The inventor of the first antibiotics is a man who changed the world. Opened twice. How did Russia not become the birthplace of antibiotics? History of the origin of natural antibiotics

The history of the creation of antibacterial drugs cannot be called long - officially, the medicine that we now call an antibiotic was developed by an Englishman Alexander Fleming at the beginning of the 20th century. But few people know that a similar invention was made in Russia 70 years earlier. Why it was not used, and who ultimately achieved recognition in this area, says AiF.ru.

When bacteria are treated

The first to suggest the existence of bacteria that could save humanity from serious diseases was a French microbiologist and chemist Louis Pasteur. He hypothesized a kind of hierarchy among living microorganisms - and that some might be stronger than others. For 40 years, the scientist searched for options for salvation from those ailments that for many years were considered incurable, and conducted experiments on the types of microbes known to him: he grew them, purified them, and added them to each other. This is how he discovered that the most dangerous anthrax bacteria could die under the influence of other microbes. However, Pasteur did not advance further than this observation. The most offensive thing is that he did not even suspect how close he was to the solution. After all, the “protector” of a person turned out to be something so familiar and familiar to many... mold.

It was this fungus, which today evokes complex aesthetic feelings among many, that became the subject of discussion between two Russian doctors in the 1860s. Alexey Polotebnov And Vyacheslav Manassein debated whether green mold is a kind of “progenitor” for all fungal formations or not? Alexey advocated the first option; moreover, he was sure that all microorganisms on earth originated from her. Vyacheslav argued that this was not so.

From heated verbal debates, doctors moved on to empirical tests and began two parallel studies. Manassein, observing microorganisms and analyzing their growth and development, discovered that where mold grows... there are no other bacteria. Polotebnov, conducting his own independent tests, discovered the same thing. The only thing is that he grew mold in an aquatic environment, and at the end of the experiment he discovered that the water did not turn yellow and remained clean.

The scientist admitted defeat in the dispute and... put forward a new hypothesis. He decided to try to prepare a bactericidal preparation based on mold - a special emulsion. Polotebnov began using this solution to treat patients - mainly for treating wounds. The result was stunning: patients recovered much faster than before.

Polotebnov did not leave his discovery, as well as all scientific calculations, a secret - he published it and presented it to the public. But these truly revolutionary experiments went unnoticed - official science reacted sluggishly.

About the benefits of open windows

If only Alexey Polotebnov had been more persistent, and official doctors a little less inert, Russia would have been recognized as the birthplace of the invention of antibiotics. But in the end, the development of a new treatment method was suspended for 70 years, until the British Alexander Fleming took up the matter. From his youth, the scientist wanted to find a means that would destroy pathogenic bacteria and save people's lives. But he made the main discovery of his life by accident.

Fleming studied staphylococci, but the biologist had one distinctive feature - he did not like to clean up his desk. Clean and dirty jars could stand mixed together for weeks, and he forgot to close some of them.

One day, a scientist left test tubes with the remains of colonies of grown staphylococci unattended for several days. When he returned to the glass, he saw that they were all overgrown with mold - most likely, the spores had flown in through the open window. Fleming did not throw away the spoiled samples, but with the curiosity of a true scientist, he placed them under a microscope - and was amazed. There was no staphylococcus, only mold and drops of clear liquid remained.

Fleming began experimenting with different types of mold, growing gray and black mold from ordinary green mold and “planting” it with other bacteria - the result was amazing. It was as if she was “fencing off” harmful neighbors from herself and did not allow them to multiply.

He was the first to pay attention to the “moisture” that appears next to the fungal colony, and suggested that the liquid should have literally “killing power.” As a result of long research, the scientist found out that this substance can destroy bacteria, moreover, it does not lose its properties even when diluted with water 20 times!

He called the substance he found penicillin (from the name of the mold Penicillium - lat.).

From that time on, the development and synthesis of antibiotics became the main business of a biologist’s life. He was interested in literally everything: on what day of growth, in what environment, at what temperature the fungus works best. As a result of the tests, it turned out that mold, although extremely dangerous for microorganisms, is harmless to animals. The first person to test the effect of the substance was Fleming's assistant - Stuart Graddock who suffered from sinusitis. As an experiment, a portion of mold extract was injected into his nose, after which the patient’s condition improved.

Fleming presented the results of his research in 1929 at the London Medical and Scientific Club. Surprisingly, despite the terrible pandemics - just 10 years earlier, the Spanish flu claimed the lives of millions of people - official medicine was not very interested in the discovery. Although Fleming did not have eloquence and, according to contemporaries, was a “quiet, shy person,” he nevertheless took up advertising the drug in the scientific world. The scientist regularly published articles and made reports for several years in which he mentioned his experiments. And in the end, thanks to this persistence, fellow doctors finally paid attention to the new remedy.

Four generations

The medical community finally noticed the drug, but a new problem arose - penicillin was quickly destroyed when isolated. And only 10 years after the discovery was made public, English scientists came to Fleming’s aid. Howard Fleury And Ernst Chain. It was they who came up with a way to isolate penicillin so that it could be preserved.

The first open trials of the new drug on patients took place in 1942.

