New and better antibiotics of a wide spectrum of action: names of tablets, ointments, drops, suspensions

Diseases caused by bacterial infections existed as much as there is humanity itself. But the trouble is, with each year their number grows, and the bacteria evolve, they learn to disguise themselves and survive in unfavorable conditions. An empirical approach to the treatment of infectious pathologies implies the appointment of an antimicrobial agent at the time of admission, without waiting for the results of the analysis for the causative agent of the disease. In such conditions, it is very difficult to select an effective drug, since many antibiotics act only on a certain group of bacteria. And here antibiotics of a wide spectrum of action, effective against a large number of pathogens come to the aid and are used to treat various infectious pathologies of different organs and systems of the human body.

Doctors often have to deal not with one, but with several pathogens that have settled in the body of a particular person. Antibacterial agents with a wide range of antimicrobial activity also help out in this situation, limiting the number of drugs prescribed to the patient.

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

Indications of the broad-spectrum antibiotics

Antibiotics of a wide spectrum of action are rightfully considered universal drugs, since whatever infection is hidden in the body, they will necessarily inflict a devastating blow on it. They are used for various pathologies of human organs and systems caused by a bacterial infection of one or more species.

Antibiotics of a wide spectrum of action for infection can be prescribed in the following cases:

• If there is no possibility in a short time to determine the causative agent of the disease, and the treatment is appointed empirically. Those. On the basis of the patient's complaints, a preliminary diagnosis is established and an antimicrobial drug is prescribed which will contain the infection until the true pathogen is identified.

By the way, this is a common practice in most medical institutions, especially when it comes to outpatient treatment. Even if there are well-equipped laboratories.

To justify this approach to antibiotic therapy is possible if it is a case of severe infections characterized by a rapid course and spread of the process to other organs, and pathologies of high prevalence, the pathogens of which are well known.

• If the bacteria causing the disease are antibiotic resistant to drugs with a narrow spectrum of action.
• In the case of detection of non-standard superinfection, which is characterized by the presence of several types of bacterial pathogens.
• In order to prevent the development of infectious pathologies after surgical operations or cleaning of wound surfaces.

The doctor decides whether to prescribe a particular drug from a specific group of broad-spectrum antibiotics independently, based on the situation and effectiveness of previously prescribed treatment.

Antibiotics of a wide spectrum of action for various diseases

A surprising feature of broad-spectrum antibiotics is the lack of the need to invent many such drugs for the treatment of various diseases. The same antibiotic can be used for the treatment of the respiratory system, and in the therapy of genito-urinary infections. Indications for use are noted in the instructions to the drugs, and the doctors-specialists have an opportunity to familiarize with them and use this information in their work.

Consider the use of different groups of active antibiotics in the therapy of the most popular pathologies.

Antibiotics of a wide spectrum of action at an infection of the genitourinary system. IMPP and UTI are the most common diagnoses in the practice of a urologist. Their treatment does not do without the use of effective antibiotics, which ideally should completely destroy the pathogens of infection, without causing much harm to the human body.

Drugs for the treatment of the genitourinary system should be excreted by the kidneys and be effective against any bacteria that can cause these pathologies. The use of several drugs is a stroke primarily about GIT (with oral administration), liver and kidneys. Avoid this allow antibiotics a wide range of action, because with the correct selection of drugs you can do with one single drug.

Infections of the genitourinary system can cause various types of bacteria, but the most popular are streptococci, staphylococcus and E. Coli, and with hospital infection - ureoplazma and chlamydia. They should be the purpose of an antibiotic.

This requirement corresponds to several groups of drugs:

• Beta-lactams
  • Penicillins (in particular aminopenicillins and combined antibiotics of a broad spectrum of action of the penicillin series, which are protected from the damaging effect of beta-lactamases by including inhibitors of this enzyme in the preparation).
  • Cephalosporins 3 and 4 generations with extended spectrum of action. The third generation of drugs is an effective remedy for pyelonephritis, and the 4th generation is an indispensable remedy for complex, persistent infections.
• Aminoglycosides. They are also used for pathologies of the urinary tract, but due to the negative effect on the kidneys, their use is justified only in a hospital setting.
• Macrolides are used only in connection with such pathology as non-gonococcal urethritis when an atypical microflora is detected (for example, chlamydia).
• The same can be said about tetracyclines.
• Carbapenems. They are often the drugs of choice for pyelonephritis (usually prescribed imipynem or its analogs).
• Fluoroquinolones are indicative of their ability to accumulate in tissues, including the urino-genital organs (bladder, kidney, prostate, etc.). And due to the ability to suppress most strains resistant to other antibiotics bacteria, they found quite a wide application in urology.

In particular,  with cystitis, one of the most common pathologies of the genitourinary system, the following broad-spectrum antibiotics are applicable:

• New generation penicillin drugs that are relevant for various pathogens (E. Coli, anaerobic microbes, trichomonads, chlamydia, mycoplasma, ureoplasma, etc.), including protected penicillins ("Augmentin", "Amoxiclav", etc.).
• Antibiotics of cephalosporin series, resistant to resistant strains of bacterial infection ("Ceftriaxone", "Cefotaxime" in the form of injections, "Cefurakshim" for oral administration, etc.).
• Macrolides ("Azithromycin" and its analogues for oral administration). The experience of their application in the therapy of urogenital infections in women with intolerance to penicillins is indicative, since macrolides have less toxicity.
• Fluoroquinolones ("Ciprofloxacin", "Nolitsin", etc.). Their advantage is a low multiplicity of administration and efficacy against strains that are insensitive to beta-lactams and macrolides. A good effect of the drugs shown in the treatment of acute cystitis, the causative agent of which is Pseudomonas aeruginosa.
• In addition, such broad-spectrum drugs as Monural, Levomycetin, Furadonin and other medications can be prescribed at the doctor's discretion.

Speaking of cystitis, we meant an inflammatory process in the bladder, but also inflammation of the kidneys (nephritis) is no less a pathology. Despite the fact that the concept of nephritis is a composite and implies several types of kidney pathologies, the most popular of which is pyelonephritis, the approaches to the treatment of these diseases in terms of antibiotic use have many common points of contact.

Antibiotics for inflammation of the kidneys  are used predominantly for a wide spectrum of action, since this pathology knows a large number of pathogens that can act both alone (representatives of one group) and collectively (representatives of several groups and strains of bacteria).

With the appointment of effective drugs, representatives of the penicillin series (Amoxicillin, Amoxiclav, etc.), who are effective in combating enterococci and Escherichia coli, come to the forefront. Such drugs can be prescribed even for the treatment of pyelonephritis in pregnancy.

As a variant for uncomplicated nephritis, macrolides (Sumamed, Vilprofen, etc.), effective both in the case of gram-negative pathogens and Gram-positive, can be prescribed.

Cephalosporins ("Ciprolet", "Tsefaleksin", "Supraks", etc.) are prescribed at a high probability of purulent inflammation. In the severe course of the disease and the development of complications, aminoglycosides ("Gentamycin", "Netilmicin", etc.) are preferred, and for strong pains - fluoroquinolones ("Levofloxacin", "Nolitsin", etc.).

Treatment of inflammatory kidney pathologies is always complex and multicomponent. Antibiotics can be administered either orally, and in the form of injections, which is often practiced in severe forms of kidney disease.

Many diseases of the reproductive system have an unpleasant property of being transmitted during sex. Thus, this becomes a problem for both genders. Treat such infectious diseases only with the use of effective antibiotics, and the earlier, the better. Therefore, in cases where  sexually transmitted diseases (STDs) can not immediately identify the pathogen, preference is given to broad-spectrum antibiotics.

Venereal diseases requiring the use of antibiotics can be different (syphilis, gonorrhea, urogenital chlamydia, Reiter's disease with an unidentified pathogen, venereal lymphogranulomatosis and granuloma), and the approach to their treatment of AMP may also differ.

With syphilis, preference is given to antibiotics of the penicillin series, which in this case are considered more effective. Treatment of gonorrhea is also better to start with these antibiotics, but in case of intolerance they can be replaced without doubt by other wide-spectrum antibiotics.

