Antibiotics for erysipelas, legs, hands, face

Probably, the reader more than once had to meet people on the street with inflamed swollen purple spots on the skin of the face, hands or feet. This disease is called erysipelas because of the skin's intense pink color. The appearance of a bright spot indicates that the affected tissues are highly inflamed, and the cause of this condition is the infection that has penetrated the tissue through a small wound. And since any bacterial infection is treated only with the help of antimicrobial agents, antibiotics for erysipelas are the basis of therapy.

What is erysipelas?

Erysipelas is a disease of soft tissues caused by ingestion of a bacterial pathogen through the damaged skin. The causative agent of this pathology is considered to be group A streptococci, which secretes enzymes and toxins that promote 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. Foci of inflammation in most cases can be seen on the hands and feet of patients, as well as in the face where the inflammation gradually passes to the mucous membranes and skin around the neck. Stop the further spread of the process with erysipelas and prevent recurrences of the disease, which are quite possible in chronic course (there are cases when relapses occurred up to 6 times a year), antibiotics of various groups help.

Despite the fact that the disease is caused by a bacterial infection, it does not have an epidemic nature. Infection is not transmitted from person to person. So, the maintenance of patients in quarantine conditions is not required.

This pathology is more common in the female environment. Men are less likely to get sick. Most patients are over 40-50 years old and overweight, many have diabetes mellitus or pre-diabetic condition, when any wound heals very hard, keeping the risk of infection for a long time.

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

The erysipelas is such a pathology that not only negatively affects the appearance of a person, causing a certain psychological discomfort, but is also dangerous with its complications. In the erysipelas, pus and tissue necrosis can be formed, which is dangerous for the development of sepsis (blood poisoning). In the field of inflammation there is a strong edema, the tissues are tightly compressed, lymph flow and limb mobility (elephantia) are disturbed. Chronic forms of pathology in some cases became even the cause of a serious decline in performance, and a person became disabled.

Treatment of erysipelas with antibiotics

Humanity has not yet come up with a more effective way to combat bacterial infection than the use of antimicrobial agents. Let's just say, antibiotics were developed for this purpose in due time, and their active use in erysipelas, which is an infectious pathology, is quite logical.

Yes, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids (SCS) can also cope with inflammation, but they can not prevent recurrence of the disease, since they do not have sufficient antibacterial activity.

The fact that the erysipelas is caused by such a common bacterium as streptococcus greatly facilitates the task of treating this pathology, because in fact all antibiotics are active against this pathogen: from old kind penicillins and ending with the latest achievements of the pharmacological industry in the field of antibacterial agents.

The problem, as in many other cases, is the development of antibiotic resistance of pathogenic microorganisms due to uncontrolled intake of antibiotics according to the doctor's prescription and without it, and the emergence of mutant new resistant strains of long-known bacteria. This situation leads to the fact that among the many antibiotics it is not always possible to find the one whose action will be disastrous in relation to the causative agent of the disease.

Earlier erysipelas can be effectively treated with natural and semisynthetic penicillins or cephalosporins, which perfectly cope with streptococcal infection. However, beta-lactam antibiotics do not cope with the new strains that produce a special enzyme beta-lactamase, which destroys the antimicrobial drug.

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

The fact that erysipelas develops under the influence of bacteria of the streptococcal group does not cause doctors doubts. However, quite often other pathogens join this pathogen, so physicians prefer antibiotics of a wide spectrum of action. Especially when it comes to the erysipelas, developing against a background of diabetes mellitus or bullous form of inflammation with the formation of multiple vesicles. The presence of pus in the wound can also indicate a rich bacterial composition of the lesion.

To date, despite the development of new effective groups of antibiotics, many doctors still consider antimicrobial preparations of the penicillin line to be the best antibiotic for erysipelas. Among penicillin antibiotics penicillin, amoxicillin, ampicillin in combination with clavuonic acid and oxacillin are popular.

The cephalosporin series of antibiotics used for erysipelas is represented by cephalexin, cephradin and antibiotics of later generations, at the choice of the treating physician. The resistance of the antibiotic to the causative agent of the disease can be established with the help of bacterial analysis, which will make the treatment more effective.

