First generation antibiotics. Broad spectrum parenteral penicillins. There are two main mechanisms of action of antibiotics.

Treatment of bacterial infections today is impossible without the use of antibiotics. Microorganisms tend to develop resistance over time chemical compounds and older drugs are often ineffective. Therefore, pharmaceutical laboratories are constantly looking for new formulas. In many cases, infectious disease specialists prefer to use antibiotics. a wide range actions of a new generation, the list of which includes drugs with different active ingredients.

The principle of action of drugs

Antibiotics only work on bacterial cells and are unable to kill viral particles.

According to the spectrum of action, these drugs are divided into two large groups:

• narrowly targeted, coping with a limited number of pathogens;
• broad spectrum of action, fighting different groups of pathogens.

In the case when the pathogen is known exactly, antibiotics of the first group can be used. If the infection is of a complex combined nature, or the pathogen is not detected by laboratory tests, drugs of the second group are used.

According to the principle of action, antibiotics can also be divided into two groups:

• bactericides - drugs that kill bacterial cells;
• bacteriostatics - drugs that stop the reproduction of microorganisms, but are not able to kill them.

Bacteriostatics are safer for the body, therefore, in mild forms of infections, preference is given to this particular group of antibiotics. They allow you to temporarily restrain the growth of bacteria and wait for their independent death. Severe infections are treated with bactericidal drugs.

List of new generation broad spectrum antibiotics

The division of antibiotics into generations is heterogeneous. So, for example, cephalosporin drugs and fluoroquinolones are divided into 4 generations, macrolides and aminoglycosides - into 3:

Unlike older drugs, new generation antibiotics affect the beneficial flora much less, are absorbed faster, and have a less toxic effect on the liver. They can quickly accumulate in tissues active substance, due to which the multiplicity of receptions is reduced, and the intervals between them increase.

What drugs to take depending on the disease?

Often the same broad-spectrum drug is prescribed for various diseases. But this does not mean that you can do without preliminary diagnosis. Only the correct diagnosis allows you to adequately choose an antibiotic.

Bronchitis treatment

Bronchitis is a common infectious and inflammatory disease that can lead to severe complications. For the treatment of bronchitis, the following drugs can be prescribed:

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Simultaneously with antibiotics in the treatment of bronchitis, mucolytic and anti-inflammatory drugs are used.

With pneumonia

Pneumonia should never be treated on its own at home. This disease requires mandatory hospitalization and serious therapy with intramuscular or intravenous administration antibiotics.

For the treatment of pneumonia in a hospital, the following drugs for injection can be used:

• "Ticarcillin";
• "Carbenicillin";
• "Cefepim";
• "Meropenem".

In some cases, antibiotics are also prescribed in tablets. These can be drugs:

• "Tigeron";
• "Gatispan";
• "Sumamed";
• "Avelox".

Dosage and frequency of administration this case is determined individually, based on the patient's condition and therapeutic strategy.

Antibiotics for sinusitis

The decision to prescribe antibiotics for the treatment of sinusitis is made by the ENT doctor. Therapy with these drugs is carried out in without fail if there is purulent discharge from the sinuses and intense headaches:

Before prescribing antibiotics, the ENT doctor usually gives a referral to bacterial culture and an antibiogram to determine the type of pathogen and its sensitivity to a particular active substance.

With angina

Angina in everyday life is called acute tonsillitis - inflammation of the tonsils caused by viruses or bacteria. The bacterial form of angina is caused by streptococci or staphylococci, and this disease can only be treated with antibiotics:

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It is important to understand that if acute tonsillitis is not bacterial, but viral nature, it is useless to treat it with antibiotics. Only a doctor can distinguish between these two forms of the disease, so you should not take any drugs without his advice.

Colds and flu

Respiratory infections, which in everyday life are called colds, as well as the flu, are caused by viruses. Therefore, antibiotics in their treatment are used only in one case: if the disease becomes complicated and a bacterial infection joins the viral infection.

In such situations, therapy is usually started with penicillin antibiotics:

• "Flemoxin Solutab";
• "Flemoklav Solutab".

If after 72 hours after the start of taking these drugs there is no improvement, new generation macrolides are connected to therapy:

• "Sumamed";
• "Rulid";
• AzitRus.

Antibiotic regimen for treatment respiratory infections standard, but medical supervision is necessary in this case.

Urinary tract infections

Urinary infections can be caused by pathogens different nature- viruses, fungi, bacteria, protozoa. Therefore, it makes sense to start treatment only after a thorough laboratory diagnostics and determining the type of pathogen.

In mild cases, you can remove the infection from the urinary tract using the following drugs:

• "Furadonin" - 2 mg per 1 kg of weight 3 times a day;
• "Furazolidone" - 2 tablets of 0.05 g 4 times a day;
• "Palin" - 1 capsule 2 times a day.

In more complex situations, when pathogens are highly resistant (resistance) to chemical attack broad-spectrum antibiotics may be prescribed:

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Simultaneously with antibiotics in the treatment of genitourinary infections is prescribed plentiful drink and diuretic drugs. AT severe cases injections of the drug "Amicin" are advisable.

Antifungal drugs

For the treatment of fungal infections, drugs with fungistatic or fungicidal action are used. They differ from the drugs listed above and stand out in a separate class, within which there are three groups:

As with the treatment of bacterial infections, the treatment of fungal diseases requires accurate diagnosis pathogen and strict specialist control.

For eye disease

Antibiotics for treatment eye diseases available in the form of ointments or drops. They are prescribed if the ophthalmologist has diagnosed conjunctivitis, blepharitis, meibomitis, keratitis and a number of other infections.

Most often, therapy is carried out using the following drugs:

• "Tsipromed" - drops containing Ciprofloxacin;
• "Albucid" - drops with sulfacetamide;
• "Dilaterol" - drops based on tobramycin;
• "Tobrex" - an analogue of "Dilaterol" in the form of an ointment;
• "Kolbiocin" is a multicomponent ointment containing tetracycline, chloramphenicol and sodium colistimethate.

A specific drug is prescribed based on the diagnosis, the severity of the disease and individual features patient.

