Antibiotics for rotavirus: what are the best to take?

Rotavirus infection is an infectious disease that causes diarrhea and symptoms of a respiratory disease at the very beginning. It got its name from its appearance - a wheel (this is how rota is translated from Latin). Every year, 25 million cases of infection occur in the world, of which 2 to 4% are fatal. Outbreaks of the disease occur both episodically and en masse. They occur especially often in crowded places: kindergartens, schools. Epidemics are clearly seasonal in nature, their frequency and mass increases in the winter months. The infection is transmitted by the feco-oral route. The 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, sore throat, pain when swallowing, runny nose, and several days of recovery. How is this pathology treated and are antibiotics used for rotavirus infection?

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Indications antibiotics for rotavirus

According to the recommendations of the World Health Organization, antibiotics are not used to treat rotavirus infection, since their action is aimed at destroying bacteria, not viruses. The famous doctor Komarovsky emphasizes this in his video and printed works. What are the indications for the use of antibiotics in case of intestinal infection? Antibiotics should be prescribed based on three reasons:

• fragments of blood in the stool;
• cholera or suspicion of it;
• diarrhea that lasts more than 10 days.

Another possible reason for prescribing antibiotics is the presence of a bacterial infection confirmed by laboratory tests. In other situations, antibiotic treatment should be regarded as a doctor's overcaution 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 suppress the activity of infectious disease pathogens using various mechanisms of action on them. There are different dosage forms. In the treatment of intestinal infections, tablets, syrups, suspensions, solutions or powders for their preparation are acceptable. Each of them has its own advantages and disadvantages. Thus, tablets are used for adults, while syrups and suspensions are more convenient for children. Solutions have 100% bioavailability and speed of action, but the introduction causes painful sensations.

Names

If it is necessary to use antibiotics to treat rotavirus infection, then broad-spectrum drugs are used. These include penicillins, macrolides, etc. Here are some names:

• enterofuril (its synonyms are ercefuril, diastat) is an antidiarrheal agent, the active substance is nifuroxazide, available in tablets, capsules, suspensions;
• loraxone (cephriaxone) - made on the basis of cefriaxone, which belongs to the third generation of antibiotics. Sold in powders, the bottle with the contents is diluted with an injection solution or novocaine (0.25-0.5%) before administration. The injection is done intramuscularly or intravenously;
• Macropen - refers to macrolides, produced on the basis of midecamycin. Exist in tablets and granules for the preparation of suspension. Often used as a backup option when other antibiotics have not had an effect.

The decision to use antibiotics for rotavirus infection in children is made only by a pediatrician. The most acceptable form for them is suspensions and syrups. They taste good due to flavor additives, so it is easier to persuade a child to take the medicine.

Antibiotics for rotavirus infection in adults can be in any of the existing forms, but injections are the most effective, especially since adults are able to tolerate the physical pain that accompanies injections.

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Pharmacodynamics

The pharmacodynamics of antibiotics is based on different principles of action, therefore, when prescribing one or another drug, it is necessary to have the results of laboratory tests. Thus, enterofuril, depending on the dose, can have both a bactericidal and bacteriostatic effect. High doses of the drug in the first case destroy the microorganism, in the second, slow down their growth and reproduction. It is also able to activate the immune system, does not cause dysbacteriosis.

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

Macropen is the least toxic antibiotic, its mechanism of action is based on disruption of protein synthesis of microbial cell ribosomes. It is a bacteriostatic, but in high doses it acts bactericidally. In addition, macrolides, which include macropen, have immunomodulatory and anti-inflammatory activity.

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Pharmacokinetics

Pharmacokinetics of different antibiotics is different. Of the drugs under consideration, enterofuril is not absorbed in the gastrointestinal tract. The highest concentration of the active substance occurs in the intestines, and is excreted with feces.

When administered intravenously, Loraxone reaches its maximum concentration in the blood plasma after 5-10 minutes, subcutaneously - after 30-45. The half-life of elimination from the body is 8 hours. The active component of the drug, cetriaxone, is excreted unchanged through the kidneys (50-60%), the rest - with bile.

Macropen is completely absorbed from the gastrointestinal tract and excreted by the liver.

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Dosing and administration

The method of administration and dosage are as follows:

Enterofuril - children from one month to 7 are given half a measuring spoon of suspension 2-3 times a day; from 7 months to 2 years - the same amount 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 them at equal intervals.

When dosing loraxone, the severity of the disease, age, weight are taken into account. Therefore, the prescription 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 g once.

Macropen is prescribed to 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 depending on the child's weight and is given twice a day:

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

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

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Use antibiotics for rotavirus during pregnancy

If it is necessary to resort to antibiotics for pregnant women, the doctor must assess whether the expected benefit for the woman exceeds the possible risks for the future child. For example, there is no data on the harmful effects of enterofuril or macropen on the fetus, so the decision should be made by a specialist. Loraxone is not recommended for women in the first trimester of pregnancy.

Contraindications

Contraindication to use is individual intolerance to antibiotic components. Enterofuril is not used for small children under one month of age, and antibiotic capsules are not prescribed for children under 7 years of age. Loraxon is contraindicated for patients with simultaneous renal and hepatic insufficiency, macropen - for severe renal insufficiency.

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Side effects antibiotics for rotavirus

Different antibiotics can cause side effects, depending on the mechanism of action on pathogenic microorganisms. Thus, enterofuril is well tolerated by patients. There are isolated cases of urticaria. Loraxon has many more side effects. These are dizziness, headaches, nausea, vomiting, stomach pain, constipation or intestinal disorders, colitis. Injections are painful, abscesses are possible at the puncture sites. Macropen can cause an allergic reaction, nausea, vomiting, loss of appetite.

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Overdose

An overdose of antibiotics can cause the side effects that the instructions warn about. Thus, when administering large doses of loraxone, convulsions, encephalopathy and even coma can occur, and taking macropen in quantities exceeding the norm can be accompanied by nausea and vomiting.

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Interactions with other drugs

It is known about the interaction of antibiotics with other drugs that they are not compatible with enterosorbents, as this reduces their effectiveness. Enterofuril is not recommended for combined 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 together with loop diuretics and is not used in the same syringe with other antibiotics. Taking macropen should be diluted in time with carbamazepine - an antiepileptic and antidepressant drug, ergot-based drugs used mainly in gynecology. During treatment with cyclosporine (used in transplantation) and warfarin (for thrombosis and thromboembolism), macropen is not prescribed.

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Storage conditions

Storage conditions are standard for all medicines: dry, dark place at a temperature not exceeding +25 ⁰ C, out of reach of children. Liquid forms are not frozen.

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Shelf life

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

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