BACTERIOPHAGE COLYPROTEAN SOLUTION D/ORAL AND D/RECT. ENTER 100ML

BACTERIOPHAGE COLYPROTEAN SOLUTION D/ORAL AND D/RECT. ENTER 100ML

The drug is used for oral administration (oral), rectal administration, applications, irrigation, administration into wound cavities, vagina, uterus, nose, sinuses and drained cavities.

Recommended dosages of the drug:

• Patient age 0-6 months - 5 doses per 1 dose when administering the drug orally (ml) - 5-10 doses per 1 dose when administering the drug as an enema (ml).
• Patient age 6-12 months - 10 doses per 1 dose when administering the drug orally (ml) - 10-20 doses per 1 dose when administering the drug as an enema (ml).
• Patient age from 1 year to 3 years - 15 doses per 1 dose when administering the drug orally (ml) - 20-30 doses per 1 dose when administering the drug in an enema (ml).
• Patient age from 3 to 8 years - 15-20 doses per 1 dose when administering the drug orally (ml) - 30-40 doses per 1 dose when administering the drug in an enema (ml).
• Patient age 8 years and older - 20-30 doses per 1 dose when administering the drug orally (ml) - 40-50 doses per 1 dose when administering the drug in an enema (ml).

Treatment of purulent-inflammatory diseases with localized lesions should be carried out simultaneously both locally and by taking the drug orally for 7-20 days (according to clinical indications).

If chemical antiseptics were used to treat wounds before using the bacteriophage, the wound should be thoroughly washed with a sterile 0.9% sodium chloride solution.

Depending on the source of infection, the bacteriophage is used:

1. In the form of irrigation, lotions and tamponing in a volume of up to 200 ml, depending on the size of the affected area. In case of an abscess, after removing the purulent contents using a puncture, the drug is administered in an amount less than the volume of the removed pus. In case of osteomyelitis, after appropriate surgical treatment, 10-20 ml of bacteriophage is poured into the wound.
2. When administered into cavities (pleural, articular and other limited cavities), up to 100 ml, after which capillary drainage is left, through which the bacteriophage is administered for several days.
3. For cystitis, pyelonephritis, urethritis, the drug is taken orally. If the cavity of the bladder or renal pelvis is drained, the bacteriophage is injected through the cystostomy or nephrostomy 1-2 times a day, 20-50 ml into the bladder and 5-7 ml into the renal pelvis.
4. For purulent-inflammatory gynecological diseases, the drug is administered into the vaginal cavity, uterus in a dose of 5-10 ml once daily, for colpitis - 10 ml by irrigation or tamponing 2 times a day. Tampons are placed for 2 hours.
5. For purulent-inflammatory diseases of the ear, throat, nose, the drug is administered in a dose of 2-10 ml 1-3 times a day. The bacteriophage is used for rinsing, washing, instillation, and introducing moistened turundas (leaving them for 1 hour).
6. For enteral infections and intestinal dysbiosis, the drug is taken orally 3 times a day 1 hour before meals. It is possible to combine double oral administration with a single rectal administration of a single age-specific dose of the bacteriophage in the form of an enema after bowel movement.

Use of bacteriophage in children (up to 6 months).

For sepsis and enterocolitis in newborns, including premature babies, the bacteriophage is used in the form of high enemas (through a gas tube or catheter) 2-3 times a day in a dose of 5-10 ml. In the absence of vomiting and regurgitation, it is possible to use the drug by mouth. In this case, it is mixed with breast milk. A combination of rectal (in the form of high enemas) and oral (through the mouth) use of the drug is possible. The course of treatment is 5-15 days. In case of recurrent course of the disease, repeated courses of treatment are possible. In order to prevent sepsis and enterocolitis during intrauterine infection or the risk of nosocomial infection in newborns, the bacteriophage is used in the form of enemas 2 times a day for 5-7 days.

In the treatment of omphalitis, pyoderma, and infected wounds, the drug is used in the form of applications twice daily (a gauze pad is moistened with a bacteriophage and applied to the umbilical wound or affected area of ​​skin).

Bacteriophage coli-proteus liquid fl 100ml

Active substance

international nonproprietary name not assigned (non appropriated)

ATX code

V03A (Miscellaneous other preparations)

Release form, packaging and composition of the drug

◊ Solution for oral, local and external use

transparent, yellow of varying intensity, a greenish tint is allowed.

