Antibiotics from staphylococcus: indications for use

It so happened that the world around us is inhabited not only by friendly beings, and man has many pests, most of which can not even be seen without the help of a microscope. We are talking about bacteria - the smallest microorganisms that in the human body find all the conditions for their development and reproduction. In this case, staphylococcal infection is considered one of the most popular causes of various diseases. Not without reason, almost all antimicrobial agents are designed to fight precisely with this bacterium. But applying  antibiotics from staphylococcus, it must be remembered that these ancient bacteria in the course of evolution learned to fight with drugs used against them and became more resistant to their effects.

[1], [2], [3], [4], [5]

Indications Antibiotics against staphylococcus aureus

As we have already said, many narrow-spectrum drugs and virtually all broad-spectrum antibiotics can be successfully applied to get rid of staphylococcus. But there is one nuance. Staphylococcal infection is a common concept that combines several varieties of staphylococcus aureus. Some of them are absolutely harmless, and other species are capable of causing various diseases in humans.

In total there are more than 50 types of staphylococcus a day. Most of them live around us, without causing any harm. More than 14 species of bacteria live on our skin and with the stable functioning of the immune system also cause no diseases.

It must be said that most of the staphylococci can be reliably attributed to non-pathogenic microorganisms. And only 4 varieties of this globular bacterium claim to attribute them to a conditionally pathogenic microflora. These are strains:

• Staphylococcus aureus (Staphylococcus aureus) - the most dangerous of all varieties of bacteria,
• Staphylococcus epidermidis (epidermal staphylococcus),
• Staphylococcus haemolyticus (hemolytic staphylococcus),
• Staphylococcus saprophyticus (saprophytic staphylococcus).

Staphylococcus aureus is a fairly common form of bacteria that can be found both in soil or in the air, and on the surface of the skin and mucous membranes of a person. Activation of the microorganism occurs if the intestinal microflora is impaired or general / local immunity is reduced.

Under suitable conditions, the pathogenicity of bacteria of this species is undeniable. They produce substances that can destroy proteins, leukocytes and red blood cells of the human body, increase clotting of blood plasma, synthesize toxic substances that cause diarrhea and components that damage the skin. It is this infection that is associated with multiple pathologies of the skin and subcutaneous tissue, inflammatory diseases of the respiratory system, brain, nervous, genitourinary and digestive system, hearing and vision. Staphylococcus aureus can cause inflammation of the tissues of the cardiovascular and musculoskeletal systems. It is associated with multiple food intoxication and toxic shock syndrome.

Penetrating into the body, the bacterium causes purulent-inflammatory processes, proceeding according to the type of abscesses. Moreover, Staphylococcus aureus is capable of destroying the cells of the immune system, weakening its work and creating a fertile soil for its further reproduction and generalization of the inflammatory process.

The most interesting thing is that babies have innate immunity to Staphylococcus aureus. Later the body begins to produce antibodies to it, but it is only necessary to disrupt the intestinal microflora, as getting into the body staphylococcus begins to show increased activity and reduces the work of the immune system to naught.

For the treatment of pathologies caused by Staphylococcus aureus, antimicrobials are used. But the bacterium is so adapted to survival in adverse conditions that antibiotics from staphylococcus do not always help. Stability of staphylococci of  this species  to antibiotics  makes it dangerous even in a hospital. Staphylococcus aureus, according to WHO, is the main culprit of nosocomial infections.

Epidermal staphylococcus is a representative of the microflora of our body, which is always present on the skin and mucous membranes. Getting inside the body, it undergoes attacks of the immune system, but unlike Staphylococcus aureus can not affect its work, therefore it is considered less dangerous.

But the fact that the bacterium settles on the skin, makes it an insidious enemy in medical institutions. Insufficient sterility of the instrument and implants, non-observance of hygiene and sanitation requirements lead to contamination by opportunistic bacteria of people whose body is weakened by the disease. It is clear that the addition of staphylococcal infection leads to various kinds of inflammatory complications.

Hemolytic Staphylococcus is a bacterium that leads to the destruction of red blood cells under the action of toxins produced by it. Its habitat is air and soil, although in some quantities it can be found on the skin. Getting into the body through the mouth, it often causes tonsillitis and other tonsillitis. But you do not need to exclude his involvement in the development of many skin, genitourinary and some other infections.

This variety of bacteria is also resistant to most antibiotics, which causes problems in the treatment of diseases caused by hemolytic staphylococcus.

