Antibiotics for swelling of the leg, shin arm, face

The reader has probably encountered people on the street with inflamed, swollen, purple spots on the skin of their face, arms, or legs. This disease is called erysipelas because of the deep pink hue the skin takes on. The appearance of a bright spot indicates that the affected tissues are severely inflamed, and the cause of this condition is an infection that has penetrated the tissues through a small wound. And since any bacterial infection is treated only with antimicrobial agents, antibiotics for erysipelas form the basis of therapy.

What is erysipelas?

Erysipelas is a soft tissue disease caused by a bacterial pathogen entering the body through damaged skin. The pathogen of this pathology is considered to be group A streptococci, which secrete enzymes and toxins that contribute to the development of a strong inflammatory process on the skin and mucous membranes.

The inflammatory process begins at the site of entry of pathogenic microorganisms and spreads to nearby areas. Inflammatory foci in most cases can be seen on the hands and feet of patients, as well as in the face, from where the inflammation gradually spreads to the mucous membranes and skin in the neck area. Antibiotics of various groups help to stop the further spread of the process in erysipelas and prevent relapses of the disease, which are quite possible in its chronic course (there are cases when relapses occurred up to 6 times a year).

Despite the fact that the disease is caused by a bacterial infection, it is not epidemic in nature. The infection is not transmitted from person to person. This means that there is no need to keep patients in quarantine.

This pathology is more common among women. Men are less often affected by the disease. Most patients are over 40-50 years old and overweight, many are diagnosed with diabetes or prediabetes, when any wound heals very hard, maintaining the risk of infection for a long time.

By the way, in the case of long-term non-healing wounds, as in the case of diabetes, not one, but several types of pathogenic microorganisms may be found in the wound, which complicates the course of the disease and requires the use of broad-spectrum antimicrobial agents.

Erysipelas is a pathology that not only negatively affects a person's appearance, causing certain psychological discomfort, but is also dangerous due to its complications. In the area of erysipelas, pus and areas of tissue necrosis can form, which is dangerous due to the development of sepsis (blood poisoning). In the area of inflammation, there is severe swelling, the tissues are tightly compressed, lymph flow and limb mobility are impaired (elephantiasis). Chronic forms of the pathology in some cases even became the cause of a serious decrease in performance, and the person became disabled.

Treatment of erysipelas with antibiotics

Mankind has not yet come up with a more effective way to combat bacterial infection than using antimicrobial agents. Let's say that antibiotics were once developed for this very purpose, and their active use in erysipelas, which is an infectious pathology, is quite logical.

Yes, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids (GCS) can cope with inflammation, but they will not be able to prevent relapses of the disease, since they do not have sufficient antibacterial activity.

The fact that erysipelas is caused by such a common bacterium as streptococcus makes the task of treating this pathology much easier, since almost all antibiotics are active against this pathogen: from good old penicillins to the latest achievements of the pharmaceutical industry in the field of antibacterial agents.

The problem, as in many other cases, is the development of antibiotic resistance in pathogenic microorganisms due to uncontrolled use of antibiotics prescribed by a doctor and without it, as well as the emergence of new resistant strains of long-known bacteria due to mutations. This state of affairs leads to the fact that among the many antibiotics it is not always possible to find the one whose effect will be detrimental to the pathogen.

Previously, erysipelas could be effectively treated with natural and semi-synthetic penicillins or cephalosporins, which cope well with streptococcal infections. However, beta-lactam antibiotics do not cope with newly emerging strains that produce a special enzyme, beta-lactamase, which destroys the antimicrobial drug.

The modern approach to the treatment of erysipelas involves the use of protected penicillins and combination cephalosporins, in which the integrity of the beta-lactam antibiotic is protected by a special component (most often clavulanic acid).

Doctors have no doubt that erysipelas develops under the influence of streptococcal bacteria. However, quite often other pathogens join this pathogen, so doctors prefer broad-spectrum antibiotics. Especially when it comes to erysipelas developing against the background of diabetes mellitus or bullous inflammation with the formation of multiple bubbles. The presence of pus in the wound may also indicate a rich bacterial composition of the lesion.