With urogenital chlamydiosis and Reiter's disease, mainly AMP tetracycline (Tetracycline and Doxycycline), macrolides (Erythromycin, Azithromycin, etc.) and fluoroquinolones (usually Ciprofloxacin) are used.

With venereal lymphogranulomatosis, preparations of tetracycline ("Dixycycline", "Metacyclin", etc.), and granuloma - penicillin series are used mainly. In the latter case, sometimes prescribed drugs and other groups (usually with intolerance to penicillins), for example, "Levomycetin", "Erythromycin", "Tetracycline", etc.

Among sexually transmitted infections, I want to note balanoposthitis. And although this pathology in the people is considered to be purely masculine, because it is the inflammation of the head and some part of the male penis, it can be transmitted sexually and women.

Antibiotics of a broad spectrum of action for balanoposthitis  are prescribed only in the advanced stage of the disease and only when it is not possible to identify the pathogen or several. With gangrenous, purulent-ulcerative and phlegmonous form of pathology, antibiotics are used mainly in injection form. With fungal pathogens, AMP is not used.

Another common pathology of health, reminiscent of itself in the autumn-winter period, is considered a cold. Such a diagnosis, of course not, usually it is a question of respiratory diseases, which in the medical card appear as ORZ or ARVI. In the latter case, the causative agent is a virus that is treated not with AMP, but with antiviral imunomodulating agents.

Antibiotics of a wide spectrum of action for cold  are appointed only in the event that weakening of immunity under the influence of the virus provokes the awakening of bacterial infections in the body 3-5 days after the appearance of the first symptoms of the disease. In this case, it is necessary to treat complications of the common cold, such as bronchitis, tracheitis, pneumonia, etc.

ARI, in turn, with ineffectiveness of treatment can easily go into the sore throat, which treatment is also performed with the use of antimicrobial drugs.

With an angina of  bacterial nature, a broad-spectrum antibiotic, which the doctor will first prescribe, will be from a number of penicillins effective against most pathogens of this pathology. The most popular drugs of this plan are "Amoxil", "Flemoxin", "Ampicillin", "Augmentin", etc.

If the patient is allergic to penicillins, they can be replaced by macrolides ("Erythromycin", "Clarithromycin", "Azithromycin", etc.). In pathology that occurs with complications, antibiotics of the cephalosporin series ("Ceftriaxone", "Cefabol, etc.) will be preferred.

Let us briefly consider which antibiotics are useful for the treatment of bronchitis and pneumonia. With bronchitis  with a large number of various pathogens, doctors prefer to prescribe broad-spectrum antibiotics for the following groups:

• Aminopenicillins ("Amoxicillin", "Augmentin", "Amoxiclav", etc.).
• Macrolides ("Azithromycin", "Summamed", "Macropen", etc.).
• Fluoroquinolones ("Ofloxacin", "Levofloxacin", etc.). Assign in the absence of problems with the work of the digestive tract.
• Cephalosporins ("Ceftriaxone", "Cefazolin", etc.), resistant to strains that destroy penicillins.

When pneumonia,  doctors prescribe the same groups of broad-spectrum antibiotics, but preference is given to:

• macrolides ("Azithromycin", "Clarithromycin", "Spiramycin, etc.)
• fluoroquinolones ("Levofloxacin", "Ciprofloxacin", etc.).

The purpose of AMP of a wide spectrum of action in this case is due to the long waiting time for the results of the tests to determine the pathogen. But pneumonia is accompanied by a strong rise in temperature and other severe symptoms, the rapid removal of which depends only on the effectiveness of the antibiotic.

Another common complication of acute respiratory disease and tonsillitis is otitis media (inflammation of the middle ear). The disease develops morbidly and the pathogen can not be identified, not always, so  when otitis  doctors prefer to use antibiotics in a wide range of activities. Usually, these are penicillin preparations (Amoxicillin, Augmentin, etc.) and cephalosporin ("Cefroxim", "Ceftriaxone", etc.), which can be administered either orally and injectively. In addition, the alcohol solution "Levomycetin" is often prescribed, which is used for instillation in the ear.

Antibiotics of a wide spectrum of action and for treatment of some gastrointestinal pathologies are applied  . To begin with, intestinal infections are quite common, occurring both in adult patients and among children. Their pathogens penetrate the body through unwashed hands, food, water. Unpleasant symptoms of intestinal infections are the result of poisoning the body with poison (enterotoxin) secreted by bacteria.

Dysentery, salmonellosis, cholera, escherichiosis, giardiasis, typhoid fever, food poisoning with staphylococcus - all these infectious pathologies are treated with antibiotics. The causative agents of these pathologies can become more than 40 species of pathogenic microorganisms, the detection of which requires time during which the toxic infection can spread, causing various complications. That is why the drugs of choice for intestinal infections are antibiotics that are active against a variety of bacteria.

Intestinal broad-spectrum antibiotic is  designed to prevent the development of the disease and intoxication of the organism, destroying completely any pathogen in the intestine.

This task is best handled by the new generation of cephalosporins (Claforan, Cefabol, Rozetsim and others) and fluoroquinolones (Ciprofloxacin, Normax, Ciprolet, etc.). And the drugs are used both in tablet form and in the form of injections.

Aminoglycosides for intestinal infections are used after the diagnosis is clarified. The same can be said about the antibiotics of penicillin ("Ampicillin") and tetracycline ("Doxal", "Tetradox", etc.) series.

For the treatment of Giardiasis, another wide-spectrum drug from the group of antiprotozoal antibiotics "Metronidazole" is used.

Everyone knows that such common gastrointestinal pathologies as gastritis and stomach ulcer are very often caused by the Helicobacter pylori bacterium. To treat such pathologies of a bacterial nature, despite the fact that the pathogen is known, all the same broad-spectrum antibiotics are used.

Gastric antibiotics of a wide spectrum of action  are all the same "Amoxicillin". "Clarithromycin", "Metronidazole", "Erythromycin", etc., which are used to eradicate bacterial infections in various treatment regimens. Sometimes two antibiotics are used simultaneously, and in other cases a three-component scheme is preferred.

Diseases of the prostate are a scourge of the male population of the planet. In one third of patients, prostatitis of bacterial nature is detected, which requires special antibacterial treatment.

With bacterial prostatitis,  doctors can apply any broad-spectrum antibiotics that can quickly cope with any infection.

We will describe them in descending order of frequency for this pathology:

• Fluoroquinolones ("Ofloxacin", "Ciprofloxacin", etc.)
• Tetracyclines of the new generation (Doxycycline, etc.)
• Penicillins, beginning with the third generation ("Amoxicillin", "Amoxiclav", etc.)
• Cephalosporins of a new generation ("Ceftriaxone", "Cefuroxime", etc.)
• Macrolides ("Azithromycin", "Wilprafen", "Josamycin", etc.).

Antibiotics of a wide spectrum of action and in gynecology are applied  . They are a universal medicine for any inflammatory process that has arisen in the internal sexual organs of a woman. In this case, their purpose is often carried out even before the results of smears on the microflora.

The most common appointments for gynecologists are Ampicillin, Erythromycin, Streptomycin, and other drugs from different groups of antibiotics that have activity against numerous types of bacterial infection. In severe pathologies, preference is given to the preparation "Amoxiclav" and to the representatives of cephalosporins. Sometimes a combination of broad-spectrum drugs such as Ginekit (azithromycin + secnidazole + fluconazole) is prescribed, which can defeat both bacterial and fungal infections.

Antibiotics of a wide spectrum of action have gained great popularity and for fighting infectious agents  in some skin diseases  (pemphigus of newborns, lupus erythematosus, erysipelas, red lichen, scleroderma, etc.). The advantage in this case remains with penicillins. The drugs of choice in most cases are: "Oxacillin", "Ampicillin", "Ampioks."

Also for skin diseases, AMP is widely used in the form of ointments. Antibiotic-containing ointments make it possible to influence the pathogen from the outside, which reduces the tonic effects for the patient's body (tetracycline, erythromycin, sintomycin, and many other ointments containing an antibiotic).

