Widespread antimicrobials. Antibacterial components of suppositories. Irritant effect on the routes of administration

The term "antibacterial drugs" itself indicates the principle of action directed against bacteria. They are prescribed only for infectious processes; using them for allergies and viruses is useless.

Antibacterial chemicals were originally synthetic drugs that were created artificially, but have a similar effect to antibiotics in suppressing bacteria.

These included only sulfonamides. With the creation of antibiotics, they were included in this class.

With the creation of the strongest antibacterial drugs similar to antibiotics and even superior to them, the concept of antibiotic has expanded and is now used as a synonym for antibacterial agents, which includes everything.

It is not right; antibacterial drugs and antibiotics are two different things. Antibiotics are just a part of antibiotics.

Antibiotics are essentially substances that some microorganisms produce against others in order to destroy them. These are naturally occurring substances.

Antibacterial agents include antibiotics, antiseptics, antimicrobials and antibacterials. Their purpose is the destruction of pathogenic microorganisms (germs).

These smallest forms of life arose long before the advent of man and are flourishing to this day. The entire environment is inhabited by billions of bacteria that live both outside and inside the human body.

Microbes include bacteria (they do not have a nucleus), some fungi, protists (they have a nucleus and are familiar to everyone from the school curriculum - for example, ciliates), archaea. They are not necessarily single-celled, but they are all living.

Unlike viruses and prions (protein structures in tissues that have the ability to reproduce), which can only develop in living host cells. That is why antibiotics cannot affect viruses. They can only be affected antiviral drugs and some antiseptics. In turn, antiviral drugs are useless in a bacterial infection.

Antiseptics - act on all microorganisms, but are used only externally. These include iodine, alcohol, potassium permanganate. They disinfect wounds and prevent decomposition processes.

Antimicrobial agents - it is possible to use both externally and internally (orally, by injection, in suppositories, etc.). These include sulfonamides.

Antibiotics are a narrower group of drugs that are effective against bacteria and protozoa (for example, malarial plasmodia, chlamydia, etc.). They are divided like this: antibacterial and antiprotozoal.

According to the method of use, among them there are also antiseptics and antimicrobials; for example, Levomycetin, Amoxicillin.

Those antimicrobial and antiseptic that act on fungi are antifungal or antimycotic drugs.

All antibacterial drugs include 6 groups:

• quinolones;
• fluoroquinolones;
• nitrofurans;
• oxyquinolines;
• quinoxalines;
• sulfonamides.

Their action will be discussed below.

A bit of history

In 1928, penicillin was discovered by A. Fleming, who discovered it by chance on a bread mold and gave it such a name. The mold of this fungus destroyed the colonies of staphylococcus in a Petri dish. But this did not cause delight in anyone, because the drug turned out to be very unstable and quickly collapsed.

But only 10 years later, in 1938, a drug was created where penicillin remained in its active form. This was done by the English from Oxford, HowardFlory and Ernst Cheyne; they isolated it in its purest form.

The production of this drug began in 1943, and saved the lives of millions of people in the war, turning the course of history. And in 1945. these three scientists received the Nobel Prize.

In the USSR in 1942, Krustozin was created, which turned out to be one and a half times more effective than foreign penicillin. It was created by microbiologist Zinaida Ermolyeva.

Classification

A lot of antibiotics have been created today and their classifications are based on the principle of action and chemical structure.

According to their effect, all antibiotic agents are divided into bacteriostatic and bactericidal. Bacteriostatics - stop the reproduction of bacteria, but do not destroy them.

In the second group, the bacteria die and are excreted from the kidneys and feces. Bactericidal activity is manifested in the suppression of all types of synthesis: proteins, DNA, bacterial cell membranes.

The concept of antibacterial drugs

So, antibacterial agents can be divided as follows:

1. Quinolones are antibacterial agents, this also includes fluoroquinolones. They are successfully used in various systemic infectious pathologies.
2. Fluoroquinolones - have a wide spectrum of action. They are not purely antibiotics, although they are close to them in action. But they have a different origin and structure. Many antibiotics are of natural origin or are close to natural analogues. This is not the case with fluoroquinolones.
3. There are 2 generations of these drugs. Some of them are included in the ZhVL list: these are Ciprofloxacin, Levofloxacin, Moxifloxacin, Lomefloxacin, Ofloxacin.
4. Nitrofurans are also not antibiotic agents, although they have a bacteriostatic effect. They are used for chlamydia, trichomonas, giardia, some gram-positive and gram-negative bacteria. Bactericidal in high doses. Resistance to them rarely develops.
5. Sulfonamides - have a bacteriostatic effect; are not antibiotics, are often prescribed to enhance their action.
6. Oxyquinolines - inhibit gram-negative bacteria by inhibiting the activity of their enzymes. Used for intestinal and kidney infections, leprosy.
7. Quinoxalines are bactericidal substances with a poorly studied effect.

The classification according to the chemical structure currently used is as follows:

1. Beta-lactam antibiotics; they combine 3 subgroups - penicillins, cephalosporins, carbapenems.
2. Macrolides are a large group of bacteriostatic antibiotics; the safest in terms of side effects.
3. Tetracyclines are also bacteriostatics; still remain in the forefront in the treatment of anthrax, tularemia, cholera, brucellosis.
4. Aminoglycosides - have bactericidal properties. Assign for sepsis, peritonitis. Highly toxic.
5. Levomycetins - bacteriostatics; they are toxic to the bone marrow, so they are used to a limited extent.
6. Glycopeptide antibiotics are bactericidal; but known cocci act only bacteriostatically.
7. Lincosamides are bacteriostatics in a therapeutic dose. In high doses, they exhibit a bactericidal effect.
8. Anti-tuberculosis drugs - effective with Koch's wand. According to the strength of the action are divided into the most, moderately and least effective.
9. Antibiotics of different groups - Fusidin-sodium, PolymyxinM, Gramicidin, Rifamycin, etc. They are used quite infrequently, therefore they remain effective in the treatment of intestinal infections, throat infections, etc.
10. Antifungal antibiotics - the spectrum of action is limited to fungi, destroy the membrane of fungal cells. They do not work on other pathogens.
11. Antileprosy drugs - rarely used, only for the treatment of leprosy - Diucifon, Solusulfon, etc.

Methods of reception

Antibiotics are available in tablets, ampoules, ointments, sprays, drops, suppositories and syrup. Accordingly, and different ways of application.

The frequency of administration and duration are prescribed by the doctor. Syrups are mainly prescribed for young children. Methods of administration: oral; injection; local.

Topical application can be external, intranasal, intravaginal, rectal. Injectable forms are used for moderate to severe infections. In these cases, the antibiotic enters the bloodstream quickly, bypassing the gastrointestinal tract.

All details are discussed by the doctor, and do not depend on the knowledge of the patient. For example, Abaktal is diluted before the introduction of glucose; physical the antibiotic solution destroys, and, therefore, the treatment will not work.

Otherwise, it is unacceptable to self-medicate, although there are detailed instructions for their use.

The duration of treatment is not less than 7-10 days, even despite the improvement in well-being.

