Tienam - an antibiotic from the group of carbapenems.
The composition and the form of tienama
Tienam produced in two dosage forms:
- Powder for solution for intravenous infusion containing the active components: imipenem 500 mg and 500 mg cilastatin. Supporting components: sodium bicarbonate. In glass vials of 20 ml and 115;
- Powder for solution for intramuscular injection containing the active components: imipenem 500 mg and 500 mg cilastatin. The bottle of 5 ml.
Tienama analogues are the following drugs: Grimipenem, imipenem and cilastatin, Imipinem with cilastatin, Tsilapenem, Tsilaspen.
Pharmacological action tienama
Tienam - an antibiotic with a broad spectrum of action, which consists of two components.
Imipenem is a derivative of thienamycin. This is the first representative of the carbapenems - a new class of beta-lactam antibiotics.
Imipenem inhibits the synthesis of bacterial cell walls, produces a bactericidal effect against many gram-negative and gram-positive, aerobic and anaerobic pathogenic microorganisms. Imipenem is active even against the Gram-positive microorganisms that are used to operate only a narrow spectrum antibiotics.
Cilastatin sodium - specific enzyme, inhibiting the metabolism of imipenem in the kidney and increases the concentration of unchanged imipenem in the urinary tract.
According to the instructions on Tien, its spectrum of activity includes Staphylococcus aureus, Pseudomonas aeruginosa, Bacteroides fragilis and Enterococcus faecalis, diverse group of pathogens that are resistant to other antibiotics.
Tienam antibiotic effective against many microorganisms, such as Enterobacter spp., Serratia spp., Pseudomonas aeruginosa, resistant to other beta-lactam antibiotics. This is due to the fact that Tienam resistant to bacterial destruction of beta-lactamase.
Review Tienam active against nearly all clinically important pathogens.
By tienama resistant certain strains Pseudomonas cepacia, Xanthomonas maltophilia, Streptococcus faecium, and staphylococci resistant to methicillin.
This strong efficacy tienama Review makes it particularly useful in the treatment of mixed anaerobic and aerobic polymicrobial infections, as well as the primary treatment prior to the determination of bacterial pathogens.
According to the instructions Tienam shown in the following cases:
- infections of the genitourinary system;
- infective endocarditis (preferably intravenous administration);
- gynecological infections;
- mixed infections;
- soft tissue infections and skin;
- abdominal infections;
- infections of joints and bones;
- infections of the lower respiratory tract;
- septicemia (preferably intravenous administration).
The preparation and analogues tienama not used to treat meningitis.
Antibiotic Tienam contraindicated only in case of hypersensitivity to the drug.
Dosing and dosing regimen tienama
The average daily dosage of the drug, or analog tienama and administration method is determined based on the severity of the disease.
Tienam on instructions preferably administered intravenously in the initial stages of treatment of endocarditis, bacterial sepsis and other life-threatening infections.
Typically, the average dose for adults is 1-2 grams per day, divided into 3-4 hours. The maximum daily dose is 4 grams
Intravenous antibiotic Tienam administered in a dosage ≤500 mg for an hour, and at a dosage of 500 mg - for one hour.
Children older than three months and weighing less than 40 kg administered Tienam instructions for dosage of 15 mg / kg every six hours. If the weight more than 40 kg, the dosage is equivalent to an adult.
Intramuscular drug is used as an alternative in the treatment of those infections where intramuscular injection is preferred.
Typically, the drug is administered intramuscularly to adults in a dosage of 500-750 mg every 12 hours. The maximum daily dose of 1, 5 If necessary, the preparation is applied at higher doses, preferably the intravenous route.
For the treatment of cervicitis and urethritis drug is administered intramuscularly once at a dose of 500 mg.
Application tienama during pregnancy and breastfeeding
Application tienama during pregnancy is not desirable due to the lack of clinical trials in this area. It is also unknown whether the stand with the mother's milk the active drug substance. Therefore, the period of its use is recommended to interrupt breastfeeding.
In the opinion of Tienam may cause the following side effects:
- Digestive system: diarrhea, nausea, vomiting, tooth staining, a slight increase in liver transaminases, hepatitis, pseudomembranous colitis.
- Local reactions: thrombophlebitis, erythema and pain at the injection site (intramuscular injection).
- The urinary system: acute renal failure, polyuria. There were reviews of tienama showing the change in urine color, increasing the level of urea nitrogen and serum creatinine.
- Allergic reactions: urticaria, skin rash, itching, fever, angioedema, anaphylactic reactions, exfoliative dermatitis.
- Peripheral and Central Nervous System: there were reviews of tienama intravenous administration, indicating cases of myoclonus, confusion, hallucinations, taste disturbance, seizures.
- Laboratory findings: leukopenia, eosinophilia, neutropenia, thrombocytosis, decreased hemoglobin level, and thrombocytopenia. There were some reviews about tienama showing positive direct Coombs test.
Solution for intravenous administration are chemically incompatible with the salt of lactic acid. It is not recommended to mix it with solutions of other antibiotics.
Storage conditions of the drug
The preparation is stored at room temperature.
The final solution for intravenous administration should not be stored more than four hours at room temperature and longer days in the refrigerator.
Ready Tienam solution for intramuscular injection must be used for an hour.