Antibiotics of a wide spectrum of action are applied and at such pathologies of a skin which are connected with its thermal or mechanical damage  (at wounds and burns). Treatment of small wounds usually does not require the use of serious AMP, but with the appearance of pus in the wound, the use of antibiotics becomes mandatory.

In the first days of treatment of purulent wounds, antibiotics of a broad spectrum of action (penicillins, cephalosporins and other types of AMP) are prescribed. The drugs are used both in tablets and injections, and in the form of solutions for the treatment of wounds. The second stage of treatment also shows the use of antibacterial gels and ointments.

With burns, the aim of antibiotic therapy is to prevent and prevent the spread of purulent infection that is characteristic of such wounds. The environment for reproduction of different microorganisms becomes necrotic tissue in place of a severe burn. With light burns, antibiotics are usually not used.

To suppress microbial infestation  with burns of 3 B and 4 degrees,  broad-spectrum antibiotics (protected and semi-synthetic penicillins, 3 generations of cephalosporins, aminoglycosides and fluoroquinolones) are used. If the process affects the bone structure, "Lincomycin" is prescribed. Systemic drugs are most often administered intramuscularly or intravenously. Local antibiotic therapy is selected depending on the nature of the wound process.

Surgical intervention also implies a violation of the integrity of the skin and underlying tissues. Despite the fact that operations are performed strictly in aseptic conditions, it is not always possible to avoid the risk of postoperative purulent complications. To prevent and treat such complications after surgery, just apply broad-spectrum antibiotics.

Drugs used in the postoperative period are selected by the doctor individually. The first place is occupied by cephalosporins ("Ceftriaxone", "Cefazolin", etc.) and aminoglycosides ("Amikacin", etc.). Then come protected penicillins (for example, "Amoxiclav") and carbapenems ("Maropenem", etc.).

Its use of antibiotics of a wide spectrum of action was found  in dentistry. Bacteria that are in the oral cavity, through the wounds on the mucosa and damage to the tooth enamel, can get inside the tissues of the jaw area. Such inflammatory processes (especially acute) occurring in the head region are considered very dangerous and require immediate treatment, including antibiotic therapy. Detection of the pathogen in this case is not always carried out. So the antibiotics of a wide spectrum of action remain the drugs of choice: protected penicillins (most often "Augmentin") and fluoroquinolones ("Pefloxacin" and its analogs, "Cyphran", etc.). Macrolides are also used (for example, Summamed) and Lincomycin.

[5], [6], [7], [8], [9], [10],

Release form

In the wide-spectrum antibiotics produced by the pharmaceutical industry, not only the names and scope of application, but also the release forms can differ. There are drugs that are intended only for oral administration or only for injecting, and others have several different forms of release, which makes it possible to apply them in different situations.

One of the most common forms of release of drugs are pills. Antibiotics of a broad spectrum of action in tablets are also used much more often than other dosage forms. In addition, many of them can easily be purchased at the pharmacy without a prescription.

The most popular penicillin drugs that are effective for various infectious pathologies of the respiratory, urogenital and other body systems, necessarily have the form of release in the form of tablets (as an option capsule or granule) for oral administration. It is especially convenient if the treatment is carried out on an outpatient basis, since it does not require additional costs and skills of use. This is largely due to the wider use of tablets than injectable solutions.

The most popular penicillins in tablets are Ampicillin, Amoxicillin, Amoxil, Flemoxin, Augmentin, Amoxiclav, Ecobol, Trifamox.

In cephalosporins 3 generations and above, which are often prescribed in place of penicillins with intolerance of the latter, the list of drugs in tablets is very small. The active substances of these preparations can be cefixime ("Cefixim", "Suprax", "Ceforal solutab", etc.) or ceftibutene ("Tsedeks", etc.).

Macrolides, which are well tolerated and able to inhibit bacterial infection, have a rather large list of drugs in tablets: Azithromycin, Sumamed, Azizid. Ecomed, Clarithromycin, Klabaks, Erythromycin, Macropen, Rulid, and others.

There are drugs in tablets and the most powerful group of antibacterial drugs - fluoroquinolones, designed to treat severe infections of the respiratory, urogenital, digestive and other systems. The most popular fluoroquinolone is ofloxacin, which in tablet form can be named "Ofloxacin", "Zanotsin", "Oflo", "Tarivid", etc.

No less popular are tablets based on ciprofloxacin (Ciprofloxacin, Ciprolet, Cyphran, etc.).

The most powerful representative of fluoroquinolones is moxifloxacin. Find it in the form of tablets can be called "Moxifloxacin", "Avelox", etc.

Despite the fact that many tablets from the AMP series can be purchased at the pharmacy without any restrictions, they can only be used for the prescribing of the attending physician and in the prescribed dosage.

The number of tablets in the packaging of AP may be different, as is the course of treatment with such drugs. Recently, the so-called broad-spectrum antibiotics are gaining popularity  for 3 days. The packaging of such AMS usually contains 3 (sometimes 6) tablets or capsules that are designed for a 3-day course of therapy. The dosage of such drugs is slightly higher than those that are designed for 5-14 days. A positive effect is achieved by a shock dose of an antibiotic.

Antibiotics for oral administration may also be available as a suspension or granules for its preparation. Antibiotics of a wide spectrum of action in a suspension  are most often used for the treatment of young children, to whom tablet forms simply do not fit. Suspension is also used if a person has certain difficulties with swallowing tablets.

The second popular form of release of broad-spectrum antibiotics is injection. In this case, some antibiotics can be found on sale in the form of ampoules with a ready injection solution, and others - in the form of a powder for the preparation of a solution, which is subsequently dissolved in a liquid medium (saline solution, anesthetics, etc.).

The way of using such drugs can also differ. Antibiotics of a wide spectrum of action in ampoules use parenteral administration of the drug: for intravenous or intramuscular injections, as well as for use in droppers.

Antibiotics of a broad spectrum of action  in injections  are usually used in the treatment of inpatients of medium and high severity. However, in some cases (for example, in pathologies of the gastrointestinal tract, when the drug irritation causes additional trauma to the gastric mucosa), the ampoule form of the drug may be prescribed for treatment on an outpatient basis. In this case, the injections are made by health workers in fizkabinets of medical institutions or a nurse coming to the house.

If the drug is sold not in a liquid form, but in powder or suspension for the preparation of an injection or infusion solution, then it will be necessary to add a solvent, prescribed by the doctor along with the antibiotic, in addition to the syringe. For infusion administration of the drug will need a system (dropper).

Antibiotics in injections are faster and more effective than oral forms. Their use is indicated in severe pathologies requiring urgent measures. Relief in this case occurs already in the first days of taking the drug.

Antibiotics of a wide spectrum of action  in ampoules  with a ready solution or a medicinal substance for its preparation are practically in all groups of preparations. Among the popular tetracycline drugs in the form of injections, you can use "tetracycline" and "doxycycline." In cephalosporins, most drugs are available in the form of powder for the preparation of solutions for the transdermal administration ("Ceftriaxone", "Cefazolin", etc.). Carbapenems are produced only in the form of injectable solutions.

This form of release is available in penicillins (Penicillin, Ampilillin, Trifamox, Ampiside, Timentin, Tizacin, etc.) and fluoroquinolones (Levofloxacin).

Very often injections of antibiotics are painful, so for intramuscular injection the drugs in the powder are diluted with a solution of lidocaine.

Ointments with a broad-spectrum antibiotic  are not used as often as the above forms. However, in some cases, their use significantly increases the effectiveness of antibiotic therapy.

Their use is actual in infectious pathologies of the organs of vision, external otitis, infectious diseases of the skin, healing of wounds and burns, etc. In these cases, the use of systemic drugs does not always allow for good results, while the ointment makes it possible to act directly on the bacterial pathogen located on the surface of the body. In addition to the composition of the ointment, in addition to the antibiotic, you can add other components that have a positive effect on the wound.

With skin diseases, such ointments as "Baneocin", "Fastin", "Fuziderm", "Levosin", "Terramycin ointment", "Synthomycin" have become very popular. Ointment with antibiotic "Sangviritrin" is used in dermatology and dentistry. Ointment "Dalatsin" is used in gynecology for inflammatory diseases caused by some bacterial pathogens.

