Today even young children know what antibiotics are school age. However, the term "antibiotics" wide range actions” sometimes baffles 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, to treat such infectious diseases, special, often intramuscular or intravenous antibiotics wide spectrum of action.
Based on this “separation” of gram-negative and gram-positive bacteria, the empirical therapy, which involves selecting an antibiotic without prior seeding, that is, almost “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;
- infection is prevented after surgical interventions.
List of broad-spectrum antibiotics
Let's try to name those antibacterial drugs, which 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 broad-spectrum drugs, 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, and infectious skin diseases. 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 the known Ampicillin and Amoxicillin in their additional activity against Pseudomonas aeruginosa Pseudomonas aeruginosa. This microorganism causes soft tissue infections - abscesses, purulent wounds. Pseudomonas also act as causative agents of cystitis - inflammation of the bladder, as well as inflammation of the 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 consider the most 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 abdominal infections, including peritonitis, genitourinary system, respiratory tract, as well as meningitis, sepsis, infections bone tissue, skin.
The drug is administered intramuscularly, and severe cases intravenous drip.
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 the treatment of 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 as an infusion drip, that is, in the form of 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 group of tetracyclines has a general spectrum of action, 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 rather limited therapeutic activity, as well as the ability to change the composition of the 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 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, 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 fluoroquinolones were discovered antibacterial agents and the range of their activities 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.
In Russian pharmaceutical market Many drugs containing lomefloxacin are registered. 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: Escherichia 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. That's why injection form 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 for infections of the skin and soft tissues. IN ophthalmological practice eye drops with Gentamicin are prescribed for blepharitis, conjunctivitis, keratitis and other infectious eye lesions.
The reason for a wary attitude towards Gentamicin is data on the side effects of the antibiotic, in particular ototoxicity. IN last years There is sufficient evidence 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 (ointments) are prescribed for purulent skin diseases and 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 an affordable, effective, and therefore a broad-spectrum intestinal antibiotic loved by many. 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 ready to follow a fairly 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, life-threatening. 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 the 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 a good doctor can assess the risks and benefits of using a broad-spectrum antibiotic, select a drug that can cover the spectrum of “your” microorganisms and prevent possible side effects. Trust the knowledge and experience of a great specialist, and this will help you maintain your health for many years.
For diseases of the ENT organs and bronchi, four main groups of antibiotics are used. These are penicillins, cephalosporins, macrolides and fluoroquinolones. They are convenient because they are available in tablets and capsules, that is, for oral administration, and they can be taken at home. Each group has its own characteristics, but for all antibiotics there are rules of administration that must be followed.
- Antibiotics should only be prescribed by a doctor for specific indications. The choice of antibiotic depends on the nature and severity of the disease, as well as on what medications the patient has previously received.
- Antibiotics should not be used to treat viral diseases.
- The effectiveness of the antibiotic is assessed during the first three days of its use. If the antibiotic works well, you should not interrupt the course of treatment until the time recommended by your doctor. If the antibiotic is ineffective (the symptoms of the disease remain the same, the heat), tell your doctor about this. Only the doctor decides whether to replace the antimicrobial drug.
- Side effects (eg, mild nausea, bad taste in the mouth, dizziness) do not always require immediate discontinuation of the antibiotic. Often it is enough just to adjust the dose of the drug or additionally introduce drugs that reduce side effects. Coping measures side effects determined by the doctor.
- The consequence of taking antibiotics may be the development of diarrhea. If you have large, loose stools, contact your doctor as soon as possible. Do not try to treat diarrhea caused by taking an antibiotic on your own.
- Do not reduce the dose of the medicine prescribed by your doctor. Antibiotics in small doses can be dangerous because after their use there is a high probability of the emergence of resistant bacteria.
- Strictly adhere to the time of taking the antibiotic - the concentration of the drug in the blood must be maintained.
- Some antibiotics must be taken before meals, others after. Otherwise, they are absorbed worse, so do not forget to check with your doctor about these features.
Cephalosporins
Peculiarities: broad-spectrum antibiotics. They are mainly used intramuscularly and intravenously for pneumonia and many other severe infections in surgery, urology, and gynecology. Of the oral medications, only cefixime is now widely used.
- They cause allergies less frequently than penicillins. But a person with an allergy to the penicillin group of antibiotics may develop a so-called cross-allergic reaction to cephalosporins.
- Can be used by pregnant women and children (each drug has its own age restrictions). Some cephalosporins are approved from birth.
Allergic reactions, nausea, diarrhea.
Main contraindications:
| Trade name of the drug | Price range (Russia, rub.) | |
| Active substance: Cefixime | ||
| Pantsef (Alkaloid) Suprax(various products) Ceforal Solutab (Astellas) |
A widely used drug, especially in children. The main indications for use are tonsillitis and pharyngitis, acute otitis media, sinusitis, , uncomplicated urinary tract infections. The suspension is allowed from 6 months, capsules - from 12 years. Breastfeeding women are advised to temporarily stop breastfeeding during the days of taking the drug. | |
Penicillins
Main indications:
- Angina
- Exacerbation of chronic
- Spicy medium
- Exacerbation of chronic
- Community-acquired pneumonia
- Scarlet fever
- Skin infections
- Acute cystitis, pyelonephritis and other infections
Peculiarities: are low-toxic antibiotics wide spectrum of action.
