Piperacilina

           

Piperacillinum J01C A12

Specialitati: Piperacillin.

Proprietati

Acil-ureido-penicilina semisintetica cu spectru antibacterian larg, din familia penicilinelor antipseudomonadice. Activa fata de bacterii gram-pozitive: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp., inclusiv Streptococcus pneumoniae, streptococii beta-hemolitici (Streptococcus pyogenes, Streptococcus agalactiae), Enterococcus spp., bacterii gram-negative: Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Serratia spp., Klebsiella spp., incl. Klebsiella pneumoniae, Enterobacter spp., Salmonella spp., Shigella spp., Pseudomonas spp., incl. Pseudomonas aeruginosa, Acinetobacter spp., Haemophilus influenzae (tulpinile neproducatoare de beta-lactamaze) Neisseria gonorrhoeae (inclusiv producatoare de beta-lactamaze), Neisseria meningitidis, Moraxella spp., Yersinia spp., bacterii anaerobe: Actinomyces spp., Bacteroides spp., inclusiv Bacteroides fragilis, Clostridium spp. (inclusiv Clostridium difficile, agentul patogen al colitei pseudomembranoase), Eubacterium spp., Fusobacterium spp., Peptococcus spp., Peptostreptococcus spp., Veionella spp.

Indicatii

Infectiile cailor respiratorii inferioare cu E. coli, Klebsiella spp., Enterobacter spp., Pseudomonas aeruginosa, Proteus spp., Bacteroides spp si coci anaerobi, Streptococcus pneumoniaeale pielii si tesuturilor moi cu E. coli, Klebsiella spp., Serratia spp., Acinetobacter spp., Enterobacter spp., Proteus spp., Bacteroides spp., coci anaerobi si enterococi, osteo-articulare cu Ps. aeruginosa, Bacteroides spp. si coci anaerobi, ginecologice (incl. endometrite si boli pelviene cu Bacteroides fragilis coci anaerobi, Neisseria gonorrhoeae si enterococi), intraabdominale cu E. coli, Ps. aeruginosa, enterococi, Clostridium spp., coci anaerobi, Bacteroides spp., septicemii cu E. coli, Klebsiella spp., Enterobacter spp., Serratia spp., Proteus spp.,, Streptococcus pneumoniae, enterococi, Ps. aeruginosa, Bacteroides spp., coci anaerobi, infectiile tractului urinar cu E. coli, Klebsiella spp., Ps. aeruginosa, Proteus spp., enterococi.

Contraindicatii

Hipersensibilitatea la peniciline si cefalosporine.

Posologie

Adulti si copii peste 14 ani in infectiile moderate 100-200 mg/kg/zi, in cele severe 200-300 mg/kg/zi i.v. divizate in 2-4 prize, infectiile urinare necomplicate 6-8 g/zi i.m. divizate in 2-3 prize, complicate 8-16 g/zi i.v. divizate in 3-4 prize. Doza maxima este de 24 g/zi. Copii 100-200 mg/kg/zi divizate in 2-4 prize, in cazurile grave (septicemii, infectii encefalice) 200-300 mg/kg (zi divizata in 2-4 prize). Tratamentul se prelungeste inca 2-4 zile dupa normalzarea clinica a starii pacientului. In insuficienta renala doza se ajusteaza dupa clearance-ul creatininei.

Supradozare

Cazuri de supradozaj nu au fost semnalate.

Efecte adverse

Dureri locale, eritem, induratii, tromboflebite, diaree, hiperbilirubinemie, hepatita colestatica, greata, diaree cu sange, colita pseudomembranoasa.

Interactiuni

Aminoglicozidele potenteaza actiunea antibacteriana a piperacilinei.

Precautii

A se testa sensibilitatea la peniciline si cefalosporine. Pot surveni suprainfectii si manifestatii hemoragice in special in combinatii cu anticoagulante.

Piperacillin (Antibiotic-Co, Bulgaria). Pulbere parenterala 1000 mg, 2000 mg, 3000 mg si 4000 mg in flacoane N 1, N 5 si N 10.

Piperacillin (Life Pharma, Italia). Pulbere parenterala 1000 mg si 2000 mg in flacoane, in complet cu solvent 4 ml si respectiv 8 ml in fiole.

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