A tetracycline and erythromycin ointment are effective in the treatment of infectious diseases of the eyes, as well as pustules on the skin and mucous membranes. They are generally considered to be a broad-spectrum eye antibiotic. Although ointments are not the only and preferred form of release of antibiotics in eye diseases. Yes, and doctors often prefer  eye drops with broad-spectrum antibiotics, which are more convenient to use.

Eye drops with antibiotic contain AMP of certain groups. These are aminoglycosides, fluoroquinolones and levomycetin (drops "Torbeks", "Tsipromed", "Levomycetin", etc.).

Antibiotics of a wide spectrum of action can be issued and in the form of rectal or vaginal suppositories. Most often, such drugs are used in gynecology for the treatment of inflammation immediately after its detection, while the smear for microflora is being analyzed. Often, this form of the drug is prescribed in parallel with the use of antibacterial tablets. Suppositories under the influence of heat from the body dissolve and release the active substance, which has the ability to act directly in the source of infection.

[11], [12], [13], [14], [15], [16], [17], [18]

Pharmacodynamics

Antibiotics of a wide spectrum of action of various groups can render unequal influence on pathogenic microorganisms. The action of some is aimed at destroying the bacterial cell structure (bactericidal), while others are aimed at inhibiting (inhibiting) the synthesis of protein and nucleic acids (bacteriostatic).

Bactericidal antibiotics of a  wide range of action, inhibiting the biosynthesis of the cell wall of pathogenic bacteria, thereby destroying them. Bacteria can not continue to develop and die. Such action is particularly rapid in the case of bacteria that are capable of active propagation (and microorganisms multiply by dividing the cell). The lack of a wall in "newborn" bacteria contributes to the fact that they quickly lose the substances necessary for life, and die in fact from exhaustion. To kill adult bacteria this way takes a little longer. A disadvantage of drugs with bactericidal action is relatively high toxicity for the organism (especially at the time of the death of a large number of bacteria) and a small selectivity of action (not only pathogenic but also beneficial microorganisms perish).

Bacteriostatic antibiotics of a  wide range of action affect microorganisms differently. By inhibiting the production of a protein that participates in virtually all processes in the living body and nucleic acids that carry important genetic information, they thereby inhibit the ability of the bacteria to multiply and preserve species characteristics. At the same time, microorganisms do not die, but go into an inactive stage. With good work of the human immune system, such bacteria are no longer able to cause the development of the disease, so the symptoms disappear. Alas, with weak immunity, the effects of drugs with a bacteriostatic effect will not be enough. But they have less toxic effect on the human body than bactericidal drugs.

Antibiotics of the  penicillin series of a  wide spectrum of action are famous for their appreciable bactericidal action on the majority of gram-positive and gram-negative bacteria (staphylococci, streptococci, diphtheria, anaerobes, striptoheta, etc.). They found wide application in the treatment of infectious diseases of the respiratory organs (pneumonia, bronchitis, etc.) and ENT organs (otitis, sinusitis, etc.), infections of the abdominal cavity (peritonitis), genitourinary system (pyelonephritis, cystitis, etc.). They are used for purulent surgical infections and for preventing complications after surgical interventions.

The most common are semisynthetic (they are more resistant to the acidic environment of the stomach and can be used orally) and protected penicillins (combined preparations resistant to the effects of beta-lactamase enzymes that destroy them, produced by bacteria for protection purposes).

The disadvantage of AMP penicillin series is considered a high probability of allergic reactions of varying severity, including life-threatening. But these drugs are considered the least toxic of all known AMP.

Antibiotics of a wide spectrum of action of a  cephalosporin series  also possess a strong bactericidal action. They have good resistance to beta-lactamases and do not require the inclusion of additional components. The disadvantage of these antibiotics is that most of these effective drugs are not absorbed into the digestive tract, which means that they can be used only parenterally (in the form of injections and droppers). Nevertheless, these AMPs have found wide application in the therapy of infectious pathologies in the respiratory and urogenital systems. They are used in the treatment of venereal diseases, infections of the ENT organs, for the control of pathogens of peritonitis, endocarditis, as well as diseases of joints and bones.

Broad-spectrum antibiotics from aminoglycosides and fluoroquinolones are also classified as AMP with a bactericidal effect, but they are prescribed much less often. Aminoglycosides are useful in controlling anaerobic bacteria and Pseudomonas aeruginosa, but because of the large neurotoxicity they are rarely used, and fluoroquinolones with their powerful antibacterial action are preferred mainly in severe purulent infections.

Individual preparations from the aminoglycoside group can also have bacteriostatic effects.

Antibiotics of a wide spectrum of action  from the group of macrolides, like tetracyclines, belong to AMP with bacteriostatic action. With their help they treat infectious diseases of the skin, respiratory organs, joints. Indicative is their use in severe diseases, (for example, with pneumonia) in combination with bactericidal antibiotics. Such a double effect of AMP enhances the therapeutic effect. In this case, the toxic effect on the body does not increase, since macrolides are considered one of the least toxic drugs. In addition, they rarely cause allergic reactions.

Speaking about bactericidal and bacteriostatic action of AMP it is necessary to understand that the same drug, depending on the pathogen and the dosage used, can have either one or the other action. So, penicillins at a small dosage or in case of using them for fighting enterococci have a bacteriostatic rather than bactericidal effect.

Dosing and administration

We figured out what antibiotics are of a wide spectrum of action and how they work with various infectious pathologies. Now it's time to get to know more closely the most prominent representatives of various groups of the AASD.

List of broad-spectrum antibiotics

Let's start with the popular antibiotics of a wide range of action of the penicillin series.

[19], [20], [21], [22],

Amoxicillin

The drug belongs to the class of semisynthetic antibiotics of the penicillin series of a broad spectrum of the 3 rd generation. With its help, many infectious pathologies of ENT organs, skin, bile ducts, bacterial diseases of the respiratory, genitourinary and musculoskeletal systems are treated. It is used in conjunction with other AMPs and for the therapy of inflammatory gastrointestinal pathologies caused by bacterial infection (the notorious Helicobacter pylori).

The active substance is amoxicillin.

Pharmacodynamics

Like other penicillins, Amoxicillin has a pronounced bactericidal effect, destroying the bacterial cell membrane. Such an effect it has on gram-positive (streptococci, staphylococcus, clostridia, most of the corynobacteria, eubacteria, causative agents of anthrax and erysipelas) and gram-negative aerobic bacteria. Nevertheless, the drug remains ineffective against strains capable of producing penicillas (aka beta-lactamase), so in some cases (for example, with osteomyelitis) it is used in conjunction with clavulanic acid, which protects Amoxicillin from destruction.

Pharmacokinetics

The drug is considered resistant to the effects of acid, so it is taken orally. In this case, it is absorbed in the intestines and spreads through tissues and body fluids, including the brain and the cerebral spinal fluid. After 1-2 hours, the maximum concentration of AMP in the blood plasma can be observed. With normal functioning of the kidneys, the half-life of the drug will be from 1 to 1.5 hours, otherwise the process can take up to 7-20 hours.

The drug is excreted mainly through the kidneys (about 60%), some part in the original form is removed from the bile.

Use during pregnancy

Amoxicillin is allowed for use during pregnancy, because the toxic effects of penicillins are weak. However, doctors prefer to seek antibiotic care only if the disease threatens the life of the expectant mother.

The ability of an antibiotic to penetrate into fluids, including breast milk, requires, for the period of treatment, the preparation to transfer the baby to milk formulas.

Contraindications for use

Due to the fact that penicillins are generally relatively safe, there are very few contraindications to the use of the drug. It is not prescribed for hypersensitivity to the components of the drug, with intolerance to penicillins and cephalosporins, as well as in such infectious pathologies as mononucleosis and lymphocytic leukemia.

Side effects

First of all Amoxicillin is famous for the possibility of developing allergic reactions of varying severity, ranging from rashes and itching on the skin and ending with anaphylactic shock and Quinck's swelling.