Today, despite the development of new effective groups of antibiotics, many doctors still consider penicillin antimicrobials to be the best antibiotic for erysipelas. Among the penicillin antibiotics, penicillin, amoxicillin, ampicillin in combination with clavulanic acid and oxacillin are popular.

The cephalosporin series of antibiotics used for erysipelas is represented by cephalexin, cephradine and antibiotics of later generations at the discretion of the attending physician. The resistance of the antibiotic to the causative agent of the disease can be determined using bacterial analysis, which will make the treatment more effective.

However, such effective antibiotics against streptococci as penicillins and cephalosporins (including beta-lactamase-resistant drugs) have one significant drawback - they very often cause severe intolerance reactions, which means they are not suitable for everyone. In this case, doctors have to look for effective drugs among other groups of antibiotics: macrolides (azithromycin, olethetrin, oleandomycin, etc.), sulfonamides (syntomycin), carbapenems (imipenem), nitrofurans, tetracyclines, etc. Additionally, lincosamides, such as clindamycin, which reduces the toxic effect of streptococcal bacteria, can be included in the therapeutic regimen.

Sometimes doctors resort to the help of combined antibiotics (for example, olethetrin, which is a combination of tetracyclines and macrolides) and antibiotics of new previously unknown groups (daptomycin, oxazolidones: linezolid, amizolid, zenix, zyvox, raulin-routec). Fluoroquinolones are not used in case of erysipelas, because this group of antibiotics is used mainly in severe cases of purulent infections.

Antibiotics for erysipelas can be intended for systemic (tablets and injections) and local (mainly creams and ointments) use, after all, we are talking about a disease of the skin and underlying soft tissues. Among the effective local antimicrobial agents, tetracycline, erythromycin and syntomycin ointments can be named.

It should be said right away that the choice of an effective drug is made by the doctor regardless of the localization of the pathological process, i.e. in case of erysipelas of the arm, leg, shin alone or face, including mucous membranes, the same antibiotics can be used. It is important that the antibiotic chosen by the doctor can cope with the streptococcal infection that caused the inflammation of soft tissues, and other pathogenic microorganisms that could enter the body through a wound on the body.

The answer to the question of whether antibiotics can be changed for erysipelas is affirmative. Antimicrobial drugs are replaced if the antibiotic used does not give a positive result or if a bacterial analysis shows the presence of resistance of the pathogen to the previously prescribed drug.

Indications for use

Indications for the use of specific antimicrobial drugs may be:

• an accurate diagnosis of erysipelas - an infectious pathology, the effective treatment of which is possible only with the help of antibiotics,
• ineffectiveness of disease treatment with popular antimicrobial agents.

Names and descriptions of systemic antibiotics used for erysipelas

As the reader has already understood, there are a great many antibiotics that a doctor can prescribe for the treatment of erysipelas. There is no point in describing them all. Readers have already encountered many of these drugs more than once in their lives, because they are prescribed for various infectious pathologies, including popular respiratory pathologies. Let's talk about less popular and new antimicrobial drugs that a doctor can include in antibiotic therapy.

Let's start with antibacterial agents of the cephalosporin series. Unlike the names of popular penicillins, which are heard at every step, the names of effective cephalosporins are not known to everyone. Let's dwell on a couple of the most frequently used drugs for the treatment of erysipelas.

Cephalexin

"Cefalexin" is a semi-synthetic antibiotic from the cephalosporin group, which, unlike most drugs in its group, can be taken orally.

Release form. The medicine is produced in the form of granules, from which a medicinal suspension is prepared. In the pharmacy you can also find capsules for oral administration with the same name.

Pharmacodynamics. The active substance of the drug is cephalexin in the form of monohydrate, which has a bactericidal effect on many strains of bacteria. It has a detrimental effect on most types and strains of streptococci. It is used to treat skin and soft tissues affected by bacterial infection.

Pharmacokinetics. The antibiotic is very quickly and almost completely absorbed in the gastrointestinal tract regardless of food intake and easily penetrates into various physiological environments. The maximum concentration in the blood is detected 1-1.5 hours after taking the drug. It is excreted in the urine unchanged.

