Streptocide® [Sulfonamide]

Pharmacological properties

streptocid, like other sulfonamides, disrupts the formation of growth factors in microorganisms - folic, dehydrofolic acid, and other compounds containing pabc in their molecules. due to the proximity of its structure to that of streptocide, the latter as a competitive antagonist of the aforementioned acid is included in the metabolic chain and disrupts the metabolic processes in microorganisms, exhibiting a bacteriostatic effect. the drug relates to short-acting sulfonamides. streptocide has a bacteriostatic effect against streptococci, meningococci, pneumococci, gonococci, Escherichia coli, toxoplasmosis and malaria pathogens. in effectiveness, significantly inferior to modern antibiotics. Currently, many strains of microorganisms, especially hospital ones, are resistant to streptocide.

Streptocide activity increases in an alkaline environment.

Enterococci, Pseudomonas aeruginosa, anaerobes are insensitive to streptocide.

Pharmacokinetics When taken orally, it is rapidly absorbed: C_max in plasma is reached after 1-2 hours, after 4 hours the drug is determined in the CSF. Decrease C_max 50% in the blood occurs in less than 8 hours. About 95% of the drug is excreted by the kidneys.

Indications

Infectious and inflammatory diseases caused by drug-sensitive microorganisms: infectious diseases of the skin and mucous membranes (wounds, ulcers, bedsores), enterocolitis, pyelitis, cystitis.

Application

Take orally during or after meals with 150-200 ml of water. a single dose for adults and children over the age of 12 years is 600 mg - 1.2 g, the daily dose is 3–6 g. The daily dose should be divided into 5 doses.

Children aged 3–6 years — 300 mg per dose, 6–12 years –– 300–600 mg per dose. Multiplicity of admission for children is 4-6 times a day.

The duration of treatment is determined individually and depends on the severity and course of the disease, the localization of the process, the effectiveness of therapy.

Highest doses for adults: single - 2 g, daily - 7 g.

The maximum daily dose for children is 900 mg - 2.4 g.

Contraindications

Individual sensitivity to sulfonamides, sulfones and other components of the drug; the presence in the history of pronounced toxic-allergic reactions to sulfonamides;

• nephrosis, jade;
• bazedova disease;
• acute hepatitis;
• inhibition of bone marrow hematopoiesis;
• renal and / or liver failure;
• decompensated chronic heart failure;
• congenital deficiency of glucose-6-phosphate dehydrogenase, porphyria;
• diseases of the hematopoietic system: anemia, leukopenia;
• hyperthyroidism;
• azotemia.

Side effects

On the part of the blood system and lymphatic system: leukopenia, agranulocytosis, aplastic anemia, thrombocytopenia, hypoprothrombinemia, eosinophilia, hemolytic anemia with a deficiency of glucose-6-phosphate dehydrogenase.

From the cardiovascular system: tachycardia, myocarditis.

From the nervous system: headache, neurological reactions, including aseptic meningitis, ataxia, minor intracranial hypotension, cramps, dizziness, drowsiness / insomnia, feeling tired, depression, peripheral or optical neuropathies, blurred vision, psychosis, depression, paresthesia.

From the respiratory system: pulmonary infiltrates, fibrosing alveolitis.

From the alimentary canal: thirst, dry mouth, dyspeptic symptoms, nausea, vomiting, diarrhea, anorexia, pancreatitis, pseudomembranous colitis.

From the hepatobiliary system: increased activity of hepatic enzymes (AlAT, AsAT, ALP), cholestatic hepatitis, hepatonecrosis, hepatomegaly, jaundice, cholestasis.

From the urinary system: a change in the color of urine (saturated yellow-brown color), crystalluria with an acid reaction of urine; nephrotoxic reactions are possible: interstitial nephritis, tubular necrosis, renal failure, hematuria, shock kidney with anuria.

On the part of the skin and subcutaneous tissue: skin hyperemia, skin rash (including erythematous-squamous, papular), itching, urticaria, allergic dermatitis, photosensitivity, exfoliative dermatitis, erythema nodosum, cyanosis.

On the part of the immune system: hypersensitivity reactions, including toxic epidermal necrolysis (Lyell syndrome), Stevens-Johnson syndrome, systemic lupus erythematosus, serum syndrome, anaphylactic reactions, Quinckes edema, runny nose.

General disorders: drug fever, pain in the right hypochondrium and lower back.

Others: shortness of breath, periarteritis nodosa, hypothyroidism, hypoglycemia.

special instructions

In the treatment of streptocide, it is necessary to systematically monitor renal function and peripheral blood counts, blood glucose levels.

With prolonged treatment with the drug, it is necessary to periodically conduct a blood test (biochemical and general blood tests). Inadequate prescribing of the drug or early cessation of the use of the drug may lead to increased resistance of microorganisms to sulfonamides.

Sulfanilamides should not be used to treat infections caused by beta-hemolytic group A streptococcus, since they do not eradicate it and, therefore, cannot prevent complications such as rheumatism and glomerulonephritis.

The drug should be prescribed with caution to patients with chronic heart failure, liver disease and impaired renal function. With renal failure, the accumulation of sulfonamide and its metabolites in the body is possible, which can lead to the development of a toxic effect.

