Antibiotic "Zivox": instructions for use, analogues
In the treatment of diseases of bacterial nature, the doctor usually prescribes antibiotics. These drugs have a huge number of varieties. Of course, it is impossible to know all kinds of antiseptic pharmaceutical products, but some medicines against bacterial infection are of particular interest.
One of the modern antibiotics, which is presented in our market of medicines is Zivox. Instructions for use of this drug indicates that it is an antimicrobial agent of synthetic origin. He belongs to a special group - oxazolidinones. The main active ingredient is linezolid. Next we will consider the following information: the action of the drug "Zyvox", instructions for use, analogs, side effects and contraindications.
In what form is it produced?
This medication is available in two dosage forms:
- in the form of granules that are either white or yellowish with an orange flavor. Of these, a reagent solution is prepared, with the expectation that 100 mg of linezolid will be contained in 5 ml of the finished suspension. The granules are placed in a 150 ml sterile container. Also in the package there is a measuring spoon with divisions( 2.5 and 5 ml of suspension).
- In the form of tablets containing 600 mg of linezolid. In the package there is one blister with 10 tablets inside.
- Infusion solution containing 2 mg of linezolid / 1 ml, in packs of 100, 200, 300 ml.
What is the pharmacological effect of the drug?
Active substance linezolid has the ability to penetrate bacteria cells, bind to their ribosomes and suppress protein synthesis. As a result, microorganisms die.
Against which microorganisms does the drug help?
Zivox preparation, the instruction for which accompanies each medicine package, effectively affects the following microorganisms:
- gram-positive aerobic bacteria: enterococci, corynebacter, staphylococci, streptococci;
- Gram-negative aerobic bacteria of the genus Pasteurella;
- Gram-positive anaerobic bacteria: clostridium and peptostreptococci;
- gram-negative anaerobic bacteria of genera prevotella, bacteroides, chlamydia.
To linezolid, the bacteria of the genera moraxella, legionella, mycoplasma are moderately sensitive.
There are also microorganisms that show resistance to the linezolid included in the Zivox preparation. The instructions for use indicate the following resistant strains: hemophilic bacteria, as well as genera of enterobacteriaceae, nizera and pseudomonas.
What are the symptoms of this medication?
Antibiotic "Zivox" is prescribed for the following diseases:
- Infectious inflammatory diseases that are caused by bacteria that show sensitivity to this drug.
- In cases of hospital or community-acquired pneumonia.
- With infectious lesions of the skin and soft tissues of the human body.
- In the presence of diseases, the causative agents of which are enterococci, showing resistance to vancomycin.
Also, the antibiotic "Zyvox" can be used as a component of combination therapy for infection caused by gram-negative bacteria.
Linezolid is characterized by a fairly rapid absorption from the digestive tract into the blood, regardless of the form of release of the agent. Already after 2 hours after taking the drug, its concentration in the plasma reaches its maximum values. Linezolid is characterized by complete bioavailability, and its distribution to organs and tissues is fairly rapid. Regardless of what the concentration of antibiotic in the blood, 31% is associated with plasma proteins.
In the human body, linezolid is metabolized by oxidation to two products that do not have an antimicrobial effect. They are excreted by the kidneys( about 50%) and the intestines( up to 6%).Up to 35% of non-metabolized antibiotic is excreted together with urine.
Stable pharmacokinetics characterized by Zivox is noted. Instruction for use notes the absence of dependence of this criterion of the drug on the patient's age. In this regard, older people do not need to adjust the dosage of this pharmaceutical product.
Dosage of the drug
The drug Zivox can be prescribed by a doctor to a patient for oral use or as an infusion intravenously. And the patient can be transferred from one type of drug administration to another without losing the effectiveness of treatment.
Dosage of the drug, the duration of the course is prescribed by the attending physician, and these circumstances of the therapy are determined by the following factors:
- what kind of bacteria the disease was caused by;
- infection localization;
- severity of the disease;
- clinical effect of therapy.
For streptococcal pneumonia of the community and hospital type in adults and children over 12 years of age, 600 mg of Zivox are prescribed. The instruction indicates that the dose should be taken every 12 hours, and the duration of the course is 10-14 days.