[PRING] 8-hydroxyquinoline sulfate monohydrate 0.0001 g/ml.

20 ml - bottles (8) - cardboard packs.

◊ Solution for oral, local and external use

transparent, yellow of varying intensity, a greenish tint is allowed.

[PRING] 8-hydroxyquinoline sulfate monohydrate 0.0001 g/ml.

100 ml - bottles (1) - cardboard packs.

Clinical and pharmacological group

Immunobiological drug - bacteriophage

Pharmacotherapeutic group

MIBP-bacteriophage

Indications for use

Treatment and prevention of purulent-inflammatory and enteric diseases, dysbiosis caused by Proteus bacteria and enteropathogenic Escherichia coli as part of complex therapy:

• diseases of the ear, throat, nose, respiratory tract and lungs (inflammation of the sinuses, middle ear, sore throat, pharyngitis, laryngitis, tracheitis, bronchitis, pneumonia, pleurisy);
• surgical infections (wound suppuration, burns, abscess, phlegmon, boils, carbuncles, hidradenitis, panaritium, paraproctitis, mastitis, bursitis, osteomyelitis);
• urogenital infections (urethritis, cystitis, pyelonephritis, colpitis, endometritis, salpingoophoritis);
• enteral infections (gastroenterocolitis, cholecystitis), intestinal dysbiosis;
• generalized septic diseases;
• purulent-inflammatory diseases of newborns (omphalitis, pyoderma, conjunctivitis, gastroenterocolitis, sepsis, etc.);
• other diseases caused by Proteus and Escherichia coli.

An important condition for effective phage therapy is the preliminary determination of the phage sensitivity of the pathogen.

Dosage

The drug is used for oral administration (oral), rectal administration, applications, irrigation, administration into wound cavities, vagina, uterus, nose, sinuses and drained cavities.

Recommended dosage of the drug

Treatment of purulent-inflammatory diseases with localized lesions should be carried out simultaneously both locally and by taking the drug orally for 7-20 days (according to clinical indications).

If chemical antiseptics were used to treat wounds before using the bacteriophage, the wound should be thoroughly washed with a sterile 0.9% sodium chloride solution.

Depending on the source of infection, the bacteriophage is used:

1. In the form of irrigation, lotions and tamponing in a volume of up to 200 ml, depending on the size of the affected area. In case of an abscess, after removing the purulent contents using a puncture, the drug is administered in an amount less than the volume of the removed pus. In case of osteomyelitis, after appropriate surgical treatment, 10-20 ml of bacteriophage is poured into the wound.

2. When administered into cavities (pleural, articular and other limited cavities) up to 100 ml, after which capillary drainage is left, through which the bacteriophage is administered for several days.

3. For cystitis, pyelonephritis, urethritis, the drug is taken orally. If the cavity of the bladder or renal pelvis is drained, the bacteriophage is injected through the cystostomy or nephrostomy 1-2 times a day, 20-50 ml into the bladder and 5-7 ml into the renal pelvis.

4. For purulent-inflammatory gynecological diseases, the drug is administered into the cavity of the vagina, uterus in a dose of 5-10 ml once daily, for colpitis - 10 ml by irrigation or tamponing 2 times a day. Tampons are placed for 2 hours.

5. For purulent-inflammatory diseases of the ear, throat, nose, the drug is administered in a dose of 2-10 ml 1-3 times a day. The bacteriophage is used for rinsing, washing, instillation, and introducing moistened turundas (leaving them for 1 hour).

6. For enteral infections and intestinal dysbiosis, the drug is taken orally 3 times a day 1 hour before meals. It is possible to combine double oral administration with a single rectal administration of a single age-specific dose of the bacteriophage in the form of an enema after bowel movement.

Use of bacteriophage in children (up to 6 months).

For sepsis and enterocolitis in newborns, including premature babies, the bacteriophage is used in the form of high enemas (through a gas tube or catheter) 2-3 times a day in a dose of 5-10 ml. In the absence of vomiting and regurgitation, it is possible to use the drug by mouth. In this case, it is mixed with breast milk. A combination of rectal (in the form of high enemas) and oral (through the mouth) use of the drug is possible. The course of treatment is 5-15 days. In case of recurrent course of the disease, repeated courses of treatment are possible. In order to prevent sepsis and enterocolitis during intrauterine infection or the risk of nosocomial infection in newborns, the bacteriophage is used in the form of enemas 2 times a day for 5-7 days.

