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Antibiotic group macrolides. Has a bacteriostatic effect due to inhibition of protein synthesis by bacteria. When creating a high inflammation in the focus of inflammation has a bactericidal effect.

Highly active against intracellular microorganisms: Chlamydia trachomatis and Chlamydia pneumonuae, Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum, Legionella pneumophila; for Gram-positive aerobic bacteria: Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae (pneumococcus), Corynebacterium diphtheriae; Gram-negative aerobic bacteria: Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis; for some anaerobic bacteria: Peptococcus, Peptostreptococcus, Clostridium perfringens.

Jozamycin is also active against Treponema pallidum.

After ingestion, josamycin is rapidly absorbed from the digestive tract. C max is achieved 1-2 hours after administration. 45 minutes after taking a dose of 1 g, the average concentration of josamycin in plasma is 2.41 mg / l.

Binding to plasma proteins does not exceed 15%.

The equilibrium state is achieved after 2-4 days of regular intake.

Josamycin is well distributed in the body and accumulates in various tissues: in the pulmonary, lymphatic tissues of the tonsils, urinary system, skin and soft tissues. Especially high concentrations are determined in the lungs, tonsils, saliva, sweat and tear fluid. The concentration of josamycin in human polymorphonuclear leukocytes, monocytes and alveolar macrophages is approximately 20 times higher than in other cells of the body.

Jozamycin is biotransformed in the liver to less active metabolites.

It is excreted mainly with bile, excretion in the urine is less than 20%.

Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to dzhozamycin: infections of the upper respiratory tract and ENT organs (including pharyngitis, tonsillitis, paratonzillitis, otitis media, sinusitis, laryngitis); diphtheria (in addition to treatment with diphtheria antitoxin); scarlet fever (with increased sensitivity to penicillin); infections of the lower respiratory tract (including acute bronchitis, bronchopneumonia, pneumonia, including atypical form, whooping cough, psittacosis); infections of the oral cavity (including gingivitis and periodontal disease); infections of the skin and soft tissues (including pyoderma, furuncles, anthrax, erysipelas (with increased sensitivity to penicillin), acne, lymphangitis, lymphadenitis); urinary tract and genital tract infections (including urethritis, prostatitis, gonorrhea, with increased sensitivity to penicillin - syphilis, venereal lymphogranuloma); chlamydia, mycoplasmal (including ureaplasma) and mixed infections of the urinary tract and genital organs.

Severe violations of liver function, increased sensitivity to erythromycin and other antibiotics of macrolides.

When administered to adults and children over 14 years of age - 1-2 g / day in 2-3 hours. Children under the age of 14 years - 30-50 mg / kg / day in 3 divided doses. The duration of treatment depends on the indications for use.

From the digestive system: rarely - lack of appetite, nausea, heartburn, vomiting, diarrhea, pseudomembranous colitis; in some cases - increased activity of hepatic transaminases, violation of outflow of bile and jaundice.

Allergic reactions: rarely - hives.

Other: in some cases - dose-dependent transient hearing impairment.

Bacteriostatic antibiotics can reduce the bactericidal action of other antibiotics, such as penicillins and cephalosporins (simultaneous use of josamycin with penicillins and cephalosporins should be avoided).

With the simultaneous use of josamycin with lincomycin, the effectiveness of both drugs may be reduced.

Josamycin slows down the release of theophylline less than other macrolide antibiotics.

Josamycin slows the withdrawal of terfenadine or astemizole, which increases the risk of life-threatening arrhythmias.

There are some reports of increased vasoconstrictor action with the simultaneous use of antibiotics of macrolides and ergot alkaloids. One case of intolerance to ergotamine with josamycin was noted.

With the simultaneous use of josamycin and cyclosporine, an increase in the concentration of cyclosporine in the blood plasma is possible up to nephrotoxic.

With the simultaneous use of josamycin and digoxin, an increase in the level of the latter in the blood plasma is possible.

In rare cases, against the background of treatment with macrolides, the contraceptive effect of hormonal contraceptives may be inadequate.

If pseudomembranous colitis develops, josamycin should be discontinued and appropriate therapy prescribed. Drugs that reduce intestinal motility are contraindicated.

In patients with renal insufficiency, correction of the dosing regimen is required in accordance with the values ​​of CK.

Jozamycin is not prescribed for premature infants. When used in newborns, it is necessary to monitor liver function.

The possibility of cross-resistance to various antibiotics of the macrolide group should be taken into account (for example, microorganisms resistant to treatment with antibiotic related chemical structures may also be resistant to josamycin).

Application in pregnancy and lactation is possible only in cases where the intended benefit to the mother exceeds the potential risk to the fetus or child.

In the treatment of macrolides and the simultaneous use of hormonal contraceptives should additionally use non-hormonal contraceptives.