Broad-spectrum antibacterial drugs: application features. Antibiotics of the latest generation of a wide spectrum of activity

What are antibiotics, today even the youngest children know school age. However, the term "antibiotics" a wide range actions" sometimes baffles even adults and raises many questions. How wide is the spectrum? What are these antibiotics? And, yes, it looks like there are narrow-spectrum drugs that may not help?

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

Diverse world of bacteria

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

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

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

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

Gram- and Gram+: decoding the puzzle

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

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

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

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

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

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

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

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

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

Broad-spectrum antibiotics: the whole army under the gun

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

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

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

List of broad-spectrum antibiotics

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

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

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

Penicillins - drugs that are known and loved

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

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

Ampicillin and Amoxicillin are popular broad spectrum penicillins

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

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

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

Ampicillin

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

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

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

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

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

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

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

Broad spectrum parenteral penicillins

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

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

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

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

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

Carbenicillin

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

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

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

Ticarcillin

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

Piperacillin

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

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

Protected broad-spectrum penicillins: antibiotics to fight resistance!

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

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

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

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

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

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

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

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

Broad-spectrum tetracyclines: time-tested

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

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

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

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

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

Tetracycline

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

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

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

Doxycycline

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

Fluoroquinolones are essential broad spectrum antibiotics.

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

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

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

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

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

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

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

Moxifloxacin

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

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

Gatifloxacin

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

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

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

Aminoglycosides: essential antibiotics

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

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

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

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

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

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

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

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

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

The reason for the wary attitude towards Gentamicin is the data on the side effects of the antibiotic, in particular, ototoxicity. AT last years there is sufficient evidence of hearing impairment due to treatment with Gentamicin. There are even cases of complete deafness that developed against the background of the introduction of an antibiotic. The danger is that, as a rule, the ototoxic effect of Gentamicin is irreversible, that is, hearing is not restored after the antibiotic is discontinued.

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

Amikacin

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

Amphenicols: let's talk about the good old Levomycetin

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

The spectrum of action of Levomycetin covers:

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

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

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

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

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

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

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

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

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

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

Carbapenems: reserve antibiotics

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

Antibiotics in this group include:

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

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

Antibiotic therapy: the golden rule of safety

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

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

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

Therapy of diseases caused by pathogenic bacterial microflora requires right choice etiotropic drug. Broad-spectrum antibiotics of the new generation take into account bacterial resistance factors and for the most part do not suppress the growth of normal intestinal microflora. However, they cannot be used without a doctor's prescription. These drugs have a detrimental effect on cellular immunity, can form resistance to therapy, and provoke the appearance of negative side effects. The list of broad-spectrum antibiotics in injections and tablets provided here is for informational purposes only. All names are taken from pharmacological reference books, mainly trade marks. The same drugs may be present in the pharmacy network in the form of analogues that have the same active ingredient and completely different names.

The material also provides background information on the recommended daily and course dosages. A list of bacterial microflora is indicated, in relation to which treatment with one or another agent can be used. But it is immediately worth clarifying that any treatment must begin with a visit to the doctor and a bacterial analysis to clarify the sensitivity pathogenic microflora to the spectrum of antibiotics.

An excursion into the microscopic world of bacteria

In order to understand how and what broad-spectrum antibiotics affect, you need to understand the representatives of the world of bacteria. An excursion into the microscopic and mysterious world of bacteria can be made in any bacterial laboratory. The vast majority of these microorganisms can only be seen under the powerful eyepiece of a microscope. This is what thoroughly allows them to dominate the world. Invisible to the eye, they dot themselves and their colonies on absolutely all surfaces, food, household items and human skin. Incidentally, the epidermis is the first natural barrier to potential enemies - bacteria. Upon contact with the skin, they collide with an impenetrable film of sebum for them. If the skin is dry and prone to cracking, then this protection is significantly reduced. Regular water procedures with detergent increase the chances of not getting infections by almost 5 times.

By its structure, any bacterium is a prokaryote that does not have its own protein core. The first prototypes of this microflora appeared on the planet more than 4 million years ago. Currently, scientists have discovered more than 800,000 species of various bacteria. More than 80% of them are pathogenic for the human body.

In the human body there is a huge amount of bacterial microflora. Most live in the intestines, where the basis of cellular humoral immunity. Thus, bacteria can be beneficial to humans. If the bacterium is responsible for the condition immune status. Some species help break down food and prepare substances for absorption in the small intestine. Without lactobacilli, the human body is not able to break down milk protein. In people with reduced content lacto and bifidobacteria develop serious disorder intestines, immunity decreases, dysbacteriosis occurs.

A huge role in protecting the body from negative factors external environment play the so-called opportunistic bacteria. They are a kind of immunity trainers, they teach it to recognize hostile invasions and respond to them in a timely manner. With weakened immunity and after suffering stressful situations conditionally pathogenic microflora can turn into an aggressive state and harm health.

When choosing a new generation of broad-spectrum antibiotics, preference should be given to those names from the list that, according to manufacturers, do not inhibit the growth of beneficial intestinal microflora.

All bacteria are divided into gram-positive and gram-negative species. The primary division was carried out by Hans Gram in 1885 in present-day Denmark. In the course of his research, in order to improve visual perception, he painted with a special chemical composition different kinds pathogens. Those of them that changed color at the same time were classified as gram-positive. Broad-spectrum antibiotics of the new generation act on both forms of pathogenic microflora.

Gram-positive microflora includes the entire group of cocci (staphylococcus, streptococcus, gonococcus, pneumococcus) - they differ in the characteristic shape of a ball with spikes. This also includes corynobacteria, enterococci, listeria and clostridia. All this gang can cause inflammation in the pelvic cavity, gastrointestinal tract, respiratory organs, nasopharynx and conjunctiva of the eye.

The "specialization" of gram-negative bacteria practically excludes their effect on the mucous membranes of the upper respiratory tract, but they can affect the lung tissue. Most often they cause intestinal and urinary infections, cystitis, urethritis, cholecystitis, etc. This group includes salmonella, E. coli, legionella, shigella and others.

Accurately determine the pathogen and its sensitivity to antibiotic therapy allows bacterial culture of the collected physiological fluid (vomit, urine, throat and nose swab, sputum, feces). The analysis is carried out within 3-5 days. In this regard, on the first day, if there are indications, broad-spectrum antibiotics are prescribed, then the therapy regimen is adjusted depending on the sensitivity result.