The 33-year-old young wife of a Yale University administrator Anna Miller, a mother of three children, contracted streptococcal sore throat from her 4-year-old son and fell ill. The disease quickly became complicated by fever and meningitis began to develop. Anna was dying; when she was taken to the main hospital in New Jersey, she was diagnosed with streptococcal sepsis, which in those years was practically a death sentence. Immediately upon arrival, Anna was given the first injection of penicillin, and a few hours later another series of injections. Within 24 hours the temperature stabilized, and after several weeks of treatment the woman was discharged home.

A well-deserved reward awaited the scientists: in 1945, Fleming, Florey and Chain were awarded the Nobel Prize for their work.

For a long time, penicillin was the only drug that saved people's lives during severe infections. However, it periodically caused allergies and was not always available. And doctors sought to develop more modern and inexpensive analogues.

Scientists and doctors have found that all antibacterial substances can be divided into 2 groups: bacteriostatic, when microbes remain alive but cannot reproduce, and bactericidal, when bacteria die and are eliminated from the body. After prolonged use, scientists noted that microbes begin to adapt and get used to antibiotics, and therefore they have to change the composition of the drugs. This is how more “strong” and high-quality purified drugs of the second and third generation appeared.

Like penicillin, they are still used today. But for severe diseases, highly effective 4th generation antibiotics are already used, most of which are synthesized artificially. Modern medications add components that help reduce the risk of complications: antifungal, antiallergic, and so on.

Antibiotics helped defeat the terrible “pestilence” - the plague that terrified all countries, smallpox, and reduced mortality from pneumonia, diphtheria, meningitis, sepsis, and polio. Surprisingly, it all started with scientific disputes and a couple of uncleaned test tubes.

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Today the hero of our post is the inventor of antibiotics. In general, it is very interesting to learn about discoveries thanks to which humanity makes a breakthrough in any area of ​​knowledge and skills. In this case, there was a breakthrough in medicine and a very serious breakthrough. This is exactly what hooked me, read it and be surprised how accidents can change history.

Sir Alexander Fleming is known to the world for being the inventor of penicillin, the world's first antibiotic. But the famous bacteriologist always believed that saving human lives cannot be a source of enrichment. Therefore, he in no way claimed authorship in the invention of penicillin.
Today we are familiar with many things. Despite the fact that their invention and discovery at one time changed our life beyond recognition. Today we take for granted electricity and everything that runs on it: refrigerators, microwave ovens, automatic washing machines, etc. Now we cannot do without computers, smartphones, and the Internet. It seems to us that all this has always been. We don’t even notice the significance of all these inventions, we don’t appreciate the efforts of the people who worked on them.
But this article is not about household amenities, but about medicines that save human lives. Today we are accustomed to the fact that you can buy a variety of antibiotics at the pharmacy. But there was a time when they did not exist. During the First World War, thousands of soldiers died not from wounds, but from dysentery, tuberculosis, typhoid, and pneumonia. After all, then there were no antibiotics that could help them. The inventor of antibiotics could radically change this situation, which is not best for people.
At the beginning of the twentieth century, the cause of high mortality was not disease, but postoperative complications and blood poisoning. Without penicillin, doctors could not help hopelessly ill people. Although back in the 19th century, French microbiologist Louis Pasteur suggested that one microorganism, bacteria, could be destroyed by another, fungi.
Pasteur noticed that the anthrax bacterium is killed by other microbes. As a result of this discovery, no ready-made means for saving humanity appeared. But scientists all over the world, having learned about it, began to look for answers to the questions that had arisen: what microbes destroy bacteria, how this happens, etc. While the answer has existed since the beginning of life on Earth.
This is mold. An annoying mold that always accompanies humanity has become its healer. In the 1860s, mold fungus, spreading in the form of spores, aroused a scientific controversy between Alexei Polotebny and Vyacheslav Manassein.

Russian doctors argue about the nature of mold. Polotebnov claimed that all the microbes came from mold. Manassein did not agree with him. This dispute led to the greatest discovery of the healing properties of mold.
To prove that he was right, Manassein began to examine green mold. And after some time I noticed an interesting fact: in the immediate vicinity of the mold, there were no bacteria. Hence the logical conclusion: mold somehow interferes with the development of other microorganisms. Polotebnov came to the same conclusion when he saw that the liquid next to the mold was clean. In his opinion, this indicated that there were no bacteria in it.
Such a fruitful loss in a scientific dispute prompted Polotebnov to continue his research with a new goal - to study the bactericidal properties of mold. To do this, he sprayed an emulsion with mold on the skin of people suffering from skin diseases. The result was stunning: ulcers that underwent such treatment disappeared much earlier than those with which nothing was done. In 1872, the doctor published an article in which he outlined his discovery and recommended this method of treatment.

