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Antibiotics for inflammation of the appendages
Last reviewed: 23.04.2024
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Antibiotics for inflammation of the appendages are appointed immediately after diagnosis, without waiting for the results of the analysis for the type of bacteria and their susceptibility to the drug.
Treatment with antibiotics, usually used in acute inflammatory processes, but sometimes such drugs are prescribed and with exacerbation of the chronic form.
With inflammation of the appendages, specialists usually prescribe broad-spectrum drugs that are active against most bacteria that provoke diseases of the genitourinary system. It also takes into account the ability of antibiotics to influence the pathogens of mycoplasma, chlamydia, ureaplasma, as in most cases these microorganisms cause inflammation.
After receiving the results of the analysis, a specialist can correct the treatment (prescribe a different kind of antibiotics, depending on the causative agent and its susceptibility).
It is also necessary to change the treatment if the patient's condition against the prescribed treatment does not improve.
[Indications for the use of antibiotics for inflammation of the appendages
Adnexitis or inflammation of the appendages is an infectious inflammation of the ovaries, the fallopian tubes, so antibiotics are mandatory for the disease.
Antibiotics for inflammation of the appendages are prescribed depending on the causative agent of the disease, as a rule, several drugs are used for maximum effectiveness.
Form of issue
The form of release of antibacterial drugs used for adnexitis may be different. Most often at the beginning of treatment, antibiotics for inflammation of the appendages are given in the form of injections (intramuscular, intravenous, ready-made solutions or powders from which the solution is prepared), then the doctor can prescribe the tablets. In addition, there are suspensions and a suppository with antibiotics.
Pharmacodynamics of antibiotics for inflammation of the appendages
Antibiotics in inflammation of tetracycline-related appendages suppress the ability of pathogenic microorganisms to multiply. Preparations from this group are active against staphylococci, streptococci, gonococci, pertussis, enterobacteria, klebsiella, salmonella, chlamydia, mycoplasma, spirochete.
Macrolides are highly active against staphylococci, streptococci. According to the latest data, immunity to the preparations of their group of pathogenic microorganisms began to increase, but some macrolides retained activity for pneumococci, pyogenic streptococci.
Preparations of this group suppress the ability of bacteria to multiply and are effective only if the causative agent of infection refers to the multiplying type of bacteria.
Fluoroquinolone antibiotics destroy bacteria due to suppression of DNA-gyrase and topoisomerase, a violation of DNA synthesis.
Fluoroquinolones are active against most bacteria (Gram-positive aerobes, Gram-negative). Also, the drugs of this group are active towards microorganisms resistant to first-generation quinolones.
The third and fourth generation of fluoroquinolones are more active in relation to pneumococci, intracellular microorganisms (mycoplasma, mycobacteria, etc.) in comparison with the drugs of this second generation group.
To fluoroquinolones, the sensitivity of enterococci varies to a different degree.
Pharmacokinetics of antibiotics for inflammation of appendages
Antibiotics for inflammation of the appendages from the tetracycline series when ingested are absorbed into the digestive tract by an average of 70%. The active substance is quickly distributed over the fluids and tissues of the body, overcomes the placental barrier.
Excretion of tetracycline occurs predominantly with feces and urine in unchanged form.
The absorption of antibiotics of the macrolide group is affected by a number of factors (food intake, dosage form, type of drug).
Eating can significantly affect the bioavailability of certain drugs, in particular, ezithromycin.
Bioavailability of clarithromycin, josamycin and some other drugs is practically independent of food intake.
Most macrolides are largely accumulated in tissues, in the serum of maximum concentrations reaches roksitoromycin, the minimum - azithromycin.
Macrolides are well distributed to tissues and organs, especially in inflammatory processes, they penetrate into cells and accumulate in them at fairly high concentrations.
Preparations of this group are able to overcome the placental barrier, practically do not penetrate the blood-brain and hemato-ophthalmic barriers.
Splitting occurs in the liver, excretion is carried out mainly by the gall bladder.
The elimination half-life is 1 to 55 hours, depending on the preparation.
Most of the macrolides do not change in renal failure.
