Bistrep (benzylpenicillin procaine, dihydrostreptomycin sulfate)  solution for injection

Storage

1 ml of the drug contains:

benzylpenicillin procaine — 200 thousand IU

dihydrostreptomycin sulfate — 200 mg

Description

White or yellow liquid.

Pharmacological properties

A complex preparation based on benzylpenicillin and dihydrostreptomycin with a wide spectrum of bactericidal action.

Benzylpenicillin procaine is an equimolecular compound of benzylpenicillin with procaine (novocaine), which ensures its prolonged effect. Benzylpenicillin is a bactericidal antibiotic of the penicillin series that acts on gram-positive microorganisms — Clostridium spp., Corynebacterium spp., Erysipelothrix spp., Bacillus spp., Actinomyces spp., Listeria spp., Leptospira spp., Staphylococcus spp., Streptococcus spp., gram-negative microorganisms — Campylobacter spp., Haemophilus spp., Pasteurella spp., Actinobacillus spp. and some Bacteroides spp. The mechanism of action consists in disrupting the synthesis of peptidoglycan, a mucopeptide of the cell membrane, which leads to the inhibition of the synthesis of the microorganism’s cell wall, inhibiting the growth and reproduction of bacteria.

Dihydrostreptomycin is an aminoglycoside antibiotic. It has a bactericidal effect on gram-positive microorganisms — Staphylococcus spp., gram-negative microorganisms — Pasteurella spp., Salmonella spp., Escherichia coli, Klebsiella spp., Leptospira spp., Actinobacillus spp., Shigella spp., Francisella tularensis, Yersinia spp. Not active against anaerobic microorganisms. The bactericidal effect is due to the ability to bind to the 30S subunits of bacterial ribosomes and disrupt protein synthesis.

Benzylpenicillin procaine is slowly absorbed from the injection site when administered intramuscularly. The maximum concentration in blood serum of 1.6-4.2 μg/ml is observed after 1.5-6 hours depending on the type of animal and slowly decreases within 16-24 hours. After administration, it gets into almost all organs and tissues except cerebrospinal fluid, easily passes through the placental barrier. It binds to blood serum proteins: 28.5% in cattle, 30.4% in sheep and goats, 60% in pigs and dogs. It is excreted unchanged from the body mainly with urine (up to 90%), partly with bile and milk.

Dihydrostreptomycin is quickly absorbed when administered intramuscularly. Bacteriostatic concentration in blood plasma is observed after 15-30 minutes, the maximum — after 1 hour. The maximum concentration reaches: in cattle — 44-78 μg/ml, pigs — 87 μg/ml, sheep, goats — 44-70 μg/ml, dogs — 41 μg/ml, cats — 25 μg/ml and persists for 24-48 hours. Proteins bind up to 20-25% of dihydrostreptomycin, due to which its high concentration in the kidneys is achieved. It is excreted unchanged from the body mainly by the kidneys (more than 90%), partly with bile.

Indication

Treatment of cattle, sheep, goats, pigs, cats, dogs with bacterial infections of the respiratory tract (tracheitis, bronchitis, pneumonia), gastrointestinal tract, genitourinary system (cystitis, metritis), skin and connective tissue infections (wounds, abscesses, hoof infections, purulent inflammation of the joints, umbilical sepsis), as well as mastitis, postoperative infections caused by microorganisms sensitive to the active substances of the drug.

The drug is effective in the treatment of leptospirosis.

Contraindication

Do not prescribe to animals with increased sensitivity to the active substances of the drug, impaired kidney function, as well as to rabbits, ferrets, hamsters and gerbils.

Do not administer intravenously.

Method of application and dosage

Before use, the suspension is thoroughly shaken and administered intramuscularly or subcutaneously once a day, the course is 3 days.

The doses of the drug are:

• cattle — 5 ml per 100 kg of body weight;
• calves under 6 months of age — 8 ml per 100 kg of body weight;
• pigs, sheep, goats, dogs, cats — 1 ml per 10 kg of body weight.

If the dose exceeds the following values, the injection is divided into two parts and injected into different places: cattle — 20 ml, pigs — 10 ml, sheep, goats — 5 ml, dogs, cats — 2 ml.

*Kilograms to a Pounds conversion table

Reservation

Local allergic reactions and hypersensitivity to the drug (pain and swelling) are possible.

Studies on laboratory animals have not revealed a teratogenic effect of the active ingredients. In the absence of studies in the target species of animals, the drug is prescribed according to the benefit/risk assessment carried out by a veterinarian.

Dihydrostreptomycin has the lowest nephrotoxicity among aminoglycosides, but it should not be used simultaneously with other potentially nephrotoxic drugs (furasemide, ethacrynic acid), methoxyflurane, and amphotericin.

Dihydrostreptomycin is a mild neuromuscular blocker, but in significant doses it can enhance the effect of other aminoglycoside antibiotics. Therefore, the drug should be used with caution in animals under anesthesia and together with magnesium and muscle relaxants.

After the last use of the drug, animals can be slaughtered for meat after 30 days, and people can consume milk after 4 days (8 milkings). Meat and milk obtained before the specified term are disposed of or fed to unproductive animals, depending on the opinion of the veterinarian.

You should strictly adhere to the recommended doses and terms of treatment.

Storage conditions

In a dry, dark place inaccessible to children, at a temperature of +2 to +8 °C. After opening the bottle, store the drug in the refrigerator and use it within 28 days.

Expiration date

2 years.