In the treatment of omphalitis, pyoderma, and infected wounds, the drug is used in the form of applications twice daily (a gauze pad is moistened with a bacteriophage and applied to the umbilical wound or affected area of ​​skin).

Contraindications

• hypersensitivity to the components of the drug.

Overdose

Not installed.

Side effects

Not installed.

Overdose

The drug can be used in combination with other drugs, including antibiotics.

Storage conditions

The drug is stored in accordance with SP 3.3.2.1248-03 in a dry place, protected from light and out of reach of children, at a temperature of 2 to 8 ° C. Shelf life: 2 years.

Conditions for dispensing from pharmacies

Over the counter.

Special Instructions

Precautions for use

If cloudy, do not use the drug!

Due to the content of a nutrient medium in the drug, in which bacteria from the environment can develop, causing cloudiness of the drug, the following rules must be observed when opening the bottle:

• wash your hands thoroughly;
• treat the cap with an alcohol-containing solution;
• remove the cap without opening the stopper;
• do not place the cork with the inner surface on a table or other objects;
• do not leave the bottle open;
• Store an opened bottle only in the refrigerator.

When using small doses (2-8 drops), the drug must be taken with a sterile syringe in a volume of 0.5-1 ml.

The drug from an opened bottle, subject to storage conditions, the above rules and the absence of turbidity, can be used throughout the shelf life.

Impact on the ability to drive vehicles and operate machinery

Absent.

Bacteriophages, what do we know about them? Modern possibilities of phage therapy in the practice of a pediatrician

THEM. SHCHERBENKOV

, PhD,
CELT, Moscow Bacteria resistant to most or all of the known antibiotics are causing increasingly serious problems.
This increases the risk of the medical community returning to the problems of the period when antibiotics were unknown and incurable infections and epidemics were widespread. Despite the intensive work of leading chemists and pharmacists around the world, over the past 30 years the synthesis of new classes of antibiotics has sharply decreased, and fundamentally new representatives of antibacterial agents are not expected to enter clinical practice in the near future. It is hoped that the newfound ability to completely sequence microbial genomes and determine the molecular basis of pathogenicity will open new ways to treat infectious diseases, but the search for other approaches to this problem is increasingly being pursued. One of the results of this search is a renewed interest in the possibilities of the therapeutic use of bacteriophages (from bacteria and Greek phagos eater; literally eaters of bacteria) specific viruses that attack only bacteria and kill pathogenic microorganisms. Bacteriophages have the ability to penetrate bacterial cells, reproduce in them and cause their lysis.

History of the study and use of bacteriophages

In 1896, Ernest Hankin reported that the waters of the Ganges and Jumna rivers in India had significant antibacterial activity, which remained after passing through a porcelain filter with very small pores, but was eliminated by boiling. He studied in most detail the effect of an unknown substance on Vibrio cholerae and suggested that it was responsible for preventing the spread of cholera epidemics caused by drinking water from these rivers. However, he did not subsequently explain this phenomenon.

In 1898, the first transplantable lysis of bacteria (anthrax bacillus) was observed by the Russian microbiologist N.F. Gamaleya.

Bacteriophages were officially discovered almost 20 years later, independently of each other, by F. Twort, together with A. Londe and F. d'Herelle, as filterable, transmitted agents of destruction of bacterial cells. The English scientist F. Twort in 1915 described the phenomenon of lysis in purulent staphylococcus and discovered the first “virus that devours bacteria” when he observed a curious degenerative change - lysis in cultures of staphylococci from calf lymph. The name “Twort phenomenon” is associated with his name. In 1917, Felix d'Herelle made a similar discovery; it was he who gave them the name "bacteriophages", using the suffix "phage" not in its direct sense of "is", but in the sense of development due to something.

