Azithromycin in otitis

Azithromycin in otitis media: pharmacological action

Azithromycin - the first of the azalides (subgroup of macrolide antibiotics) quickly became one of the most common drugs prescribed by pediatricians.

Azithromycin is used to treat various types of infections caused by bacteria:

• infections of the upper and lower respiratory tract (sinusitis, tonsillitis, pneumonia, etc.);
• skin infections;
• ear infections;
• diseases transmitted through sexual contact.

This drug is resistant to acidic pH, has bioavailability> 30% and a relatively long half-life (up to 96 hours).

The intracellular concentration of azithromycin can be 100 times higher than its concentration in the blood plasma. High drug concentrations in phagocytes partly explain the effectiveness of azithromycin for the treatment of intracellular infectious agents. This quality is also the basis for a five-day treatment with azithromycin in otitis media and acute pharyngitis.

Azithromycin inhibits the synthesis of bacterial proteins. It is effective in the treatment of diseases caused by:

• different gram-positive and gram-negative bacteria;
• some anaerobic microorganisms;
• mycobacteria.

However, azithromycin is inert against gram-positive bacteria that are resistant to erythromycin.

The main problem with the use of azithromycin in otitis media is repeated, resistant pneumococcal strains and a non-optimal clinical efficacy against hemophilic infection.

Modern pediatric recommendations favor the use of azithromycin for the treatment of acute otitis media of the middle ear only when the patient has an anaphylactic allergy to penicillin.

Method of using azithromycin

You can take most forms of azithromycin medication before and after meals.

Admission of azithromycin in the form of an oral is performed on an empty stomach, at least one hour before or two hours after they have eaten.

• Dosage for adultswhen otitis is 500 mg per day at a time. The course of admission is 3 days.
• Dosage for childrenare based on the calculation of 10 mg per kg of body weight once a day. The course of admission is 3 days.

Do not store the prepared suspension for further use. Throw away the suspension, which is not used for 12 hours.

Azithromycin in tablets should be taken once a day. The bioavailability of tablets does not decrease with food intake.

• When otitis children over 12 years of age and adults500 mg of azithromycin is administered once a day. The course of treatment is 3 days.
• To children of primary school agethe drug is given at a rate of 10 mg per kg body weight once a day. Usually appoint a three-day course of admission.

Important

Take exactly as directed by your doctor. Follow the instructions on the instructions. The dose and duration of treatment with azithromycin are not the same for different types of infection.

Only a doctor can decide to prescribe an antibiotic for otitis in adults, depending on the confidence in the diagnosis, the age of the patient and the severity of the symptoms.

Not all forms of otitis should be treated with antibiotics.

It is important to distinguish acute catarrhal otitis, which can be treated with antibiotics from exudative otitis media, in which the use of antibiotics is still controversial. When otitis with effusion, antibiotics can help if the fluid is in the ear after several months of treatment and causes hearing impairment in both ears.

Many children do not need an antibiotic, because their ailment is not caused by a bacterial infection.

gajmorit.com

Antibiotics for otitis

Otitis is an otolaryngological disease that is associated with the course of the inflammatory process in various parts of the ear. There are external and middle otitis, both of which can be both chronic and acute.

Otitis - treatment with antibiotics

Bactericidal agents are applied topically (externally) and internally. The type of antibiotic therapy is prescribed depending on the type of otitis and the nature of the course of the disease.

What antibiotics to drink with chronic purulent otitis, and which ones to use externally?

The use of bactericidal preparations for chronic otitis is justified if the inflammatory process is in the acute stage and the purulent contents appear at the site of the disease localization.

Symptoms:

• gradual deterioration of hearing;
• increased body temperature;
• the appearance of ears of mucous consistence with purulent inclusions;
• pain in the ear;
• weakness;
• pallor.

Typically, antibiotics are used from the following list:

1. For oral administration:

• ampicillin (ampicillin trihydrate). Scheme: one capsule 4 r. in day 5 days;
• amoxicillin. Scheme: one capsule 3 r. a day for 10 days;
• spiramycin. Scheme: one capsule 2-3 r. in day 7 days;
• ciprofloxacin. Scheme: one capsule 2 r. a day is also 7 days;
• azithromycin: one capsule 1 p. a day, for three days;
• phenoxymethylpenicillin: three capsules per day for 5 days.

2. For injection:

• cefazolin - intramuscular injection, up to 4 r. per day, 5 days;
• Netilmicin - ear injection, 2 r. per day for 7 days.