Method of administration and dosage. The antibiotic should be taken every day in a dosage of 0.5 to 1 g, depending on the patient's condition. The daily dose should be divided into 2-3 times.

For erysipelas, the drug is prescribed in a dosage of 250 mg (1 capsule) at intervals of 6 hours or 500 mg every 12 hours. In severe cases of the disease, the dosage may be doubled.

Contraindications for use. The antibiotic is not prescribed for hypersensitivity to penicillins and cephalosporins, intolerance to the components of the drug, porphyria, infectious and inflammatory pathologies of the brain.

Use during pregnancy. The drug is approved for use in the treatment of pregnant women only in severe situations, since its effect on fetal development has not been sufficiently studied. Antibiotic therapy during lactation requires the transfer of the baby to artificial feeding.

Side effects. The list of side effects of the drug is quite large. We will list only a few of them. These are changes in blood characteristics, allergic reactions, including anaphylaxis, headaches, fainting, hallucinations, seizures, development of jaundice and hepatitis. Since the drug passes through the gastrointestinal tract, its intake may be accompanied by nausea and vomiting, stool disorders (diarrhea), dyspeptic phenomena, abdominal pain with the development of gastritis, colitis, stomatitis. Symptoms of reversible damage to the kidneys and joints may appear.

Taking antibiotics can cause the development of vaginal candidiasis and be accompanied by itching in the anus and genital area.

Overdose. Taking large doses of the antibiotic can cause nausea, vomiting, stomach pain, diarrhea, and cramps. First aid: gastric lavage and activated carbon. The drug is excreted during hemodialysis.

Interaction with other drugs. It is not advisable to use Cephalexin and bacteriostatic antibiotics at the same time.

The antibiotic may enhance the toxic effect of potentially nephrotoxic drugs when taken together.

"Probenecid" increases the half-life of "Cephalexin". "Cephalexin" itself leads to the accumulation of metformin in the body.

The drug, as a representative of the cephalosporin series, reduces the effectiveness of oral contraceptives.

Storage conditions. It is recommended to store the antibiotic in its original packaging at room temperature, protecting it from direct sunlight. Keep out of the reach of children.

Shelf life. The medicine can be stored for 3 years, the prepared suspension can only be used for 2 weeks.

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Cephradine

The antibiotic "Cefradine" is also considered a cephalosporin drug with bactericidal action. It is effective in infectious diseases of the skin and underlying tissues, including erysipelas. It is resistant to most beta-lactamases.

It is one of the few cephalosporins that can be taken orally. However, it is available in injection and infusion forms.

The antibiotic in tablet form is prescribed in a daily dose of 1-2 g, divided into 2-4 doses. The maximum permissible daily dose is 4 g. The dose for treating small patients is calculated based on the ratio: 25-50 mg of the drug for each kilogram of weight. It is recommended to divide the daily dose into 2 doses.

Intramuscular and intravenous infusion of antibacterial solution is performed four times during the day. A single dosage can range from 500 mg to 1 g (no more than 8 g per day).

Contraindications to the use of the antibiotic are primarily considered to be a negative reaction of the body to cephalosporin and penicillin drugs. The use of the drug during pregnancy and lactation is prohibited.

Caution should be exercised when prescribing the drug to newborns, patients with severe liver and kidney dysfunction, and enterocolitis.

Possible side effects: allergic reactions (both superficial and severe), headache and dizziness, renal dysfunction, stomach upset, signs of dysbacteriosis and candidiasis, liver problems, stomatitis, changes in blood characteristics. When administered by injection, irritation reactions and swelling at the injection site are possible.

The prescription and use of antibiotics should be carried out taking into account drug interactions with other drugs. Joint prescription with bactericidal antibiotics is possible, but not with bacteriostatic ones due to a decrease in the effectiveness of antibiotic therapy.

Combined use with diuretics, vincomycin and clindomycin increases the toxic effect of Cephradine on the kidneys. We have an identical situation with the simultaneous use of the described antibiotic and antibacterial agents from the aminoglycoside group.

The drug is incompatible with ethanol.

