Antibacterial and antimicrobial. Broad-spectrum antimicrobials

Antibiotics are considered very important group drugs. The effect they have on microorganisms has made it possible to radically change treatment regimens for infectious diseases and significantly reduce the likelihood of death and severe consequences from the action of harmful microflora.

In recent decades, the development of newer and newer generations of medicines has been actively underway. In particular, the emphasis is on obtaining more highly specialized antibiotics that deliver a more concentrated attack on the source of infection. In addition, researchers are trying to minimize the harm from the use of antibacterial drugs and minimize the required course of taking them.

Types of new generation antibiotics

There are several families of antibiotics wide range actions.

Macrolides

In this case, macrolides exhibit a mainly bacteriostatic effect. An additional advantage of antibiotics in this group is rapid absorption, good tolerance by the body and the absence of a noticeable effect of any food on the digestibility and effectiveness of the antibiotic.

To the most effective basics drugs include clarithromycin, which inhibits protein synthesis in bacteria, and azithromycin, which inhibits the development bacterial infection, developed under the influence of gram-positive cocci.

Trade names of macrolides: Summed, Azitral, Hemomycin (active ingredient - azithromycin), Clabel and Clamed (active ingredient clarithromycin).

Macrolides are actively used in therapy acute tonsillitis, as well as sore throat. An effective new generation antibiotic is Roxitomycin, which combines the action of macro- and azalides. The trade names of the drug are Roxilor and Rulide.

Antibiotics of the amoxicillin group

The active ingredients in this group of drugs are amoxicillin and clavulanic acid. Both chemical compounds belong to the group of penicillins, which together have a very wide spectrum of action.

The principle of action of amoxicillin antibiotics is the inhibition of bacterial wall formation.

Trade names of the drugs: amoxiclav and the lesser known augmentin. Drugs in this group are used for infections digestive tract, diseases respiratory tract and nasopharynx.

New generation cephalosporins

Antibiotics of the cephalosporin group are used for severe infectious diseases. Most often they are used in a hospital setting and exclusively parenterally.

Fourth generation cephalosporins are very potent drugs and have an intense Negative influence on the patient's liver and kidneys.

The principle of action of cephalosporins is to damage the membrane of reproducing bacteria by suppressing the synthesis of the protein-glycan layer. The release of enzymes leads to the destruction of bacteria. Thanks to this principle of action, cephalosporins exhibit not a bacteriostatic, but a highly effective bactericidal effect and are used for severe infections in which stopping the development of bacteria is not enough, and the actions are aimed at destroying the infectious agents.

Trade names: cefpirome, cefepime.

Fourth generation cephalosporins are considered much more effective than classic ceftriaxone (third generation drugs), and as a result have a less toxic overall effect on other organs of the patient.

The advantages of 4th generation cephalosporins are a very wide spectrum of action (including gram-positive and gram-negative bacteria), good penetration into tissue (including bone) and a very prolonged effect due to maintaining a high concentration of the drug in the body.

Antibiotics of the fluoroquinol group

Antibiotics of the fluoroquinol group are included in the list of vital drugs. They have a very strong bactericidal effect, but are quite toxic to the kidneys and dangerous to the musculoskeletal system.

The principle of action of fluoroquinols is to suppress the production of enzymes important for the synthesis of bacteria, which leads to its death. In addition, fluoroquinols have a negative effect on the RNA of bacterial cells and the stability of membranes, as well as on vital processes in them.

Due to toxicity, fluoroquinol antibiotics are strictly contraindicated in children and adolescents under 18 years of age, as well as pregnant and breastfeeding women.

A common antibiotic in this group is Moxifloxacin, which effectively reduces the quality of the synthesis of bacterial genetic material, but has a strong effect on the human musculoskeletal system.

Carbapenems

Antibiotics of this group do not show allergies to beta-lactamases. Bacteria against which carbapenems are used cannot develop high resistance (antibiotic resistance) for a number of reasons, which makes the drugs highly effective.