Saprophytic staphylococcus chooses wet places for its habitat in the area of genital folds and mucous of genital organs, and infects more often women than men, causing inflammatory pathologies of the genitourinary system. Most often this is cystitis and urethritis, less frequent inflammation of the kidneys. This is the least common type of staphylococci that can cause disease in humans, which is due to his preferences in terms of residence.

The bacterium is resistant to various environmental conditions, but it is not able to resist strong human immunity. Saprophytic staphylococcus is sensitive to most antibiotics. But if you treat the treatment lightly or do not finish it, it is likely that some representatives of the bacterial saprophyte flora will survive and become more resistant to drugs designed to fight them.

Staphylococcal infection is a common concept that unites many different inflammatory pathologies with localization in various parts of the body. Symptoms depend on how deep the infection has gone inward, how it actively multiplies, and what are the capabilities of the human immune system in fighting the causative agent of the disease.

When "Amoxiclav" and "Summed", very beloved by doctors for their high effectiveness in fighting various types of bacterial infection, experts from different fields of medicine prescribe to patients, the patients have doubts: how can one drug treat completely different pathologies? It turns out that it is possible, and quite successfully.

The fact is that the same staphylococcus can cause a lot of unrelated diseases, and lesions can be located both inside and outside the body. Consider in what situations a general practitioner or an expert can prescribe antibiotics from staphylococcus, i.e. What diseases can cause staphylococcal infection.

Let's start with Staphylococcus aureus. He most often becomes the reason:

• inflammatory processes on the skin and in the subcutaneous tissue, resulting in the formation of:
  • furuncles (boils)
  • pyoderma (purulent inflammation on the skin),
  • sycosis (inflammation of hair follicles in the region of the nose, eyebrows, scalp, mustache, pubis, armpits, etc.)
  • abscesses (purulent-necrotic changes in the skin and fatty tissue),
  • phlegmon (diffuse purulent inflammation of the superficial and deeper tissues without definite boundaries),
  • pustules with purulent fluid inside (vesiculopustulosis),
  • panacion or inflammation of the skin on the extreme phalanx of the finger,
  • burn-like skin syndrome (exfoliative dermatitis or Ritter's disease), when the surface of the skin behaves as if burned, first reddens and swells, then cracks and bubbles form on it, it begins to peel and becomes crimson.
• Lesions of the eye mucosa (staphylococcal conjunctivitis)
• Inflammation of bone and cartilaginous tissue (osteomyelitis, arthritis, etc.),
• Inflammatory processes in the nasopharynx (most often staphylococcal angina, difficult to treat antibiotics penicillin series, as well as rhinitis with secretion of purulent secretion, pharyngitis).
• Inflammatory processes in the lower respiratory tract (bronchitis, tracheitis, pleurisy, pneumonia, occurring with complications or against the background of other infectious pathologies, most often at high temperature).
• Inflammation of the heart tissue (damage to the inner shell of the heart and its valves due to the penetration of infection there with blood flow, resulting in heart failure).
• Acute toxic infections, which cause inflammation of the intestinal tissues (enteritis, enterocolitis) with fever, greenish stools, frequent vomiting.
• Lesions of the brain and CNS (inflammation of the meninges and brain abscess).
• Inflammatory processes in the kidney and urinary tract (cystitis, pyelonephritis, urethritis, etc.).
• Septic lesions (blood poisoning). Distinguish:
  • septicopyemia, when an infection with blood spreads through the body and causes the appearance of purulent foci in different places,
  • septicemia, at which there is an intoxication of the body with bacterial secretions (in severe cases an infectious-toxic shock develops with the fall of blood pressure, loss of consciousness, coma).

Hemolytic staphylococcus often causes severe purulent tonsillitis, whose treatment is difficult due to the high resistance of the causative agent to changing environmental conditions and the effects of antibiotics. Preparations for the treatment of tonsillitis caused by Staphylococcus haemolyticus are difficult to select, given the resistance of many of its strains to most antibiotics. But in this case it is not always possible to achieve complete irradiation of the pathogen. After the course of treatment with antibiotics from staphylococcus bacteria can simply lie low and wait for a suitable moment to again manifest themselves in all "glory."

Not much less often, hemolytic staphylococcus causes skin and genito-urinary infections. Often it is detected in pregnant women, whose body is weakened by work for two, in people with immunodeficiency, chronic diseases, exhausting human strength.

In principle, this kind of bacteria is able to cause all those pathologies that are characteristic of its golden-like kindred. And diseases in most cases will also occur with fever, lymph nodes, severe weakness and fatigue, and with a high probability of complications to nearby organs.