Fluoroquinolones are well absorbed in the digestive system after ingestion. Simultaneous reception may slow the absorption process, but there is no significant effect on the bioavailability of the drug.
On average, after two hours, the active substance reaches its maximum concentration in the blood. Preparations of this group penetrate well through the placenta.
Excretion is performed by the kidneys and partly by the gall bladder.
Fluoroquinolones are well distributed in tissues and organs, where they reach rather high concentrations (except norfloxacin).
The degree of cleavage depends on the properties of the preparation, the greatest biotransformation is subjected to pefloxacin, the least - ofloxacin, lomefloxacin, etc.
On average, the half-life is between 3 and 14 hours (for some drugs up to 20 hours).
If there is a violation of the kidneys, the half-life of ofloxacin, levofloxacin, increases.
With renal failure in severe form, a specialist must adjust the dosage.
What are the antibiotics for inflammation of the appendages?
Antibiotics for inflammation of tetracycline-related adnexa demonstrate good efficacy, however, as practice shows, the susceptibility of some microorganisms provoking diseases of the genitourinary system began to decline, in addition, the drugs in this group have many side effects.
Most often with inflammation of the appendages, doctors prefer doxycycline, which causes fewer adverse reactions and is quickly removed from the body.
Macrolides also show good efficacy in the treatment of inflammation of the appendages. In addition, these drugs are resistant to the acidic environment of the stomach and a long half-life, so that the infected body accumulates the active substance in large quantities.
Usually appointed sumamed, klatsid, etc.
Macrolide antibiotics are active against most microorganisms that provoke diseases of the genitourinary system, including intracellular microorganisms.
Antibiotics from the group of fluoroquinols are considered the most effective in inflammation of the appendages to date.
Insensitivity of microorganisms to drugs develops extremely slowly. In the absence of contraindications, specialists prescribe drugs of this particular group (pefloxacin, ofloxacin, norfoloxacin, lomefloxacin, etc.).
But, as a rule, with diseases of the genitourinary system of an antibacterial drug is not enough. Experts usually prescribe two or more antibiotics, because the disease, in most cases, provokes several pathogens, both aerobic and anaerobic.
To destroy all microorganisms, various combinations of antibiotics are prescribed. To anaerobic bacteria (develop without access to oxygen), tinidazole and metronidazole are highly active; therefore, combinations with these drugs are often prescribed.
Name of antibiotics for inflammation of appendages
The main antibiotics for inflammation of the appendages:
- azithromycin, zoomaks - are active against most bacteria, effective in the complex treatment of diseases of the genitourinary system;
- ceftaptene, zeidex - are active against streptococci, gonococci, enterococci (usually the drug is prescribed in the form of capsules);
- erythromycin - effectively treats chlamydia, mycoplasmosis, intravenous injections are prescribed as an auxiliary treatment;
- Metronidazole - the drug acts in the lesion;
- ciprolet, ceftriaxone, ciprofloxacin - the latest generation drugs, are used as an alternative to the above drugs.
Antibiotics for inflammation of the appendages are the basis of therapy.
Most often, tetracyclines, penicillins, macrolides, fluoroquinols, nitromidazoles, aminoglycosides are prescribed.
Of the tetracycline group, doxacyclin and tetracycline are commonly used, but these drugs cause severe side effects and have a number of contraindications.
Of penicillins, oxacillin, ampiox, ampicillin are more often prescribed. These drugs suppress the multiplication of bacteria and destroy pathological microorganisms in cells. Penicillins of the new generation are active against most bacteria that have developed resistance to penicillins, in addition, these drugs have few adverse reactions.
Among macrolides, azithromycin and erythromycin roxithromycin are very popular among doctors. Drugs block the propagation of pathogenic flora and destroy bacteria that have penetrated into the cells of the body.
Macrolides are usually prescribed for allergies to penicillin, pregnant women and children.
Of fluoroquinolone group is prescribed ofloxacin, but this drug is contraindicated in pregnant women, in addition, its use can provoke pain in the joints, inflammation or ruptures of tendons.