Meropenem and Imipenem, which belong to this group, have a very broad spectrum of action and are active against both gram-positive and gram-negative bacteria, as well as against anaerobes.

Carbapenems are primarily used for infections life-threatening patient as one of the most effective means. They can even be used as a single drug, without support in the form of other antibiotics.

Precautions when using antibiotics

1. Do not use strong antibiotics without a doctor's prescription! Drugs in this group are very nephro- and hepatotoxic: the results of self-medication can be dangerous to the health and life of the patient. In addition, bacteria can quickly develop resistance to most antibiotics, which makes further treatment with drugs of a particular group absolutely useless.
2. In parallel with taking antibiotics, it is strictly forbidden to drink alcohol (it reduces the effectiveness of the drugs), however, it is recommended to drink drugs for recovery beneficial microflora intestines.
3. Do not increase the dose of medications on your own, even if the relief effect is not noticeable. Be sure to consult with your doctor. The treatment regimen may need to be changed in such conditions.
4. Do not shorten or increase the period of taking the medication, reducing or increasing the dosage accordingly: such a dose will not be equivalent due to the fact that a certain concentration of the antibiotic must be maintained in the blood.
5. Inform your doctor about any individual reactions to drugs that have occurred in the past, as well as about all medications that you take on a regular basis.

Today on the pharmaceutical market there is a wide selection of varieties - broad-spectrum antibiotics that instantly resist various gynecological ailments, colds, infections of various etiologies and bacterial pathological processes.

Today you will find out what new generation antibiotics currently exist, the form of release, when they are prescribed. This group pharmaceuticals, aimed at suppressing microbes, viruses and fungi in a matter of days.

Now they are being produced that can act exclusively on a specific disease and not cause severe side effects, do not affect the intestinal microflora.

What it is

Macrolides, a synonym for the name, are aimed at fighting infections in the following diseases:

• Urological - for kidney inflammation, pyelonephritis, ailments genitourinary system, antibiotic treatment for prostatitis;
• ENT (for sinusitis, rhinitis, sinusitis, tonsillitis);
• For injuries with gangrenous outcome, for purulent wounds and abscesses;
• ARV, acute respiratory infections, flu, sore throat;
• Respiratory tract infections, pneumonia, tuberculosis;
• STI.

Antibiotics of the latest generation have a narrowly targeted specific action, destroying pathogenic cells of the microorganism, namely those that cause infection and inflammation.

Modern ones are involved in the fight against many diseases, even those that were considered incurable.

After diagnosis, the patient is prescribed narrowly targeted antibiotics that can defeat a specific disease. Only the attending physician can prescribe the exact dose without health consequences.

At the same time, medications are prescribed for thrush and dysbiosis. They are available in pharmacies and sold without a prescription. Many groups are relatively inexpensive and are not inferior to third- and fourth-generation drugs.

Release form

• After determining the severity of the disease, full examination and diagnosis, the doctor prescribes an antibiotic;
• The dosage of the drug is prescribed taking into account weight, age and severity of the disease;
• The daily rate is determined by the doctor and the course of treatment is individual, generally no more than 10 days;
• In severe cases, it is prescribed intramuscularly.

List of the most basic:

1. In tablets;
2. Injections – in ampoules;
3. Candles;
4. Suspensions for children.

Titles:

• "Sumamed";
• "Unidox Solutab";
• "Tetracycline";
• "Penicillin";
• "Streptomycin";
• "Imipenem";
• "Amoxiclav";
• "Cefodox";
• "Avelox";
• "Cefixime".

Antibiotic injections are prescribed when the disease progresses in severe form, after surgical intervention, pathologies in gynecology, urology, bronchitis and pneumonia.

How to use

• Strictly according to the recipe;
• They act on bacterial (pneumonia) and fungal (deep mycoses), ENT infections, but are not used against viral diseases;
• Compliance with the course and regimen of taking the antibiotic, do not stop using the medications yourself;
• If treatment is not effective after 5 days, the dynamics remain unchanged, you need to consult a doctor to prescribe an antibiotic of a narrower focus and action;
• In parallel, a probiotic, bifidobacteria, is always taken to prevent the appearance of dysbiosis, diarrhea and against the occurrence of candidiasis (for women);
• Read the instructions for visiting hours and follow them;
• Do not drink alcohol during treatment.