Most common side effects: allergic reactions.
Main contraindications: individual intolerance.
Important information for the patient:
- Drugs in this group are more likely than other antibiotics to cause allergies. It is possible to have an allergic reaction to several drugs from this group at once. If you experience a rash, hives, or other allergic reactions, stop taking the antibiotic and contact your doctor as soon as possible.
- Penicillins are one of the few groups of antibiotics that can be used by pregnant women and children from a very early age.
- Medicines containing amoxicillin reduce the effectiveness of birth control pills.
| Trade name of the drug | Price range (Russia, rub.) | Features of the drug that are important for the patient to know about |
| Active substance: Amoxicillin | ||
| Amoxicillin(different produced) Amoxicillin DS(Mecofar Chemical-Pharmaceutical) Amosin (Sintez OJSC) Flemoxin Solutab (Astellas) Hiconcil(KRKA) |
Widely used antibiotic. Particularly suitable for the treatment of sore throat. It is used not only for respiratory tract infections, but also in treatment regimens for gastric ulcers. Well absorbed when taken orally. It is usually used 2-3 times a day. However, sometimes it is ineffective. This is due to the fact that some bacteria are capable of producing substances that destroy this drug. | |
| Active substance: Amoxicillin + clavulanic acid | ||
| Amoxiclav(Lek) Amoxiclav Quiktab (Lek d.d.) Augmentin (GlaxoSmithKline) Panclave (Hemofarm) Flemoklav Solutab(Astellas) Ecoclave (Ava Rus) |
Clavulanic acid protects amoxicillin from resistant bacteria. Therefore, this drug is often prescribed to people who have already been treated with antibiotics more than once. It is also better for treating sinusitis, kidney infections, biliary tract, skin. It is usually used 2-3 times a day. More often than other drugs in this group, it causes diarrhea and liver dysfunction. | |
Macrolides
Main indications:
- Infection with mycoplasma and chlamydia (bronchitis, pneumonia in people over 5 years of age)
- Angina
- Exacerbation chronic tonsillitis
- Acute otitis media
- Sinusitis
- Exacerbation chronic bronchitis
- Whooping cough
Peculiarities: antibiotics, used mainly in the form of tablets and suspensions. They act a little slower than antibiotics from other groups. This is due to the fact that macrolides do not kill bacteria, but stop their reproduction. Relatively rarely cause allergies.
Most common side effects: allergic reactions, abdominal pain and discomfort, nausea, diarrhea.
Main contraindications: individual intolerance.
Important information for the patient:
- Resistance of microorganisms to macrolides develops quite quickly. Therefore, you should not repeat the course of treatment with drugs from this group for three months.
- Some of the drugs in this group may affect the activity of other drugs, and are also less well absorbed when interacting with food. Therefore, before using macrolides, you must carefully study the instructions.
| Trade name of the drug | Price range (Russia, rub.) | Features of the drug that are important for the patient to know about |
| Active substance: Azithromycin | ||
| Azithromycin(different produced) Azitral(Shreya) Azitrox (Pharmstandard) Azicide (Zentiva) Zetamax retard (Pfizer) Z factor (Veropharm) Zitrolide (Valens) Zitrolide forte(Valens) Sumamed (Teva, Pliva) Sumamed forte(Teva, Pliva) Hemomycin (Hemofarm) Ecomed (Ava Rus) |
168,03-275 |
One of the most commonly used drugs in this group. It is better tolerated than others and is well absorbed. Unlike other macrolides, it inhibits the growth of Haemophilus influenzae, which often causes otitis media and sinusitis. It is advisable to take on an empty stomach. It circulates in the body for a long time, so it is taken once a day. Short courses of treatment are possible as prescribed by a doctor: from 3 to 5 days. If necessary, can be used with caution during pregnancy. Contraindicated in severe violations liver and kidney functions. |
| Active substance: Erythromycin | ||
| Erythromycin(different produced) |
26,1-58,8 | An antibiotic that has been used for a long time, and therefore some bacteria are resistant to it. Nausea is caused somewhat more often than other representatives of this group of antibiotics. Inhibits the work of liver enzymes, which are responsible for the destruction of other drugs. Therefore, some drugs, when interacting with erythromycin, are retained in the body and cause toxic effects. It is very important to use the drug on an empty stomach. Can be used during pregnancy and breastfeeding. |
| Active substance: Clarithromycin | ||
| Clarithromycin(different produced) Clubax (Runbaxy) Clubax OD (Ranbaxy) Klacid(Abbott) Klacid SR (Abbott) Fromilid(KRKA) Fromilid Uno(KRKA) Ecositrin (Ava Rus) |
773-979,5 |
It is used not only for the treatment of respiratory tract infections, but also in treatment regimens for peptic ulcers to destroy the bacterium Helicobacter pylori. It is active against chlamydia, therefore it is often included in treatment regimens for sexually transmitted diseases. Side effects and drug interactions are similar to those of erythromycin. Not for use in children under 6 months of age, during pregnancy and breastfeeding. |
| Active substance: Midecamycin/midecamycin acetate | ||
| Macropen(KRKA) | 205,9-429 | A classic macrolide antibiotic, often used in suspension form to treat infections in children. Well tolerated. It is advisable to take 1 hour before meals. It is eliminated from the body quite quickly, so the minimum frequency of administration is 3 times a day. Drug interactions are less likely. During pregnancy, can only be used in exceptional cases, do not use during breastfeeding. |
| Active substance: Roxithromycin | ||
| Rulid(Sanofi-Aventis) | 509,6-1203 | Well absorbed and well tolerated. Indications and side effects are standard. Not for use during pregnancy and breastfeeding. |
Fluoroquinolones
Main indications:
- Heavy otitis externa
- Sinusitis
- Exacerbation of chronic bronchitis
- Community-acquired pneumonia
- Dysentery
- Salmonellosis
- Cystitis, pyelonephritis
- Adnexit
- Chlamydia and other infections
Peculiarities: powerful antibiotics, most often used for severe infections. They can disrupt the formation of cartilage, and therefore are contraindicated for children and expectant mothers.
