How does mononucleosis

From the moment of infection until the first symptoms of the disease (incubation period) usually takes from four days to four weeks, but more often - a week. In children, the disease usually begins acutely, in adults and is gradually beginning. It raises the temperature to 38˚, at least - higher, with a slight chilling and severe sweating. The fever may last from several days to months. When prolonged fever, it can have wavy character (that disappears, then reappears). But there are cases which occur without an increase in temperature.

Along with the increase in temperature increased cervical lymph nodes, which take the form of a chain along the side of the neck. A slight increase of (especially in adults) can go unnoticed. Often also appears easy eyelid edema, puffiness of the face, thickening and change the configuration of the neck. Swollen lymph nodes and elsewhere.

A slight redness and an increase of the tonsils usually appears from the early days of the disease, some patients may occur, or lacunar tonsillitis Tonsillitis - frequent complications . In addition to angina may occur, and other signs of the nasopharynx: stuffy nose, voice changes. Patients breathe through the mouth, although the nasal passages usually free, and no nasal discharge ("dry" defeat of the nasopharynx).

The majority of patients found enlarged liver and spleen, and sometimes the symptoms of hepatitis Symptoms of hepatitis - are not always clear   (yellow skin and sclera, pain in the liver).

The period of recovery, many patients become protracted and slow, with a slight rise in temperature at night. The slight increase in the liver, spleen and cervical lymph nodes may remain for several weeks and even months after recovery.

Changes in blood in infectious mononucleosis

Changes in blood in infectious mononucleosis characterized by originality and cyclical. In the first few days of the disease in the blood can not be the characteristic features. At the height of the disease is marked a moderate increase in the number of white blood cells (leukocytosis) while decreasing the number of granular white blood cells (neutrophils) responsible for cell-mediated immunity (they absorb pathogens) and the increasing number nezernistyh leukocytes - lymphocytes and monocytes. In this case, there are special blood cells - mononuclear cells that are very diverse in size, shape and structure. The large number of monocytes in the blood in combination with the presence of mononuclear cells at the height of the disease - a characteristic feature of infectious mononucleosis.

In the recovery period the number of white blood cells is reduced to normal or below, the content of mononuclear cells also decreases rapidly. But there is a high increase in the number of lymphocytes and reduction in the number of neutrophils. Tendency to moderate leukopenia (reduction in the number of white blood cells) with a decrease in the number of granular white blood cells and an increase in the number of lymphocytes can hold from a few months to two years.

Complications

Complications are rare. Children - a stomatitis Stomatitis - to breath fresh , Otitis media, sinusitis, pneumonia Pneumonia - Symptoms and Causes . There are isolated cases of splenic rupture, hepatic failure, acute respiratory failure (due to compression of the larynx enlarged lymph nodes). Complications can also arise from the central and peripheral nervous system, as well as the heart.

Treatment of infectious mononucleosis

Specific treatment of the disease has been found. Antibiotics and sulfa drugs noticeable effect on the infectious mononucleosis do not have. But their prescribed for septic tonsillitis. Influence of antiviral drugs is also not proven.

Showing bed rest, diet, drugs, relieving allergic disposition of the body, vitamins, gargling with antiseptic solutions. With the development of hepatitis and severe intoxication are appointed by the steroid hormones.

Prognosis is usually favorable, the disease is usually completed within 3-6 weeks.

pharmachologic effect

Amoxiclav - antibacterial combination product. Amoxicillin - an antibiotic of the penicillin and clavulanic acid, - beta-lactamase inhibitor, i.e. a substance that prevents deactivation of amoxicillin by the action of bacteria. Amoxicillin is effective against bacteria that have the sensitivity to it. By including in the preparation of clavulanic acid, the drug can be administered and bacterial infections that are resistant to the effects of amoxicillin. Amoxicillin in combination with clavulanic acid is active against the following bacterial species: Streptococcus pneumonie, Str. bovis, Str. pyogenes, Listeria spp., Staphylococcus aureus, S. epidermidis, Enterococcus spp. (gram-positive aerobic bacteria), Moraxella catarrhalis, N. meningitidis, H. influenzae, E. coli, Klebsiella spp., Proteus spp., N. gonorrhoeae, Pasteurella multocida (gram-negative aerobic microorganisms), as well as against anaerobic infektantov (Bacteroides spp. , Peptococcus spp., Clostridium spp., Actinomyces israelii, Peptostreptococcus spp.).

Amoxicillin kills pathogens, disrupting the formation of the cell walls of bacteria. The walls protect bacterial cells from the infiltration of unwanted substances. Amoxicillin breaks the chemical bonds in the cell walls of bacteria, resulting in gaps formed in them, through which penetrates the antibiotic. The second active ingredient - clavulanic acid - is connected to the protective bacterial enzyme beta-lactamase, which deprives it of the ability to degrade amoxicillin. Clavulanic kiclota binds beta-lactamase, which can produce a gram-positive and gram-negative, including anaerobic microorganisms.

Pharmacokinetics

Application amoksiklava during a meal does not affect the absorption of clavulanic acid and amoxicillin. The half-life for clavulanic acid is 60 - 70 minutes, amoxicillin - 78 minutes. Both compounds penetrate into the tissues and body fluids easily accumulated especially secret maxillary sinuses, lung, middle ear cavity, peritoneal and pleural fluids, ovary and uterus. When meningitis amoksiklava ingredients penetrate the blood-brain barrier. Amoxicillin and Clavulanic acid also penetrates the placental barrier and is determined in trace quantities in breast milk.

