Everyone knows about penicillin. This antibiotic has saved many lives. But today it is no longer so popular, as more modern medicines have appeared. However, despite this, it can still be found in the pharmacy. Why is this so? The fact is that penicillin helps much better with purulent infections and some inflammations than other antibiotics. In addition, it is safer for human body. We will tell you more about penicillin and the history of its discovery in this article.
Penicillin is the first antibiotic that was discovered at the beginning of the 20th century. It was discovered by one famous bacteriologist - Alexander Fleming. During the war he worked as a military doctor. And at that time there were no antibiotics, so many people died due to blood poisoning, inflammation and complications. Fleming was very upset by this and he began to work on creating a medicine that could save people from various infections.
Thanks to his talent and perseverance, Fleming was already famous in scientific circles by the age of 20. At the same time, he was a terrible slob, but oddly enough, this was precisely what played a decisive role in his discovery. At that time, all experiments with bacteria were carried out in the simplest bioreactor (Petri dish). This is a wide glass cylinder with low walls and a lid. After each experiment, this bioreactor had to be well sterilized. And then one day Fleming got sick and during the experiment he sneezed, right into this Petri dish, into which he had already placed a bacterial culture. A normal doctor would immediately throw everything away and sterilize everything again. But Fleming did not do this.
A couple of days later, he checked the cup and saw that in some places all the bacteria had died, namely where he had sneezed. Fleming was surprised by this and began to work on it in more detail. A little later, he discovered lysozyme - a natural enzyme in the saliva of humans, animals and some plants, which destroys the walls of bacteria and dissolves them. But lysozyme acts too slowly, and not on all bacteria.
As mentioned above, Fleming was a slob and very rarely threw away the contents of Petri dishes. He did this only when the clean ones had already run out. And then one day he went on vacation, and left all the cups unwashed. During this time, the weather changed many times: it got colder, warmer, and the humidity level increased. Because of this, fungus and mold appeared. When the scientist returned home, he started cleaning and noticed that in one cup with staphylococci there was mold that killed these bacteria. By the way, this mold was also introduced completely by accident.
Until the 40s, Fleming actively studied his new discovery and tried to understand production technology. And he had to fail many times. Penicillin was very difficult to isolate, and its production was not only expensive but also slow. Therefore, he almost abandoned his discovery. But Oxford University doctors saw future potential of this medicine and continued Fleming's work. They disassembled the technology for producing penicillin, and already in 1941, thanks to this antibiotic, the life of a 15-year-old teenager who had blood poisoning was saved.
As it turned out later, similar studies were also carried out in the USSR. In 1942, penicillin was obtained by Zinaida Ermolyeva, a Soviet microbiologist.
By 1952, the technology had been improved, and this antibiotic could be purchased at any pharmacy. It has become widely used to treat various inflammations: pneumonia, gonorrhea, and so on.
We all know that antibiotics destroy not only pathogenic microbes, but also our microflora, that is, beneficial microbes. Penicillin works completely differently. It does not cause any harm to the human body and only acts on bacteria. This antibiotic blocks the synthesis of peptidoglycan, which takes part in the construction of new bacterial cell walls. As a result, the proliferation of bacteria stops. Our cell membranes have a different structure, so they do not react in any way to the administration of the drug.
A lot of time has passed since the creation of penicillin. Scientists have already discovered the fourth generation of antibiotics. Therefore, most doctors began to make complaints about penicillin - they say it is no longer effective, since the bacteria are accustomed to it. In addition, it disrupts the intestinal microflora. But is this really so?
Doctors are right about the fact that antibiotics disrupt the intestinal microflora. But we should not forget that today there are special preparations that help restore this microflora. In addition, antibiotics are no more harmful than smoking, alcohol, and so on.
Allergy to penicillin
A person can have an allergic reaction to any medicine. Therefore, taking any medication, especially antibiotics, should be prescribed and monitored by a doctor.
An allergic reaction to penicillin manifests itself as follows:
- signs of hives may appear;
- anaphylaxis;
- attacks of suffocation;
- angioedema;
- fever.