Epidermal staphylococcus most often becomes the cause of skin infections, therefore, with the development of purulent-inflammatory lesions of the skin and subcutaneous tissue, suspicion primarily falls on it, because this type of staphylococcal infection is used to settle on the surface of the body. And we are already so used to it that we do not even think about the possible consequences of traumatic skin damage or food intake with unwashed hands, until the immune system fails and the conditionally pathogenic microorganism does not remind us of painful symptoms.

Yes, the fact that Staphylococcus epidermidis is used to live on the surface of the body does not at all mean that it can not enter inwardly, that is, Through a mouth, or having gone deep in a wound on a skin. Thus, epidermal staphylococcus can cause intestinal infections and inflammatory processes of internal organs. But unlike the haemolytic and golden type of bacteria, Staphylococcus epidermidis will not cause severe symptoms. The disease in most cases occurs subacute without a strong increase in temperature, increased lymph nodes and other dangerous manifestations.

But the danger of epidermal staphylococcus is that it provokes a large number of nosocomial infections, causing suppuration in the area of the introduction of catheters and surgical interventions that cut the skin, if the disinfection of instruments and skin was insufficient, or the patient himself infected the wound with the help of hands.

Nevertheless, the infection is an infection, and without antibiotics it will be difficult to get rid of it, especially when it comes to inflammation of the internal organs. And if skin pathologies sometimes get to do with the help of antiseptics used to cleanse the wound from bacteria, then with internal diseases this practice does not work, which means that even from epidermal staphylococcus one must take systemic antibiotics.

With saprophytic staphylococcus is associated primarily with diseases of the urinary system, although it can be detected in gynecological pathologies. Most often saprophyticus is guilty of developing cystitis, urethritis and inflammatory pathologies of the male sexual organ (balanitis, balanoposthitis). But even then they do not think of him in the first place, because the prevalence of the saprophyte type of staphylococcus is very low (about 5%).

The peroral path of infection in the body in this case is irrelevant. It is unlikely that someone will eat after visiting the toilet with unwashed hands. A disease in children is not associated with Staphylococcus epidermidis.

[6], [7], [8], [9], [10], [11], [12], [13]

Release form

But let us return to our preparations, with the help of which doctors are currently struggling with staphylococcal infection. If used previously to prescribe cephalosporins and penicillins, then today in the treatment of staphylococcus involves other groups of antibiotics: lincosamides, sulfonamide preparations, macrolides, fluoroquinolones (for purulent infections), modern antibiotics glycopeptides, etc.

But again, in the mild cases of staphylococcal infection, it is primarily the penicillins that are being treated, preferring their protected variants, and cephalosporins, necessarily considering the type of pathogen.

Since the most common and dangerous causative agent of various internal and external inflammatory diseases is Staphylococcus aureus (golden staphylococcus aureus), then it is worthwhile to begin the review of effective drugs with staphylococcal infection.

The antibiotics that kill Staphylococcus aureus include:

• protected and unprotected penicillins (Ampicillin, Benzylpenicillin, Amoxicillin, pure or in combination with clavuonic acid, Augmentin, Methicillin, Dicloxacillin, Flemoxin solute, etc.),
• cephalosporins of 2-3 generations ("Cephalexin", "Ceftriaxone", "Cefazolinum", "Cefuroxime", "Ospexin", "Flexin", etc.)
• macrolides ("Azithromycin", "Sumamed", "Clarithromycin", "Oleandomycin", etc.)
• Lincosamides ("Clindamycin", "Lincomycin"),
• fluoroquinolones ("Ofloxacin", "Moxifloxacin», etc.),
• aminoglycosides (& quot; Gentamycin & quot;),
• tetracyclines ("Doxycycline"),
• Nitrofurans ("Furazidine", "Furamag", "Nifuroxazide", etc.)
• karbopenemı (İmipenem, Tienam)
• new antibiotics: glycopeptide "Vancomycin", oxazolidone "Linezolid", others - "Fuzidin" in combination with "Biseptol" (a drug from the group of sulfonamides), etc.

The list of drugs effective against Staphylococcus aureus can be continued further, it is quite extensive. But this does not mean that drugs are prescribed with the same frequency. In most cases, access to protected penicillins (eg, "Augmentin"), "Methicillin" (although it does not have the same efficiency as before, before the appearance of methicillin-resistant strains), cephalosporins (for example, "Cefuroxime").

