Spiramycin

Spiramycin As a macrolide antibiotic, it is used in human medicine as a single preparation with a half-life of 3 to 4 hours in the treatment of infections in children and adults. Spiramycin has also proven itself in a toxoplasmosis infection during pregnancy.

What is spiramycin?

Spiramycin is a macrolide antibiotic that belongs to the group of macrolides. The half-life is 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 used as an alternative in case of existing penicillin intolerance. Macrolides are often prescribed, especially in pediatrics. The extraction or production takes place from certain strains of Streptomyces ambofaciens.

It is prescribed in human medicine as a single preparation under the names Rovamycine® and Selctomycin®.

Pharmacological effect

In order to summarize the pharmacological effects on the body, it should already be mentioned that macrolides inhibit the protein synthesis of bacteria and thus prevent them from multiplying (bacteriostasis). Compared to other antibiotic preparations of the macrolide group, the development of resistance occurs more slowly. There is cross resistance between spiramycin and erythromycin. This does not exist between spiramycin and penicillin as well as tetracycline and streptomycin and chloramphenicol.

The breakdown takes place via the liver, which unfortunately can lead to interactions with other drugs. Provided that these are also broken down by the liver.

When used during or after the 16th to 20th week of pregnancy, the effect of the therapy must under no circumstances be defined as an elimination of the parasite from the fetal or child's body. Experimental studies show that an induced transformation of the parasite from an aggressive tachyzoite or thrombocoite form into a harmless bradyzoite or cystozoite form can be expected as a result of the therapy.

Medical application & use

Respiratory diseases such as pneumonia, whooping cough and tonsillitis can be treated with macrolides as well as pharyngitis and an ear, nose and throat infection. Superficial skin infections including acne can also be treated. Urethral infections 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 gastric ulcers, the goal is to get rid of Helicobacter pylori from the stomach lining.

Corresponding to erythromycin, there is no effect on H. influenzae. High doses are effective against Toxoplasma gondii.

For an infection with toxoplasmosis during pregnancy, therapy with spiramycin is the treatment of choice. This in particular until the final, decisive serology result for the second serum is available. The frequency of congenital toxoplasmosis can be reduced by 50 to 70 percent if therapy is started in good time. An increase of up to 90 percent is apparently possible with a combined therapy of spiramycin with pyrimethamine and sulfadiazine during or after the 16th to 20th week of pregnancy. In addition, the intrauterine damage must be significantly reduced in terms of its possible degree of severity.

Risks & side effects

The most common internal side effects include gastrointestinal complaints such as diarrhea and flatulence. Not infrequently, these symptoms are also associated with nausea. Disturbances of the bile and liver as well as the development of a so-called antibiotic-induced pseudomembranous colitis.

But cardiac arrhythmias are also observed more frequently and unfortunately belong to the list of undesirable side effects when taking spiramycin. In the ECG, these disturbances appear as torsade de pointes. This means that the period of time between the electrical excitation of the ventricle and the regression of excitation is extended.

Dermatologically, skin irritations can often be observed. Allergies, i.e. immune reactions to non-infectious foreign substances (allergens or antigens), also occur frequently. The result is signs of inflammation and the formation of antibodies.

Mycosis (fungal infection), for example from external pathogenic fungi, can also occur. In general, there are reports of tiredness on the one hand and sleep disorders on the other. Many sufferers also complain of a fever.