Sensitivity to antibiotics

Today, the uncontrolled use of antibiotics has led to the fact that they are often ineffective. This happens because bacteria become resistant to these agents.

Therefore, in order to get into the top ten right away, it is necessary to identify the type of pathogen and the sensitivity of the pathogen to a particular antibiotic.

For this purpose, a cultural diagnostic method is used by the method of bak.sowing. This is ideal. But it often happens that help is needed quickly, and sowing will reveal the result in a few days.

In such cases, the doctor empirically, assuming a possible pathogen, prescribes the antibiotic that turned out to be the most effective in this region.

Most often, broad-spectrum antibiotics are used for this. If the analysis is ready by that time, it becomes possible to replace the antibiotic with the right one if the prescribed one did not give an effect within 3 days.

Possible resistance mechanisms

The mechanism of resistance can be as follows:

1. Microorganisms can mutate with illiterate treatment and the reactions that the antibiotic blocks become indifferent to the pathogen.
2. The pathogen can surround itself with a protective capsule and become impenetrable to the antibiotic.
3. The bacterium does not have a structure vulnerable to antibiotics.
4. A bacterium may have an antibiotic-destroying enzyme at the chemical formula level, which converts the drug into a latent form (staphylococci, for example, contain lactamase that destroys penicillins).

Are antibiotics always effective?

Antibiotics can only kill bacteria, fungi and protozoa; with viruses - their use is impractical. That is why, with ARVI, antibiotics do not give a result, since 99% of ARVI are of viral origin.

And this is also why antibiotics are effective in sore throats, because they are caused by strepto- and staphylococci. The same picture is observed in pneumonia. 80% of them are caused by bacteria. For viral pneumonia, the doctor may prescribe antibiotics to prevent secondary infection at the end of antiviral therapy.

Antibiotics and alcohol

If a person uses alcohol and antibiotics together, he, first of all, strikes at his liver, since all antibacterial agents are decomposed by the liver, like alcohol.

In addition, some drugs themselves can combine with alcohol through chemical reactions and reduce their effectiveness. Among such funds, Trichopolum, Cefaperazon, Levomycetin, etc. can be noted.

Antibiotics during pregnancy

Treatment of pregnant women with antibiotics is always difficult, since the teratogenicity of the prescribed drug is taken into account. In the 1st trimester, their appointment is completely excluded; in the 2nd and 3rd trimesters, they can be prescribed, but with caution and in exceptional cases. During these weeks, the main organs of the baby are already formed, but there is always a risk of adverse effects.

It is impossible not to use antibiotics for a future mother if it is diagnosed: tonsillitis, pyelonephritis, infected wound, sepsis, pneumonia, STIs; specific infections: borreliosis, brucellosis, TB, etc.

Can be used during pregnancy

Penicillins, cephalosporins, Josamycin and Erythromycin, Azithromycin, Gentamicin do not have a teratogenic effect (the last 2 drugs can be used for health reasons). Cephalosporins cross the placenta very little to harm the fetus.

Not prescribed during pregnancy:

• aminoglycosides (may cause congenital deafness);
• clarithromycin and roxithromycin (toxic to the fetus);
• fluoroquinolones;
• metronidazole (teratogenic);
• amphotericin (causes fetal growth retardation and miscarriages);
• tetracyclines (impairs the formation of the skeletal system of the fetus);
• Levomycetin (inhibits the bone marrow of the fetus).

Why is there so little information about the effects of antibiotics on the fetus? Because such experiments on humans are prohibited. And the metabolism of humans and laboratory animals is not 100% the same, so the results may vary.

What are the consequences?

In addition to the antibacterial effect, antibiotics have a systemic effect on the body, so there are always side effects.

These include:

• hepatotoxicity;
• toxic-allergic reactions; dysbiosis;
• decreased immunity (this is especially important in a baby);
• effects on the kidneys;
• the development of pathogen resistance, especially with illiterate treatment;
• superinfection - when, in response to the introduction of an antibiotic, those microorganisms that were resistant to it are activated and they cause a new disease in addition to the existing one.

Also, with antibacterial therapy, the metabolism of vitamins is disrupted due to the inhibition of the microflora of the large intestine, where some vitamins are synthesized.

A rarer, but more complex and dangerous reaction is Jarisch-Herxheimer bacteriolysis - a reaction. It can occur with the massive death of bacteria from a bactericidal antibiotic with the same massive release of their toxins into the blood. The reaction downstream resembles the ITS.

Allergic reactions can lead to anaphylactic shock; that is why it is dangerous to inject antibiotics at home, here you will not be able to provide emergency care to the patient.

The intake of antibacterial drugs affects the gastrointestinal tract and most often this manifests itself in the inhibition of the intestinal microflora, which is expressed by diarrheal syndrome and disrupts the metabolism in general. This is a dysbacteriosis, the scientific name of which is antibiotic-associated diarrhea. Therefore, along with antibiotic therapy, pre- and probiotics should always be prescribed.

Prophylactic antibiotics

Many young mothers advanced on the Internet, at the slightest sign of a cold, immediately begin to drink antibiotics themselves and give them to their children. This is a gross mistake.

Antibiotics have no preventive effect. If there is no pathogen, you will not get anything other than side effects. Antibacterial and antimicrobial drugs for children in the treatment of infections are used today unambiguously, but only if its bacterial origin is identified.

Preventive antibiotics can be prescribed in a hospital only during surgical operations to prevent the development of a secondary infection; the maximum dose is administered half an hour before the operation once. Without purulent complications after surgery, antibiotic therapy is not prescribed.

The second case is the introduction of an antibiotic in the presence of an infected wound. The purpose of this is to suppress the infection before it manifests itself.

And the third moment - for emergency prevention (unprotected sex - for the prevention of syphilis and gonorrhea).

Rules for antibiotic treatment:

1. Treatment is prescribed only by a doctor.
2. Antibiotics are not indicated for viral infections.
3. Fully comply with the course of treatment; don't stop on your own. Take at the same time of day.
4. Do not adjust the dose yourself.
5. Take antibiotic tablets with water only; milk, tea, soda - do not use.
6. Between doses of the drug should be the same interval in time.
7. During treatment, physical activity and training are excluded.
8. Antibacterial drugs for a child are prescribed only taking into account his body weight and age. This is the prerogative of the pediatrician.

Treatment of Helicobacter pylori infection

It is carried out only when the specified bacterium is detected on the gastric mucosa:

1. Powerful drugs against this type of bacteria are: Clarithromycin - a macrolide with high anti-Helicobacter activity; dissolves in the environment of the stomach and blocks the synthesis of bacteria. Also has an anti-inflammatory effect. Has a minimum of side effects, well tolerated. Its analogues are Macropen, Fromilid, Binocular, etc.
2. Amoxicillin is a bactericidal drug. With Helicobacter it is combined with Metronidazole. Analogues - Augmentin, Amoxil.
3. Azithromycin is a 3rd generation macrolide. It has solubility in the acidic environment of the stomach and is well tolerated. Analogues - Azamax, Brilid, Sumamed, etc.
4. Levofloxacin - refers to fluoroquinolones; bactericidal drug against Helicobacter. Analogues - Glevo, Lebel, Ivatsin, Levoxin. Quite toxic, therefore, require caution in use.
5. Metronidazole is an antimicrobial agent, not an antibiotic. Bactericidal, prescribed in conjunction with other antibiotics.
6. Pylobact is a combination drug for the treatment of pylori. It contains Clarithromycin, Tinidazole and Omez (an antacid). Each component suppresses the vital activity of Helicobacter pylori.

