Antibiotics for rotavirus: which ones to take better?

Rotavirus infection is an infectious disease that causes diarrhea and the symptoms of respiratory disease at the very beginning. Its name was due to its appearance - the wheels (so translated from Latin rota). In the world, 25 mln. Cases of infection, of which 2 to 4% result in death. Outbreaks of the disease occur both episodically and massively. Especially often they arise in places where people gather: kindergartens, schools. Epidemics are clearly seasonal in nature, their frequency and mass increase in the winter months. The infection is transmitted by fecal-oral route. Pathology is characterized by an incubation period lasting up to 5 days, an acute period of a week or more with vomiting, diarrhea, high fever, redness of the throat, pain on swallowing, a runny nose, and several days of recovery. How is this pathology treated and are antibiotics used for rotavirus infection?

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Indications of the antibiotics for rotavirus

According to the recommendations of the World Health Organization, treatment of rotavirus infection with antibiotics is not carried out. Their action is aimed at the destruction of bacteria, not viruses. This is emphasized in his video and printed works by the famous doctor Komarovsky. What are the indications for the use of antibiotics in the case of an intestinal infection? Antibiotics should be prescribed for three reasons:

• fragments of blood in the feces;
• Cholera or suspicion of it;
• Diarrhea that does not stop more than 10 days.

Perhaps another reason why antibiotics are prescribed is the connection of a bacterial infection, confirmed by laboratory tests. In another situation, treatment with antibiotics should be regarded as reinsurance of the doctor and unwillingness to take responsibility for the patient, or incompetence.

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Release form

Antibiotics are substances that either exist in nature, or are manufactured artificially, and inhibit the vital activity of pathogens of infectious diseases through various mechanisms of action on them. There are different dosage forms. When treating intestinal infection, such as tablets, syrups, suspensions, solutions or powders are acceptable. Each of them has its advantages and disadvantages. So, for adults, pills are used, syrups and suspensions are more convenient for children. Solutions have 100% bioavailability and rapidity of exposure, but the introduction has a painful sensation.

Titles

If antibiotics need to be used to treat rotavirus infection, then a wide range of drugs are used. Such means include penicillins, macrolides, etc. Here are some names:

• enterofuril (its synonyms are ercefuril, diastat) - antidiarrheal agent, active substance nifuroxazide, are available in tablets, capsules, suspensions;
• Loraxon (cefrioxone) - is made on the basis of cefrioxone, belonging to the third generation of antibiotics. It is sold in powders, a vial of contents before injection is diluted with a solution for injections or novocaine (0.25-0.5%). The injection is done intramuscularly or intravenously;
• macropen - refers to macrolides, is made on the basis of midekamycin. There are tablets and granules for the preparation of a suspension. It is often used as a backup option, when other antibiotics did not have an effect.

The decision to use antibiotics in case of rotavirus infection in children is taken only by the pediatrician. The most acceptable form for them - suspensions and syrups. They are pleasant to taste because of flavoring additives, so the child is easier to persuade to take the medicine.

Antibiotics for rotavirus infection in adults can be in any of the existing forms, but the most effective is the injection, especially since adults are able to endure the physical pain that is accompanied by injections.

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Pharmacodynamics

Pharmacodynamics of antibiotics is based on different principles of action, therefore, when assigning this or that drug it is necessary to have the results of laboratory studies. Thus, enterofuril, depending on the dose, can have both bacteriocidal and bacteriostatic effect. High doses of the drug in the first case destroy the microorganism, in the second they slow down their growth and reproduction. It is also capable of activating the immune system, does not cause the emergence of dysbiosis.

Loraxon destroys the walls of the cell membrane of the bacterium, has an antibacterial effect on both gram-positive and gram-negative organisms.

Macroben is the least toxic antibiotic, the mechanism of its action is based on the violation of protein synthesis by the ribosome of a microbial cell. It is a bacteriostatic, but in a large dose they are bactericidal. In addition, macrolides, to which macropen belongs, have immunomodulating and anti-inflammatory activity.