Most common side effects: allergic reactions, pain in tendons, muscles and joints, pain and discomfort in the abdomen, nausea, diarrhea, drowsiness, dizziness, increased sensitivity to ultraviolet rays.
Main contraindications: individual intolerance, pregnancy, breastfeeding, age under 18 years.
Important information for the patient:
- Fluoroquinolones for oral administration should be taken with a full glass of water, and in total, drink at least 1.5 liters per day during the treatment period.
- For complete absorption, you must take the medications at least 2 hours before or 6 hours after taking antacids (heartburn medications), iron, zinc, and bismuth supplements.
- It is important to avoid sunbathing while using the medications and for at least 3 days after finishing treatment.
| Trade name of the drug | Price range (Russia, rub.) | Features of the drug that are important for the patient to know about |
| Active substance: Ofloxacin | ||
| Ofloxacin(various products) Zanotsin (Runbaxy) Zanotsin OD(Runbaxy) Zoflox (Mustafa nevzat ilach sanai) Ofloxin (Zentiva) Tariwid(Sanofi-Aventis) |
Most often used in urology and gynecology. For respiratory tract infections it is not used in all cases. Indicated for sinusitis, bronchitis, but not recommended for sore throat and pneumococcal community-acquired pneumonia. | |
| Active substance: Moxifloxacin | ||
| Avelox(Bayer) | 719-1080 | The most powerful antibiotic of this group. Used when severe course acute sinusitis, exacerbations of chronic bronchitis and community-acquired pneumonia. It can also be used in the treatment of drug-resistant forms of tuberculosis. |
| Active substance: Ciprofloxacin | ||
| Ciprofloxacin(various products) Tsiprinol(KRKA) Tsiprobay(Bayer) Tsiprolet (Dr. Reddy's) Tsipromed (Promed) Tsifran (Runbaxy) Tsifran OD(Runbaxy) Ecotsifol (Ava Rus) |
46,6-81 |
The most widely used drug from the group of fluoroquinolones. It has a wide spectrum of action, including against pathogens of severe infections. Indications are the same as ofloxacin. |
| Active substance: Levofloxacin | ||
| Levofloxacin(various products) Levolet (Dr. Reddy's) Glevo (Glenmark) Lefoccin(Shreya) Tavanik(Sanofi-Aventis) Flexid(Lek) Floracid (Valens, Obolenskoe) Hyleflox(Higlans Laboratories) Ecolevid (Ava Rus) Eleflox (Runbaxy) |
366-511 |
The drug has a very wide spectrum of action. Active against all pathogens of respiratory tract diseases. It is especially often prescribed for pneumonia and sinusitis. It is used when penicillins and macrolides are ineffective, as well as in cases of severe diseases of a bacterial nature. |
Remember, self-medication is life-threatening; consult a doctor for advice on the use of any medications.
Antibiotics are substances that inhibit the growth of living cells or lead to their death. May be of natural or semi-synthetic origin. Used to treat infectious diseases caused by the growth of bacteria and harmful microorganisms.
Universal
Broad-spectrum antibiotics - list:
- Penicillins.
- Tetracyclines.
- Erythromycin.
- Quinolones.
- Metronidazole.
- Vancomycin.
- Imipenem.
- Aminoglycoside.
- Levomycetin (chloramphenicol).
- Neomycin.
- Monomycin.
- Rifamcin.
- Cephalosporins.
- Kanamycin.
- Streptomycin.
- Ampicillin.
- Azithromycin.
These drugs are used in cases where it is impossible to accurately determine the causative agent of the infection. Their advantage is a large list of microorganisms that are sensitive to the active substance. But there is also a drawback: in addition to pathogenic bacteria, broad-spectrum antibiotics contribute to suppression of the immune system and disruption of normal intestinal microflora.
List of strong new generation antibiotics with a wide spectrum of action:
- Cefaclor.