Inexpensive new generation antibiotics

The cost of new generation antibiotics is never low, so you can save money only by buying inexpensive analogues. They are produced on the basis of the same active substances, however, the degree of chemical purification of such preparations may be lower, and the cheapest excipients are taken for their production.

replace some expensive antibiotics can be based on the following table:

Another way to save money is to buy older antibiotics, not the latest generation.

For example, in many cases, such proven antibacterial drugs can help out:

• "Erythromycin";
• "Ceftriaxone";
• "Bicillin";
• "Cefazolin";
• "Ampicillin".

If after starting treatment inexpensive antibiotics more than 72 hours have passed, and there is no improvement in the condition, it is urgent to consult a doctor and change the drug.

Can it be used during pregnancy?

Antibiotics during pregnancy are prescribed by doctors only in emergency cases and after a thorough analysis of the possible risks.

But even in such situations, drugs of the following groups are not used:

• all fluoroquinolones;
• macrolides based on roxithromycin, clarithromycin, midecamycin;
• all aminoglycosides.

Only the attending physician can decide on the advisability of prescribing antibiotics during pregnancy. Self-administration of any drugs, even relatively safe and related to the new generation, is strictly prohibited.

Antibiotics are a group of medicines that harm or kill bacteria that cause infectious diseases. As antiviral agents this type of medicine is not used. Depending on the ability to destroy or inhibit certain microorganisms, there are different groups of antibiotics. In addition, this type of medication can be classified by origin, the nature of the effect on bacterial cells, and some other features.

general description

Antibiotics belong to the group of antiseptic biological preparations. They are the waste products of moldy and radiant mushrooms and some types of bacteria. Currently, more than 6,000 natural antibiotics are known. In addition, there are tens of thousands of synthetic and semi-synthetic. But in practice, only about 50 such drugs are used.

Main groups

All such drugs available on this moment are divided into three large groups:

• antibacterial;
• antifungal;
• antitumor.

In addition, according to the direction of action, this type of medicine is divided into:

• active against gram-positive bacteria;
• anti-tuberculosis;
• active against both gram-positive and gram-negative bacteria;
• antifungal;
• destroying helminths;
• antitumor.

Classification according to the type of effect on microbial cells

In this regard, there are two main groups of antibiotics:

• Bacteriostatic. Medicines of this type inhibit the development and reproduction of bacteria.
• Bactericidal. When using drugs from this group, the destruction of existing microorganisms occurs.

Species by chemical composition

The classification of antibiotics into groups in this case is as follows:

• Penicillins. This is the oldest group, from which, in fact, the development of this direction of drug treatment began.
• Cephalosporins. This group is used very widely and is characterized by a high degree of resistance to the destructive action of β-lactamases. So called special enzymes secreted by pathogens.
• Macrolides. These are the safest and most effective antibiotics.
• Tetracyclines. These drugs are used mainly for the treatment of respiratory organs and urinary tract.
• Aminoglycosides. They have a very wide spectrum of action.
• Fluoroquinolones. Low-toxic drugs with bactericidal action.

These antibiotics are used in modern medicine most often. In addition to them, there are some others: glycopeptides, polyenes, etc.

Antibiotics of the penicillin group

Medicines of this variety are the fundamental basis of absolutely any antimicrobial treatment. At the beginning of the last century, no one knew about antibiotics. In 1929, the Englishman A. Fleming discovered the very first such remedy - penicillin. The principle of action of drugs of this group is based on the suppression of protein synthesis of the pathogen cell walls.

On the this moment There are only three main groups of penicillin antibiotics:

• biosynthetic;
• semi-synthetic;
• semi-synthetic broad-spectrum.

The first variety is mainly used to treat diseases caused by staphylococci, streptococci, meningococci, etc. Such antibiotics can be prescribed, for example, for diseases such as pneumonia, skin infections, gonorrhea, syphilis, gas gangrene, etc. .

Antibiotics penicillin group semi-synthetic are most often used to treat severe staph infections. Such drugs are less active against certain types of bacteria (for example, gonococci and meningococci) than biosynthetic ones. Therefore, before their appointment, procedures such as isolation and accurate identification of the pathogen are usually performed.

Broad-spectrum semi-synthetic penicillins are usually used if traditional antibiotics (levomycetin, tetracycline, etc.) do not help the patient. This variety includes, for example, the rather commonly used amoxicillin group of antibiotics.

Four generations of penicillins

In honey. In practice, four types of antibiotics from the penicillin group are currently used:

• First generation - medicines natural origin. This type of drug is characterized by a very narrow spectrum of application and not very good resistance to the effects of penicillinases (β-lactamases).
• The second and third generation are antibiotics that are much less affected by the destructive enzymes of bacteria, and therefore more effective. Treatment with their use can take place in a fairly short time.
• The fourth generation includes broad-spectrum penicillin antibiotics.

The most famous penicillins are the semi-synthetic drugs "Ampicillin", "Carbenicillin", "Azocillin", as well as the biosynthetic "Benzylpenicillin" and its durant forms (bicillins).

Side effects

Although the antibiotics of this group belong to low-toxic drugs, they, along with beneficial influence can affect the human body and negatively. Side effects when using them are as follows:

• itching and skin rash;
• allergic reactions;
• dysbacteriosis;
• nausea and diarrhea;
• stomatitis.

You can not use penicillins simultaneously with antibiotics of another group - macrolides.

Amoxicillin group of antibiotics

This variety antimicrobials refers to penicillins and is used to treat diseases when infected with both gram-positive and gram-negative bacteria. Such drugs can be used to treat both children and adults. Most often, antibiotics based on amoxicillin are prescribed for respiratory tract infections and different kind diseases of the gastrointestinal tract. They are also taken for diseases of the genitourinary system.

The amoxicillin group of antibiotics is also used for various infections of soft tissues and skin. Side effects of these drugs can cause the same as other penicillins.

Group of cephalosporins

The action of drugs in this group is also bacteriostatic. Their advantage over penicillins is their good resistance to β-lactamases. Antibiotics of the cephalosporin group are classified into two main groups:

• taken parenterally (bypassing the gastrointestinal tract);
• taken orally.