Nitromidazoles prefer trihopol, metronidazole, metrogil. The drugs have high activity against anaerobic and microorganisms
Kanamycin, gentamicin, which belong to the aminoglycoside group, are used in severe cases, with advanced form of the disease, with the spread of infection to other internal organs.
The drugs are quite effective, but they have strong toxicity and have a negative effect on the kidneys, the liver, and the development of deafness is also possible. As a rule, these drugs are prescribed in exceptional cases.
Dosing and Administration
Antibiotics for inflammation of the appendages of the tetracycline group are usually prescribed during or after meals.
Adult patients are assigned 100 mg of the drug in 3-4 doses (0.25 mg each). Children over eight years of age are prescribed not more than 25 mg / kg per day.
Duration of treatment with tetracyclines from 5 to 7 days.
If there is redness, burning or itching, the treatment is canceled.
Tetracyclines should not be taken with dairy products or milk, as there is a violation of absorption of the antibiotic.
Most macrolides are taken two hours after or one hour before meals.
Clarithromycin, spiramycin, josamycin have no restrictions and can be taken at any time, regardless of food intake.
Erythromycin should be washed down with plenty of water (at least 200ml).
Suspensions for internal reception must be diluted and taken in accordance with the attached instructions.
Throughout the course of treatment it is important to observe the duration, regimen and treatment regimen (do not miss the time of admission, take the drug at a certain interval).
Macrolides can not be taken concomitantly with antacids (taken with acid-dependent gastrointestinal diseases).
Fluoroquinolones should be washed down with plenty of water and taken at least two hours before meals (or six hours after taking antacids and preparations containing bismuth, zinc, iron).
During the treatment period, it is important to follow the regimen and regimen of the drug. During treatment it is necessary to use a sufficient amount of liquid (1.5 liters per day).
Use of antibiotics for inflammation of the appendages during pregnancy
Antibiotics for inflammation of the appendages of their tetracycline group are contraindicated in pregnancy, as tetracyclines overcome the placental barrier and can accumulate in the fetal tissues (bones, dentition), causing a violation of mineralization and severe developmental disorders of the bones.
Some macrolides (clarithromycin) can have a negative effect on the unborn child. Studies on the safety of the use of midecamycin, roxithromycin in this period was not conducted.
Erythromycin, spiramycin, josamycin do not have a negative effect on the fetus and are used in pregnancy, azithromycin is prescribed only in extreme cases.
Fluoroquinolones can disrupt the normal development of the fetus, so this group of drugs are not prescribed to pregnant women.
Contraindications to the use of antibiotics for inflammation of the appendages
Antibiotics for inflammation of appendages of tetracycline are not used for increased susceptibility to the drug, kidney failure, in children under 8 years old, with leukopenia, and the drug is contraindicated in pregnant women and during lactation.
Macrolides are contraindicated in allergies, some drugs are not used during pregnancy (roxithromycin, clarithromycin, etc.) and breastfeeding (clarithromycin, spiramycin, etc.).
Fluoroquinolones are not prescribed for pregnant women, nursing women, for allergic reactions, for lack of glucose-6-phosphate dehydrogenase, in childhood.
Side effects of antibiotics for inflammation of the appendages
Antibiotics for inflammation of appendages from the group of tetracyclines cause dizziness, increased intracranial pressure, a change in the level of platelets, neutrophils, hemoglobin in the blood.
Also, these drugs can provoke a violation of appetite, nausea, stool disorders, inflammatory processes in the digestive tract, disruption of the kidneys. After tetracyclines develop allergic reactions, anaphylactic shock, on the skin can appear a strong reddening, etc.
Because of some drugs, there may be increased susceptibility to ultraviolet light, fungal lesions of the mucous (candidiasis), the formation of teeth and bones may be disturbed in children, the colors of tooth enamel may change.
Macrolides cause various allergic reactions. With prolonged use of the drug macrolide series, a second infection may develop, in which microorganisms will have resistance to eryphomycin.
It is also possible the appearance of a feeling of nausea, pain in the GI tract, visual impairment, omission of the upper eyelid, paralysis of the oculomotor musculature, a strong dilatation of the pupil.