For infections of the skin or soft tissues, complicated or uncomplicated, caused by staphylococci, streptococci and vancomycin-resistant enterococci, including diabetic foot syndrome( without osteomyelitis), a dose of Zivox 600 mg is prescribed. The instruction also says that the interval between doses should be 12 hours. The course of therapy lasts 10-14 days, but it can also last up to 28 days according to the prescription of the doctor.
If the patient has renal failure, then he does not need to adjust the dose of the medicine. When carrying out the hemodialysis procedure, linezolid is removed during the time interval of 3 hours. In connection with this circumstance, the drug should be taken after the blood purification measure. Patients who are diagnosed with liver failure also do not need to adjust the dosage.
Patients under 12 years of age are prescribed only the infusion form of the Zivox. Instructions for use in newborns and children indicate that linezolid should be taken at a dosage of 10 mg / kg of the child's weight at a frequency of every 8 hours. The course of treatment is from 10 to 14 days. This dosage of the drug is relevant for therapy in the case of community and hospital pneumonia, infections of soft tissues and skin, as well as for the control of enterococcal infections.
A protective sheath made of foil is removed immediately before the infusion procedure. You should check the package for leaks, compressing it for 1 minute. Unsealed packaging is not suitable due to non-sterility. Infusion solution is administered during the time period of 30-120 minutes.
Features of the application of
There are some features of taking Zivox. The instruction indicates that if the infection is caused by gram-negative bacteria, then it is necessary to connect additional drugs with activity against this group of microorganisms.
When taking linezolid, some patients may experience reversible reversal of myelosuppression. Depending on the duration of therapy, it is characterized by anemia, leukopenia, thrombocytopenia or pancytopenia. Based on these data, blood tests should be performed in patients who are at risk of bleeding. Also, these measures are appropriate if the patient has a history of myelosuppression or he takes medications that reduce the level of hemoglobin and platelets or their activity. Evaluation of blood counts is also necessary for a long period of treatment( more than 14 days).
In some patients, the use of linezopa may be accompanied by a risk of developing colitis pseudomembranous nature of different types of severity.
Diarrhea occurs in people taking antibiotics quite often. The extent of this side effect can range from mild to severe. When taking Zivox, a pill or suspension, the normal microflora of the intestine is suppressed and the bacterium of the genus Clostridium is overgrown. In the process of its life, this microorganism secretes toxins of groups A and B, and they provoke diarrhea. The increased content of these components can cause death in patients. All patients who have had a diarrhea of this type need to be closely monitored by physicians for a period of 2 months.
In some cases, visual impairment is observed when treated with Zivox. Instructions for use in children and adults indicate a possible change in the perception of colors, focus sharpness, field defects, fogging. In these cases, the patient needs urgent consultation of an oculist. If this drug is taken by the patient for a long time period( more than 3 months), then it is necessary to perform visual control without fail. When the emergence and development of such phenomena as peripheral or optic nerve neuropathy, the question is raised about discontinuing drug treatment if the benefit from it is less than the damage to health.
There have also been cases of lactic acidosis when taking Zyvoksa. It manifests itself in the form of nausea, vomiting, unreasonable acidosis, or a decrease in carbonate anions. This phenomenon should be carefully observed by a medical specialist.
If a patient needs to take serotonin reuptake inhibitors together with Zyvox, then he must be taken under medical supervision to identify serotonin syndrome: a cognitive function failure, hyperreflexia, hyperpyrexia, and a lack of coordination. In the presence of the phenomena described, treatment is stopped by one or both drugs. In this case, a discoloration of the tooth enamel is observed, which is removed by professional cleaning.
There is one more caution to take Zivox. Instructions for use( tablets or pellets for the preparation of a suspension - not the essence) says: in the treatment with linezolid, it is not recommended to drive vehicles, manage special equipment and activities that involve a risk to life and health.
What are the side effects of the drug?
Undesirable reactions that may occur in a patient when taking Zivox 600 mg are classified according to the incidence: from very frequent( 10%) to very rare( 0.01%).
Usually, as side effects when treated with Zyvox, the instructions for use, a solution of this or a tablet, calls the phenomenon of mild or moderate severity. The following symptoms are particularly frequent:
Adults may also experience constipation, vomiting, abdominal pain, flatulence, and candidal disease of the oral cavity.
Instructions for use( for children over 12 years of age and adults) refer to changes in the color of the tongue to infrequent side effects from Zyvox.