But science around the world simply did not notice this publication; doctors from different countries continued to treat patients with antediluvian remedies, which can now be mistaken for the usual set of medical quacks: bloodletting, various powders from dried animal remains and similar preparations. Just think, these “medicines” were used in medicine already at a time when the Wright brothers were creating their first flying machines, and Einstein was working on his theory of relativity. And who knows, perhaps the inventor of antibiotics would have been a completely different person if the world's pundits had paid attention to the research of the Russian doctor at one time

Inventor of antibiotics - how it happened

The world scientific community ignored Polotebnov's discovery. For half a century, scientists ignored the healing properties of mold. And only at the very beginning of the turbulent twentieth century, due to an accident that can rightly be called happy and to one sloppy scientist, Polotebnov’s scientific idea was “resurrected.”
Alexander Fleming was a Scot and the inventor of antibiotics. His youthful dream was to find a way to destroy the invisible enemies of humanity - pathogenic bacteria. In a cramped room in one of the London hospitals, which was his laboratory, he carried out daily research in the field of microbiology. His colleagues more than once noted in him, in addition to such important and useful qualities as perseverance and dedication to work, his serious flaw - sloppiness. The future discoverer of penicillin could not and did not like to keep his workplace clean. Containers with bacterial cultures could sit on it for several weeks. Oddly enough, it was thanks to this that Fleming literally stumbled upon a great discovery.
One day, the future inventor of antibiotics left a colony of staphylococci unattended on his desk. When he finally decided to start cleaning a few days later, he discovered mold on the surface of the preparations. Fleming did not get rid of the seemingly deteriorated material, but looked at it through a microscope. Imagine his surprise when he saw that there was no trace left of the pathogenic bacteria. There was nothing in the bottles except mold and drops of colorless liquid.

The hypothesis that mold kills disease-causing microorganisms required immediate research. The scientist took a fungus grown in a nutrient medium and placed it in a cup along with other bacteria. The result was stunning: mold and microorganisms were light and transparent spots. The mold “fenced” itself from bacteria and prevented them from multiplying.
Fleming had a question: what is this liquid that forms near the mold? He began a new experiment - observing mold grown in a large flask. First, her color turned from white to green, and then to black. The liquid near the mold changed its color from transparent to yellow. The scientist concluded that mold releases certain substances.

• Do they have the same power that fought the staphylococci on his untidy desk?
• What is that strange transparent substance that forms between mold and bacteria?

These questions haunted the Scottish scientist day and night, and the search for answers forced him to continue working and conduct experiments again and again.

The liquid environment in which the mold was located turned out to be even more destructive for bacteria. It, even if dissolved in water 1 to 20, completely destroyed bacteria. Realizing the importance of his discovery, Fleming abandoned his other studies and devoted himself entirely to studying the liquid he had discovered. During his research, he studied the manifestations of the antibacterial properties of the fungus.
It was important to find all the parameters at which these properties become maximum:

• on what day of growth;
• in what nutrient medium;
• at what temperature;

The scientist found that the liquid released by mold destroys only bacteria and does not cause any harm to animals. He named the resulting and studied liquid penicillin.

In 1929, Fleming publicly spoke at the London Medical Research Club about a new drug found and studied. And again, a message of great importance from the inventor of antibiotics was practically ignored - just like Polotebnov’s medical article at one time. However, a Scot, in full accordance with the temperament of his people? turned out to be much more stubborn than the Russian doctor. At all conferences, speeches, congresses and meetings of medical luminaries, the inventor of antibiotics, Fleming, constantly talked about the means he had discovered to destroy pathogenic bacteria. But the scientist was faced with another very important task - it was necessary to somehow absorb pure penicillin from the mixture, while also preserving its integrity.

It took more than one year to isolate penicillin. Fleming and his assistants undertook many experiments. But penicillin was destroyed in a foreign environment. In the end, it became clear that microbiology could not solve this problem without the help of chemistry.

It took 10 years for information about the amazing medicine to reach the American continent after Fleming's first statement about penicillin. The discovery of the Scottish scientist interested two Englishmen who settled in America. This was Howard Fleury, professor of pathology at one of the Oxford institutes, and his colleague, biochemist Ernst Chain. They were looking for a topic for joint research. In 1939 they found it. Their topic for scientific work was the problem of isolating penicillin.

The Second World War became a broad field for testing the resulting antibiotic. In 1942, penicillin saved the life of a man dying of meningitis for the first, but not the last, time. This fact, having become known to the general public, made a great impression on the latter. The doctors were under the same impression. But it was never possible to organize mass production of penicillin in England, so it was opened in America in 1943. In the same year, an order was received from the American government for 120 million units of the drug.

Fleur, Chain and Fleming received the Nobel Prize for their breakthrough discovery in 1945. The inventor of antibiotics, Fleming, was awarded dozens of times with various scientific titles and awards. He has received a knighthood, 25 honorary degrees, 26 medals, 18 prizes, 13 awards and honorary membership in 89 academies of sciences and scientific societies. He remained forever in the memory of mankind and on his grave today you can see an inscription of gratitude from all the people of the planet - “Alexander Fleming - inventor of penicillin.”

Antibiotics are an international invention

Scientists from different countries were looking for a drug to combat harmful bacteria. This search has been going on since people could see them under a microscope and first learned of their existence. A special need for such a medicine arose at the beginning of World War II. USSR scientists also worked on this problem.
In 1942, Professor Zinaida Ermolyeva was able to isolate penicillin from mold obtained from the wall of a Moscow bomb shelter. In 1944, after conducting a series of experimental studies, she tested the resulting drug on seriously wounded soldiers of the Soviet army. Her penicillin became a powerful weapon for field doctors and a healing agent for many soldiers wounded in the battles of the Great Patriotic War. In the same year, after the testing of penicillin by Ermolyeva in the Soviet Union, its mass production was established.
Antibiotics are not only penicillin, they are a wide range of medicines. Gause, who obtained gramicidin in 1942, worked on the creation of an antibiotic. And also Waxman, an American of Ukrainian origin, who isolated streptomycin in 1944.
All the scientists mentioned in this article gave the world a new, healthy time, the time of antibiotics. Now we are not in danger of dying from many previously incurable diseases. The remedy for them is now familiar to us; it is available in every pharmacy. The most interesting thing in this story (apart from Fleming’s dirty desk, of course) is that no one was issued a patent for penicillin. Not a single inventor of antibiotics wanted to profit from saving human lives.