Antibiotics in gynecology

Only broad-spectrum antibacterial drugs are used. They are used in conjunction with other medications to avoid side effects. For example, the use of antibiotics and OCs leads to an unintended pregnancy.

Antibiotics or antibacterial drugs is the name of a group of medicines that are used in the treatment of diseases caused by microorganisms. Their discovery took place in the 20th century and became a real sensation. Antimicrobial agents were considered a panacea for all known infections, a miracle cure for terrible diseases that humanity has been exposed to for thousands of years. Due to their high efficiency, antibacterial agents are still actively used in medicine for the treatment of infectious diseases. Their prescribing has become so commonplace that many people buy their own over-the-counter antibiotics from a pharmacy without waiting for a doctor's recommendation. But we must not forget that their reception is accompanied by a number of features that affect the result of treatment and human health. What you should definitely know before using antibiotics, as well as the features of treatment with this group of medications, we will consider in more detail in this article.

It is interesting! Depending on the origin, all antibacterial drugs are divided into synthetic, semi-synthetic, chemotherapeutic drugs and antibiotics. Chemotherapeutic or synthetic drugs are obtained in the laboratory. In contrast, antibiotics are the waste products of microorganisms. But, despite this, for a long time the term "antibiotic" in medical practice has been considered a full synonym for "antibacterial agent" and has a general free distribution.

Antibiotics - what is it?

Antibiotics are special substances that selectively affect certain microorganisms, inhibiting their vital activity. Their main task is to stop the reproduction of bacteria and gradually destroy them. It is realized by disrupting the synthesis of malicious DNA.

There are several types of effects that antibacterial agents can have: bacteriostatic and bactericidal.

• bactericidal action. It indicates the ability of drugs to damage the cell membrane of bacteria and cause their death. The bactericidal mechanism of action is characteristic of Klabaks, Sumamed, Isofra, Tsifran and other similar antibiotics.
• bacteriostatic action. It is based on the inhibition of protein synthesis, the suppression of the reproduction of microorganisms and is used in the treatment and prevention of infectious complications. Unidox Solutab, Doxycycline, Tetracycline hydrochloride, Biseptol, etc. have a bacteriostatic effect.

Ideally, antibiotics block the vital functions of harmful cells without negative impact on host cells. This is facilitated by the unique property of this group of drugs - selective toxicity. Due to the vulnerability of the bacterial cell wall, substances that interfere with its synthesis or integrity are toxic to microorganisms but harmless to host cells. The exception is potent antibiotics, the use of which is accompanied by adverse reactions.

In order to get only a positive effect from the treatment, antibiotic therapy should be based on the following principles:

1. The principle of rationality. The key role in the treatment of an infectious disease is played by the correct identification of the microorganism, therefore, in no case should you choose an antibacterial drug on your own. Contact your doctor. Based on the tests and a personal examination, a medical specialist will determine the type of bacteria and prescribe you the appropriate highly specialized medicine.
2. The umbrella principle. It is used when it is not possible to identify the microorganism. The patient is prescribed broad-spectrum antibacterial drugs that are effective against most of the most likely pathogens. In this case, combination therapy is considered the most optimal, providing a reduction in the risk of developing resistance of the microorganism to the antibacterial agent.
3. The principle of individualization. When prescribing antibiotic therapy, it is necessary to take into account all the factors associated with the patient: his age, gender, localization of the infection, the presence of pregnancy, as well as other concomitant diseases. It is equally important to choose the optimal route of drug administration for a timely and effective result. It is believed that oral administration of the drug is acceptable for moderate infections, and parenteral administration is optimal in extreme cases and in acute infectious diseases.

General rules for taking antibacterial drugs

There are general rules for antibiotic treatment that should not be neglected to achieve the maximum positive effect.

• Rule number 1. The most important rule in antibiotic therapy is that all medications must be prescribed by a medical specialist.
• Rule number 2. It is forbidden to take antibiotics for viral infections, as there is a possibility of the opposite effect - aggravation of the course of a viral disease.
• Rule number 3. You should follow the prescribed course of treatment as carefully as possible. It is recommended to take medicines at approximately the same time of day. In no case should you stop taking them on your own, even if you begin to feel much better, as the disease may return.
• Rule number 4. You can not adjust the dosage during treatment. Reducing the dose can cause the development of bacterial resistance to this group of drugs, and increasing it is fraught with an overdose.
• Rule number 5. If the medicine is presented in the form of a tablet, then it should be washed down with 0.5 - 1 glass of water. Do not take antibiotics with other drinks: milk, tea, etc., as they reduce the effectiveness of medicines. Remember well that you can not drink milk at elevated temperatures, as it will not be completely digested and may provoke vomiting.
• Rule number 6. Work out your system and the sequence of taking the medicines prescribed for you in such a way that there is approximately the same period of time between their use.
• Rule number 7. It is not recommended to play sports during antibiotic therapy, therefore, during treatment, reduce physical activity or eliminate it completely.
• Rule number 8. Alcoholic beverages and antibiotics don't mix, so stay away from alcohol until you're fully recovered.

Should children be treated with antibiotics?

According to the latest statistics in Russia, 70-85% of children suffering from viral diseases receive antibiotics due to non-professional treatment. Despite the fact that taking antibacterial drugs contributes to the development of bronchial asthma, it is these medications that are the most "popular" method of treatment. Therefore, parents should be careful at the doctor's appointment and ask the specialist questions if you have doubts about the appointment of antibacterial agents for the child. You yourself must understand that a pediatrician, prescribing a long list of medicines for a baby, protects only himself, insures himself in case of complications, etc. After all, if the child becomes worse, then the responsibility for the fact that he “did not cure” or “treated badly” falls on the doctor.

Unfortunately, this model of behavior is increasingly common among domestic doctors who seek not to cure the child, but to “heal” him. Be careful and remember that antibiotics are only prescribed to treat bacterial, not viral diseases. You should know that only you care about the health of your child. A week or a month later, when you again come to the appointment with another disease that arose against the background of weakened by the previous “treatment” immunity, doctors will only indifferently meet you and again prescribe a long list of medicines.

Antibiotics: good or bad?

The belief that antibiotics are extremely harmful to human health is not without merit. But it is valid only in case of improper treatment, when there is no need to prescribe antibacterial drugs. Despite the fact that this group of drugs is now freely available, sold over the counter through the pharmacy network, in no case should you take antibiotics on your own or at your own discretion. They can only be prescribed by a doctor in case of a serious bacterial infection.