- Cefamandole.
- Unidox Solutab.
- Cefuroxime.
- Rulid.
- Amoxiclav.
- Cefroxitin.
- Lincomycin.
- Cefoperazone.
- Ceftazidime.
- Cefotaxime.
- Latamoxef.
- Cefixime.
- Cefpodoxime.
- Spiramycin.
- Rovamycin.
- Clarithromycin.
- Roxithromycin.
- Klacid.
- Sumamed.
- Fuzidin.
- Avelox.
- Moxifloxacin.
- Ciprofloxacin.
Antibiotics of the new generation are notable for their deeper degree of purification of the active substance. Thanks to this, the drugs have much less toxicity compared to earlier analogues and cause less harm the body as a whole.
Narrowly targeted:
Bronchitis
The list of antibiotics for cough and bronchitis usually does not differ from the list of broad-spectrum drugs. This is explained by the fact that the analysis of sputum takes about seven days, and until the causative agent of the infection is definitely identified, a drug with maximum number bacteria sensitive to it.
In addition, recent studies show that in many cases the use of antibiotics in the treatment of bronchitis is unjustified. The point is that the purpose similar drugs effective if the nature of the disease is bacterial. If the cause of bronchitis is a virus, antibiotics will not have any positive effect.
Often used antibiotic drugs with inflammatory processes in the bronchi:
- Ampicillin.
- Amoxicillin.
- Azithromycin.
- Cefuroxime.
- Ceflocor.
- Rovamycin.
- Cefodox.
- Lendatsin.
- Ceftriaxone.
- Macropen.
Angina
List of antibiotics for sore throat:
- Penicillin.
- Amoxicillin.
- Amoxiclav.
- Augmentin.
- Ampiox.
- Phenoxymethylpenicillin.
- Oxacillin.
- Cefradine.
- Cephalexin.
- Erythromycin.
- Spiramycin.
- Clarithromycin.
- Azithromycin.
- Roxithromycin.
- Josamycin.
- Tetracycline.
- Doxycycline.
- Lidaprim.
- Biseptol.
- Bioparox.
- Inhalipt.
- Grammidin.
The listed antibiotics are effective against sore throats caused by bacteria, most often bethemolytic streptococci. As for the disease caused by fungal microorganisms, the list is as follows:
- Nystatin.
- Levorin.
- Ketoconazole.
Colds and flu (ARI, ARVI)
Antibiotics for the common cold are not included in the list of necessary medications, given the fairly high toxicity of antibiotics and possible side effects. Treatment with antiviral and anti-inflammatory drugs, as well as restoratives, is recommended. In any case, it is necessary to consult a therapist.
Sinusitis
List of antibiotics for sinusitis - in tablets and for injections:
- Zitrolide.
- Macropen.
- Ampicillin.
- Amoxicillin.
- Flemoxin solutab.
- Augmentin.
- Hiconcil.
- Amoxil.
- Gramox.
- Cephalexin.
- Digital
- Sporidex.
- Rovamycin.
- Ampiox.
- Cefotaxime.
- Vertsef.
- Cefazolin.
- Ceftriaxone.
- Duracef.
- These are substances that have a detrimental effect on bacteria. Their origin can be biological or semi-synthetic. Antibiotics have saved many lives, so their discovery has great value for all humanity.
History of the creation of antibiotics
Many infectious diseases, such as pneumonia, typhoid fever, and dysentery were considered incurable. Also, patients often died after surgical interventions, as the wounds festered, gangrene and further blood poisoning began. Until there were antibiotics.
Antibiotics were discovered in 1929 by Professor Alexander Fleming. He noticed that green mold, or rather the substance it produces, has a bactericidal and bacteriostatic effect. Mold produces a substance Fleming called penicillin.
Penicillin has a detrimental effect on some types of protozoa, but has absolutely no effect on leukocytes that fight the disease.
And only in the 40s of the twentieth century did mass production of penicillin begin. Around the same time, sulfonamides were discovered. The scientist Gause obtained gramicidin in 1942, and streptomycin was developed by Selman Voxman in 1945.
Subsequently, antibiotics such as bacitracin, polymyxin, chloramphenicol, and tetracycline were discovered. By the end of the twentieth century, all natural antibiotics had synthetic analogues.
Classification of antibiotics
There are a huge variety of antibiotics now.
First of all, they differ in their mechanism of action:
- Bactericidal effect - penicillin antibiotics, streptomycin, gentamicin, cephalexin, polymyxin
- Bacteriostatic effect - tetracycline series, macrolides, erythromycin, chloramphenicol, lincomycin,
- Pathogenic microorganisms either die completely (bactericidal mechanism) or their growth is suppressed (bacteriostatic mechanism), and the body itself fights the disease. Antibiotics with a bactericidal effect help faster.
Then, they differ in the spectrum of their action:
- Broad-spectrum antibiotics
- Narrow-spectrum antibiotics
Broad-spectrum drugs are very effective against many infectious diseases. They are also prescribed when the disease is not clearly established. Detrimental to almost everyone pathogenic microorganisms. But they also have a negative effect on healthy microflora.