The drug passes along the gastrointestinal tract, so it can cause unpleasant reactions from the digestive system. Most often it's nausea and diarrhea. Occasionally, colitis and thrush may develop.

The liver is not taking the drug can respond with increased hepatic enzymes. In rare cases, develops hepatitis or jaundice.

Headache and insomnia drug rarely causes, as, however, a change in the composition of urine (the appearance of crystals of salts) and blood.

Dosing and Administration

The drug on sale can be found in the form of tablets, capsules and granules for the preparation of a suspension. You can take it regardless of the meal at an interval of 8 hours (with pathologies of the kidneys -12 hours). A single dose varies from 125 to 500 mg depending on the age (for children up to 2 years - 20 mg per kg).

Overdose

Overdose can occur when the admissible dose of the drug is exceeded, but usually it is accompanied only by the appearance of more pronounced side effects. Therapy consists of washing the stomach and taking sorbents, in severe cases resorting to hemodialysis.

Interactions with other drugs

Amoxicillin has a negative effect on the effectiveness of oral contraceptives.

Undesirable simultaneous reception of the drug with probenecid, allopurinol, anticoagulants, antacids, antibiotics with bacteriostatic effect is undesirable.

Storage conditions

Store the drug at room temperature in a dry and darkened room. Keep away from children.

Shelf life

Shelf life of the drug of any of the forms of release is 3 years. The suspension prepared from granules can be stored for no more than 2 weeks.

[23], [24], [25], [26], [27], [28], [29]

Amoxiclav

Combined drug of the new generation of penicillin. Representative of protected penicillins. It has 2 active ingredients: antibiotic amoxicillin and penicillase inhibitor clavuonic acid, which has a slight antimicrobial effect.

Pharmacodynamics

The drug has a pronounced bactericidal effect. Effective against most Gram-positive and Gram-negative bacteria, including strains resistant to unprotected beta-lactams.

Pharmacokinetics

Both active substances are rapidly absorbed and penetrate into all the environments of the body. Their maximum concentration is noted one hour after administration. The half-life period ranges from 60 to 80 minutes.

Amoxicillin is excreted unchanged, and clavuonic acid is metabolized in the liver. The latter is excreted by the kidneys, like amoxicillin. However, a small part of its metabolites can be found in feces and exhaled air.

Use during pregnancy

For vital signs, use during pregnancy is allowed. When breastfeeding, you need to consider that both components of the drug are able to penetrate into breast milk.

Contraindications for use

The drug is not used for violations of liver function, especially associated with the intake of any of the active substances, which was noted in the anamnesis. Do not appoint Amoxiclav and hypersensitivity to the components of the drug, and if in the past there have been reactions of intolerance to beta-lactams. Infectious mononuleosis and lymphatic leukemia also refer to contraindications for this drug.

Side effects

The side effects of the drug are identical to those observed during the administration of Amoxicillin. They suffer from no more than 5% of patients. The most common symptoms: nausea, diarrhea, various allergic reactions, vaginal candidiasis (thrush).

Dosing and Administration

The drug in the form of tablets is taken regardless of the meal. The tablets are dissolved in water or chewed with water in an amount of ½ cup.

Usually a single dose of the drug is equal to 1 tablet. The interval between doses is 8 or 12 hours, depending on the weight of the tablet (325 or 625 mg) and severity of the pathology. Children under 12 years of age are given a drug in the form of a suspension (10 mg per kg per 1 dose).

Overdose

When an overdose of the drug life-threatening symptoms are not observed. Usually, everything is limited to abdominal pain, diarrhea, vomiting, dizziness, sleep disturbances.

Therapy: gastric lavage plus sorbents or hemodialysis (blood purification).

Interactions with other drugs

It is undesirable to take the drug simultaneously with anticoagulants, diuretics, NVPs, allopurinol, phenylbutazone, metotriecate, disulfiram, probenecid because of the development of side effects.

Parallel administration with antacids, glucosamine, laxatives, rifampicin, sulfonamides and antibiotics with bacteriostatic action reduces the effectiveness of the drug. He himself reduces the effectiveness of contraceptives.

Storage conditions

Store the drug at room temperature away from sources of moisture and light. Keep away from children.

Shelf life

The shelf life of the drug, subject to the above requirements, will be 2 years.

As for the drug "Augmentin", it is a complete analogue of "Amoxiclave" with the same indications and method of application.

Now let's move on to the no less popular group of broad-spectrum antibiotics - cephalosporins.

[30], [31], [32], [33], [34], [35], [36], [37], [38]

Ceftriaxone

Among the antibiotics of the third generation of cephalosporins, he is a great favorite among therapists and pulmonologists, especially when it comes to severe pathologies prone to complications. It is a drug with a pronounced bactericidal action, the active substance of which is ceftriaxone sodium.

The antibiotic is active against a huge list of pathogenic microorganisms, including many hemolytic streptococci, considered the most dangerous pathogens. Most strains producing enzymes against penicillins and cephalosporins remain sensitive to it.

In this regard, the drug is indicated in many pathologies of the abdominal organs, infections affecting the musculoskeletal, urogenital and respiratory system. It helps to treat sepsis and meningitis, infectious pathologies in weakened patients, and prevent infections before and after operations.

Pharmacokinetics

The pharmacokinetic properties of the preparation are highly dependent on the administered dose. Only half-life (8 hours) remains constant. The maximum concentration of the drug in the blood with intramuscular injection is observed after 2-3 hours.

Ceftriaxone penetrates well into various environments of the body and retains sufficient concentration for the day to kill most bacteria. Metabolized in the intestine with the formation of inactive substances, is excreted in equal amounts with urine and bile.

Use during pregnancy

The drug is used in those cases if there is a real threat to the life of the future mother. From breastfeeding for the period of treatment with the drug should be discarded. Such limitations are due to the fact that ceftriaxone is able to pass through the placental barrier and penetrate into breast milk.

Contraindications for use

The drug is not prescribed for severe liver and kidney pathologies with violations of their functions, gastrointestinal pathologies affecting the intestine, especially if they are associated with taking AMP, with hypersensitivity to cephalosporins. In pediatrics, they are not used to treat newborns diagnosed with hyperbilirubinemia, in gynecology - in the first semester of pregnancy.

Side effects

The incidence of undesirable effects during the administration of the drug does not exceed 2%. Most often, nausea, vomiting, diarrhea, stomatitis, reversible changes in blood composition, skin allergic reactions are noted.

Less common headache, fainting, fever, severe allergic reactions, candidiasis. Occasionally, inflammation may occur at the site of injection, painful sensations with the / m administration are removed with the help of ice medicine, administered in a single syringe with ceftriaxone.

Dosing and Administration

It is mandatory to conduct a sample of the tolerability of ceftriaxone and lidocaine.

The drug can be administered intramuscularly and intravenously (injections and infusions). With the / m introduction, the drug is diluted in 1% solution of ice medicine, with IV: in case of injections, water is used for injections, for drippers - one of the solutions (saline solution, glucose solutions, levulose, dextran in glucose, water for injection).

The usual dosage for patients over 12 years is 1 or 2 g of ceftriaxone powder (1 or 2 bottles). For children, the drug is administered at a rate of 20-80 mg per kg of body weight, taking into account the age of the patient.

Overdose

In case of an overdose of the drug, neurotoxic effects and an increase in side effects are observed, including convulsions and confusion. Treatment is carried out in a hospital.

Interactions with other drugs

The antagonism between ceftriaxone and chloramphenicol was noted experimentally. Physical incompatibility is also observed with aminoglycosides, so when combined therapy drugs are administered separately.

The preparation is not mixed with solutions containing calcium (solutions of Hartmann, Ringer, etc.). It is not recommended simultaneous administration of ceftriaxone with vancomycin, fluconazole or amzacrine.

Storage conditions

Vials with the drug should be stored at room temperature, protecting them from light and moisture. The finished solution can be stored for 6 hours and at a temperature of the order of 5 ^to C it retains its properties during the day. Keep away from children.

Shelf life

Shelf life of the antibiotic in powder is 2 years.