To avoid similar symptoms It is recommended that before prescribing treatment with penicillin, allergy test. To do this, you need to inject a small amount of antibiotic into the patient and see what the body’s reaction will be. In small quantities, the drug will not cause any harm, so there is no need to worry that the sample may cause one of the above symptoms.
It is also worth noting that an allergy to penicillin may disappear over time. This is evidenced by some studies conducted by specialists.
As you can see, penicillin is a very useful antibiotic. During the time that it existed, this medicine was able to save many lives. It is prescribed for inflammatory processes. Since its discovery, it has been improved several times. Due to this, the microbes have not yet adapted to it. This is the reason for the highly effective action of this antibiotic.
Registration number: P N003271/02-060810
Trade name of the drug: Benzylpenicillin
International generic name(INN): benzylpenicillin
Dosage form: powder for the preparation of solution for intramuscular and subcutaneous administration.
Compound:
Benzylpenicillin sodium in terms of the active substance - 500,000 units, 1,000,000 units
Description: white powder with a weak characteristic odor.
Pharmacotherapeutic group: biosynthetic antibiotic penicillin
ATX Code J01CE01
Pharmacological properties
Pharmacodynamics
Bactericidal antibiotic from the group of biosynthetic “natural” penicillins. Suppresses the synthesis of the cell wall of microorganisms. Active against gram-positive pathogens: Staphylococcus spp. (non-penicillinase-forming), Streptococcus spp. (including Streptococcus pneumoniae), Corynebacterium diphtheriae, Bacillus anthracis, Actinomyces spp.; gram-negative microorganisms: Neisseria gonorrhoeae, Neisseria meningitidis, as well as families of the Spirochaetes class, including Treponema spp. Not effective against most gram-negative bacteria, Rickettsia spp., protozoa. Penicillinase-forming strains of microorganisms are resistant to the action of the drug.
Pharmacokinetics
Time to reach maximum concentration (TCmax) at intramuscular injection- 20-30 minutes. Communication with plasma proteins - 60%. Penetrates into organs, tissues and biological fluids, except for cerebrospinal fluid, eye tissue and prostate gland, during inflammation of the meningeal membranes, penetrates the blood-brain barrier (BBB). It is excreted unchanged by the kidneys. Half-life (T½) 30-60 minutes, with renal failure- 4-10 hours or more.
Indications for use
Infectious and inflammatory diseases caused by sensitive pathogens:
- respiratory organs: community-acquired pneumonia, pleural empyema, bronchitis;
- ENT organs;
- genitourinary system: pyelonephritis, pyelitis, cystitis, urethritis, cervicitis;
- biliary tract: cholangitis, cholecystitis;
- skin and soft tissues: erysipelas, impetigo, secondary infected dermatoses, wound infection;
- eye diseases: gonoblennorrhea, corneal ulcer;
- sepsis, septic endocarditis (acute and subacute),
- peritonitis;
- gonorrhea, syphilis;
- meningitis;
- osteomyelitis;
- diphtheria; scarlet fever; actinomycosis; anthrax.
Hypersensitivity, including to other penicillins, cephalosporins.
With caution
Allergic diseases ( bronchial asthma, hay fever), renal failure.
Use during pregnancy and breastfeeding
Use during pregnancy is possible if the expected benefit to the mother exceeds potential risk for the fetus. If necessary, use of the drug during lactation should be discontinued. breast-feeding.
Directions for use and doses
Intramuscularly, subcutaneously.
Intramuscularly for moderate infections of the upper and lower respiratory tract, urinary and biliary tract, soft tissue infections, etc.
- 2.5-5 million units for 4 administrations per day.
The daily dose for children under 1 year of age is 50,000-100,000 units/kg, over 1 year of age - 50,000 units/kg; if necessary - 200,000-300,000 units/kg; according to “vital” indications - an increase to 500,000 units/kg. The frequency of administration is 4-6 times a day.
Subcutaneously for injection of infiltrates at a concentration of 100,000-200,000 units in 1 ml of 0.25-0.5% procaine solution.
