Author: Wang Na, Department of Pharmacy, Hefei Second People's Hospital
pharmacist, may I ask the doctor to prescribe these medicines for diarrhea (cefixime granules, montmorillonite powder) for my baby , Bifidobacterium triplex viable bacteria powder), which one should I take first? What should I pay attention to when giving children these kinds of medicines?
I often encounter a parent who looks at several medicines prescribed by the doctor and looks at a loss, not knowing how to give it to his child. Next, we discuss the following precautions such as the order of taking the medicines commonly used to treat children with diarrhea .
Pediatric diarrhea is a disease mainly caused by diarrhea caused by multiple pathogens and multiple factors. The clinical symptoms are mainly based on increased stool frequency and changes in character, which may be accompanied by fever, vomiting, abdominal pain and other symptoms. Clinically, viral infectious diarrhea is more common, often self-limiting , generally no antiviral drugs or antibacterial drugs should be used. However, bacterial infectious diarrhea in children often requires anti-infective treatment. Common pathogenic bacteria include diarrheal Escherichia coli, Campylobacter jejuni, non-typhoid Salmonella, Shigella, etc. The commonly used antibacterial drugs include third-generation cephalosporin. Erythromycin, azithromycin, etc.
cefixime
Cefixime is a third-generation cephalosporin commonly used in clinical practice.It has a killing effect on common pathogenic bacteria of infectious diarrhea in children, with fewer clinical adverse reactions, and it can be made into an oral preparation, which is relatively safe, effective and convenient for children to take.
The administration time of cefixime and precautions:
cephalosporin
Taking it with food will increase the absorption time.
Therefore, whether cefixime is taken on an empty stomach has no effect. However, it is recommended to take it on an empty stomach in the treatment of intestinal infections, so that the drug can be in contact with the intestinal bacteria to the greatest extent, and has a certain local sterilization effect. Then cefixime will be absorbed into the blood to exert its systemic antibacterial effect.
Montmorillonite powder
Montmorillonite powder is the most widely used intestinal mucosal protective agent in clinical application. It can effectively adsorb intestinal viruses and bacteria in children, and inhibit pathogen damage to the intestinal tract. In addition, it can also enhance the self-defense ability of the intestinal mucosa to achieve the effect of antidiarrheal. Afterwards, the montmorillonite powder and the adsorbed bacteria and viruses are excreted with intestinal peristalsis, thereby preventing intestinal cells from being damaged by pathogens. The advantage of montmorillonite powder in the treatment of diarrhea in children is that it is relatively mild, not absorbed by the gastrointestinal tract of the child, and will not enter the blood circulation system of , so it has no harm to the organs and nervous system of the child.
The dosing time of montmorillonite powder:
1spanIt should be taken after the stomach is basically empty, and it is not suitable to eat for at least 2 to 3 hours after taking it; taking montmorillonite before or half an hour after a meal is ineffective, because montmorillonite cannot cover evenly On the mucosa, the influence comes into play.
Probiotics
Probiotics are given to a certain number of live microorganisms that can have a beneficial effect on the health of the host. The probiotic preparations commonly used in clinic mainly include Lactobacillus , Bifidobacterium , Clostridium butyricum and Enterococcus .
The taking time of cefixime and precautions:
0.5 hour after the meal, it is recommended In addition, the food stays in the stomach can neutralize gastric acid, and the PH value in the stomach can be increased, which can greatly reduce the destruction of probiotics by gastric acid. Probiotics are living microorganisms. Except for the freeze-dried and inactivated Lactobacillus acidophilus (trade name: Letuoer) and Saccharomyces boulardii (trade name: Yihuo), which are not sensitive to antibiotics, others should be avoided. Take antibiotics at the same time. If you need to use antibiotics at the same time, you should increase the dose of probiotics or stagger the medication time, preferably more than 2-3 hours apart. Most probiotics are live bacteria and need to be stored in a refrigerator (2-8°C) and should be taken with warm water. Table 1 shows the types, storage conditions and precautions of common probiotics.
When probiotics are used in combination with antibacterial drugs and gastrointestinal mucosal protective agents, according to the characteristics and precautions of the above three types of drugs, they can kill the pathogen first Microorganisms, then use gastrointestinal mucosal protective agents such as montmorillonite powder to adsorb various bacteria and their toxins (especially pathogenic gram-negative bacterial endotoxins), and finally use probiotics to restore normal intestinal flora. The interval between three types of medicine is at least 1 hour. The order and time interval of the three medications are shown in the figure below.
In summary, for the treatment of children’s diarrhea, to achieve the best therapeutic effect, the time and order of the above three drugs are recommended as follows: Take cefixime 2-2.5 hours → take montmorillonite powder 1-1.5 hours before meals after 1 hour interval → eat normally → take probiotics 0.5-1 hour after meals Antibacterial drugs, will montmorillonite powder also adsorb the antibacterial drugs? won’t be , because montmorillonite powder is taken 1 hour after taking antibacterial drugs. At this time, the antibacterial drugs have been absorbed by the intestines after they have been locally sterilized in the intestines, and will exert systemic antibacterial effects after being absorbed into the blood. Therefore, mastering the correct interval of medication is also the key to rational medication! This is the content discussed today.Hope parents and mothers should not only ensure the correct route of administration, usage and dosage, but also pay attention to the reasonable time and order of medication when giving medicine to the baby, so that the medicine you give your baby can give the best treatment. effect! The second people’s hospital of Hefei and strong2span 5 If you reprint the original works, please indicate the author and source! 【Pharmacy Shield Public Welfare】 is a public welfare organization jointly initiated and established by China Non-Prescription Drug Association, Chinese Pharmaceutical Association, Chinese Medical Association, etc.-PSM Pharmaceutical Shield Public Welfare (public number: PSMChina), Gathering resources, pooling strength, and promoting the safety of drug use by the public.
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