Ceftriaxone in angina in adults and children: how correctly to treat?

Angina is too common a disease that can overtake, both in the cold and in the warm season. Such a disease can for a few days "knock out" a person from the rut: disruption of working capacity, significantly worsens well-being. Therefore, many people who get sick are interested in: what antibiotics and how can you take to get rid of the disease extremely quickly and not harm yourself? For example, is it possible to choose ceftriaxone in angina? After all, this is a powerful antibiotic, and how to properly treat this drug?

Will Ceftriaxone help with sore throat?

To date, doctors are using the following therapeutic approach in angina. Antibiotics are prescribed only if there are clear indications when there is a laboratory confirmation of the bacterial origin of the disease. Indeed, the unjustified use of antibacterial agents over the past few decades has acquired the epidemic scale: drugs are often "prescribed" to themselves by patients or by pharmacists who do not have the proper qualifications for prescribing treatment.

The massive use of antibiotics has led to the fact that microbes are becoming increasingly resistant to such medicines. According to statistics, the degree of stability of β-hemolytic streptococcus A to macrolide preparations is already at least 10%. Significant resistance microbes have and tetracyclines, so these tools are not advised to use in angina. In this situation, optimal for angina, caused by the action of β-hemolytic streptococcus A, use β-lactam antibiotics, which include preparations of the penicillin and cephalosporin group. In particular, Ceftriaxone is often used in angina, since this antibiotic belongs to the third generation cephalosporin representatives and, in addition, has a prolonged effect.

Can I prick the Ceftriaxone at a temperature?

If the temperature increases with angina, and the doctor has appointed Ceftriaxone, then it can be stabbed and even necessary. But only in cases where angina is caused by a bacterial flora that is sensitive to the effects of Ceftriaxone itself, or in the development of secondary bacterial complications.

By the way, angina in almost all patients is accompanied by a certain increase in temperature indicators - an average of 38-39 ° C. This is due to the infectious nature of the disease. Most often, the temperature rises on the background of purulent secretion in the tonsils, which is typical for lacunar and follicular angina. As a rule, febrile or subfebrile temperature worries the patient for a short time: its gradual decrease is observed already on the second-third day after the onset of the disease. The average duration of the high-temperature period is 1-3 days.

If you do not take ceftriaxone with angina, or another antibiotic prescribed by the doctor, then the heat can last for a longer time. Especially often, long high temperature values indicate the development of various complications.

[1], [3], [5], [6],

Treatment of angina ceftriaxone

As we have already noted, the use of ceftriaxone in angina is justified only in two cases:

• if angina has a proven bacterial aetiology;
• if there are secondary bacterial complications.

It is equally important that the bacterium is sensitive to the effects of Ceftriaxone.

We must not forget that viral angina with antibiotics can not be cured: as long as the patient expects the effect by taking an unnecessary antibacterial drug, the virus will continue its active reproduction and amaze all new tissues while simultaneously releasing dangerous toxic substances. Therefore, Ceftriaxone is appropriate only for the treatment of bacterial sore throat.

It should also be borne in mind that Ceftriaxone, like other antibiotics, does not affect the symptoms of the disease: it does not eliminate headache, sore throat, runny nose, etc. Therefore, to obtain an early healing effect, you should take other drugs - for example, analgesics, antipyretics , vitamins, etc.

Treat a sore throat with ceftriaxone, or some other drug, only the doctor can decide. And the antibiotic should be prescribed only if the bacterial nature of the sore throat is established, and never - just for the sake of either prevention.

Indications Ceftriaxone

Ceftriaxone is prescribed not only with angina. This antibiotic can be used in the treatment of other infections, if the pathogen-bacterium is sensitive to it:

• infectious diseases of the respiratory system (ENT diseases, pneumonia);
• infectious lesions of the abdominal cavity (inflammation of the hepatobiliary system, digestive tract, peritonitis);
• infectious lesions of the genitourinary system;
• infections that are sexually transmitted (eg, gonorrhea);
• septic conditions;
• infectious lesions of the musculoskeletal system, wounds and other infected soft tissue injuries;
• meningitis.

Ceftriaxone for bacterial angina is used for such diagnoses:

• Follicular angina (proceeds with the formation on the tonsils of small pustules, diameter from the head of the match).
• Lacunar angina (characterized by a cluster of purulent secretions in lacunae, high temperature up to 40 ° C, severe pain in the throat).
• Acute paratonsillitis, or phlegmonous tonsillitis (not only amygdala, but also near-minute-long fibrous tissue is affected, with the formation of a phlegmonous focus).

