Acos 500 mg

Description

Indications Acos is prescribed for infections caused by susceptible bacteria. It is used in treating lower respiratory tract infections such as bronchitis and pneumonia, upper respiratory tract infections including sinusitis and pharyngitis/tonsillitis, otitis media, and skin and soft tissue infections. Additionally, Acos is effective in managing sexually transmitted diseases, specifically non-gonococcal urethritis and cervicitis caused by Chlamydia trachomatis.

Pharmacology Azithromycin, the active ingredient in Acos, is acid-stable, allowing it to be taken orally without protection from stomach acids. It is well absorbed, especially on an empty stomach, reaching peak concentrations in 2.1 to 3.2 hours after oral administration. Azithromycin accumulates in phagocytes and is transported to infection sites, where it is released in high concentrations during active phagocytosis. Its high tissue concentration results from ion trapping and its lipid solubility. The drug’s extended half-life allows for a single large dose to maintain bacteriostatic levels for several days. The primary route of elimination is through biliary excretion, with approximately 6% of the dose excreted unchanged in urine.

Microbiology Azithromycin functions by binding to the 50S ribosomal subunit of susceptible bacteria, thereby inhibiting microbial protein synthesis without affecting nucleic acid synthesis. It is active against a variety of microorganisms, including:

• Gram-positive bacteria: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes.
• Gram-negative bacteria: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae.
• Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis, Mycoplasma pneumoniae.
• Additional bacteria: Streptococci (Groups C, F, G), Viridans group streptococci, Bordetella pertussis, Legionella pneumophila.
• Anaerobic bacteria: Peptostreptococcus species, Prevotella bivia.

Dosage and Administration

Oral Administration:

• Adults: 500 mg once daily for 3 days, or 500 mg on day 1 followed by 250 mg once daily for the next 4 days.
• Sexually Transmitted Infections: 1 g as a single dose or 500 mg on day 1, followed by 250 mg once daily for 2 more days.
• Children (over 6 months old):
  • 10 mg/kg body weight once daily for 3 days.
  • 15-25 kg: 200 mg (1 teaspoonful) daily for 3 days.
  • 26-35 kg: 300 mg (1.5 teaspoonfuls) daily for 3 days.
  • 36-45 kg: 400 mg (2 teaspoonfuls) daily for 3 days.
  • Typhoid Fever: 500 mg (2.5 teaspoonfuls) daily for 7-10 days.

Intravenous Administration:

• Community-Acquired Pneumonia: 500 mg intravenously for at least 2 days, followed by oral therapy (500 mg daily) to complete a 7-10 day regimen.
• Pelvic Inflammatory Disease: 500 mg intravenously for 1-2 days, followed by 250 mg orally for a total of 7 days. If anaerobic infection is suspected, an additional antimicrobial agent should be used.
• Pediatric Use: Safety and efficacy in children under 16 years of age have not been established.

Reconstitution Procedure for Suspension

1. Shake the bottle to loosen the powder.
2. Add previously boiled and cooled water up to the indicated mark on the bottle label.
3. Shake well until the powder is completely mixed.
4. Take at least 1 hour before or 2 hours after a meal.

Drug Interactions

• Antacids: Take azithromycin at least 1 hour before or 2 hours after antacids.
• Carbamazepine: No significant interaction observed.
• Cyclosporin: May require dose adjustments; monitor cyclosporin levels.
• Digoxin: Monitor digoxin levels, as azithromycin may affect metabolism.
• Ergot Derivatives: Avoid co-administration due to the risk of ergotism.
• Methylprednisolone & Theophylline: No significant interactions observed.
• Warfarin: Monitor prothrombin time closely.
• Terfenadine: No significant effect on pharmacokinetics or cardiac repolarization.

Contraindications Azithromycin is contraindicated in patients with hypersensitivity to azithromycin or other macrolide antibiotics. It should not be used in patients with hepatic disease or those taking ergot derivatives.

Side Effects Acos is generally well tolerated. Common side effects include nausea, abdominal discomfort, vomiting, diarrhea, flatulence, and loose stools. Rare cases of allergic reactions, cholestatic jaundice, and transient reductions in neutrophil counts have been reported. High doses for prolonged periods may cause reversible hearing impairment.

Pregnancy and Lactation Azithromycin is classified as Pregnancy Category B. Animal studies have not shown harm to the fetus, but human data is limited. It should be used during pregnancy only when no safer alternatives are available. The presence of azithromycin in breast milk is unknown, so caution is advised when prescribing to nursing mothers.

Precautions and Warnings Serious allergic reactions, including angioedema and anaphylaxis, have been reported, sometimes requiring prolonged monitoring and treatment. Caution is needed in patients with severe renal impairment due to limited safety data. As the liver is the primary route of elimination, patients with liver disease should avoid this medication.

Overdose Effects Symptoms of overdose may include hearing loss, severe nausea, vomiting, and diarrhea. In such cases, gastric lavage and supportive treatment are recommended.

Storage Conditions Store in a cool, dry place away from heat and direct sunlight. Keep out of reach of children.

Common Questions

• What is Acos 500 mg Tablet? Acos works by inhibiting bacterial protein synthesis, effectively treating infections.
• What conditions does it treat? It is used for pneumonia, pharyngitis/tonsillitis, and skin infections.
• Can it cause diarrhea? Yes, as it affects gut bacteria. If severe, consult a doctor.
• Is it an antibiotic? Yes, it belongs to the macrolide class.
• What if my symptoms don’t improve? If symptoms persist after 3 days, consult your doctor.

Quick Tips

• Complete the full course even if you feel better.
• Take 1 hour before or 2 hours after meals.
• Avoid antacids within 2 hours of taking Acos.
• If diarrhea persists or contains blood, contact your doctor.
• Seek immediate medical help if you experience severe allergic reactions.