Treatment of tuberculosis with antibiotics

Today, tuberculosis is a serious medical problem. The incidence of tuberculosis is increasing. Treatment is becoming less effective, as the pathogen acquires resistance to the antibacterial drugs used. Pharmaceutical companies are developing all new tools, but over time they cease to be effective. Currently, many experts are convinced that antibiotics for tuberculosis remain the only reliable remedy for this disease.

For treatment, antibiotics of the aminoglycoside group are used. The most effective means of this group are kanamycin and amikacin. Also used antibiotics from the group of polypeptides, presented by such drugs as capreomycin, cycloserine. Fluoroquinolones are well established. Of this group, such drugs as lomeflocacin, ciprofloxacin ofloxacin, levofloxacin, moxifloxacin have proved to be the best.

It should be borne in mind that antibiotics are prescribed to each patient individually, taking into account the sensitivity of the pathogen to the active substance. Also necessarily take into account the results of the analysis, the current status of the patient, the severity of the disease, concomitant diseases. This is due to the fact that antibiotics prescribed for the treatment of tuberculosis are very dangerous, toxic and affect not only the pathogen, but also the human body.

When choosing the optimal treatment regimen, the doctor tries to choose the option in which the drug will have the maximum effect on the microorganism, killing the causative agent of the disease. It is also necessary to ensure the minimal effect of the drug on the human body, while protecting the liver, kidneys, heart and other systems from dangerous complications.

The so-called drug-resistant tuberculosis is a great danger - it is a form of the disease in which the pathogen acquires resistance to the medicinal product used and other drugs. This can occur at a low dosage, with improper selection of the drug, with a sudden mutation of the microorganism.

If you break the drug regimen, do not take the drug in time, or reduce the dose, the bacterium can undergo mutation and become resistant. In rare cases, stability is primary. In most cases, it is the result of incorrect therapy and the patient's irresponsible treatment.

Stability can be either single or multiple. With a single microorganism acquires resistance only to one drug. In this case, it remains possible to designate an alternative variant, to which stability has not yet been developed. More dangerous is considered multiple resistance, in which the bacterium acquires resistance to two or more microorganisms, or to the entire adjacent group. This deprives the doctor of the opportunity to choose an effective treatment. As a result, the disease progresses, and there is no cure for it.

In case of finding the resistance of the pathogen doctors are looking for ways to overcome the infection. A test for antibiotic sensitivity can help here, which will show which drug the pathogen still has resistance to. Also, if an effective agent is detected, its optimal dosage can be selected. But the problem is that it is not always possible to conduct such an investigation and often because there is not enough time. The study is conducted not less than a month, because first it is necessary to grow the necessary number of pathogens, and only after that you can conduct a study. In most cases, the doctor does not have this time, because the patient can die during this time. Urgent measures must be taken.

In this case, physicians usually go empirically, trying various combinations of drugs. It is recommended that the drugs be selected in such a way that they overlap the range of action of each other and affect various groups of microorganisms. It is also important that there was a different mechanism of action of the drug. This will increase the chance of successful treatment. For example, the use of a drug that destroys a cell membrane of a microorganism is advisable, thereby preventing its further development. Then the second drug is to choose one that will be aimed at inhibiting the synthesis of enzymes and the main biochemical cycles of the pathogen, which will also lead to the death of the microorganism. Thus, we have the opportunity to influence the same microorganism from different sides.

Antibiotics for tuberculosis in adults

Often prescribed isoniazid and rifampicin, which can be very effective against the pathogen, but are extremely dangerous for the body. They have multiple side effects on the liver, kidneys, heart. Isoniazid is one of the main means by which dogs and cats are poisoned. The level of toxicity speaks for itself. Drugs can destroy liver and kidney cells, can cause stomach ulcers. If the dosage is exceeded or if the patient is taken for a long time, severe intoxication develops, which can result in complete failure of the liver and kidneys.