For eye diseases: eye drops at a concentration of 20,000-100,000 units in 1 ml of 0.9% sodium chloride solution or distilled water, 1-2 drops 6-8 times a day.
The duration of treatment with the drug, depending on the form and severity of the disease, is 7-10 days.
Method of preparing solutions
A solution of the drug for intramuscular administration is prepared immediately before administration by adding 1-3 ml of water for injection or 0.9% sodium chloride solution, or 0.5% procaine solution to the contents of the bottle.
When benzylpenicillin is diluted in a procaine solution, cloudiness of the solution may be observed due to the formation of benzylpenicillin procaine crystals, which is not an obstacle to intramuscular and subcutaneous administration of the drug. Solutions are used immediately after preparation, avoiding the addition of other medicines.
A solution for topical use in ophthalmology should be prepared ex tempore: dilute the contents of the bottle in 0.9% sodium chloride solution or distilled water - 500,000 units in 5-25 ml, 1,000,000 units in 10-50 ml, respectively.
Side effect
Allergic reactions: hyperthermia, urticaria, skin rash, rash on mucous membranes, arthralgia, eosinophilia, angioedema, interstitial nephritis, bronchospasm; rarely - anaphylactic shock. At the beginning of the course of treatment (especially when treating congenital syphilis) rarely - fever, chills, increased sweating, exacerbation of the disease, Jarisch-Herxheimer reaction.
From the outside cardiovascular system
: decreased myocardial ejection fraction, arrhythmias, cardiac arrest, chronic heart failure (since hypernatremia may occur when large doses are administered).
Local reactions: pain and hardness at the intramuscular injection site
Other: with long-term use dysbacteriosis, development of superinfection.
Overdose
Symptoms: convulsions, impaired consciousness.
Treatment: drug withdrawal, symptomatic therapy.
Interaction with other drugs
Bactericidal antibiotics (including cephalosporins, vancomycin, rifampicin aminoglycosides) have a synergistic effect; bacteriostatic (including macrolides, chloramphenicol, lincosamides, tetracyclines) - antagonistic Increases the effectiveness of indirect anticoagulants (suppressing intestinal microflora reduces prothrombin index); reduces the effectiveness of oral contraceptives of drugs, during the metabolism of which para-aminobenzoic acid is formed - the risk of developing “breakthrough” bleeding.
Diuretics, allopurinol, tubular secretion blockers, phenylbutazone, non-steroidal anti-inflammatory drugs, reducing tubular secretion, increase the concentration of benzylpenicillin.
Allopurinol increases the risk of developing allergic reactions(skin rash).
Special instructions
If no effect is observed after 2-3 days (maximum 5 days) after starting to use the drug, you should move on to the use of other antibiotics or combination therapy. Due to the possibility of developing fungal infections, it is advisable to long-term treatment benzylpenicillin to prescribe B vitamins, if necessary - antifungal drugs. It must be taken into account that the use of insufficient doses of the drug or stopping treatment too early often leads to the emergence of resistant strains of pathogens.
There is no information on the effect of the drug on the ability to drive vehicles and other mechanisms. However, given the possible side effect from the cardiovascular system, caution should be exercised when engaging in this type of activity.
Release form
Powder for the preparation of a solution for intramuscular and subcutaneous administration of 500,000 units, 1,000,000 units in 10 ml bottles.
1 bottle along with instructions for use is placed in a pack.
10 bottles along with instructions for use are placed in a cardboard box.
For a hospital: 50 bottles and 5 instructions for use are placed in a cardboard box.
Storage conditions
List B. In a dark place at a temperature not exceeding 25°C.
Keep out of the reach of children.
Best before date
3 years. Do not use after expiration date.
Conditions for dispensing from pharmacies
According to the recipe.
The manufacturer accepts claims from buyers
OJSC Kraspharma
Russia 660042 Krasnoyarsk, st. 60 let Oktyabrya, no. 2.
Penicillin is a drug from the group of antibiotics, obtained in a special way from penicillium - mold.
What is the composition and release form of the drug Penicillin?