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Imipenem

Let's also pay attention to an antimicrobial drug from the carbapenem group, which are also considered beta-lactam antibiotics, but they are considered more resistant to specific enzymes produced by streptococcal bacteria. We are talking about a drug called "Imipenem".

This effective antimicrobial drug, which is credited with bactericidal action, is produced in the form of a powder for the preparation of a solution, which is immediately used for intravenous and intramuscular administration.

The drug acts quickly. The maximum concentration of the antibiotic in the blood is noted after 15-20 minutes. The drug maintains its effect for 5 hours after entering the body.

Antibiotic use: The solution can be used for both intramuscular injections and drips. The latter is practiced only in severe cases complicated by sepsis.

Deep intramuscular injections are allowed for adults and young patients, starting from 12 years of age. The daily dose ranges from 1000 to 1500 mg. It is recommended to give injections twice a day.

The daily dosage for intravenous administration ranges from 1000 to 4000 mg maximum. Droppers should be administered every 6 hours. For children under 12 years and over 3 months, the dosage is calculated based on the ratio: 60 mg for each kilogram of the child's weight.

Contraindications for use. The drug is not prescribed to patients who have had hypersensitivity reactions to any type of beta-lactam antibiotics. It is dangerous to prescribe infusions or injections to children who have been diagnosed with renal failure.

The use of the antibiotic during pregnancy is not prohibited for acute indications when there is a danger to the mother's life. Breastfeeding during treatment with the drug is unacceptable.

The side effects of the drug are similar to those of Cephradine, but in some cases additional seizures similar to epileptic seizures and muscle cramps were noted.

Interaction with other drugs. Increased seizure activity is observed if Imipenem is taken together with drugs such as Cilastatin or Ganciclovir.

Oxacillin

Let's return to the well-known penicillins. The new generation of these antibiotics, effective against erysipelas, is distinguished by increased resistance to bacterial beta-lactamases, which is an obstacle to the development of antibiotic resistance. One of these drugs is "Oxacillin".

The antibiotic has a pronounced antimicrobial effect against most pathogens of erysipelas of the streptococcal and other groups.

The antimicrobial preparation in the form of a lyophilisate is intended for the preparation of a solution, which is then used for intramuscular injections or intravenous drips. The medicine for injections is diluted with water for injections (3 g per bottle of antibiotic). Intramuscular injections should be made in the area of the inner quadrant of the buttock.

For intravenous injections, water for injection or saline (5 ml) is added to lyophysilate at a dose of 0.25-0.5 g. The injection is done slowly, over 10 minutes.

Infusion administration involves dissolving lyofisilate in saline or glucose solution. The drip is placed for 1-2 hours.

A single dose of the drug when administered by injection ranges from 0.25 mg to 1 g. Injections are recommended to be done every 6 hours.

The course of treatment usually lasts 1-3 weeks or more.

With prolonged administration of large doses of the drug, an overdose may occur, which is accompanied by bleeding and the development of dangerous superinfections. Kidney function may also be impaired due to the toxic effect of the antibiotic.

Restrictions on use: "Oxacillin" is not used to treat patients with hypersensitivity to beta-lactam antibiotics, as well as with a tendency to allergies.

Side effects of the drug may manifest themselves in the form of allergic reactions, including anaphylaxis and bronchospasm. In this case, the therapy is supplemented with antihistamines.

While taking the medicine, nausea and vomiting, bowel disturbances, liver and kidney problems, development of candidiasis of the skin and mucous membranes, pseudomembranous colitis, etc. may be observed.

Drug interactions: Oxacillin belongs to the category of bactericidal antibiotics, which means that bacteriostatic antimicrobial agents can reduce its effectiveness.

Use with Probenecid may provoke an increase in serum concentrations of the antibiotic, which has a negative effect on the kidneys.

To expand the spectrum of action of Oxacillin, it is advisable to combine it with such penicillin-type AMPs as Ampicillin and Benzylpenicillin.

Storage conditions. The optimal temperature is 15-25 degrees. Dry, darkened rooms are suitable for storing the medicine. Keep out of reach of children.

Shelf life: When stored properly, the medicine remains effective and relatively safe for 2 years.

