Uses of Midantin 250

Midantin 250/31.25 contains two main active ingredients, Amoxicillin and Clavulanic Acid. Midantin is indicated in infections caused by beta-lacamase-producing strains of bacteria that have not responded to treatment with aminopenicillin alone. The following article provides some information about the uses, dosage and precautions when using Midantin 250/31.25.

Amoxicillin and clavulanic acid is a bactericidal combination. This does not change the mechanism of action of Amoxicillin (inhibiting bacterial cell membrane peptidoglycan synthesis) but also has a synergistic bactericidal effect. Clavulanic acid extends the antibacterial spectrum of Amoxicillin against bacteria, producing beta-lactamases that are resistant to Amoxicillin alone, because clavulanic acid binds to bacterial beta-lactamases to inhibit them.
Bactericidal spectrum of Midantin 250/31.25 includes:
Gram-positive bacteria: aerobic type (Streptococcus pneumoniae, Streptococcus faecalis, Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus, Corynebacterium, Listeria monocytogenes, Bacillus anthracis); anaerobic species (Clostridium species, Peptostreptococcus, Peptococcus species). Gram-negative bacteria: Aerobic (Escherichia coli, Haemophilus influenzae, Proteus mirabilis, Proteus vulgaris, Klebsiella species, Shigelta, Salmonella, Bordetella, Neisseria meningitidis, Neisseria gonorrhoeae, Vibrio cholerae, Pasteurella multocida), anaerobic species (species) Bacteroides including B.fragilis). Midantin 250/31.25 has a risk of causing cholestatic jaundice, so it should not be used for more than 14 days. Before starting treatment with Midantin, an antibiotic must be done to identify the causative organism. Pending antibiogram results, amoxicillin may be used in combination with clavulanic acid if beta-lactamase-producing bacteria are suspected. In case the results of the antibiogram show that the bacteria are resistant to the drug, the drug must be stopped immediately. If the results are due to bacteria that do not produce aminopenicillin-sensitive bela-lactamases, some physicians recommend switching to aminopenicillins, but this is difficult in practice.

2.1 Indications Midantin 250/31.25 is used in the treatment of infections caused by beta-lacamase-producing strains of bacteria that have not responded to treatment with aminopenicillin alone. Midantin is used in a short time <14 days:
Severe upper respiratory tract infections: sinusitis, tonsillitis, otitis media treated with common antibiotics but did not improve. Lower respiratory tract infections caused by strains of Haemophilus influenzae and Moraxella catarrhalis producing beta-lactamase: pneumonia - bronchiolitis, acute bronchitis, chronic bronchitis. Severe urinary-genital tract infections caused by beta-lactamase-producing strains of E.coli, Enterobacter, Klebsiella: cystitis, urethritis, pyelonephritis, female genital tract infections. Skin and soft tissue infections: insect stings, boils, abscesses, wound infections, cellulitis. Bone and joint infections: osteomyelitis. Dental infections: alveolar abscess. Other infections: postpartum infections, infections caused by miscarriage, infections in the abdomen. 2.2 Contraindications Allergy or hypersensitivity to beta-lactams (penicillins and cephalosporins). Pay attention to the possibility of cross-allergy with beta-lactam antibiotics such as cephalosporins.

Midantin 250/31.25 is used under the prescription of a doctor. Taking Midantin tablets at the beginning of food helps limit the phenomenon of drug intolerance in the gastrointestinal tract. The duration of taking Midantin 250/31.25 should not exceed 14 days.
Dosages below are expressed in terms of the Amoxicillin content of the compound. Do not use Midantin 250/31.25 for children weighing <40kg.
Adults and children weighing > 40kg: Take 2 tablets every 12 hours. For respiratory infections or severe infections: Take 2 tablets every 8 hours for 5 days. Patients with renal impairment (doses below are based on amoxicillin content):

Overdose of Midantin 250/31.25 and management:
Symptoms of Midantin overdose include abdominal pain, vomiting and diarrhea. Rarely, patients have developed a rash, increased agitation, or lethargy.
Treatment of overdose Midantin: it is necessary to stop using the drug immediately when symptoms of overdose appear.
If symptoms of Midantin 250/31.25 overdose occur early and there are no contraindications, measures to induce vomiting or gastric lavage can be applied. Overdosage of Midantin less than 250 mg/kg is usually asymptomatic and does not require gastric emptying. Treatment of Midantin overdose is mainly symptomatic supportive treatment.
In a small number of patients, an overdose of Amoxicillin can cause interstitial nephritis leading to renal failure, oliguria, crystaluria. Providing adequate fluids and electrolytes to the patient helps maintain diuresis and reduces the risk of crystalluria. Kidney damage is usually reversible upon discontinuation of Midantin. Patients with renal impairment due to decreased excretion of Amoxicillin and clavulanic acid may develop hypertension.

Side effects on the gastrointestinal tract when using Midantin 250/31.25 are more common. Other adverse events occurred with similar frequency and severity as with amoxicillin alone. Unwanted effects when taking Midantin are usually mild and transient, only less than 3% of patients have to stop using the drug with the following manifestations: nausea, vomiting, diarrhea; Skin: rash, itching.
There are also a few other side effects not listed here, if you have any unusual signs, you should contact your doctor for advice.

Clavulanic acid has the potential to increase the risk of intrahepatic cholestasis, so Midantin 250/31.25 should be used with caution in the elderly, in patients with a history of jaundice or liver dysfunction. These symptoms are rare when taking Midantin but can be severe, but are usually reversible and disappear after 6 weeks of stopping the drug.
Severe allergic or hypersensitivity reactions in patients with a history of allergy to penicillins or other allergens, so before starting Midantin, it is necessary to carefully ask for a history of allergy to penicillins, cephalosporins and other allergens. other.
Patients with moderate or severe renal impairment require dose adjustment of Midantin 250/31.25. Using Amoxicillin can cause redness, fever and lymphadenopathy. Use of Midantin increases the risk of rash in patients with infectious mononucleosis.
Prolonged use of drugs sometimes leads to the development of resistant bacteria. Must periodically check hematological index, liver function during treatment. A differential diagnosis is needed to detect Clostridium difficile diarrhea and pseudomembranous colitis.
Pregnant and lactating women avoid using the drug unless directed by a doctor.

Anticoagulants: Concomitant use with Midantin 250/31.25 may prolong bleeding and clotting time.
Oral contraceptives: Midantin reduces the effectiveness of oral contraceptives, so patients should be informed.
Nifedipine: increases the absorption of Amoxicillin.
Allopurinol : will increase the possibility of rash appearance of Amoxicillin.
There may be antagonism between amoxicillin and bacteriostatic agents such as fusidic acid, chloramphenicol and tetracycline.
Methotrexate: Amoxicillin reduces drug excretion and increases toxicity on the gastrointestinal tract and hematopoietic system.
Probenecid: taking immediately before or simultaneously with Amoxicillin reduces Amoxicillin elimination, increases Amoxicillin blood concentration.
Above is all the important information about Midantin 250/31.25. Patients should note before using to achieve the best results as well as minimize side effects during treatment.