In addition, cephalosporins are classified into:

• First generation drugs. They differ in a narrow spectrum of action and have practically no effect on gram-negative bacteria. Moreover, such drugs are successfully used in the treatment of diseases caused by streptococci.
• Second generation cephalosporins. More effective against Gram-negative bacteria. Active against staphylococci and streptococci, but have virtually no effect on enterococci.
• Third and fourth generation drugs. This group of drugs is very resistant to the action of β-lactamases.

The main disadvantage of such a drug as antibiotics of the cephalosporin group is that, when taken orally, they irritate the gastrointestinal mucosa very strongly (except for the drug "Cefalexin"). The advantage of drugs of this variety is a much smaller number of induced drugs compared to penicillins. side effects. Most often in medical practice, the drugs "Cefalotin" and "Cefazolin" are used.

Negative effects of cephalosporins on the body

Side effects sometimes manifested in the process of taking antibiotics of this series include:

• negative impact on the kidneys;
• violation of hematopoietic function;
• various kinds of allergies;
• negative impact on the gastrointestinal tract.

macrolide antibiotics

Among other things, antibiotics are classified according to the degree of selectivity of action. Some are able to negatively affect only the cells of the pathogen, without affecting human tissue in any way. Others may have on the patient's body toxic effect. Preparations of the macrolide group are considered the safest in this regard.

There are two main groups of antibiotics of this variety:

• natural;
• semi-synthetic.

The main advantages of macrolides include the highest efficiency of bacteriostatic effects. They are especially active against staphylococci and streptococci. Among other things, macrolides do not adversely affect the gastrointestinal mucosa, and therefore are often available in tablets. All antibiotics to some extent affect the human immune system. Some species are depressing, some are beneficial. Antibiotics of the macrolide group have a positive immunomodulatory effect on the patient's body.

Popular macrolides are Azithromycin, Sumamed, Erythromycin, Fuzidin, etc.

Antibiotics of the tetracycline group

Medicines of this variety were first discovered in the 40s of the last century. The very first tetracycline drug was isolated by B. Duggar in 1945. It was called "Chlortetracycline" and was less toxic than other antibiotics that existed at that time. In addition, it also turned out to be very effective in terms of influencing pathogens of a huge number of very dangerous diseases (for example, typhoid).

Tetracyclines are considered somewhat less toxic than penicillins, but have more negative impact on the body than macrolide antibiotics. Therefore, at the moment they are being actively replaced by the latter.

Today, the drug "Chlortetracycline", discovered in the last century, oddly enough, is very actively used not in medicine, but in agriculture. The fact is that this drug is able to accelerate the growth of animals taking it, almost twice. The substance has such an effect because, when it enters the intestines of the animal, it begins to actively interact with the microflora present in it.

In addition to, in fact, the drug "Tetracycline" in medical practice, drugs such as "Metacycline", "Vibramycin", "Doxycycline", etc. are often used.

Side effects caused by antibiotics of the tetracycline group

The rejection of the widespread use of drugs of this variety in medicine is primarily due to the fact that they can have not only beneficial, but also negative effects on the human body. For example, long-term use of tetracycline antibiotics can interfere with the development of bones and teeth in children. In addition, interacting with the human intestinal microflora (with misuse), such drugs often provoke the development of fungal diseases. Some researchers even argue that tetracyclines can have a depressing effect on the male reproductive system.

Aminoglycoside antibiotics

Preparations of this variety have a bactericidal effect on the pathogen. Aminoglycosides, like penicillins and tetracyclines, are one of the oldest groups of antibiotics. They were opened in 1943. In subsequent years, preparations of this variety, in particular "Streptomycin", were widely used to cure tuberculosis. In particular, aminoglycosides are effective against gram-negative aerobic bacteria and staphylococci. Among other things, some drugs of this series are active in relation to the simplest. Since aminoglycosides are much more toxic than other antibiotics, they are prescribed only for severe diseases. They are effective, for example, in sepsis, tuberculosis, severe forms of paranephritis, abscesses abdominal cavity etc.

Very often, doctors prescribe aminoglycosides such as Neomycin, Kanamycin, Gentamicin, etc.

Preparations of the fluoroquinolone group

Most drugs of this type of antibiotics have a bactericidal effect on the pathogen. Their advantages include, first of all, the highest activity against a huge number of microbes. Like aminoglycosides, fluoroquinolones can be used to treat serious illnesses. However, they do not have such a negative impact on the human body as the first ones. There are antibiotics of the fluoroquinolone group:

• First generation. This variety is mainly used for inpatient treatment sick. First-generation fluoroquinolones are used for infections of the liver, biliary tract, pneumonia, etc.
• Second generation. These drugs, unlike the first, are very active against gram-positive bacteria. Therefore, they are prescribed, including in the treatment without hospitalization. Second-generation fluoroquinolones are widely used in the treatment of sexually transmitted diseases.

Popular drugs in this group are Norfloxacin, Levofloxacin, Gemifloxacin, etc.

So, we have found out which group antibiotics belong to, and figured out exactly how they are classified. Because most of these drugs can cause side effects, they should only be used as directed by your doctor.

Random Fact:

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Article added by user Maria
20.12.2016

Generation of antibiotics

Antibiotics (antimicrobials) are a group medicines, with the help of which infectious diseases that are caused by bacteria are treated. Viral diseases, contrary to popular belief, cannot be treated with antibiotics.

Antibiotics either lead to the death of microbes and bacteria, or prevent their reproduction. Antibiotics are distinguished by the main groups, each of which is most effective against certain types of bacteria. The choice of one or another antibiotic is determined by the doctor based on the alleged causative agent of the disease. The first antibiotic was penicillin, a substance isolated from a mold colony.

There are two main types of action of antibiotics on bacteria: bactericidal and bacteriostatic. Antibiotics with a bactericidal effect lead to the death of bacteria. Antibiotics with a bacteriostatic effect do not allow bacteria to multiply. Any group of antibiotics is effective against various types bacteria, which is associated with certain mechanisms of action of these drugs. There are the most common groups of antibiotics and diseases in which they must be used.