Narrow-spectrum antibiotics affect certain types bacteria. Let's look at them in more detail:
- Antibacterial effect on gram-positive pathogens or cocci (streptococci, staphylococci, enterococci, listeria)
- Effect on gram-negative bacteria (Escherichia coli, salmonella, shigella, legionella, proteus)
- Antibiotics that act on gram-positive bacteria include penicillin, lincomycin, vancomycin and others. Drugs that have an effect on gram-negative pathogens include aminoglycoside, cephalosporin, polymyxin.
In addition, there are several more highly targeted antibiotics:
- Anti-tuberculosis drugs
- drugs
- Drugs that affect protozoa
- Antitumor drugs
Antibacterial agents vary by generation. Now there are 6th generation drugs. Antibiotics latest generation have a wide spectrum of action, are safe for the body, easy to use, and most effective.
For example, let’s look at penicillin drugs by generation:
- 1st generation - natural penicillins (penicillins and bicillins) - this is the first antibiotic that has not lost its effectiveness. It's inexpensive and accessible. Refers to drugs with a narrow spectrum of action (has a detrimental effect on gram-positive microbes).
- 2nd generation - semi-synthetic penicillinase-resistant penicillins (oxacillin, cloxacillin, fluclosacillin) - are less effective, unlike natural penicillin, against all bacteria except staphylococci.
- 3rd generation – broad-spectrum penicillins (ampicillin, amoxicillin). Starting from the 3rd generation, antibiotics have a negative effect on both gram-positive and gram-negative bacteria.
- 4th generation - carboxypenicillins (carbenicillin, ticarcillin) - in addition to all types of bacteria, 4th generation antibiotics are effective against Pseudomonas aeruginosa. Their range of action is even wider than that of the previous generation.
- 5th generation - ureidopenicillins (azlocillin, mezlocillin) - more effective against gra-negative pathogens and Pseudomonas aeruginosa.
- 6th generation - combined penicillins - include beta-lactamase inhibitors. These inhibitors include clavulanic acid and sulbactam. Strengthen the action, increasing its effectiveness.
Of course, the higher the generation of antibacterial drugs, the wider their spectrum of action, and, accordingly, their effectiveness is higher.
Methods of application
Treatment with antibiotics can be carried out in several ways:
- Orally
- Parenterally
- Rectally
The first way to take an antibiotic is orally or by mouth. Tablets, capsules, syrups, and suspensions are suitable for this method. This method of taking the drug is the most popular, but it has some disadvantages. Some types of antibiotics may be destroyed or poorly absorbed (penicillin, aminoglycoside). They also have an irritating effect on the gastrointestinal tract.
The second method of using antibacterial drugs parenterally or intravenously, intramuscularly, in spinal cord. The effect is achieved faster than the oral route.
Some types of antibiotics can be given rectally or directly into the rectum (therapeutic enema).
When especially severe forms diseases, the parenteral method is most often used.
U various groups antibiotics available different localization in certain organs and systems of the human body. Based on this principle, doctors often select one or another antibacterial drug. For example, with pneumonia, azithromycin accumulates in, and in the kidneys with pyelonephritis.
Antibiotics, depending on the type, are excreted in modified and unchanged form from the body along with urine, sometimes with bile.
Rules for taking antibacterial drugs
When taking antibiotics, certain rules must be followed. Since medications often cause allergic reactions, they must be taken with great caution. If the patient knows in advance that he has an allergy, he should immediately inform the attending physician.
In addition to allergies, there may be other side effects when taking antibiotics. If they have been observed in the past, this should also be reported to the doctor.
In cases where there is a need to take another drug along with an antibiotic, the doctor should know about this. There are often cases of incompatibility of drugs with each other, or the drug reduced the effect of the antibiotic, as a result of which the treatment was ineffective.
During pregnancy and breastfeeding many antibiotics are prohibited. But there are medications that can be taken during these periods. But the doctor must be informed about the fact that the baby is being fed with breast milk.
Before taking, you must read the instructions. The dosage prescribed by the doctor should be strictly observed, otherwise, if the dose of the drug is too large, poisoning may occur, and if the dose is too small, bacterial resistance to the antibiotic may develop.
Do not stop taking the drug ahead of schedule. Symptoms of the disease may return again, but in this case this antibiotic will no longer help. It will be necessary to change it to another. Recovery can long time don't step on This rule especially applies to antibiotics with bacteriostatic action.
It is important to observe not only the dosage, but also the time of taking the drug. If the instructions indicate that you need to drink the medicine with meals, it means that this is how the drug is better absorbed by the body.
Along with antibiotics, doctors often prescribe prebiotics and probiotics. This is done for recovery purposes. normal microflora intestines, which are adversely affected by antibacterial drugs. Probiotics and prebiotics treat intestinal dysbiosis.
It is also important to remember that at the first sign allergic reaction, such as itchy skin, urticaria, swelling of the larynx and face, shortness of breath, you should immediately consult a doctor.
If the antibiotic does not help within 3-4 days, this is also a reason to consult a doctor. The drug may not be suitable for treating this disease.