Therefore, you need to take the drugs in combination with hepatoprotectors and nephroprotectors, always keep an antidote on the case of poisoning. Antidote isoniazid is pyridoxine, or vitamin B. If any negative side effects occur, you should immediately consult a doctor. It is also impossible to stop taking or lowering the dose alone, as the microorganism will become stable, and it will be impossible to cure the disease. Unfortunately, it is impossible not to take medicines for a tuberculosis patient, despite the high risk, since this is a fatal disease that will end in a lethal outcome without treatment. In addition, the disease is considered to be socially dangerous, as the patient can infect others. The disease is transmitted by contact and airborne droplets.

Isoniazid and rifampicin are not the only possible combinations of medications. Means are selected individually for each person. Thus the combination can contain 5 antibacterial preparations and more. One or two drugs are taken from the main, the rest - from the reserve antituberculous drugs.

Often prescribe antibiotics in combination with antifungal drugs. This is due to the fact that the development of fungal infection is one of the side effects of prolonged and intensified antibiotic therapy. The normal microflora is bent, its place is quickly occupied by a fungus, which begins to grow uncontrollably and multiply. Most often develop severe candidiasis, which affects the genitals, intestines, mouth, and other microbiocenoses. To suppress fungal growth, the most effective means is fluconazole.

A relatively new drug in the treatment of tuberculosis is perchlorone, a drug that is effective against forms of microorganisms that are resistant to drugs. But the mechanism of action and the consequences of its application are still unexplored.

Also antibiotics against tuberculosis can significantly reduce immunity, resulting in the development of bacterial and viral microflora, the body is more susceptible to various diseases. To maintain immunity, antituberculosis antibiotics are administered in combination with immunomodulating or immunostimulating agents. These are drugs that are aimed at restoring human immunity.

Most often used drugs such as tactivin and thymalin, interferons, leukinferon. Anyway. Select the necessary drug should only the doctor-immunologist.

Medicines against tuberculosis are given to people free of charge. To do this, you need to register with an anti-TB dispensary.

[1], [2], [3], [4], [5],

Antibiotic effective in the treatment of tuberculosis

In the treatment of tuberculosis in general, antibiotic rifampicin is used continuously. It is strong, fairly effective, has a powerful antibacterial effect. Before his appearance, tuberculosis was considered an incurable fatal disease, from which every third patient died. But today this remedy gives us an opportunity to overcome the disease.

But in this case there is a problem: the bacteria have managed to develop resistance to it. There are more and more cases in which the pathogen remains insensitive and the treatment does not bring any results. In this case, it is necessary to combine preparations, to search for effective combinations. Many doctors are saved by prescribing rifampicin together with isoniazid. In such a combination, both the effectiveness of the drugs in terms of the effect on the causative agent of the disease is enhanced, and its toxicity and the risk of side effects for the organism increase.

The problem of sustainability was partially solved by Indian scientists. So, they invented a new compound, which still has exceptional activity against the pathogens - desmethyltrifampicin. This tool was synthesized in a biochemical laboratory, it is a modification of traditional rifampicin. Has a more pronounced antibacterial effect against mycobacteria tuberculosis. To achieve this effect, scientists milled the drug precursor for the treatment of tuberculosis infection. The development is carried out by molecular-genetic and biochemical methods. While bacteria could not develop resistance to this compound, so today, desmethyrylfamycin can be considered the most effective drug against tuberculosis. But the problem is that the remedy has not yet entered industrial production. It was received only in the laboratory, but in order to make it available to people, it is necessary to undergo a number of preclinical and clinical studies.

[6], [7], [8]

Sensitivity of tuberculosis to antibiotics

The problem of sensitivity and its constant reduction is one of the most urgent topics of modern phthisiology and pulmonology. Tuberculosis can be treated with antibiotics. In this case, the appearance of a new drug is always effective first, but over time, the causative agent develops resistance to it, and the antibiotic ceases to function.