Watch the film Penicillin Race about how these historical events took place:

Now many people don’t even think that the inventor of antibiotics is the savior of many lives. But just recently, most diseases and wounds could cause very long and often unsuccessful treatment. 30% of patients died from simple pneumonia. Now death is possible only in 1% of cases of pneumonia. And this became possible thanks to antibiotics.

When did these drugs appear in pharmacies and thanks to whom?

First steps to invention

It is now widely known in what century antibiotics were invented. There is also no question as to who invented them. However, as in the case of antibiotics, we only know the name of the person who came closest to the discovery and made it. Usually a large number of scientists in different countries work on one problem.

The first step towards the invention of the drug was the discovery of antibiosis - the destruction of some microorganisms by others.

Doctors from the Russian Empire Manassein and Polotebnov studied the properties of mold. One of the conclusions of their work was the statement about the ability of mold to fight various bacteria. They used mold-based drugs to treat skin diseases.

Then the Russian scientist Mechnikov noticed the ability of bacteria contained in fermented milk products to have a beneficial effect on the digestive tract.

The closest to the discovery of a new drug was a French doctor named Duchenne. He noticed that the Arabs used mold to treat wounds on the backs of horses. Taking mold samples, the doctor conducted experiments on treating guinea pigs for intestinal infections and received positive results. The dissertation he wrote did not receive a response in the scientific community of that time.

This is a brief history of the path to the invention of antibiotics. In fact, many ancient peoples were aware of the ability of mold to have a positive effect on wound healing. However, the lack of necessary methods and technology made it impossible for a pure drug to appear at that time. The first antibiotic could appear only in the 20th century.

Direct discovery of antibiotics

In many ways, the invention of antibiotics was the result of chance and coincidence. However, similar things can be said about many other discoveries.

Alexander Fleming studied bacterial infections. This work became especially relevant during the First World War. The development of military technology led to more casualties. Wounds became infected, leading to amputations and deaths. It was Fleming who identified the causative agent of infections - streptococcus. He also proved that traditional antiseptics in medicine are not able to completely destroy a bacterial infection.

There is a clear answer to the question of what year the antibiotic was invented. However, this was preceded by 2 important discoveries.

In 1922, Fleming discovered lysozyme, a component of our saliva that has the ability to destroy bacteria. During his research, the scientist added his saliva to a Petri dish in which bacteria were inoculated.

In 1928, Fleming inoculated staphylococcus in Petri dishes and left them for a long time. By accident, mold particles got into the crops. When the scientist returned to work with the seeded staphylococcus bacteria after a while, he discovered that the mold had grown and destroyed the bacteria. This effect was produced not by the mold itself, but by the transparent liquid produced during its life. The scientist named this substance in honor of mold fungi (Penicillium) - penicillin.

Next, the scientist continued his research on penicillin. He found that the substance effectively affects bacteria, which are now called gram-positive. However, it is also capable of destroying the causative agent of gonorrhea, although it is a gram-negative microorganism.

Research continued for many years. But the scientist did not have the knowledge in chemistry necessary to obtain a pure substance. Only the isolated pure substance could be used for medical purposes. The experiments continued until 1940. This year, scientists Flory and Chain began researching penicillin. They were able to isolate the substance and obtain a drug suitable for starting clinical trials. The first successful results of human treatment were obtained in 1941. This same year is considered the date of the introduction of antibiotics.

The history of the discovery of antibiotics has been quite long. And only during the Second World War the possibility of its mass production became possible. Fleming was a British scientist, but it was impossible to produce medicine in Great Britain at that time due to military operations. Therefore, the first samples of the drug were released in the United States of America. Part of the medicine was used for the internal needs of the country, and the other part was sent to Europe, to the epicenter of the fighting to save wounded soldiers.

After the end of the war, in 1945, Fleming, as well as his successors Howard Florey and Ernst Chain, received the Nobel Prize for their services to medicine and physiology.

As with many other discoveries, the question of “who invented the antibiotic” is difficult to answer. This was the result of the collaboration of many scientists. Each of them made a necessary contribution to the process of drug discovery, without which it is difficult to imagine modern medicine.

Importance of this invention

It is difficult to argue that the discovery of penicillin and the invention of antibiotics are one of the most important events of the 20th century. Its mass production opened a new milestone in the history of medicine. Not so many years ago, ordinary pneumonia was fatal. After Fleming invented the antibiotic, many diseases were no longer a death sentence.

Antibiotics and the history of World War II are closely connected. Thanks to these drugs, many deaths of soldiers were prevented. After being wounded, many of them developed severe infectious diseases, which could lead to death or amputation of limbs. New drugs were able to significantly speed up their treatment and minimize human losses.

After the revolution in medicine, some expected that bacteria could be destroyed completely and forever. However, the inventor of modern antibiotics himself knew about the peculiarity of bacteria - the phenomenal ability to adapt to changing conditions. At the moment, medicine has mechanisms to combat microorganisms, but they also have their own ways of protecting against drugs. Therefore, they cannot be completely destroyed (at least for now); moreover, they are constantly changing and new types of bacteria appear.

