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Vraag

Gepost op: 6 maart 2013

Clavucid 175mg in zetpillen voor een kind +/- 2 jaar. Posologie 3x1 per dag.


We hebben zetpillen van 2 g bereid, aangien 1 g onmogelijk bleek, maar hoe is het gesteld met de biologische beschikbaarheid? Welke zou de ideale suppobasis zijn voor deze bereiding?

Antwoord

Er is geen eensgezindheid over de rectale absorptie van antibiotica. Ik kon spijtig genoeg geen informatie vinden over de rectale absorptie van amoxycillin. Dus de klinische verschijnselen zullen moeten uitwijzen of er een therapeutisch effect is. Een ideale zetpilmassa kan ik u ook niet aanbevelen. Daarenboven de beschikbaarheid in België is minimaal. Ik zou dan nog opteren voor Suppocire AS2X.

ADDENDUM (dank aan Prof. Dr. G. Laekeman)

Clinical Evaluation of Ractally Administered Ampicillin in Acute Otitis Media
B.K.V. Bergström, S.O. Bertilson and G. Movin
The Journal of International Medical Research (1988) 16:376-385.

An ampicillin suppository was compared with amoxycillin suspension in the treatment of acute otitis media in children. Both antibiotics were given three times daily for 5 days in a daily dose of 25-50 mg/kg body weight. Safety was evaluated in 454 patients in the group given suppository and in 229 given the suspension, and 421 and 229 patients, respectively, were evaluable for efficacy. Ampicillin was rapidly absorbed and produced plasma concentrations well above the minimum inhibitory concentration for common respiratory pathogens. The overall clinical outcome was satisfactory (cured plus improved) in 89% of the patients given the suppository and in 86% given the suspension. Gastro-intestinal disturbances occurred in 28.4% of the patients given the suppository compared with 14.4% of those given the suspension. Perianal irritation was recorded in 12.1% of the patients given the suppository and in 5.2% of those given the suspension. Treatment was interrupted in 9.8% of patients given the suppository and in 0.9% of those given the suspension. In spite of these discomforts rectally administered ampicillin is considered to be a good alternative in children when oral medication is not feasible.