Streptocide-Darnitsa should be prescribed with caution to patients with severe allergic diseases or bronchial asthma, with diseases of the blood system. If signs of a hypersensitivity reaction appear, the drug should be discontinued.

With caution, sulfonamides, including streptocide, should be used in patients with diabetes mellitus, since sulfonamides can affect blood glucose levels. High doses of sulfonamides have a hypoglycemic effect.

Since sulfonamides are bacteriostatic and not bactericidal, a full-fledged course of therapy is required to prevent recurrence of infection and the development of resistant forms of microorganisms.

Given the similarity of the chemical structure, sulfonamides cannot be used in individuals with hypersensitivity to furosemide, thiazide diuretics, carbonic anhydrase inhibitors and sulfonylurea derivatives.

Patients need to drink enough fluid to prevent crystalluria and the development of urolithiasis.

Elderly people have an increased risk of developing severe adverse reactions from the skin, inhibition of blood formation, thrombocytopenic purpura (the latter - especially when combined with thiazide diuretics).

The prescription of the drug should be avoided for patients over the age of 65 due to the increased risk of severe adverse reactions.

It is recommended to avoid exposure to direct sunlight and artificial ultraviolet radiation due to the possibility of the development of photosensitization with the use of sulfonamides.

During treatment, it is necessary to comply with the dosing regimen, apply the recommended dose with an interval of 24 hours, do not miss the dose. In case of missing a dose, do not double the next dose.

If the signs of the disease do not begin to disappear or, conversely, the health condition worsens or undesirable phenomena occur, it is necessary to suspend the use of the drug and seek medical advice regarding further use of the drug.

Use during pregnancy and lactation. The drug is contraindicated during pregnancy or lactation.

If it is necessary to use the drug, breast-feeding should be discontinued.

Children. The drug is used in children over the age of 3 years.

The ability to influence the reaction rate when driving vehicles and other mechanisms. There is no information on the effect of the drug on the ability to drive vehicles and work with complex mechanisms.

Until the individual reaction to the drug is clarified, one should refrain from driving vehicles or other mechanisms, since in the treatment of sulfonamides, adverse reactions from the nervous system, such as dizziness, convulsions, ataxia, drowsiness, depression, and psychosis, are possible.

Interactions

With simultaneous use with:

NSAIDs, sulfonylurea derivatives, antithrombotic agents, vitamin K antagonists - the effect of these drugs is enhanced;

folic acid, bactericidal antibiotics (including penicillins, cephalosporins) - the effectiveness of sulfonamides decreases;

bactericidal antibiotics, oral contraceptives - the effect of these drugs is reduced;

paraaminosalicylic acid and barbiturates - the activity of sulfonamides is enhanced;

pyrazolone derivatives, indomethacin and salicylates - the activity and toxicity of sulfonamides are enhanced;

methotrexate and diphenin - the toxicity of sulfonamides is enhanced;

erythromycin, lincomycin, tetracycline - antibacterial activity is mutually enhanced, the spectrum of action expands;

rifampicin, streptomycin, monomycin, kanamycin, gentamicin, derivatives of oxyquinoline (nitroxoline) - the antibacterial effect of the drugs does not change;

nalidixic acid (nevigramone) - sometimes antagonism is observed;

chloramphenicol, nitrofurans - the total effect is reduced;

with preparations containing esters of para-aminobenzoic acid (novocaine, anestezin, dicain), the antibacterial activity of sulfonamides is inactivated.

Sulfanamides should not be prescribed simultaneously with hexamethylenetetramine (urotropine), antidiabetic drugs (sulfonylurea derivatives), diphenin, neodikumarin and other indirect anticoagulants.

Streptocide can enhance the effect and / or toxicity of methotrexate due to its displacement from communication with proteins and / or weakening of its metabolism.

With simultaneous use with other drugs that cause bone marrow depression, hemolysis, hepatotoxic effects, there may be a risk of toxic effects.

Concomitant use with methenamine (urotropin) is not recommended due to an increased risk of crystalluria with an acidic urine reaction.

Phenylbutazone (butadione), salicylates and indomethacin can displace sulfanilamides from the connection with blood plasma proteins, thereby increasing their concentration in the blood. When used together with para-aminosalicylic acid and barbiturates, the activity of sulfonamides is enhanced; with chloramphenicol - the risk of developing agranulocytosis is increased.

Overdose

Perhaps an increase in the manifestations of side effects.

In case of an overdose, anorexia (lack of appetite), nausea, vomiting, colicky pain, headache, drowsiness, dizziness, and fainting are possible.With prolonged use, fever, hematuria, crystalluria, cyanosis, tachycardia, paresthesia, diarrhea, cholestasis, renal failure with anuria, toxic hepatitis, leukopenia, agranulocytosis are possible.

Treatment. In case of overdose, it is recommended to consult a doctor. Before providing medical care, the stomach should be washed with 2% sodium bicarbonate and take a suspension of activated carbon or other enterosorbents. The use of a large amount of fluid, forced diuresis, hemodialysis are shown. Symptomatic treatment

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C.