Names of broad-spectrum antibiotics (list)

Universal regimens of therapy in modern medicine not provided. An experienced doctor, based on the history and examination of the patient, can only assume the presence of one form or another of bacterial pathogenic microflora. The names of the broad-spectrum antibiotics listed below often appear in doctors' prescriptions. But I would like to convey to the patients everything possible types their use. This list includes the most effective drugs of the new generation. They do not act on viruses and fungal flora. Therefore, with candidal tonsillitis and ARVI, they cannot be taken.

All drugs of similar action are divided into groups depending on the active substance: penicillins, semi-synthetic penicillins, tetracyclines, macrofoams, fluoroquinolones, carbapenems, tsifrans, aminoglycosides and amphenicols.

The beginning of the story - "Benzylpenicillin"

For the first time, antibiotics entered the arsenal of doctors a little less than a century ago. Then a group of penicillins was discovered growing on moldy bread. The beginning of the history of successful fight against pathogenic microflora fell on the second world war. It was this open that made it possible to save hundreds of thousands of lives of soldiers wounded at the front. "Benzylpenicillin" is not a broad-spectrum antibiotic, it is prescribed mainly for inflammatory processes of the upper respiratory tract as the drug of first choice until the sensitivity of the microflora is clarified.

On the basis of this remedy, more effective preparations were subsequently developed. They are widely used in patients from the very early age. This is "Ampicillin", which has a wide spectrum of action against gram-positive and gram-negative bacteria. It can be prescribed for intestinal infections caused by salmonella and E. coli. It is also used to treat bronchitis and tracheitis, which were formed under the influence of coccal flora (streptococcus, staphylococcus aureus). In children, "Ampicillin" in injections and tablets is prescribed as an effective remedy against Bordetella pertussis, which causes whooping cough. This drug has a long history of use, it was first produced in the late 60s of the last century. It differs in that it does not cause persistence and resistance in most known bacteria of the pathogenic series. Among the shortcomings, doctors call the low level of availability of the active substance when used in tablets. Also, the drug is rapidly excreted in the urine and feces, which requires an increase in the frequency of taking a single dose, sometimes up to 6 times a day.

The standard dosage for an adult is 500 mg 4 times a day for 7 days. For children aged 2 to 7 years, a single dose of 250 mg. Perhaps intramuscular injection of a solution with the addition of Novocaine or Lidocaine. At least 4 injections are required per day.

Amoxicillin is a newer, broad-spectrum antibiotic. It is prescribed for inflammatory processes of the paranasal sinuses, upper respiratory tract, pneumonia, intestinal infections, diseases of the urinary system. Active against a wide spectrum pathogenic microorganisms. Used in medical practice since the late 70s of the last century. Can be used in children with infancy. For these purposes, it is available in the form of a suspension.

It is especially effective in the treatment of inflammatory processes in the upper respiratory tract. This is due to the fact that the concentration of the active substance in the cells of the mucous membranes of the bronchi, trachea and larynx reaches a maximum within 30 minutes and remains there for 5-6 hours. The bioavailability of "Amoxicillin" is very high - after 40 minutes from taking the tablet inside, the concentration in the tissues is 85%. Quickly helps to ensure elimination from bacteria in all forms of bacterial purulent tonsillitis. Applied in combined schemes eradication of Helicobacter pylori (the causative agent of gastric ulcer and some forms of gastritis).

The standard dosage is 500 mg 2 times a day for 7-10 days. For children, a suspension is prescribed at a dosage of 250 mg 2 times a day.

"Augmentin" and "Amoxiclav" are two more modern broad-spectrum antibiotics from a number of penicillins. They contain clavulanic acid. This substance destroys the shell of pathogenic bacteria and accelerates the process of their death. These drugs do not have injectable forms. Used only in tablets and in the form of a suspension.

Broad-spectrum antibiotics in injections are prescribed for severe inflammatory processes. They quickly reach the focus of inflammation and bactericidal effect on microorganisms. They are prescribed for abscesses caused by resistant forms, such as Pseudomonas aeruginosa. Susceptibility is detected in relation to streptococci and pneumococci, staphylococci and enterobactria.

"Ampisid" is available both in tablets and in injections. It contains ampicillin and sulbactam, which inhibits lactamase and eliminates the effect of resistance in all pathogenic microorganisms without exception. Given 2 times a day for intramuscular injection and taking tablets.

"Carbenicillin" is available in the form of a disodium salt in powder vials, which can be diluted with water for injection, novocaine and lidocaine before injection. It is used for stable forms of inflammatory processes in the chest and abdominal cavity, bronchitis, tonsillitis, paratonsillar abscess. Shows high efficiency in meningitis, blood poisoning, peritonitis, sepsis. Intravenous drip is used in the postoperative period. In other cases, it is prescribed intramuscularly for 500 - 750 IU 2 times a day.

Another effective drug "Piperacillin" is used in anti-inflammatory therapy in combination with the drug "Tazobactam". It is this combination that deprives the coccal flora of stability. It is advisable to conduct a preliminary bacterial culture to determine the sensitivity of microorganisms. If there is no production of penicillinase, then it is possible to prescribe non-combination therapy only with Piperacillin. It is administered intramuscularly for severe tonsillitis, tonsillitis, pneumonia and acute bronchitis.

"Ticarcillin" is not highly resistant to penicillinase produced by bacteria. Under the action of this enzyme, the active substance of the drug will disintegrate without causing any harm to the pathogens of inflammatory processes. It can be used only in cases where the pathogenic microflora does not have resistance to the drug.

Among the protected forms of broad-spectrum antibiotics from the group of benzylpenicillins, it is worth noting Trifamox and Flemoklav - these are the latest drugs. No form of infection is currently resistant to their action.

"Trifamox" is a combination drug, which includes amoxicillin and sulbactam, in combination they deal a crushing blow to the pathogenic microflora. It is given in the form of tablets and intramuscular injections. Daily dosage for adults 750 - 1000 mg, divided into 2-3 doses. Initial treatment with intramuscular injections and subsequent pills are practiced.

Fluoroquinolone effective broad-spectrum antibiotics

Fluoroquinolone preparations are highly effective against a wide range of bacterial pathogenic microflora. They reduce the risk of side effects and do not kill natural microflora intestines. These effective antibiotics broad spectrum of activity are fully synthetic substances.

"Tavanic" (tavanic) is a ready-made solution for injection with the active substance levofloxacin hemihydrate. Analogues of the drug - "Signicef" and "Levotek". They can be administered intravenously and intramuscularly, also in pharmacies there is a tablet form. The dosage is calculated strictly individually, depending on the body weight, age of the patient and the severity of the condition.