The drug is produced by the pharmaceutical industry in a homogeneous white powder with a characteristic faint odor. Medicine intended for the preparation of a solution administered parenterally, in particular for subcutaneous administration and for injection into gluteal muscle.
Active substance drug - penicillin G sodium salt 500,000 units, as well as 1,000,000 units. The antibiotic is sold in the prescription department. The bottle with the medicine shows the date of manufacture of the medicine; in addition, the packaging indicates the expiration date of the product, after which you should refrain from further use of the powder.
What is the effect of Penicillin powder?
The drug Penicillin is an antibiotic belonging to the group of biosynthetic penicillins, has a bactericidal effect by inhibiting the synthesis of the cell wall of some pathogenic microorganisms.
Active against the following microorganisms: Staphylococcus spp., Bacillus anthracis, in addition, Streptococcus spp., Corynebacterium diphtheriae, Neisseria gonorrhoeae, Actinomyces spp., as well as Neisseria meningitidis, Spirochaetaceae.
After intramuscular injection the antibiotic is quickly absorbed directly from the injection site into the bloodstream, and the drug is widely distributed in the tissues of the human body and in biological fluids, but in cerebrospinal fluid comes in small quantities, penetrates well through the placenta.
The half-life is thirty minutes. Excreted in urine. After injecting an antibiotic into a muscle, it maximum concentration in the bloodstream will be noted after half an hour or sixty minutes. The concentration of the drug, as well as the duration of circulation active component in the blood will depend on the size of the administered dose of the drug.
What are the indications for use of the drug Penicillin?
The instructions for use of the drug Penicillin are prescribed for use in the following situations: lobar and focal pneumonia, pleural empyema, meningitis, sepsis, septicemia, tonsillitis, in addition, septic endocarditis, osteomyelitis, infections urinary tract, purulent skin infections, erysipelas, diphtheria, gonorrhea, scarlet fever, syphilis, and anthrax, eye diseases, actinomycosis, purulent-inflammatory pathology of ENT organs.
What are the contraindications for use of Penicillin?
The antibiotic Penicillin (powder) instructions for use prohibit use in case of hypersensitivity to its components; in addition, endolumbar administration of the medication is not carried out for patients suffering from epilepsy.
What are the uses and dosage of Penicillin?
The drug Penicillin is used individually, the route of administration of the antibiotic is: into the muscle, intravenously, subcutaneously, and also endolumbarally. Usually IM and IV daily dose medications range from 250,000 to 60 million units, which is determined by the stage of the infectious process.
A solution of the antibiotic Penicillin is prepared immediately before administration, and water for injection can be used as a solvent, or 0.9% sodium chloride, as well as a 0.5% solution of procaine, can be used.
It is worth noting that when diluting the antibiotic with procaine, a slight cloudiness of the solution may be observed as a result of the formation of a crystal-like precipitate, which is not an obstacle to the subsequent use of the medicine.
What are the side effects of Penicillin?
The use of the drug Penicillin, which we continue to talk about on this page www.site, can cause a number of adverse reactions, among which the following manifestations: diarrhea, nausea, vomiting is possible, vaginal and oral candidiasis is associated, the development of a neurotoxic reaction is possible, especially with endolumbar administration of the antibiotic in large doses, and increased excitability, convulsions, and coma may be observed.
In addition, the antibiotic Penicillin can cause allergic reactions, characterized by fever, urticaria, skin rash, rash on mucous membranes, joint pain, eosinophilia, and angioedema.
Overdose from Penicillin
In case of an overdose of Penicillin, the patient will experience nausea and vomiting, it is possible loose stool, in addition, hyperkalemia is also not excluded epileptic seizures. In such a situation, the patient is given symptomatic treatment.
Special instructions
Penicillin is used with caution in persons with impaired renal function, with hypersensitivity to cephalosporins, with heart failure, in addition, with a predisposition to allergies.
If three days after starting use of the drug Penicillin therapeutic effect does not manifest itself, then it is recommended to switch to the use of other antibiotics. Due to the possibility of fungal superinfection, it is recommended to prescribe antifungal agents during treatment with benzylpenicillin.