Penicillins

Penicillins are a group of antibiotics that includes medicines: Carbenicillin, Azlocillin, Augmentin, Penicillin, Ampicillin, Amoxicillin, Oxacillin and others. They act bactericidal. Penicillins lead to the death of bacteria and destroy their shell. This group belongs to broad-spectrum antibiotics, because they are effective against bacteria: meningitis, causative agents of syphilis, staphylococci, gonorrhea, streptococci and the rest. Penicillins are used to treat diseases of the inflammatory respiratory tract (pneumonia, bronchitis), ENT organs (tonsillitis, sinusitis).

Cephalosporins

Cephalosporins, like penicillins, have a bactericidal effect and destroy the membrane of bacteria. Cephalosporins is large group antibiotics, which includes 5 generations of drugs:

• 1 generation: Cefalexin (Lexin), Cefazolin. As is customary, these antibiotics are used in the treatment of diseases of soft tissues and skin (subcutaneous fat, muscles) caused by streptococci and staphylococci: erysipelas, carbuncle, furuncle and the rest.
• 2 generations: Cefoxitin, Cefuroxime (Zinacef), Cefachlor, and others. According to the rules, they are used to treat diseases of the upper respiratory tract (tonsillitis, sinusitis, tonsillitis), respiratory diseases (pneumonia, bronchitis) and more.
• 3 generations: Ceftazidime (Orzid), Cefotaxime, Ceftriaxone, Cefexime, etc. The most used for the treatment of ENT organs (otitis media, sinusitis, pharyngitis, tonsillitis), various diseases respiratory system(pneumonia, bronchitis). In addition, they are effective for gynecological diseases(cervicitis, endometritis), pyelonephritis, meningitis, cystitis, etc.
• 4 generations: Cefepime is used to treat severe infectious diseases in which other drugs are ineffective: meningitis, peritonitis (inflammation of the peritoneum), pyelonephritis, bronchitis, pneumonia and others.
• 5th generation: Ceftobiprol is used to treat severe infections in immunocompromised patients (eg diabetes mellitus) and is effective in diseases caused by staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli (e.coli).

macrolides

• Macrolides are broad-spectrum antibiotics, including the following drugs: Rovamycin, Vilprafen, Clarithromycin (Klacid), Erythromycin, Azithromycin (Sumamed), etc.

Tetracyclines

• Tetracyclines include the following drugs: Minocycline, Unidox, Tetracycline, Doxycycline, etc.

Aminoglycosides

• Aminoglycosides include: Amikacin, Kanamycin, Neomycin, Gentamicin, etc.

Fluoroquinolones

• Fluoroquinolones are a group antibacterial agents, which includes: Norfloxacin, Ofloxacin, Moxifloxacin, Levofloxacin, Ciprofloxacin, etc.

Levomecithin

• Levomecithin is a broad-spectrum antibiotic used for meningitis, brucellosis, typhoid fever and other infectious diseases.

Sulfonamides

• Sulfonamides are antibacterial agents, which include Sulfalen, Trimethoprim, Sulfadiazine, Cotrimoxazole, Biseptol, Streptocid, and others.

Metronidazole

• Metronidazole is an antibacterial drug that is available under various trade names: Flagyl, Trichopolum, Klion, Metrogil, etc.

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Antibiotics are a huge group of bactericidal drugs, each of which is characterized by its spectrum of action, indications for use and the presence of certain consequences.

Antibiotics are substances that can inhibit the growth of microorganisms or destroy them. According to the definition of GOST, antibiotics include substances of plant, animal or microbial origin. This definition is now somewhat outdated, as it was created great amount synthetic drugs, but it was natural antibiotics that served as the prototype for their creation.

The history of antimicrobial drugs begins in 1928, when A. Fleming was first discovered penicillin. This substance was just discovered, and not created, since it has always existed in nature. In wildlife, it is produced by microscopic fungi of the genus Penicillium, protecting themselves from other microorganisms.

In less than 100 years, more than a hundred different antibacterial drugs. Some of them are already outdated and are not used in treatment, and some are only being introduced into clinical practice.

How antibiotics work

All antibacterial drugs according to the effect of exposure to microorganisms can be divided into two large groups:

• bactericidal- directly cause the death of microbes;
• bacteriostatic- prevent the growth of microorganisms. Unable to grow and multiply, bacteria are destroyed immune system sick person.

Antibiotics realize their effects in many ways: some of them interfere with the synthesis of microbial nucleic acids; others interfere with the synthesis of the bacterial cell wall, others disrupt the synthesis of proteins, and others block the functions of respiratory enzymes.

Groups of antibiotics

Despite the diversity of this group of drugs, all of them can be attributed to several main types. This classification is based on the chemical structure - drugs from the same group have a similar chemical formula, differing from each other in the presence or absence of certain fragments of molecules.

The classification of antibiotics implies the presence of groups:

1. Derivatives of penicillin. This includes all drugs created on the basis of the very first antibiotic. In this group, the following subgroups or generations of penicillin preparations are distinguished:

• Natural benzylpenicillin, which is synthesized by fungi, and semi-synthetic drugs: methicillin, nafcillin.
• Synthetic drugs: carbpenicillin and ticarcillin, which have a wider range of effects.
• Mecillam and azlocillin, which have an even wider spectrum of action.

1. Cephalosporins are close relatives of penicillins. The very first antibiotic of this group, cefazolin C, is produced by fungi of the genus Cephalosporium. Most of the drugs in this group have a bactericidal effect, that is, they kill microorganisms. There are several generations of cephalosporins:

• I generation: cefazolin, cephalexin, cefradin, etc.
• II generation: cefsulodin, cefamandol, cefuroxime.
• III generation: cefotaxime, ceftazidime, cefodizime.
• IV generation: cefpir.
• V generation: ceftolosan, ceftopibrol.

The differences between different groups are mainly in their effectiveness - later generations have greater spectrum actions are more efficient. Cephalosporins of the 1st and 2nd generations are now used extremely rarely in clinical practice, most of them are not even produced.