In modern medicine, IV-generation fluoroquinolones are predominantly used, and III-generation drugs are less often prescribed. Most modern facilities- this is Gatifloxacin, Levofloxacin. Obsolete forms - "Ofloxacin" and "Norfloxacin" are currently used very rarely due to their low efficiency. The drugs have toxic activity in relation to the process of peptidoglycan synthesis, which forms connective tissue tendons. Not allowed for use in patients under the age of 18 years.

Fluoroquinolones can be successfully used in the treatment of diseases caused by gram-positive and gram-negative bacteria. All forms of pathogenic microflora are sensitive to them, including those capable of producing penicillinase.

Levofloxacin is prescribed for otitis and bronchitis, sinusitis and pneumonia, tracheitis and pharyngitis in tablets. The daily dosage for an adult is 500 mg. Children are not assigned. The course of treatment is from 7 to 10 days. Intravenous and intramuscular administration may be required in severe disease. This is usually done in a specialized hospital under round-the-clock supervision of the attending physician.

"Gatifloxacin" is an effective drug with a small daily dosage and minimal risk development of side effects. The daily dose is 200 mg. The course of treatment for diseases of the upper respiratory tract can be reduced to 5 days.
"Avelox" and "Moxifloxacin" are effective in diseases of the ear, throat and nose. Less commonly prescribed for internal political infections. It is prescribed 1 tablet (400 mg) 1 time per day for 10 days.

"Streptocid" and other aminoglycosides

Aminoglycosides are a separate group of broad-spectrum antibiotics. "Streptocide" and other drugs are known to a wide range of patients. They are assigned at various infections. In particular, "Streptocide" allows you to quickly and effectively treat lacunar and follicular tonsillitis without the risk of developing intestinal dysbacteriosis. The basis of the bactericidal action of aminoglycosides is the principle of disruption of the protein shell of the bacterial cell, then the synthesis of the life of the supporting elements stops and the pathogenic microflora dies.
Currently, 4 generations of this group of antibacterial drugs are being produced. The oldest of them "Streptomycin" is used in injections in combined treatment regimens for tuberculosis. Analogue "Streptocid" can be injected into the trachea and into tuberculous cavities in the lung tissue.

"Gentamicin" in modern conditions mainly used as an external agent. It is not effective when administered intramuscularly. Not available in tablets.

More popular "Amikacin" for intramuscular injection. It does not cause the development of deafness, does not negatively affect the auditory and optic nerve, as is observed with the introduction of "Gentamicin".

"Tetracycline" and "Levomycetin" - is it worth taking?

Among the well-known drugs, some occupy a worthy and honorable place in any home first-aid kit. But it is important to understand whether it is worth taking drugs such as Levomycetin and tetracycline. While there are more modern forms of data pharmacological agents, patients prefer "just in case" to buy them.

Broad-spectrum tetracycline antibiotics are produced based on a four-ring structure. They are highly resistant to beta-lactamase. It has a detrimental effect on the staphylococcal and streptococcal groups, actinomycetes, coli, Klebsiela, Bordetella pertussis, Haemophilus influenzae and many other microorganisms.

After absorption in the small intestine, tetracyclines bind to plasma proteins and are quickly transported to the site of accumulation of pathogenic microflora. It penetrates into the bacterial cell and paralyzes all vital processes inside it. Absolute inefficiency was revealed in diseases formed under the influence of Pseudomonas aeruginosa. It is preferable to prescribe "Doxycycline" in capsules, 1 capsule 3 times a day. Children under 12 years of age are not prescribed. "Tetracycline" can be used as an effective external agent in the form of eye and ear drops, ointments for skin and wound surfaces.

Levomycetin belongs to the group of amphenicols. These are obsolete broad-spectrum antibiotics. Used in the treatment of a large number of inflammatory bacterial diseases. The most common home use is against liquid stool caused by food poisoning, salmonellosis and dysentery. And here you should strictly observe the dosage and the recommended course of treatment. It is prescribed 500 mg 4 times a day. The course of treatment can not be less than 5 days in a row. Even skipping 1 single dose can form the resistance of the microflora. In this case, it is required to immediately change the tactics of antibiotic therapy in order to avoid negative health consequences.

These funds are able to block the spread of disease-causing agents or have a detrimental effect on them. But in order for the fight against them to be successful, it is necessary to establish exactly which ones. In some cases, it is impossible to determine the diagnosis and the best way out is antimicrobials wide spectrum of action.

Features of the fight against pathogens

It is important to consider that many antimicrobial drugs have a powerful effect not only on foreign agents, but also on the patient's body. So, they have a detrimental effect on the microflora of the gastric region and some other organs. To cause minimal damage, it is important to start treatment immediately, because microorganisms spread at a tremendous speed. If you miss this moment, the fight against them will be longer and more exhausting.

In addition, if antimicrobials are to be used for treatment, they should be administered in the maximum number so that microorganisms do not have time to adapt. The assigned course cannot be interrupted, even if improvements are noticed.

Also, in the treatment it is recommended to use different antimicrobials, and not just one type. This is necessary so that after the therapy there are no foreign agents left that have adapted to a particular drug.

In addition to this, be sure to take a course that will strengthen the body. Because many drugs can cause serious allergic reactions they should only be taken as directed by your doctor.

Sulfanilamide funds

We can say that they are divided into three types - these are nitrofurans, antibiotics and sulfonamides. The last means exert their destructive effect by preventing microbes from getting folic acid and other components that are important for their reproduction and life. But the premature termination of the treatment course or a small amount of the drug makes it possible for microorganisms to adapt to new conditions. In the future, sulfonamides are no longer able to fight.

This group includes well-absorbed drugs: "Norsulfazol", "Streptocid", "Sulfadimezin", "Etazol". It should also be noted that difficult-to-absorb medicines: "Sulgin", "Ftalazol" and others.

If necessary, for the best result, the doctor may recommend combining these two types of sulfa drugs. It is also possible to combine them with antibiotics. Some antimicrobials are described below.

"Streptocide"

Mostly this drug is prescribed for the treatment of tonsillitis, cystitis, pyelitis, erysipelas. In some cases, the medicine can cause side effects such as headache, severe nausea accompanied by vomiting, some complications from the nervous, hematopoietic or cardiovascular systems. But medicine does not stand still, and in practice similar drugs are used, but they have less adverse reactions. These drugs include "Etazol" and "Sulfadimezin".