True, antibiotics such as penicillins and cephalosporins (including beta-lactamase-resistant drugs) are effective in treating streptococci, they often cause severe reactions of intolerance, which means that they are not suitable for everyone. In this case, doctors need to look for effective drugs among other groups of antibiotics: macrolides (azithromycin, oletetrine, oleandomycin, etc.), sulfonamides (synthomycin), carbapenems (imipenem), nitrofurans, tetracyclines, etc. Additionally, the therapeutic regimen may include lincosamides, for example, clindomycin, which reduces the toxic effect of bacteria in the streptococcal group.

Sometimes doctors resort to the help of combined ani- biotics (for example, oletetrin, a combination of tetracyclines and macrolides) and antibiotics of new previously unknown groups (daptomycin, oxazolidones: linezolid, amisolide, zenix, zyvox, raulin routec). To help fluoroquinolones in the case of erysipelas do not resort, because this group of antibiotics is used mainly in severe cases of purulent infections.

Antibiotics for erysipelas can be used for systemic (tablets and nyxes) and for local (mostly creams and ointments) applications, yet it is a case of skin disease and underlying soft tissues. Among the effective local antimicrobial agents are tetracycline, erythromycin and sintomycin ointment.

It should immediately be said that the choice of an effective drug is performed by a physician, regardless of the localization of the pathological process, i.e. With erysipelas, hands, feet, only the lower leg or face, including mucous membranes, the same antibiotics can be used. It is important that the antibiotic chosen by the doctor can cope with streptococcal infection that caused inflammation of soft tissues, and other pathogenic microorganisms that could enter the body through the wound on the body.

When asked whether antibiotics can be changed with erysipelas, the answer will be yes. Replacement of antimicrobials is carried out if the antibiotic used does not give a positive result, or bacterial analysis indicates the presence of resistance of the pathogen to the previously prescribed drug.

Indications for use

Indications for the use of specific antimicrobial agents may be:

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

Names and description of systemic antibiotics used in erysipelas

As the reader has already realized, antibiotics that a doctor can prescribe for the treatment of erysipelas are a great deal. To describe them all does not make sense. With many drugs, readers have repeatedly faced in their lives, because they are prescribed for various infectious pathologies, including popular respiratory pathologies. Let's talk about the less popular and new antimicrobial drugs that a doctor can include in antibiotic therapy.

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

Cephalexin

"Cephalexin" is a semisynthetic antibiotic from the group of cephalosporins, which, unlike most drugs of its group, can be taken orally.

Form of issue. The medicine is produced in the form of granules, from which a therapeutic 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 against many strains of bacteria. It is harmful to most types and strains of streptococci. It is used to treat skin and soft tissues that are affected by a bacterial infection.

Pharmacokinetics. The antibiotic is absorbed very quickly and almost completely in the digestive tract, regardless of the food intake and easily penetrates into various physiological environments. The maximum concentration in the blood is detected after 1-1,5 hours after taking the medicine. It is excreted unchanged in urine.

Method of administration and dose. 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 2-3 times.

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

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

Use during pregnancy. The drug is allowed for use in the therapy of pregnant women only in difficult situations, because its influence on the development of the fetus 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 large enough. Here are just a few of them. These changes in the characteristics of blood, allergic reactions, including anaphylaxis, headaches, fainting, hallucinations, convulsions, the development of jaundice and hepatitis. As the drug passes through the gastrointestinal tract, its reception can be accompanied by nausea and vomiting, a violation of the stool (diarrhea), dyspeptic symptoms, abdominal pain with the development of gastritis, colitis, stomatitis. Symptoms of reversible lesions of the kidneys and joints may appear.

Taking an antibiotic can cause the development of candidiasis of the vagina and is accompanied by itching in the anus and genital area.

Overdose. Taking large doses of antibiotic can cause nausea, vomiting, stomach pain, diarrhea, convulsions. First aid: washing the stomach and taking activated charcoal. The drug is excreted during hemodialysis.

Interaction with other drugs. It is undesirable to simultaneously use "Tsefalexin" and bacteriostatic antibiotics.

An antibiotic can enhance the toxic effect of potentially nephrotoxic drugs when taken together.

Probenecid increases the half-life of Cephalexin. The very same "Tsefaleksin" leads to the accumulation in the body of metmorphine.

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

Storage conditions. Store antibiotic is recommended in native packaging at room temperature, protecting from direct sunlight. Do not allow children to fall into the hands.

