Macrolides are considered one of the most effective and safest antibacterial drugs for children. They are often prescribed for respiratory tract infections by microorganisms and are in demand for otitis media, pneumonia, sinusitis, or bronchitis. One of the most popular drugs of this group can be called "Klacid". Not everyone knows in what form it is prescribed to children, is it allowed for infants, how to calculate its dose and what analogs can be replaced if necessary.
Release form
Klacid is produced in three different versions:
- Suspension powder. It is placed in a 60 or 100 ml bottle with a line mark and is represented by almost white granules with a fruit scent. After mixing with water, it forms a white, opaque liquid that smells like fruit. This form is produced in two different dosages, allowing the use of the medication for children of different ages. The bottle comes with a plastic spoon or a graduated syringe to accurately measure the right amount of sweet medicine.
- Pills. They have a yellow shell and an oval shape convex on both sides. Such tablets are also produced in two dosages and are packed in blisters of 7, 10 or 14 pieces. One pack contains 7 to 42 tablets.
- Lyophilisate for injections. It is presented as a white powder with a slight specific odor. This product is housed in hermetically sealed glass vials, which are sold 1 piece or in a pack of 121 pieces.
Separately, the drug "Klacid SR" is produced, presented in coated tablets with a prolonged effect. They are characterized by an oval shape and yellow color. These tablets are sold in packs of 5 to 56 pieces.
Composition
The active ingredient in each form of the drug is clarithromycin. Its dosage in 5 ml of suspension can be 125 mg or 250 mg. Tablets can contain 250 mg or 500 mg of such a substance in each. A vial with a lyophilisate contains 500 mg of the active ingredient. The dosage in "Klacid SR" is also 500 mg in one tablet.
Additionally, the medicine includes:
- Sucrose, fruit flavor, xanthan gum, K90 povidone, maltodextrin, potassium sorbate and other substances in the suspension powder.
- Talc, hypromellose, microcrystalline cellulose, vanillin, stearic acid, croscarmellose, sorbic acid and other compounds in the composition of tablets.
- Sodium hydroxide and lactobionic acid in injection form.
- Magnesium stearate, antria alginate, citric acid, macrogol and other components in the drug "Klacid SR".
Operating principle
"Klacid" acts on the ribosomes of bacteria, as a result of which protein synthesis in microbial cells is suppressed. Usually sensitive to the drug:
- Staphylococcus aureus;
- pneumococci and some other streptococci;
- listeria;
- hemophilic sticks;
- gonococci;
- moraxelles catarralis;
- legionella pneumophila;
- mycoplasma pneumonia;
- chlamydia;
- ureaplasma;
- mycobacteria;
- Helicobacter pylori.
Clostridia, peptococci, whooping cough sticks, bacteroids, borrelia, campylobacter and some other microorganisms are destroyed by clarithromycin in laboratory studies. If they are the causative agents of the disease, then Klacid should be used after a sensitivity test to make sure that the medicine will work.
Indications
The medicine is prescribed:
- with bronchitis;
- with pharyngitis;
- with pneumonia;
- with sinusitis and other sinusitis;
- with otitis media;
- with laryngitis;
- with tracheitis;
- with folliculitis, impetigo, erysipelas and other skin lesions;
- with mycobacterial infection;
- when infected with chlamydia;
- to eliminate H. pylori and prevent recurrence of peptic ulcer disease;
- with pulpitis, periodontitis and other infections called odontogenic.
The medication is recommended for use only when infected with microorganisms that are sensitive to clarithromycin. Prescribing a medicine for angina, whooping cough, scarlet fever and other infectious diseases, it is first advisable to determine whether the "Klacid" will affect their pathogen.
From what age is it allowed to take?
The drug in the form of a suspension is not prescribed for newborns and infants up to 6 months, since the safety of the drug for such small patients has not been established. For children over 6 months of age, the medicine should be prescribed by a doctor who will evaluate the indications and calculate the required dosage by weight.