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Pharmacokinetics

The pharmacokinetics of different antibiotics has its own. Of the drugs under consideration, enterofuril is not absorbed into the digestive tract. The highest concentration of the active substance occurs in the intestines, comes out with feces.

Loraxon when administered to a vein is maximally concentrated in the blood plasma after 5-10 minutes, subcutaneously - after 30-45. The half-period of reference from the body is 8 hours. The active component of cetriaxone is released unchanged through the kidneys (50-60%), the rest - with bile.

Macrofen is completely absorbed from the digestive tract, it is excreted by the liver.

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Dosing and administration

Dosage and administration are as follows:

Enterofuril - children from a month to 7 give half a measuring spoon of the suspension 2-3 times a day; from 7 months to 2 years - the same with a frequency of 4 times; from two to 7 years - one spoon (200 mg) three times a day; after 7 years and adults - a capsule or spoon, but 4 times, dividing through equal intervals of time.

When dosing Loraxon takes into account the severity of the disease, age, weight. Therefore, the purpose of the drug is individual, but should not exceed 20-75 mg per kilogram of weight twice a day for children under 12 years old, after this age - 1 time only once.

Macropen is prescribed for children weighing up to 30 kg in suspension, adults and children, whose weight exceeds this figure, in tablets (1 piece three times a day). The dose of the suspension is calculated according to the weight of the child and is given twice a day by:

• up to 5 kg - 3.75 ml;
• 5-10kg - 7.5ml;
• 10-15kg - 10ml;
• 15-20kg - 15ml;
• 20-30kg - 22.5ml.

The suspension is prepared by adding 100 ml of water to the contents of the bottle. The course of treatment on average is 1-1.5 weeks, if necessary, prolonged to 14 days.

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Use of the antibiotics for rotavirus during pregnancy

If it is necessary to resort to antibiotics for pregnant women, the doctor should evaluate whether the expected benefits for the woman will be possible risks for the future child. For example, there is no data on the harmful effects of enterofuril or macro-foam on the fetus, so the specialist should take the decision. Loraxon is not recommended for women in the first trimester of pregnancy.

Contraindications

Contraindication to use is the individual intolerance of the components of antibiotics. Enterofuril does not apply to small children up to a month of life, and antibiotic capsules are not prescribed until 7 years. Loraxon is contraindicated in patients with concurrent renal and hepatic insufficiency, macropen - with severe renal failure.

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Side effects of the antibiotics for rotavirus

Different antibiotics can cause side effects, depending on the mechanism of action on pathogenic microorganisms. So, enterofuril is well tolerated by patients. Single cases of hives are known. Loraxon has many more side effects. These are dizziness, headaches, nausea, vomiting, stomach pain, constipation or bowel disorders, colitis. The injections are painful, abscesses are possible at puncture sites. Macropen can cause an allergic reaction, nausea, vomiting, loss of appetite.

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Overdose

An overdose of antibiotics can cause those side reactions, which the instruction warns. Thus, with the introduction of large doses of Loraxon, convulsions, encephalopathy and even coma may occur, and the use of macropen in amounts exceeding the norm is accompanied by nausea and vomiting.

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Interactions with other drugs

On the interaction of antibiotics with other drugs known that they are not compatible with enterosorbents, tk. This reduces their effectiveness. Enterofuril is not recommended for joint use with drugs that contain ethyl alcohol. Parallel administration of Loraxone and non-steroidal anti-inflammatory drugs can lead to bleeding. It is also not used in conjunction with loop diuretics and is not used in one syringe with other antibiotics. The intake of macro-foam should be diluted in time with carbamazepine - antiepileptic and antidepressant drug, drugs based on ergot, used, mainly in gynecology. During treatment with cyclosparin (used in transplantation) and warfarin (with thrombosis and thromboembolism), macropen is not assigned.

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Storage conditions

Storage conditions are standard for all medicines: dry, dark place at a temperature not exceeding + 25 ^° C, out of reach of children. Liquid forms do not freeze.

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Shelf life

The shelf life of enterofuril in capsules is 5 years, in suspension - 3 years. Loraxon and Macropen are kept for 3 years.

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