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

[1], [2], [3], [4]

Cefradine

The antibiotic "Cephadine" is also considered a preparation of a cephalosporin group with a bactericidal action. It is effective in infectious diseases of the skin and underlying tissues, including erysipelas. It shows resistance to most beta-lactamases.

This is one of the few cephalosporins that can be taken orally. However, it has release forms that can be used for injections and infusion.

Antibiotic in the form of tablets prescribed in a daily dose of 1-2 g, divided into 2-4 admission. The maximum allowable daily dosage is 4 g. The dose for the treatment of small patients is calculated based on the ratio: 25-50 mg of the drug per kilogram of weight. The daily dose is recommended to be divided by 2 times.

In / m and IV infusion of antibacterial solution is carried out four times during the day. Single dosage can range from 500 mg to 1 g (not more than 8 g per day).

Contraindication to the use of antibiotic in the first place is considered a negative reaction of the body to drugs cephalosporin and penicillin series. Use the drug during pregnancy and lactation is prohibited.

Caution should be observed when prescribing medication to newborn babies, patients with severe impairment of liver and kidney work, with enterocolitis.

Possible side effects: allergic manifestations (both superficial and severe), headache and dizziness, disruption of the kidney system, indigestion, the appearance of signs of dysbiosis and candidiasis, liver problems, stomatitis, changes in blood characteristics. When injected, irritation and swelling at the injection site are possible.

The purpose and use of the antibiotic should be done taking into account the drug interaction with other drugs. Perhaps a joint appointment with bactericidal antibiotics, but not with bacteriostatic because of a decrease in the effectiveness of antibiotic therapy.

Joint use with diuretics, drugs vincomycin and clindomycin increases the toxic effect on the kidneys of "Cephradin". An identical situation is also present in the simultaneous administration of the antibiotic and antibacterial agents described in the aminoglycoside group.

The drug is incompatible with ethanol.

[5], [6], [7], [8]

Imipenem

We also pay attention to the antimicrobial drug from the group of carbapenems, which are also considered beta-lactam antibiotics, but they are considered to be more resistant to the specific bacteria produced by streptococcal bacteria. It's about a drug called Imipenem.

This effective antimicrobial is given to which bactericidal action is attributed, in the form of a powder for the preparation of a solution, which is immediately used for intravenous and intramuscular administration.

The drug works quickly. The maximum concentration of antibiotic in the blood is noted after 15-20 minutes. The drug retains its action within 5 hours after ingestion.

Use of antibiotic: The solution can be used for both intravenous injections and for droppers. The latter is practiced only in severe cases, complicated by sepsis.

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

The daily dosage for intravenous administration ranges from 1000 to 4000 mg as much as possible. Droppers should be placed every 6 hours. For children younger than 12 years and older than 3 months, the dose is calculated. Based on the ratio: 60 mg per kilogram of the weight of the child.

Contraindications. The drug is not prescribed to patients who have had hypersensitivity reactions to any kind of beta-lactam antibiotics. It is dangerous to prescribe infusions or injections to children who are diagnosed with kidney failure.

It is not forbidden to use antibiotic during pregnancy on acute indications in case of danger to mother's life. Breastfeeding during treatment with the drug is unacceptable.

Side effects of the drug are similar to "Tsefradin", only in some cases there were additional seizures similar to epileptic, and muscle cramps.

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

Oxacillin

Let us return to the penicillins known long ago. A new generation of these antibiotic-effective antibodies to erysipelas is characterized by increased resistance to bacterial beta-lactamases, which is an obstacle to the development of antibiotic resistance. One of these drugs is "Oxacillin".

Antibiotic has a pronounced antimicrobial effect in relation to most pathogens of erysipelas of streptococcal and other groups.

Antimicrobial preparation in the form of lyophilizate is intended for the preparation of a solution, which is subsequently used for intravenous injections or IV injections. The medicine for injections is diluted with water for injection (3 g per bottle of antibiotic). In / m injections must be made in the region of the inner quadrant of the buttock.

For intravenous injection in lyophilate in a dose of 0.25-0.5 grams, add water for injection or saline (5 ml). The injection is done slowly, for 10 minutes.

Infusion introduction implies the dissolution of lyophilate in saline or glucose solution. A dropper is placed for 1-2 hours.

A single dose of the drug with an injectable administration ranges from 0.25 mg to 1 g. Injections are recommended to be done every 6 hours.