In the 1980s The effectiveness of antibiotic treatment has decreased significantly; bacteria are actively developing drug resistance. To create a new powerful antibiotic, pharmaceutical companies today must spend an average of 10 years and $800 million. This has led to increased interest in phage therapy. In the early 2000s. Glenn Morris, an employee of the University of Maryland (USA), together with the Research Institute of Bacteriophages, Microbiology and Virology in Tbilisi, set up tests of phage preparations to obtain a license for their use in the USA. And already in July 2007, bacteriophages were approved for use in the United States. Over the past few years, research into the properties of bacteriophages has been carried out in Russia, Georgia, Poland, France, Germany, Finland, Canada, USA, Great Britain, Mexico, Israel, India, and Australia. Characteristics of phages

The use of modern electron microscopes, as well as improved methods for preparing preparations for electron microscopy, have made it possible to study the fine structure of phages in more detail. It turned out that it is very diverse and in many phages it is more complex than the structure of plant viruses and a number of human and animal viruses. Bacteriophages, like other viruses, carry their genetic information in the form of DNA or RNA. Most bacteriophages have tails, the tips of which are attached to specific receptors, such as carbohydrate, protein, and lipopolysaccharide molecules on the surface of the host bacterium. The bacteriophage injects its nucleic acid into the host, where it uses the host's genetic machinery to replicate its genetic material and reads it to form new phagocapsular material to create new phage particles. The number of phages produced during a single infection cycle (yield size) varies between 50 and 200 new phage particles.

Phages have strict specificity, i.e. they are capable of parasitizing only a certain type of microorganism: streptococci, staphylococci, etc. Phages with more strict specificity, which parasitize only certain representatives of a given species, are called type phages. Phages that lyse microorganisms of related species, for example, species included in the genus of dysentery pathogens (Shigella), are called polyvalent.

Lysogenization of bacteria is accompanied by changes in their morphological, cultural, enzymatic, antigenic and biological properties. For example, non-toxigenic strains of corynebacteria diphtheria become toxigenic as a result of lysogenization.

Practical use of phages

Phage therapy (the use of bacterial viruses to treat bacterial infections) was a problem of great interest to scientists 60 years ago. Discovery of penicillin and other antibiotics in the 1940s. provided a more effective and multifaceted approach to suppressing viral diseases and provoked the closure of work in this area.

Due to the catastrophically increasing antibiotic resistance and the absence of new antibacterial agents in the near future, active interest in phage therapy has been revived.

Scientific data of recent decades prove that, unlike antibiotics, bacteriophage preparations have the following positive qualities:

• when multiplying, they independently regulate their numbers (increasing or decreasing them), since they multiply only as long as there are sensitive bacteria, and then are gradually eliminated from the body and the environment; • they are much more specific than most antibiotics; By targeting specific problem bacteria, they cause much less damage to the body's normal microbial balance. The bacterial imbalance, or “dysbiosis,” caused by treatment with many antibiotics can lead to serious secondary infections involving sufficiently resistant bacteria, increasing treatment costs and mortality. Specific problems resulting include infections with Pseudomonas, which are difficult to treat, and Clostridium difficile, a cause of severe diarrhea and pseudomembranous colitis; • phages have the ability to use receptors on the bacterial surface involved in pathogenesis as targets, which means that the virulence of any mutants resistant to them is weakened; • few side effects have been described regarding phage therapy; • phage therapy would be particularly useful for individuals with allergies to antibiotics; • properly selected phages can be easily used prophylactically, helping to prevent bacterial diseases in humans or animals upon contact with microbes, or for the sanitation of hospitals and the fight against hospital-acquired infections; • phage can be used either independently or in combination with other antibiotics to reduce the likelihood of bacterial resistance developing; • phages do not affect the normal intestinal flora and preparations of eubiotics and protobiotics, which makes it possible to use them together.

Possessing a wide range of antibacterial activity and clinical effectiveness, bacteriophages are effective against drug-resistant organisms, which makes it possible to regard them as analogues or substitutes for antibiotics and antiseptic therapy.

Phage therapy can be used prophylactically to control the spread of an infectious disease where the source is identified early, or where outbreaks occur within relatively closed organizations such as schools or daycare centers.