1. - drugs with complex chemical structure that have a bacteriostatic effect on a wide range of microbes. Representatives: azithromycin, rovamycin, josamycin, leukomycin and a number of others. Macrolides are considered one of the safest antibacterial drugs - they can be used even by pregnant women. Azalides and ketolides are varieties of macrolides that differ in the structure of active molecules.

Another advantage of this group of drugs is that they are able to penetrate into cells. human body, which makes them effective in the treatment of intracellular infections:,.

1. Aminoglycosides. Representatives: gentamicin, amikacin, kanamycin. Effective against a large number of aerobic gram-negative microorganisms. These drugs are considered the most toxic, can lead to enough serious complications. Used to treat infections urinary tract, .
2. Tetracyclines. Basically, this semi-synthetic and synthetic drugs, which include: tetracycline, doxycycline, minocycline. Effective against many bacteria. The disadvantage of these drugs is cross-resistance, that is, microorganisms that have developed resistance to one drug will be insensitive to others from this group.
3. Fluoroquinolones. These are completely synthetic drugs that do not have their natural counterpart. All drugs in this group are divided into the first generation (pefloxacin, ciprofloxacin, norfloxacin) and the second (levofloxacin, moxifloxacin). They are most often used to treat infections of the upper respiratory tract (,) and respiratory tract (,).
4. Lincosamides. This group includes natural antibiotic lincomycin and its derivative clindamycin. They have both bacteriostatic and bactericidal effects, the effect depends on the concentration.
5. Carbapenems. This is one of the most modern antibiotics acting on a large number of microorganisms. The drugs of this group belong to the reserve antibiotics, that is, they are used in the most difficult cases when other drugs are ineffective. Representatives: imipenem, meropenem, ertapenem.
6. Polymyxins. These are highly specialized drugs used to treat infections caused by. Polymyxins include polymyxin M and B. The disadvantage of these drugs is toxic effects on the nervous system and kidneys.
7. Anti-tuberculosis drugs. it separate group drugs that have pronounced action on the . These include rifampicin, isoniazid, and PAS. Other antibiotics are also used to treat tuberculosis, but only if resistance has developed to the mentioned drugs.
8. Antifungals. This group includes drugs used to treat mycoses - fungal infections: amphotyrecin B, nystatin, fluconazole.

Ways to use antibiotics

Antibacterial drugs are available in different forms: tablets, powder, from which a solution for injection is prepared, ointments, drops, spray, syrup, suppositories. The main ways to use antibiotics:

1. Oral- intake by mouth. You can take the medicine in the form of a tablet, capsule, syrup or powder. The frequency of administration depends on the type of antibiotics, for example, azithromycin is taken once a day, and tetracycline - 4 times a day. For each type of antibiotic, there are recommendations that indicate when it should be taken - before meals, during or after. The effectiveness of treatment and the severity of side effects depend on this. For young children, antibiotics are sometimes prescribed in the form of syrup - it is easier for children to drink a liquid than to swallow a tablet or capsule. In addition, the syrup can be sweetened to get rid of the unpleasant or bitter taste of the medicine itself.
2. Injectable- In the form of intramuscular or intravenous injections. With this method, the drug enters the focus of infection faster and acts more actively. The disadvantage of this method of administration is pain when injected. Injections are used for moderate and severe course diseases.

Important:injections should be done exclusively nurse in a clinic or hospital! Doing antibiotics at home is strongly discouraged.

1. Local- applying ointments or creams directly to the site of infection. This method of drug delivery is mainly used for skin infections - erysipelas, as well as in ophthalmology - with infectious lesion eyes, for example, tetracycline ointment for conjunctivitis.

The route of administration is determined only by the doctor. This takes into account many factors: the absorption of the drug in the gastrointestinal tract, the state digestive system in general (in some diseases, the rate of absorption decreases, and the effectiveness of treatment decreases). Some drugs can only be administered one way.

When injecting, you need to know how you can dissolve the powder. For example, Abaktal can only be diluted with glucose, since when sodium chloride is used, it is destroyed, which means that the treatment will be ineffective.

Sensitivity to antibiotics

Any organism sooner or later gets used to the most severe conditions. This statement is also true in relation to microorganisms - in response to prolonged exposure microbes develop resistance to antibiotics. The concept of sensitivity to antibiotics was introduced into medical practice - with what efficiency this or that drug affects the pathogen.

Any prescription of antibiotics should be based on knowledge of the susceptibility of the pathogen. Ideally, before prescribing the drug, the doctor should conduct a sensitivity test, and prescribe the most effective drug. But the timing of such an analysis is best case- a few days, and during this time the infection can lead to the saddest result.

Therefore, in case of an infection with an unknown pathogen, doctors prescribe drugs empirically - taking into account the most likely pathogen, with knowledge of the epidemiological situation in a particular region and medical institution. For this, broad-spectrum antibiotics are used.

After performing a sensitivity test, the doctor has the opportunity to change the drug to a more effective one. Replacement of the drug can be made in the absence of the effect of treatment for 3-5 days.

Etiotropic (targeted) prescription of antibiotics is more effective. In this case, it turns out what caused the disease - with the help of bacteriological research the type of exciter is set. Then the doctor selects a specific drug to which the microbe has no resistance (resistance).

Are antibiotics always effective?

Antibiotics only work on bacteria and fungi! Bacteria are unicellular microorganisms. There are several thousand species of bacteria, some of which coexist quite normally with humans - more than 20 species of bacteria live in the large intestine. Some bacteria are opportunistic - they become the cause of the disease only when certain conditions, for example, when they enter a habitat that is not typical for them. For example, very often prostatitis causes coli falling ascending way in from the rectum.

Note: antibiotics are completely ineffective viral diseases. Viruses are many times smaller than bacteria, and antibiotics simply do not have a point of application of their ability. Therefore, antibiotics for colds do not have an effect, since colds in 99% of cases are caused by viruses.

Antibiotics for coughs and bronchitis may be effective if these symptoms are caused by bacteria. Only a doctor can figure out what caused the disease - for this he prescribes blood tests, if necessary - a sputum examination if it departs.

Important:Do not prescribe antibiotics to yourself! This will only lead to the fact that some of the pathogens will develop resistance, and the next time the disease will be much more difficult to cure.