The problem of resistance

Bacteria are the first living organisms on the planet, and over thousands of years they have developed mechanisms to help them survive. After penicillin was discovered, it became known about the ability of bacteria to adapt to it and mutate. In this case, the antibiotic becomes useless.

Bacteria multiply quite quickly and pass on all the genetic information to the next colony. Thus, the next generation of bacteria will have a mechanism of “self-defense” against the drug. For example, the antibiotic methicillin was invented in 1960. The first cases of resistance to it were reported in 1962. At that time, 2% of all cases of diseases for which methicillin was prescribed were untreatable. By 1995, it had become ineffective in 22% of clinical cases, and 20 years later, bacteria were resistant in 63% of cases. The first antibiotic was obtained in 1941, and in 1948, resistant bacteria appeared. Typically, drug resistance first appears several years after the drug is marketed. This is why new drugs appear regularly.

In addition to the natural mechanism of “self-defense,” bacteria become resistant to drugs due to the incorrect use of antibiotics by people themselves. Reasons why these medications become less effective:

1. Self-prescription of antibiotics. Many people do not know the true purpose of these drugs, and take them for minor illnesses. It also happens that a doctor once prescribed one type of drug, and now the patient takes the same drug when he is ill.
2. Non-compliance with the course of treatment. Often the patient stops the drug when he begins to feel better. But to completely destroy bacteria, you need to take the tablets for the time indicated in the instructions.
3. Antibiotic content in food products. The discovery of antibiotics made it possible to cure many diseases. Now these drugs are widely used by farmers to treat livestock and kill pests that destroy crops. Thus, the antibiotic gets into the meat and plant crops.

Advantages and disadvantages

We can say unequivocally that the invention of modern antibiotics was necessary and allowed us to save the lives of many people. However, like any invention, these drugs have positive and negative sides.

The positive aspect of creating antibiotics:

• diseases that were previously considered fatal are many times less likely to end in death;
• when these drugs were invented, people's life expectancy increased (in some countries and regions by 2-3 times);
• newborns and infants die six times less often;
• the mortality rate of women after childbirth decreased by 8 times;
• the number of epidemics and the number of people affected by them have decreased.

After the first antibiotic drug was discovered, the negative side of this discovery also became known. At the time of the creation of a medicine based on penicillin, there were bacteria that were resistant to it. Therefore, scientists had to create several other types of medicines. However, microorganisms gradually developed resistance to the “aggressor”. Because of this, there is a need to create more and more new drugs that will be able to destroy mutated pathogens. Thus, new types of antibiotics and new types of bacteria that are resistant to them appear every year. Some researchers say that currently about one tenth of infectious disease pathogens are resistant to antibacterial drugs.

The ability of some microorganisms to suppress the life of others ( antibiosis) was first installed I. I. Mechnikov, who proposed using this property for medicinal purposes: in particular, he used lactic acid coli, which he proposed to administer with yogurt, to suppress the activity of harmful putrefactive bacteria in the intestines.

IN 1868-1871 V. A. Manassein and A. G. Polotebnov pointed out the ability of green mold to suppress the growth of various pathogenic bacteria and successfully used it to treat infected wounds and ulcers.

Of great importance in the study of antibiotics were the studies of N. A. Krasilnikov, A. I. Korenyako, M. I. Nakhimovskaya and D. M. Novogrudsky, who established the widespread distribution in the soil of fungi that produce various antibiotic substances.

IN 1940 methods were developed for treatment and obtaining pure antibiotic substances from culture liquid. Many of these antibiotic substances have proven to be very effective in treating a number of infectious diseases.

The following antibiotics are of greatest importance in medical practice:

Penicillin,

Streptomycin,

Levomycetin,

Sintomycin,

Tetracyclines,

Albomycin,

Gramicidin S,

Mitserin et al.

The chemical nature of many antibiotics is now known, which makes it possible to obtain these antibiotics not only from natural products, but also synthetically.

Antibiotics, having the ability to suppress the development of pathogenic microbes in the body, are at the same time low-toxic for the human body. By delaying the development of pathogenic microbes in the body, they thereby help strengthen the body’s protective properties and speed up the patient’s recovery. This is why the right choice of antibiotic is required to treat various infectious diseases. In some cases, you can use a combination of antibiotics or carry out complex treatment with antibiotics, sulfonamides and other drugs.

Penicillin

Penicillin has the ability to inhibit the reproduction in the body of many pathogenic microbes - staphylococci, streptococci, gonococci, anaerobic bacilli, syphilis spirochetes. Penicillin has no effect on typhoid fever, dysentery, brucella, and tubercle bacilli. Penicillin is widely used to treat suppurative processes, septic diseases, pneumonia, gonorrhea, cerebrospinal meningitis, syphilis, and anaerobic infections.

Unlike most synthetic chemicals, penicillin is slightly toxic to humans and can be administered in large doses. Penicillin is usually administered intramuscularly, since when administered through the mouth it is quickly destroyed by gastric and intestinal juice.