Activity of therapeutic and prophylactic bacteriophages in infectious diseases of the digestive system, purulent-septic diseases of the skin, circulatory system, respiratory system, musculoskeletal system, genitourinary system (more than 180 nosological units of diseases caused by bacteria Klebsiella, Escherichiae, Proteus, Pseudomonas, Staphylococcus, Streptococcus, Serratia, Enterobacter) is quite high - from 72 to 90% - and is often the only effective treatment. This also applies to strains of hospital origin characterized by multiple resistance to antibiotics.

Bacteriophage preparations

Therapeutic and prophylactic preparations of bacteriophages are composed of polyclonal pathogenic bacteriophages with a wide range of action, effective against antibiotic-resistant bacteria. Based on their composition, they distinguish between polyvalent (active against various species and serovars of one pathogen) and combined (containing phages for several pathogens) bacteriophages, which makes it possible to obtain a therapeutic effect in the presence of microbial associations. FSUE NPO Microgen of the Russian Ministry of Health produces a wide range of medicinal bacteriophages: staphylococcal, streptococcal, coli, proteus, pseudomonas, klebsiella, typhoid, dysentery, salmonella. There are also their combined forms: coliproteus bacteriophage, intesti bacteriophage (a mixture of sterile filtrates of phagolysates of bacteria: Shigella Flexneri 1-6 serogroup B, Sonnei serogroup D; Salmonella paratyphi A, B, Typhimurium, Choleraesuis, Oranienburg, Enteritidis, the most common serological groups E. coli – 0111, 055, 026, 125, 0119, 0128, 018, 044, 025, 020, Proteus (vulgaris, mirabilis), Staphylococcus, Pseudomonas, Enterococcus – phage titer of at least 1 x 106).

Bacteriophage preparations are a sterile filtrate of bacterial phagolysates; they are prescribed for oral use, topically for irrigation of lesions and mucous membranes, introduction into the cavities of the uterus, bladder, ear, paranasal sinuses, as well as into drained cavities - abdominal, pleural, and also into abscess cavities and ulcers after removal of exudate. Bacteriophages are able to quickly penetrate the bloodstream and lymphatic system, and are removed from the body along with urine. The correspondence of bacteriophage preparations to the current atiological structure of pathogens is achieved by the production of strains, or producer strains, or synthesized material that is not subject to any transformations. This plasticity of bacteriophage preparations ensures a long-lasting effect of primary phage resistance of pathogens. The use of bacteriophages for the treatment of infectious diseases initiates factors of specific and nonspecific immunity, which is especially effective for the treatment of long-term infectious diseases that arise as a result of weakened immunity against the background of depressive disorder due to bacterial carriage. Scientific research, during clinical observations, and experimental methods have revealed the inability of plasmids to transfer antibiotic immunity to toxigenicity to prophylactic and therapeutic drugs of bacterial carriage, because they are polyclonal complexes of virulent bacteriophages.

When using bacteriophages in large clinics, it is advisable to include hospital strains of pathogens of purulent-inflammatory diseases characteristic of a given hospital in the production strains on which commercial drugs are prepared. Domestic neonatologists have shown the high effectiveness of phage therapy for purulent-septic infections in young children. In addition to the lytic effect on microbes, their importance in the mechanism of antitoxic, cellular and humoral immunity is noted. A study of the possibility of using bacteriophages as an alternative to antibiotic therapy for the treatment of acute intestinal infection (AIE) in children under 3 years of age, carried out at the Department of Children's Infectious Diseases of the KNMU, showed the high effectiveness of the polyvalent Intesti-bacteriophage. It was concluded that it is possible to carry out etiotropic therapy with a polyvalent Intesti-bacteriophage without the inclusion of antibiotics in patients with mild and moderate-severe acute intestinal infections, even in the conditions of a general intestinal department.

Dysbiosis as a pressing problem in children

In recent years, rational pharmacotherapy of dysbiosis of various origins remains an urgent task in pediatrics. The problem of intestinal dysbiosis in young children is especially relevant. The results of modern studies indicate the presence of intestinal dysbiosis of I-II degree in 50% of healthy infants, III-IV degree - in 20-25% of children. Disturbances of intestinal microbiocenosis are observed in almost all childhood diseases. With the formation of dysbiosis, the patient’s general condition worsens, the body’s resistance to infectious and antigenic agents, and tolerance to food products decreases. All this creates the background for a more severe course of the disease, the occurrence of complications, and the transition of acute forms to chronic ones. Children in the first six months of life are especially susceptible to dysbiosis, which is caused by transient deficiency of enzymes (mainly lactase), immaturity of the autonomic nervous system (ANS), which regulates intestinal motility, and immaturity of immune mechanisms.