Of course, antibiotics are effective for - this disease has only bacterial nature caused by streptococci or staphylococci. For the treatment of angina use the most simple antibiotics- penicillin, erythromycin. The most important thing in the treatment of angina is compliance with the frequency of taking drugs and the duration of treatment - at least 7 days. You can not stop taking the medicine immediately after the onset of the condition, which is usually noted for 3-4 days. True tonsillitis should not be confused with tonsillitis, which may be of viral origin.

Note: untreated angina can cause acute rheumatic fever or !

Inflammation of the lungs () can be of both bacterial and viral origin. Bacteria cause pneumonia in 80% of cases, so even with empirical prescription, antibiotics for pneumonia have a good effect. In viral pneumonia, antibiotics do not have a therapeutic effect, although they prevent the bacterial flora from joining the inflammatory process.

Antibiotics and alcohol

Simultaneous reception alcohol and antibiotics short span time does not lead to anything good. Some drugs are broken down in the liver, like alcohol. The presence of an antibiotic and alcohol in the blood puts a heavy burden on the liver - it simply does not have time to neutralize ethanol. As a result, the likelihood of developing unpleasant symptoms: nausea, vomiting, intestinal disorders.

Important: a number of drugs interact with alcohol at the chemical level, as a result of which the therapeutic effect is directly reduced. These drugs include metronidazole, chloramphenicol, cefoperazone and a number of others. The simultaneous use of alcohol and these drugs can not only reduce healing effect but also lead to shortness of breath, convulsions and death.

Of course, some antibiotics can be taken while drinking alcohol, but why risk your health? It is better to abstain from alcoholic beverages for a short time - course antibiotic therapy rarely exceeds 1.5-2 weeks.

Antibiotics during pregnancy

pregnant women get sick infectious diseases no less than all the others. But the treatment of pregnant women with antibiotics is very difficult. In the body of a pregnant woman, the fetus grows and develops - future child, highly sensitive to many chemicals. The ingress of antibiotics into the developing organism can provoke the development of fetal malformations, toxic damage to the central nervous system fetus.

In the first trimester, it is advisable to avoid the use of antibiotics altogether. In the second and third trimesters, their appointment is safer, but also, if possible, should be limited.

It is impossible to refuse the prescription of antibiotics to a pregnant woman with the following diseases:

• Pneumonia;
• angina;
• infected wounds;
• specific infections: brucellosis, borreliosis;
• genital infections:,.

What antibiotics can be prescribed to a pregnant woman?

Penicillin, cephalosporin drugs, erythromycin, josamycin have almost no effect on the fetus. Penicillin, although it passes through the placenta, does not adversely affect the fetus. Cephalosporin and other named drugs cross the placenta in extremely low concentrations and are not capable of harming the unborn child.

K conditionally safe drugs include metronidazole, gentamicin, and azithromycin. They are appointed only vital indications when the benefit to the woman outweighs the risk to the baby. These situations include severe pneumonia, sepsis, other severe infections, in which a woman can simply die without antibiotics.

Which of the drugs should not be prescribed during pregnancy

The following drugs should not be used in pregnant women:

• aminoglycosides- can lead to congenital deafness (with the exception of gentamicin);
• clarithromycin, roxithromycin– in experiments they had a toxic effect on animal embryos;
• fluoroquinolones;
• tetracycline- disturbs the formation skeletal system and teeth;
• chloramphenicol- dangerous to later dates pregnancy due to inhibition of functions bone marrow The child has.

For some antibacterial drugs, there is no evidence of a negative effect on the fetus. This is explained simply - on pregnant women do not conduct experiments to determine the toxicity of drugs. Experiments on animals do not allow with 100% certainty to exclude all negative effects, since the metabolism of drugs in humans and animals can differ significantly.

It should be noted that before you should also stop taking antibiotics or change plans for conception. Some drugs have a cumulative effect - they are able to accumulate in a woman's body, and for some time after the end of the course of treatment they are gradually metabolized and excreted. Pregnancy is recommended no earlier than 2-3 weeks after the end of antibiotics.

Consequences of taking antibiotics

The ingestion of antibiotics into the human body leads not only to the destruction pathogenic bacteria. Like all foreign chemicals, antibiotics have systemic action- in one way or another affect all systems of the body.

There are several groups of side effects of antibiotics:

allergic reactions

Almost any antibiotic can cause allergies. The severity of the reaction is different: a rash on the body, Quincke's edema ( angioedema), anaphylactic shock. If a allergic rash practically not dangerous, then anaphylactic shock can lead to death. The risk of shock is much higher with antibiotic injections, which is why injections should only be given in medical institutions- there may be emergency assistance.

Antibiotics and other antimicrobial drugs that cause cross-allergic reactions:

Toxic reactions

Antibiotics can damage many organs, but the liver is most susceptible to their effects - against the background of antibiotic therapy, toxic hepatitis can occur. Individual drugs have a selective toxic effect on other organs: aminoglycosides - on hearing aid(cause deafness) tetracyclines inhibit growth bone tissue in children.

note: the toxicity of the drug usually depends on its dose, but with individual intolerance, sometimes smaller doses are enough to show the effect.

Impact on the gastrointestinal tract

When taking certain antibiotics, patients often complain of stomach pain, nausea, vomiting, stool disorders (diarrhea). These reactions are most often due to the local irritating effect of drugs. The specific effect of antibiotics on the intestinal flora leads to functional disorders of its activity, which is most often accompanied by diarrhea. This condition is called antibiotic-associated diarrhea, which is popularly known as dysbacteriosis after antibiotics.

Other side effects

To others side effects include:

• suppression of immunity;
• the emergence of antibiotic-resistant strains of microorganisms;
• superinfection is a condition in which resistant to this antibiotic microbes, leading to the emergence of a new disease;
• violation of vitamin metabolism - due to the inhibition of the natural flora of the colon, which synthesizes some B vitamins;
• Jarisch-Herxheimer bacteriolysis is a reaction that occurs when bactericidal drugs are used, when, as a result of the simultaneous death of a large number of bacteria, a large amount of toxins are released into the blood. The reaction is clinically similar to shock.

