Azithromycin during pregnancy

Antibiotic group of macrolides of the third generation Azithromycin during pregnancy can be prescribed by a doctor only in cases of extreme necessity, when its health benefit for a pregnant woman does not cause doubts in the doctor, far exceeding the probability of adverse effects on the fetus.

Other trade names for this medication are: Azithromycin dihydrate, Sumamed, Sumamecin, Azitral, Azitrox, Zitrolite, Hemomycin.

[1], [2], [3],

Indications of the azithromycin in pregnancy

Azithromycin in the 2nd trimester of pregnancy and Azithromycin in the 3rd trimester of pregnancy are prescribed for serious infectious inflammatory diseases caused by the most frequent pathogens during pregnancy: Streptococcus pneumoniae and Streptococcus pyogenes, Staphylococcus aureus, Neisseria gonorrhoeae, Gardnerella vaginalis, Chlamydia trachomatis, Mycoplasma pneumoniae, Mycobacterium avium complex , Bacteroides fragilis, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdorferi, and others.

Such diseases include bacterial vaginosis; chlamydia (chlamydial cervicitis); urethritis; endometritis; pelvic inflammatory diseases caused by gonococci; pyelonephritis; purulent sinusitis, pharyngitis or tonsillitis; purulent otitis media; bacterially caused pneumonia; scarlet fever; Tick-borne borreliosis (Lyme disease), which occurs when a bite of ixodid ticks infected with Borrelia spirochetes.

[4], [5], [6]

Can Azithromycin be used during pregnancy?

Azithromycin in the planning of pregnancy is prescribed in the same cases, as well as with infected dermatoses and erysipelas.

[7], [8], [9]

Release form

Powder or lyophilizate for the preparation of solution for injection, tablets, capsules. Sumamed is also available as a powder for the preparation of a suspension taken internally.

[10],

Pharmacodynamics

Bacteriostatic, and for some infections and bactericidal action of Azithromycin is due to binding to the transferase catalysts of the subunit of the 50S ribosome of microorganisms, as a result of which the order of translocation of RNA chains is disrupted and protein formation is suppressed.

In addition, the active substance azithromycin dihydrate stimulates tissue immunity cells, activating chemoksis of T-leukocytes, neutrophils and phagocytes.

[11], [12]

Pharmacokinetics

Due to its high acid resistance, Azithromycin in the form of tablets is absorbed quickly enough in the gastrointestinal tract and enters the systemic circulation and tissues of the respiratory and urinary tract. After 2.5-3 hours after taking the drug concentration in the plasma reaches a maximum with a bioavailability of about 40%. The peculiarity of macrolides is accumulation in cells damaged by microbes and phagocytes, therefore Azithromycin during pregnancy does not give fetotoxic effects.

In this case, after the course of taking the active substance is at the site of inflammation in the therapeutic concentration for five to six days.

Transformation of the drug occurs in the liver; two-stage excretion is performed by the kidneys - in the first day after application on average for 28-40 hours.

[13], [14],

Dosing and administration

During pregnancy, oral antibiotic use is preferable to parenteral, so it is more often prescribed Azithromizine in the form of tablets (1.5 hours before or after meals).

In inflammatory diseases of the respiratory tract, skin and soft tissues - one tablet (0.5 g) once a day, duration of admission - three days. With urogenital infections - once a day, two tablets of 0.5 g (1 g).

When bitten by an infected tick and borreliosis, two tablets of 0.5 g (1 g) should be taken on the first day, and 0.5 g per day in the next 4 days (the total course of treatment is 5 days).

[17], [18],

Contraindications

It is contraindicated to use Azithromycin in the first trimester of pregnancy, with increased sensitivity to antibiotics of the macrolide group, with hepatic and / or renal insufficiency.

[15], [16]

Side effects of the azithromycin in pregnancy

Macrolides do not belong to teratogenic antibacterial agents, but the side effects of azithromycin in pregnancy can manifest as nausea and diarrhea, abdominal pain, ringing in the ears and hearing loss, increased heart rate, and skin allergic reaction.

It should be borne in mind and a side effect such as candidiasis of the vagina (thrush), which often occurs when using antibiotics. The suppression of obligate microflora by the preparations of this group contributes to the activation of fungal infection, in particular, fungi Candida albicans.

Overdose

Overdose Azithromycin leads to increased side effects, and with prolonged overdose, stagnation of bile may occur and liver inflammation develop.

[19], [20], [21]

Interactions with other drugs

Azithromycin is not prescribed concomitantly with antacids on the basis of magnesium or aluminum, anticoagulants, hypoglycemic agents and heparin.

[22], [23]

Storage conditions

Storage conditions - at a temperature of + 18-25 ° C.

[24],

Shelf life

Shelf life - 24 months.

[25], [26],

Reviews

The doctors' comments on the effectiveness of Azithromycin and its broad spectrum of antimicrobial activity put this drug on the first place among antibiotics-macrolides used for pneumonia and purulent tonsillitis, and also for second place in the treatment of gonorrhea, chlamydia and mycoplasmosis.