Diferencia entre revisiones de «Spiramycin»

Sin resumen de edición
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric))
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==Adult Dosing==
==Adult Dosing==
*1-2g PO BID OR 500-1000mg PO TID. May increase to 2-2.5g BID for severe infections
===Indications by Disease===
*[[Toxoplasmosis]] in pregnant women:  
{{#ask: [[Has DrugName::Spiramycin]] [[Has Population::Adult]]
**1st trimester: 3g PO daily in 3-4 divided doses
|?Treats disease=Disease
**2nd/3rd trimesters: 25-50mg [[pyrimethamine]] PO daily AND 2-3g [[sulfadiazine]] daily AND folinic acid 5mg daily for 3 weeks, alternating with 1g PO spiramycin TID for 3 weeks
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
*>20kg: 25mg/kg PO BID or 16.7mg/kg PO TID
===Indications by Disease===
*Subclinical congenital toxoplasmosis: 0.5-1mg/kg PO daily [[pyrimethamine]] AND 50-100mg/kg PO daily [[sulfadiazine]] x 4 weeks, alternating with 50-100mg/kg spiramycin x 6 weeks, alternating courses for 1 year
{{#ask: [[Has DrugName::Spiramycin]] [[Has Population::Pediatric]]
*Overt congenital toxoplasmosis: 0.5mg/kg PO [[pyrimethamine]] daily AND 50-100mg/kg [[sulfadiazine]] PO daily AND 5mg folinic acid q3d for 6 months, alternating with 50-100mg/kg spiramycin AND pyrimethamine AND sulfadiazine for 4 weeks. Repeat dosing courses x 18mo
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Special Populations==
==Special Populations==

Revisión del 01:53 20 mar 2026

Administration

  • Type: macrolide antibiotic
  • Dosage Forms: 250, 500
  • Routes of Administration: PO, IV
  • Common Trade Names: Rovamycine

Adult Dosing

Indications by Disease

DiseaseDoseContext
Toxoplasmosis1g PO q8hrsPregnant

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Toxoplasmosis50-100mg/kg/day PO divided q8hrsPediatric/Congenital alt

Special Populations

Pregnancy Rating

  • Category B, Safe in pregnancy[1]

Lactation risk

  • Distributed in breast milk

Renal Dosing

  • Adult: n/a
  • Pediatric: n/a

Hepatic Dosing

  • Caution in hepatic impairment

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Cardiac toxicity, specifically QT prolongation
  • Thrombocytopenia
  • Cholestatic hepatitis
  • GI toxicity, specifically acute colitis, C. diff colitis, or other intestinal injury
  • Ulcerated esophagitis
  • Worsening hepatic impairment in patients with pre-existing liver disease

Common

  • Injection site pain
  • Nausea/vomiting, diarrhea, abdominal pain

Pharmacology

  • Half-life: 4.5-13.5h (increases with increasing age)
  • Metabolism: Hepatic
  • Excretion: Fecal (predominant), renal

Mechanism of Action

  • Reversibly binds to the 50 S subunit of bacterial ribosomes, resulting in blockage of the transpeptidation or translocation reactions, inhibiting protein synthesis and subsequent cell growth[2]

Comments

  • Not approved in US for standard use, though exceptions can be made to treat toxoplasmosis in pregnant women[3]

See Also

References

  1. ↑ Stray-Pedersen B. Treatment of toxoplasmosis in the pregnant mother and newborn child. Scand J Infect Dis 1992; 84(suppl): 23-31
  2. ↑ Rovamycine (spiramycin) [product monograph]. Quebec, Canada: Aventis Pharma Inc; April 2018.
  3. ↑ Spiramycin. Lexicomp. http://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/7697?searchUrl=%2Flco%2Faction%2Fsearch%3Forigin%3Dapi%26t%3Dglobalid%26q%3D6982%26nq%3Dtrue. Accessed March 5, 2020.
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