Kinds

• 3rd generation cephalosporins - “Pancef”, “Ceforal”, “Solyutab”, “Suprax”. They are often used for pneumonia, after major operations to avoid complications, and in urology. Prescribed intravenously, intramuscularly;
• Penicillin groups. Indications: tonsillitis, tonsillitis, sinusitis, ENT diseases, cystitis, otitis media, bronchitis. Restrictions - intolerance to this group, allergies, anaphylactic shock, hives and skin rashes. Suitable for pregnant women and children over one year old. Medicines: Amoxicillin, Amoxin, Flemoxin, Solutab.
• Microlide group. Indications – venereal diseases, for sore throat, tonsillitis, otitis media, bronchitis, sinusitis. The release form is tablets or suspensions, the action here is slower than that of antibiotics in injections.

It is important to know! It should not be used for a long time; there is a possibility that pathogens will become accustomed to this species. Side effects: nausea, vomiting, dysbacteriosis.

Popular names: “Azithromycin”, “Aziral”, “Summamed”, “Ecomed”, “Hemomycin”.

• Fluoroquinolone group. Indications: salmonellosis, urological diseases, Chronical bronchitis and its relapse, diarrhea, pneumonia. Powerful drugs that are prescribed in severe and extreme cases.

Side effects: nausea, fatigue, joint pain, diarrhea. Contraindications: pregnancy, nursing mothers. Take at the same time vitamin complex and probiotics. Only a doctor prescribes. Name: “Ofloxacin”, “Zanocin”, “Avelox”, “Cifran”, “Ciprofloxacin”.

Pregnancy

During this exciting period, a woman’s body resists heavy loads and can sometimes fail. Then chronic diseases, weakened immunity makes itself felt.

Expectant mothers understand how taking antibiotics negatively affects the fetus, but not everyone knows that only in the first trimester and not every group of antibacterial medications. Which one only a doctor can prescribe to the expectant mother, and dosage.

Indications:

• Chronic and acute course of diseases of the genitourinary system;
• Sexually transmitted infections;
• Upper respiratory tract diseases.

Admission rules:

1. Stick to them and your doctor’s orders;
2. Do not change the dose or prolong treatment on your own;

If you feel worse after antibiotic therapy, immediately stop taking them and consult a doctor for advice.

Ointments

For external use, it is prescribed by a doctor of a narrow specialty - ENT, ophthalmologist, dermatologist, venereologist. The cream is used externally to treat:

• Skin – balanitis, urticaria, allergic reactions, burns;
• Eye pathologies, postoperative recovery;
• Diseases of the hearing organs - acute external otitis.

Name of well-known and effective:

• "Tetracycline";
• "Erythromycin";
• "Levomekol";
• "Oflocain";
• "Klenzit S";
• "Fusiderm";
• "Gentaxan".

Narrowly targeted diseases

Let's look at the most common ailments and ways to treat them. In case of cystitis, it can alleviate the disease in the first days. These include:

• "Furadonin";
• "Monural";
• "Levomycetin";
• "Palin";
• "Furagin".

Kidney inflammation

• "Ofloxacin"
• "Amoxicillin";
• "Penicillin";
• "Cefaclor";
• "Cephalexin";
• "Gentamicin";

Intestinal infections

• 1st generation antibiotics – “Oxolinic acid”, “Nalidix acid”;
• The second – “Lomefloxacin”, “Norfloxacin”, “Ofloxacin”;
• Third – “Levofloxacin”, “Sparfloxacin”;
• Fourth - “Moxifloxacin”, “Cefepime”.

