Bi-tol

Bi-tol is an antimicrobial drug used for systemic therapy.

Indications Dancing

It is used for diseases whose development is triggered by the activity of bacteria sensitive to the medicament:

• lesions in the respiratory tract (pneumonia with bronchitis, and in addition the pneumocystic form of pneumonia);
• inflammations affecting the middle ear and lateral nasal sinuses;
• infections in the area of kidneys and urinary ducts (pyelitis with urethritis, as well as pyelonephritis or cystitis);
• genital lesions with bacterial genesis;
• diseases affecting the digestive tract and triggered by the activity of Shigella strains with Salmonella and Escherichia coli;
• purulent dermatitis .

[1], [2]

Release form

The release of the drug is made in the form of a suspension for oral administration, in 0.1 l bottles having a capacity of vials or jars, also equipped with a measuring cup.

Pharmacodynamics

The drug is complex, it contains the component sulfamethoxazole (it is a sulfanilamide, which slows down the binding of vitamin B9), and in addition, trimethoprim, which is a derivative of diaminopyridine (it slows down the dehydropholic acid reductase with a proportion of 5k1).

The drug has bactericidal and bacteriostatic properties. Has a large range of therapeutic activity - with respect indolpolozhitelnyh Proteus strains (here includes ordinary Proteus), Escherichia coli (here also included enteropathogenic strains) klebisell, Enterobacteriaceae with the bacterium Morgan, and in addition, Proteus mirabilis, Haemophilus influenzae, Rneumocystis carinii, pneumococcus and Shigella Flexner with Shigella Sonne.

[3], [4], [5], [6]

Pharmacokinetics

The drug is absorbed at high speed inside the gastrointestinal tract. Values of serum Cmax are noted after 1-4 hours, and the effect itself lasts for about 12 hours.

The substance passes inside the fluids with tissues: inside the palatine tonsils, lung tissues, cerebrospinal fluid secreted by the inner ear, kidneys, prostate, as well as vaginal and bronchial secretions. In addition, excreted in breast milk and passes through the placenta. The indicator of the distribution volume of sulfamethoxazole is 0.36 l / kg; trimethoprim - 2 l / kg. Metabolic processes of drugs occur inside the liver.

Excretion of both substances occurs mainly through the kidneys. The biological half-life of sulfamethoxazole is 9-11 hours, and trimethoprim is 2 hours. The half-life of the drug in children is determined by their age: up to 12 months of age - within 7-8 hours; 1-10 years - 5-6 hours.

[7], [8], [9], [10]

Dosing and administration

Suspension is taken orally, after taking food. Before use, the substance must be shaken to obtain a homogeneous mixture. Complete with a bottle also produced a special measuring cup, having a division.

The drug is prescribed in the following portions:

• babies aged 0.5-2 years - in the amount of 2.5 ml (corresponding to 0.12 g) at 12-hour intervals;
• age of the child within 3-5 years - dosage of 5 ml (corresponds to 0.24 g) with 12-hour intervals;
• at the age of 6-12 years old - intake of 10 ml (corresponds to 0.48 g) with 12-hour breaks;
• adolescents from 12 years and adults - the use of 20 ml (corresponding to 0.96 g) at 12-hour intervals.

The therapeutic cycle lasts 10-14 days (for infections in the gastrointestinal tract it is 5 days).

If the infection has occurred under the influence of Pneumocystis carinii, it is required to apply 0.1 g / kg of sulfamethoxazole per day, as well as 20 mg / kg of trimethoprim in equal portions, at 6-hour intervals, for 2–3 weeks.

[13]

Use Dancing during pregnancy

It is forbidden to take Bi-tol during pregnancy or breastfeeding.

Contraindications

Main contraindications:

• strong sensitivity to drug elements;
• renal failure or hepatic activity, which has a severe degree of severity;
• anemia triggered by vitamin B9 deficiency;
• agranulocytosis.

It is forbidden to appoint children suffering from hyperbilirubinemia, pharyngitis or tonsillitis streptococcal nature.

[11]

Side effects Dancing

Taking the suspension can trigger the development of some side effects:

• gastrointestinal dysfunction: vomiting with nausea and loss of appetite. Occasionally, there is pain in the abdominal area, diarrhea, or inflammation of the gastric mucosa;
• allergy symptoms: often urticaria and rashes. Occasionally, itching, photosensitivity, polyformal erythema and exfoliative dermatitis occur. Chills or fever may occur;
• disorders of hematopoietic activity: neutro or thrombocytopenia. Occasionally, anemia of a megaloblastic nature or agranulocytosis occurs;
• others: dizziness, hepatitis of parenchymatous nature, sleep disorders and treatable dysfunction of the central nervous system, and in addition hallucinations, headaches and disorders of the kidneys (hematuria, crystalluria or hypercreatininemia) develops rarely.

Occasionally, there may be a strong negative reaction to taking sulfonamides: such as heating elements and Stevens-Johnson syndrome. In addition, pancreatitis, acute hepatic necrosis, allergic nature of myocarditis, aseptic type meningitis, inflammation in the oral mucosa, state of apathy or depression, and besides pain in the area of muscles with joints may appear. The stomatitis, myalgia, colitis of pseudomembranous nature, glossitis, pulmonary infiltration, arthralgia and photophobia are rarely observed.

[12]

Overdose

Drug intoxication leads to the appearance of pronounced signs of negative reactions. Among these are dizziness, nausea, drowsiness, colic, headaches, vomiting, visual disturbances and loss of consciousness. In addition, fever or depression, hematuria, a sense of disorientation and crystalluria develop. Prolonged poisoning causes the occurrence of jaundice, leuco- or thrombocytopenia, as well as anemia of a megaloblastic nature.

To eliminate the violations, stop taking the drug, perform gastric lavage and induce vomiting. You also need to consult a medical professional. Taking into account the resulting damage, symptomatic procedures are performed. Hemodialysis will be ineffective.

[14],

Interactions with other drugs

Difenin, hypoglycemic drugs, NSAIDs, barbiturates and anticoagulants with indirect type of influence increase the likelihood of adverse effects.

Ascorbic acid increases the possibility of crystalluria.

Diuretics, especially thiazide, in older people increase the likelihood of thrombocytopenia. Bi-tol in such patients is able to increase serum digoxin values.

The combination with tricyclics leads to a weakening of their medicinal properties.

The drug can potentiate the effects of diphenyl, anticoagulants and phenytoin, and with it reduce the effectiveness of oral contraception. In addition, the drug increases the serum values of the free fraction of methotrexate.

[15], [16]

Storage conditions

Bi-tol is required to be kept in a place closed from the infiltration of children, at temperature marks not exceeding 25ºС.

Shelf life

Bi-tol can be used within 36 months from the moment of production of the pharmaceutical agent. After opening the package, the shelf life of the drug is 28 days.

Application for children

Do not assign to infants up to 6 months of age.

[17]

Analogs

Analogues of the drug are drugs Bakteptol, Oriprim, Triseptol and Bactrim with Grossptol. In addition, Bel-septol, Blepeseptol with Bi-septum, Co-trimoxazole and Bikotrim with Sumetrolim, as well as Raseptol, Biseptol, Soluleptol and Biseptrim are on the list.