[9], [10], [11]

Ceftriaxone in purulent angina

Purulent sore throat is a conditional concept that is used in the description of acute tonsillitis in cases where a purulent secret is present on the tonsils. Thus, there may be a follicular and lacunar angina. Purulent sore throats always cause patients more discomfort, since their course is especially severe: severe pains in the throat and head, increased and soreness of the submaxillary lymph nodes, fever.

If purulent angina occurs in one member of the family, the other members of the family usually get sick - the disease belongs to highly contagious infections. Treatment of such a disease necessarily includes the use of an antibiotic - for example, Ceftriaxone. In addition, rinses are mandatory - to speed up removal of purulent secretions from the oropharynx. In addition, they take analgesics, antipyretics, vitamins.

During the first few days after the onset of the disease should always adhere to bed rest. So ceftriaxone with angina will act faster, and the disease will recede.

[13], [15]

Release form

Ceftriaxone, which is often used in angina, has the appearance of a fine crystalline powder of white or slightly yellowish hue. The vial may contain 0.5 or 1 g of ceftriaxone sodium salt (recalculated to ceftriaxone). The powder is used to prepare an injection solution.

This feature of the dosage form has both advantages and disadvantages.

• Advantages of the injection form of an antibiotic in angina:

1. the active ingredient enters the body in a "pure" form, without auxiliary components and dyes, which can become additional allergens;
2. the effect of the injectable antibiotic is more rapid;
3. an injection can be made to a patient who has a fever or vomiting, making it difficult to treat with pills;
4. The administration of the drug is controlled by a medical specialist (for example, it is more difficult to control the intake of a pill: a patient, especially a child, can cheat, spit out a drug, etc.).

• Disadvantages of this dosage form are:

1. injection is always more painful than taking a pill;
2. the patient is far from always able to introduce itself Ceftriaxone with angina independently;
3. Sometimes injection injection is complicated by the formation of a compaction, the development of an abscess.

[16], [17], [18], [19], [21], [22], [24], [25]

Pharmacodynamics

Ceftriaxone, which can be prescribed to a patient with angina, is considered one of the basic representatives of third-generation cephalosporin antibacterial drugs. The drug is administered parenterally (injectively), thereby achieving a rapid bactericidal effect of the antibiotic.

Ceftriaxone inhibits the development of many Gram (+) and Gram (-) bacteria, shows resistance to β-lactamase enzymes produced by the majority of microbes.

The efficacy of Ceftriaxone for such pathogens has been proven:

• Gram (+) staphylococci, streptococci (except staphylococcus spp. And faecalis);
• Gram (-) aeromonads, eubacteria alkaligenes, branhamelles, cytrobacteria, escherichia coli, hemophilic rod, klebsiella, moraxella, morganella, neisheria, proteus, pseudomonas, salmonella, shigella, pr.

Antibiotic inhibits the synthesis of the bacterial cell wall, which explains the bactericidal property of ceftriaxone in angina.

How quickly does Ceftriaxone work?

With intramuscular injection of the antibiotic, the active ingredient is absorbed into the bloodstream gradually, but still faster than using a tablet form inside. If you get into the blood circulation system, the antibiotic passes through the liver and accumulates in the blood and tissues of the body in various concentrations.

It is believed that the action of ceftriaxone in angina should be assessed after about 2 days from the start of treatment, since the effect only affects itself after 2-3 days. Do not count on the immediate effect of the drug: to destroy all pathogenic bacteria in a few seconds, the antibiotic can not.

Each antibacterial drug has its own specific period of action. And with each time, when the concentration content of the drug in the blood drops, it must be replenished. This means that ceftriaxone in angina should be administered strictly according to schedule, every day at the same time. If we follow this principle, then the bacteria will be destroyed, and soon the desired relief will come. If you miss injections, or take treatment at different times, you can form stable strains of the pathogen: the disease will be delayed, you will have to take a second course of the antibiotic with the replacement of the main drug.

If the positive effect of antibiotic therapy is found on day 2-3, then in no case can the treatment be stopped immediately: the bacteria remain in the body, and if the treatment is stopped, they will again have an effect. Therefore, the period of therapy, indicated by the attending physician, must be completed completely (for example, it can be seven or ten days).

[27], [28], [29], [33], [34], [35],

Pharmacokinetics

With the injection of ceftriaxone in angina, its penetration into tissues and fluids occurs. When testing the drug in adults, a prolonged, about eight hours, half-life was noted. The biological availability of an antibiotic after injection is determined to be 100%.

Bactericidal effect in relation to sensitive flora can persist throughout the day.

The half-life of a healthy adult is eight hours. Infants within a week after birth, as well as in the elderly from 75 years, the average half-life can be 16 hours.