[39], [40], [41], [42], [43], [44]

Cefotaxime

One of the 3 generation cephalosporins, showing, like others, a good bactericidal effect. The active substance is cefotaxime.

It is used for the same pathologies as the previous drug, found wide application in the therapy of infectious diseases of the nervous system, with the infection of blood (septicemia) with bacterial elements. It is intended only for parenteral administration.

It is active against many, but not all, bacterial pathogens.

Pharmacokinetics

The maximum concentration of cefutaxime in the blood is observed after half an hour, and the bactericidal effect lasts 12 hours. The half-life period ranges from 1 to 1.5 hours.

Has good penetrating ability. In the process of metabolism forms an active metabolite, which is excreted with bile. The bulk of the drug in its original form comes out with urine.

Use during pregnancy

The drug is forbidden to use during pregnancy (at any time) and breastfeeding.

Contraindications for use

Do not prescribe with hypersensitivity to cephalosporins and during pregnancy. With intolerance to ice cream, the drug can not be administered intramuscularly. Do not make intramuscular injections and children younger than 2 and a half years.

Side effects

The drug can cause both mild skin reactions (redness and itching) and severe allergic (Quincke's edema, bronchospasm, and in some cases anaphylactic shock).

Some patients report epigastric pain, stool disorders, dyspepsia. There are small changes in the liver and kidneys, as well as in laboratory blood tests. Sometimes patients complain of fever, inflammation at the injection site (phlebitis), worsening of the condition due to the development of superinfection (repeated infection with a modified bacterial infection).

Dosing and Administration

After carrying out the test for sensitivity to cefotaxime and lidocaine, the drug is prescribed in a dosage of 1 g (1 vial of powder) every 12 hours. In severe infectious lesions, the drug is administered 2 g every 6-8 hours. The dose for newborns and premature infants is 50-100 mg per kg of body weight. Dosage is also calculated for children older than 1 month. Babies up to 1 month are prescribed 75-150 mg / kg per day.

For intravenous injections, the drug is diluted in water for injection, for drip (within an hour) - in saline solution.

Overdose

An overdose of the drug can cause damage to the brain structures (encephalopathy), which is considered reversible with appropriate professional treatment.

Interactions with other drugs

It is undesirable to apply the drug simultaneously with other types of antibiotics (in one syringe). Aminoglycosides and diuretics can increase the toxic effect of the antibiotic on the kidneys, so combination therapy should be carried out with monitoring the condition of the organ.

Storage conditions

Store at a temperature no higher than 25 ^{on the} C in dry darkened room. Ready solution at room temperature can be stored up to 6 hours at a temperature of from 2 to 8 ^{of the} C - not more than 12 hours.

Shelf life

The preparation in the original packaging can be stored for up to 2 years.

[45], [46], [47], [48], [49], [50], [51],

Hepatsef

This drug also applies to antibiotics of the 3-generation cephalosporin series. It is intended for parenteral administration for the same indications as the 2 above described drugs from the same group. The active substance - cefoperazone, has a noticeable bactericidal effect.

Despite the great effectiveness with respect to many significant pathogenic microorganisms, many bacteria produced by beta-lactamase retain antibiotic resistance to it, i.e. Remain insensitive.

Pharmacokinetics

With a single administration of the drug, a high content of active substance in liquid body fluids such as blood, urine and bile is already observed. The half-life of the drug does not depend on the mode of administration and is 2 hours. It is excreted in urine and bile, and in bile its concentration remains higher. Does not accumulate in the body. The repeated administration of cefoperazone is also permissible.

Use during pregnancy

You can use the drug during pregnancy, but without the special need to use it is not necessary. In breast milk, an insignificant part of cefoperazone falls, and yet breastfeeding during the treatment with Hepatsef should be limited.

Contraindications for use

Other contraindications to use, in addition to intolerance to antibiotics cephalosporin series, the drug is not found.

Side effects

Skin and allergic reactions to the drug occur infrequently and are associated mainly with hypersensitivity to cephalosporins and penicillins.

Symptoms such as nausea, vomiting, stool, jaundice, arrhythmia, increased blood pressure (in rare cases, cardiogenic shock and cardiac arrest), exacerbation of sensitivity of teeth and gums, anxiety, etc. May be noted. Superinfection may develop.

Dosing and Administration

After carrying out a skin test for cefoperazone and lidocaine, the drug can be administered both intravenously and intramuscularly.

The usual adult daily dosage ranges from 2 to 4, which corresponds to 2-4 vials of the drug. The maximum dose is 8 g. The drug should be injected every 12 hours, evenly distributing the daily dose.

In some cases, the drug was administered in large doses (up to 16 g per day) at an interval of 8 hours, which did not adversely affect the patient's body.

The daily dose for a child, starting from the newborn period, is 50-200 mg per kg of body weight. Maximum 12 g per day.

With the / m introduction, the drug is diluted with lidocaine, with / in water for injection, saline solution, glucose solution, Ringer's solution and other solutions containing the above-mentioned fluids.

Overdose

Acute toxic effects of the drug does not. Possible increased side effects, the appearance of seizures and other neurological reactions due to the drug getting into the cerebrospinal fluid. In severe cases (for example, with renal failure), treatment can be carried out through hemodialysis.

Interactions with other drugs

Do not administer the drug simultaneously with aminoglycosides.

At the time of treatment, the drug should be limited to the use of alcohol-containing beverages and solutions.

Storage conditions

Store the preparation is recommended in the native containers at low positive temperatures (up to 8 ^on C) in a dark, dry place.

Shelf life

The drug retains its properties for 2 years from the date of release.

Antibiotics from the group of fluoroquinolones help physicians with severe infectious pathologies.

[52], [53], [54], [55], [56], [57]

Ciprofloxacin

A popular budget antibiotic from the group of fluoroquinolones, which is available in the form of tablets, solutions and ointments. Has a bactericidal action against many anaerobes, chlamydia, mycoplasma.

Has a wide range of indications for use: infections of the respiratory system, middle ear, eyes, urinary and genital system, abdominal cavity organs. It is also used in the therapy of infectious skin diseases and the musculoskeletal system, as well as for preventive purposes in patients with immunocompromised patients.

In pediatrics, it is used to treat a complicated course of illnesses if there is a real risk to the life of the patient that exceeds the risk of developing joint pathologies when treated with the drug.

Pharmacokinetics

With the oral administration of the drug, it is quickly absorbed into the blood in the initial part of the intestine and penetrates into various tissues, liquids and cells of the body. The maximum concentration of the drug in the blood plasma is observed after 1-2 hours.

Partially metabolized with the release of low-activity metabolites with antimicrobial action. The elimination of the drug is mainly involved in the kidney and intestines.

Use during pregnancy

The drug is not used at any time of pregnancy due to the risk of damage to the cartilage tissue in newborns. For the same reason, it is worth noting breastfeeding for the period of drug therapy, since ciprofloxacin freely penetrates into breast milk.

Contraindications for use

The drug is not used to treat pregnant and lactating women. Peroral forms of the drug are not used in people with deficiency of gluose-6-phosphate dehydrogenase and patients under 18 years of age.

It is forbidden to use drugs for patients with hypersensitivity to ciprofloxacin and other fluoroquinolones.

Side effects

Usually the drug is tolerated by patients normally. Only in some cases can there be various abnormalities of the digestive tract, including bleeding in the stomach and intestines, headaches, sleep disturbances, tinnitus and other unpleasant symptoms. There are rare cases of arrhythmias and hypertension. Allergic reactions also occur very rarely.

Can provoke the development of candidiasis and dysbiosis.

Dosing and Administration

Peroral and intravenously (jet or drip) the drug is used 2 times a day. In the first case, a single dose is from 250 to 750 mg, in the second - from 200 to 400 mg. The course of treatment is from 7 to 28 days.

Local treatment of the eye with drops: drip every 1-4 hours for 1-2 drops in each eye. Suitable for adults and children, starting from 1 year.

Overdose

Symptoms of drug overdose when ingested indicate an increase in its toxic effect: headache and dizziness, trembling in the limbs, weakness, convulsions, the appearance of hallucinations, etc. In large doses leads to impaired renal function.

