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Health

Ziomycin

, medical expert
Last reviewed: 03.07.2025
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Ziomycin is a systemic antibacterial drug from the category of lincosamides, macrolides and streptogramins. Contains the element azithromycin.

Indications Ziomycin

It is used in the treatment of infectious diseases caused by bacteria that are sensitive to the component azithromycin:

  • ENT organs – sinusitis or otitis media, and also tonsillitis or pharyngitis of bacterial type;
  • respiratory system – community-acquired pneumonia, and along with it, bacterial bronchitis;
  • soft tissues with skin: the initial stage of development of tick-borne borreliosis, impetigo with erysipelas, and in addition, secondary pyoderma;
  • STDs: cervicitis caused by exposure to Chlamydia trachomatis, as well as urethritis (with or without complications).

Release form

Released in tablet form, 6 or 21 pieces inside a blister pack. The pack contains 1 such blister.

Pharmacodynamics

The element azithromycin is a macrolide of the azalide category. This molecule is formed by introducing a nitrogen atom into the lactone ring of type A erythromycin.

The substance acts by inhibiting the process of protein binding of bacteria as a result of synthesis with the ribosomal 50 S-subunit, and in addition by suppressing peptide translocation.

Full cross-resistance to the substances azithromycin with erythromycin, and also other lincosamides with macrolides, is formed among pneumococci, faecal enterococci with Staphylococcus aureus (this includes, among other things, Staphylococcus aureus with resistance to the component methicillin), and also in the so-called β-hemolytic streptococcus, an element of category A.

Acquired resistance may spread differently over time and place for the designated categories, making local resistance data particularly important during treatment of severe infections.

The range of antimicrobial medicinal activity is quite diverse.

Among the sensitive microorganisms are:

  • gram-positive aerobes - methicillin-sensitive Staphylococcus aureus, penicillin-sensitive pneumococci, and along with them pyogenic streptococci;
  • gram-negative aerobes - Haemophilus parainfluenzae with influenza bacillus, also Moraxella catarrhalis with Legionella pneumophila, and in addition Pasteurella multocida;
  • anaerobes – Fusobacterium spp., Clostridium perfringens, Prevotella, and Porphyriomonas spp.;
  • other bacteria - Chlamydophila pneumoniae with Chlamydia trachomatis, and along with this Mycoplasma pneumoniae.

Among the microorganisms capable of acquiring resistance to the drug are: gram-positive aerobes – pneumococci that are resistant to penicillin or have intermediate sensitivity to it.

Bacteria with innate resistance:

  • gram-positive aerobes - fecal enterococcus, as well as methicillin-sensitive Staphylococcus aureus;
  • anaerobes - some pathogenic microorganisms from the category of Bacteroides fragilis.

Pharmacokinetics

As a result of oral administration of the tablet, the bioavailability of the drug reaches approximately 37%. Peak serum levels of the drug are seen 2-3 hours after administration of the drug.

The substance is distributed throughout the body. Pharmacokinetic tests have shown that the level of the component inside tissues is much higher than its plasma values (50 times). This demonstrates its significant connection with tissues.

The level of protein synthesis inside the plasma fluctuates taking into account the existing plasma values and is a minimum of 12% (0.5 μg/ml) and a maximum of 52% (0.05 μg/ml) inside the blood serum. At the same time, the equilibrium value of the distribution volume is 31.1 l/kg.

The terminal plasma half-life is similar to the half-life of Ziomycin from tissues – within 2-4 days.

About 12% of the dose of the drug is excreted simultaneously with urine in unchanged form - over the next 3 days. Very high levels of the unchanged component were noted in bile, where in addition to this, 10 products of drug breakdown were found, formed during the processes of N-, as well as O-demethylation, cleavage of the conjugate of the cladinose element, and in addition to this, during hydroxylation of aglycone, and along with this, desosamine rings.

Dosing and administration

The medicine is taken once a day, without regard to food intake. It is necessary to swallow the tablets without chewing them. If a dose was missed for some reason, this portion should be taken as soon as possible, and all subsequent doses should be taken at intervals of 24 hours.

Children weighing more than 45 kg, as well as adults.

During the treatment of infectious diseases related to the respiratory system, ENT organs, and in addition to soft tissues with skin (in addition to the migratory form of chronic erythema), the total dose of azithromycin per course is 1500 mg. In this case, the daily dose of the drug is 500 mg (a single dose of 2 tablets). The course lasts 3 days.