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

With prolonged administration of large doses of the drug, an overdose phenomenon is possible, which is accompanied by bleeding and the development of dangerous superinfections. The kidneys can also be damaged because of 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 as allergic reactions, including anaphylaxis and bronchospasm. In this case, therapy is supplemented with antihistamine drugs.

During medication, nausea may be observed, vomiting, malfunctioning of the liver and kidneys, development of candidiasis of the skin and mucous membranes, pseudomembranous colitis, etc.

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

The use of "Probenecid" can provoke an increase in serum antibiotic concentration, which has a negative impact on the kidneys.

To expand the spectrum of the action of "Oxacillin", it is advisable to combine it with AMP penicillin series such as "Ampicillin" and "Benzylpenicillin".

Storage conditions. The optimum temperature regime is 15-25 degrees. Dry darkened rooms are suitable for storing the medicine. Keep away from children.

Shelf life. With proper storage, the medicine remains effective and relatively safe for 2 years.

Clindomycin

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

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

Pharmacokinetics. Quickly passes into the blood with oral administration, but eating can slow down this process somewhat. Easily spreads through various fluids and body tissues, including exudate wound surfaces. The excretion of the drug from the body involved kidneys and intestines.

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

Application of the medicine: Antibiotic capsules are taken between meals, washed down with a glass of water, which will help protect the stomach mucosa from irritation. The daily dosage for adults varies 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 from 6 years, the dose is calculated based on the ratio: 8-25 mg per kilogram of the child's weight. Young children receive the drug injectively.

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

Contraindications. Systemic use of the antibiotic is prohibited when the drug is intolerant, hypersensitivity to lincomycin, infectious meningitis, regional enteritis, ulcerative colitis, inflammation of the intestine against antibiotic therapy. Myasthenia gravis, severe liver and kidney disorders. In pediatrics it is applied from 1 month.

Potential for use during pregnancy: Despite the fact that Clindamycin is able to penetrate the placenta and accumulate in the liver of the fetus, it has not been shown to have a negative effect on the developing organism or the course of pregnancy. For this reason, the antibiotic according to the doctor's indications can be used during pregnancy. But from breastfeeding it is better to be.

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

The oral administration of the medication may be accompanied by pain in the epigastrium, the development of colitis, nausea with stool disorders. Sometimes there are violations of the liver and kidneys. There is a taste of metal in the mouth.

Allergic reactions, as a rule. Light and moderate. Anaphylaxis can develop only in case of hypersensitivity to the drug.

Interaction with other drugs. The incompatibility of "Clindamycin" is noted with such groups of drugs as aminoglycosides and barbiturates. You can not mix the antibiotic with solutions containing B vitamins. This antibiotic is also incompatible with drugs based on ampicillin, phenytoin, aminophylline, calcium gluconate and magnesium sulfate.

When combined with erythromycin and chloramphenicol, drug antagonism is suspected, which reduces therapy to naught.

Caution should be observed when taking an antibiotic concomitantly with muscle relaxants, because of the risk of impaired neuromuscular conduction.

Opioid analgesics, taken against the background of antibiotic therapy "Clindamycin", can greatly reduce respiratory function and cause apnea.

The combined use of antibiotic and drugs against diarrhea can trigger the development of pseudomembranous colitis.

Storage conditions. You can store the antibiotic at room temperature, protecting against direct rays of the sun and children.

The manufacturer guarantees that, while observing the requirements for the storage of the medicine, it retains its antibacterial properties for 3 years.

[9], [10],

Oletketrin

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

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

Method of administration and dose. It is recommended to take an antibiotic after a meal to reduce the irritating effect of 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. Multiplicity of admission - 4 times a day. For children from 8 years, 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. "Oletetrin" can not be prescribed to patients who have an increased sensitivity to the components of the drug, to those who suffer, leukopenia or mycosis. It is dangerous to prescribe this antibiotic to patients with severe impairment of liver and kidney function.

In pediatrics, the medication is used from the age of 8.

Use during pregnancy and lactation is unacceptable.

Side effects. The intake of tablets in different patients can be accompanied by problems with the gastrointestinal tract in the form of impaired appetite, nausea with vomiting, stool disorders, epigastric pain. There were also reported cases of development of the inflammatory process in the tissues of the tongue (glossitis) and allergic reactions. There is a possibility of uterine bleeding when taking oral contraceptives.

It can affect the color of the teeth in children, which has irreversible consequences.

