Panmycin

Panmycin (tetracycline hydrochloride) is a time-tested, broad-spectrum antibiotic belonging to the tetracycline class, widely utilized in clinical practice for its efficacy against a diverse range of susceptible bacterial pathogens. It functions by inhibiting bacterial protein synthesis, effectively halting microbial proliferation and enabling the host’s immune system to clear the infection. This agent is a cornerstone in the treatment of various common and complex bacterial infections, from respiratory tract infections to certain sexually transmitted diseases and zoonotic infections. Its established pharmacokinetic profile and well-documented clinical history make it a reliable choice for physicians when indicated.

Features

• Active Pharmaceutical Ingredient: Tetracycline Hydrochloride.
• Drug Class: Broad-spectrum tetracycline antibiotic.
• Mechanism of Action: Binds reversibly to the 30S ribosomal subunit, inhibiting aminoacyl-tRNA attachment and thus preventing protein synthesis in susceptible bacteria.
• Spectrum of Activity: Effective against a wide range of Gram-positive and Gram-negative bacteria, including Rickettsia, Chlamydia, Mycoplasma pneumoniae, and some protozoa.
• Available Formulations: Typically supplied as 250 mg and 500 mg capsules for oral administration.
• Bioavailability: Absorption is approximately 75-80% under fasting conditions but is significantly impaired by concomitant ingestion of dairy products, antacids, or iron preparations.

Benefits

• Provides effective treatment for a comprehensive list of bacterial infections, reducing morbidity and complication rates.
• Offers a reliable therapeutic option for less common infections like brucellosis, tularemia, and psittacosis, where it is often a drug of choice.
• The oral formulation allows for convenient outpatient treatment, supporting patient compliance and reducing healthcare costs associated with hospitalization.
• Its bacteriostatic action controls bacterial growth, allowing the body’s natural immune defenses to eradicate the infection effectively.
• Decades of clinical use have resulted in a robust understanding of its efficacy, safety profile, and drug interaction potential.

Common use

Panmycin is indicated for the treatment of infections caused by susceptible strains of designated microorganisms. Common uses include the management of upper and lower respiratory tract infections (e.g., exacerbations of chronic bronchitis, pneumonia), skin and soft tissue infections, and genitourinary infections including uncomplicated gonorrhea and infections caused by Chlamydia trachomatis. It is also employed in the treatment of ophthalmic infections, Rocky Mountain spotted fever, typhus fever, Q fever, and as an adjunct therapy in intestinal amebiasis. The selection of Panmycin should be based on in vitro susceptibility testing whenever possible.

Dosage and direction

The dosage of Panmycin must be individualized based on the severity and nature of the infection, as well as the patient’s renal function.

• Adults: The usual adult oral dosage is 1 to 2 grams per day, divided into two or four equal doses (e.g., 500 mg twice daily or 250 mg four times daily). For more severe infections, an initial dose of 2 grams followed by 500 mg every 6 hours may be utilized.
• Children (above 8 years): 25 to 50 mg/kg/day divided into four doses. Therapy should not be continued for longer than necessary.
• Administration: Capsules must be swallowed whole with a full glass of water (approx. 240 mL) while the patient is in an upright or sitting position to minimize the risk of esophageal irritation and ulceration. To achieve optimal absorption, administer Panmycin one hour before or two hours after meals. It is imperative to avoid concomitant administration with dairy products, antacids, or iron supplements.

Precautions

• Tooth Development: Panmycin, like all tetracyclines, may cause permanent discoloration (yellow-gray-brown) of teeth and enamel hypoplasia if used during tooth development (last half of pregnancy, infancy, and childhood up to the age of 8 years).
• Photosensitivity: Exaggerated sunburn reaction has been observed; patients should be advised to avoid direct sunlight and ultraviolet light and to use protective clothing and sunscreen.
• Hepatic and Renal Impairment: Use with caution in patients with impaired hepatic function. In patients with significant renal impairment (CrCl < 50 mL/min), increased serum levels may lead to azotemia, hyperphosphatemia, and acidosis. Dosage reduction is recommended.
• Superinfection: Use of antibiotics may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, discontinue Panmycin and institute appropriate therapy.
• Antianabolic Action: Tetracyclines have been shown to cause an increase in BUN, which is dose-related.