3. For topical application (instillation in the ear), an alcohol solution of chloramphenicol is used.

What antibiotics should I take with acute otitis media, and which ones should be applied externally?

Acute catarrhal otitis media, in general, does not require antibiotic therapy. The appointment of such drugs is necessary only in extreme cases, when traditional treatment has not had positive results.

Symptoms:

• sharp pain in the ear;
• obstruction of the ear;
• a strong increase in body temperature;
• noise in the ear;
• headache;
• tooth pain.

Antibiotics are used:

1. For oral administration, the same drugs are used as in the case of chronic purulent otitis media.
2. For intramuscular injections, it is recommended to use cefazolin.
3. For topical application:

• normax;
• norfloxacin;
• otofa;
• cipromed;
• fugentin;
• fuzafunzhin - spray.

Drops are used according to the instructions.

What antibiotics can I treat with external otitis media?

Usually, the use of local antifungal agents is sufficient to treat inflammatory processes on the skin of the external auditory canal. If the nature of the disease is protracted and accompanied by severe pain, it is justified to prescribe bactericidal preparations.

Symptoms:

• pain from touching the auricle;
• an earache;
• feeling of ear stiffness;
• increased lymph nodes;
• low hearing loss;
• purulent discharge from the auricle.

Antibiotics for external otitis:

1. For oral administration:

• nystatin: two capsules 4 r. in day 14 days;
• azithromycin: on the first day of treatment - two capsules per day, starting with the second - one capsule of 1 p. per day, only 5 days;
• Ampicillin: one capsule 3 r. per day for 5 days.

2. For topical application:

• ofloxacin;
• neomycin;
• sophrax;
• gramicidin - alcohol drops;
• Oxycort - ointment with hydroortisone and oxytetracycline.

Preparations for topical use are instilled and applied in accordance with the attached instructions.

Do not self-prescribe bactericidal drugs and antibiotic therapy. This can lead to a worsening of the general condition and provoke the development of superinfection.

WomanAdvice.ru

How to treat otitis media of the middle ear depending on the form of the disease

The average otitis is expressed in the inflammatory process in the middle ear department. The disease, depending on the form, can manifest itself differently.

In different parts of the middle ear, such as the auditory tube, the tympanum, the mastoid process, the inflammatory process can be caused to a greater or lesser extent.

Not always it is possible to put the exact diagnosis on the basis of external survey.

In such cases, a more detailed diagnosis may be required. Conducting diagnostic procedures will help determine how to treat otitis media of the middle ear.

The purpose of the survey is to determine the following indicators:

• stage of the disease;
• type of pathogen;
• indication for taking antibiotics;
• accompanying complications: perforation of the tympanic membrane, purulent contents, hearing loss.

Often, the average otitis occurs against the background of infectious diseases of the nose, such as sinusitis, chronic rhinitis, sinusitis. In this case, the infection occurs due to sneezing, incorrect blowing.

Also, the infection can penetrate into the middle ear as a result of trauma, hypothermia, drafts, meningitis, and immunity.

Otitis media are distinguished by the following manifestations:

• acute and chronic forms;
• purulent, serous and catarrhal (otitis morphology).

How to treat otitis media of the middle ear and what medications the doctor decides, based on the form of otitis, the course of the disease, the physiology of the patient and other factors.

Treatment of otitis media of the middle ear with antibiotics and drops

Treatment of otitis media of the middle ear should be started as soon as possible. Inflammation of the middle ear as a result of improper treatment or its absence can cause serious complications.

The medication for otitis media of the middle ear is prescribed in accordance with the form of the disease and includes the following medicines:

• antibiotics;
• antipyretics;
• painkillers;
• ear drops.

Antibiotic in otitis media is not always prescribed. If the disease touched one ear and has mild symptoms, then it is possible to confine oneself to antipyretic and analgesic drugs.

Treatment with antibiotics is prescribed without fail in the following cases:

• age up to two years;
• both ear are sick;
• an accurate diagnosis is made;
• clearly show symptoms:
• heat;
• acute pain.

Antibiotic in otitis media is selected based on the sensitivity to the drug and the presence of allergies in the patient.

Antibiotics "1st line

• penicillin;
• cephalosporin:
• amoxicillin;
• augmentin;
• amoksiklav;
• cefazolin;
• ceftriaxone.

Antibiotics "2nd line

• clarithromycin;
• levofloxacin;
• azithromycin.