The development of stability is a natural mechanism for the adaptation of the microorganism to changing conditions. Tuberculosis pathogens - mycobacteria are tiny microorganisms that are also constantly evolving and are striving to survive and increase the number of their own population. To do this, there are constantly emerging new and new mechanisms of adaptation to the action of antibiotics.

The pharmaceutical industry, in turn, seeks to study these mechanisms and overcome them. All new effective remedies overcome the mechanism of bacterial resistance. But over time, they develop new factors, and the antibiotic again becomes ineffective, which prompts the pharmacist to further search for medicines.

Solve the problem by combining several tools. In order to determine exactly how effective the antibiotic will be, a preliminary analysis is carried out for antibiotic susceptibility. To do this, the patient is taken for examination of biological material, which presumably contains pathogens of the disease. With pulmonary tuberculosis, it is most often taken from the surface of the nasopharynx, pharynx. You may need an endotracheal or alveolar secret, sputum, which is taken by puncture. Most often the patient is simply asked to collect a morning portion of phlegm in a Petri dish and bring it to the study.

Then the test material is resuscitated onto nutrient medium, growth factors are introduced and placed in thermostat conditions under optimal conditions for the growth of the microorganism. It grows very slowly, even with the introduction of growth factors. On average, it takes about a month to grow enough microorganisms for further research. The growth of microorganisms is checked every week.

Upon achievement of the necessary growth indices, microorganisms are identified by carrying out a number of immunological and biochemical tests. The obtained data are compared with the Berji determinant, which allows to accurately determine the generic and species affiliation of the microorganism.

After this, they begin to investigate the sensitivity itself to various antibiotics. Most often, a disc-diffusion method is used, in which paper disks impregnated with antibiotics are placed on a Petri dish with a microorganism. Then cover with a lid and incubate for at least a week. After that, the results are evaluated. The sensitivity of bacteria to the antibiotic can be said in the case of the appearance of a zone of bacterial growth retardation, around a disk with an antibiotic. The diameter is measured using a conventional ruler or special tools. After that, the degree of sensitivity is judged by the diameter of the delay zone. The higher the sensitivity, the greater the diameter of the delay zone.

Then, using the method of decimal dilutions, the minimum inhibitory concentration of the antibiotic is evaluated, at which the bacterium still retains sensitivity. That is, they make a series of consecutive dilutions of the antibiotic with a physiological solution, in which each subsequent concentration is 10 times lower than the previous one. That concentration, with the addition of which there is still a growth retardation, even minimal, is considered MIC - the minimum inhibitory concentration at which the antibiotic still remains effective.

In the zone of maximum growth retardation, the largest, determine the most effective concentration, which completely inhibits the growth of microorganisms, or completely stops it. Based on these results, the necessary concentration of the substance is determined, which will suppress the growth of microorganisms and cure the disease.

Always make an amendment to the fact that the result is obtained under laboratory conditions, which are considered ideal. For the microorganism, optimal conditions have been created, there is a constant source of nutrients. The action of the antibiotic is also unlimited.

If you get into the body of such conditions will not be. The microorganism will be exposed to immune factors, should seek protection mechanisms. The antibiotic is partially neutralized, starting with getting into the mouth, under the influence of saliva. Then it dissolves in the stomach. Also undergoes transformation under the action of enzymes, gastric juice, hydrochloric acid. Part of the active substance is lost during the absorption through the walls of the digestive tract.

When ingested, the antibiotic is also perceived by the cells of the immune system as a foreign agent, subjected to neutralizing effects from lymphocytes, neutrophils, and other immunological defense factors.

Thus, penetrating into the focus of infection, the final concentration is significantly reduced. Therefore, it is not surprising that the dosage should substantially exceed the results obtained in the laboratory study. How much to increase the concentration in each case is decided by the doctor individually. Everything depends on the severity of the disease, the current condition of the patient, concomitant diseases and aggravating factors. The doctor is based on the results of laboratory studies, as well as the results of a survey and examination of the patient.

