Diferencia entre revisiones de «Spiramycin»
Sin resumen de edición |
(Restore original dosing content alongside dynamic SMW tables) |
||
| (No se muestra una edición intermedia del mismo usuario) | |||
| Línea 10: | Línea 10: | ||
**1st trimester: 3g PO daily in 3-4 divided doses | **1st trimester: 3g PO daily in 3-4 divided doses | ||
**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 | **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 | ||
===Indications by Disease=== | |||
{{#ask: [[Has DrugName::Spiramycin]] [[Has Population::Adult]] | |||
|?Treats disease=Disease | |||
|?Has Dose=Dose | |||
|?Has Context=Context | |||
|format=table | |||
|limit=50 | |||
|mainlabel=- | |||
|headers=show | |||
|sort=Treats disease | |||
}} | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
| Línea 15: | Línea 28: | ||
*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 | *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 | ||
*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 | *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 | ||
===Indications by Disease=== | |||
{{#ask: [[Has DrugName::Spiramycin]] [[Has Population::Pediatric]] | |||
|?Treats disease=Disease | |||
|?Has Dose=Dose | |||
|?Has Context=Context | |||
|format=table | |||
|limit=50 | |||
|mainlabel=- | |||
|headers=show | |||
|sort=Treats disease | |||
}} | |||
==Special Populations== | ==Special Populations== | ||
Revisión actual - 02:37 20 mar 2026
Administration
- Type: macrolide antibiotic
- Dosage Forms: 250, 500
- Routes of Administration: PO, IV
- Common Trade Names: Rovamycine
Adult Dosing
- 1-2g PO BID OR 500-1000mg PO TID. May increase to 2-2.5g BID for severe infections
- Toxoplasmosis in pregnant women:
- 1st trimester: 3g PO daily in 3-4 divided doses
- 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
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Toxoplasmosis | 1g PO q8hrs | Pregnant |
Pediatric Dosing
- >20kg: 25mg/kg PO BID or 16.7mg/kg PO TID
- 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
- 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
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Toxoplasmosis | 50-100mg/kg/day PO divided q8hrs | Pediatric/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
- ↑ Stray-Pedersen B. Treatment of toxoplasmosis in the pregnant mother and newborn child. Scand J Infect Dis 1992; 84(suppl): 23-31
- ↑ Rovamycine (spiramycin) [product monograph]. Quebec, Canada: Aventis Pharma Inc; April 2018.
- ↑ 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.