List of new generation antibiotics
There are a lot of antibiotics on sale now. It's easy to get confused in such diversity. New generation drugs include the following:
- Sumamed
- Amoxiclav
- Avelox
- Cefixime
- Rulid
- Ciprofloxacin
- Lincomycin
- Fuzidin
- Klacid
- Hemomycin
- Roxylor
- Cefpir
- Moxifloxacin
- Meropenem
These antibiotics belong to different families or groups of antibacterial drugs. These groups are:
- Macrolides – Sumamed, Hemomycin, Rulid
- Amoxicillin group - Amoxiclav
- Cephalosporins - Cefpirome
- Fluoroquinol group - Moxifloxacin
- Carbapenems – Meropenem
All new generation antibiotics are broad-spectrum drugs. They are highly effective and have minimal side effects.
The treatment period averages 5-10 days, but in particularly severe cases it can be extended to one month.
Side effects
Side effects may occur when taking antibacterial drugs. If they are pronounced, you should immediately stop taking the drug and consult your doctor.
To the most common side effects from antibiotics include:
- Nausea
- Vomiting
- Stomach ache
- Dizziness
- Headache
- Hives or rash on the body
- Itchy skin
- Liver toxicity separate groups antibiotics
- Toxic effects on the gastrointestinal tract
- Endotoxin shock
- Intestinal dysbiosis, which causes diarrhea or constipation
- Decreased immunity and weakening of the body (brittle nails, hair)
Because antibiotics a large number of possible side effects, they should be taken with great caution. It is unacceptable to self-medicate; this can lead to serious consequences.
Particular precautions should be taken when treating children and the elderly with antibiotics. If you have allergies, you should take antihistamines along with antibacterial drugs.
Treatment with any antibiotics, even the new generation, always seriously affects health. Of course, from the main infectious disease They relieve, but overall immunity is also significantly reduced. After all, not only pathogenic microorganisms die, but also normal microflora.
It will take some time to restore your defenses. If side effects are pronounced, especially those related to the gastrointestinal tract, then a gentle diet will be required.
It is mandatory to take prebiotics and probiotics (Linex, Bifidumbacterin, Acipol, Bifiform and others). The start of administration should be simultaneous with the start of taking the antibacterial drug. But after a course of antibiotics, probiotics and prebiotics should be taken for about two more weeks to repopulate the intestines with beneficial bacteria.
If antibiotics have a toxic effect on the liver, hepatoprotectors may be recommended. These drugs will restore damaged cells liver and protect healthy ones.
As immunity decreases, the body is susceptible to colds especially strong. Therefore, you should be careful not to overcool. Take immunomodulators, but it is better if they are plant origin(, Echinacea purpurea).
If the disease is of viral etiology, then antibiotics are powerless, even broad-spectrum and newest generation. They can only serve as a preventive measure in joining a bacterial infection to a viral one. Antiviral drugs are used to treat viruses.
While watching the video you will learn about antibiotics.
It's important to lead healthy image life in order to get sick less often and resort to antibiotic treatment less often. The main thing is not to overdo it with the use of antibacterial drugs in order to prevent the emergence of bacterial resistance to them. Otherwise, any one will be impossible to cure.
Antibiotics are substances that can cause death or inhibit the growth of simple microorganisms. Their list includes not only substances natural origin and their derivatives, but also drugs that have no biological analogues. When it comes to new generation broad-spectrum antibiotics, the list of synthetically created drugs significantly exceeds drugs of biological origin.
Thanks to antibiotics, many incurable diseases of the early 20th century can now be cured in less than a week.
The discovery of this group of drugs was a real revolution in medicine. Subsequent research made it possible to create effective drugs against bacteria of various types.
Why are new antibiotics being developed?
Uncontrolled, often unjustified use of antibiotic drugs leads to constant mutations of bacteria and the formation of resistance to the drugs used in pathogens. In this regard, scientists are constantly working on the creation of new antibiotics and the transformation of already identified ones.
Antibiotics of the new generation are less toxic and differ from those created earlier by higher therapeutic efficiency, a decrease in the number of side effects and the burden on the body as a whole. Their effect is selective - opportunistic flora is destroyed, human microflora is not affected and immunity is not suppressed.
Over the past twenty years, scientists have discovered and developed more than seven thousand substances with strong antimicrobial and bactericidal effects, which has allowed pharmaceutical companies to constantly produce new, more advanced antibiotics.
Over the previous ten years alone, about 150 antibacterial drugs, and about twenty of them are new generation medicines.
The prices of antibiotics can vary greatly, but they should not become a criterion for choosing treatment, neither from the position of economy, nor from the position of “expensive, so it will help.” The choice factor should be the doctor's prescription!
Types of bacteria
Today at medical science bacteria are conventionally divided into gram-negative and gram-positive.
The essence of the separation lies in the properties of the bacterial cell membrane. The world learned about them thanks to the research of bacteriologist Hans Gram, which involved staining colonies of microorganisms.
It turned out that different types bacteria interact with the dye in different ways. Some stained easily and quickly, others stained slowly and quickly discolored.
