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Targcid
One of the representatives of powerful antibacterial medicines - glycopeptide antibiotics, - is considered Targotsid. The main substance of the drug is teicoplanin, an active antimicrobial ingredient.
Indications of the targotsida
Assign Targotsid for infectious pathologies, which were originally caused by Gram-positive microorganisms. It is recommended the appointment of Targosis with the resistance of bacteria to Methicilin, or patients prone to allergic to β-lactam antibiotics.
From the age of 18, the Targogid can be used for therapeutic purposes in such pathologies:
- microbial dermatological lesions;
- microbial damage to the urinary system;
- microbial pathology of the respiratory system;
- bacterial pathologies in otolaryngology;
- infections of the musculoskeletal system;
- sepsis, endocarditis;
- caused by prolonged peritoneal dialysis of peritonitis.
Targovid it is appropriate to use and to prevent bacterial endocarditis, as well as in dental and pulmonological practice, with surgical interventions.
Perhaps the use of Targogid in childhood (exception - the period of newborns).
Release form
The Targosis is produced in the form of a lyophilized substance for making an injection solution.
The lyophilized substance is packaged in 400 mg vials. The preparation is additionally completed with a solvent in an ampoule with a volume of 3.2 ml.
The substance of the lyophilizate is a light (almost white) homogeneous mass. Teicoplanin is an active ingredient, and sodium chloride is an auxiliary ingredient.
Water for injection is used as a dissolving agent.
Pharmacodynamics
Targoside belongs to a number of glycopeptide antibacterial agents of systemic activity. It is an enzymatic product that acts on aerobic and anaerobic Gram-positive microbes.
The active ingredient inhibits the vital activity of sensitive bacteria, changing the process of biological synthesis of cell membranes in areas where β-lactam antibiotics do not work.
Targotsid is active in gram (+) aerobes (bacilli, enterococci, listeria, rhodococcus, staphylococcus, streptococcus) and anaerobes (clostridia, eubacteria, peptostreptococci, propionobacteria).
Resistant to the influence of Targots actinomycetes, erysipelotriksy, heterofermentative lactobacilli, nocardia, pedicococci, chlamydia, mycobacteria, mycoplasma, rickettsia, treponema.
Antibiotics Targoside is not characterized by cross-resistance with other groups of antimicrobial agents.
Synergistic effect of aminoglycosides and fluoroquinolones.
Pharmacokinetics
Oral administration of the drug does not lead to its absorption.
Biological accessibility after intramuscular injection can be about 94%.
The type of concentration distribution in plasma after intravenous infusion is two-stage (rapid and delayed distribution), with half-lives of 0.3 and three hours, respectively. At the end of the distribution phase, a gradual elimination is observed, the half-life is between 70 and 100 hours.
Five minutes after the intravenous infusion of Targoside in an amount of 3-6 mg per kg, the plasma concentration is 54.3 or 111.8 mg / liter, respectively. The residual plasma content in the day after administration can be 2.1 or 4.2 mg / liter, respectively.
The connection with plasma albumins is from 90 to 95%.
The distribution of the drug in the tissues is 0.6-1.2 l / kg. The active ingredient of the drug penetrates well into various layers of tissues - especially teicoplanin penetrates into the skin and bone tissue. The active ingredient is absorbed by the leukocytes, thereby increasing their antimicrobial effect.
Teicoplanin is not found in erythrocytes, cerebrospinal fluid and lipid tissue.
The degradation products of the active ingredient Targoside were not detected. More than 80% of the drug injected into the bloodstream is excreted with the urinary fluid unchanged after 16 days after administration.
Use of the targotsida during pregnancy
Testing of the medicament Targosid on experimental animals was not accompanied by teratogenic manifestations. Nevertheless, experts believe that the clinical information on the effect of Targosid on the body of a pregnant woman is not enough at the moment.
Since Targotsid has a high therapeutic antibacterial effect, its use in pregnant patients is possible, however, with extreme caution. At any gestation period, it is necessary to monitor the development of the fetus, and after the birth of the baby, a check of its auditory functionality should be carried out, since the Targoside may have an ototoxic effect.
Due to the lack of information, it is not advisable to carry out treatment using Targoside to nursing patients.