To eliminate erythema migrans, 3 g of the drug is required for the entire course. The dosage regimen is as follows: take 1 g of Ziomycin on the first day (4 tablets per dose), and then 500 mg (2 tablets per dose) during the period of days 2-5. The total duration of therapy is 5 days.

Treatment of STDs: the total dose of the medicine is 1 g. You need to take 4 tablets of the drug at one time.

Elderly patients.

Because older people may be at risk for developing cardiac electrical conduction disorders, the drug should be used with caution, as its use increases the likelihood of developing torsades de pointes or cardiac arrhythmia.

People with kidney problems.

Azithromycin should be used with great caution in individuals with severe renal impairment (glomerular filtration rate <10 ml/minute).

People with liver disorders.

Because azithromycin is metabolized in the liver and excreted in the bile, it is prohibited to use the drug in the presence of severe disorders in liver function. No tests have been performed on the treatment of such individuals with azithromycin.

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Use Ziomycin during pregnancy

Tests for the effect of the drug on the reproductive system of animals were conducted using dosages that are moderately toxic to the body of a pregnant woman. These tests did not show that azithromycin has a toxic effect on the fetus. Although it is still necessary to take into account that well-controlled adequate tests involving pregnant women have not been conducted. And therefore, since tests of the effect on reproductive activity of animals do not always show results similar to the effect of drugs on the human body, it is recommended to prescribe Ziomycin only in the presence of serious vital indications.

There is information about azithromycin getting into breast milk, although no relevant studies of this effect have been conducted. Therefore, the drug can be used during lactation only in situations where the possible benefit from taking it for the woman being treated will exceed the likelihood of complications in the baby.

Fertility testing was performed on rats - the frequency of conception after using the active component of the drug decreased. But there is no data that the substance can have a similar effect on humans.

Contraindications

Among the contraindications:

  • intolerance to erythromycin with azithromycin, as well as any ketolides or macrolides, as well as other components of the drug;
  • because in theory, when combining the drug with ergot derivatives, the development of ergotism is possible, it is prohibited to combine these drugs;
  • children weighing less than 45 kg.

Side effects Ziomycin

Taking tablets may cause the appearance of certain side effects:

  • pathologies of an infectious or invasive nature: candidiasis (this includes its oral form), vaginal infections, fungal or bacterial infections, pulmonary pneumonia, rhinitis with pharyngitis, and in addition gastroenteritis and pseudomembranous colitis;
  • problems with the general blood flow and lymph: development of eosinophilia, thrombocyto-, leuko-, and also neutropenia and hemolytic anemia;
  • immune disorders: manifestations of hypersensitivity (including Quincke's edema and anaphylactic symptoms);
  • metabolic disorders: the appearance of asthenia or anorexia;
  • mental disorders: a feeling of nervousness, aggressiveness, agitation, anxiety, restlessness, the appearance of hallucinations or insomnia, and along with this the development of delirium;
  • reactions of the nervous system: dizziness or headaches, convulsions, paresthesia, and a feeling of drowsiness. In addition, syncope, parosmia, dysgeusia with ageusia and anosmia with hypesthesia and myasthenia gravis develop. An increase in psychomotor activity is also observed;
  • manifestations in the visual organs: decreased vision or its disorder;
  • disturbances of the auditory organs: hearing loss or disorder (manifestations include tinnitus or development of deafness);
  • disorders in the functioning of the heart: palpitations and changes in the heartbeat rhythm, pirouette tachycardia, as well as arrhythmia (this list also includes ventricular tachycardia) and an increase in the QT interval on the ECG;
  • vascular disorders: the appearance of hot flashes or a noticeable decrease in blood pressure;
  • manifestations from the respiratory system: problems with respiratory function, dyspnea, and also nosebleeds;
  • gastrointestinal dysfunction: discomfort, vomiting, abdominal pain, diarrhea and nausea. Sometimes there is also frequent and loose stool, dyspepsia and bloating, constipation or gastritis, pancreatitis, anorexia and dysphagia. Belching may occur, salivation may increase, dryness of the oral mucosa or ulcers in the mouth may develop, and in addition, the color of the tongue may change;
  • disorders of the hepatobiliary system: liver failure develops (sometimes resulting in death), functional liver disorder, hepatitis (among other things, necrotic and fulminant forms of the pathology) and intrahepatic cholestasis;
  • skin and subcutaneous lesions: itching, dryness, rashes, photosensitivity, increased sweating, development of dermatitis, urticaria, TEN, erythema multiforme and Stevens-Johnson syndrome;
  • dysfunction of muscles and bones: the appearance of myalgia, pain in the neck or back, as well as osteoarthritis and arthralgia;
  • urinary system reactions: renal pain, acute renal failure, as well as dysuria and tubulointerstitial nephritis;
  • problems with the functioning of the mammary glands together with the reproductive organs: uterine bleeding, vaginitis, and in addition testicular lesions;
  • systemic disorders: feeling of malaise or increased fatigue, pain in the sternum, hyperthermia or asthenia, as well as swelling (peripheral type, as well as on the face);
  • laboratory diagnostic results: decreased leukocyte count and bicarbonate levels in the blood. In addition, an increase in the number of eosinophils, neutrophil and monocyte levels, as well as ALT and AST levels. Creatinine, urea or bilirubin levels in the blood, sugar values, alkaline phosphatase, chloride, bicarbonate and chloride may also increase. A decrease in hematocrit levels, a change in blood potassium values and a deviation in sodium levels are also possible;
  • intoxication and damage: development of complications after the procedure.