So different reaction on the dye clearly showed the properties of the cell wall of various bacteria and, accordingly, showed scientists what effect of the drug would be most effective.
- The largest group of Gram (+) bacteria are staphylococci and streptococci. They are the causative agents of most ear infections and eye diseases, as well as diseases of the nasopharynx and respiratory organs.
- Gram (-) bacteria include Escherichia coli, Koch coli, meningococcus, salmonella, gonococcus and shigella .
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The complex structure and ability to resist the effects of drugs for a long time became the reason that scientists developed the most powerful antibiotics to destroy precisely such pathogens.
Systematization of antibiotics
Classification of drugs from the antibiotic group occurs according to two main parameters:
- pathogen control mechanism;
- spectrum
Based on the mechanism of action of the drug on the pathogen, the following are distinguished:
- Bactericidal drugs destroy the bacteria themselves directly.
- bacteriostatic drugs suppress the reproduction function of microorganisms;
The spectrum of drugs includes highly specialized drugs and broad-spectrum antibiotics. Separation occurs depending on the type of microorganisms that are sensitive to the active substance of the drug.
Narrow-spectrum antibiotics can act on either Gram (+) or Gram (-) bacteria. They are more gentle on the body, but are effective only when the source of the disease is a specific microorganism (this is determined using bacteriological culture).
Broad-spectrum antibiotics are capable of infecting both gram-positive and gram-negative pathogens.
Combination drugs are used:
- as a preventive measure for the development infectious inflammation after surgery,
- if there is a threat of rapid development of a serious infection,
- when the pathogen is resistant to a narrow-profile active substance,
- with superinfection, when the disease is provoked simultaneously by several pathogenic agents.
- when prescribing treatment based on clinical picture, if you determine the type of pathogen in laboratory conditions no possibility. Thus, when treating sore throat and respiratory tract infections, wasting time on identifying the causative agent of the disease is completely inappropriate. And in severe and rapid developing diseases diseases such as meningitis, there is simply no time to wait for bacterial culture results. Bacteria quickly begin to infect the brain and the slightest delay in prescribing antibacterial therapy may cause disability or even be fatal.
Side effects and complications
Doctors all over the world call broad-spectrum antibiotics a real salvation from a number of complex and dangerous infections.
At the same time, the unique ability of broad-spectrum antibiotics to destroy an infection even when the pathogenic agent is not identified is also a negative side of this group of medications.
Patients should in no case consider the versatility of the medicine as a reason to treat it themselves. Uncontrolled treatment can cause harm to the body.
Only a physician can determine the advisability of taking antibacterial drugs, choose the optimal medicine, prescribe the dosage and set the duration of use.
It is important to understand that fever and cough do not always indicate bacterial infection– and even the most powerful broad-spectrum antibiotic is powerless against other pathogens.
In particular, the following complications are possible:
- The destruction of microorganisms entails an imbalance in the intestinal flora and can provoke dysbacteriosis.
- When prescribing antibacterial therapy, the doctor must also prescribe procedures and medications aimed at restoring the microbiocenosis of the gastrointestinal tract. Most often, doctors prescribe prebiotics and probiotics to help preserve normal condition intestines.
- Failure to comply with the duration of the course or reducing the dosage prescribed by the doctor may lead to a decrease in sensitivity to the drug against the background of a new round of the disease. This happens when patients stop taking an antibiotic or decide to reduce the dose when their condition has improved. This is absolutely impossible to do. The course must be taken completely, otherwise the remaining, and the strongest, bacteria will begin to multiply and cause the disease to return, but the surviving bacteria will already have a kind of immunity to the substance, and treatment with the same drug will become ineffective.
- Long-term use of antibiotics can cause serious complications. Medicines of the penicillin group can have a toxic effect on the central nervous system, and streptomycins - affect the functioning of the auditory nerve.
- The demand for new generation antibiotics is associated not only with their high efficiency, but also with improvements aimed at reducing toxicity and minimizing the harmful effects on the intestinal tract.
Characteristics and list of drugs
New generation antibiotics have a minimal number of side effects; many are protected by inhibitors that can destroy beta-lactamase-producing pathogens and contain clavuanic acid, which neutralizes the harmful effects of enzymes on active substance medicines.
Among the new generation of antibiotics, the most commonly used are:
- Flemoklav Solutab
- Sumamed
- Amoxiclav
- Rulid,
Modified formulations of new antibiotics and a more complex principle of action have made it possible for the drug to act on the cellular level of a pathogenic agent, without destroying the beneficial microflora of the body.
Just 10-15 years ago, only narrow-spectrum antibiotics gave such results, and then only against a small number of pathogens. New generation medications are effective against a whole group of pathogens at once.