Pathological processes of the upper respiratory tract

Bronchitis, pneumonia, caused by various pathogens:

• "Erythromycin";
• "Amoxiclav";
• "Panklav";
• "Augmentin";
• "Levofloxacin";
• "Ciprofloxacin";
• "Cefuroxime";
• "Cefotaxime", "Cefoxin", "Ceftriaxone" - antibiotics for pneumonia;
• “Lincomycin”, “Clindamycin”, “Acyclovir”, “Ganciclovir” - pneumonia caused by CMV infection.

ENT diseases

For sinusitis - Cefachlor, Cefexime, Macropen.

For sore throat:

• "Spiramycin";
• "Erythromycin";
• "Azithromycin";
• "Clarithromycin";
• "Dirithromycin";
• "Aziral."

STD

• "Doxycycline";
• "Ofloxacin";
• "Tavanik";
• "Biseptol";
• "Faktiv";
• "Monural".
• Azithromycin;

Antiviral

For acute respiratory infections, colds and flu

• "Cefaclor";
• "Rulid";
• "Sumammed";
• "Avelox". The drug is also prescribed for prostatitis in men;
• "Clarithromycin."

Antifungal

• "Levorin";
• "Nystatin";
• "Miconazole";
• "Antraconazole";
• "Posaconazole";
• "Ravuconazole".

Ophthalmology

• Drops – “Maxaquin”, “Tobrex”, “Dilaterol”;
• Ointments – “Oxacin”, “Vitabact”, “Kolbiotsin”.

There are a large number of broad-spectrum antibiotics now available in every pharmacy to suit every pocket. There are cheap ones, but they are in no way inferior to the new generation of drugs.

Expensive ones, which are available in suspensions and are prescribed to young children, without great harm for good health.

But most importantly, do not self-medicate; only a qualified doctor can prescribe the exact dosage of an antibiotic and which one is necessary to treat a specific disease.

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In the medical literature and among doctors you can hear the term “broad-spectrum antibacterial drugs.” What does it mean?

Any antibacterial drug (ABP) has a spectrum of action. These are the microorganisms on which it acts. The more bacteria are sensitive to a drug, the wider its spectrum.

Typically, such antibiotics are drugs that destroy or inhibit the growth of gram-negative and gram-positive bacteria. These pathogens cause most of the inflammatory diseases in the body.

Most often, ABPs are prescribed for the following diseases:

• pneumonia and bronchitis;
• sinusitis and frontal sinusitis;
• streptococcal sore throat;
• otitis;
• pyelonephritis.

Antimicrobials broad spectrum of action are indicated in a situation where the exact pathogen is unknown, and there is no time to carry out bacterial culture to determine sensitivity to drugs.

For example, pneumonia requires treatment on the day of diagnosis, and the only solution is the use of broad-spectrum antibiotics.

With this approach, there is always the possibility of choosing an ineffective drug to which a specific pathogen is resistant. But this does not happen so often and in any case is preferable to waiting for the results of bacterial culture.

The following groups of such antibiotics are distinguished:

• penicillins;
• cephalosporins;
• macrolides;
• fluoroquinolones.

Penicillins

Penicillin is the first antibiotic to be used in the fight against purulent infection. Thanks to its action, patient survival in postoperative period has risen sharply. The mortality rate of patients from pneumonia, which was common at all times, has also decreased.

The group of penicillins includes the following representatives:

• benzylpenicillin;
• bicillin;
• oxacillin;
• ampicillin;
• amoxicillin.

One, due to the widespread and often unjustified use of these antibiotics, most microbes have developed resistance to them, and penicillins have practically ceased to be used. Also, a significant drawback of this group was the inability to resist the destructive effects of beta-lactamases - bacterial enzymes.

However, modern penicillins are protected from microbial influence due to their combination with clavulanic acid.

The most popular drug amoxiclav (Augmentin, Amoxiclav Quiktab) is widely used by doctors of all specialties and is the gold standard in the treatment of infectious and purulent diseases.

Cephalosporins

In terms of their spectrum of action, cephalosporins are not much different from penicillins. Moreover, these groups are characterized by cross-sensitivity.