If the drug is taken for a long time, there may be a violation of the internal microflora and the development of thrush. Prolonged antibiotic therapy can lead to a deficiency in the body of B vitamins or increased photosensitivity.

Interaction with other drugs. Acid-lowering agents, preparations that contain iron, as well as dairy products, make it difficult to absorb in the digestive tract of this antimicrobial substance.

Antibiotic, which has a bacteriostatic effect, can not be used together with bactericidal, it 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 reception with methoxyflurane helps to increase the toxic effect on the body of the latter, which affects the work of the kidneys.

Storage conditions. The optimum temperature regime for storing the antibiotic is from 15 to 25 degrees. Its properties in such conditions, it retains up to 2 years from the date of issue.

It's time to talk about the latest developments in the pharmaceutical industry, which along with old drugs doctors are actively involved in the treatment of erysipelas. It should be understood that new generations and varieties of antibiotics effective in erysipelas and other infectious lesions of the skin and muscles have been developed taking into account mutational changes in the pathogen environment, which have led to the emergence of new strains of bacteria resistant to many antimicrobial preparations. Doctors knowingly prefer innovative development, because they are effective even where other antibiotics do not work because of 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 known only that linezolid is capable of violating protein synthesis. It binds to the ribosomes of bacteria and disrupts the formation of a complex responsible for the translation of genetic material to future generations. Cross-resistance in the antibiotic, which is so far the only representative of oxazolidones, with other variants of antibiotics is not observed because their mechanism of action is different from the others.

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

Pharmacokinetics. The drug is characterized by almost 100-percent bioavailability even when taking tablets, which is quite rare. The medicine is able to easily penetrate into various tissues of the body, with the exception of white adipose tissue and bones. Metabolised in the liver. It is excreted mainly by the kidneys.

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

Method of administration and dose. Intravenous administration of the antibiotic is performed infusion twice a day, in adults with an interval of 12 hours, in children - 8 hours. Infusion should last from half an hour to 2 hours.

A single dose of patients older than 12 years is 600 mg of linozolide (300 ml solution), for children under 12 years is calculated as 10 mg per kilogram of the weight of the child.

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

Contraindications. Solution for infusion is used in the treatment of children from 5 years of age, tablets - from 12 years. Do not administer a dropper if the components of the drug are intolerant.

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

Use during pregnancy. The drug is still little studied, but there are reasons to consider it potentially dangerous for the fetus and newborns. So during pregnancy and breastfeeding therapy with the drug is not recommended.

Side effects. The most common of the unpleasant symptoms observed with antibiotic treatment are headaches, nausea with vomiting, diarrhea, the development of fungal infections, the appearance of metallic taste in the mouth, impaired liver function, changes in blood characteristics. Occasionally, cases of development of various types of neuropathies were noted.

Interaction with other drugs. This innovative antibiotic can be attributed to the group of weak circulating MAO inhibitors, so it is not desirable to use it together with drugs having a similar effect.

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

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

It is impossible to mix in one container for infusions "Linezolid" and any other medicines, except the above.

Antagonism can be noted if Linezolid is taken at the same time with such medicines:

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

The same goes for pentamidine, phenytoin, erythromycin.

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

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

Kubitsin

Another completely new antimicrobial drug, which 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 with the name "Kubitsin".

Form of issue. A medicine is prepared in the form of a lyophilizate, from which an infusion solution is prepared (vials of 350 or 500 mg).

Pharmacodynamics. This antibiotic is useful in combating Gram-positive microorganisms. It has a rapid bactericidal effect, which allows a short time to normalize the patient's condition.

Pharmacokinetics. Rapidly and well distributed inside tissues, abundantly provided with blood vessels. Is able to penetrate the placenta. It is excreted mainly by the kidneys.

Method of administration and dose. The drug is intended for use in droppers. You need to enter it for at least half an hour. The daily (one-time) 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. With the introduction of large doses of the drug may increase the side effects. Treatment is symptomatic. You can remove the antibiotic from the body using hemodialysis or peritoneal dialysis.

Contraindications. The main contraindication to drug therapy is hypersensitivity to its components. Caution should be observed by prescribing an antibiotic to patients with severe impairment of kidney or liver function, obesity, people over 65 years of age.