The tablet form is not used for babies who have not reached the age of 3, but even for children over three years of age, the medication is often prescribed in suspension, which is due to the simpler dosing of liquid medicine. The drug "Klacid SR" is used in the treatment of children over 12 years old, if their weight is more than 40 kg.
Injections are not prescribed for children under 18 years of age. They are in demand only in very severe infections or in a situation where it is impossible to take "Klacid" inside. Such injections are done exclusively by intravenous drip, mixing the lyophilisate with sterile water, and then with glucose or saline. As soon as the patient's condition improves, they immediately switch to suspension or tablets.
Contraindications
The medication is not used for allergies to clarithromycin or another ingredient of the selected form, as well as intolerance to any other antibiotic that is included in the macrolide group. In addition, "Klacid" is not prescribed or used under medical supervision:
- with severe liver disease;
- with renal failure;
- with hypokalemia;
- with porphyria;
- with heart failure;
- with bradycardia or arrhythmia.
The suspension should not be given to patients with isomaltase or sucrase deficiency, as well as with glucose-galactose malabsorption or fructose intolerance. In addition, this form is not recommended for children with diabetes.
Side effects
Treatment with "Klacid" can cause:
- allergic rash;
- insomnia;
- headaches;
- heavy sweating;
- diarrhea;
- nausea;
- abdominal pain;
- vomiting;
- taste disorders;
- changes in liver function tests.
Sometimes the medicine causes fever, chills, fatigue, discoloration of urine, increased urea or creatinine levels, leukopenia, liver damage, arrhythmias, nosebleeds, constipation, muscle pain, decreased appetite, seizures, and other symptoms. If they appear in a child, the question of continuing treatment with Klacid should be resolved with the pediatrician.
When taken for very long periods of time, the bacteria can become insensitive to the drug, requiring a different antibiotic. Long-term use of "Klacid" can cause activation of the fungal infection.
Instructions for use
Suspension
The drug is not available ready-made, so parents need to prepare it for admission on their own. The powder should be mixed with water immediately before use, since the finished medicine is stored for a certain time.
After opening the bottle, pour inside non-carbonated plain water to the mark, then close the medicine and shake. So, depending on the dosage, 60 ml of a homogeneous white suspension is obtained with 125 mg of active ingredient in 5 ml or 100 ml of suspension containing 250 mg of active ingredient in 5 ml.
Before each use of such a product, it must be shaken, and only then taken with a spoon or a graduated syringe. The medication is given regardless of the diet. If the child does not like the taste of the suspension, the medicine can be washed down with juice, water or some other drink. For babies, this "Klacid" can be mixed with milk, water or milk mixture.
If a child's infection is provoked by any microorganism (in addition to mycobacteria), a single dose of the drug is calculated by weight, multiplying 7.5 mg by the body weight of a small patient in kilograms. The resulting amount of antibiotic is given twice a day, and the maximum dosage per day for children is 1 g (500 mg twice a day).
For example, a child's body weight is 20 kg, which means that he needs 7.5x20 = 150 mg of clarithromycin (300 mg per day) per dose. If a suspension of 125mg / 5ml is used, then 1 ml of such a product contains 25 mg of active compound, which means that the baby should be given 6 ml of such "Klacid". When using a suspension of 250mg / 5ml, the child will have to be given 3 ml of the medication, since 1 ml of the drug with this dosage contains 50 mg of clarithromycin. The annotation to the medicine also has a table with an approximate single dose for different body weights.
The course of treatment usually lasts 5-10 days and is more accurately determined by the doctor, taking into account both the type of pathogen and the severity of the child's condition. In some cases, a 5-day suspension intake is enough to fight the infection, and sometimes the pediatrician, after 10 days of use, continues therapy for up to 14 days (or even up to 21 days).
If a child becomes infected with mycobacteria, the doctor may increase the dosage to 15 mg for each kilogram of the patient's weight. The drug is taken until clinical symptoms are eliminated, often combined with other antibiotics.