Indications Antibiotics for tuberculosis

Antibiotics are used in the open form of tuberculosis, with its latent flow, as well as in the presence of objective signs indicating the infection with tuberculosis. In this case, it is necessary to confirm: a positive Mantoux reaction in a child with repeated sampling, presence of mycobacterium tuberculosis in the smear or sputum of the patient, which are the causative agent of the disease.

[9], [10], [11], [12], [13], [14], [15], [16], [17], [18]

Release form

Antibiotics are available in the form of tablets or capsules for oral administration. Different antibiotics contain different concentrations of the drug. Also, antibiotics are released in the form of ampoules with contents for injection and in vials for intravenous infusions.

Titles

There are not many drugs that are highly effective in treating microbacteria. All of them can be conditionally divided into three groups: isoniazid and its analogues, artificially synthesized substances, combined into different chemical groups, antibiotics. Known antibiotics used in anti-tuberculosis therapy: streptomycin, rifampicin, cycloserine, rifabutin, kanamycin, amikacin, capreomycin.

[19], [20], [21],

Rifampicin

The antibiotic, which refers to broad-spectrum drugs, affects the main and accompanying microflora. It is characterized by a high capacity for absorption through the walls of the intestinal cavity. They penetrate into the blood quickly enough, after which they are carried along the body, fall into the organs, to which they are tropic and have their main action there. A lot of rifampicin can be found in inflamed pulmonary tissue, because it is characterized by high tropism to the lung tissue and also to the pleural cavity. Some amount is contained in the bronchi, easily enters the lung and even the pleura, exerting an increased effect. It is able to penetrate into the alveoli, accumulates in the intercostal space of the pleura. A large amount of the active substance is in cavities filled with dead lung tissue. Begin to act, then, when the necessary concentration has accumulated, therefore, it is by no means possible to reduce the dose on its own. This can lead to the development of resistance in bacteria. It works for 12 hours, after which it is necessary to inject the drug repeatedly. In the case of high sensitivity of mycobacteria (which are rare enough), there is a day.

The drawback of the drug is that it is quickly developed resistance, and it ceases to be effective. Effective in the treatment of pleurisy, with infectious processes in the airway, nasopharynx, pharynx. It is also recommended to take with strong infectious processes in other parts of the body. For example, with meningitis, osteomyelitis, infections of the urinary system, the drug has proved itself well enough. It can be used to eliminate those pathogens that show sensitivity to it.

Is taken orally, about 30-40 minutes before meals, on an empty stomach. Adults can be injected intravenously. The exact dosage depends on the weight of the person. You can appoint children over three years old. In general, it is recommended to take the drugs inside, because they are administered intravenously only in an emergency, or with a strong progression of the disease. It is administered intravenously mainly in sepsis and other purulent-inflammatory diseases, which tend to progress.

Also, treatment in combination with immunostimulating drugs is quite effective. These drugs increase the body's natural defense, stimulate the immune system. As a result, the immune system acts as another factor that suppresses bacterial growth by natural methods. In combination with antibiotics, bacteria can be overcome, resulting in a possible recovery.

Treatment in any case can not be done independently. It should be carried out under the strict supervision of a physician. If necessary, it will be necessary to take control tests that will allow you to assess the dynamics of recovery and, if necessary, make the necessary adjustments.

The drug has numerous side effects. But you can not not take it, because in the absence of treatment, a person will die from tuberculosis infection much faster than from any complications. In addition, you can always try to reduce the risk, minimize losses and complications.

Allergic reactions are possible, the severity of which varies widely: from mild irritation to severe anaphylactic shock. The most severe can be lesions of the digestive tract, dysfunction and dyspepsia. It is very toxic, and the bulk of it accumulates in the liver and kidneys. It is important to regularly give blood, this will allow timely detection of such violations as neutrophilia, leukopenia, a complete shift of the formula. Also it is necessary to observe many nuances. So, if the drug is injected too fast, there may be inflammation of the vein, a sharp drop in blood pressure.