Allergies to these medications occur quite often. And if the patient has hypersensitivity to antibiotics penicillin series, the prescription of drugs of the second group should be approached with caution. The likelihood of allergies in such a patient will be increased.

There are four generations of cephalosporins, the first does not have a wide spectrum of action. In routine practice, the third generation drugs most often prescribed are ceftriaxone (Medaxon) and cefixime (Cefix).

Cephalosporins are available in tablets and ampoules. Parenteral forms are widely used in surgical, therapeutic and pulmonology (pneumonia, COPD, pleurisy) hospitals.

Macrolides

Considering that the proportion of these pathogens in the development of diseases respiratory system has increased significantly, the relevance of macrolides is increasing every year.

Representatives of this group are:

• azithromycin;
• clarithromycin;
• erythromycin.

The latter drug is currently practically not used. Doctors can prescribe it only for strict indications - for example, with confirmed sensitivity of microbes to this antibiotic.

Fluoroquinolones

Fluoroquinolones are reserve antibiotics due to large quantity side effects. They affect the liver and kidneys, the blood system, and the central nervous system.

However, the effectiveness of these drugs is quite high, and there are still not many bacteria resistant to them.

Currently, fluoroquinolones are beginning to displace even penicillins and cephalosporins from practice. If at first these drugs were prescribed only for diseases of the urinary system, now a group of respiratory fluoroquinolones has been identified. They are widely used for the following pathologies:

• bronchitis;
• pneumonia;
• COPD;
• pleurisy;
• exacerbation of bronchiectasis.

However, when prescribing fluoroquinolones, their various side effects should be kept in mind and patients should be warned about this.

Antimicrobial drugs in children

Which antimicrobial agent can be freely used in pediatrics? Most often, pediatricians recommend antibiotics from the group of penicillins, cephalosporins or macrolides for children. The latter are used most often due to their high efficiency and ease of use.

Fluoroquinolones, according to the manufacturer's instructions, are not used in children under 14 years of age. This is due to their negative influence on cartilage tissue child.

However, in recent years, pediatricians have begun to use these antibiotics in children with cystic fibrosis. The disease is extremely difficult to treat and is characterized by frequent exacerbations, while the pathogens are resistant to most drugs.

No broad spectrum antibiotics modern medicine can't get by. However, you should not abuse them, what not to form drug resistance in microbes. These drugs are prescribed only by a doctor.

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

The most surprising thing is that even the all-knowing 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, as well as when, how and how many times a day they are used.

The diverse world of bacteria

And we will start from the very beginning - with microbes. Bacteria make up the majority of prokaryotes - single-celled 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 estimated that their number reaches a million.

And of course, bacteria live in the bodies of plants, animals and humans. Relationships between lower unicellular organisms and higher multicellular organisms can be 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 bifidobacteria and lactobacilli, microbes that cause a wide variety of diseases enter our bodies.

The microflora also includes so-called opportunistic microorganisms. Under favorable conditions, they do no harm, but as soon as our immunity decreases, these yesterday’s friends turn into vicious enemies. In order to somehow understand the host of bacteria, doctors proposed classifying them.

Gram- and Gram+: deciphering the puzzle

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

Back in 1885, the Dane Hans Gram decided to color the sections lung tissue to make bacteria more visible. The scientist found that the causative agent of typhus, Salmonella typhi, did not change color, while other microorganisms were exposed to the chemical.

The most famous classification today is based on the ability of bacteria to stain according to Gram. A group of bacteria that do not change color are 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, no less important classification of antibiotics breaks down drugs according to their spectrum of action and structure. Again, to understand the complex paragraphs of instructions explaining the spectrum of activity and belonging to a specific group, you need to get to know the microbes better.

Gram-positive bacteria include cocci, that is, spherical microorganisms, including numerous families of staphylococci and streptococci. In addition, clostridia, corynebacteria, listeria, and enterococci belong to this group. Gram-positive pathogens most often cause infectious diseases of the nasopharynx, respiratory tract, ear, as well as inflammatory processes of the eye.