Clindomycin

According to the annotation to the drug from the lincosamide group called "Clindomycin", this antibiotic can also be successfully used in the treatment of erysipelas.

Pharmacodynamics. This antimicrobial and antiprotozoal agent has a bacteriostatic effect in small concentrations, i.e. it inhibits the growth and reproduction of bacteria, but an increase in the concentration of the antibiotic leads to the rapid death of bacteria (bactericidal effect).

Pharmacokinetics. Rapidly passes into the blood when taken orally, but food intake may slow this process down somewhat. Easily spreads through various fluids and tissues of the body, including exudate from wound surfaces. Kidneys and intestines are involved in the elimination of the drug from the body.

The drug can be found on pharmacy shelves in the form of tablets (capsules) for internal use, injection solution, vaginal tablets, and gel for external use.

Application of the medicine: Antibiotic capsules are taken between meals with a glass of water, which will help protect the gastric mucosa from irritation. The daily dosage for adults ranges from 4 to 12 capsules depending on the severity of the infection. The frequency of taking the drug is 3-4 times a day.

For children over 6 years old, the dose is calculated based on the ratio: 8-25 mg per kilogram of the child's weight. For younger children, the drug is administered by injection.

To increase the effectiveness of antibiotic therapy, it is recommended to combine this antimicrobial drug with penicillin drugs. In this case, the dose will be lower, and therefore the toxic effect of the drug will be lower.

Contraindications for use. Systemic use of the antibiotic is prohibited in case of intolerance to the drug, hypersensitivity to lincomycin, infectious meningitis, regional enteritis, ulcerative colitis, intestinal inflammation against the background of antibiotic therapy. Myasthenia, severe liver and kidney disorders. In pediatrics, it is used from 1 month.

Possibilities of use during pregnancy: Despite the fact that "Clindamycin" is able to penetrate the placenta and accumulate in the liver of the fetus, no negative impact on the developing organism or the course of pregnancy has been detected. For this reason, the antibiotic can be used during pregnancy according to the doctor's instructions. But it is better to avoid breastfeeding.

Side effects. Taking the drug may cause changes in the blood composition. Rapid intravenous administration of the drug is undesirable, as it may cause symptoms of heart failure, development of collapse and arterial hypotension.

Oral administration of the drug may be accompanied by pain in the epigastrium, development of colitis, nausea, and bowel disorders. Liver and kidney dysfunctions are sometimes observed. A metallic taste appears in the mouth.

Allergic reactions are usually mild to moderate. Anaphylaxis may develop only in case of hypersensitivity to the drug.

Interaction with other drugs. Incompatibility of "Clindamycin" is noted with such groups of drugs as aminoglycosides and barbiturates. The antibiotic cannot be mixed with solutions containing B vitamins. This antibiotic is also incompatible with drugs based on ampicillin, phenytoin, aminophylline, calcium gluconate and magnesium sulfate.

When used in combination with erythromycin and chloramphenicol, drug antagonism is suspected, which negates therapy.

Caution should be exercised when taking antibiotics simultaneously with muscle relaxants due to the risk of impaired neuromuscular conduction.

Opioid analgesics taken during antibiotic therapy with Clindamycin can greatly reduce respiratory function and cause apnea.

The combined use of antibiotics and antidiarrheal medications may trigger the development of pseudomembranous colitis.

Storage conditions. The antibiotic can be stored at room temperature, protected from direct sunlight and children.

The manufacturer guarantees that if the drug is stored according to the storage requirements, it will retain its antibacterial properties for 3 years.

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Oletetrin

Another antibiotic with a bacteriostatic effect, which has found application in the treatment of erysipelas, is called "Oletetrin". This drug does not belong to a specific group of antibiotics, as it is a combination of the macrolide oleandomycin and tetracycline, which helps to reduce the rate of development of antibiotic resistance to the drug.

The drug is available in the form of tablets of various dosages (125 and 250 mg).

Method of administration and dosage. It is recommended to take the antibiotic after meals to reduce the irritating effect of the tablets on the gastrointestinal mucosa. For the same reason, it is recommended to drink the medicine with a sufficient amount of liquid.