Also, "Streptocid" can be applied topically for burns, festering wounds, skin ulcers. In addition, you can inhale the powder through your nose if you have an acute runny nose.

"Norsulfazol"

This drug is effective in cerebral meningitis, pneumonia, sepsis, gonorrhea, etc. This antimicrobial agent is quickly eliminated from the body, but it must be drunk daily a large number of water.

"Ingalipt"

Good antimicrobials for the throat, which are prescribed for laryngitis, ulcerative stomatitis, pharyngitis, are those that contain streptocide and norsulfazol. Such means include "Ingalipt". Among other things, it contains thymol, alcohol, mint and eucalyptus oil. It is an antiseptic and anti-inflammatory agent.

"Furacilin"

This is an antibacterial liquid known to many, which has a detrimental effect on various microbes. You can use the medicine externally, treating wounds, washing the nasal and auditory passages, as well as internally for bacillary dysentery. On the basis of "Furacilin" some antibacterial and antimicrobial drugs are produced.

"Ftalazol"

This slowly absorbed drug can be combined with antibiotics. It is also combined with "Etazol", "Sulfadimezin" and other drugs. It actively works, inhibiting intestinal infections. Effective in dysentery, gastroenteritis, colitis.

Nitrofuran

In medicine, there are many drugs that are derivatives of "Nitrofuran". Such funds have a wide range of effects. For example, "Furagin" and "Furadonin" are often prescribed for cystitis, urethritis, pyelonephritis and other infectious diseases of the genitourinary system.

"Penicillin"

The drug is an antibiotic that has a detrimental effect on young microbes. In the fight against influenza, smallpox and other viral diseases, it is ineffective. But with pneumonia, peritonitis, abscess, sepsis, meningitis "Penicillin" is a good helper. Various drugs are obtained from it, which are superior in effect, for example, "Benzylpenicillin". These medications are low-toxic, they practically do not cause complications. That is why it is considered that these are strong antimicrobials for children.

But still it is worth considering that a low-quality medicine can cause intense allergies. It can also suppress the natural intestinal microflora in the elderly and newborns. Weakened people or in childhood simultaneously with "Penicillin" are prescribed vitamins of groups C and B.

"Levomitsetin"

Strains resistant to Penicillin are inhibited by Levomycetin. It has no effect on protozoa, acid-fast bacteria, anaerobes. In psoriasis and skin diseases, this drug is contraindicated. It is also forbidden to take it with oppression of hematopoiesis.

"Streptomycin"

This antibiotic has several derivatives that help in different situations. For example, some can treat pneumonia, others are effective for peritonitis, and others cope with an infection of the genitourinary system. Note that the use of "Streptomycin" and its derivatives is permissible only after a doctor's prescription, since overdose does not exclude such a serious complication as hearing loss.

"Tetracycline"

This antibiotic is able to cope with many bacteria that cannot be treated with other drugs. Side effects may occur. "Tetracycline" can be combined with "Penicillin" in case of a severe septic condition. There is also an ointment that copes with skin diseases.

"Erythromycin"

This antibiotic is considered a "fallback" option, which is resorted to if other antimicrobial agents have not done their job. He successfully defeats diseases that have appeared due to the action of resistant strains of staphylococci. There is also erythromycin ointment, which helps with bedsores, burns, purulent or infected wounds, trophic ulcers.

The main broad-spectrum antimicrobials are listed below:

• "Tetracycline".
• "Levomycetin".
• "Ampicillin".
• "Rifampicin".
• "Neomycin".
• "Monomycin".
• "Rifamcin".
• "Imipenem".
• "Cephalosporins".

Gynecology and antibacterial treatment

If in any other area it is permissible to attack the disease with broad-spectrum antibacterial drugs, then in gynecology it is required to strike with a well-chosen, narrowly targeted remedy. Depending on the microflora, not only drugs are prescribed, but also their dosage and duration of the course.

Most often, antimicrobial drugs in gynecology are used externally. It can be suppositories, ointments, capsules. In some cases, if the need arises, treatment is supplemented with broad-spectrum drugs. These may include "Terzhinan", "Polizhinaks" and others. A faster result can be achieved if you take two or three drugs at the same time. In any case, a preliminary consultation with a doctor is important.

Antibacterial drugs are substances that have the ability to inhibit the growth of pathogens. unicellular organisms. Experiments on their synthesis began at the beginning of the last century. The first Soviet antibiotic was obtained in 1942 by the microbiologist Z. Ermolyeva. Names and detailed specifications drugs that belong to the group of antibacterials are presented in this material.

Antibacterial agents: use and side effects

Bactroban - Mupirocin.

Release forms. Ointment 2% for the nose in a tube of 2 g, dermatological ointment 2% in a tube of 15 g.

Compound. Antibacterial drug of natural origin. Paraffin-based antimicrobial ointment with the addition of glycerol ester or polyethylene glycol-based - 2% mupirocin.

Pharmachologic effect. Broad-spectrum antibacterial drug for topical use only. Effective against microorganisms that cause most skin infections, including strains resistant to other antibiotics.

Indications. Impetigo, folliculitis, boils, ecthyma, as well as secondary infections - infected dermatitis, eczema, otitis externa, etc.

Contraindications. Hypersensitivity to the components of the drug. Do not prescribe during pregnancy.

Side effects. Rarely there is a slight burning sensation at the site of application of the ointment.

Application and doses. Apply an antibacterial drug inside the nostrils 2-3 times a day (bacterial carriage in the nose usually stops after 5-7 days of treatment). Dermatological ointment should be applied to the affected area of ​​the skin 2-3 times a day for 10 days.

Special remarks. Avoid getting ointment in the eyes. Do not use dermatological ointment intranasally. Use with caution in moderate to severe kidney disease.

Clindacin - Clindacin.

Release forms. Cream 2% from white to white with a yellowish or creamy tint for vaginal administration in tubes of 20 g, complete with 3 applicators, in tubes of 40 g, complete with 7 applicators; also capsules in the package, solution for injections.

Compound. The active substance is clindamycin phosphate. A slight specific smell is allowed.

Pharmachologic effect. An antibiotic of the lincosamide group. Broad-spectrum antibacterial drug: bacteriostatic, and in higher concentrations against certain microorganisms - bactericidal. Active against microorganisms that cause vaginitis, except for causative agents of trichomoniasis and candidiasis. Cross-resistance of microorganisms to clindamycin and lincomycin has been established.

Indications. An antibacterial drug is indicated for the treatment of bacterial vaginosis caused by susceptible microorganisms.

