Duactylam

Duactylam is a combination drug that contains two active ingredients: ampicillin and sulbactam.

1. Ampicillin is an antibiotic from the group of semisynthetic penicillins that acts by destroying bacteria or preventing their reproduction. It is effective against a wide range of bacterial infections, including upper and lower respiratory tract infections, urinary tract infections, skin infections, soft tissue infections, gastrointestinal tract infections and others.
2. Sulbactam is a beta-lactamase that increases the effectiveness of ampicillin. It inhibits the action of beta-lactamases, an enzyme that can break down ampicillin, making it more effective against bacteria that produce this enzyme and exhibit resistance to the antibiotic.

Duactylam is used to treat infections caused by susceptible bacteria and can be used for a variety of medical conditions where antibiotic therapy is required.

Indikasjoner Duactylama

1. Respiratory tract infections:

   • Acute and chronic bronchitis
   • Pneumonia
   • Upper respiratory tract infections, including sinusitis and tonsillitis

2. Urinary tract infections:

   • Acute and chronic pyelonephritis
   • Cystitis
   • Urethritis

3. Skin and soft tissue infections:

   • Abscesses
   • Phlegmon
   • Infected wounds

4. Infections of bones and joints:

   • Osteomyelitis
   • Arthritis of bacterial origin

5. Intra-abdominal infections:

   • Peritonitis
   • Cholecystitis
   • Infections after abdominal surgery

6. Gynecological infections:

   • Inflammatory diseases of the pelvic organs
   • Infections after gynecological operations

7. Sepsis and bacterial endocarditis.

Utgivelsesskjema

Duactylam is available in powder form for solution for injection.

Farmakodynamikk

Duactylam is a combination drug consisting of ampicillin, an antibiotic from the penicillin group, and sulbactam, which is a beta-lactamase inhibitor. Ampicillin works by killing bacteria or preventing them from reproducing by weakening their cell walls, and sulbactam improves the activity of ampicillin by protecting it from the action of beta-lactamases. Thus, Duaktilam is effective against a wide range of bacterial infections.

Duactylam is active against a wide range of bacteria, including some gram-positive and gram-negative organisms. These may include bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli and others, but specific sensitivity to the drug may vary depending on region and time.

Farmakokinetikk

1. Absorption: After oral administration of Duactilam, both components - ampicillin and sulbactam - are absorbed from the gastrointestinal tract. They are quickly and completely absorbed into the blood.
2. Distribution: Both components have good distribution throughout the tissues and body fluids. They penetrate many tissues and organs, including the lungs, joints, pleura, skin, bladder, prostate, uterus and other organs.
3. Metabolism: Ampicillin and sulbactam are metabolized in the liver. However, their metabolism is negligible.
4. Excretion: Both components are excreted from the body primarily by the kidneys through filtration during the day. Part of the dose may be excreted in bile.

Usually the half-life of Duaktilam is about 1-1.5 hours.

Dosering og administrasjon

Adults and teenagers over 12 years of age:

• The recommended dose is 1.5-3 g every 6-8 hours depending on the severity of the infection.
• The maximum daily dose should not exceed 12 g.

Children:

• The dosage is calculated based on the child’s body weight: 150 mg/kg per day, divided into 3-4 administrations.
• For newborns (up to 1 week), the dosage is 75 mg/kg per day, divided into 2 injections.
• For children from 1 to 4 weeks, the dosage is 100 mg/kg per day, divided into 3 doses.

Patients with renal failure:

• With a creatinine clearance of 15-30 ml/min, the interval between administrations should be at least 12 hours.
• If creatinine clearance is less than 15 ml/min, the interval between doses should be at least 24 hours.

Instructions for preparation and administration:

1. Preparation of the solution:

   • The powder is dissolved in an appropriate volume of sterile water for injection or saline.
   • The solution should be used immediately after preparation.

2. Introduction:

   • Duaktil is administered intramuscularly or intravenously.
   • When administered intravenously, the solution should be administered slowly (over 30 minutes).
   • For intramuscular injections, the solution must be prepared under sterile conditions and injected deep into the muscle.

Duration of treatment:

• Determined by your doctor and depends on the severity of the infection, the patient's response to treatment, and laboratory results.
• It is important to complete the full course of antibiotics, even if symptoms have resolved early, to avoid bacterial resistance developing.

Bruk Duactylama under graviditet

The question of its safety and effectiveness during pregnancy is important to ensure the well-being of both mother and fetus.

Efficiency and research results

1. Pharmacokinetics in pregnancy: Studies have shown that pregnancy significantly increases the rate of elimination of ampicillin and sulbactam, which requires dosage adjustment to achieve a therapeutic effect (Chamberlain et al., 1993).
2. Prevention of infections during caesarean section: Ampicillin/sulbactam was found to be as effective as cefotetan in preventing postoperative infections in high-risk women after caesarean section (Bracero, 1997).
3. Treatment of infections in newborns: The drug administered to the mother before birth significantly reduced colonization and bacteremia in newborns, indicating its effectiveness in preventing neonatal infections (Mcduffie et al., 1996).
4. Premature rupture of membranes: Ampicillin/sulbactam was not associated with an increased risk of necrotizing enterocolitis in neonates and was also effective in increasing time to delivery (Ehsanipoor et al., 2007).
5. Treatment of gynecological infections: Ampicillin/sulbactam has been shown to be highly effective in the treatment of various gynecological infections, including endometritis and infections after first trimester abortion (Giamarellou et al., 1986).

Duactylam is an effective and safe drug for the treatment and prevention of various bacterial infections during pregnancy. However, due to altered pharmacokinetics during pregnancy, careful adjustment of dosage and dosing intervals is recommended to achieve optimal therapeutic effect.

Kontra

Contraindications to the use of Duactilam may include:

1. Known allergy or hypersensitivity to ampicillin, sulbactam or other penicillin antibiotics, cephalosporins or other components of the drug.
2. History of serious allergic reaction (including anaphylaxis) to previous antibiotics.
3. Previous porphyria while taking ampicillin.
4. Severe liver or kidney problems.
5. History of antibiotic-associated colitis.
6. Presence of infections caused by viruses, such as flu or colds, for which antibiotics are not an effective treatment.

Bivirkninger Duactylama

Side effects of Duaktilam may include allergic reactions such as urticaria or angioedema, as well as diarrhea, nausea, vomiting, dyspepsia and dysbiosis. In rare cases, anemia, leukopenia, thrombocytopenia, and liver or kidney dysfunction may occur.

Overdose

An overdose of Duactilam may result in increased side effects such as diarrhea, nausea, vomiting, as well as other possible drug-related reactions.

Interaksjoner med andre legemidler

1. Antibiotics: Using Duaktilam together with other antibiotics, especially tetracyclines or macrolides, may reduce their effectiveness.
2. Anti-epileptic drugs: Duactylam may reduce the blood concentrations of anti-epileptic drugs such as carbamazepine and phenytoin, which may reduce their effectiveness.
3. Antifungal drugs: Use of Duaktilam concomitantly with antifungal drugs such as ketoconazole or fluconazole may increase the concentration of ampicillin in the blood.
4. Anticonvulsants: Duaktilam's interaction with anticonvulsants, such as benzodiazepines, may increase their undesirable effects, such as sedation and decreased responsiveness.
5. Methotrexate: Using Duactilam with methotrexate may increase the toxic effects of methotrexate on the body.