In the body, penicillin is quickly eliminated by the kidneys, so it is prescribed as intramuscular injections every 3-4 hours. The amount of penicillin administered is calculated in action units (AU). One unit of penicillin is taken to be the amount that completely inhibits the growth of Staphylococcus aureus in 50 ml of broth. Penicillin preparations produced by the domestic industry contain from 200,000 to 500,000 units of penicillin in one bottle.

To extend the period of action of penicillin in the body, a number of new drugs have been manufactured containing penicillin in combination with other substances that promote slow absorption of penicillin and even slower excretion from the body by the kidneys (novocillin, ecmopenicillin, bicillin 1, 2, 3, etc.). Some of these drugs can be taken orally, as they are not destroyed by gastric and intestinal juices. These drugs include, for example, phenoxymethylpenicillin; the latter is available in the form of tablets for oral administration.

Currently, a large group of new penicillin preparations—semisynthetic penicillins—has been obtained. These drugs are based on 6-amino-penicillinic acid, which forms the core of penicillin, to which various radicals are chemically attached. New penicillins (methicillin, oxacillin, etc.) act on microorganisms resistant to benzylpenicillin.

The largest number of antibiotics are produced by radiant fungi - actinomycetes. Of these antibiotics, streptomycin, chloromycetin (chloromycetin), biomycin (aureomycin), terramycin, tetracycline, colimicium, mycerin, etc. are widely used.

Streptomycin

Chloromycetin

Along with chloramphenicol, another synthetic drug is widely used - syntomycin, which is crude chloramphenicol. In its action, synthomycin is similar to chloramphenicol; it is prescribed in a dose 2 times greater than chloramphenicol.

Tetracyclines

Neomycins

The group of neomycins includes the Soviet drugs mycerin and colimycin, which are widely used for the treatment of colienteritis in children caused by Escherichia coli or staphylococci resistant to other antibiotics.

Nystastin

Nystatin is often included in tablets along with another antibiotic - tetracycline - in order to prevent candidiasis as a complication of long-term use of tetracycline.

Of the antibiotics of bacterial origin, gramicidin is of greater importance.

Gramicidin

Antibiotics of animal origin are also of great interest.

Among the antibiotics of animal origin, the following are used.

1. Lysozyme- a substance produced by animal and human cells. It was first discovered by P. N. Lashchenkov in 1909 in the white of a chicken egg. Lysozyme is found in tears, mucous secretions, liver, spleen, kidneys, and serum. Has the ability to dissolve both living and dead microbes. Lysozyme in purified form was used by Z. V. Ermolyeva and I. S. Buyanovskaya in clinical, industrial and agricultural practice. There is an effect from the use of lysozyme for diseases of the ear, throat, nose and eyes, and for post-influenza complications.

2. Ekmolin obtained from fish tissue, biologically active against typhoid and dysentery bacilli, staphylococci and streptococci, and also acts against the influenza virus. Ecmolin enhances the effect of penicillin and streptomycin. Positive results have been reported from the combined use of ecmolin with streptomycin for the treatment of acute and chronic dysentery and ecmolin with penicillin for the treatment and prevention of coccal infections.

3. Phytoncides- substances secreted by plants. Discovered by Soviet researcher B.P. Tokin in 1928. These substances have an antimicrobial effect on many microorganisms, including protozoa. The most active phytoncides are produced by onions and garlic. If you chew onions for a few minutes, the oral cavity is quickly cleared of germs. Phytoncides are used for local treatment of infected wounds. Antibiotics have become extremely widely used in medical practice and have contributed to a sharp reduction in the number of deaths from various infectious diseases (suppurative processes, meningitis, anaerobic infection, typhoid and typhus, tuberculosis, childhood infections, etc.).

However, some side and undesirable effects should also be indicated.

If antibiotics are used incorrectly (small doses, short-term treatment), forms of pathogenic microbes resistant to this antibiotic may appear. As a result, it is of great importance for medical practice to determine the sensitivity of the causative agent of an infectious disease to one or another antibiotic.

There are 2 ways to determine the sensitivity of isolated microbes to antibiotics

2) diffusion method.

First the method is more complex and consists of the following: multiple dilutions of the antibiotic are poured into a series of test tubes with 2 ml of broth, then 0.2 ml (aged for 18 hours) of the broth culture of the test microbe is inoculated into each test tube; The tubes are placed in a thermostat for 16-18 hours. The last test tube, where there is no growth of microbes, determines the degree of sensitivity of the microbe to a given antibiotic.

A simpler method is the diffusion method. For this purpose, laboratories have a set of special filter paper discs soaked in solutions of various antibiotics. The isolated culture is inoculated onto a Petri dish with meat peptone agar. Place these discs on the seeded surface.

The cups are placed in a thermostat for 24-48 hours, after which the result is noted.

Other complications with antibiotic use include decreased immunological reactivity. In this case, relapses of the disease sometimes occur, for example with typhoid fever.

When antibiotics are taken for too long and in large doses, toxic effects are often observed. In some patients, taking one or another antibiotic causes an allergic reaction in the form of skin rashes, vomiting, etc.

In some cases, as a result of long-term use of biomycin, chloramphenicol, synthomycin, it is possible to suppress the normal human microflora, which leads to the activation of opportunistic microbes that live on the mucous membranes of the oral cavity or intestines: enterococcus, yeast-like microorganisms, etc. This flora in a weakened body can cause various types of diseases (candidiasis, etc.). All this indicates that medical workers should use antibiotics, strictly following existing guidelines and instructions, carefully monitoring the patient’s condition, and, if necessary, stop treating him with antibiotics or replace this drug with another.