Contraindications. Hypersensitivity to clindamycin or lincomycin.

Side effect. Rarely, allergic reactions are observed, as well as headache, dizziness, abdominal pain, nausea, vomiting, diarrhea, constipation, cervicitis, vaginitis, vulvar irritation.

Application and doses. The cream is administered vaginally with an applicator, 5 g at bedtime for 3-7 days. In the 1st trimester of pregnancy, use with caution during lactation.

Likacin gel (Amikacin gel) - Likacin gel (Amikacin gel).

International non-proprietary name - Amikacin. Release form. Gel for external use in tubes of 30 g. Composition. In 1 g of gel - 50 mg of amikacin.

Pharmachologic effect. Amikacin is a semi-synthetic aminoglycoside antibacterial drug with a wide spectrum of action against Gr+ and Gr- microorganisms.

Indications. For short courses in severe skin infections caused by Gr-bacteria resistant to other antibiotics. Chronic skin pyogenic infections, phlebostatic and ischemic ulcers (due to arteriopathy, hypertension, diabetes), mixed ulcers, non-healing bedsores. Contraindications. Individual intolerance to the drug or other aminoglycosides.

Side effect. With long-term therapy, high doses, ototoxicity, nephrotoxicity, neurotoxicity are sometimes possible.

The use and dose of an antibacterial drug. Apply once a day in a thick layer and rub in lightly. In pregnant women and newborns - only in case of emergency.

Special remarks. Should not be combined with anesthetics and neuromuscular blockers.

Antibacterial drugs and contraindications to their use

Lincomycin hydrochloride - Lyncomycini hydrochloridum.

Release form. Ointment 2% in tubes of 15 g.

Compound. Antibiotic, produced in the form of a monohydrate.

Pharmachologic effect. An antibiotic from the group of lincosamines, it is active mainly against Gr+ microorganisms, acts bacteriostatically or bactericidal, depending on the concentration in the body and the sensitivity of microorganisms. Active against mycoplasmas.

Indications. This is one of the best antibacterial agents for the treatment of infectious and inflammatory skin diseases. severe course caused by susceptible microorganisms. In terms of antibacterial activity, it is similar to antibiotics of the macrolide group.

Neomycin sulfate - Neomycini sulfas.

Release forms. Ointment 0.5 and 2% in tubes of 15 and 30 g.

Compound. Neomycin - a complex antibiotic (neomycins A, B, C) from the group of aminoglycosides - and neomycin sulfate is a mixture of neomycin sulfates. White or yellowish-white powder, almost odorless.

Pharmachologic effect. Activity spectrum: Gr+ and Gr- cocci, Gr bacilli, mycobacteria.

Indications. It is an antibacterial drug for therapy purulent diseases skin - pyoderma, infected dermatitis, eczema, etc. Neomycin is part of the ointments Sinalar-N, Lokakorten-N. Neomycin sulfate is well tolerated when used topically.

Application and doses. Apply to lesions in a thin layer.

Synthomycin liniment (emulsion) - Linim. Synthomycini.

Release form. In glass jars of 25 g.

Compound. Active ingredients: synthomycin 1.5 or 10%, castor oil. The active principle of synthomycin is chloramphenicol.

Pharmachologic effect. This antibacterial drug has a wide spectrum of action.

Indications. Pustular skin lesions, boils, carbuncles, long-term non-healing ulcers, burns of the 2nd-3rd degree, nipple cracks in puerperas.

Application and doses. This effective antibacterial agent is used only externally. Apply to the affected area, and apply a regular bandage on top, you can use parchment or compress paper.

Supirocin - Supirocin.

International non-proprietary name - Mupirocin.

Release form. Ointment 2% for external use in tubes of 15 g. Composition. Antibiotic of natural origin.

Pharmachologic effect. Depending on the concentration, it has a bacteriostatic or bactericidal effect: Gr + cocci and Gr ~ bacilli.

Indications for use. Primary skin infections: impetigo, folliculitis, boils, ecthymas and secondary infections: infected eczema, infected skin lesions.

Contraindications. Children under 3 years of age, hypersensitivity to components. Side effect. Rarely - non-allergic contact dermatitis, as well as allergic reactions.

Application and doses. A small amount is applied to the lesion, and a bandage can be applied on top; then wash your hands thoroughly. Apply 2-3 times a day for up to 10 days. If after 2-3 days of treatment there is no effect, then reconsider the diagnosis and treatment tactics. Use with caution during pregnancy and lactation.

Special instructions. Do not apply to mucous membranes; In case of contact with eyes, rinse thoroughly with water.

Tetracycline ointment - Ung. Tetracyclini.

International non-proprietary name - Tetracycline.

Release form. In aluminum tubes of 5, 10, 30 and 50 g. Ointment 3% yellow color, store in a cool place.

Pharmachologic effect. An antimicrobial substance produced by Streptomyces aurefaciens and other related organisms.

Indications. Acne, streptostaphyloderma, folliculitis, furunculosis, infected eczema, trophic ulcers, etc.

Side effect. With the appearance of redness of the skin, itching, burning, the treatment is stopped.

Application and doses. This antimicrobial antibacterial agent is applied to the lesions 1-2 times a day or in the form of a bandage, replaced after 12-24 hours. The duration of treatment is up to 2-3 weeks.

Fucidin - Fucidin.

International non-proprietary name - Physidic acid.

Release forms. Ointment and cream 2% for external use in tubes of 15 g. Homogeneous translucent ointment from white to yellowish-white, white homogeneous cream.

Compound. In ointment active substance- sodium fusidate, in cream - anhydrous fusidic acid.

Pharmachologic effect. Antibiotic of polycyclic structure. Streptococci, Gy-microorganisms, etc. are sensitive to sodium fusidate.

Indications. Bacterial skin infections in adults, children and newborns.

Contraindications. Hypersensitivity to the components of the drug.

Side effect. When using this remedy from the antibacterial group, itching, burning, contact dermatitis, urticaria.

Application and doses. Topically, an ointment or cream is applied to the affected areas 3 times a day for up to 10 days. Use with caution during pregnancy and lactation.

Special remarks. Avoid contact with eyes.

Erythromycin ointment - Ung. Erythromycini.

Release form. Ointment 1% in tubes of 3, 7, 10, 15 and 30 g.

Compound. Antibacterial substance - an antibiotic from the group of macrolides erythromycin.