How to replace Penicillin, what analogues should I use?
The drug Benzylpenicillin, Penicillin G, Benzylpenicillin-KMP, in addition, Novocin, Procaine-benzylpenicillin sterile, as well as Procaine-Benzylpenicillin.
Conclusion
Despite its impressive age, penicillin continues to be one of the most commonly used antibiotics for the treatment of sore throat. Even large number analogues and antibiotics of other families, in the isolation and development of which pharmacists tried to circumvent the shortcomings of penicillin, were unable to displace it from medical practice. Penicillin for sore throat is widely used in both adults and children, although its use is associated with some difficulties and limitations.
Note
Other names for penicillin (mainly used in the scientific community) are benzylpenicillin and penicillin G. At the same time, compounds such as benzathine benzylpenicillin or procaine benzylpenicillin, although they are its analogs and belong to the penicillin family, differ from the original substance in some properties.
Three-dimensional model of the molecule of the first antibiotic - penicillin
The effectiveness of penicillin for angina
Penicillin is a bactericidal antibiotic. When it enters the source of infection, it interferes with the synthesis and restoration of bacterial cell walls, which leads to their rapid death. Due to this, by the way, penicillin acts very quickly, and patients notice signs of improvement after taking it within the first day after the first injection.
Initially, penicillin effectively destroyed both pathogens of sore throat - streptococcus and staphylococcus, and therefore, immediately after its introduction into the arsenal of doctors, it was used to effectively treat sore throat in all situations.
Today, in most cases of the disease, staphylococcus is resistant to penicillin, since over several decades of use of this antibiotic it has managed to develop resistance to it.
At the same time, staphylococcal tonsillitis occurs on average in 10% of cases, and in another 10% the disease is caused by a mixed staphylococcal and streptococcal infection. This means that penicillin for sore throat may be ineffective in about one case out of five. In other situations, this also works quite effectively for adults.
The causative agents of bacterial sore throat are streptococcus and staphylococcus
Note
In addition, strains of staphylococci sensitive to penicillin are sometimes found today. However, this happens less and less every year. If the doctor knows that a sore throat is caused by a staphylococcal or mixed staphylococcal-streptococcal infection, in order to prescribe penicillin he needs to obtain data on the sensitivity of the pathogen to antibiotics. Only after such an examination will he be able to say whether penicillin will help with sore throat.
Penicillin is also effective in cases of atypical gonococcal tonsillitis. This is partly why the diagnosis itself is made less often than the disease actually happens: sore throat caused by gonococcus is very similar to streptococcal and even if the doctor makes a mistake in diagnosis, it is successfully cured using this remedy.
In some countries today there is an increase in the number of cases in which the use of penicillin is unsuccessful even against streptococcal infections. For example, in some cities in Germany, in 28% of cases the use of penicillin does not produce results, and some authors indicate even 35-38%, that is, in every third case, after several days of unsuccessful use, penicillin has to be replaced with other antibiotics.
Gonococcus is the causative agent of gonorrhea; if it gets into the throat it can cause gonococcal sore throat.
More often, this is not due to the development of resistance in the streptococcus itself (although this is being noted more and more often), but due to the fact that, along with streptococcus, other bacteria are present in the deep tissues of the tonsils that do not cause inflammation, but produce enzymes that break down penicillin. Thus, these bacteria (usually non-pathogenic staphylococci or Haemophilus influenzae) protect the causative agent of sore throat from the antibiotic.
Interestingly, the more often inflammation of the tonsils occurs (even not associated with a sore throat), the more copathogen bacteria are present in them and the greater the likelihood that penicillin will not work specifically for sore throat.
How to determine whether an infectious agent is resistant to penicillin or not?