Can antibiotics be used prophylactically?

Self-education in the field of treatment has led to the fact that many patients, especially young mothers, try to prescribe themselves (or their child) an antibiotic for the slightest sign colds. Antibiotics do not have a preventive effect - they treat the cause of the disease, that is, they eliminate microorganisms, and in the absence of only side effects of drugs appear.

There are a limited number of situations where antibiotics are given before clinical manifestations infection, in order to prevent it:

• surgery- in this case, the antibiotic in the blood and tissues prevents the development of infection. As a rule, a single dose of the drug administered 30-40 minutes before the intervention is sufficient. Sometimes, even after an appendectomy, antibiotics are not injected in the postoperative period. After "clean" surgical operations antibiotics are not prescribed at all.
• major injuries or wounds (open fractures, soil contamination of the wound). In this case, it is absolutely obvious that an infection has entered the wound and it should be “crushed” before it manifests itself;
• emergency prevention of syphilis carried out in unprotected sexual contact with a potentially sick person, as well as among health workers who have blood infected person or another biological fluid got on the mucous membrane;
• penicillin can be given to children for the prevention of rheumatic fever, which is a complication of tonsillitis.

Antibiotics for children

The use of antibiotics in children in general does not differ from their use in other groups of people. children young age pediatricians most often prescribe antibiotics in syrup. This dosage form more convenient to take, unlike injections, it is completely painless. Older children may be prescribed antibiotics in tablets and capsules. In severe cases, infections progress to parenteral route injections - injections.

Important: main feature in the use of antibiotics in pediatrics lies in dosages - children are prescribed smaller doses, since the drug is calculated in terms of a kilogram of body weight.

Antibiotics are very effective drugs while having a large number of side effects. In order to be cured with their help and not harm your body, you should take them only as directed by your doctor.

What are antibiotics? When are antibiotics needed and when are they dangerous? The main rules of antibiotic treatment are told by the pediatrician, Dr. Komarovsky:

Gudkov Roman, resuscitator

Antibiotics are a group of medicines that can inhibit the growth and development of living cells. They are most often used to treat infectious processes caused by different strains of bacteria. The first drug was discovered in 1928 by the British bacteriologist Alexander Fleming. However, some antibiotics are also prescribed for oncological pathologies as a component of combination chemotherapy. This group of drugs has practically no effect on viruses, with the exception of some tetracyclines. In modern pharmacology, the term "antibiotics" is increasingly being replaced by "antibacterial drugs".

The first to synthesize drugs from the group of penicillins. They have helped to significantly reduce the lethality of diseases such as pneumonia, sepsis, meningitis, gangrene and syphilis. Over time, due to the active use of antibiotics, many microorganisms began to develop resistance to them. Therefore, the search for new groups of antibacterial drugs has become an important task.

Gradually, pharmaceutical companies synthesized and began to produce cephalosporins, macrolides, fluoroquinolones, tetracyclines, levomycetin, nitrofurans, aminoglycosides, carbapenems and other antibiotics.

Antibiotics and their classification

Basic pharmacological classification antibacterial drugs is the division behind the action on microorganisms. Behind this characteristic, two groups of antibiotics are distinguished:

• bactericidal - drugs cause the death and lysis of microorganisms. This action is due to the ability of antibiotics to inhibit membrane synthesis or suppress the production of DNA components. This property is possessed by penicillins, cephalosporins, fluoroquinolones, carbapenems, monobactams, glycopeptides and fosfomycin.
• bacteriostatic - antibiotics are able to inhibit the synthesis of proteins by microbial cells, which makes it impossible for them to reproduce. As a result, limited further development pathological process. This action is characteristic of tetracyclines, macrolides, aminoglycosides, lincosamines and aminoglycosides.

Beyond the spectrum of action, two groups of antibiotics are also distinguished:

• with a wide - the drug can be used to treat pathologies caused by a large number microorganisms;
• with a narrow - the drug affects individual strains and types of bacteria.

There is also a classification of antibacterial drugs according to their origin:

• natural - obtained from living organisms;
• semi-synthetic antibiotics are modified molecules of natural analogues;
• synthetic - they are produced completely artificially in specialized laboratories.

Description various groups antibiotics

Beta lactams

Penicillins

Historically the first group of antibacterial drugs. It has a bactericidal effect on a wide range of microorganisms. Penicillins are divided into the following groups:

• natural penicillins (synthesized under normal conditions by fungi) - benzylpenicillin, phenoxymethylpenicillin;
• semi-synthetic penicillins, which have greater resistance against penicillinases, which significantly expands their spectrum of action - medicines oxacillin, methicillin;
• with extended action - preparations of amoxicillin, ampicillin;
• penicillins with broad action on microorganisms - medicines mezlocillin, azlocillin.

To reduce bacterial resistance and increase the chance of success of antibiotic therapy, penicillinase inhibitors - clavulanic acid, tazobactam and sulbactam - are actively added to penicillins. So there were drugs "Augmentin", "Tazozim", "Tazrobida" and others.

These medications are used for infections of the respiratory (bronchitis, sinusitis, pneumonia, pharyngitis, laryngitis), genitourinary (cystitis, urethritis, prostatitis, gonorrhea), digestive (cholecystitis, dysentery) systems, syphilis and skin lesions. Of the side effects, allergic reactions are most common (urticaria, anaphylactic shock, angioedema).

Penicillins are also the safest drugs for pregnant women and babies.

Cephalosporins

This group of antibiotics has a bactericidal effect on a large number of microorganisms. Today, the following generations of cephalosporins are distinguished:

The vast majority of these medicines exist only in injection form Therefore, they are used mainly in clinics. Cephalosporins are the most popular antibacterial agents for use in hospitals.

These drugs are used to treat a huge number of diseases: pneumonia, meningitis, generalization of infections, pyelonephritis, cystitis, inflammation of bones, soft tissues, lymphangitis and other pathologies. Hypersensitivity is common with cephalosporins. Sometimes there is a transient decrease in creatinine clearance, muscle pain, cough, increased bleeding (due to a decrease in vitamin K).