After using fluoroquinolones, pain in the area of the digestive tract, loss of appetite, nausea, upset of the chair, headaches, sleep, vision, tremors, convulsions, and various allergic reactions may appear.
In rare cases, there is inflammation in the joints, tendons, tendon ruptures, disruption of the kidneys, changes in the heart rate.
Often after the use of such antibiotics, women develop thrush, candidiasis of the oral cavity, disease of the large intestine.
Overdose
Antibiotics for inflammation of the tetracycline group of appendages cause an increase in side effects (nausea, vomiting, stomach pain, upsetting of the stool, discoloration of the tooth enamel, dizziness, headaches, changes in platelet count, hemoglobin, increased susceptibility to ultraviolet, skin rashes and itching in case of an overdose , candidiasis). Treatment in this case is symptomatic.
With an overdose of macrolides, there is usually no threat to life. Often, when the dosage is exceeded, nausea, upset of the stool, and disturbance of the heart rhythm appear.
Fluoroquinols in elevated doses do not pose a danger to life, when symptoms of an overdose appear, the doctor can prescribe treatment at home.
In extremely rare cases, epileptic seizures occur.
Elevated doses of fluoroquinols have a serious negative effect on the liver, joints, tendons, heart and blood vessels.
Interactions of antibiotics with inflammation of the appendages with other drugs
Antibiotics for inflammation of the appendages of the tetracycline group are not prescribed with drugs that contain magnesium, calcium, zinc, iron and other metal ions.
Simultaneous reception of carbamazepine, barbiturates reduces the antibacterial effect of tetracyclines.
It is not prescribed simultaneously with penicillin preparations.
Tetracyclines decrease the effectiveness of contraceptive oral medications.
Macrolides are not assigned simultaneously with aminoglycosides.
The effectiveness of chloramphenicol, lincomycin with simultaneous admission with tetracyclines is reduced.
Erythromycin decreases biotransformation and increases concentrations in the body of cyclosporine, warfarin, caffeine, aminophylline, theophylline.
Macrolides increase the effectiveness of glucocorticosteroid drugs.
A combination of erythromycin with tetracyclines, polymyxins, sulfonamides is acceptable.
Bioavailability of fluoroquinolones with simultaneous reception with preparations containing zinc, bismuth, magnesium, iron decreases.
Some fluoroquinols (norfloxacin, ciprofloxacin) reduce the excretion of methylxanthines (caffeine) and increase the toxicity of the drug.
Non-steroidal anti-inflammatory drugs, derivatives of nitromidazole, methylxanthines increase the toxic effect of fluoroquinolones.
It is not assigned simultaneously with nitrofuran derivatives.
With caution is prescribed with drugs that increase the QT interval because of the possible development of arrhythmia.
Glucocorticosteroids with fluoroquinolones increase the risk of rupture of tendons, especially in old age.
Citrates, sodium bicarbonate, carbonic anhydrase inhibitors with simultaneous administration with fluoroquinolones increase the risk of developing a poison effect on the kidneys, the appearance of salt crystals in the urine.
Excretion of fluoroquinolones reduces cimetidine, azlocillin, while the concentration of fluoroquinolones in the blood increases.
Shelf life
Antibiotics for inflammation of the appendages are stored for 2-3 years, depending on the preparation.
Shelf life is indicated on the package. It is necessary to observe the storage conditions, do not use the drug after the expiry date or if the storage conditions and the integrity of the package are violated.
Antibiotics for inflammation of the appendages are designated as the main treatment for acute and, in some cases, chronic, form of the disease.
Take antibiotics for a few more days, after the disappearance of the main symptoms of the disease (pain, temperature, spotting).
When the course of treatment with antibiotics is interrupted or the scheme and time of reception are disturbed, the microorganisms that provoked the disease will become resistant to the drug and can cause a repeated infectious and inflammatory process (treatment in this case is longer and more difficult).
Attention!
To simplify the perception of information, this instruction for use of the drug "Antibiotics for inflammation of the appendages" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.