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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › COMBINATIONS OF ANTIBACTERIALS › Combinations of antibacterials
spiramycin and metronidazole
J01RA04
Forms & Strengths
- Combination tablet: Spiramycin 1,500,000 IU + Metronidazole 250 mg
Adult Dosing
- Standard: 1 to 2 tablets 3 times daily during meals
- Severe infections: Up to 2 tablets 4 times daily
Pediatric Dosing
- Not recommended for children under 6 years of age
- Children 6-10 years: 1 tablet twice daily
- Children 10-15 years: 1 tablet 3 times daily
Indications
- Severe acute, chronic, or recurrent dental and oral infections (e.g., dental abscesses, cellulitis, periodontitis, gingivitis)
- Prevention of local postoperative complications in dental surgery
Mechanism of Action
- Synergistic antimicrobial combination
- Spiramycin: Macrolide antibiotic inhibiting bacterial protein synthesis via 50S ribosomal subunit binding
- Metronidazole: Synthetic nitroimidazole that disrupts bacterial DNA synthesis in obligate anaerobes
Contraindications
- Hypersensitivity to spiramycin, metronidazole, imidazole derivatives, or excipients
- Children under 6 years of age
- Concomitant alcohol consumption (disulfiram-like reaction due to metronidazole component)
Adverse Reactions
- Gastrointestinal: Nausea, vomiting, abdominal pain, diarrhea, metallic taste
- Central nervous system: Headache, dizziness, peripheral neuropathy (with prolonged use)
- Hypersensitivity: Skin rash, urticaria, pruritus
- Hematological: Transient leukopenia (rare)
Drug Interactions
- Disulfiram: Acute psychosis or confusion when combined with metronidazole
- Alcohol: Severe disulfiram-like reaction (flushing, vomiting, tachycardia)
- Oral anticoagulants (warfarin): Potentiation of anticoagulant effect and increased bleeding risk
- Lithium: Increased serum lithium concentrations and risk of toxicity
- Vecuronium: Enhanced neuromuscular blockade
Curated Content: Needs Vetting Before Put to Clinical Use