If there is serious illness, which is accompanied by high fever and other symptoms confirming the severity of the disease - it is impossible to delay or refuse antibiotics, referring to the fact that they are harmful. In many cases, antibacterial agents save a person's life, prevent the development of serious complications. The main thing is to approach antibiotic treatment wisely.

Below is a list of popular antibacterial agents, instructions for which are presented on our website. Just follow the link in the list for instructions and recommendations for the use of this drug.

To date, there is no shortage of drugs - pharmacies can offer several drugs that are similar in effect. We have prepared for you a list of broad-spectrum antibiotic tablets in order to avoid unnecessary confusion, because each pharmacological agent has certain features.

Strong broad-spectrum antibiotics in tablets - what to choose?

Depending on the nature of the main active substance, several groups of antibiotics are distinguished. Each of them may be preferable to others, depending on the condition of the patient, his age and past illnesses.

The most effective and commonly used group is the penicillins. They can be of natural or synthetic origin. Here are the most popular oral medications:

• Hyconcil;
• Augmentin;
• Flemoxin;
• Solutab;
• Panklav;
• Flemoklav Solutab;
• Ecoclave.

These drugs can be prescribed during pregnancy and children. They are effective for various types of bacterial infections - both in the respiratory system and in the genitourinary system. Can be used for suppuration as a result of operations and injuries. A similar broad-spectrum antibiotic is drunk 3 tablets per day, unless the doctor has given other recommendations. The disadvantages of penicillins include frequent cases of allergies to this entire group of drugs.

As an alternative to penicillins, cephalosporins can be offered. Typically, antibiotics of this type are prescribed intramuscularly and intravenously, only Cefixime can be taken orally.

Another large group of broad-spectrum antibiotics are macrolides. The action of these drugs is slower, since their purpose is not to kill bacteria, but to stop their reproduction. As a plus, rare cases of allergies can be noted. Here are the most popular drugs:

• Azitrox;
• Zetamax Retard;
• Z-factor;
• Zitrolide forte;
• Sumamed;
• Clarithromycin;
• Clubax;
• Fromilid;
• Rulid.

This type of broad-spectrum antibiotic is also prescribed 3 tablets per day for adults.

The most powerful broad-spectrum antibiotics belong to the group of fluoroquinolones. They are prescribed only in emergency situations due to a large number side effects and possible contraindications. First of all, it is forbidden to stay in the sun for 3 days after the end of the reception. This group includes such drugs.

Antibiotics occupy a special place among medicines, because. their action is aimed at combating diseases of an infectious nature. If these drugs are of the latest generation, they help to cope with most of the existing pathogenic microbes.

Modern broad-spectrum antibiotics of a new generation can significantly alleviate the course of infectious diseases and speed up recovery. Their use made it possible to significantly reduce the number of deaths due to pneumonia, to quickly cope with the symptoms and consequences of bronchitis, urological diseases and many other ailments.

How do the latest antibiotics work?

Antibacterial spectrum drugs of the new generation act selectively in the body, i.e. affect the cells of pathogenic microbes, while not affecting human cells.

The classification of drugs depends on how the effect of the drug on the vital activity of bacteria occurs. Some drugs are able to suppress the synthesis of a bacterial cell externally (drugs of the penicillin series, cephalosporins), others inhibit protein synthesis in bacterial cells (tetracyclines, macrolides). The antibacterial activity of a particular drug must be indicated in the instructions for the drug.

Antibiotics can have a wide range of effects and have a narrow focus, i.e. target a specific group of bacteria. This happens because bacteria and viruses differ in function and structure, so what kills bacteria may not affect viruses.

Important! The older the generation of antibacterial agents, the more minimal the set of side effects and the greatest efficiency.

When broad-spectrum antibiotics are used:

• If the causative agents of the disease are resistant when using the drug with a narrow focus;
• If an infection is detected that is caused by several varieties of bacteria at once;
• If prophylaxis against infections is needed after surgery has been performed;
• If treatment is carried out on the basis of symptoms, when a specific pathogen is not detected (with rapidly developing dangerous pathologies).

The latest generation of broad-spectrum antibacterial drugs are considered universal medicines in the fight against inflammation of the lymph nodes, with colds, in gynecology, etc. Drugs allow you to cope with microbes, no matter what pathogen causes the disease. After all, each newly released drug has a more perfect effect on pathogenic microorganisms, while causing minimal damage to the human body.

Methods of application and forms of antibiotics

Antibiotic treatment can be carried out in several ways:

1. Orally (by mouth). To do this, use drugs in capsules, tablets, suspensions, syrups. This is the most common method of application, which has its drawbacks, because. some types of antibiotics can be destroyed in the stomach or poorly absorbed into its walls, thereby exerting a negative irritating effect on the gastrointestinal tract.
2. Parenterally. This is the most effective method treatment with broad-spectrum antibiotics intramuscularly or intravenously, as well as by injection into the spinal cord.
3. Rectally or by injecting the drug directly into the rectum (enema).

Injections and injections are usually used in severe forms of diseases, because. act faster on the focus of infection, starting their work immediately after the injection.

Modern broad-spectrum antibiotics in injections:

• Cephalosporins (Cefotaxime, Cefpirome, Cefoperazone, Ceftazidime);
• Minopenicillins (Sulbactam);
• Aminoglycoside antibiotics (Netilmicin, Amikacin);
• Carbapenems (Meropenem, Ertapenem, Impinem-cilastatin).

The choice of drug depends on the characteristics of the causative agent of the infection, the complexity of the case.

Strong broad-spectrum antibiotics in tablets:

• Fluoroquinolones (Moxifloxacin, Gatifloxacin);
• Natural macrolides (Levofloxacin, Sparfloxacin, Midecamycin);
• Synthetic macrolides (Amoxicillin, Azithromycin, Clarithromycin);
• Nitrofurans (Ersefuril, Nitrofurantoin).

Different groups of antibiotics have different localization in certain systems and human organs. According to this principle, physicians select a certain drug for the treatment of a particular disease, which will have the strongest effect on pathogenic microorganisms in a certain part of the human body.

All broad-spectrum antibiotics have a high effect on infectious agents, so they successfully fight many diseases. The doctor selects a course and a combination of drugs in order to increase the effectiveness of treatment. This takes into account the individual characteristics of the patient, the stage of the disease, progress or regression in its course. On average, the course is from 7 to 10 days, taking into account the above factors.

List of broad-spectrum antibacterial drugs

The pharmaceutical industry is constantly developing and releasing new antibacterial drugs, so there is a very significant number of the latest generation of antibiotics with a wide range of effects. Consider the most popular and common drugs.

1. Penicillins:

• Amoxiclav is a combination of a bat-lactamase inhibitor (clauronic acid). It is prescribed for infections of the genitourinary, musculoskeletal, respiratory systems and infections of the biliary tract.
• Aomoxicillin, Augmentin, Medoklav. Can be used to treat most infectious diseases. Not used for intolerance to cephalosporins and penicillins, for severe liver pathologies, infectious mononucleosis, lymphocytic leukemia.