The main causes of intestinal dysbiosis in childhood are:

• untimely onset and improper management of lactation; • early transition and irrational artificial feeding in the first year of a child’s life and violation of the diet in older age; • acute intestinal infections and non-infectious diseases of the digestive canal; • irrational use of antibiotics and other chemotherapeutic drugs; • allergic predisposition; • reduction of the body's natural resistance.

Treatment of patients with intestinal dysbiosis should be carried out differentially and begin with identifying the underlying disease, without treatment of which the signs of dysbiosis recur. The duration of one course of treatment for children is individual and ranges from 10 days. up to 1.5–2 months. Repeated courses are carried out after intermediate bacteriological control (stool examination) no earlier than 2 weeks later. after completion of the course of therapy. The total duration of recovery (to the level of stable clinical compensation) depends on many associated factors and is 6–9 months.

In modern pediatric gastroenterology, a wide arsenal of drugs is used to correct impaired intestinal microbiocenosis. In clinical practice, pediatricians and gastroenterologists are increasingly using bacteriophages to correct dysbiosis. They use coli-proteus, staphylococcal, pseudomonas, polyvalent dysenteric, salmonellosis, combined (a mixture of staphylococcal, streptococcal, coli, pseudomonas, proteus bacteriophages), polyvalent pyobacteriophage, intestifage, etc. The use of specific bacteriophages allows for optimal selective decontamination carried out in a number of pathological conditions. conditions for the purpose of a sanitizing effect, as well as to restore normal microbiocenosis. As a harmless biological treatment method, bacteriophage therapy can be used in young children. To obtain positive results from the use of bacteriophages, a preliminary study of the sensitivity of microorganisms to them is necessary.

We use liquid coli-proteus bacteriophage in the treatment of children with dysbiosis caused by enteropathogenic Escherichia coli (Escherichia) and Proteus (mirabilis or vulgaris). We administer the bacteriophage orally or as an enema. Daily dose of the drug for oral use: children under 6 months of age. 5 ml 3 times a day orally and 10 ml 1 time a day in an enema instead of one of the oral doses; from 6 months up to 1 year: 1015 ml 2 times a day orally and 20 ml 1 time a day as an enema; at the age of 13 years, 1520 ml 2 times a day orally and 40 ml 1 time a day as an enema; over 3 years: 20 ml 2-3 times a day orally and 40-60 ml 1 time a day as an enema. The bacteriophage is administered orally 1-1.5 hours before meals. For children in the first month of life, the bacteriophage is diluted with boiled water 2 times. Children over 6 months. 5-10 minutes before administration of the drug, give 10-20 ml (depending on age) of 2-3% sodium bicarbonate solution to neutralize gastric juice. The course of treatment is 5-10 days. depending on the severity of dysbiotic disorders.

It is advisable to use the drug as an enema in the absence of malabsorption syndrome: for children under 6 months. — 20 ml, from 6 months. up to 3 years - 30-40 ml, over 3 years - 40-50 ml. The drug is administered once a day in 2-3 courses lasting 3-4 days. With an interval between courses of 3 days. There are no contraindications to the use of the drug. Prescribing a bacteriophage does not exclude the use of other drugs.

We prescribe liquid staphylococcal bacteriophage orally in a daily dose: for children up to 6 months. — 20 ml, 6 months. - 3 years - 40 ml, over 3 years - 100 ml. Administered in 2 doses, on an empty stomach, 1.5-2 hours before meals. In an enema, the same doses should be administered once a day according to the same scheme.

Since in real clinical practice with dysbiosis we encounter the simultaneous growth of various representatives of pathogenic microflora, it is important to prescribe in such cases, taking into account the data of bacteriological studies of combined bacteriophages - a mixture of staphylococcal, streptococcal, coli, Pseudomonas, Proteus bacteriophages. They are prescribed to children under 3 years of age, 3-5 ml 3 times a day orally and 10 ml 1 time a day as an enema; over 3 years - 5-10 ml 3 times a day orally and 10 ml 1 time a day as an enema. Orally administered 1 hour before meals. It is possible to additionally administer the combined phage in a high enema of 5-20 ml. The course of treatment is 5-15 days.