The listed complications do not reduce the value of antibiotics as therapeutic drugs. Thanks to antibiotics, healthcare professionals now have specific drugs to treat most infectious diseases.

Antibiotics are a huge group of bactericidal drugs, each of which is characterized by its own 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 GOST definition, antibiotics include substances of plant, animal or microbial origin. Currently, this definition is somewhat outdated, since a huge number of synthetic drugs have been created, but natural antibiotics served as the prototype for their creation.

The history of antimicrobial drugs begins in 1928, when A. Fleming first discovered penicillin. This substance was discovered, and not created, since it has always existed in nature. In living nature, 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 have been created. Some of them are already outdated and are not used in treatment, and some are just being introduced into clinical practice.

How do antibiotics work?

All antibacterial drugs can be divided into two large groups according to their effect on microorganisms:

• bactericidal– directly cause the death of microbes;
• bacteriostatic– prevent the proliferation of microorganisms. Unable to grow and reproduce, bacteria are destroyed by the immune system of a sick person.

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

Antibiotic groups

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

The classification of antibiotics implies the presence of groups:

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

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

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

• I generation: cefazolin, cephalexin, cefradine, etc.
• II generation: cefsulodin, cefamandole, cefuroxime.
• III generation: cefotaxime, ceftazidime, cefodizime.
• IV generation: cefpirom.
• V generation: ceftolozane, ceftopibrol.

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

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

Another advantage of this group of drugs is that they are able to penetrate the cells of the 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 and can lead to quite serious complications. Used to treat genitourinary tract infections.
2. Tetracyclines. These are mainly 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 first generation (pefloxacin, ciprofloxacin, norfloxacin) and second generation (levofloxacin, moxifloxacin). They are most often used to treat infections of the ENT organs (,) and respiratory tract (,).
4. Lincosamides. This group includes the natural antibiotic lincomycin and its derivative clindamycin. They have both bacteriostatic and bactericidal effects, the effect depends on the concentration.
5. Carbapenems. These are one of the most modern antibiotics that act on a large number of microorganisms. Drugs in this group belong to 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 their toxic effect on the nervous system and kidneys.
7. Antituberculosis drugs. This is a separate group of drugs that have a pronounced effect on. These include rifampicin, isoniazid and PAS. Other antibiotics are also used to treat tuberculosis, but only if resistance to the drugs mentioned has developed.
8. Antifungal agents. This group includes drugs used to treat mycoses - fungal infections: amphothirecin B, nystatin, fluconazole.

Methods of using antibiotics

Antibacterial drugs are available in different forms: tablets, powder from which an injection solution is prepared, ointments, drops, spray, syrup, suppositories. The main uses of antibiotics:

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

Important:Only a nurse should give injections in a clinic or hospital setting! It is strictly not recommended to inject antibiotics at home.

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 - for infections of the eye, for example, tetracycline ointment for conjunctivitis.

The route of administration is determined only by the doctor. In this case, many factors are taken into account: the absorption of the drug in the gastrointestinal tract, the state of the digestive system as a whole (in some diseases, the absorption rate decreases and the effectiveness of treatment decreases). Some drugs can only be administered one way.

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

Antibiotic sensitivity

Any organism sooner or later gets used to the harshest conditions. This statement is also true in relation to microorganisms - in response to prolonged exposure to antibiotics, microbes develop resistance to them. The concept of sensitivity to antibiotics was introduced into medical practice - the effectiveness with which a particular drug affects the pathogen.

Any prescription of antibiotics should be based on knowledge of the sensitivity of the pathogen. Ideally, before prescribing a drug, the doctor should conduct a sensitivity test and prescribe the most effective drug. But the time required to carry out such an analysis is, in the best case, several days, and during this time the infection can lead to the most disastrous result.

Therefore, in case of 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 purpose, broad-spectrum antibiotics are used.

After performing a sensitivity test, the doctor has the opportunity to change the drug to a more effective one. The drug can be replaced if there is no effect from treatment for 3-5 days.

Etiotropic (targeted) prescription of antibiotics is more effective. At the same time, it becomes clear what caused the disease - using bacteriological research, the type of pathogen is established. Then the doctor selects a specific drug to which the microbe does not have resistance (resistance).

Are antibiotics always effective?

Antibiotics only act on bacteria and fungi! Bacteria are considered single-celled 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 cause disease only under certain conditions, for example, when they enter an atypical habitat. For example, very often prostatitis is caused by E. coli, which enters through the ascending route from the rectum.

Note: Antibiotics are absolutely ineffective for viral diseases. Viruses are many times smaller than bacteria, and antibiotics simply do not have a point of application for their ability. That's why antibiotics have no effect on colds, since colds in 99% of cases are caused by viruses.

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

Important:Prescribing antibiotics to yourself is unacceptable! This will only lead to the fact that some of the pathogens will develop resistance, and next time the disease will be much more difficult to cure.

Of course, antibiotics are effective for - this disease is exclusively bacterial in nature, caused by streptococci or staphylococci. To treat sore throat, the simplest antibiotics are used - penicillin, erythromycin. The most important thing in the treatment of angina is compliance with the frequency of dosing and the duration of treatment - at least 7 days. You should not stop taking the medicine immediately after the onset of the condition, which is usually noted on the 3-4th day. True tonsillitis should not be confused with tonsillitis, which can be of viral origin.