A single dose for adults is 250 mg. The frequency of administration is 4 times a day. For children over 8 years old, an effective and safe single dose is calculated based on the ratio: 5-7 mg per kilogram of the patient's weight with the same frequency of administration. The course of treatment is usually 1-1.5 weeks.

Contraindications for use. "Oletetrin" should not be prescribed to patients who have increased sensitivity to the components of the drug, those who suffer from leukopenia or mycosis. It is dangerous to prescribe this antibiotic to patients with severe liver and kidney dysfunction.

In pediatrics, the drug is used from the age of 8 years.

Use during pregnancy and lactation is not allowed.

Side effects. Taking the tablets in different patients may be accompanied by problems with the gastrointestinal tract in the form of loss of appetite, nausea with vomiting, stool disorders, pain in the epigastrium. There have also been reports of cases of inflammation in the tissues of the tongue (glossitis) and allergic reactions. There is a possibility of uterine bleeding when taking oral contraceptives.

May affect the color of children's teeth, which has irreversible consequences.

If the drug is taken for a long time, the internal microflora may be disrupted and thrush may develop. Long-term antibiotic therapy may lead to a deficiency of B vitamins in the body or increased photosensitivity.

Interaction with other drugs. Acid-reducing agents, drugs that contain iron, and dairy products hinder the absorption of this antimicrobial substance in the digestive tract.

An antibiotic with a bacteriostatic effect cannot be used together with bactericidal ones, as this will reduce the effectiveness of antibiotic therapy.

"Oletetrin" should not be taken together with retinol. This can provoke a strong increase in intracranial pressure. Parallel administration with methoxyflurane contributes to an increase in the toxic effect of the latter on the body, which affects the functioning of the kidneys.

Storage conditions. The optimal temperature for storing the antibiotic is from 15 to 25 degrees. In such conditions, it retains its properties for up to 2 years from the date of production.

It is time to talk about the latest developments in the pharmaceutical industry, which doctors are beginning to actively include in the treatment of erysipelas along with old drugs. It is important to understand that new generations and varieties of antibiotics that are effective in erysipelas and other infectious lesions of the skin and muscles were developed taking into account mutational changes in the environment of pathogenic microorganisms, which caused the emergence of new strains of bacteria resistant to many antimicrobial drugs. It is not for nothing that doctors give preference to innovative developments, because they are effective even where other antibiotics do not give results due to the development of antibiotic resistance.

Linezolid

So, "Linezolid" is a synthetic drug from a new group of antibiotics (oxazolidones) with a unique mechanism of action (pharmacodynamics), which has not yet been fully studied. It is only known that linezolid is capable of disrupting protein synthesis. It binds to bacterial ribosomes and disrupts the formation of a complex responsible for the translation of genetic material to future generations. Cross-resistance of the antibiotic, which is currently the only representative of oxazolidones, with other antibiotics is not observed due to the fact that their mechanism of action is different from others.

The drug is actively used in severe infectious processes on the skin and in soft tissues. The only drawback of the drug is its high cost.

Pharmacokinetics. The drug is characterized by almost 100 percent bioavailability even when taken in tablets, which is quite rare. The drug can easily penetrate into various tissues of the body, with the exception of white adipose tissue and bones. Metabolized in the liver. Excreted mainly by the kidneys.

Release form. The medicine can be found on sale in the form of a solution used for infusions and tablets weighing 600 mg.

Method of administration and dosage. The antibiotic is administered intravenously by infusion twice a day, with an interval of 12 hours in adults and 8 hours in children. The infusion should last from half an hour to 2 hours.

A single dose for patients over 12 years of age is 600 mg of linozolid (300 ml of solution), for children under 12 years of age it is calculated as 10 mg for each kilogram of the child's weight.

The therapeutic course is from 10 to 14 days. But as soon as the patient feels better, he is transferred to oral administration of the drug in the same dosage.

Contraindications for use. The infusion solution is used to treat children from 5 years of age, tablets - from 12 years of age. Droppers are not prescribed in case of intolerance to the components of the drug.

The use of tablets is limited in cases of uncontrolled hypertension, pheochromocytoma, carcinoid, thyrotoxicosis, bipolar disorder, schizophrenia and affective disorders, acute attacks of dizziness.