Table of groups and characteristics of modern antibiotics
| Group | Characteristic | Drugs |
| Penicillin group of antibiotics | Inhibits the synthesis of the outer cell membrane of pathogens without negatively affecting it itself. The number of side effects and all kinds of complications is reduced to a minimum, especially with the latest generation of medicines. Preferably prescribed to children, and in case of bacterial complications after acute respiratory infections, drugs from this group are predominantly prescribed |
Amoxicillin, Flemoclav Solutab, Ampicillin, Augmentin, Ticarcycline, Bilmicin, |
| Tetracycline group | They destroy the protein synthesis of microorganisms at the cellular level. Effective in the treatment of infectious lesions skin and soft tissues. Traditional tetracycline tablets have big number side effects, when treating the skin, it is preferable to use tetracycline ointment. |
Tetracycline, Doxycycline, Levofloxacin, Oxytetracycline, Metacycline, Minocycline, Tigecycline |
| Aminoglycosides | Used in the treatment of primary tuberculosis, brucellosis and tularemia. inhibit protein synthesis in bacterial ribosomes, and therefore bactericidal effectiveness depends on the concentration of the active substance in body fluids. The level of toxicity is very high, there are many side effects. Practically do not cause allergic reactions. |
Streptomycin |
| Fluoroquinols | Used for severe forms of organ diseases respiratory system and reproductive system. | Gatifloxacin, Ciprofloxacin Moxifloxacin, Levofloxacin |
| Cephalosporin group | The mechanism of action is similar to penicillin series, however, the substance is more resistant to bacterial enzymes. Due to low toxicity and excellent tolerability, it is acceptable for use during pregnancy. | Ceftriaxone, Cefoperazone |
| Carbapenems | They act as so-called reserve drugs. Used exclusively for the treatment of severe nosocomial diseases. Effective in the fight against drug-resistant flora. With the development of infectious processes that threaten the patient’s life, these drugs are the first priority in the empirical regimen. Combination with other beta-lactam drugs is not possible. |
Imipenem, Tienam, Meropenem, Ertapenem, Doripenem, Meronem |
| Macrolides | By inhibiting protein synthesis in the bacterial membrane, drugs inhibit the growth and reproduction of pathogens. A bactericidal effect can be achieved by increasing the dosage | Azivok, Brilid |
| Sulfonamides | Due to their structural similarity to a substance involved in the life of bacteria, the drugs inhibit the growth and reproduction of bacteria and microorganisms. There is a high level of resistance to the substance in many types of bacteria. Used for treatment rheumatoid arthritis, toxoplasmosis and malaria |
Argosulfan, Duo-Septol, Biseptol, Tsiplin, Trimezol |
| Quinolones | The bactericidal effect is achieved through inhibition of DNA hydrase. Efficacy is proportional to the concentration of the substance in body fluids. | Levofloxacin, Ciprofloxacin, Moxifloxacin, Sparfloxacin, |
Issued combination antibiotics in tablets, powders for suspensions, ready-made ampoules and powders for injections, ointments and creams for topical use.
The effectiveness of antibiotics for various diseases
Initially, broad-spectrum antibacterial drugs are prescribed by a doctor based on clinical symptoms.
Based on the results of bacteriological culture, the attending physician can correct the treatment regimen by replacing ASSD with narrow-profile medications.
- For bronchitis, Amoxiclav is most effective. In its chronic forms, Levofloxacin is used to relieve inflammation.
- If the development of pneumonia is suspected, Cefoxin or Ceftriaxone is prescribed.
- If identified fungal infection Third generation cephalosporins are highly effective.
- The main drugs in complex therapy for sinusitis are Cefuroxin or Cefotaxime. In case of severe illness, the doctor may prescribe a strong broad-spectrum antibiotic Azithromycin or Macropen.
- In the treatment of angina, the latest generation of cephalosporins are recognized to be most effective.
- For bacterial complications of influenza and other acute respiratory viral infections, therapy using Sumamed, Rulid, Avelox and Clarithromycin shows maximum effectiveness.
- Cystitis responds well to treatment with Unidox Solutab.
Use of broad-spectrum antibiotics in pediatrics
The primary prescription of ASSD to children is justified and advisable only if there is a suspicion of complications of the disease or its rapid development.
A change in treatment to narrowly targeted medications should be made immediately after laboratory identification of the causative agent of the disease.
Most often, a broad-spectrum antibiotic is prescribed when acute forms bronchitis, otitis, sinusitis and rhinitis.
In pediatrics they are used:
Treating children with antibiotic drugs without medical supervision is unacceptable! Even the best antibiotics of the new generation, if prescribed incorrectly or if the dosage regimen is not followed, can cause harm to the child’s body.
Only a doctor will be able to correctly prescribe the dosage and duration of the course, assess the feasibility of taking it and weigh all the risks.
Thus, according to several studies, children who took broad-spectrum antibiotics in the first year of life are more susceptible to developing asthmatic syndrome.
In conclusion, it should be noted that broad-spectrum antibiotics help heal complex diseases and maintain health only with the right approach. The doctor must take into account the origin of the infection, the patient’s medical history, weight and age, and individual characteristics of the body.
Trying to identify the most powerful broad-spectrum antibiotic, even among new generation drugs, is absolutely pointless. Each medicine has its own pharmacological properties, has specific indications for use, contraindications, adverse reactions and nuances of application. In particular, the features of drug interactions with other drugs involved in complex therapy.
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