Levomycetin, 1% 25 ml

A broad spectrum antibiotic. The mechanism of antimicrobial action is associated with disruption of microbial protein synthesis.

It has a bacteriostatic effect. It is active against Gram-positive bacteria: Staphylococcus spp., Streptococcus spp.; Gram-negative bacteria: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Haemophilus influenzae, Salmonella spp, Shigella spp., Klebsiella spp., Serratia spp., Yersinia spp., Proteus spp., Rickettsia spp.; also active against Spirochaetaceae, some major viruses.

Chloramphenicol is active against strains resistant to penicillin, streptomycin, sulfonamides.

The resistance of microorganisms to chloramphenicol develops relatively slowly.

Indications

For oral administration: Infectious and inflammatory diseases caused by microorganisms sensitive to chloramphenicol, including.Including: typhoid, paratyphoid, dysentery, brucellosis, tularemia, whooping cough, typhus and other rickettsioses; trachoma, pneumonia, meningitis, sepsis, osteomyelitis.

For external use: purulent skin lesions, furuncles, trophic ulcers which do not heal for a long time, II and III degree burns, cracked nipples of nursing women.

For topical use in ophthalmology: inflammatory eye diseases.

Active ingredient

Composition

100 ml contains: Chloramphenicol – 250 mg.

How to take, the dosage

Individual. When administered orally, the dose for adults is 500 mg 3-4 times a day.

The single dose for children under 3 years of age is 15 mg/kg, 3-8 years – 150-200 mg; over 8 years – 200-400 mg; the frequency of use is 3-4 times a day.

The course of treatment is 7-10 days.

When applied topically it is applied on gauze swabs or directly on the affected area. A normal dressing is applied on top, it may be with parchment or compress paper. Dressings are applied in 1-3 days, sometimes in 4-5 days, depending on indications.

Locally it is used in ophthalmology as part of combined preparations according to indications.

Interaction

In concomitant use of chloramphenicol with oral hypoglycemic drugs increased hypoglycemic effect is noted due to inhibition of the metabolism of these drugs in the liver and increased concentrations in the blood plasma.

In concomitant use with drugs that inhibit bone marrow hematopoiesis, an increase in the inhibitory effect on the bone marrow is noted.

In concomitant use with erythromycin, clindamycin, lincomycin mutual weakening of action is noted due to the fact that chloramphenicol may displace these drugs from the bound state or prevent their binding to the 50S subunit of bacterial ribosomes.

In concomitant use with penicillins, chloramphenicol counteracts the bactericidal effect of penicillin.

Chloramphenicol inhibits cytochrome P450 enzyme system, therefore concomitant use with phenobarbital, phenytoin, warfarin decreased metabolism of these drugs, slowed excretion and increased their plasma concentrations.

Special Instructions

Chloramphenicol is not used in newborns because of the possible development of “gray syndrome” (flatulence, nausea, hypothermia, gray-blue skin color, progressive cyanosis, dyspnea, cardiovascular failure).

With caution, use in patients who have previously been treated with cytostatic drugs or radiation therapy.

The simultaneous use of alcohol may cause disulfiram-like reactions (skin hyperemia, tachycardia, nausea, vomiting, reflex cough, seizures).

The peripheral blood count must be monitored systematically during treatment.

Contraindications

Blood diseases, marked liver function abnormalities, glucose-6-phosphate dehydrogenase enzyme deficiency, skin diseases (psoriasis, eczema, fungal diseases); pregnancy, lactation, children under 4 weeks (infants), hypersensitivity to chloramphenicol, thiamphenicol, azidamphenicol.

Side effects

Blood system disorders: thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia.

In the digestive system: nausea, vomiting, diarrhea, flatulence.

CNS and peripheral nervous system disorders: peripheral neuritis, optic neuritis, headache, depression, confusion, delirium, visual and auditory hallucinations.

Allergic reactions: skin rash, urticaria, angioedema.

Local reactions: irritant effect (when applied externally or topically).

Similarities