Oxamp sodium, 0.5 g, 50 pcs.

Oxamp sodium is a combined antibiotic that combines the spectrum of action of ampicillin and oxacillin.
Ampicillin is a semi-synthetic penicillin, acts bactericidal, acid-resistant.

It is active against Gram-positive, non-penicillinase forming (Staphylococcus spp., Streptococcus spp, Streptococcus pneumoniae), and gram-negative (Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Salmonella spp., Shigella spp., Proteus mirabilis, Haemophilus influenzae) microorganisms.

Oxacillin is a penicillin-resistant semi-synthetic antibiotic from the group of penicillins, acid-resistant; it has bactericidal action against Gram-positive microorganisms (Staphylococcus spp, Streptococcus spp. including Streptococcus pneumoniae, Actinomyces spp, Bacillus anthracis, Corynebacterium diphtheriae, anaerobic spore-forming bacilli including Clostridium spp.), Gram-negative cocci; Escherichia coli, Proteus mirabilis, Haemophilus influenzae, Klebsiella pneumoniae, Actinomyces spp.

Pseudomonas aeruginosa and other non-fermenting gram-negative bacteria, most strains of Proteus vulgaris, Providencia rettgeri, Morganella morganii are resistant to the drug.

Pharmacokinetics

The time to reach maximum concentration (TC_maõ) of both antibiotics in blood is 0.5-1 h after intramuscular administration. The elimination half-life is 1-2 hours. The drug penetrates well into various organs and tissues.

In intravenous administration of the drug in the blood quickly (after 5-10 minutes) generates drug concentrations exceeding those of intramuscular administration. Both antibiotics are excreted by the kidneys, partially with the bile. When repeated administration they do not cumulate.

Indications

Active ingredient

Composition

Active ingredient:

ampicillin sodium;

Auxiliary substances:

oxacillin sodium;

How to take, the dosage

Intramuscularly and intravenously (by trickle or drip).

The doses of the drug indicated below are the sum of doses of ampicillin and oxacillin (sodium salts) in their fixed ratio of 2:1 (i.e. in the doses indicated below 1 g of the drug is equal to the sum of 667.0 mg of ampicillin + 333.0 mg of oxacillin).
The daily dose for adults and children over 14 years of age is 3-6 g; for infants, premature infants and children under 1 year of age – 100-200 mg/kg/day; 1-6 years of age – 100 mg/kg/day; 714 years of age – 50 mg/kg/day. The daily dose is administered in 3-4 injections, with an interval of 6-8 hours.

If necessary the indicated doses can be increased by 1.5-2 times.

The duration of treatment depends on the severity of the disease (from 5-10 days to 2-3 weeks, and in chronic cases – for several months).

For intramuscular administration the content of the bottle is dissolved in 10 ml of water for injection.

For intravenous jet injection (for 2-3 minutes) a single -dose is dissolved in 10-15 ml of water for injection or 0.9% sodium chloride solution.

In intravenous drops for adults a single dose is dissolved in 100-200 ml of 0.9% sodium chloride solution or 5% dextrose (glucose) solution and is infused at a rate of 60-80 drops/min; for children the solvent used is 30-100 ml of 5-10% dextrose (glucose) solution. The drug is administered intravenously for 5-7 days, with subsequent transition to intramuscular administration.
Solutions are used immediately after preparation.

Interaction

Ampicillin.

Pharmaceutically incompatible with aminoglycosides.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) – antagonistic.

Increases the effectiveness of indirect anticoagulants (by suppressing intestinal microflora, reduces the synthesis of vitamin K and prothrombin index); reduces the effectiveness of estrogen containing oral contraceptives, drugs, in the metabolism of which paraaminobenzoic acid is formed, ethinylestradiol (in the latter case the risk of bleeding “breakthrough” increases).

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone non-steroidal anti-inflammatory drugs and other drugs that block tubular secretion increase the concentration of ampicillin in plasma (by reducing tubular secretion).

Allopurinol increases the risk of skin rash.

Decreases clearance and increases toxicity of methotrexate.

Oxacillin.

Increases methotrexate toxicity (competition for tubular secretion); may require increased doses of calcium folinate (antidote to folic acid antagonists) and longer use.

The concomitant use with other drugs with hepatotoxic effects should be avoided.
It is not recommended to prescribe simultaneously with bacteriostatic antibiotics (reduction of effectiveness).

Drugs that block tubular secretion increase the concentration of oxacillin in the blood.

Special Instructions

During the course of treatment it is necessary to monitor the hematopoietic, hepatic and renal function.
In case of signs of anaphylactic shock urgent measures should be taken to remove the patient from this state: epinephrine (adrenaline), glucocorticosteroids (hydrocortisone or prednisolone) and antihistamines, if necessary artificial lung ventilation is performed.

The possibility of superinfection (due to growth of microflora insensitive to the drug) requires appropriate changes in antibiotic therapy.

In patients with hypersensitivity to penicillins cross-allergic reactions with cephalosporin antibiotics are possible.

When used in high doses in patients with renal insufficiency, toxic effects on the central nervous system are possible.

Contraindications

Hypersensitivity, infectious mononucleosis, lympholeukosis.

With caution: children born to mothers with hypersensitivity to penicillins. Allergic reactions in the anamnesis and/or bronchial asthma, renal failure, bleeding in the anamnesis, enterocolitis on the background of antibiotic use (in the anamnesis).

Side effects

Allergic reactions: itching and skin flaking, urticaria, skin hyperemia, rhinitis, conjunctivitis, angioedema, rarely – fever, arthralgia, eosinophilia, erythematous and maculopapular rash, exfoliative dermatitis, erythema multiforme exudative (including Stevens-Johnson syndrome).including Stevens-Johnson syndrome), reactions similar to serum sickness, in single cases anaphylactic shock, non-allergic ampicillin rash, may disappear without drug withdrawal.

Gastro-intestinal tract: dysbacteriosis, change of taste, vomiting, nausea, diarrhea, moderate increase in “hepatic” transaminase activity, rarely – pseudomembranous colitis.

Laboratory measures: leukopenia, neutropenia, anemia, hematuria, proteinuria.

Local reactions: pain at the site of injection, phlebitis and periphlebitis (with intravenous injection); with intramuscular injection – infiltrate at the site of injection.

Others: interstitial nephritis, nephropathy, superinfection (especially in patients with chronic diseases or reduced body resistance), vaginal candidiasis.

Overdose

Symptoms:

Treatment: symptomatic. Withdrawn by hemodialysis.

Pregnancy use

The use of the drug during pregnancy is possible only when the estimated benefit to the mother exceeds the potential risk to the fetus.

If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped (excreted with breast milk).