Based on laboratory studies, it can be argued that during treatment with this antibiotic is often detected thrombocytopenia. The increase in the content of triglycerides in the blood, the anomalous activation of liver enzymes ALT, AST, APF, LDH, as well as lipase and amylase are not as regular. An increase in the concentration of total bilirubin, creatine and prolactin was also recorded.
The patient's nervous system can also respond to the drug with linezolid. Often this is expressed in dizziness and migraines, as well as in convulsions. The more rare manifestations of side effects of the drug are the cases of taste distortion.
Changes in the normal functioning of the central nervous system can cause "Zyvox"( tablets).The instruction indicates a rather frequent insomnia in patients during the course of treatment with this pharmaceutical preparation.
On the functioning of the genitourinary system, therapy with the use of "Zyvox" can be reflected in the form of vaginal candidiasis.
Skin manifestations of treatment with linezolid in the form of rashes are also common.
Among other side effects can be called fever and opportunistic fungal infection, which occurs infrequently.
Also in the study of the drug Zivox, there were cases of increased blood pressure, pruritus and dyspepsia.
When treating linezolid in adolescents aged 12 to 17 years, the following undesirable manifestations are common:
- diarrhea, vomiting, nausea, abdominal pain;
- vertigo, migraine;
- infectious diseases of the upper respiratory tract, cough, pharyngitis;
- pain, the localization of which is difficult to describe.
The following phenomena with a lower frequency may also occur:
- increase in triglycerides, ALT, creatine and lipase;
In the clinical trial, additional side effects were identified that characterize Zyvox( solution and tablets).These include:
- myelosuppression is reversible;
- optic nerve neuropathy;
- angioedema edema;
- lactic acidosis;
- peripheral neuropathy;
- discoloration of tooth enamel;
- increased fatigue;
- serotonin syndrome.
How is Zyvox combined with other medicines?
When combined with cytochrome isoenzymes, there is no change in the activity of the latter.
If concurrently treated with linezolid and monoamine oxidase inhibitors, then the effect of the latter is enhanced. On this basis, the dosages of adrenomimetics and dopaminomimetics should be reduced.
When co-administered with Zivox and antidepressants that inhibit the seizure of serotonin, serotonin syndrome may occur.
In the case of concomitant administration with "Aztreonam" or "Gentamicin" pharmacokinetics of linezolid was not observed.
Joint reception with "Rifampicin" entails a decrease in the maximum concentration of "Zivoks" - up to 32%.
The drug is not suitable for use by patients with increased sensitivity to the main or additional components that make up its composition.
If the patient is taking phenelzine or isocarboxazide, then linezolid can not be taken during this therapy and 2 weeks after it.
If there is no possibility to monitor blood pressure, then Zyvox is unacceptable for treating patients with the following diseases:
- unstable hypertension;
- as well as with joint admission with adrenomimetics and dopaminomimetics.
If it is not possible to closely monitor patients at risk of serotonin syndrome, Zyvox should not be administered under the following circumstances:
- presence of a carcinoid disease;
- administration of serotonin reuptake inhibitors, tricyclic antidepressants, triptans, Miperedin and Buspirone.
The tablet form of Zyvoks is contraindicated for children under 12 years due to the inability to select an adequate dosage.
The drug is indicated for treatment if the expected benefit from it exceeds the risk in the following cases:
- renal and hepatic insufficiency;
- systemic infections;
- pregnancy and lactation.
Can an overdose occur with the drug?
In clinical trials, as well as in the further use of Zyvox in hospital or out-of-hospital cases, no overdose has been detected. If such a situation arises, it is recommended to perform symptomatic therapy.
Storage and dispensing conditions
The drug "Zivox" is sold in a pharmacy under the prescription of a doctor. Store it in a place that is restricted from moisture and sunlight at an air temperature of not more than 30˚C, restrict children's access.
In case of unacceptability of treatment with Zivox, its analogs can be assigned for reasons of similarity of effects of the main active substance:
- For pneumonia and bronchitis, doxycycline hydrochloride, Bronchorus, and Arlet.
- In bacterial infections - "Levomycetin 0.25 g", "Vancoumabol", "Lifaxon."
- When infections of the skin - "Benzatin benzylpenicillin", "Sulfadimetoksin."
- For non-healing wounds - "Tsifaleksina sodium salt", "Lifuzol".
Only the attending physician should prescribe the drug on this list, as each medication has its own indications, reception characteristics and contraindications.