Gram-negative bacteria are a not so numerous group of microorganisms that mainly cause intestinal infections, as well as diseases of the genitourinary tract. Much less commonly, gram-negative pathogens are responsible for respiratory tract pathologies. These include Escherichia coli, Salmonella, Shigella (the causative agent of diphtheria), Pseudomonas, Moraxella, Legionella, Klebsiella, Proteus.

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

Empirical therapy is based on this “separation” of gram-negative and gram-positive bacteria, which involves selecting an antibiotic without prior culture, that is, practically “by eye.” As practice shows, in the case of “standard” diseases, this approach to choosing a drug is completely justified. If the doctor has doubts about whether the pathogen belongs to one group or another, prescribing broad-spectrum antibiotics will help “get the ball in the air.”

Broad spectrum antibiotics: the whole army is at gunpoint

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

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

• treatment is prescribed empirically, that is, based on clinical symptoms. When selecting an antibiotic empirically, 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-acting 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;
• pathogens are resistant to narrow-spectrum antibiotics;
• a superinfection has been diagnosed, in which several types of bacteria are the culprits of the disease;
• prevention of infection after surgical interventions is carried out.

List of broad-spectrum antibiotics

Let's try to name by 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 detailed description We will start with probably the most popular group of drugs - penicillin antibiotics.

Penicillins - drugs that people know and love

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

• drugs for parenteral (injection) and enteral administration, which withstand the acidic environment of the stomach;
• injection 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 well-known infectious agents are:

• gram-positive bacteria: staphylococci and streptococci, enterococci, listeria;
• gram-negative bacteria: gonorrhea pathogen Neisseria gonorrhoeae, E. coli, Shigella, salmonella, Haemophilus influenzae, whooping cough pathogen Bordetella pertussis.

With an identical spectrum, Ampicillin and Amoxicillin differ significantly 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 compared favorably with the antibiotics of the 50s, to which persistence, that is, addiction, had already developed.

However, Ampicillin has significant disadvantages - low bioavailability and short half-life. The antibiotic is absorbed by only 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 ability parenteral administration 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 20th century. Nevertheless, this antibiotic is still one of the most popular and effective means 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. Moreover, the degree of absorption does not depend on food intake. The medicine has high degree affinity for respiratory tract tissues: the concentration of Amoxicillin in the lungs and bronchi is almost twice as high as the content in other tissues and blood. It is not surprising that Amoxicillin is considered the drug of choice for uncomplicated forms of bacterial bronchitis and pneumonia.

In addition, the medicine is indicated for sore throat, infections of the urinary and reproductive tract, infectious diseases skin. Amoxicillin is a component of eradication therapy for peptic ulcer stomach and duodenum.

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 the known Ampicillin and Amoxicillin in their additional activity against Pseudomonas aeruginosa. This microorganism causes soft tissue infections - abscesses, purulent wounds. Pseudomonas also act as causative agents of cystitis - inflammation Bladder, as well as inflammation of the intestines - enteritis.

In addition, broad-spectrum parenteral penicillin antibiotics have bactericidal and bacteriostatic effects against:

• gram-positive microorganisms: staphylococci, streptococci (except for 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.

Let's look at the most well-known antibiotics - Carbenicillin, Ticarcillin and Piperacillin.

Carbenicillin

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

Carbenicillin is indicated for infections abdominal cavity, including peritonitis, genitourinary system, respiratory tract, as well as meningitis, sepsis, infections 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 together with the beta-lactamase inhibitor tazobactam. However, if it is determined that the causative agent of the disease does not produce penicillinase, an unprotected antibiotic may be prescribed.

Indications for the use of Piperacillin include severe purulent-inflammatory 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 beta-lactamases, which are produced by some strains of bacteria. Such “harmful” pathogens include many types of staphylococcus, including Staphylococcus 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 found a way out of the situation by creating complexes of penicillin antibiotics with substances that inhibit beta-lactamases. In addition to the most famous clavulanic acid, inhibitors of destructive enzymes include sulbactam and tazobactam.

