Spiramycin as a macrolide antibiotic is used in human medicine as a monopreparation with a half-life of 3 to 4 hours in the treatment of infections in children and adults. Spiramycin has also proven effective in toxoplasmosis infection during pregnancy.
What is spiramycin?
Spiramycin is a macrolide antibiotic that belongs to the macrolide group. It has a half-life of 3 to 4 hours. It is used in tablet form in the treatment of bacterial infections. Because of the similarity of the active ingredient to penicillin, it can be prescribed as an alternative in cases of penicillin intolerance. Macrolides are frequently prescribed, especially in pediatrics. It is obtained or produced from certain strains of Streptomyces ambofaciens. It is prescribed in human medicine as a monopreparation under the names Rovamycine and Selctomycin.
Pharmacological action
To summarize the pharmacological effect on the body in front, it should be mentioned now that macrolides inhibit the protein synthesis of bacteria, preventing them from multiplying (bacteriostasis). Compared to other antibiotic preparations of the macrolide group, the development of resistance occurs more slowly. Cross-resistance exists between spiramycin and erythromycin. This does not exist between spiramycin and penicillin and tetracycline and streptomycin and chloramphenicol. Degradation occurs via the liver, which unfortunately can lead to interactions with other drugs. Provided that these are also broken down via the liver. When used during or after the 16th to 20th week of pregnancy, the effect of the therapy should in no case be defined as an elimination of the parasite from the fetal or infant body. Experimental studies indicate that an induced transformation of the parasite from an aggressive tachyzoite or a thrombozoite form to a harmless bradyzoite or cystozoite form can be expected as a result of therapy.
Medical application and use
Respiratory infections such as pneumonia, whooping cough, and tonsillitis can be treated with macrolides as well as pharyngitis and ear, nose, and throat infections. Superficial infections of the skin, including acne, are also treatable. Infections of the urethra caused by gonorrhea also respond to this treatment. This also applies to infections caused by non-tuberculous atypical mycobacteria in HIV-infected patients. In the preventive or curative treatment of peptic ulcers, the goal is to eliminate Helicobacter pylori from the gastric mucosa. According to erythromycin, there is no effect in H. influenzae. There is efficacy against Toxoplasma gondii at high doses. In case of infection with toxoplasmosis during pregnancy, therapy with spiramycin is the drug of choice. This is especially true until the final decisive serological result regarding the second serum is available. The incidence of connatal toxoplasmosis can be reduced by 50 to 70 percent if therapy is started in time. An increase of up to 90 percent is apparently possible with combined therapy of spiramycin with pyrimethamine and sulfadiazine during or after the 16th to 20th week of pregnancy. In addition, intrauterine damage can also be significantly reduced in terms of its potential severity.
Risks and Side Effects
The most common internal side effects include gastrointestinal symptoms such as diarrhea (diarrhea) and flatulence. It is not uncommon for these symptoms to be associated with nausea. Disturbances of bile and liver as well as the development of a so-called antibiotic-induced pseudomembranous colitis. However, cardiac arrhythmias are also observed more frequently and thus unfortunately belong to the list of undesirable side effects when taking spiramycin. In the ECG, these disturbances present themselves as torsade de pointes. This means that the period of time between the electrical excitation of the ventricle and the return of excitation is prolonged. Dermatologically, irritation of the skin is common. Allergies, immune reactions to non-infectious foreign substances (allergens or antigens) are also common. The result is signs of inflammation and the formation of antibodies. Mycosis (fungal infection), for example caused by pathogenic fungi from outside, can also occur.Generally, fatigue is reported on the one hand and sleep disturbances on the other. Many sufferers also complain of fever.