Treatment: gastric lavage, taking antacids and vomit preparations, plentiful drink (acidified liquid).

Interactions with other drugs

Beta-lactam antibiotics, aminoglycosides, vancomycin, clindomycin and metronidazole increase the effect of the drug.

It is not recommended to take ciprofloxacin concurrently with sucralfate, bismuth preparations, antacids, vitamin-mineral supplements, caffeine, cyclosporine, oral anticoagulants, tizanidine, aminophylline and theophylline.

Storage conditions

Store the drug at room temperature (up to 25 ^о С). Keep away from children.

Shelf life

The shelf life of the drug should not exceed 3 years.

Ciprolet - another popular drug from the group of fluoroquinolones, belonging to the category of broad-spectrum antibiotics. This drug is an inexpensive analog of the preparation Ciprofloxacin with the same active substance. Has indications similar to the above-mentioned drug for use and release forms.

The popularity of the antibiotics of the next group - macrolides - is caused by low toxicity of these drugs and relative hypoallergenicity. Unlike the above AMP groups, they have the property of inhibiting the multiplication of a bacterial infection, but they do not completely destroy the bacteria.

[58], [59], [60], [61]

Sumamed

A physician's favorite antibiotic of a wide spectrum of action, which belongs to the group of macrolides. On sale can be found in the form of tablets and capsules. But there are also forms of the drug as a powder for the preparation of the oral suspension and lyophilizate for the preparation of injection solutions. The active substance is azithromycin. It is characterized by bacteriostatic action.

The drug is active against most anaerobic bacteria, chlamydia, mycoplasma, etc. It is used primarily for the treatment of respiratory infections and ENT organs, as well as for infectious skin and muscle pathologies, STDs, gastrointestinal diseases caused by Helicobacter pylori ..

Pharmacokinetics

The maximum concentration of the active substance in the blood is observed after 2-3 hours after its administration. In tissues, the content of the drug is ten times higher than in liquids. It is excreted from the body for a long time. The half-life can be from 2 to 4 days.

It is excreted mainly with bile and slightly with urine.

Use during pregnancy

According to experiments with animals, azithromycin has no adverse effect on the fetus. And yet, when treating people, the drug should be used only in extreme cases because of a lack of information about the human body.

The concentration of azithromycin in breast milk is not clinically significant. But the decision about breastfeeding during the period of drug therapy should be well thought out.

Contraindications for use

The drug is not prescribed for hypersensitivity to azithromycin and other macro-lysers, including ketolides, as well as in renal or hepatic insufficiency.

Side effects

Undesirable reactions during the administration of the drug are observed in only 1% of patients. It can be dyspeptic phenomena, disorders of stool, deterioration of appetite, development of gastritis. Sometimes there are allergic reactions, including angioedema. May cause inflammation of the kidney or thrush. Sometimes the medication is accompanied by pain in the heart, headaches, drowsiness, sleep disturbances.

Dosing and Administration

Tablets, capsules and suspension should be taken once every 24 hours. At the same time, the last two forms are taken either an hour before meals, or 2 hours after eating. You do not need to chew the tablets.

A single adult dose of the drug is 500 mg or 1 g, depending on the pathology. Therapeutic course - 3-5 days. Dosage for a child is calculated based on the age and weight of the small patient. Children up to 3 years are given a drug in the form of a suspension.

The use of lyophilate implies a 2-step process of preparation of a medicinal solution. First, the drug is diluted with water for injection and shaken, then add saline solution, r-dextrose or Ringer's solution. The drug is administered only intravenously in the form of a slow infusion (3 hours). The daily dose is usually 500 mg.

Overdose

Overdose of the drug manifests itself in the form of side effects of the drug. Treatment is symptomatic.

Interactions with other drugs

It should not be used simultaneously with ergot preparations due to the development of strong toxic effects.

Lincosamines and antacid agents can weaken the action of the drug, and tetracyclines and chloramphenicol - strengthen.

Undesirable simultaneous administration of the drug with drugs such as heparin, warfarin, ergotamine and its derivatives, cycloseril, methylprednisolone, felodipine. Indirect anticoagulants and agents exposed to microsomal oxidation increase the toxicity of azithromycin.

Storage conditions

Store the drug in a dry room with a temperature regime of 15-25 degrees. Keep away from children.

Shelf life

Shelf life of capsules and tablets is 3 years, powder for oral administration and lyophilate - 2 years. The suspension prepared from a powder is stored no more than 5 days.

[62], [63], [64]

Antibiotics for children with a broad spectrum of action

When studying the description of various broad-spectrum antibiotics, it is easy to see that not all of them are used to treat children. The danger of development of toxic effects and allergic reactions makes doctors and parents of the baby think a thousand times before offering a child an antibiotic.

It is clear that if possible, it would be better to refuse to take such strong drugs. But this is not always possible. And here you already have to choose from all the diversity of AMP that will help the child cope with the disease without causing much harm to his body.

Such relatively safe drugs can be found in virtually any of the groups of antibiotics. For small children forms of preparations in the form of a suspension are provided.

The administration of drugs with a wide range of antimicrobial activity in pediatrics is practiced when there is no possibility to quickly identify the causative agent of the disease, while the disease is actively gaining momentum and carries an obvious danger to the child.

The choice of an effective antibiotic is carried out according to the following principle: the drug should show sufficient activity in relation to the prospective causative agent of the disease in minimally effective doses and to have the form of release corresponding to the age of the child. Multiplicity of reception of such antibiotics should not exceed 4 times a day (for newborns - 2 times a day).

The instructions to the drug should also indicate how to calculate the effective dose of the drug for a child of the appropriate age and weight.

These requirements are met by the following drugs:

• Penicillin group - amoxicillin, ampicillin, oxacillin and some preparations on their basis: Augmentin, Flemoxin, Amoxil, Amoxiclav, etc.
• Cephalosporin group - ceftriaxone, cefuroxime, cefazolin, cefamandol, ceftibuten, cefipim, cefoperazone and some preparations on their basis: Zinnat, Tsedeks, Vineks, Supraks, Azaran, etc.
• Aminoglycosides based on streptomycin and gentamicin
• Carbapenems - Imipenem and Moropenem
• Macrolides - Clarithromycin, Clacid, Sumamed, Macroben, and others.

On the possibilities of using the drug in childhood can be found from the instructions attached to any medication. However, this is not an excuse to prescribe to your child antimicrobial drugs on your own or change the appointment of a doctor at your discretion.

Frequent sore throats, bronchitis, pneumonia, otitis, various colds in childhood have long surprised neither doctors nor parents. And taking antibiotics with these diseases is not uncommon, as the kids do not yet have a sense of self-preservation, and they continue to actively move and communicate even during the illness, which causes various complications and the joining of other types of infection.

It should be understood that the mild course of the above pathologies does not require the administration of antibiotics either a broad or a narrow spectrum of action. They are prescribed for the transition of the disease to a more severe stage, for example, with purulent angina. In viral infections, antibiotics are prescribed only in case of bacterial infection, which is manifested in the form of various serious complications of acute respiratory viral infection. With the allergic form of bronchitis, the use of AMP is impractical.

The appointments of doctors with different pathologies of the respiratory organs and ENT organs can also differ.

For example, with angina, doctors prefer drugs from macrolide groups (Sumamed or Clacid), which give babies in the form of a suspension. Treatment of complicated purulent sore throat is carried out mainly by Ceftriaxone (most often in the form of IM injections). From cephalosporins for oral administration, a suspension of Zinnat can be used.

With bronchitis, the drugs of choice are often penicillins (Flemoxin, Amoxil, etc.) and cephalosporins for oral administration (Suprax, Cedex). With complicated pathologies again resort to the help of Ceftriaxone.

For complications of acute respiratory infections and ARI, protected penicillins (usually Augmentin or Amoxiclav) and macrolides (Sumamed, Macroben, etc.) are shown.

Usually antibiotics intended for the treatment of children have a pleasant taste (often crimson or orange), so there are no special problems with their reception. But anyway, before offering a medicine to a child, it is necessary to find out from what age it is possible to take it and with what side effects one may encounter in the course of drug therapy.