Depending on the complexity of the disease, treatment of otitis media of the middle ear includes the taking of painkillers, remedies against the common cold. With concomitant disease, you need to get a doctor's advice about which drops to use better. Antihistamines are prescribed concomitantly with antibiotics.

Drops from the otitis media of the middle ear are divided into three types:

• contain anti-inflammatory components: otypax, otinum (anti-inflammatory ear drops);
• contain antibacterial components: otofa, normax, tsipromed;
• combination dropscontain antibiotic and glucocorticosteroids: sfradex, dexon, anauran.

Ear drops are prescribed based on the way the middle ear disease is affected. Since this part of the body is closed from the outer tympanic membrane, the use of drops is advisable only on indications.

It should be remembered that drops from the otitis media of the middle ear, in which an antibiotic is present, are prescribed by a doctor only in rare cases. Such drops can be not only useless, but also dangerous in the event that a perforation of the tympanic membrane has occurred. In this case, the antibiotic is better taken orally.

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gajmorit.com

Antibiotics for otitis

Otitis is an acute or chronic inflammatory process in various ear zones (external, middle or inner). Antibiotics in otitis are prescribed necessarily, based on the severity and stage of the process, the sensitivity of microorganisms, the degree of development of clinical symptoms, the age of the patient.

Untreated ear infections require the appointment of stronger antibiotics. Sometimes it is necessary to use not one, but several types of antibacterial agents, if the pathological process is in a neglected stage.

Consider the advisability of antibiotic therapy for inflammatory diseases of the ear.

Do you need antibiotics for otitis?

Antibiotic therapy is very important in the development of inflammatory processes. However, many experts are of the opinion that before the spontaneous perforation of the ear membrane and the exit of the exudative fluid, there is no need to prescribe antibiotics. The acute stage of uncomplicated otitis usually lasts for 5 days. Antimicrobial therapy is used in cases when symptomatic treatment of catarrhal otitis does not bring relief to the patient: the ear pain does not pass, the severity of the hearing worsens, there are signs of general intoxication organism.

When purulent discharge appears, an analysis is made of the content of microflora and the determination of its sensitivity to antibiotics. If there is no way to gain access to exudate, they make a puncture for taking samples of the intra-oral contents, or dispense with the prescription of broad-spectrum antimicrobials.

Prevention of complications, especially in patients with low immune defense, can also serve as an indication for the prescription of antibiotic therapy.

What antibiotics to drink when otitis?

The most popular remedy, amoxicillin, has an excellent antimicrobial and antiseptic effect. In the absence of a patient's allergy to semisynthetic penicillins, it can be successfully administered at any stage of the inflammatory process. However, this drug is contraindicated in patients with impaired functional ability of the liver, during pregnancy and breastfeeding.

Aminoglycoside, netilmicin, is a drug for local injection use, used for no more than 14 consecutive days. Has good therapeutic parameters and a minimum of side effects.

The question about the appointment of medications is taken by the doctor individually after the results of the tests for the microflora of secretions.

If it is not possible to test the sensitivity of microflora to the action of antimicrobial agents, broad-spectrum drugs are prescribed:

• levomycetin, alcohol solution. Used on 2-3 drops with purulent otitis;
• amoxicillin 3 gram per day;
• augmentin 375 mg 3 times a day;
• cefuroxime IM injection;
• ceftriaxone 1 time per day;
• ampicillin in / m injection.

The connection of antibiotics to the otitis treatment schedule significantly reduces the likelihood of complications and improves the prognosis of the disease.

Antibiotics for otitis in children

Immediately before prescribing any medications, the child needs to assess his general condition and determine the further treatment tactics.

If a child has signs of otitis, it should not be rushed to prescribe antibiotics. They are used only in severe, moderate and complicated cases, especially in children under 2 years old, when the immune system is still in its infancy.

With an easy course of the inflammatory process, older children are usually treated with the elimination of clinical manifestations of the disease, using analgesics, ear drops, compresses, ointments, lotions. But if there is a characteristic picture of the general intoxication of the body, there is an increased temperature, persistent headaches - you can not do without antibiotics. In such cases, the sick child is hospitalized in the hospital, where the doctor decides on the further use of the drugs. Typically, preference is given to the known and effective antibiotic amoxicillin. However, if within two days after taking the child's well-being did not improve, another drug, for example, from the cephalosporin series, is prescribed.

During the treatment with antibiotics, the prescribed dosage should be strictly observed throughout the entire prescribed course, even in cases of persistent improvement in the general condition of the patient. Because of the unmotivated dose reduction, weakened, but living bacteria can gain new strength, and then the inflammatory process will flash again.