Pharmachologic effect. In medium doses, the effect is bacteriostatic, in high doses it is bactericidal in relation to some pathogens. It is active against Gr+ (staphylococci, streptococci, etc.) and some Gr- (gonococci, Haemophilus influenzae, etc.) microorganisms, as well as mycoplasmas, chlamydia, spirochetes, rickettsia, amoeba dysentery. When combined with streptomycin, tetracyclines and sulfonamides, an increase in the action of erythromycin is observed.

Indications. Locally, this antibacterial drug is used in the treatment pustular diseases skin, bedsores, burns of the 2-3rd degree, trophic ulcers.

Side effect. Generally well tolerated, but mild irritant effects may occur.

Application and doses. Apply the ointment to the affected areas 2-3 times a day, for burns - 2-3 times a week.

The use of antibiotics for the treatment of diseases

Claforan - Claforan.

International non-proprietary name - Cefotaxime. Other trade names: Cefosin, Cefotaxime.

Release form. Dry substance for injection in vials.

Compound. 1 vial of an antibacterial drug called Claforan contains 1.048 gcefotaxime sodium.

Pharmachologic effect. Semi-synthetic antibiotic of the third generation cephalosporin group. Acts bactericidal. It has a wide spectrum of activity, resistant to the action of beta-lactamase.

Indications. Infectious and inflammatory diseases of the skin and soft tissues, urinary tract, including gonorrhea, prevention of infections after urological and gynecological operations.

Contraindications. This antibacterial drug is contraindicated in case of hypersensitivity to cephalosporins.

Side effects. Angioedema, bronchospasm, urticaria, neutropenia, agranulocytosis, eosinophilia, thrombocytopenia, arrhythmias, encephalopathy, liver dysfunction, fever, injection site pain, skin rashes, candidal stomatitis, vaginitis.

Application and doses. In uncomplicated acute gonorrhea, the use of this antibacterial agent is prescribed intramuscularly at a dose of 0.5-1 g once. For uncomplicated infections, the drug is administered in a single dose of 1-2 g every 8-12 hours, the daily dose is 2-6 g. In severe cases, Klaforan is administered intravenously at 2 g every 8-12 hours, the daily dose is 6-8 g. For intravenous injections, sterile water for injections (0.5-1 g per 4 ml of solvent) is used as a solvent, for intravenous infusions - 5% glucose solution (1-2 g of the drug per 50-100 ml). For intramuscular injections, sterile water or 1% lidocaine is used.

Special remarks. It is administered with caution to persons with intolerance to penicillin, during pregnancy and lactation.

Maximim - Maximime.

International non-proprietary name - Cefepime. Release form. 1 bottle in a box. Compound. 1 bottle contains 500 mg or 1 g of cefepime dihydrochloride monohydrate.

Pharmachologic effect. Cephalosporin antibiotic IV generation. This antibacterial agent has a wide spectrum of action against Gr+ and Gr-bacteria, strains resistant to aminoglycosides, III generation cephalosporin antibiotics. Highly resistant to hydrolysis by most beta-lactamases.

Indications. It is one of the best antibacterial drugs for the treatment of infectious diseases caused by susceptible microorganisms, including diseases of the skin and soft tissues.

Contraindications. Hypersensitivity to cefepime, L-arginine, as well as to cephalosporin antibiotics, penicillins or other beta-lactam antibiotics.

Side effects. Diarrhea, nausea, vomiting, abdominal pain, constipation, headaches, dizziness, allergic reactions, anemia, liver dysfunction, candidiasis.

Application and doses. Adults and children weighing more than 40 kg with normal kidney function and mild to moderate infections are administered 1 g intravenously or intramuscularly every 12 hours. In severe cases - 2 g intravenously every 12 hours for 7-10 days. The average dose for children weighing up to 40 kg is 50 mg / kg every 12 hours, in severe cases - 50 mg / kg every 8 hours.

Special remarks. The drug is recommended for use in children from 2 months, the safety profile of use in children and adults is the same. If diarrhea occurs during treatment, the possibility of developing pseudomembranous colitis should be considered.

Rocephin - Rocephin.

International non-proprietary name - Ceftriaxone. Other trade name: Ceftriaxone.

Release form. Glass vials, 1 per pack, complete with solvent - 1 ampoule of 1% lidocaine solution - 2 ml.

Compound. 1 vial contains 250 or 500 mg or 1 g of rocefin.

Pharmachologic effect. An antibiotic of the III generation cephalosporin group for parenteral use with prolonged action. The bactericidal activity of rocephin is due to the suppression of the synthesis of cell membranes. Active against Gr+ and Gr-aerobes, anaerobes.

Indications. Infectious and inflammatory diseases caused by pathogens sensitive to the drug. Also, this antibacterial agent is indicated for disseminated Lyme borreliosis, infections of the genital organs, including gonorrhea and syphilis, purulent infections skin and soft tissues.

Contraindications. Hypersensitivity to cephalosporins and penicillins, with hyperbilirubinemia in newborns, as well as during lactation.

Side effects. Diarrhea, nausea, vomiting, stomatitis, glossitis, increased activity of ALT, ACT, alkaline phosphatase, eosinophilia, leukopenia, thrombocytosis, thrombocytopenia, allergic reactions, oliguria, hematuria, increased serum creatinine concentration, headache, dizziness, convulsions.

Application and doses. Adults and children over the age of 12 are prescribed 1-2 g 1 time per day. In severe cases or in infections whose pathogens are only moderately sensitive to ceftriaxone, daily dose can be increased to 4 g. This effective antibacterial drug is prescribed for full-term and premature newborns at a dose of 20-50 mg / kg of body weight 1 time per day. For infants and young children, the drug is prescribed at a dose of 20-80 mg / kg of body weight 1 time per day. Children weighing over 50 kg are prescribed doses for adults. The drug at a dose of 50 mg / kg or higher intravenously should be administered drip for at least 30 minutes. Elderly patients do not require dose adjustment.

Special remarks. During pregnancy, especially in the first trimester, and during lactation, the drug should be prescribed only for strict indications: in small concentrations, rocefin is excreted with breast milk. Caution should also be exercised in hepatic and kidney failure(daily dose should not exceed 2 g). In patients with hypersensitivity to penicillin, the possibility of cross-allergic reactions is taken into account.

In the final section of the article, you will learn what other antibacterial drugs are.

What other drugs belong to the group of antibacterial

Cefalexin - Cefalexin.

International non-proprietary name - Cefalexin.

Release forms. Capsules of 16 pcs. in the package, bottle with 40 g of granulate for the preparation of 100 ml of suspension.