In middle-aged patients, more than 50% of active ceftriaxone is excreted unchanged with urinary fluid. A little less - about 45% is excreted with bile mass.

Under the influence of the microflora of the intestine, ceftriaxone is transformed into an inactive substance. In infants during the first month of life, about 70% of the antibiotic administered is excreted by the kidneys.

In adult patients with a broken kidney or liver, the kinetic characteristics of ceftriaxone remain virtually unchanged. Thus, with kidney failure, the excretion of the antibiotic with bile mass is enhanced, and in liver disease, excretion through the kidneys is activated.

Ceftriaxone binds back to proteins, the antibiotic content in the interstitial fluid exceeds the concentration in the plasma.

[37], [38], [39], [41], [42], [43], [44], [45], [46],

Dosing and administration

An adult patient, as well as a child, starting at age 12, has a daily amount of Ceftriaxone 1 g. In case of a serious illness, the dosage can be increased to 2-4 g.

To carry out intramuscular injection, the powder should be dissolved with sterile water for injection. To do this, use the following formula:

• 0.5 g of Ceftriaxone powder - 2 ml of solvent;
• 1 g of Ceftriaxone powder - 3.5 g of solvent.

How many times a day to stab, and how many days to prick with ceftriaxone in angina?

Antibiotic is administered once a day, every day at the same time. The duration of therapy is not always constant: the course of treatment can last from 5 to 10 days. It is generally believed that Ceftriaxone in angina should be used until the main symptoms disappear, plus three more days.

Antibiotic is injected deep into the upper-external gluteal quadrant. It is undesirable to administer more than 1 g of the drug into one gluteal zone. To prevent pain during intramuscular injections, it is allowed to use 1% lidocaine as a solvent.

Newborn infants up to 2 weeks of age are administered per day from 20 to 50 mg / kg of body weight.

Infants and children under 12 years of age are administered daily from 20 to 75 mg / kg of body weight. If the child weighs more than 50 kg, the amount of Ceftriaxone is calculated according to the scheme for adults.

[61], [62], [63], [64]

Ceftriaxone in sore throat in adults

When choosing an antibiotic for the treatment of angina, the doctor, first of all, should pay attention to the results of diagnosis. Pre-bapses: the tonsils are taken from the tonsils, sent to laboratory technicians, which are sown on the appropriate nutrient medium. After a while germs of germs germinate, and in the laboratory specialists determine their species affiliation and degree of sensitivity to antibacterial drugs.

Backpacking refers to standard diagnostic procedures and helps to pinpoint which microbe has become the causative agent of the disease.

In practice, many doctors prefer to immediately prescribe any of the antibiotics of the most extensive spectrum of antimicrobial activity, primarily because they do not waste time waiting for bapses and waiting for the result. To such "universal" antibiotics is Ceftriaxone. However, this approach is not always correct. To date, there are also express methods for determining the pathogen in the smear: the result can be obtained after 10 minutes. Unfortunately, such tests are not available in all medical institutions.

[65], [67], [68], [70], [72]

Application for children

Standard for angina, the child is prescribed penicillin group drugs: they are effective, easily tolerated by children of childhood. As for cephalosporins, these antibiotics are prescribed for children only in a few cases:

• if it is not possible to use penicillins and macrolides for treatment;
• with complex lingering angina, prone to the development of complications;
• with ineffective treatment conducted by other antibacterial groups.

Angina is most often provoked by streptococci and staphylococci, but the viral and mycotic origin of the disease is not excluded - this is necessarily taken into account, and laboratory diagnosis is performed before the start of treatment. Pathogenic microorganisms are able to actively multiply under favorable conditions for them, which are created against the background of childhood fatigue, malnutrition, frequent cold and viral diseases.

Independently to give a child such a powerful antibiotic, as Ceftriaxone, in no case can not: this can lead to the development of superinfection. In addition, it is quite difficult for children to choose a medicine and calculate the dosage, which depends on the specific pathogen of the sore throat, on the severity of the disease, on the weight of the body and the age of the sick child. The appointment of a child with ceftriaxone in angina is a measured step that only a doctor can do.

[74], [75], [77], [78], [79], [80], [81], [82], [83],

Use Ceftriaxone during pregnancy

The pregnancy period is very complicated - not only for the woman herself, but also for the doctors. After all, the future mother is not immune from various diseases in this period, including from tonsillitis. But antibiotics to take at this stage is highly undesirable.

How are things with the appointment of ceftriaxone in angina? For pregnant women this medication is allowed only in extreme situations, and only in the second half of pregnancy. The first trimester is the most undesirable time for treatment with ceftriaxone. In addition, the drug is not prescribed for hypersensitivity to cephalosporin drugs, with impaired renal function.