Antibiotics for otitis in adults

Otitis in adults often has an infectious etiology. Therefore, antibacterial drugs are used quite often, along with analgesics and anti-inflammatory drugs, with warming procedures and washing with antiseptic.

The type of antibiotic administered is determined depending on the infection present in the ear. In severe cases, several types of antibiotics can be used concomitantly, for example, orally and as intramuscular injections.

In acute otitis media, antibiotics are prescribed without fail: amoxicillin, amoxiclav, doxycycline, rovamycin. The drugs are administered in the form of tablets and capsules for internal use, and for severe and unfavorable course of the disease, intramuscular or intravenous injections are used.

Antibiotic therapy with caution is prescribed to elderly people and is categorically contraindicated in women during gestation and breastfeeding of a child.

Antibiotics for acute otitis media

The acute course of otitis is characterized by a sharp increase in symptoms, a rapid deterioration in the overall well-being of the patient - worried painful pain in the ear, giving away the entire half of the head and teeth, a rapid rise in body temperature to 39 degrees.

Very effective in such situations antibacterial agents, applied topically, in the form of drops and ointments. But in many cases there is a need for taking systemic drugs. Combined antibiotics have a wider range of effects, high functional activity. Such combinations of drugs as neomycin + bacitracin, polymyxin + hydrocortisone have high performance indicators.

For the treatment of acute otitis can be used any of the antibiotics of a wide range of applications that have a pronounced bactericidal action and restore the natural weakly acidic environment of the auditory passage. The most suitable are semi-synthetic penicillins, resistant to beta-lactamases (dicloxacillin orally or oxacillin intravenously, and also a group of cephalosporins).

Antibiotics for chronic otitis media

Chronic otitis develops, as a rule, with improper or untimely treatment of acute inflammation.

In chronic otitis, a wide variety of pathogens is characteristic, mixing various types of bacteria in the exudate, which greatly complicates the choice of antibiotic and the appointment of a general scheme treatment. Destruction of the polymicrobial flora requires the use of more powerful drugs, and sometimes their combinations.

In the case of long-standing and hard-to-treat chronic forms of otitis, medications such as sparflof (400 mg orally at first, on subsequent days, 200 mg daily), avelox 400 mg daily for one reception. The course of treatment should last from 10 to 14 days, with mandatory background reception of antifungal and normalizing microflora drugs and vitamin complexes.

Ciprofloxacin is a fluoroquinolone antibiotic, which is very popular in medical institutions in Europe. This drug is good in that it has a harmful effect on both active bacteria and immobile ones. It is taken on an empty stomach three times a day, the maximum daily dose of 750 mg.

Antibiotics for medium otitis media

Otitis media, the most common form of otitis media, is an inflammatory process in the middle ear region.

Antibiotic therapy is prescribed, as a rule, with the development of complications, a protracted course of the disease and the presence of fluid in the ear canal. The most suitable drug is selected based on the patient's allergic sensitivity, his condition and age. If it is impossible to clarify which specific pathogen caused the disease, a systemic antibiotic is prescribed, on a wide spectrum of the most typical pathogens of otitis media (pneumococcal infection, hemophilic rod, moraxella and other).

Most often in the treatment of otitis media preference is given to amoxicillin. The usual dosage for adults is 3 g daily, three times a day. Children take 85 mg per kg of body weight per day.

If after 2-3 days the clinical picture does not improve, it is necessary to replace this antibiotic with a stronger combination drug - for example, amoxiclav, cefuroxime.

Antibiotics for purulent otitis

The development of purulent otitis is characterized by the breakthrough of the internal membrane and the release of purulent contents outwards.

During this period it is advisable to designate rinses with antimicrobial agents (not having ototoxic action, that is, not depressing the auditory function), the introduction of combined solutions into the ear cavity antibiotics. Such procedures are carried out exclusively in a hospital or clinic by an otolaryngologist.

General therapeutic methods for purulent otitis do not differ from those in the standard inflammatory process. Antibacterial therapy is carried out by complex preparations erythromycin, clarithromycin, amoxiclav, ceftriaxone. With the development of complications and long-term course of the disease, non-steroidal anti-inflammatory drugs (diclofenac, olfen) are connected. The well-known drug of the first generation ampicillin remains popular, although more rational use of newer drugs - amoxicillin (flemoxin, ospamox).