Pills
Solid form medicine is taken at any time, regardless of meals. Since the tablets are coated and should not be bitten or chewed, this form is often not prescribed for children weighing up to 40 kg.
If the child weighs 40 kg or more, he is given a tablet "Klacid" in the dosage prescribed for adult patients. The medicine is prescribed at 250-500 mg (depending on the disease), twice a day. The drug "Klacid SR" due to its longer action is taken only once a day.
Overdose
A high dosage of "Klacid" disrupts the digestive system, provokes headaches, confusion and requires an immediate reaction in the form of gastric lavage and the use of sorbents... If the child's condition has worsened, a doctor should be called for symptomatic therapy.
Interaction with other drugs
"Klacid" is not advised to be combined with many medications, including: aminoglycoside antibiotics, "Terfenadine", "Ergotamine", "Carbamazepine", "Triazolam", "Omeprazole", "Colchicine", indirect anticoagulants, "Methylprednisampicin", "Rifenadine" , "Verapamil" and many other medicines. A complete list of them is noted in the annotation to the drug.
Terms of sale
Any form of "Klacid" can be purchased only after the presentation of the prescription. The average price of a bottle of powder from which a suspension with an antibiotic concentration of 125 mg / 5 ml is obtained is 350-380 rubles. For a package of 10 tablets of 250 mg of clarithromycin, you need to pay about 600 rubles. One bottle of injectable "Klacid" costs about the same.
Storage conditions and shelf life
Storing the sealed suspension powder for the entire shelf life of 2 years is recommended at room temperature in a place hidden from a small child. After mixing with water, the drug can be stored at temperatures from +15 to +30 degrees for no longer than 14 days. It is not recommended to keep the medicine in the refrigerator, and the medicine that has not been used within two weeks should be thrown away.
Tablets and vials for injection should be kept in a place protected from sunlight, where the temperature will not exceed 25 degrees Celsius. The shelf life of the tablet form is 5 years, the injectable form is 4 years.
Reviews
In most reviews of treatment with "Klacid" they note the high effectiveness of such an antibiotic. The advantages of the mother's medicine include several forms of release, a wide range of antimicrobial effects, a fairly rapid manifestation of the therapeutic effect and relatively good tolerance by young patients.
For children, a suspension is usually chosen and this medicine is praised for its ease of use and sweet taste, about which babies often do not protest. The main disadvantages of "Klacid" parents call its high cost and the presence of contraindications. Often they also complain about the side effects of the medication on the digestive tract and the nervous system of babies.
Analogs
Other drugs with the same active ingredient, for example, Fromilid, Ecositrin, Clarithromycin, Klabaks, Claritrosin, Klasine, Clarbakt and others, can replace Klacid.... Most of them are available in tablets, but some are also presented in suspension, so there is usually no difficulty in replacing Klacid with a similar medicine.
In addition, the doctor can change "Klacid" for another antibiotic from the group of macrolides and azalides:
- "Macropen"... The action of this antibacterial agent is provided by midecamycin. The preparation in granules is allowed for babies of any age. It is used to prepare a banana-flavored syrup for a little patient. In addition, "Macropen" is available in tablets, which are prescribed for children weighing more than 30 kg.
- "Azitrox"... Such a medicine containing azithromycin is used in the form of a suspension for babies over six months old, and in capsules from 12 years old.
- Sumamed. The basis of such a drug is also azithromycin. The drug in the form of a suspension is prescribed from the age of six months, and in the form of dispersible tablets - from the age of 3.
- "Vilprafen Solutab". These dissolving tablets, in which josamycin is the active ingredient, are prescribed for children weighing more than 10 kg.
In some cases, after determining the sensitivity of microorganisms, a pediatrician may recommend an antibacterial agent from another group as a replacement - for example, the cephalosporin antibiotic Suprax or amoxicillin preparations (Flemoxin Solutab, Augmentin, Panklav, Ospamox, Amoxiclav " and others). This is most often done when an allergy to Klacid or another macrolide is detected.
The rules of antibiotic treatment will be explained by Dr. Komarovsky in the video below.
