Syntomycin

Syntomycin is an antibiotic that belongs to the chloramphenicol group. It is used to treat a variety of bacterial infections, including skin infections, conjunctivitis, and other conditions caused by microorganisms that are sensitive to it. Syntomycin is effective against a wide range of Gram-positive and Gram-negative bacteria. However, its use should be cautious due to the possibility of serious side effects, such as suppression of bone marrow hematopoiesis and development of aplastic anemia.

Indications Syntomycin

Syntomycin is used to treat a variety of bacterial infections, especially those that are resistant to other antibiotics. Indications for its use include:

1. Skin Infections: Treatment of infectious and inflammatory skin conditions such as boils, pustules, wounds, burns, trophic ulcers, and infected dermatitis.
2. Eye infections: Conjunctivitis, blepharitis and other bacterial eye infections.
3. Gynecologic infections: Endometritis, cervicitis, vaginitis caused by chloramphenicol-sensitive microorganisms.
4. Upper respiratory tract and ENT infections: Acute and chronic otitis media, sinusitis and other infections caused by sensitive microorganisms.
5. Urinary tract infections: In infections caused by Syntomycin-sensitive bacteria.

Release form

Syntomycin is available in several dosage forms, which allows you to choose the most appropriate option for the treatment of specific infectious diseases. The main forms of syntomycin release include:

1. Liniment (ointment): Often used for external application for skin infections, burns, ulcers and other skin lesions. Liniment has antibacterial action and promotes rapid healing of lesions.
2. Capsules: Used for the systemic treatment of infections requiring oral administration of an antibiotic.
3. Solution for Injection: Used when high concentrations of an antibiotic in the blood need to be reached quickly to treat severe infections.
4. Eye drops: Used to treat infectious eye diseases such as conjunctivitis.

The choice of release form of syntomycin depends on the type and severity of the infectious process, as well as the age and condition of the patient.

Pharmacodynamics

Pharmacodynamics of syntomycin is based on its ability to inhibit protein synthesis in the bacterial cell, which leads to stopping the growth and reproduction of microorganisms sensitive to it. Syntomycin, like other antibiotics of the chloramphenicol group, acts by binding to the 50S-subunit of bacterial ribosomes, which prevents the formation of peptide bonds between amino acids during translation. This stops the process of protein synthesis, which is vital for bacterial growth and reproduction.

Syntomycin has a broad spectrum of antimicrobial activity, including Gram-positive and Gram-negative bacteria, as well as some strains of anaerobes and intracellular pathogens.

Syntomycin is active against a wide range of microorganisms including:

• Gram-positive bacteria: Streptococci (including some penicillin-resistant strains), staphylococci (including methicillin-resistant strains), enterococci.
• Gram-negative bacteria: Shigella, Salmonella, Escherichia, Klebsiella, Haemophilus bacillus, some strains of Neisseria.
• Anaerobes: Bacteroides, clostridia.
• Intracellular pathogens: Rickettsiae, chlamydiae, mycoplasmas.

However, its use is limited due to the potential risk of serious side effects such as suppression of medullary hematopoiesis and toxic effects on the liver.

Syntomycin is effective against a variety of pathogens that cause infections of the skin, eyes, respiratory tract, and urinary tract.

The possibility of bacterial resistance to syntomycin should be considered, which may reduce the effectiveness of treatment.

Pharmacokinetics

The pharmacokinetics of Syntomycin (chloramphenicol) includes several key aspects such as absorption, distribution, metabolism and excretion that affect the efficacy and safety of its administration.

Absorption

Syntomycin is well absorbed from the gastrointestinal tract after oral administration. High blood concentrations are usually reached within 1-2 hours after administration. Absorption may be partially reduced when taken with food, but this effect is not of significant clinical importance.

Distribution

Syntomycin is well distributed in all tissues and body fluids, including brain and cerebrospinal fluid, making it effective for the treatment of central nervous system infections. It also penetrates the placental barrier and is found in breast milk.

Metabolism

Metabolism of syntomycin occurs in the liver. The main metabolic pathway involves glucuronidation, which leads to the formation of inactive metabolites.

Withdrawal

The drug and its metabolites are eliminated from the body mainly with urine, partially with bile. The half-life (t1/2) of chloramphenicol from blood plasma in adults is approximately 1.5-4 hours, which may be prolonged in neonates and patients with impaired liver function.

Features

• The ability to penetrate brain and cerebrospinal fluid makes Syntomycin valuable for the treatment of meningitis and other CNS infections.
• It is necessary to take into account individual differences in metabolism and possible accumulation of the drug in patients with impaired hepatic or renal function, which requires dose adjustment.

Dosing and administration

The method of use and dosage of Syntomycin depend on the form of the drug, type and severity of infection, as well as on the age, weight and general condition of the patient. It is important to strictly follow the doctor's recommendations when using Syntomycin and not to exceed the specified dosages to minimize the risk of side effects.

Liniment (ointment) for external application:

• Liniment is usually applied to the affected skin areas with a thin layer 2-3 times a day. Duration of treatment depends on the severity and dynamics of the process, but usually does not exceed 5-7 days.

Oral capsules:

• In adults and children over 12 years of age, the usual dose is 250-500 mg every 6 hours. The maximum daily dose should not exceed 4 g.
• For children under 12 years of age, the dosage should be reduced and is calculated individually depending on the weight and age of the child.

Solution for injection:

• The dosage and route of administration (intramuscular or intravenous) are determined by the doctor depending on the severity of the infection and the patient's condition. The usual adult dose is 500 mg every 6-8 hours.

Eye drops:

• It is usually prescribed to drop 1-2 drops into the affected eye 3-4 times a day for 5-7 days.