Antibiotics for external otitis

External otitis affects the skin of the ear, the outer zone of the auditory canal and the periosteum, which is located just under the skin. If it is not possible to examine the state of the tympanic membrane and to exclude a deeper spread of the process, the treatment is prescribed simultaneously for both external and internal otitis media.

The main point in the treatment of external otitis media is the use of antibiotics in the form of ear drops (ofloxacin, neomycin). You can also use a cotton swab with an antimicrobial ointment or antibiotic solution, injected deep into the ear canal. Such a tampon should be changed every, hour during the day.

It is necessary to connect additional methods of treatment, such as warming compresses, vitamin therapy, support of intestinal microflora.

Most often, in the treatment of external otitis media, there is no need to prescribe antimicrobial agents. Antibiotic therapy is carried out only in cases of complications, or in patients with critically weakened immune forces of the body.

Drops from otitis with antibiotic

Drops used to treat ear inflammatory processes are usually very effective, since they are injected directly into the inflammatory focus. They can be of several types:

• hormonal anti-inflammatory drugs (otinum, otypaks);
• solutions of antibiotics (levomitsetin, noraks, tsipromed, fugentin);
• Combined solutions combining the action of an antibiotic and a glucocorticoid (sfradex, anauran, polydex, garazon).

The drug anauran is applicable for all types of acute and chronic forms of otitis, used by adults and children 3-5 drops three times a day.

Drops of sfradex can be used for medicinal purposes with otitis and conjunctivitis, have a strong anti-inflammatory and antiallergic local effect.

Drops, as a rule, have a fairly wide range of action. Used topically 4 drops twice a day in the affected ear, children 2-3 drops three times a day.

Ear drops, which contain corticosteroids, are cautiously prescribed to young children and pregnant women.

If you suspect a possible allergic reaction (swelling of the ear, the appearance of rash, itching) The use of drops is stopped, and the doctor reviews the treatment regimen and replaces the drug for more suitable.

The best antibiotic for otitis

The best antibiotic for otitis is determined by the results of the analysis for the microflora. As for preparations of a wide spectrum of action, it should be especially noted amoxicillin, which is most often used in medical practice with various types of otitis and in most cases has a positive therapeutic effect in all age groups.

Amoxicillin belongs to the penicillin series of antibiotics, it oppresses the action of most harmful microorganisms: streptococci, staphylococcus, E. coli, etc.

The drug is administered separately from food intake, g, g 3 times a day, with a complicated disease up to 3 grams per day. The duration of taking amoxicillin, like any other antibiotic, is at least 8-10 days. Even with a marked improvement in the patient's well-being and the disappearance of clinical symptoms, treatment continues until the indicated time. Untimely cancellation of antimicrobial agents can trigger a relapse of the inflammatory process, and in a more severe form.

How to cure otitis without antibiotics?

Therapeutic actions in uncomplicated otitis media may not include antibiotics. Sometimes there is more than enough conservative complex treatment of the inflammatory process:

• if necessary, prescribe antipyretics (aspirin, paracetamol);
• three times a day otipax preparation - 2 drops per diseased ear;
• application of a nasal spray to remove the edema of mucous membranes (nasivin, noxprey, etc.);
• at regular intervals, change ear pads with the drug substance (boric alcohol, vodka, onion juice);
• with external otitis, apply antibacterial agent to the ear and the adjacent zone;
• when inflammation should drink a lot of fluids, as with colds (tea made from raspberries, currants, dogrose, linden);
• provide the patient with peace, monitor the absence of drafts.

At the first signs of otitis, you can try to use folk methods of treating the disease. Even those plants that grow directly in the house, on the window: aloe, colanchoe, agave, geranium, can be useful. A freshly cut leaf or a portion of it is folded into a turunda and inserted into a sore ear. You can squeeze out the juice from the plants and dig it in 3-5 drops into the diseased ear.

As a drop, you can also use a warm solution of honey, celandine juice, mint tincture, boric alcohol.

During treatment, you should drink a lot of liquid, it is not superfluous to take multivitamin complexes, as well as funds that strengthen immunity.

With a clear deterioration of the patient's condition, it is still necessary to consult a doctor to prevent further progression of the disease and the development of complications.

To avoid inflammation in the ear, remember that during the cold season it is not permissible to go out to street without a headdress, the more you should not do this immediately after showering or taking bath. After visiting the pool or swimming on the beach, you need to wipe your ears well, not allowing a long time of water, especially dirty, in the ear canals.

If the disease still comes up, treatment is best conducted under the supervision of a specialist who will prescribe the appropriate treatment and the necessary antibiotics for otitis.

ilive.com.ua

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