It should be taken with caution in the propensity to thrombosis, because it reduces the effect of anticoagulants, which prevent blood clotting. Also, the effect of antiglucotic drugs decreases, accordingly, care must be taken for people prone to diabetes. Absolute contraindication is hypoxia, pregnancy, liver problems.

Antibiotics for the prevention of tuberculosis

The intake of antibiotics to prevent prophylaxis is contraindicated. The exception is postoperative periods, and some time after organ transplantation. This is due to the fact that during this period the immune system is lowered and the body remains vulnerable to any infection. If you take antibiotics for prevention, without the need, this will lead to the development of resistance in microorganisms and the occurrence of side effects. In addition, antituberculosis antibiotics are too toxic to be taken for preventive purposes. They are prescribed exclusively for medicinal purposes.

To prevent tuberculosis, preventive vaccinations are carried out. The first inoculation - BCG is done to the child back in the hospital, in the first few days after birth. Then the planned revaccinations are carried out in accordance with the vaccination calendar. For prevention, it is also useful to maintain a high level of immunity. To this end, you need to get an immunologist's advice, which, if necessary, will select the optimal means: interferons, immunoglobulins, gamma globulins and others.

And of course, the most reliable way of prevention is full nutrition, enough vitamins in food, a healthy lifestyle, exercise. Important breathing exercises.

[22], [23], [24], [25],

Antibiotics for pulmonary tuberculosis

The first and main antibiotic, which is used in the detection of tuberculosis, is rifampicin. It is prescribed by almost all doctors. But there are cases when it is contraindicated, or it developed resistance. In this case, resort to alternative options.

Kapastat, which is an antibiotic isolated from strains of streptomycetes fungi, proved itself well. But recently cases of cross-reaction with such preparations as capreomycin, florimycin, kanamycin, neomycin began to be registered. That is, if the causative agent of the disease is resistant to one of these drugs, it is likely that it will be resistant also to the kapastat.

Applied for the treatment of pulmonary tuberculosis. Effective if the disease is caused by a stick of Koch. For the beginning it is expedient to conduct the analysis for antibiotic sensitivity, but in practice it is not always done. The first is due to the fact that the analysis is done for a long time (at least a month). Often a doctor does not have that much time, because a person needs urgent treatment, without which he will die before the analysis is ready.

During the administration of the drug, it is necessary to monitor the functional state of the kidneys, as well as to regularly perform a metering, in which the patient's hearing is checked. This is due to the fact that it has ototoxic effect, that is, it significantly reduces hearing. May cause hypokalemia, implying a decrease in the level of potassium in the blood. This indicator must be constantly monitored, since this is an important component of the overall biochemical cycle.

Tibinex consists of two antibiotics - rifampicin and isoniazid, which have a tuberculocidal effect. Rifampicin depresses the synthesis of RNA in microorganisms, preventing their further multiplication. Isoniazid inhibits the synthesis of mycolic acids, which act as important components of the biochemical cycle, support the vital activity of the pathogen. Stability in mycobacteria is extremely rare.

Tricox is a drug that contains rifimpicin, isoniazid and pyrazinamide. Has a bactericidal effect, completely destroying bacteria. Due to the action of three differently directed components simultaneously, stability develops extremely rarely.

[26], [27], [28]

Pharmacodynamics

Depends on the mode of administration of the drug. So, if administered orally, there is a splitting in the stomach and absorption. It becomes active after about 2 hours.

When intramuscular introduction enters the tissue fluid, from which it is then filtered with lymph, during tissue metabolism. With this method, the drug appears in the blood after about 30 minutes.

With intravenous infusions, the maximum concentration in the blood is detected by the end of the infusion of the drug.

[29], [30], [31], [32], [33]

Pharmacokinetics

After penetration into the blood, the drug is transported directly to the focus of the infection. It reacts with microorganisms. The mechanism of further interaction depends on the type of antibiotics.