Nitrofurans are prescribed mainly with staphylococcus in the intestine and urinary system. "Gentamicin" has the sense to prescribe with hypersensitivity to beta-lactam drugs. And "Doxycycline", fluoroquinolones and new antibiotics are usually prescribed only in very severe cases of purulent inflammation.

Speaking about the effectiveness of macrolides and lincosamides, one should not forget that these are drugs with a bacteriostatic effect that do not kill microorganisms, but inhibit their reproduction. To destroy the population of Staphylococcus aureus in the body, you need to take such medications in large dosages.

It is not easy to fight with Staphylococcus aureus, as the bacterium constantly mutates with the formation of new strains, insensitive to traditional antibiotics. When strains that were resistant to beta-lactams appeared, a new preparation of the penicillin series Methicillin was created. For a long time it was considered to be the most effective against Staphylococcus aureus, but soon strains appeared that were insensitive to this drug and caused both hospital-acquired and domestic infections.

And insensitive to methicillin bacteria do not show sensitivity to various beta-lactams. In the treatment of infectious pathologies caused by persistent pathogens, antibiotics that use methicillin-resistant strains of staphylococcus (Clindamycin, Spiromycin, Tetracycline, Doxycycline, Linezolid, etc.) are used.

The fight against hemolytic streptococcus, which has developed "immunity" against most antibacterial drugs, does not go any easier either. When prescribing antibiotics from hemolytic staphylococcus, it is necessary to take into account the results of the test for the pathogen and the stability of the detected strain against the recommended drugs.

Hemolytic staphylococcus most often settles in the throat, causing tonsillitis (more habitual name of angina). And against the sore throat, it is customary to prescribe antibiotics of the penicillin series, to which Staphylococcus haemolyticus has long shown no special sensitivity, which is connected with the absence of positive dynamics.

If penicillins are ineffective, they turn to cephalosporins, and when beta-lactams are intolerant, they go to macrolides and lincosamides. If it is a question of a serious course of the disease, it makes sense to try therapy with new antibiotics: "Vancomycin" in conjunction with "Ciprofloxacin", "Linezolid" and other drugs.

It should be understood that angina is not the only pathology caused by the hemolytic variety of staphylococci. And in each case, the doctor will have to develop a complex scheme for treating the disease associated with a very persistent pathogen. In the fight against hemolytic staphylococcus, several antibiotics often have to be used to permanently exterminate this insidious parasite.

Epidermal staphylococcus though settles on the skin, it can also penetrate into the body, causing inflammation there. Diseases caused by epidermal staphylococcus occur more easily than when Staphylococcus aureus is affected, because strains of skin dwellers do not know how to synthesize an enzyme that promotes blood coagulability. And antibiotic-resistant strains of Staphylococcus epidermidis are much less than in other types of staphylococcus.

Most often in the treatment of epidermal staphylococcus appoint:

• penicillinyls (& quot; Amoxicillin & quot ;, & quot; Amoxiclav & quot ;, & quot; Methicillin &
• cephalosporins (Ceftriaxon, Cefoproizone, Cefuroxime, etc.),
• macrolides ("Clarithromycin", "Jozamicin", "Azithromycin", etc.),
• nitrofurans ("Nifuroxazide", "Furazolidon", etc.)
• Lincosamides ("Lincomycin", "Clindamycin"),
• karbopenemı (İmipenem, Tienam)
• a new antibiotic "Rifaximin" and its analogue "AlphaNormix".

In severe infections, doctors can resort to fluoroquinolones. Strains sensitive to methicillin can be defeated with the drugs "Levofloxacin" and "Moxifloxacin". To resistant strains you can try to apply fluoroquinolone "Norfloxacin".

Because Staphylococcus epidermidis is able to cause a variety of diseases at the place of residence, i.e. On the skin, often not only systemic, but also local antibiotics are used to fight it in the form of ointments, creams, solutions (Mupirocin, Bactroban, Altargo, Baneocin, Fuzidin, Chlorophyllipt and others .).

Saprophytic staphylococcus is the most rare resident of our body, who likes to settle in intimate places. To get rid of saprophyte staphylococcus, you can use any antibiotics, which we wrote about above. The only thing to consider is the sensitivity of the detected strain of the bacteria to the drugs that the doctor plans to use for the treatment of genitourinary infections caused by Staphylococcus saprophyticus.

Since staphylococcal infection can equally affect both adults and children, leaking from different locations and severity, antibiotics are used to treat it, the form of which corresponds to the patient's condition and age. It is clear that these are preparations with proven efficacy against the identified species and strain of bacteria.