To identify resistance, a smear of mucus from the tonsils is taken from the patient and bacteriological examination. Based on the results of the analysis, it becomes known which bacterium caused the sore throat, which antibiotics it is sensitive to, and which it is resistant to. Such an examination takes several days, and when severe course illness, when there may not be time, the doctor usually prescribes antibiotics, which are likely to work even on resistant bacteria- a mixture of amoxicillin with clavulanic acid, antibiotics of the macrolide family, and others. This allows you to quickly begin treatment and in most cases ensures recovery.
A smear from the tonsils will help to accurately determine the causative agent of a sore throat, but during its analysis, in most cases, the disease can already be cured
Advantages and disadvantages of penicillin
Penicillin has several advantages, thanks to which it successfully competes with many more modern antibiotics. Among these positive qualities:
On the other hand, it is precisely the shortcomings of penicillin that require pharmacists to constantly strive to develop more advanced analogues. Here are the main disadvantages of penicillin:
A specific property of penicillin is its rapid elimination from the body. It acts within 3-4 hours after administration, after which most the substance is eliminated from the body and the injection must be repeated. This rate of elimination has both positive and negative aspects. The downside is the need to frequently repeat injections (and therefore the need for inpatient treatment), a plus is the ability to quickly stop therapy when side effects.
Other penicillin preparations, in particular its procaine and benzathine salts, on the contrary, are characterized by a very long presence in the body, due to which they are used to prevent complications of angina.
Penicillin preparations
There are a large number of penicillin preparations on the market today. At the same time, in different means The antibiotic is found in two different chemical forms:
- Benzylpenicillin potassium salt;
- Sodium salt of benzylpenicillin.
Penicillin is sold in this form in pharmacies.
Procaine and benzathine salts of benzylpenicillin are also actively used, but they have different pharmacokinetics and are used as part of bicillins - long-acting drugs for the prevention of complications of angina.
Here are just the main penicillin preparations:
- Bicillins - Bicillin-1, Bicillin-3, Bicillin-5, Retarpen, Extensillin
- Capicillin;
- Angincillin;
- Novopen;
- Cracillin;
- Christacillin;
- Pradupen;
- Pharmacillin;
- Lanacillin;
- Falapen…
Procaine salts of penicillin are used in bicillins
...and others. Basically, all of them are imported products, some are no longer produced today. In our country, benzine penicillin salts, packaged in special vials, are usually used for injection.
Rules of application
To treat angina, penicillin preparations are administered intramuscularly into the gluteal muscle, sometimes intravenously (only sodium salt). The doses of these drugs for the treatment of sore throat are the same.
For angina, it is prescribed in the amount of 3-6 million units per day (about 1.8-3.6 g) for 4-6 injections. The specific amount is prescribed by the doctor depending on the severity of the disease.
Injections are the main method of introducing penicillin into the body.
Penicillin for angina for children is prescribed in quantities of 50-150 thousand units per kg of body weight per day. The total dose is divided into 4-6 injections. Typically for children aged six months to 2 years single dose is 240-250 mg, from 2 to 6 years - 300-600 mg, 7-12 years - 500-900 mg.
During treatment, it is very important to maintain the frequency of injections without missing injections. The general course of using penicillin for angina should be approximately 10-12 days, but not less than a week. If complications are suspected, the doctor may extend treatment to 21 days, or prescribe a course of bicillin prophylaxis.
Premature cessation of treatment or irregular injections are fraught with the development of complications of angina.
What to do if penicillin against a sore throat does not help?
If penicillin is clearly ineffective in a particular case, it is replaced with antibiotics of other groups - macrolides, cephalosporins, and sometimes lincosamides. Antibiotic-based products can sometimes be effective penicillin series with auxiliary components - clavulanic acid or sulbactam. At the same time obvious signs The effects of penicillin should appear within a few hours, most likely after 1-2 days of treatment. Practice shows that if effective treatment begins within the first 9 days of illness, sore throat is extremely rarely complicated. Accordingly, if you consult a doctor in a timely manner, it is quite acceptable to try injecting penicillin, and if it does not help, prescribe another drug.
Safety, side effects and contraindications
The main side effects after using penicillin are allergies, and in some cases they can be very severe. They usually manifest themselves with the following set of symptoms:
- Skin rash all over the body;
- Bronchospasm;
- Increase in temperature;
- Eosinophilia.