Carbapenems

Are pretty new group antibiotics. Like other beta-lactams, carbapenems have a bactericidal effect. A huge number of different strains of bacteria remain sensitive to this group of medicines. Carbapenems are also resistant to enzymes synthesized by microorganisms. Data properties have led to the fact that they are considered rescue drugs when other antibacterial agents remain ineffective. However, their use is severely restricted due to concerns about the development of bacterial resistance. This group of drugs includes meropenem, doripenem, ertapenem, imipenem.

Carbapenems are used to treat sepsis, pneumonia, peritonitis, acute surgical pathologies abdominal cavity, meningitis, endometritis. These drugs are also prescribed to patients with immunodeficiencies or on the background of neutropenia.

Side effects include dyspeptic disorders, headache, thrombophlebitis, pseudomembranous colitis, convulsions and hypokalemia.

Monobactams

Monobactams act mainly only on gram-negative flora. The clinic uses only one active substance from this group - aztreonam. With its advantages, resistance to most bacterial enzymes stands out, which makes it the drug of choice when treatment with penicillins, cephalosporins and aminoglycosides is ineffective. AT clinical guidelines aztreonam is recommended for enterobacter infection. It is used only intravenously or intramuscularly.

Among the indications for admission, it is necessary to highlight sepsis, community acquired pneumonia, peritonitis, infections of the pelvic organs, skin and musculoskeletal system. The use of aztreonam sometimes leads to the development of dyspeptic symptoms, jaundice, toxic hepatitis, headache, dizziness and allergic rash.

macrolides

Medicines are also marked by low toxicity, which allows them to be used during pregnancy and in early age child. They are divided into the following groups:

• natural, which were synthesized in the 50-60s of the last century - preparations of erythromycin, spiramycin, josamycin, midecamycin;
• prodrugs (converted to active form after metabolism) - troleandomycin;
• semi-synthetic - medicines of azithromycin, clarithromycin, dirithromycin, telithromycin.

Macrolides are used for many bacterial pathologies: peptic ulcer, bronchitis, pneumonia, ENT infections, dermatosis, Lyme disease, urethritis, cervicitis, erysipelas, impentigo. You can not use this group of medicines for arrhythmias, renal failure.

Tetracyclines

Tetracyclines were first synthesized over half a century ago. This group has a bacteriostatic effect against many strains of microbial flora. In high concentrations, they also exhibit a bactericidal effect. A feature of tetracyclines is their ability to accumulate in bone tissue and tooth enamel.

On the one hand, this allows clinicians to actively use them in chronic osteomyelitis, and on the other hand, it disrupts the development of the skeleton in children. Therefore, they categorically cannot be used during pregnancy, lactation and under the age of 12 years. Tetracyclines, in addition to the drug of the same name, include doxycycline, oxytetracycline, minocycline and tigecycline.

They are used for various intestinal pathologies, brucellosis, leptospirosis, tularemia, actinomycosis, trachoma, Lyme disease, gonococcal infection and rickettsiosis. Among the contraindications are also porphyria, chronic liver disease and individual intolerance.

Fluoroquinolones

Fluoroquinolones are big group antibacterial agents with a broad bactericidal effect on pathogenic microflora. All drugs are marching nalidixic acid. The active use of fluoroquinolones began in the 1970s. Today they are classified by generation:

• I - preparations of nalidixic and oxolinic acids;
• II - medicines with ofloxacin, ciprofloxacin, norfloxacin, pefloxacin;
• III - preparations of levofloxacin;
• IV - medicines with gatifloxacin, moxifloxacin, gemifloxacin.

Recent generations of fluoroquinolones have been called "respiratory", due to their activity against microflora, which is the most common cause of pneumonia. They are also used to treat sinusitis, bronchitis, intestinal infections, prostatitis, gonorrhea, sepsis, tuberculosis and meningitis.

Among the disadvantages, it is necessary to highlight the fact that fluoroquinolones are able to influence the formation of the musculoskeletal system, therefore, in childhood, during pregnancy and lactation, they can be prescribed only for health reasons. The first generation of drugs is also characterized by high hepato- and nephrotoxicity.

Aminoglycosides

Aminoglycosides found active use in treatment bacterial infection caused by Gram-negative bacteria. They have a bactericidal effect. Them high efficiency, which does not depend on functional activity patient immunity, made them irreplaceable means with its violations and neutropenia. The following generations of aminoglycosides are distinguished:

Aminoglycosides are prescribed for infections of the respiratory system, sepsis, infective endocarditis, peritonitis, meningitis, cystitis, pyelonephritis, osteomyelitis and other pathologies. Among the side effects great importance have toxic effects on the kidneys and hearing loss.

Therefore, during the course of therapy, it is necessary to regularly carry out biochemical analysis blood (creatinine, GFR, urea) and audiometry. Pregnant women, during lactation, patients with chronic disease kidney or hemodialysis aminoglycosides are prescribed only for health reasons.

Glycopeptides

Glycopeptide antibiotics have a broad-spectrum bactericidal effect. The best known of these are bleomycin and vancomycin. In clinical practice, glycopeptides are reserve drugs that are prescribed when other antibacterial agents are ineffective or the infectious agent is specific to them.

They are often combined with aminoglycosides, which allows to increase the cumulative effect against Staphylococcus aureus, Enterococcus and Streptococcus. Glycopeptide antibiotics have no effect on mycobacteria and fungi.

Appoint this group antibacterial agents for endocarditis, sepsis, osteomyelitis, phlegmon, pneumonia (including complicated), abscess and pseudomembranous colitis. Do not use glycopeptide antibiotics in renal failure, hypersensitivity to drugs, lactation, neuritis auditory nerve, pregnancy and lactation.

Lincosamides

Lincosamides include lincomycin and clindamycin. These drugs exhibit a bacteriostatic effect on gram-positive bacteria. I use them mainly in combination with aminoglycosides, as second-line agents, for severe patients.

Lincosamides are prescribed for aspiration pneumonia, osteomyelitis, diabetic foot, necrotizing fasciitis and other pathologies.

Quite often, during their administration, a candidal infection develops, headache, allergic reactions and oppression of hematopoiesis.

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