Overdose

Among the manifestations of poisoning: reactions that occur in the case of taking high doses of drugs, similar to the side effects that appear in the case of taking standard doses - nausea, treatable hearing loss, vomiting and diarrhea.

To eliminate these symptoms, it is necessary to take activated charcoal, and then perform the procedures that are necessary to maintain the stable condition of the victim and treat the disorders.

Interactions with other drugs

Caution is required when using azithromycin in people taking drugs that may prolong the QT interval.

Antacid drugs.

During the study of the pharmacokinetic parameters of the active substance Ziomycin in combination with antacids, no changes in its bioavailability values were found in general, but tests showed a decrease in the peak level of the drug in the plasma (by approximately 25%). It is necessary to use azithromycin at least 1 hour before taking antacids or after at least 2 hours have passed after their use.

Digoxin.

There is evidence that the combination of macrolides (including azithromycin) with substrates of the P-glycoprotein component (including digoxin) causes an increase in serum values of the P-glycoprotein substrate. As a result, with such a combination, it is always necessary to keep in mind the possibility of an increase in the serum level of digoxin.

Zidovudine.

Azithromycin, administered once at a dose of 1000 and 1200 mg or repeatedly at a dose of 600 mg, did not affect the plasma parameters of zidovudine or the excretion of this element in urine (or its glucuronic-type breakdown products). However, the use of azithromycin increased the values of phosphorylated zidovudine (this is a medicinally active breakdown product) in mononuclear cells in the peripheral bloodstream. The significance of this information for treatment is not determined, but this information may be useful for those being treated.

Azithromycin interacts weakly with the hemoprotein P450 system. It is believed that this component does not have the same pharmacokinetic interaction with similar elements that is observed in erythromycin and other macrolides. The substance azithromycin does not induce/inactivate hemoprotein P450 through hemoprotein-metabolite compounds.

Tests were conducted for drug interactions with individual substances that undergo significant metabolism via hemoprotein P450:

  • cyclosporine - some macrolide-related substances may affect the metabolism of this component. Since there is no information on the likelihood of interaction in the case of a combination of azithromycin and cyclosporine, it is necessary to carefully assess the drug picture before prescribing combined treatment. If it is decided that such therapy will be appropriate, it is necessary to closely monitor cyclosporine indicators during its implementation and change its doses in accordance with them;
  • fluconazole - a combination of a single dose of the azithromycin component (1200 mg) with a single dose of fluconazole in the amount of 800 mg did not change the pharmacokinetic characteristics of the latter. The half-life and AUC of azithromycin did not change when combined with fluconazole, although an insignificant decrease in the peak level of azithromycin (by 18%) was noted for the therapeutic picture;
  • nelfinavir - taking azithromycin (in a 1200 mg dose) with an equilibrium dose of nelfinavir (3 times a day, 750 mg of the drug) increases the values of azithromycin. However, no clinically significant adverse reactions were observed, so there is no need to change the dose.

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Storage conditions

Ziomycin should be kept at a temperature of no more than 25°C, out of the reach of children.

Special instructions

Reviews

Ziomycin is considered a very effective medication that helps in the treatment of diseases of infectious origin - for example, it works very well in eliminating pathologies in the ENT organs.

But at the same time, reviews also indicate the presence of some disadvantages, including the presence of many side effects, and in addition, the high cost. Also, when taking the drug, it is necessary to take into account that it is an antibiotic, so it should be taken with caution.

Shelf life

Ziomycin can be used for a period of 3 years from the date of manufacture of the drug.

Attention!

To simplify the perception of information, this instruction for use of the drug "Ziomycin" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.

Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.

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