Model of an eosinophil, a type of blood cell that helps the body fight bacteria
Also, when treated with penicillin, violations are possible. heart rate(potassium salt can lead to cardiac arrest, sodium salt can lead to a decrease in the pumping function of the myocardium). Potassium salts also sometimes cause hyperkalemia.
If any significant side effects develop, penicillin is usually replaced with antibiotics of other groups.
During pregnancy, penicillin can be prescribed by a doctor if further use of the antibiotic will proceed under his supervision. The doctor must very correctly assess the balance between the risk of the drug affecting the fetus and the danger of the sore throat itself. Penicillin crosses the placental barrier, but negative influence does not affect the fetus. In the first months of pregnancy, the use of true penicillin can increase the contractile activity of the uterus and cause the risk of spontaneous abortion. Other penicillins - amosicillin, ampicillin - are safer.
As a rule, when using penicillin, it is not necessary to switch the child to formula milk
Breastfeeding is usually not interrupted while penicillin is used during lactation. Penicillin penetrates into breast milk, and with it in digestive tract child, but since it is not absorbed from the gastrointestinal tract, it does not have a systemic effect on the baby’s body. In cases of dysbacteriosis, the doctor can either replace the penicillin itself or prescribe the child means to restore the intestinal microflora.
In children themselves, penicillin for sore throat can be used from birth, but only under the strict supervision of a doctor. In this case, it does not enter the stomach and intestines and, therefore, rarely causes allergies and dysbacteriosis.
Rules of choice: when to prescribe penicillin and when to prescribe other antibiotics
Josamycin-based tablets - an alternative to penicillin injections
Today, throughout the world, penicillin injections are increasingly being replaced by taking pills and other drugs for oral administration based on its analogues - amoxicillin, ampicillin - as well as antibiotics of other groups - cefadroxil, erythromycin, josamycin. This is done primarily for sore throat in children, so as not to traumatize their psyche with painful injections and not cause fear of the doctor. Also, the doctor may prefer other antibiotics for a sore throat to penicillin for the following reasons:
Conversely, doctors prefer to prescribe penicillin itself for angina in the following situations:
Conclusions:
- Penicillin is often used for angina and, when prescribed by a doctor, in most cases can cure the disease;
- Penicillin can only be used by injection. You can’t “drink” it;
- Dosages and duration of treatment with penicillin are prescribed only by a doctor, taking into account the severity of the disease and the patient’s condition.
Video: How does a doctor choose an antibiotic?
Penicillin is one of the main representatives of the group of antibiotics; the drug has wide range bacteriostatic and bactericidal action (of penicillin preparations, benzylpenicillin is the most active).
Indications and dosage:
The use of penicillin is indicated:
- For sepsis (especially streptococcal)
- In all sulfonamide-resistant cases of corresponding infections (pneumococcal, gonococcal, meningococcal infection etc.)
- For extensive and deeply localized infectious processes(osteomyelitis, severe phlegmon, gas gangrene)
- After injuries involving and infection of large musculoskeletal masses
- IN postoperative period for the prevention of purulent complications
- For infected third and fourth degree burns
- For soft tissue injuries
- For chest injuries
- For purulent meningitis
- For brain abscesses
- For erysipelas
- For gonorrhea and its sulfonamide-resistant forms
- For syphilis
- For severe furunculosis
- For sycosis
- At various inflammations eyes and ears
In the internal medicine clinic, Penicillin is used to treat lobar pneumonia(together with sulfonamide drugs), focal pneumonia, acute sepsis, cholecystitis and cholangitis, prolonged septic endocarditis, as well as for the prevention and treatment of rheumatism.
In children, Penicillin is used: for umbilical sepsis, septicopyemia and septic-toxic diseases of newborns, pneumonia in newborns and infants and early age, otitis in infants and young children, septic form scarlet fever, septic-toxic form of diphtheria (necessarily in combination with a special serum), pleuropulmonary processes that cannot be acted upon sulfa drugs, purulent pleurisy And purulent meningitis, with gonorrhea.