Protected antibiotics can effectively fight infection that the fragile and lonely penicillin cannot. Therefore, combination drugs are often the drugs of choice in the most various diseases caused by bacterial infection, including hospital infections. The 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, 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, available in tablet form. A parenteral form of Trifamox is also available.

Ampicillin and sulbactam. Trade name - Ampisid, used for injections, more often in hospitals.

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

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

Broad spectrum tetracyclines: time-tested

Well-known broad-spectrum drugs include tetracycline antibiotics. This group of drugs is united general structure, which is based on the four-cyclic system (“tetra” translated from 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 general spectrum actions, which includes:

• gram-positive microorganisms: staphylococci, streptococci, clostridia, listeria, actinomycetes;
• gram-negative microorganisms: the causative agent of gonorrhea Neisseria gonorrhoeae, Haemophilus influenzae, Klebsiella, Escherichia 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 - spirochete pallidum.

A distinctive feature of tetracyclines is their ability to penetrate into the bacterial cell. Therefore, these products cope well with intracellular pathogens - chlamydia, mycoplasma, ureaplasma. Pseudomonas aeruginosa and Proteus are not susceptible 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 today, despite its advanced age and side effects. However, the prescription of tetracycline tablets can be criticized, given the existence of more modern and effective antibiotics wide spectrum of action.

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

It is much more effective and safe to prescribe external and local forms of tetracycline. Yes, tetracycline eye ointment included in the Russian list of vitally important medicines and is an excellent example of a topical broad-spectrum antibacterial drug.

Doxycycline

Doxycycline is distinguished by its 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 in the tetracycline group.

Fluoroquinolones are essential broad-spectrum antibiotics

Probably not a single doctor will be able to present 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 were discovered and the spectrum of their activity expanded.

Thus, first generation antibiotics - Norfloxacin, Ofloxacin, Ciprofloxacin - work primarily against gram-negative flora.

Modern fluoroquinolones of the 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 drugs active against:

Note that all fluoroquinolones, without exception, 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 included in the structure of the tendon. Therefore, taking fluoroquinolones in children is associated with the risk of changes in cartilage tissue.

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

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

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

Moxifloxacin

Moxifloxacin is a highly active third-generation broad-spectrum fluoroquinolone antibiotic indicated for infections of the ENT organs, 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 included in eye drops Vigamox, indicated for infectious inflammatory processes of the conjunctiva of the eye and other diseases.

Gatifloxacin

The drug of the latest, IV generation of fluoroquinolones is prescribed for severe, including hospital-acquired respiratory tract diseases, ophthalmological pathologies, infections of the ENT organs, and urogenital tract. The antibacterial effect of Gatifloxacin also applies to pathogens that are sexually transmitted.

Gatifloxacin is prescribed 200 or 400 mg per day once.

Most drugs containing gatifloxacin are produced by Indian companies. Most often in pharmacies you can find Tabris, Gaflox, Gatispan.

Aminoglycosides: essential antibiotics

Aminoglycosides comprise a group of antibacterial drugs that have similar properties in structure and, of course, spectrum of action. Aminoglycosides inhibit protein synthesis in microbes, exerting 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 - the antibiotic is now widely used in phthisiology to treat tuberculosis.

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

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

Aminoglycosides of different generations have some individual characteristics, which we will try to trace using examples of specific drugs.

Oldest aminoglycoside broad action I generation in injections, which is distinguished by its 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 intracavernosally.

A very controversial antibiotic of the second generation, which is gradually falling into oblivion, is Gentamicin. Like other aminoglycosides of the second and older generations, Gentamicin is active against Pseudomonas aeruginosa. The antibiotic exists in three forms: injection, 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 inflammatory diseases biliary tract - cholecystitis, cholangitis, urinary tract - cystitis, pyelonephritis, as well as infections of the skin and soft tissues. In ophthalmological practice, eye drops with Gentamicin are prescribed for blepharitis, conjunctivitis, keratitis and others. infectious lesions eye.