Compound. 1 capsule contains cephalexin 250 and 500 mg, 5 ml of suspension for oral administration, respectively, - 250 mg.

Pharmachologic effect. Cephalosporin antibiotic of the 1st generation of a broad spectrum with a bactericidal effect and high bioavailability. It is active against Gr+ producing and non-producing penicillinase strains of Staphylococcus spp., Streptococcus spp., Corynebacterium diphtheria, Gr-bacteria - Neisseria gonorrhoeae, Neisseria meningitidis, Shigella shh., Salmonella spp., Escherichia coli, Proteus mirabilis.

Indications. This broad-spectrum antibacterial is indicated for the treatment of skin and soft tissue infections caused by susceptible organisms and gonorrhea.

Contraindications. Hypersensitivity to the drug.

Side effects. Headache, dizziness, weakness, agitation, hallucinations, convulsions, nausea, vomiting, dry mouth, diarrhea, abdominal pain, mucosal candidiasis, interstitial nephritis, increased activity of ALT, ACT, rarely - reversible leukopenia, neutropenia, thrombocytopenia, allergic reactions (urticaria, syndromes of Lyell, Stevens-Johnson, etc.).

Application and doses. The average therapeutic oral dose of this antibacterial agent for adults is 250-500 mg every 6-12 hours. If necessary, the daily dose is increased to 4-6 g. The duration of the course of therapy is 7-14 days. In children weighing less than 40 kg - 25-50 mg / kg per day in 4 doses, in severe cases, the dose can be increased to 100 mg / kg in 6 doses.

Special instructions. This drug from the antibacterial list should be used with caution before the age of 6 months, in patients with hypersensitivity to penicillins, with renal failure, indicating a history of pseudomembranous colitis; at simultaneous application cephalexin with indirect anticoagulants enhances their effect. The combination with aminoglycosides, polymyxins, phenylbutazone, Furosemide enhances nephrotoxicity. Salicylates and indomethacin slow down the excretion of cephalexin.

Clindamycin - Clindamycin.

International non-proprietary name - Clindamycin. Other trade name: Dalatsin S.

Release form. Capsules of 16 pcs. per package, 2 ml ampoules - 10 and 25 pcs. per package, 4 ml ampoules - 5 and 50 pcs. packaged.

Compound. 1 capsule contains 150 mg of clindamypine phosphate, 2 ml of injection solution - 300 mg, 4 ml - 600 mg.

Pharmachologic effect. An antibiotic of the lincosamide group. In therapeutic doses, it has a bacteriostatic effect, in high doses- bactericidal action on sensitive strains. Active against mycoplasmas and chpamidia. Some antiprotozoal activity has been reported against Toxoplasma gondii and Plasmodium spp. Clindamycin is resistant to Enterococcus spp., methicillin-resistant strains of Staphylococcus aureus, most Gr~ aerobic bacteria, Neisseria gonorrhoeae, Neisseria meningitidis and Haemophilus influenzae, as well as fungi and viruses.

Indications. This antibacterial antimicrobial drug is indicated for infections of the skin and soft tissues, inflammatory diseases of the pelvic organs.

Contraindications. Hypersensitivity to the drug, impaired liver and kidney function, pregnancy and lactation.

Side effects. Abdominal pain, nausea, vomiting, esophagitis, impaired liver and kidney function, pseudomembranous colitis, leukopenia, thrombocytopenia, allergic reactions.

Application and doses. The intake of this antibacterial drug inside is shown at 150-450 mg 4 times a day. In infectious and inflammatory diseases of the pelvic organs - intramuscularly from 1.2 to 2.4 g per day in 3-4 injections. For intravenous drip, 600 mg of the drug is diluted in 100 ml of a solvent, injected within 1 hour.

Special remarks. It is used with caution in patients with gastrointestinal diseases.

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Medicines are used to treat various diseases. And also for their prevention. Medicines are obtained from plant materials, minerals, chemicals, etc. Potions, powders, tablets, capsules are prescribed in a strictly defined dose. This article will focus on antimicrobials.

What are antimicrobials?

The history of antimicrobials begins with the discovery of penicillin. It successfully fights bacteria. Based on it, scientists began to make antimicrobial drugs from natural or synthetic compounds. Such drugs are included in the group of "antibiotics". An antimicrobial agent, unlike others, kills microorganisms faster and more efficiently. They are used against various fungi, staphylococci, etc.

Antimicrobials are the largest group of medicines. Despite the different chemical structure and mechanism of action, they have a number of common specific properties. Destroy "pests" in cells, not in tissues. The activity of antibiotics decreases over time, because microbes begin to form addiction.

Types of antimicrobials

Antimicrobial drugs are divided into three groups. The first is natural (herbs, honey, etc.).

The second is semi-synthetic. They are divided into three types:

• Antistaphylococcal penicillins (oxacillins). They have the same antimicrobial spectrum as penicillin, but with less activity. Used for adults and children.
• Broad spectrum drugs. These include "Ampicillin", which affects (Salmonella, etc.). It is less active against streptococci. No effect at all on some other bacteria (Klebsiella, etc.). "Amoxicillin" also belongs to the second species. It is the leading oral antibiotic worldwide. Both of these drugs can be prescribed to adults and children.
• Antipseudomonal penicillins. They have two subspecies - carboxy- and ureidopenicillins.

The third is synthetic antimicrobial agents. This is an extensive group of drugs.

Sulfonamides. Medicines of this group are prescribed if there is intolerance to antibiotics or the microflora does not respond to them. By action, they are more active than sulfonamide preparations. These include:

• "Streptocide".
• Norsulfazol.
• "Sulfadimezin".
• "Urosulfan".
• "Ftalazol".
• "Sulfadimethoxin".
• "Bactrim".

quinolone derivatives. Basically, drugs in this group are used for infections of the genitourinary system, enterocolitis, cholecystitis, etc. Recently, new quinolone derivatives have been increasingly used:

• "Ciprofloxacin".
• Norfloxacin.
• "Pefloxacin".
• "Lomefloxacin".
• Moxifloxacin.
• Ofloxacin.

These are highly active antimicrobial drugs with a wide spectrum of action. They are less active against Gram-positive bacteria. An antimicrobial agent is prescribed for infections of the respiratory and urinary tract, gastrointestinal tract.

Antimicrobial agents have two types (by effect):

• "Cidal" (bacteria-, fungi-, viri- or protosia-). In this case, the death of the infectious agent occurs.
• "Static" (with the same prefixes). In this case, only the reproduction of the pathogen is suspended or stopped.