Some of them suppress the synthesis of RNA or DNA, thereby preventing further multiplication of microorganisms. Others violate the permeability of the bacterial cell membrane, which leads to the fact that the main metabolic processes in the cell are violated, the synthesis of the necessary proteins and the cell protection system are disrupted. The bacterium also dies. There are other mechanisms of action, but they are observed much less often.

[34], [35], [36], [37], [38], [39]

Dosing and administration

Kapastat is administered intramuscularly. It is important to introduce it as deeply as possible. Caution should be taken in patients prone to allergic reactions, especially if it is a drug-type allergy. The body weight is recalculated. Prescribe the drug should only the doctor, taking into account the individual anatomical and physiological characteristics of the body, as well as the features of the course of the disease. They treat TB for a long time, at least 1-2 years. Take medication with strict adherence to the treatment regimen, without violating it. The disorder can lead to further development of the pathogen resistance to the drug, as well as numerous complications and side effects.

Dosage and taking the drug can be adjusted depending on the accompanying pathologies. For example, with severe kidney and liver diseases, a reduced dosage of the drug is prescribed. Longer intervals between doses are made. This allows you to reduce the load on these organs.

Tibinex is used to treat all forms of tuberculosis. Dosage is calculated depending on the concentration of rifampicin in the preparation. Assign inside, once a day. Adults appoint 0.45-0.6 grams, depending on the body weight, children - in a dosage of 0.01-0.015 grams per day. The daily dose should not exceed 0.6 grams. Take an hour before eating.

Tricox is taken in the same way as tibinex, once a day. The maximum daily dosage should not exceed 6 grams. The calculation is made in accordance with the body weight.

Cycloserine is taken orally for a few minutes before meals. Adults are recommended to 0.25 grams three times a day. People older than 65 years - 0.25 grams twice a day. Children are recommended to 0.01-0.02 grams per kilogram of body weight.

[48], [49], [50], [51], [52],

Use Antibiotics for tuberculosis during pregnancy

Antibiotics are not recommended for pregnant women and during lactation. But there are cases when it is impossible to avoid taking them, because the risk is too big for the mother and the child. Tuberculosis is one of the most serious diseases that requires taking medications, and as soon as possible. Otherwise, there is a threat not only to health, but also to the life of the mother and child.

Due to the fact that all antituberculosis drugs have high toxicity, they call for serious side effects and complications, we should pay special attention to the selection of such a device that will allow to cause a minimum of side effects at the maximum of efficiency. Prescribe drugs is recommended only after a preliminary test for antibiotic sensitivity, which will isolate the pathogen and select the most effective antibiotic to it, and determine its maximum effective dosage.

As for the Kapastat, it has a minimum of contraindications, and possibly could have been used in pregnancy. But its effect on pregnant and newborns has not been studied. Since the drug has high nephrotoxicity, it reduces hearing, makes complications on the ears, causes general intoxication of the body, it is advisable to avoid its use during pregnancy. It is better to look for a safer and more tested drug. In addition, it is recommended to use the drugs that were tested on pregnant women and children, as this will allow, if not to avoid side effects, at least to predict them and on time to take the necessary measures to treat and eliminate the complications and defects that have arisen.

Contraindications

A minimum of side effects has kapastat. It is contraindicated only when hypersensitivity to its components.

Tibinex is contraindicated in acute and chronic diseases of the liver and kidneys. With caution should be taken to people with eye diseases, because the drug has a toxic effect on the optic nerve.

Cycloserine is contraindicated in various disorders of nerve tissue, especially in epilepsy, severe mental illness. Also, you can not take a week before the planned operations and a week after them. With caution should be taken to people with diseases of the kidneys, liver. It is better to take only in a hospital. Home should be given very carefully and after a preliminary check of tolerability.

[40], [41], [42], [43]

Side effects Antibiotics for tuberculosis

When taking kapastat many side effects are possible. Violated metabolic processes, for example, increases the level of creatinine and urea in the blood plasma, there is a large number of leukocytes and erythrocytes in the urine, indicating an acute inflammatory process in the kidney. There are cases of poisoning, toxic nephritis, in which the kidneys become inflamed and strong electrolyte disturbances occur. Very many develop inflammatory processes in the ear, as well as sharply reduced hearing, which is due to the ototoxicity of the drug.