1. Cephalosporins:

• Cefaclor (Alfacet, Ceclor), Ceftazidime. They are used for infections of the respiratory, genitourinary tract, skin infections, and otitis media.
• Cefamandol, Cefoxitin (Mefoxin), Cefotaxime. A drug in the form of injections and injections for the treatment of infections of the gastric, genitourinary, respiratory tract, with, endocarditis, sepsis, for prophylaxis in the postoperative period.
• Cefuroxime (Zinnat). Effectively affects pathogenic microorganisms that are insensitive to penicillins. It is prescribed for infections of the genitourinary, respiratory, musculoskeletal systems, for the treatment of ENT organs, for meningitis, borreliosis, sepsis, after undergoing severe abdominal operations.
• Cefoperazone. Only for intravenous use in the treatment of infectious forms of the genitourinary, respiratory organs, with sepsis, meningitis.
• Latamoxef (Moxalactam). It has a pronounced activity against gram-negative microorganisms, but the cost is very expensive.
• Cefpodoxime (Orelox, Septofek). Active against most infections of the ENT organs, with erysipelas,.

1. Macrolides:

• Rulid, Rovamycin. They are used to treat infections in the genitourinary, bone, respiratory systems, in inflammatory processes of the upper respiratory tract and oral cavity, brucellosis, scarlet fever.
• Spiramycin. Affects even weakly sensitive to the drug microorganisms.
• Clarithromycin. Effective in the treatment of infections of the respiratory, musculoskeletal, dental and jaw systems.
• Roxithromycin (Exparoxy, Rulid). It is used in dentistry, for the treatment of childhood infections (whooping cough, scarlet fever, diphtheria), and infections of the respiratory and genitourinary systems.
• Sumamed. It has a wide range of bactericidal action. It is more often used in the treatment of infections of the ENT organs, the respiratory system, and the skin.

1. Other antibiotics:

• Unidox Solutab (Doxycycline). It is prescribed for the treatment of infections in the respiratory, genitourinary system, skin diseases, gastrointestinal tract, with typhus.
• Lincomycin. It is mainly prescribed for lesions of bone tissues, for infectious processes of the skin, soft tissues, and respiratory organs.
• Fusidin. It has forms for oral and external use (creams, antibiotic ointment, gels). It is used in combination therapy with resistance of microorganisms to penicillin. Used for osteomyelitis, skin infections, sepsis.
• Ciprofloxacin, Moxifloxacin. It is used in the treatment of infections of almost all organs that are caused by gram-negative, gram-positive and opportunistic microorganisms, including cholera, peritonitis, dysentery, osteomyelitis, etc.

All antibiotics have a number of side effects, so they should be used with caution, especially in children and the elderly. In no case should you prescribe antibacterial drugs on your own, their use must be agreed with the doctor after certain studies.

Antibiotics for children and pregnant women

For children, the list of broad-spectrum antibiotics is significantly narrowed. Children are allowed to use drugs of the following groups:

• Macrolides (Clarithromycin, Midecamycin, Roxithromycin);
• Aminopenicillins (Amoxicillin, Clavulanate);
• Cephalosporins (Ceftriaxone, Cefepime).

Important! Children should not use antibiotics of a series of carbapenems and fluoroquinolones, because. this can negatively affect the development and functioning of the liver, kidneys and bones.

Pregnant women are allowed to use only a few drugs of the latest generation, and only in cases where the expected effect of their use prevails over side effects:

• Cephalosporins (cefepime, ceftriaxone, cefazolin);
• Protected aminopenicillins (Amoxiclav, Amoklav).

Macrolides (Clarithromycin, Azithromycin, Midecamycin, Roxithromycin) are approved for use only in the third trimester of pregnancy. In the absence of allergic reactions to the components, penicillin preparations can be used, but under medical supervision.

Antibiotics with a wide scope of action, belonging to the latest generation, are indeed a real find in the treatment of a mass of diseases of an infectious nature. But this does not mean that you can choose the best broad-spectrum antibiotic on your own, and use it uncontrollably without consulting a healthcare professional. The uncontrolled use of antibacterial drugs, on the contrary, can harm the body and cause negative consequences that are dangerous to health.

Today even children of primary school age know what antibiotics are. However, the term "broad-spectrum antibiotics" sometimes confuses even adults and raises many questions. How wide is the spectrum? What are these antibiotics? And, yes, it looks like there are narrow-spectrum drugs that may not help?

The most amazing thing is that even the omniscient Internet often cannot help and dispel the fog of doubt. In this article, we will try to slowly and methodically figure out what kind of broad-spectrum antibiotics they are, what bacteria they act on, and also when, how and how many times a day they are used.

Diverse world of bacteria

And we will start from the very beginning - with microbes. Bacteria make up the majority of prokaryotes - unicellular living organisms without a clearly defined nucleus. It was bacteria that first populated the lonely Earth millions of years ago. They live everywhere: in soil, water, acidic hot springs and radioactive waste. Descriptions of about 10 thousand species of bacteria are known, but it is assumed that their number reaches a million.

And of course, bacteria live in organisms of plants, animals and humans. Relations between lower unicellular and higher multicellular are different - both friendly, mutually beneficial for partners, and openly hostile.

A person cannot exist without “good”, correct bacteria that form the microflora. However, along with valuable bifido- and lactobacilli, microbes that cause a variety of diseases enter our bodies.

The composition of the microflora also includes the so-called conditionally pathogenic microorganisms. Under favorable conditions, they do no harm, but it is worth lowering our immunity, and these yesterday's friends turn into vicious enemies. In order to somehow understand the host of bacteria, doctors proposed to classify them.

Gram- and Gram+: decoding the puzzle

The most famous division of microbes is very often mentioned in pharmacies, clinics, and annotations to medicines. And just as often, a living average patient does not understand what, in fact, they are talking about. Let's figure it out together, what do these mysterious expressions gram + and gram- mean, without which not a single description of the action of antibiotics can do?

As early as 1885, Dane Hans Gram decided to stain sections of lung tissue to make bacteria more visible. The scientist found that the typhoid pathogen Salmonella typhi did not change color, while the rest of the microorganisms were exposed to the chemical.

Based on the ability of bacteria to stain according to Gram, the most famous classification is now adopted. The group of bacteria that do not change color is called gram-negative. The second category is called gram-positive, that is, Gram-staining microorganisms.

Gram-positive and gram-negative pathogens: who is who?

Another equally important classification of antibiotics breaks down drugs according to their spectrum of action and structure. And again, to understand the complex paragraphs of instructions explaining the spectrum of activity and belonging to a particular group, you should get to know the microbes better.

Gram-positive bacteria include cocci, that is, microorganisms in the form of a ball, among which there are numerous families of staphylococci and streptococci. In addition, this group includes clostridia, corynebacteria, listeria, enterococci. Gram-positive pathogens most often cause infectious diseases of the nasopharynx, respiratory tract, ear, and inflammatory processes of the eye.

Gram-negative bacteria are a less numerous group of microorganisms that mainly cause intestinal infections, as well as diseases of the genitourinary tract. Much less often, gram-negative pathogens are responsible for respiratory pathologies. These include coli, Salmonella, Shigella (causative agent of diphtheria), Pseudomonas, Moraxella, Legionella, Klebsiella, Proteus.