A woman should stop treating tonsillitis with ceftriaxone if unwanted symptoms appear in the form of nausea, fever, rashes, redness of the skin, nosebleeds.

In general, if ceftriaxone has been prescribed for angina during the second or third trimester, and the attending physician constantly monitors the course of pregnancy, complications after therapy should not occur. The main thing is to trust your doctor and consult him on any topical issues.

Contraindications

Ceftriaxone in cases of angina can not be prescribed if:

• the patient suffers from hypersensitivity to antibacterial drugs of cephalosporin and penicillin group;
• The patient stays in the first trimester of pregnancy, or practices breastfeeding;
• the patient suffers from a combination of renal and hepatic insufficiency.

[50], [51], [52],

Side effects Ceftriaxone

The most common side effects during the treatment of angina ceftriaxone are:

• frequent loose stools, nausea, development of stomatitis and glossitis;
• in blood thrombocytopenia, eosinophilia, leukopenia, hemolytic anemia;
• skin exanthema, allergic dermatitis, edema;
• pain in the head, dizziness;
• biliary stasis, increased activity of hepatic enzymes;
• fungal lesions of genital organs;
• allergic processes.

A local side effect may be the formation of infiltration and soreness in the injection zone of ceftriaxone.

[54], [57], [58], [59], [60]

Overdose

Continuous therapy with ceftriaxone may be indicated on changes in the blood picture: signs of leukopenia, hemolytic anemia, neutropenia, thrombocytopenia are noted.

Also, the side effects can not be ruled out.

Treatment of overdose is carried out according to the symptoms. If necessary, connect hemodialysis, or peritoneal dialysis.

[87],

Interactions with other drugs

Ceftriaxone should not be administered in the same syringe with other antibacterial medicines due to pharmaceutical incompatibility.

Ceftriaxone, like other antimicrobial agents, inhibits the development of the intestinal microflora, while suppressing the production of vitamin K. Simultaneous use of non-steroidal anti-inflammatory drugs or sulphin-pyrazone can lead to an increased risk of bleeding. The same can be said about the combined treatment with ceftriaxone and anticoagulants.

The combination of antibiotic and "loop" diuretics increases the burden on the kidneys - a nephrotoxic effect is possible.

[90], [91], [92], [93], [94], [95]

Storage conditions

Flasks with Ceftriaxone are stored, not removed from the carton, in a dark dry place with a temperature regime of +8 to + 25 ° C. The storage of medicines must be protected from child access.

[96], [98], [99], [100], [101]

Shelf life

Vials with Ceftriaxone are stored for up to 2 years (measured from the production date). At the end of this period, or if the integrity of the vials is damaged, the medicine is disposed of.

[103], [105]

Analogues

Ceftriaxone is a preparation of ceftriaxone sodium salt. There are many analogues to this tool, and they all have different names for the same active component, for example:

• Abithrax
• Alzizon
• Bresek
• Efmerin
• Lorcona
• Emsef
• Cefotrisis
• Tsefodar
• Cefaxone
• Rocefin
• Tercef
• Cefogram
• Promoter
• Offramax
• Norakson
• Makhachkala
• Lendacin
• Lavaxon
• Addition
• Belcef and others

[106], [108], [111], [112], [113], [114], [115]

Reviews

The use of "wrong" medication in angina is no less dangerous than the lack of treatment in general. Patients with angina should not tolerate two extremes:

• take antibiotics for any diseases and even just for prevention;
• ignore any treatment and carry the disease on its feet.

Also, it is not recommended to select a drug yourself, using the Internet or a pharmacist from the nearest pharmacy. For example, you can appoint a powerful drug such as Ceftriaxone in angina only by your doctor who has previously studied the results of your tests.

According to reviews, Ceftriaxone is indeed a very effective drug. However, many users note that injections are very painful. Therefore, it is still worth considering and using as a solvent not ordinary water for injection, but a solution of lidocaine.

Few know, but antibiotic therapy helps not only cope with the infection: the patient becomes much less contagious after the first injection of Ceftriaxone. Especially relevant is the use of the drug in purulent forms of tonsillitis.

We must not forget that an illiterate approach to therapy often entails the development of complications and the aggravation of pathology. Especially often there is a transformation of angina into a chronic process.

Despite the fact that the instructions to the medication indicate a large list of adverse events, experts note that unpleasant symptoms are found extremely rarely. Therefore, do not be afraid to take Ceftriaxone when there is evidence: the list provided in the instruction is just a warning to the patient about any, even the most unlikely, background symptoms. And this does not mean that they will necessarily.

In general, most doctors recommend the use of ceftriaxone injections in angina, especially with purulent disease.

[117], [118], [120], [121],