Side effects. Reception of a preparation can provoke development of superinfections: fungal pathologies and UTI. Also, sometimes there are changes in the composition of the blood, metabolic disorders, anxiety and sleep deterioration, headaches and dizziness, deterioration of taste perception, numbness of limbs, increased pulse. Some patients complain of redness of the face, abnormalities of the digestive tract, kidney and liver, the appearance of itching and rash on the skin, myalgia, hyperthermia, weakness.

Interaction with other drugs. The drug should be used with extreme caution if the patient undergoes treatment with drugs that can cause myopathies, or potentially nephrotoxic drugs.

Possible joint use of daptomycin with drugs such as aztreonam, ceftazidime, ceftriaxone, gentamicin, fluconazole, levofloxacin, dopamine, heparin, lidocaine.

Storage conditions. Store the solution for infusions in a cold place at a temperature of 2 to 8 degrees.

Shelf life. 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, and so, together with the pathogenic microflora, they destroy useful. Prevent the development of dysbiosis in the body can be, from the first days of antibiotic treatment taking in parallel with them drugs that restore the beneficial microflora and protective functions of the body.

Local antibiotic therapy of erysipelas

So far, we have talked about systemic drugs that prevent the spread of infection within the body. However, the erysipelas have specific external manifestations in the form of a strong reddening and swelling of the skin, and therefore, without external means with antibacterial effect in this case can not do.

Antibiotics for topical therapy for erysipelas are not unique. Most commonly, erythromycin, sintomycin and tetracycline ointments are prescribed, which have a fairly wide range of applications for various skin pathologies.

Erythromycin ointment

Erythromycin ointment refers to local antibiotics with bacteriostatic action, which have long been used to treat acne and acne. However, it shows good effectiveness in the treatment of other inflammatory pathologies of the skin and soft tissues caused by bacterial infection.

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

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

Contraindication to the use of the ointment is considered only hypersensitivity to its composition. Since the active substance of the ointment is able to penetrate deeply into the tissues of the body, including the placenta, it is necessary to apply it only during strict gestation. Breast-feeding at the time of treatment, doctors advise to interrupt.

On the site of application of the ointment, redness, burning, flaking and itching can be noted. There may be a rash on the skin and a mild allergy.

Drug Interactions: Erythromycin is incompatible with antimicrobial agents such as lincomycin, clindamycin, and chloramphenicol. Can reduce the effectiveness of drugs that are bactericidal.

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

 Store the ointment should be at temperatures above zero, but not more than 20 degrees. The use of erythromycin ointment is allowed for 3 years from the date of manufacture.

[11], [12], [13], [14], [15]

Ointment Tetracycline 3%

"Tetracycline" 3% - ointment with an antibiotic, used in erysipelas and other pathologies of the skin caused by an infectious factor. It is another preparation of a broad spectrum of antibacterial activity with bacteriostatic action.

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

Restrictions on the use of ointments with antibiotics are considered to be hypersensitivity to the components of the drug and age younger than 11 years.

It is used only for local skin treatment. Apply to diseased tissues it should be 1 or 2 times a day with a thin layer. It is allowed to put a sterile bandage on top.

Appear mainly in the place of application of the ointment. It is possible for redness, burning, swelling or itching on the ointment covered skin.

The external agent in the form of an ointment is stored at room temperatures not more than 3 years from the date of release.

Another effective for an erysipelas external agent is the liniment for topical application on the basis of chloramphenicol called "Synthomycin." Most often, doctors prescribe a 10% ointment with an antibiotic.

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

Liniment can be applied either directly to the wound or under the bandage 1 time in 1-3 days.

Contraindications to the use of ointment is hypersensitivity to its components, porphyrin disease, which occurs with the violation of pigmental metabolism, fungal skin lesions. It is not applied to the skin with signs of eczema and psoriasis. Care should be taken to prescribe the ointment to patients who have impaired kidney or liver function, a deficiency of glucose-6-phosphate dehydrogenase, a newborn is diagnosed.

Doctors do not recommend the use of an external agent based on chloramphenicol during pregnancy and breastfeeding.

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

Drug Interactions: Chloramphenicol is able to reduce the antibacterial effect of certain drugs (penicillins, cephalosporins).

The instruction does not advise the simultaneous use of this antibiotic with macrolides and lincosamides (clindamycin, lincomycin, erythromycin).

Store the ointment manufacturers recommend at a temperature not exceeding 20 degrees. Allowed to use the drug for 2 years

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