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

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

Amikacin

An excellent alternative to Gentamicin is the third-generation broad-spectrum antibiotic Amikacin, which is produced in powder form for the preparation of an injection solution. Indications for the use of Amikacin include peritonitis, meningitis, endocarditis, sepsis, pneumonia and other severe infectious diseases.

Amphenicols: let's talk about good old Levomycetin

The main representative of the amphenicol group is the natural broad-spectrum antibiotic chloramphenicol, which is known to almost every one of our compatriots 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: gonorrhea pathogens, Escherichia coli and Haemophilus influenzae, Salmonella, Shigella, Yersinia, Proteus, Rickettsia.

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

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

External forms of Levomycetin (ointment) are prescribed for purulent diseases skin, trophic ulcers. Thus, 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.

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

Levomycetin is affordable, effective, and therefore loved by many intestinal antibiotic wide spectrum. So beloved that you can often meet a patient in a pharmacy buying those same anti-diarrhea pills and praising their effectiveness. Of course: I took two or three tablets - and the problems went away. 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 taken for less than five days, but by drinking two tablets of Levomycetin, we manage to completely forget about the antibacterial origin of the drug. What happens to the bacteria in this case?

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 persistent microorganisms survive and continue their vital functions. Often as opportunistic pathogens, which become more active at the slightest decrease in immunity and show us where the crayfish hibernate. Then Levomycetin may no longer cope with selected microbes.

To prevent this from happening, you should follow 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 willing to comply enough intensive course, it is better to give preference to other antimicrobial drugs, 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 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, Jenem, etc.;
• Ertapenem, tradename Invanz;
• Imipenem.

Carbapenems are administered only intravenously, intravenously 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 most important aspect, on which the safety of drugs and, ultimately, our health is based. Every patient - current or potential - should know and remember that the right to prescribe antibiotics belongs exclusively to the doctor.

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

Only good doctor. Trust the knowledge and experience of a great specialist, and this will help you maintain your health for many years.

More than half existing diseases caused by pathogenic viruses or bacteria that penetrate the body and disrupt its internal environment. To treat such infections, various antimicrobial drugs are prescribed, which are the largest group of drugs. They cause the death of fungi, bacteria, viruses, and also suppress growth and reproduction pathogenic microorganisms. Antimicrobial agents, unlike antibacterial agents, prevent the development of a wider range of harmful organisms.

Types of drugs and their features

Antimicrobial drugs have a number of common specific signs and are divided into several types depending on:

• Depending on the area of ​​application (antiseptic, disinfectant)
• Directions of action (antifungal, antiviral)
• Method of production (antibiotics, synthetic agents, natural medicines).

Before prescribing antibiotics, check the sensitivity of the microflora to medicine and identify the causative agent of infection. It is advisable to start treatment as early as possible, until the immune system is completely destroyed and the amount of harmful bacteria in the body is not so great. Often such drugs are prescribed for various diseases skin caused by staphylococci and streptococci, as well as fever, headache, chills.

Synthetic drugs are usually prescribed in cases of intolerance to antibiotics or lack of microflora response to them. They are highly active antimicrobial drugs and are often used for infections of the gastrointestinal tract, respiratory tract and genitourinary system.
Natural remedies help to avoid certain diseases and are used for preventive purposes. These are infusions of herbs, berries, honey and more.

Choice of drug

When choosing a medicine for microbes, test data, the patient’s age, and tolerability of the drug components are taken into account. During the entire course of treatment, the dynamics of infection symptoms, as well as the appearance of undesirable consequences. These may be allergic reactions in the form of urticaria or dermatitis, as well as dysbacteriosis, renal failure, cholestasis, gastritis, colitis. Instructions for use contain the entire list side effects for each means. The doctor prescribes the appropriate doses and method of administration of the medicine, which eliminate or minimize the risk of negative effects on the patient’s body.
Despite the fact that each instruction for use contains information about the indications for use and the required doses of the medicine, you should not self-medicate. If you choose the wrong antimicrobial agents, the number of bacteria in the body will only increase, and allergic reactions and dysbacteriosis may occur.