In most cases of treatment of patients older than 3 years, antibiotics from staphylococcus are prescribed in the form of oral forms: conventional tablets or coated tablets, which are considered safer in terms of irritating effects on the digestive tract. There are also preparations that are produced in the form of gelatin capsules, inside of which there is a medicinal powder. Capsules are also a kind of protection for the gastrointestinal mucosa.

Another form of release of antibiotics, intended for oral administration, is suspensions (powder or granules for its preparation are provided for "Amoxicillin", "Augmentin", "Amoxiclava", "Zinnata", "Cephalexinum", "Sumamed", "Macropen" "Nifuroxazide" and some other antibiotics from staphylococcus). This form of medication is usually used in the treatment of children under 6 years. It is more convenient to use for those who do not know how to swallow tablets, and besides, in most cases have a more pleasant taste and aroma.

If the disease is severe, there is no time to wait for the medicine to go all the way along the digestive tract and assimilate in the intestine from which it enters the bloodstream, injections and infusions of antibacterial drugs will be more appropriate treatment. Antibiotics for these purposes are released mainly in the form of a powder (lyophilate), which before introduction is diluted with appropriate fluids. With intramuscular injection - it can be anesthetics, and with intravenous - saline solution for injection, etc.

In the form of a powder for the preparation of solutions placed in hermetically sealed bottles, most cephalosporins, some penicillins and macrolides, "Vancomycin" and some other preparations, are produced.

But some drugs can be produced and the form of ready-made infusion solutions. Among the effective antibiotics, which are available as a solution for infusions, you can use Staphylococcus fluoroquinolones Moxifloxacin, Ofloxacin, Levofloxacin (one of the few effective against saprophytic staphylococcus), antibiotics from the group of carbopenems, for example, Imipenem, and some other medicines.

Lincosamides are available in the form of tablets and ready-to-use injection solutions in ampoules. "Gentamicin" is produced both as a powder for the preparation of formulations for parenteral intramuscular injection, and for the form of ready solutions used for intravenous and / or injections. "Doxycycline" on drugstore shelves can be found both in the form of capsules, and form of lyophilate for the preparation of infusion solutions for intramuscular systems.

The choice of the form of release of the drug depends on the localization of the disease. If it is a question of defeat of internal organs, prescribe drugs in the form of tablets, capsules, suspensions, solutions for injections and infusions. Severe systemic lesions of staphylococcus are treated with injections and droppers (infusions), followed by a transition to parenteral forms.

But staphylococcal infection can multiply in the nose, throat, on the skin, causing purulent-inflammatory changes in tissues in the place of settlement. In this case, the use of systemic antibiotics is enhanced by local exposure to the causative agent of the disease.

Antibiotics from staphylococcus in the nose  for topical application can have such forms of release as aerosol (Bioparox, Anginal, Isofra, Polidexa, etc.), drops (Garazon, Fluimutsil, etc.) , ointments ("Bactroban", "Mupirocin", "Baneocin", "Altargo"), a solution of "Chlorophyllipt".

If staphylococcus settles in the ear or eyes, causing purulent inflammation, use eye and ear drops (Tsipromed, Levomycetin, Signtsef, Sofredeks, Normaks, Otofra, etc.).

Antibiotics with staphylococcus in the throat  are basically the same as for the nose. You can use the above mentioned aerosols for irrigation of the mucosa in the tonsils and nasopharynx, gargle with the solution "chlorophyllipt", apply effective antiseptics active against staphylococcal infection in the form of sprays and solutions. Ointments in this case are inconvenient to use.

With staphylococcus in the throat, preference is given to systemic antibiotics, since from the throat the bacterium can easily spread throughout the body. Local treatment is considered additional and is used mainly for purulent sore throat.

Antibiotic from staphylococcus on the skin  - most often this is a local preparation in the form of ointment, gel, solution. As effective from staphylococcus a solution is used as an antibiotic "Chlorophyllipt", and usual antiseptics - solutions of furacillin, manganese, zelenok.

With regard to ointments, in this case, the same drugs are used as from staphylococcus in the nose, which are used after treatment of the diseased surface with an antiseptic.

As you can see, antibiotics from staphylococcus can have a variety of forms of release, which makes it possible to treat the infection even in the most secret places of the body. In the instructions for each drug there is an item explaining how, with what solutions and in what proportions should the forms of antibiotics intended for intramuscular or intravenous administration (parenteral route) be prepared, how to prepare a suspension for children and adults, how to take tablets and apply ointments to in each case.

[14], [15], [16], [17], [18], [19],