Contraindications

Panmycin is contraindicated in persons who have shown hypersensitivity to any of the tetracycline antibiotics. Its use is contraindicated during pregnancy due to the risk of hepatotoxicity in the pregnant woman and discoloration of the developing fetus’s teeth. It is also contraindicated in infants and children under 8 years of age for the same reason regarding tooth development.

Possible side effect

While not all patients experience side effects, the following have been associated with tetracycline therapy:

• Gastrointestinal: Anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, and inflammatory lesions (with monilial overgrowth) in the anogenital region.
• Dermatologic: Maculopapular and erythematous rashes. Exfoliative dermatitis has been reported but is uncommon. Photosensitivity is a well-documented reaction.
• Renal: Rise in BUN, apparently dose-related.
• Hypersensitivity: Urticaria, angioneurotic edema, anaphylaxis.
• Other: Bulging fontanels in infants, hemolytic anemia, thrombocytopenia, neutropenia, eosinophilia, and transient elevation of hepatic transaminases.

Drug interaction

Panmycin has a significant potential for interactions that can alter its efficacy or increase toxicity.

• Antacids & Cations: Preparations containing aluminum, calcium, or magnesium (antacids), iron, bismuth subsalicylate, and zinc can form insoluble chelates with tetracycline, drastically reducing its absorption.
• Oral Contraceptives: Tetracyclines may decrease the effectiveness of estrogen-containing oral contraceptives, potentially leading to breakthrough bleeding or pregnancy.
• Warfarin: Tetracyclines may potentiate the anticoagulant effect of warfarin and other oral coumarin anticoagulants, necessitating closer monitoring of prothrombin time.
• Penicillin: Tetracyclines are bacteriostatic and may interfere with the bactericidal action of penicillin; avoid concomitant use.
• Methoxyflurane: Concurrent use with tetracycline has been reported to result in fatal renal toxicity.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. The patient should not double the dose to make up for the missed one. Maintaining a consistent schedule is important for maintaining effective blood levels of the antibiotic.

Overdose

Overdosage of tetracycline can lead to life-threatening toxicity. Symptoms may include dizziness, nausea, and vomiting. Significant overdose can result in hepatic failure, azotemia, hyperphosphatemia, metabolic acidosis, and pancreatitis. Tetracycline is not removed in significant quantities by dialysis. Treatment is supportive and symptomatic. There is no specific antidote.

Storage

Store Panmycin capsules at a controlled room temperature, 20° to 25°C (68° to 77°F), in a tightly closed container. Protect from light, moisture, and excessive heat. Keep all medications out of the reach of children and pets. Do not use after the expiration date printed on the container.

Disclaimer

This information is intended for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the typical properties of the drug and may not be accurate for every lot or formulation.

Reviews

• “As an infectious disease specialist for over 30 years, tetracyclines like Panmycin remain a fundamental tool in our arsenal, particularly for atypical pathogens and STIs. Its predictable spectrum and oral bioavailability are its greatest strengths, though vigilance regarding interactions and side effects is paramount.” – Dr. A. Reynolds, MD
• “From a pharmacological standpoint, the drug’s mechanism is elegant and well-understood. The primary challenge in clinical use is patient education regarding administration away from food and cations to ensure adequate systemic exposure.” – Clinical Pharmacist Review
• “While newer antibiotics have emerged, Panmycin’s role in treating rickettsial diseases and as a second-line option for acne vulgaris is well-supported by extensive clinical evidence. Its cost-effectiveness is a significant advantage in certain healthcare settings.” – Journal of Antimicrobial Chemotherapy