Intestifag contains phagolysates of Escherichia coli, Salmonella shigellosis, and UPM. Prescribed orally 1 hour before meals for children under 3 years of age, 3-5 ml 3 times a day orally and 10 ml 1 time a day as an enema; for children over 3 years old - 5-10 ml 3 times a day orally and 10 ml 1 time a day as an enema. The course of treatment is 5-6 days.

Polyvalent pyobacteriophage, or sextyphage, is a mixture of phagolysates of Escherichia coli, Klebsiella, Pseudomonas aeruginosa, Staphylococcus, Streptococcus, Proteus. This drug is distinguished by the highest degree of purification from bacterial metabolites, which significantly improves its taste and makes it the first choice for children under one year of age. Prescribed: for children under 3 years of age - 3-5 ml 3 times a day orally and 10 ml 1 time a day as an enema; over 3 years - 5-10 ml 3 times a day orally and 10 ml 1 time a day as an enema. Use internally 1 hour before meals. The course of treatment is 5-15 days.

The use of phages precedes the administration of acid-forming drugs (prebiotics, probiotics, etc.). Conclusion

Bacteriophage preparations are effective in the treatment of diseases caused by antibiotic-resistant strains of microorganisms, in particular in the treatment of peritonsillar ulcers, inflammation of the sinuses, as well as purulent-septic infections, intensive care patients, surgical diseases, cystitis, pyelonephritis, cholecystitis, gastroenterocolitis, intestinal dysbiosis, inflammatory diseases and neonatal sepsis.
With the widespread development of antibiotic resistance in pathogenic bacteria, the need for new antibiotics and alternative technologies for the control of microbial infections is becoming increasingly important. Bacteriophages likely have yet to fulfill their role in the treatment of infectious diseases, either when used independently or in combination with antibiotic therapy. Literature
1. Killer antibiotics: [history of discovery, benefits and harms, contraindications, looking for a replacement when there is no way out]. M.: Eksmo, 2007. 2. Privorotsky V.F., Lupova N.E., Shilnikova O.V. The logic of constructing corrective drug programs for impaired intestinal microbiocenosis in children // RMZh. 2007. No. 1. pp. 6–9. 3. Belmer S.V. Antibiotic-associated intestinal dysbiosis // Breast Cancer. 2004. T. 12. No. 3. pp. 148–151. 4. Methods for normalizing digestion in children with dysbiosis: a manual for doctors / ed. Academician of the Russian Academy of Medical Sciences A.A. Baranova. M., 2005. pp. 38–39. 5. Intestinal diseases. Directory for practicing doctors "Remedium Doctor". M.: LLC Publishing House "Remedium". pp. 74–76. 6. State register of medicines. M.: MZiSR (Internet version www.drugreg.ru). 7. Nizhevich A.A., Khasanov R.Sh., Nurtdinova N.M., Ochilova R.A., Loginovskaya V.V., Kalmetyeva L.R. Antibiotic-associated intestinal dysbiosis in children // RMZh. 2007. No. 1. pp. 12–15. 8. Shcherbakov P.L., Tsvetkov P.M., Nechaeva L.V. Prevention of diarrhea associated with taking antibiotics in children // Issues of modern pediatrics. 2004. T. 3. No. 2. 9. Korman D.B. Basics of antitumor chemotherapy. M.: Practical Medicine, 2006. 10. Zelenin K.N. The emergence and development of chemotherapy. 11. Ursova N.I. Intestinal dysbiosis in children: a guide for practitioners / ed. G.V. Rimarchuk. M.: BORGES Company, 2006. 12. Larcini D., Parenti F. Antibiotics / trans. from English Yu.V. Angelica. M.: Mir, 1985. 13. Clinical and immunological effectiveness of immunobiological preparations / ed. M.P. Kostinova and I.V. Medunitsyna. M.: Miklos, 2004. pp. 195–206. 14. Stent G. Molecular biology of bacterial viruses / trans. from English M., 1965. 15. Hayes W. Genetics of bacteria and bacteriophages / trans. from English M., 1965. 16. Schlegel G. General microbiology / trans. with him. M., 1987. P. 142.