Use during pregnancy. The drug has not been studied much yet, but there are reasons to consider it potentially dangerous for the fetus and newborns. This means that therapy with the drug is not recommended during pregnancy and breastfeeding.

Side effects. The most common of the unpleasant symptoms observed during antibiotic treatment are headaches, nausea with vomiting, diarrhea, development of fungal infections, the appearance of a metallic taste in the mouth, liver dysfunction, changes in blood characteristics. Rarely, cases of development of various types of neuropathies have been noted.

Interaction with other drugs. This innovative antibiotic can be classified as a weak MAO inhibitor, so it is not advisable to use it together with drugs that have a similar effect.

"Linezolid" in the form of a solution for droppers can be mixed with the following compositions:

• 5% glucose solution,
• saline solution,
• Ringer's solution.

Do not mix Linezolid and any other medications other than those listed above in the same infusion container.

Antagonism may occur if Linezolid is taken at the same time as the following drugs:

• ceftriaxone,
• amphotericin,
• chlorpromazine,
• diazepam,
• trimethoprim-sulfamethoxazole.

The same applies to pentamidine, phenytoin, erythromycin.

Storage conditions: Store the antimicrobial agent in a dry place without access to sunlight at room temperature.

The shelf life of the drug, regardless of the form of release, is 2 years.

Cubicin

Another completely new antimicrobial drug that can be successfully used in the treatment of severe erysipelas has an active substance called daptomycin. On the market, an antibiotic from the group of cyclic lipopeptides of natural origin can be found under the name "Kubitsin".

Release form. The medicine is produced in the form of a lyophilisate, from which an infusion solution is prepared (350 or 500 mg vials).

Pharmacodynamics. This antibiotic is appropriate to use to combat gram-positive microorganisms. It has a rapid bactericidal effect, which allows normalizing the patient's condition in a short time.

Pharmacokinetics. It is distributed fairly quickly and well within tissues richly supplied with blood vessels. It can penetrate the placenta. It is excreted mainly by the kidneys.

Method of administration and dosage. The drug is intended for use in droppers. It should be administered for at least half an hour. The daily (single) dose of the drug for adult patients is calculated as 4 mg per kilogram of weight. The course of treatment is 1-2 weeks.

Overdose. When administering large doses of the drug, side effects may increase. Treatment is symptomatic. The antibiotic can be removed from the body using hemodialysis or peritoneal dialysis.

Contraindications for use. The main contraindication to therapy with the drug is hypersensitivity to its components. Caution should be exercised when prescribing the antibiotic to patients with severe renal or hepatic impairment, obesity, and people over 65 years of age.

Side effects. Taking the drug may provoke the development of superinfections: fungal pathologies and UTIs. Also, sometimes changes in the blood composition, metabolic disorders, anxiety and sleep deterioration, headaches and dizziness, deterioration of taste perception, numbness of the extremities, increased pulse are noted. Some patients complain of facial flushing, gastrointestinal, kidney and liver disorders, itching and rash on the skin, myalgia, hyperthermia, weakness.

Interaction with other drugs. The drug should be prescribed with special caution if the patient is undergoing treatment with drugs that can cause myopathy or potentially nephrotoxic drugs.

It is possible to use daptomycin in combination with such drugs as aztreonam, ceftazidime, ceftriaxone, gentamicin, fluconazole, levofloxacin, dopamine, heparin, lidocaine.

Storage conditions. The infusion solution should be stored in a cool place at a temperature of 2 to 8 degrees.

Expiry date: Use within 3 years.

One of the dangerous consequences of systemic antibiotic therapy is the development of dysbacteriosis, because antimicrobial drugs do not have a selective effect, which means that they destroy the beneficial microflora along with the pathogenic microflora. You can prevent the development of dysbacteriosis in the body by taking drugs that restore beneficial microflora and the body's protective functions in parallel with them from the first days of antibiotic treatment.

Local antibiotic therapy for erysipelas

So far we have talked about systemic drugs that prevent the spread of infection within the body. However, erysipelas has specific external manifestations in the form of severe redness and swelling of the skin, which means that in this case you cannot do without external agents with an antibacterial effect.