The antimicrobial effect of Penicillin is achieved both through resorptive and local action.
Penicillin preparations can be administered intramuscularly, subcutaneously and intravenously, inside cavities, into the spinal canal, by inhalation, sublingually (under the tongue), orally; locally - in the form of eye and nasal drops, rinses, rinses.
When administered intramuscularly, penicillin is quickly absorbed into the blood, but after 3-4 hours penicillin almost completely disappears from it. For therapy to be effective, 1 ml of blood must contain 0.1–0.3 units of penicillin, therefore, to maintain a therapeutic concentration of the drug in the blood, it should be administered every 3–4 hours.
The use of Penicillin for the treatment of gonorrhea, syphilis, pneumonia, and cerebrospinal meningitis is carried out according to special instructions.
Overdose:
Not described.
Side effects:
Treatment with benzylpenicillins, bicillins and other penicillin-containing drugs may be accompanied by side effects, most often of an allergic nature.
The occurrence of allergic reactions to penicillin drugs is usually associated with sensitization of the body to them as a result of previous use of these drugs, as well as as a result of prolonged exposure to them: professional sensitization of nurses and people working in the production of antibiotics.
Allergic reactions are less common upon first contact with penicillin. They occur predominantly in people suffering from allergic diseases(urticaria, bronchial asthma). Allergic reactions to penicillin on the skin are expressed in erythema, limited or widespread rashes, urticaria and urticaria-like rashes, macular, vesicular, pustular rashes, sometimes life-threatening exfoliative dermatitis. Numerous cases of contact dermatitis have been reported ( medical staff medical institutions).
Contact dermatitis and reactions from the skin and mucous membranes are observed both with general exposure and with local application Penicillin in the form of ointments, lotions, drops for the nose and eyes.
- From the respiratory system, rhinitis, pharyngitis, laryngopharyngitis, asthmatic bronchitis, bronchial asthma are noted.
- From the outside gastrointestinal tract allergic reactions are expressed in stomatitis, nausea, vomiting, diarrhea.
In some cases, distinguishing between toxic and allergic genesis of side effects is difficult. On allergic origin these phenomena are indicated by their combination with skin rashes, under the influence of penicillin, the development of agranulocytosis is also possible.
If allergic reactions occur from the skin, respiratory tract, or gastrointestinal tract, treatment with penicillin should be stopped or its dose reduced, and the patient should be prescribed Diphenhydramine, Pipolfen, Suprastin, calcium chloride, vitamin B1.
It should be remembered about the possibility of sensitization of the body even in the prenatal period when treating pregnant women with penicillin preparations.
Contraindications:
The use of penicillin is contraindicated in:
- Availability hypersensitivity to penicillin
- Bronchial asthma
- Hives
- Hay fever and other allergic diseases
- Hypersensitivity of patients to antibiotics, sulfonamides and other drugs
The body may become sensitized to penicillin during intrauterine development when treating pregnant women with penicillin antibiotics.
Interaction with other drugs and alcohol:
Bactericidal antibiotics (including cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides) have a synergistic effect, bacteriostatic antibiotics (including macrolides, chloramphenicol, lincosamides, tetracyclines) have an antagonistic effect. Caution must be exercised when combining penicillins that are active against Pseudomonas aeruginosa ( Pseudomonas aeruginosa), with anticoagulants and antiplatelet agents (potential risk of increased bleeding). It is not recommended to combine penicillins with thrombolytics. When combined with sulfonamides, the bactericidal effect may be weakened. Oral penicillins may reduce the effectiveness of oral contraceptives due to disruption of the enterohepatic circulation of estrogen. Penicillins can slow down the elimination of methotrexate from the body (inhibit its tubular secretion). When ampicillin is combined with allopurinol, the likelihood of skin rash increases. Use of high doses potassium salt benzylpenicillin in combination with potassium-sparing diuretics, potassium supplements or ACE inhibitors increases the risk of hyperkalemia. Penicillins are pharmaceutically incompatible with aminoglycosides.
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