Significantly reflected in the reception of the drug on the blood. For example, the blood formula changes, leukopenia, eosinophilia develop rapidly, in which, respectively, there is a decrease in the number of leukocytes in the blood and a sharp increase in eosinophils. This indicates a sharp decrease in immunity, the protective mechanisms of the body, against which there is an increase in the number of eosinophils, which indicates the progression of infection and the further development of invasion and colonization of lung tissue by mycobacteria. Possible severe pain, allergic reactions, rashes, fever, increased bleeding, abscesses.

Tibinex has many side effects. Especially pronounced neurotic effect: causes various neuritis, which inflames nerves. Most often, the optic nerve is subject to inflammation. Various mental disorders, neurological reactions, convulsions, spasms, hysterical fits develop. Memory can be broken, attention. Often observed dizziness, headache, nausea, vomiting. Possible skin rashes, itching, burning. Gradually develop symptoms resembling a cold or flu: the temperature rises, chills, fever.

There are changes in blood composition: anemia, leukocytopenia, thrombocytopenia are possible. Orthostatic hypotension is possible, in which the blood pressure drops sharply in the standing position. Also, there is a pressure drop with a sharp change in position.

Tricox has side effects mainly on the liver. It is important to constantly monitor the level of uric acid in the blood plasma. Influences the optic nerve, causing its inflammation, possibly a decrease in vision. There are dermatological diseases, various symptoms resembling a cold, neurological reactions.

Cycloserine also affects primarily the nervous system. May cause neurologic reactions, headaches, dizziness. Some people have drowsiness, others, on the contrary, have insomnia. Often there is anxiety, irritability, memory impairment. In severe cases, hallucinations, panic attacks, epileptic seizures, loss of consciousness are possible.

[44], [45], [46], [47],

Overdose

Overdose can develop if a high dose of the drug is ingested once, or with prolonged use of the drug. In any case, signs of severe intoxication develop.

There is a chill, fever, intestinal disorders, manifested in the form of vomiting, diarrhea. There is profuse sweating, heart palpitations, a sharp headache. The pressure may rise sharply or decrease. A person can lose consciousness.

The first help should be given as soon as possible. Preliminary it is necessary to inform the dispatcher that poisoning caused antibiotics for tuberculosis. If there is an antidote for the medicine, you need to quickly enter it. For example, pyridoxine, or vitamin B, acts as an antidote for isoniazid. It is urgently injected into the body, intramuscularly. In the absence of an antidote, you should induce vomiting, drink plenty of water. Then you need to call an ambulance. Recommended hospitalization for further treatment.

[53], [54]

Interactions with other drugs

Rifampicin is recommended to be taken concomitantly in combination with other antibiotics, since resistance to monotherapy is very rapid. It is well combined with such agents as streptomycin, isoniazid, ethambutol. It is also combined with various second-line drugs, especially with etionamine, pyrazinomide.

Kapastat should not be combined with other anti-tuberculosis drugs that are injected through the gastrointestinal tract. Take with great care in combination with other drugs (vancomycin, gentamicin, polymyxin, colimycin, amikacin, kanamycin), since ototoxicity and nephrotoxicity may increase. It is not recommended to combine with florimycin and streptomycin.

[55], [56], [57], [58], [59],

Storage conditions

Antibiotics in tablets are stored in a dry place, in which light does not enter. Can be stored at room temperature, unless otherwise specified in the instructions. Solutions in ampoules and vials are stored in the refrigerator.

[60], [61],

Shelf life

The drug in unopened form can be stored for 2-3 years. Shelf life is usually indicated on the package. Printed products in ampoules, vials can be stored for no more than 30 minutes.

[62], [63], [64], [65], [66], [67],