Contraindications
It is not advisable to prescribe antibiotics Targoside for hypersensitivity to this medication, and also apply it during the newborn period (28 days after the birth of the baby).
Relative contraindications are:
- hypersensitivity to vancomycin (risk of cross-reaction);
- insufficient kidney function;
- the need for long-term treatment (long-term treatment with Targoside is possible only with regular check of auditory function, blood picture, liver function and urinary system);
- simultaneous administration of other oto- and nephrotoxic medicines (aminoglycoside preparations, cyclosporine, ethacrynic acid, amphotericin, furosemide, etc.).
Side effects of the targotsida
The course of treatment of Targoside can be accompanied by some unforeseen reactions from the body:
- hypersensitive reaction (rash, hyperthermia, cold, dermatitis, anaphylaxis);
- skin manifestations (epidermal necrolysis, erythema);
- violations of the liver;
- changes in the blood picture (decrease in the number of leukocytes and platelets, agranulocytosis);
- dyspepsia;
- transient increase in the amount of creatinine, insufficient kidney function;
- dizziness, headache, hearing loss, tinnitus, vestibular disorders, convulsions;
- pain at the injection site, abscess formation, phlebitis;
- development of superinfection.
Dosing and administration
Targoside is injected or infusion, intravenously or intramuscularly.
- Initial amount of Targotsid for adult patients:
- administered intravenously 400 mg to 2 times a day for 1-3 days, after which they pass to 200-400 mg per day intravenously or intramuscularly;
- with burn injury or endocarditis, the maintenance amount of the drug may be up to 12 mg per kg per day;
- with pseudomembranous enterocolitis injected 200 mg in the morning and evening;
- as a prophylactic agent during surgery, 400 mg of the drug are administered intravenously at a time.
- The initial amount of Targotsid for patients of childhood (from 2 months to 16 years):
- 10 mg per kg intravenously every 12 hours three times, after which - 6-10 mg per kg daily intravenously or intramuscularly;
- Children under the age of 2 months on the first day are prescribed 16 mg per kg (half-hour intravenous infusion), after which they switch to a maintenance dosage of 8 mg per kg daily intravenously.
- If the kidneys are damaged, the amount of Targosis is corrected from the fourth day, keeping the drug level in the blood at 10 mg per liter. If the creatinine clearance is 40 to 60 ml per minute, then the dosage is cut by half, or injected every other day. If the clearance is less than 40 ml per minute, or the patient is hemodialysis, then inject a third of the original amount of the drug every day or once every three days.
- In the elderly, with adequate performance of the kidneys to adjust the dosage is not necessary.
The duration of the therapeutic course Targotsid is assessed individually: the doctor takes into account the severity of bacterial damage and the clinical response of the patient's body. If the treatment is for endocarditis or osteomyelitis, then the duration may be 21 days or more, but do not use Targoside for longer than four months.
To cultivate Targozid, perform the following actions:
- the solvent from the ampoule is introduced into the vial with the lyophilized powder until completely dissolved;
- shake the medicine is not possible, to avoid the formation of foam;
- if the foam is still formed, it is necessary to leave the drug alone for 15-20 minutes;
- the solution is removed from the vial by means of a syringe;
- the drug is injected, or further diluted with isotonic solution, dextrose or Ringer's solution for intravenous infusion.
Overdose
There are cases when children were injected with incorrectly calculated Targotsid dosages. Thus, there is information about intravenous administration of 400 mg of the drug (95 mg per kg of body weight) to a child aged 29 days: the baby showed obvious signs of overexcitation.
Other cases do not indicate the development of any specific symptoms: situations with Targots overdose are considered in patients aged from 29 days to 8 years (dosages from 35 mg / kg to 104 mg / kg of weight were mistakenly introduced).
With excessive introduction of Targosis, the use of hemodialysis is ineffective. Therapy is performed using symptomatic medications.
Interactions with other drugs
You should not combine Targosis with other medications that have a toxic effect on the organs of hearing and kidneys. These drugs include: Streptomycin, Furosemide, Ciclosporin, Neomycin, Tobramycin, Cisplatinum, etc.).
There are data on the clinical incompatibility of Targoside with aminoglycosides.