Indications

• Bacterial infections caused by susceptible pathogens: lower respiratory tract infections: bronchitis, pneumonia, empyema, lung abscess;
• Infections of the upper respiratory tract: sinusitis, tonsillitis, otitis media;
• Infections of the urinary and pelvic organs: pyelonephritis, pyelitis, cystitis Cystitis: urgently take action , Urethritis, prostatitis, cervicitis, salpingitis, oophoritis, tubo-ovarian abscess, endometritis, bacterial vaginosis, septic abortion, puerperal sepsis, pelvioperitonit, chancroid, gonorrhea Gonorrhea - self-ruled ;
• Infections of the skin and soft tissue: erysipelas, impetigo, secondarily infected dermatoses, abscess, abscess, cellulitis, wound infection;
• Animal bites;
• Postoperative infection;
• Prevention of septic complications during surgery on the pelvic organs, abdomen, kidneys, heart, bile ducts;
• Bone and joint infections (osteomyelitis);
• Maxillofacial Surgery;
• Orthopedic practice.

Contraindications

• Hypersensitivity to the drug and to other antibiotics penicillin group;
• Allergic reactions;
• Infectious mononucleosis;
• Renal insufficiency;
• Liver failure;
• Blood cancer (lymphatic leukemia);
• Hepatitis and cholestatic jaundice, triggered by the reception of the penicillin group of antibiotics in history.

Information about the negative effects of the active ingredients amoksiklava no, so on the strict drug may be administered during pregnancy and lactation.

When an allergic reaction, stop taking amoksiklava and seek medical advice.

Side effects

Side effects amoksiklava individual; the following side effects are observed not in all cases, usually appear a few days after starting the drug and gradually disappear as the body adjusts to the antibiotic.

Possible side effects that do not require medical intervention. In addition, your doctor may recommend ways to prevent or reduce some of these side effects. Consult your doctor if any of these side effects persists or causes discomfort:

Long-term use of antibiotics encourages the multiplication of microorganisms is often insensitive to the antibiotic, for example, fungi that may lead to infections, such as thrush. Be sure to tell your doctor if during the period of receiving amoksiklava you find yourself a new infection.

Common side effects (occur in 1 in 10 people taking amoksiklav)

• Diarrhea

Side effects of moderate prevalence (1-10 observed in 100 people taking amoksiklav)

• Nausea;
• Vomiting;

The non-proliferation side effects (seen in 1 in 100 and 1 in 1000 people taking amoksiklav)

• Gastritis;
• Indigestion;
• Dizziness;
• Headache;
• Urticaria, erythematous rash;
• Itching.

Rare side effects (occur in 1 in 1000 people and 1 in 10,000 people taking amoksiklav)

• Reducing the number of white blood cells (platelets) in the blood;
• Vasculitis thrombus formation in the exposed area (thrombophlebitis) - only when administered intravenously at the injection site.

Side effects of unknown prevalence

• Severe allergic reaction, anaphylactic shock;
• Erythema multiforme;
• Exfoliative dermatitis;
• Malignant exudative erythema (Stevens-Johnson syndrome);
• Allergic vasculitis Vasculitis - when blood vessels refuse to work ;
• Hepatitis;
• Cholestatic jaundice;
• Eosinophilia;
• Leukopenia;
• Agranulocytosis;
• Hemolytic anemia;
• Pseudomembranous colitis and hemorrhagic;
• Convulsions;
• Changing behavior;
• Yellowing of tooth enamel in children, mostly using a slurry;
• Interstitial nephritis;
• Crystalluria.

Interaction with other drugs

Before applying amoksiklava definitely tell your doctor about all the medicines Phytopreparations nutritional supplements that you are taking.

Amoksiklav for intravenous use is compatible with the water for injection, Ringer lactate solution, isotonic sodium chloride, potassium chloride solution. Less resistant amoksiklav Amoxiclav - an effective tool against infections   in media that contain glucose, or dextran. The drug must not be mixed with other agents for parenteral administration in a single screen.

In an application   amoksiklava   with antacids, glucosamine, laxatives, aminoglycosides absorption is slowed, with ascorbic acid - increases.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion, increase the concentration of amoxicillin (Clavulanic acid is derived mainly by glomerular filtration).

In an application   amoksiklava   anticoagulants, and there is an increase in prothrombin time. Therefore, this combination is used with caution. In an application   amoksiklav It increases the toxicity of methotrexate and slows him excreted. In this case, you must carry out regular inspections and periodic blood tests. In an application   amoksiklava   with allopurinol increases risk of exanthema. Avoid the simultaneous application amoksiklava   with disulfiram. The combination of amoxicillin with rifampicin antagonistic (notes relative weakening of the antibacterial action).

Amoxiclav should not be used simultaneously with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in efficiency amoksiklava . Probenecid reduces the excretion of amoxicillin, increasing its serum concentration. In the past, women taking hormonal contraceptives, it was recommended to use an additional method of contraception (eg, condoms) during the use of antibiotics, including amoxiclav, and for seven days thereafter. Today the situation is different, and the use of "safety" contraceptive methods while taking antibiotics (except rifampicin and rifabutin), not necessarily because they do not prove that the use of antibiotics at the same time affect the effectiveness of oral contraceptives.

Storage conditions

Shelf life for solids suspension - 2 years, the finished slurry - 7 days when stored in a refrigerator. Shelf life of tablets - 2 year storage at a temperature no higher than 25 ° C. Amoksiklav Store in a dry, cool place, protected from light and moisture, and the reach of children. In no case do not take the drug expired.