Antibiotics for local therapy in erysipelas are not unique. Most often, erythromycin, syntomycin and tetracycline ointments are prescribed, which have a fairly wide range of applications in various skin pathologies.

Erythromycin ointment

Erythromycin ointment is a local antibiotic with bacteriostatic action, which has long been used to treat acne and pimples. However, it also shows good efficiency in the treatment of other inflammatory pathologies of the skin and soft tissues caused by a bacterial infection.

The medicine in the form of an ointment can only be used externally. It should be applied to the inflamed tissues 2 to 3 times a day in a thin layer. The course of local antibiotic therapy will be at least 1.5 months.

Increasing the dose or frequency of application of the ointment may lead to greater severity of side effects.

The only contraindication to the use of the ointment is hypersensitivity to its composition. Since the active substance of the ointment is able to penetrate deep into the tissues of the body, including the placenta, it should be used during pregnancy only according to strict indications. Doctors advise stopping breastfeeding during treatment.

Redness, burning, peeling and itching may occur at the site of application of the ointment. Skin rash and mild allergic reactions may occur.

Drug interactions: Erythromycin is incompatible with antimicrobial agents such as lincomycin, clindamycin and chloramphenicol. It may reduce the effectiveness of bactericidal drugs.

When treating the skin with erythromycin ointment, abrasive agents should not be used.

The ointment should be stored at temperatures above zero, but not more than 20 degrees. Erythromycin ointment can be used for 3 years from the date of manufacture.

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Tetracycline ointment 3%

"Tetracycline" 3% - an antibiotic ointment used for erysipelas and other skin pathologies caused by an infectious factor. It is another drug with a broad spectrum of antibacterial activity with a bacteriostatic effect.

Unlike erythromycin ointment, tetracycline as an external agent is practically not absorbed into intact skin and does not enter the systemic bloodstream, which makes it safe to use during pregnancy and lactation.

Limitations to the use of antibiotic ointment include hypersensitivity to the components of the drug and age under 11 years.

It is used only for local treatment of the skin. It should be applied to the affected tissues 1 or 2 times a day in a thin layer. It is permissible to apply a sterile bandage on top.

They appear mainly at the site of application of the ointment. Redness, burning, swelling or itching on the skin covered with the ointment are quite possible.

The external agent in the form of an ointment is stored at room temperature for no more than 3 years from the date of manufacture.

Another effective external remedy for erysipelas is a chloramphenicol-based liniment for local application called "Synthomycin". Most often, doctors prescribe a 10% ointment with an antibiotic.

The active ingredient of the ointment, chloramphenicol, is a bacteriostatic antibiotic, active against strains that have developed resistance to penicillins and tetracyclines during the course of evolution.

The liniment can be applied either directly to the wound or under a bandage once every 1-3 days.

Contraindications to the use of the ointment include hypersensitivity to its components, porphyrin disease, which occurs with a violation of pigment metabolism, fungal skin lesions. Do not use on skin with signs of eczema and psoriasis. Caution should be exercised when prescribing the ointment to patients with impaired renal or hepatic function, diagnosed with a deficiency of glucose-6-phosphate dehydrogenase, and to newborns.

Doctors do not recommend using external chloramphenicol-based products during pregnancy and breastfeeding.

Therapy with syntomycin ointment may be accompanied by allergic reactions, as well as changes in the composition of the blood.

Drug interactions: Chloramphenicol can reduce the antibacterial effect of some drugs (penicillins, cephalosporins).

The instructions do not recommend the simultaneous use of this antibiotic with macrolides and lincosamides (clindamycin, lincomycin, erythromycin).

Manufacturers recommend storing the ointment at a temperature not exceeding 20 degrees. The drug can be used for 2 years.

According to doctors, antibiotics for erysipelas should be used only in the active infection phase. Preference is usually given to penicillin antimicrobial drugs. However, the main condition for effective antibiotic therapy was and remains the correspondence of the antibiotic chosen by the doctor to the pathogen detected in the body. Otherwise, the treatment will not have a positive result, but will only contribute to the already urgent problem of antibiotic resistance.