Among gram-negative microorganisms there are also causative agents of severe nosocomial infections. These microbes are difficult to treat - in a hospital environment, they develop a special resistance to most antibiotics. Therefore, for the treatment of such infectious diseases, special, often intramuscular or intravenous broad-spectrum antibiotics are also used.

On the basis of such a “separation” of gram-negative and gram-positive bacteria, empirical therapy is based, which involves the selection of an antibiotic without prior seeding, that is, practically “by eye”. As practice shows, in the case of "standard" diseases, this approach to the choice of the drug justifies itself. If the doctor has doubts about the belonging of the pathogen to one or another group, the prescription of broad-spectrum antibiotics will help to “get a finger in the sky”.

Broad-spectrum antibiotics: the whole army under the gun

So, we come to the most interesting. Broad-spectrum antibiotics are a versatile antibacterial medicine. Whatever the pathogen is the source of the disease, broad-spectrum antibacterial agents will have a bactericidal effect and overcome the microbe.

As a rule, broad-spectrum drugs are used when:

• treatment is prescribed empirically, that is, on the basis of clinical symptoms. With the empirical selection of an antibiotic, time and money are not wasted on identifying the pathogen. The microbe that caused the disease will forever remain unknown. This approach is appropriate in the case of common infections, as well as fast-moving dangerous diseases. For example, with meningitis, death can be a foregone conclusion literally within a few hours if antibiotic therapy is not started immediately after the first signs of the disease;
• causative agents of the disease are resistant to the action of narrow-spectrum antibiotics;
• diagnosed with superinfection, in which the culprits of the disease are several types of bacteria at once;
• prevention of infection after surgical interventions.

List of broad-spectrum antibiotics

Let's try to name those antibacterial drugs that have a wide spectrum of activity:

• antibiotics of the penicillin group: Ampicillin, Ticarcycline;
• antibiotics of the tetracycline group: Tetracycline;
• fluoroquinolones: Levofloxacin, Gatifloxacin, Moxifloxacin, Ciprofloxacin;
• Aminoglycosides: Streptomycin;
• Amphenicols: Chloramphenicol (Levomycetin);
• Carbapenems: Imipenem, Meropenem, Ertapenem.

As you can see, the list of broad-spectrum antibiotics is not very large. And we will start a detailed description of drugs with the most, probably, the most popular group - penicillin antibiotics.

Penicillins - drugs that are known and loved

With the discovery of the antibiotic of this particular group - Benzylpenicillin - doctors realized that microbes can be defeated. Despite its venerable age, benzylpenicillin is still used, and in some cases is a first-line drug. However, broad-spectrum agents include other, newer penicillin antibiotics, which can be divided into two groups:

• preparations for parenteral (injection) and enteral administration, which endure the acidic environment of the stomach;
• injectable antibiotics that do not withstand the action of hydrochloric acid - Carbenicillin, Ticarcillin.

Ampicillin and Amoxicillin are popular broad spectrum penicillins

Ampicillin and Amoxicillin occupy a special place of honor among penicillin antibiotics. The spectrum and effect on the human body of these two antibiotics are almost the same. Among the microorganisms sensitive to Ampicillin and Amoxicillin, the most famous infectious agents are:

• gram-positive bacteria: staphylococci and streptococci, enterococci, listeria;
• gram-negative bacteria: the causative agent of gonorrhea Neisseria gonorrhoeae, Escherichia coli, Shigella, Salmonella, Haemophilus influenzae, whooping cough pathogen Bordetella pertussis.

With an identical spectrum, Ampicillin and Amoxicillin significantly differ in pharmacokinetic properties.

Ampicillin

Ampicillin was synthesized in the early 60s of the last century. The drug immediately won the hearts of doctors: its spectrum of action compares favorably with the antibiotics of the 50s, to which persistence, that is, addiction, has already developed.

However, Ampicillin has significant drawbacks - low bioavailability and a short half-life. The antibiotic is absorbed only by 35-50%, and the half-life is several hours. In this regard, the course of treatment with Ampicillin is quite intensive: tablets should be taken at a dose of 250–500 mg four times a day.

A feature of Ampicillin, which is considered an advantage over Amoxicillin, is the possibility of parenteral administration of the drug. The antibiotic is produced in the form of a lyophilized powder, from which a solution is prepared before administration. Ampicillin is prescribed 250-1000 mg every 4-6 hours intramuscularly or intravenously.

Amoxicillin is slightly younger than its predecessor - it went on sale in the 70s of the XX century. Nevertheless, this antibiotic is still one of the most popular and effective means of a wide range, including for children. And this became possible thanks to the undoubted advantages of the drug.

These include the high bioavailability of Amoxicillin tablets, which reaches 75-90%, against the background of a fairly long half-life. At the same time, the degree of absorption does not depend on food intake. The drug has a high degree of affinity for the tissues of the respiratory tract: the concentration of Amoxicillin in the lungs and bronchi is almost twice as high as in other tissues and blood. Not surprisingly, Amoxicillin is considered the drug of choice for uncomplicated forms of bacterial bronchitis and pneumonia.

In addition, the drug is indicated for sore throat, infections of the urinary and genital tract, infectious diseases of the skin. Amoxicillin is a component of eradication therapy for gastric and duodenal ulcers.

The drug is taken orally at a dosage of 250-1000 mg twice a day for 5-10 days.

Broad spectrum parenteral penicillins

Penicillins, which are used for parenteral administration, differ from Ampicillin and Amoxicillin known to us in their additional activity against Pseudomonas aeruginosa Pseudomonas aeruginosa. This microorganism causes soft tissue infections - abscesses, purulent wounds. Pseudomonas also act as causative agents of cystitis - inflammation of the bladder, as well as inflammation of the intestine - enteritis.

In addition, broad-spectrum parenteral penicillin antibiotics have a bactericidal and bacteriostatic effect on:

• gram-positive microorganisms: staphylococci, streptococci (with the exception of strains that form penicillinase), as well as enterobacteria;
• Gram-negative microorganisms: Proteus, Salmonella, Shigella, Escherichia coli, Haemophilus influenzae and others.

Broad-spectrum parenteral penicillins include Carbenicillin, Ticarcillin, Carfecillin, Piperacillin and others.

Consider the most famous antibiotics - Carbenicillin, Ticarcillin and Piperacillin.

Carbenicillin

In medicine, the disodium salt of carbenicillin is used, which is a white powder that dissolves before use.

Carbenicillin is indicated for infections of the abdominal cavity, including peritonitis, genitourinary system, respiratory tract, as well as meningitis, sepsis, infections of bone tissue, skin.

The drug is administered intramuscularly, and in severe cases intravenously.

Ticarcillin

Unprotected Ticarcillin is prescribed for severe infections caused by strains of bacteria that do not produce penicillinase: sepsis, septicemia, peritonitis, postoperative infections. The antibiotic is also used for gynecological infections, including endometritis, as well as infections of the respiratory tract, ENT organs, and skin. In addition, Ticarcillin is used for infectious diseases in patients with a reduced immune response.