Note: untreated sore throat can cause acute rheumatic fever or!

Pneumonia (pneumonia) can be of both bacterial and viral origin. Bacteria cause pneumonia in 80% of cases, so even when prescribed empirically, antibiotics for pneumonia have a good effect. For viral pneumonia, antibiotics do not have a therapeutic effect, although they prevent the bacterial flora from joining the inflammatory process.

Antibiotics and alcohol

Taking alcohol and antibiotics at the same time in a short period of time does not lead to anything good. Some drugs are broken down in the liver, just like alcohol. The presence of antibiotics and alcohol in the blood puts a strong strain on the liver - it simply does not have time to neutralize ethyl alcohol. As a result, the likelihood of developing unpleasant symptoms increases: nausea, vomiting, and 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. Concomitant use of alcohol and these drugs can not only reduce the therapeutic effect, but also lead to shortness of breath, seizures 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 - the course of antibacterial therapy rarely exceeds 1.5-2 weeks.

Antibiotics during pregnancy

Pregnant women suffer from infectious diseases no less often than everyone else. But treating pregnant women with antibiotics is very difficult. In the body of a pregnant woman, the fetus grows and develops - the unborn child, which is very sensitive to many chemicals. The entry of antibiotics into the developing body can provoke the development of fetal malformations and toxic damage to the central nervous system of the fetus.

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

A pregnant woman cannot refuse to prescribe antibiotics for the following diseases:

• Pneumonia;
• angina;
• infected wounds;
• specific infections: brucellosis, borelliosis;
• sexually transmitted infections: , .

What antibiotics can be prescribed to a pregnant woman?

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

Conditionally safe drugs include metronidazole, gentamicin and azithromycin. They are prescribed only for health reasons, when the benefit to the woman outweighs the risk to the child. Such situations include severe pneumonia, sepsis, and other severe infections, in which, without antibiotics, a woman can simply die.

Which 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– disrupts the formation of the skeletal system and teeth;
• chloramphenicol– dangerous in late pregnancy due to inhibition of bone marrow functions in the child.

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

Please note that you should also stop taking antibiotics or change your plans for conception. Some drugs have a cumulative effect - they can accumulate in a woman’s body, and for some time after the end of the course of treatment they are gradually metabolized and eliminated. It is recommended to become pregnant no earlier than 2-3 weeks after finishing taking antibiotics.

Consequences of taking antibiotics

The entry of antibiotics into the human body leads not only to the destruction of pathogenic bacteria. Like all foreign chemicals, antibiotics have a systemic effect - to one degree or another they 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 varies: rash on the body, Quincke's edema (angioedema), anaphylactic shock. While an allergic rash is practically harmless, anaphylactic shock can be fatal. The risk of shock is much higher with antibiotic injections, which is why injections should only be done in medical institutions - emergency care can be provided there.

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 - toxic hepatitis can occur during antibiotic therapy. Certain drugs have a selective toxic effect on other organs: aminoglycosides - on the hearing aid (cause deafness); tetracyclines inhibit bone growth in children.

note: The toxicity of a drug usually depends on its dose, but in case of individual intolerance, sometimes smaller doses are sufficient to produce an effect.

Effects on the gastrointestinal tract

When taking certain antibiotics, patients often complain of stomach pain, nausea, vomiting, and stool disorders (diarrhea). These reactions are most often caused by the locally irritating effect of the 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 dysbiosis after antibiotics.

Other side effects

Other side effects include:

• immunosuppression;
• emergence of antibiotic-resistant strains of microorganisms;
• superinfection – a condition in which microbes resistant to a given antibiotic are activated, leading to the emergence of a new disease;
• violation of vitamin metabolism - caused by inhibition of the natural flora of the colon, which synthesizes some B vitamins;
• Jarisch-Herxheimer bacteriolysis is a reaction that occurs when using bactericidal drugs, when, as a result of the simultaneous death of a large number of bacteria, a large number 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 at the slightest sign of a cold. Antibiotics do not have a prophylactic effect - they treat the cause of the disease, that is, they eliminate microorganisms, and in their absence, only side effects of the drugs appear.

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

• surgery– in this case, the antibiotic present 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 during unprotected sexual contact with a potentially sick person, as well as among health workers who have had the blood of an infected person or other biological fluid come into contact with the mucous membrane;
• penicillin can be prescribed to children for the prevention of rheumatic fever, which is a complication of tonsillitis.

Antibiotics for children

The use of antibiotics in children is generally no different from their use in other groups of people. For young children, pediatricians most often prescribe antibiotics in syrup. This dosage form is more convenient to take and, unlike injections, is completely painless. Older children may be prescribed antibiotics in tablets and capsules. In severe cases of infection, they switch to the parenteral route of administration - injections.

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

Antibiotics are very effective drugs, but at the same time they have a large number of side effects. In order to be cured with their help and not harm your body, they should be taken only as prescribed by a doctor.

What types of antibiotics are there? In what cases is taking antibiotics necessary and in what cases is it dangerous? The main rules of antibiotic treatment are explained by pediatrician Dr. Komarovsky:

Gudkov Roman, resuscitator