrolysates, aminoglycosides.
Antacids, glucosamine, laxatives, drugs, food, aminoglycosides (with enteral administration) slow down and reduce absorption, ascorbic acid increases absorption.
Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect, bacteriostatic drugs (macrolides, chloramphenicol, linkosamides, tetracyclines, sulfonamides) are antagonistic.
Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index), reduces the effectiveness of oral contraceptives, drugs, in the process of metabolism of which PABK is formed, and ethinyl estradiol (the risk of "breakthrough" bleeding).
Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that reduce tubular secretion, increase the concentration of ampicillin in the plasma.
Allopurinol increases the risk of skin rash.
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Unazin not prescribed to patients with known hypersensitivity to ampicillin, sulbactam, as well as other antibiotics of the penicillin group or cephalosporins (may develop cross-hypersensitivity).
Unazin not used for the treatment of patients with infectious mononucleosis and lymphatic leukemia.
Caution should be exercised when prescribing the drug Unazin patients suffering from hay fever, asthma, urticaria, as well as HIV-positive patients.
Newborn and premature babies should be prescribed Unazin with caution (given the increased risk of adverse effects).
Patients adhering to a low-sodium diet should take into account that each vial of Unazin 0.75 contains 55 mg (2.5 mmol) of sodium, Unazin 1.5 - 115 mg (5 mmol) of sodium, Unazin 3 - 230 mg (10 mmol) sodium.
During the period of drug therapy Unazin should be particularly careful when driving a car and driving potentially unsafe means.
Unazin may be appointed during pregnancy only for health reasons. Studies of ampicillin and sulbactam in animals did not reveal the teratogenic effect of these substances, however, clinical studies with the participation of pregnant women were not conducted.
During lactation Unazin prescribed only after the abolition of breastfeeding.
With the introduction of high doses of ampicillin and sulbactam in patients may increase the risk of developing and increasing the severity of undesirable effects. High concentrations of ampicillin can lead to the development of neurological effects, including seizures.
There is no specific antidote. In case of overdose Unazin prescribed symptomatic therapy. With the development of seizures, diazepam administration is indicated.
If necessary, reduce plasma concentrations of sulbactam and ampicillin (especially in patients with impaired renal function) hemodialysis.
Unazin can be used for 3 years after release, if stored at temperatures ranging from 15 to 25 degrees Celsius.
It is forbidden to store the prepared solution for parenteral use (unused solution should be disposed of).
1 bottle of the drug Unazin 0.75 contains:
Ampicillin sodium (in terms of ampicillin) - 500 mg,
Sulbactam sodium (in terms of sulbactam) - 250 mg.
1 bottle of the drug Unazin 1.5 contains:
Ampicillin sodium (in terms of ampicillin) - 1000 mg,
Sulbactam sodium (in terms of sulbactam) - 500 mg.
1 bottle of the drug Unazin 3 contains:
Ampicillin sodium (in terms of ampicillin) - 2000 mg,
Sulbactam sodium (in terms of sulbactam) - 1000 mg.
Dosage and method of use
The recommended dose of Unazin * in adults (including elderly patients) is 375-750 mg orally twice a day. The duration of treatment is on average from 5 to 14 days.
The drug is administered in the form of a suspension, the dosing of which is performed using a measuring spoon. When treating the majority of infections in children weighing less than 30 kg, the dose of Unazin * is 25-50 mg / kg / day in two doses, depending on the severity of the infection. For children weighing 30 kg or more, the drug is prescribed in a dose prescribed for adults.
For uncomplicated gonorrhea, Unazin * can be administered orally once at a dose of 2.25 g (six tablets of 375 mg). 1.0 g of probenecid is applied simultaneously in order to lengthen the serum levels of ampicillin and sulbactam. If a patient with gonorrhea is suspected of having a syphilitic lesion, a microscopic examination (by using a dark field method) should be performed before taking Unazin * to exclude the presence of syphilis, and then every month should be performed serological tests for at least 4 months.
Ulkender Ishіn ұsynylatin Unazin Mulsherі (It is known for Nasastards of Kos) tәulіgіne іkі ret 375-750 mg құrady.
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Asқynbagan gonorrhea sultamicillin ішуге біррет 2.25 g mөlsherde (375 mg-nan alty tablet) taғyindaloy mүmkіn. Ampicillin sulbactamyң Sarysu deңgeііn ұzartu Ushіn 1.0 g probenecidpen bіr mezgіlde қoldanady.
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Have a drug "Unazin»: 4 full analog, the cheapest - Sultasin (50-88ք), 30 analogs in action, the most similar - Ampioks
Analogs for action
The advantage of Cyberis is the versatility, thanks to which it is able to select analogues for any drugs. Artificial intelligence analyzes indications, contraindications, components, pharmacological groups, as well as information on the practical use of drugs, and displays the best replacements with a degree of similarity in percent.
Full analogues of drugs are not always available, and their use is not always possible due to the presence of dangerous drug interactions. Therefore, it is necessary to use just similar drugs, sometimes even from different pharmacological groups.