Piperacillin

Piperacillin is mainly used in conjunction with the beta-lactamase inhibitor tazobactam. However, if it is established that the causative agent of the disease does not produce penicillinase, it is possible to prescribe an unprotected antibiotic.

Indications for the use of Piperacillin are severe pyoinflammatory infections of the genitourinary system, abdominal cavity, respiratory and ENT organs, skin, bones and joints, as well as sepsis, meningitis, postoperative infections and other diseases.

Protected broad-spectrum penicillins: antibiotics to fight resistance!

Amoxicillin and Ampicillin are far from omnipotent. Both drugs are destroyed by the action of beta-lactamases, which are produced by some strains of bacteria. Such "malicious" pathogens include many types of staphylococcus, including aureus, Haemophilus influenzae, Moraxella, Escherichia coli, Klebsiella and other bacteria.

If the infection is caused by beta-lactamase-producing pathogens, Amoxicillin, Ampicillin and some other antibiotics are simply destroyed without causing any harm to the bacteria. Scientists have found a way out of the situation by creating complexes of penicillin antibiotics with substances that inhibit beta-lactamase. In addition to the most famous clavulanic acid, inhibitors of destructive enzymes include sulbactam and tazobactam.

Protected antibiotics are able to effectively fight an infection that is not subject to fragile and lonely penicillin. Therefore, combined drugs are often the drugs of choice for a variety of diseases caused by bacterial infection, including hospital ones. Leading places in this list of broad-spectrum antibiotics are occupied by two or three drugs, and some injectable drugs used in hospitals remain behind the scenes. Paying tribute to the spectrum of each combined penicillin, we will open the veil of secrecy and list these, of course, the most worthy drugs.

Amoxicillin + clavulanic acid. The most famous combined broad-spectrum antibiotic, which has dozens of generics: Augmentin, Amoxiclav, Flemoclav. There are both oral and injectable forms of this antibiotic.

Amoxicillin and sulbactam. Trade name - Trifamox, is available in the form of tablets. The parenteral form of Trifamox is also available.

ampicillin and sulbactam. The trade name is Ampisid, it is used for injections, more often in hospitals.

Ticarcillin + clavulanic acid. Trade name Timentin, available only in parenteral form. Indicated for the treatment of severe infections caused by resistant, hospital-acquired strains.

Piperacillin + tazobactam. Trade names Piperacillin-tazobactam-Teva, Tazatsin, Santaz, Tazrobida, Tacillin J, etc. The antibiotic is used by infusion drip, that is, in the form of intravenous infusions for moderate and severe polyinfections.

Broad-spectrum tetracyclines: time-tested

Tetracycline antibiotics are among the well-known broad-spectrum drugs. This group of drugs is united by a common structure, which is based on a four-cyclic system ("tetra" in Greek - four).

Tetracycline antibiotics do not have a beta-lactam ring in their structure, and, therefore, are not subject to the destructive action of beta-lactamase. The tetracycline group has a common spectrum of action that includes:

• gram-positive microorganisms: staphylococci, streptococci, clostridia, listeria, actinomycetes;
• gram-negative microorganisms: the causative agent of gonorrhea Neisseria gonorrhoeae, Haemophilus influenzae, Klebsiella, E. coli, Shigella (the causative agent of dysentery), Salmonella, the causative agent of whooping cough Bordetella pertussis, as well as bacteria of the genus Treponema, including the causative agent of syphilis - pale spirochete.

A distinctive feature of tetracyclines is their ability to penetrate into the bacterial cell. Therefore, these funds do an excellent job with intracellular pathogens - chlamydia, mycoplasmas, ureaplasmas. Pseudomonas aeruginosa and Proteus do not respond to the bactericidal action of tetracyclines.

The two most commonly used tetracyclines today are tetracycline and doxycycline.

Tetracycline

One of the founders of the tetracycline group, discovered back in 1952, is still used, despite its advanced age and side effects. However, the prescription of tetracycline tablets can be criticized, given the existence of more modern and effective broad-spectrum antibiotics.

The negative aspects of oral tetracycline undoubtedly include a rather limited therapeutic activity, as well as the ability to change the composition of the intestinal flora. In this regard, when prescribing tetracycline tablets, an increased risk of antibiotic-associated diarrhea should be taken into account.

Much more effective and safe is the appointment of external and local forms of tetracycline. Thus, tetracycline eye ointment is included in the Russian list of essential drugs and is an excellent example of a broad-spectrum local antibacterial drug.

Doxycycline

Doxycycline is distinguished by therapeutic activity (almost 10 times higher than Tetracycline) and impressive bioavailability. In addition, Doxycycline has a much lesser effect on the intestinal microflora than other drugs of the tetracycline group.

Fluoroquinolones are essential broad spectrum antibiotics.

Probably, no doctor can imagine his medical practice without fluoroquinolone antibiotics. The first synthesized representatives of this group were distinguished by a narrow spectrum of action. With the development of pharmaceuticals, new generations of fluoroquinolone antibacterial agents have been discovered and the spectrum of their activity has expanded.

So, antibiotics of the first generation - Norfloxacin, Ofloxacin, Ciprofloxacin - work mainly against gram-negative flora.

Modern fluoroquinolones II, III and IV generations, unlike their predecessors, are antibiotics of the broadest, so to speak, spectrum of action. These include Levofloxacin, Moxifloxacin, Gatifloxacin, and other medicines active against:

Note that without exception, all fluoroquinolones are contraindicated for use in children under 18 years of age. This is due to the ability of antibiotics of this group to disrupt the synthesis of peptidoglycan, a substance that is part of the tendon structure. Therefore, the use of fluoroquinolones in children is associated with the risk of changes in cartilage tissue.

Fluoroquinolone II generation, Levofloxacin is prescribed for infections of the respiratory tract - pneumonia, bronchitis, ENT organs - sinusitis, otitis media, as well as diseases of the urinary tract, genital tract, including urogenital chlamydia, infections of the skin (furunculosis) and soft tissues (atheromas, abscesses).

Levofloxacin is prescribed 500 mg per day at one time for seven, less often for 10 days. In severe cases, the antibiotic is administered intravenously.

Many drugs containing lomefloxacin are registered on the Russian pharmaceutical market. The original tool - the brand - is the German Tavanik. Its generics include Levofloxacin Teva, Levolet, Glevo, Flexil, Ecolevid, Hailefloks and other drugs.

Moxifloxacin

Moxifloxacin is a highly active broad-spectrum fluoroquinolone antibiotic of the third generation, indicated for infections of the upper respiratory tract, respiratory tract, skin, soft tissues, and postoperative infections. The drug is prescribed in tablets of 400 mg once a day. The course of treatment ranges from 7 to 10 days.

The original drug of moxifloxacin, which is most often used, is Avelox manufactured by Bayer. There are very few generics of Avelox, and it is quite difficult to find them in pharmacies. Moxifloxacin is part of Vigamox eye drops, indicated for infectious inflammatory processes of the conjunctiva of the eye and other diseases.