In case of impaired immunity, “cidic” drugs are prescribed. Moreover, antibiotics must be periodically changed or used with other drugs.

Antimicrobials may have a narrow or broad spectrum of action. Most infections are caused by a single pathogen. In this case, the "breadth" of the drug will not only be less effective, but also harmful to beneficial microflora organism. Therefore, doctors prescribe antibiotics with a "narrow" spectrum of action.

Antimicrobials

Anti-inflammatory and antimicrobial agents are divided into three groups. The main one is antibiotics. They are divided into 11 main types:

• Beta-lactam. They have three groups: A (penicillins), B (cephalosporins) and C (carbapenems). broad spectrum of activity with bacteriostatic effect. They block the protein of microbes, weaken their protection.
• Tetracyclines. Bacteriostatic, the main action is the inhibition of protein synthesis of microbes. They can be in the form of tablets, ointments ("Oletetrin", or capsules ("Doxycycline").
• Macrolides. Violate the integrity of the membrane by binding to fats.
• Aminoglycosides. They have a bactericidal effect in violation of protein synthesis.
• Fluoroquinolones. They have a bactericidal effect, block bacterial enzymes. They disrupt the synthesis of microbial DNA.
• Lincosamides. Bacteriostatics that bind microbial membrane components.
• "Chloramphenicol". Otherwise - "Levomitsetin". It has a high toxicity against bone marrow and blood. Therefore, it is used mainly locally (in the form of an ointment).
• "Polymyxin" (M and B). They act selectively, in gram-negative flora.
• Anti-tuberculosis. They are used mainly against mycobacteria, but are also effective for a wide range. But only tuberculosis is treated with these drugs, since they are considered reserve (Rifampicin, Isoniazid).
• Sulfonamides. They have many side effects, so today they are practically not used.
• Nitrofurans. Bacteriostatics, but at high concentrations - bactericides. They are mainly used for infections: intestinal ("Furazolidone", "Nifuroxazid", "Enterofuril") and urinary tract ("Furamag", "Furadonin").

The second group is bacteriophages. They are prescribed in the form of solutions for local or oral administration (rinsing, washing, lotion). The use of antimicrobial agents of this group are also used in cases of dysbacteriosis or an allergic reaction to antibiotics.

The third group is antiseptics. They are used for disinfection (treatment of wounds, oral cavity and skin).

best antimicrobial drug

"Sulfamethoxazole" is the best antimicrobial agent. Has a wide spectrum of action. Sulfamethoxazole is active against many microorganisms. It blocks the metabolism of bacteria and prevents their reproduction and growth. Sulfamethoxazole is a combined antimicrobial drug. It is intended to treat:

• urinary infections (cystitis, urethritis, prostatitis, pyelitis, pyelonephritis, gonorrhea and a number of other diseases);
• acute and chronic bronchitis;
• respiratory tract;
• gastrointestinal infections (diarrhea, cholera, paratyphoid, shigellosis, typhoid fever, cholecystitis, gastroenteritis, cholangitis);
• ENT organs;
• pneumonia;
• acne
• faces;
• furunculosis;
• wound infections;
• soft tissue abscesses;
• otitis;
• laryngitis;
• meningitis;
• malaria;
• brucellosis;
• sinusitis;
• brain abscesses;
• osteomyelitis;
• septicemia;
• toxoplasmosis;
• South American blastomycosis;
• and a number of other diseases.

The use of "Sulfamethoxazole" is extensive, but a doctor's consultation is necessary, like all medicines, it has a number of contraindications and side effects. It is necessary to control its concentration in blood plasma.

Children's antimicrobials

An antimicrobial agent for children is selected very carefully, depending on the disease. Not all medications are approved for the treatment of children.

The group of antimicrobials contains two types of drugs:

• Nitrofuran ("Furazolidone", "Furacilin", "Furadonin"). They well suppress microbes (streptococci, staphylococci, etc.) and activate the immune system. Used to treat urinary tract and intestinal infections. Good for children with allergic reactions. Simultaneously with the drugs, ascorbic and other acids are prescribed.
• Oxyquinolines ("Intestopan", "Negram", "Enteroseptol", "Nitroxoline"). These drugs destroy microbes, suppressing their vital activity (causative agents of colitis, dysentery, typhoid, etc.). They are used for diseases of the intestines. "Nitroxoline" - for urinary tract infections.

A number of other anti-inflammatory drugs are also used. But their choice depends on the disease of the child. Most often applied penicillin group. For example, with pharyngitis and some other infections that are caused by streptococcus "A", penicillins "G" and "V" are also used.

Natural preparations are prescribed for syphilis, meningococcus, listeriosis, neonatal infection (caused by streptococcus "B"). In any case, treatment is prescribed individually, taking into account the tolerability of drugs.

Children's anti-inflammatory drugs

In pediatrics, there are 3 main groups of anti-inflammatory drugs:

• Anti-influenza ("Oxolin", "Algirem"). "Remantadin" does not let the virus into the cells. But the one that is already in the body cannot be affected. Therefore, the drug must be taken in the first hours of the disease. It is also used to prevent encephalitis (after a tick bite).
• Antiherpetic ("Zovirax", "Acyclovir").
• Broad spectrum of action ("Gamma globulin"). Dibazol stimulates the immune system, but slowly. Therefore, it is mainly used for the prevention of influenza. "Interferon" is an endogenous substance that is also produced in the body. It activates the antiviral protein. As a result, the body's resistance to viruses increases. "Interferon" prevents many infectious diseases and their complications.

Antimicrobial and anti-inflammatory natural remedies

Tablets, solutions, powders are not always used immediately. If it is possible to use an antimicrobial agent that nature provides, then sometimes it does not even come to prescribing drugs at all. Also, many herbs, infusions and decoctions can relieve inflammation. Scroll:

• preparations based on calamus, wild rosemary, alder, pine buds;
• water extracts of oak bark;
• infusions of oregano;
• Hypericum perforatum;
• hyssop officinalis;
• drug burnet;
• highlander snake;
• juniper fruits;
• common thyme;
• garlic;
• sage leaves.

Can I self-medicate with antimicrobials?

It is forbidden to use antimicrobial drugs for self-medication without a doctor's prescription. The wrong choice of medicine can lead to allergies or an increase in the population of microbes that will be insensitive to the drug. Dysbacteriosis may occur. Surviving microbes can give rise to chronic infection, and the result of this is the emergence of immune diseases.