Use Syntomycin during pregnancy

The use of syntomycin (chloramphenicol) during pregnancy poses a potential risk to the developing fetus and should be limited. Chloramphenicol penetrates the placental barrier and its use during pregnancy, especially in the third trimester and during labor, can lead to the development of so-called "gray syndrome" in the newborn. "Gray syndrome" is a serious complication characterized by gray skin coloration, refusal to feed, loss of strength, sudden drop in body temperature and respiratory distress, which can be fatal.

Due to potential toxicity and possible adverse effects on the fetus and neonate, the use of Syntomycin during pregnancy is acceptable only when the potential benefit to the mother outweighs the potential risk to the fetus and there are no safer alternatives.

In addition, Syntomycin passes into breast milk, so its use is also not recommended during breastfeeding due to the risk of gray syndrome and other side effects in an infant.

Before starting treatment with Syntomycin, pregnant women and breastfeeding mothers should consult their doctor to assess all possible risks and develop a safe treatment strategy.

Contraindications

Contraindications to the use of Syntomycin (chloramphenicol) include a number of conditions and factors that may make it unsafe or undesirable to use:

1. Hypersensitivity to chloramphenicol or other components of the drug, which may lead to allergic reactions.
2. A history ofsuppression of medullary hematopoiesis, including aplastic anemia and other forms of hematopoietic dysfunction, as chloramphenicol may exacerbate these conditions.
3. Porphyria - chloramphenicol can provoke attacks of this disease.
4. Severe liver dysfunction due to the risk of accumulation of the drug in the body and development of toxic effects, given that the metabolism of syntomycin occurs in the liver.
5. Severe renal dysfunction, as this may impede the excretion of drug metabolites from the body.
6. Period of pregnancy and lactation. Chloramphenicol penetrates the placental barrier and may cause the development of "gray syndrome" in the newborn, and is also excreted with breast milk.
7. Early childhood (especially newborns and infants under 2 months ofage ), as they have an increased risk of developing "gray syndrome" due to insufficient liver and kidney function, which makes it difficult to metabolize and excrete chloramphenicol.

Side effects Syntomycin

It is important to remember that not all people experience side effects, and the severity of side effects may vary. Some of the most common side effects include:

1. Gastrointestinal disturbances: nausea, vomiting, diarrhea, abdominal pain. These symptoms are usually associated with taking antibiotics in general.
2. Hematopoietic disorders: chloramphenicol may cause bone marrow suppression, which may lead to anemia, leukopenia (low whiteblood cell count) and thrombocytopenia (low platelet count). In rare cases, aplastic anemia may develop, which can be fatal.
3. Allergic reactions: skin rash, itching, urticaria. In very rare cases, anaphylactic shock may develop.
4. Neurological disorders: headache, depression, confusion, optic neuritis.
5. Effects on newborns and infants: newborns may develop what is known as "gray syndrome" characterized by low blood pressure, breathing problems, and abdominal distress.

Overdose

An overdose of Syntomycin can lead to serious side effects requiring immediate medical attention. Syntomycin is a powerful antibiotic with a broad spectrum of action, and its use requires strict adherence to the dosage prescribed by a doctor.

Symptoms of Syntomycin overdose may include, but are not limited to, the following:

• Toxic effects on bone marrow: bone marrow suppression may become more pronounced, which can lead to anemia, leukopenia, and thrombocytopenia.
• Gastrointestinal disorders: increased nausea, vomiting, diarrhea.
• Neurological symptoms: dizziness, confusion, in rare cases coma may develop.
• "Gray syndrome" in newborns: if overdosed, newborns can develop a serious condition characterized by gray skin coloration, breathing and heartbeat problems.

In case of overdose, medical attention should be sought immediately. Treatment may include gastric lavage, administration of activated charcoal to prevent further absorption of the antibiotic from the gastrointestinal tract and symptomatic therapy.

Interactions with other drugs

Syntomycin may interact with a number of other medicines, changing their effectiveness or increasing the risk of side effects. It is important to tell your doctor about any medications you are taking before starting treatment with Syntomycin. Some examples of potential interactions are listed below:

1. Drugs affecting bone marrowhematopoiesis: Syntomycin may increase the suppressive effect on bone marrow of other drugs, such as cytostatics or drugs used for cancer treatment, which increases the risk of anemia, leukopenia and thrombocytopenia.
2. Antacids and drugs that reduce gastric acidity: May reduce the absorption of chloramphenicol when taken orally, reducing its efficacy.
3. Phenobarbital and other inducers of hepatic microsomal enzymes: May accelerate the metabolism of syntomycin, reducing its blood concentration and efficacy.
4. Oral hypoglycemic agents: Syntomycin may increase their effect, increasing the risk of hypoglycemia.
5. Anticoagulants (e.g. Warfarin): Chloramphenicol may increase their anticoagulant effect, increasing the risk of bleeding.
6. Cyclosporine: Syntomycin may increase blood concentrations of cyclosporine, increasing the risk of toxic effects, including renal failure.
7. Epilepsy drugs (e.g. Phenytoin): Chloramphenicol may increase blood levels of these drugs, increasing the risk of side effects.

This is not a complete list of Syntomycin interactions with other drugs.

Storage conditions

Storage conditions for Syntomycin (chloramphenicol) depend on the form of the drug, but in general, recommendations usually include the following aspects:

1. Storage temperature: The drug should be stored in a dry place protected from light at room temperature. A temperature range of +15°C to +25°C is suitable for most forms of Syntomycin.
2. Protection from light: Chloramphenicol may be sensitive to light, so it should be stored in its original packaging to protect it from light.
3. Humidity: Storage in places with high humidity should be avoided to prevent deterioration of the drug.
4. Availability to children: Keep the drug out of the reach of children to avoid accidental ingestion.
5. Shelf life: Do not use the drug after the expiry date indicated on the package.