Gatifloxacin

The drug of the last, IV generation of fluoroquinolones is prescribed for severe, including nosocomial diseases of the respiratory tract, ophthalmic pathologies, infections of the ENT organs, the urogenital tract. The antibacterial effect of Gatifloxacin also extends to the causative agents of the infection, which is sexually transmitted.

Gatifloxacin is prescribed at 200 or 400 mg per day once.

Most drugs containing gatifloxacin are produced by Indian companies. More often than others in pharmacies you can find Tebris, Gafloks, Gatispan.

Aminoglycosides: essential antibiotics

Aminoglycosides combine a group of antibacterial drugs that have similar properties in structure and, of course, the spectrum of action. Aminoglycosides inhibit protein synthesis in microbes, providing a pronounced bactericidal effect against sensitive microorganisms.

The first aminoglycoside is a natural antibiotic isolated during World War II. Surprisingly, modern phthisiology still cannot do without the same Streptomycin, which was discovered back in 1943 - an antibiotic is still being used with might and main in phthisiology for the treatment of tuberculosis.

All four generations of aminoglycosides, which have been gradually isolated and synthesized over more than half a century, have an equally wide spectrum of antibacterial action. Antibiotics of this group act on:

• gram-positive cocci: streptococci and staphylococci;
• Gram-negative microorganisms: Escherichia coli, Klebsiella, Salmonella, Shigella, Moraxella, Pseudomonas and others.

Aminoglycosides of different generations have some individual features, which we will try to trace on the examples of specific drugs.

The oldest broad-acting aminoglycoside of the 1st generation in injections, which is favorably distinguished by high antibacterial activity against Mycobacterium tuberculosis. Indications for the use of Streptomycin are primary tuberculosis of any localization, plague, brucellosis and tularemia. The antibiotic is administered intramuscularly, intratracheally, and also intracavernously.

A very controversial antibiotic of the second generation, which is gradually being forgotten, is Gentamicin. Like other aminoglycosides of II and older generations, Gentamicin is active against Pseudomonas aeruginosa. The antibiotic exists in three forms: injectable, external in the form of ointments and local (eye drops).

Interestingly, unlike the vast majority of antibiotics, Gentamicin perfectly retains its properties in dissolved form. Therefore, the injection form of the drug is a ready-made solution in ampoules.

Gentamicin is used for infectious and inflammatory diseases of the biliary tract - cholecystitis, cholangitis, urinary tract - cystitis, pyelonephritis, as well as infections of the skin and soft tissues. In ophthalmic practice, eye drops with Gentamicin are prescribed for blepharitis, conjunctivitis, keratitis and other infectious eye lesions.

The reason for the wary attitude towards Gentamicin is the data on the side effects of the antibiotic, in particular, ototoxicity. In recent years, there has been ample evidence of hearing loss due to Gentamicin therapy. There are even cases of complete deafness that developed against the background of the introduction of an antibiotic. The danger is that, as a rule, the ototoxic effect of Gentamicin is irreversible, that is, hearing is not restored after the antibiotic is discontinued.

Based on such a sad trend, most doctors prefer to opt for other, safer aminoglycosides.

Amikacin

An excellent alternative to Gentamicin is the III generation broad-spectrum antibiotic Amikacin, which is available as a powder for the preparation of an injection solution. Indications for the appointment of Amikacin are peritonitis, meningitis, endocarditis, sepsis, pneumonia and other severe infectious diseases.

Amphenicols: let's talk about the good old Levomycetin

The main representative of the amphenicol group is the broad-spectrum natural antibiotic chloramphenicol, which is known to almost every our compatriot under the name Levomycetin. The drug is a structural levorotatory isomer of chloramphenicol (hence the prefix "left").

The spectrum of action of Levomycetin covers:

• gram-positive cocci: staphylococci and streptococci;
• Gram-negative bacteria: pathogens of gonorrhea, Escherichia and Haemophilus influenzae, Salmonella, Shigella, Yersinia, Proteus, Rickettsia.

In addition, Levomycetin is active against spirochetes and even some large viruses.

Indications for the appointment of Levomycetin are typhoid fever and paratyphoid fever, dysentery, brucellosis, whooping cough, typhus, and various intestinal infections.

External forms of Levomycetin (ointment) are prescribed for purulent skin diseases, trophic ulcers. So, in Russia, an ointment containing Levomycetin, which is produced under the name Levomekol, is very popular.

In addition, Levomycetin is used in ophthalmology for inflammatory eye diseases.

The course of treatment with Levomycetin or How to harm your body?

Levomycetin is an affordable, effective, and therefore a broad-spectrum intestinal antibiotic beloved by many. So beloved that you can often find a patient in a pharmacy buying those same diarrhea pills and praising their effectiveness. Still: I drank two or three pills - and the problems were no matter how it happened. It is in this approach to treatment with Levomycetin that the danger lurks.

We must not forget that Levomycetin is an antibiotic that must be taken in a course. We know that, for example, the antibiotic Amoxicillin should not be drunk for less than five days, but, drinking two tablets of Levomycetin, we manage to completely forget about the antibacterial origin of the drug. But what happens in this case with bacteria?

It's simple: the weakest enterobacteria, of course, die after two or three doses of Levomycetin. The diarrhea stops, and we, giving glory to the power of bitter pills, forget about the troubles. Meanwhile, strong and resistant microorganisms survive and continue their vital activity. Often as conditional pathogens, which, at the slightest decrease in immunity, are activated and show us where the crayfish hibernate. That's when Levomycetin may no longer be able to cope with selected microbes.

To prevent this from happening, you should adhere to the recommended course of antibiotic therapy. For the treatment of acute intestinal infections, the drug is taken at a dosage of 500 mg three to four times a day for at least a week. If you are not ready to follow a sufficiently intensive course, it is better to give preference to other antimicrobials, for example, nitrofuran derivatives.

Carbapenems: reserve antibiotics

As a rule, we encounter carbapenems extremely rarely or not at all. And this is wonderful - after all, these antibiotics are indicated for the treatment of severe hospital infections that threaten life. The spectrum of action of carabapenems includes most of the existing pathological strains, including resistant ones.

Antibiotics in this group include:

• Meropenem. The most common carbapenem, which is produced under the trade names Meronem, Meropenem, Cyronem, Dzhenem and others;
• Ertapenem, trade name Invanz;
• Imipenem.

Carbapenems are administered only intravenously, intravenously by infusion and bolus, that is, using a special dispenser.

Antibiotic therapy: the golden rule of safety

At the end of our excursion into the world of broad-spectrum antibiotics, we cannot ignore the most important aspect on which the safety of drugs and, ultimately, our health is based. Each patient - present or potential - should know and remember that the right to prescribe antibiotics belongs exclusively to the doctor.

No matter how much knowledge you have in the field of medicine, you should not give in to the temptation to “treat yourself”. Moreover, one should not rely on the hypothetical pharmaceutical abilities of neighbors, friends and colleagues.

Only a good doctor can assess the risks and benefits of using a broad-spectrum antibiotic, choose a drug that can cover the spectrum of exactly “your” microorganisms and prevent possible side effects. Trust the knowledge and experience of a great specialist, and this will help maintain health for many years.