The use of penicillins and cephalosporins can cause allergic reactions in the child. In this case, antihistamines Suprastin or Tavegil will help.

Many broad-spectrum antibiotics can lead to the development of dysbacteriosis and vaginal candidiasis in girls. To improve digestion and normalize the microflora of the body will help such safe drugs as probiotics: Lineks, Hilak forte, Probiophore, Atzilact, etc. These same measures will help to maintain and even strengthen the immunity of the baby.

[65], [66], [67], [68], [69]

The best broad-spectrum antibiotic

Having learned about the disease, each of us wants to get the best treatment with the use of the most effective drugs, in order to get rid of it in a short time. In the case of infectious diseases, everything seems extremely simple: it is worth dealing with a bacterial pathogen, and the disease will be defeated. But to destroy pathogenic microorganisms can only antimicrobial drugs, among which the widely used antibiotics are widely used.

Alas, despite the development of new technologies in pharmaceuticals, scientists have not yet invented a universal medicine that can fight absolutely all types of bacterial infection. Yes it is impossible, because new uninvestigated microorganisms constantly appear in the world, mutations occur, as a result of which new strains of already known bacteria are formed, with which even drugs of new generations can not cope.

In connection with the foregoing, the term "best broad-spectrum antibiotic" should be considered only in the concept of a particular pathology. It is not for nothing that experienced doctors, in most cases preferring protected penicillins and cephalosporins with their high activity against a huge number of pathogens, pneumonia and other severe pathologies choose other antibiotics: macrolides and fluoroquinolones.

It would seem, what difference if all these preparations have a wide spectrum of action? But there is a difference. Some AMPs are more effective against aerobic bacteria, which means that they are worth using for the treatment of respiratory diseases. Others are able to cope with Pseudomonas aeruginosa, and therefore their use will be more useful in the treatment of purulent wounds and abscesses. It turns out there is no point in treating the same bronchitis with a drug effective for fighting anaerobes (bacteria that do not need oxygen for life and development) and a Pseudomonas aeruginosa.

The best will always be the drug whose action is directed against a particular pathogen. In this regard, drugs with a narrow spectrum of action even benefit. True, only in the case when the pathogen is precisely defined.

If the ability to quickly identify the causative agent is not present, a broad-spectrum drug should be administered taking into account all possible pathogens. So with infectious diseases of the respiratory organs, the drugs of choice are "Augmentin", "Amoxicillin", "Ceftriaxone", "Sumamed", because these drugs cover virtually the entire range of possible pathogens of respiratory infections.

This same requirement must be observed when antibiotic therapy is prescribed for prophylactic purposes. There is no point in fighting bacteria, which can not exist with a particular pathology.

But that's not all. An effective broad-spectrum antibiotic should not only be well treated, but also not harm the person it heals. It is good that the antibiotic, which is appointed deliberately, after the final diagnosis is made and corresponds to it, and also has the least number of side effects and is convenient in application. So for small children it is impossible to name the best antibiotic "Augmentin" in the form of tablets, but the suspension necessarily helps the kid to fight the disease without causing discomfort.

When prescribing drugs, it is necessary to take into account contraindications to use, because if, while exerting a curative effect on one organ, the antibiotic at the same time mutilates another, it can not be called the best. For example, if the patient is intolerant of penicillins, then, despite their high effectiveness in certain pathologies, the drugs will have to be replaced with drugs of another group, so as not to harm the patient, because severe allergic reactions can end even fatal.

Which antibiotic is better: cheap or expensive?

Having studied the prescription of the therapist and the state of their financial affairs, many people come to the conclusion that doctors do not specially designate cheap and inexpensive antibiotics of a wide spectrum of action, preferring more expensive ones. There is a common opinion that in this way they help out pharmacies.

For example, why assign an expensive "Augmentin", if there is a cheaper analogue of "Amoxicillin"? In fact, the active substance in preparations is the same, and hence the action, in theory, they should be the same. But it's not so simple. "Amoxicillin" is a semisynthetic penicillin, while the more modern "Augmentin" refers already to protected penicillins with a broader spectrum of action and resistance to penicillinase, produced by some strains of bacteria.

In principle, treatment can begin with "Amoxicillin", but where is the guarantee that the bacterial pathogen will not be resistant to it, which means that after the course that did not bring relief of the symptoms of the disease, you will again have to buy a more expensive "Augmentin" or another less expensive drug. So what is the saving?

True, there are drugs that completely match both the active substance and the pharmacological effect, and the difference in price is due to the difference in the composition of the auxiliary components and the policy of the manufacturing firms. For example, "Amoxicillin" and "Flemoxin", "Sumamed" and "Azithromycin", "Rulid" and "Roxithromycin". Usually a cheap analogue is an older drug, and its name often coincides with the active substance.

Such drugs are interchangeable, but the final decision on the possibility of one drug to others should be considered and agreed with the attending physician. Physicians are also people, therefore, having entered the patient's position, they will always be able to advise whiter, cheaper, but quite effective analogues. And it will be better than choosing a drug yourself.

It is clear that in the price of expensive antibiotics of a wide spectrum of action, in addition to the cost of components and work, advertising costs are also invested. By the way, often these costs become the main part of the announced price. Nevertheless, the inclusion in the composition of the drug more expensive auxiliary components, also pursues its goals. It is believed that expensive oral solutions have a more gentle effect on the mucosa of the gastrointestinal tract, less toxic. The coated tablets and capsules deliver the active substance to the intestines, where it is absorbed into the bloodstream rather than being sprayed in the stomach, it is prone to destruction by the acid of the gastric juice. Alas, inexpensive drugs do not always have similar forms of release.

As a rule, Russian antibiotics of a wide spectrum of action and domestic AMPs are much cheaper than imported ones. The quality and effectiveness of drugs may be the same, but the price will vary markedly. This is understandable, because in the price of foreign drugs in addition to transportation and registration (which, by the way, is much more expensive than in the case of domestic) is also a considerable customs fee. Take, for example, the cheap Russian "Clarithromycin" and "Clatid" produced in Italy, which is approximately 5 times more expensive than its counterpart.

To say that Russian analogs of known antibiotics are worse than foreign ones. Competition in this case is not on the quality of products, but at the price and popularity of the manufacturer. And there is already a buyer for each product. Someone does not trust the domestic manufacturer, therefore takes though also not cheap, but the import analogue. And others are guided by the price.

And on the other hand, sometimes there is no choice. For example, a drug from the group of fluoroquinolones "Gatifloxacin" and drugs based on gatifloxacin can be called Indian broad-spectrum antibiotics, since most of them are manufactured in India. And there are a lot of such drugs among broad-spectrum antibiotics. To say whether it's good or bad is definitely not. Still, drugs from India are famous for good quality and relatively low price.

Or here is the situation with the French antibiotic of the broad spectrum of action "Rovamycin". According to the reviews, the drug copes well with its task, but its cost (almost 200 UAH for 10 tablets) seems to many to be quite high. The drug has domestic analogues "Rovatsid" (Kiev) and "Starket" (Kharkov and Borispol), as well as the Russian analogue "Spiramycin". These drugs are much cheaper than "Rovamycin" at a price, but unlike a French drug, it is not so easy to find them in pharmacies.

Safe broad-spectrum antibiotics

Every time buying antibiotics prescribed by a doctor, you think about how much harm to your body can cause drugs that kill other living organisms. And if we take into account a wide spectrum of activity of antibiotics of a new generation, then willy-nilly there is an idea how much they are safe for humans.

Producers of drugs and doctors argue that in the absence of contraindications and in the prescribed dosage, AMP should not harm human health. But this statement in most cases is true with a short duration of treatment.

Of all types of broad-spectrum antibiotics, the most safe are the AMP of the penicillin series and macrolides. It is these drugs pediatricians most often assigned to children.

The greatest danger of penicillins is the development of dyspeptic phenomena and allergic reactions. Macrolides are generally considered to be the least toxic drugs with rare and mild side effects. As for cephalosporins, short-term treatment with drugs of this group (for example, "Ceftriaxone") is prescribed even to small children, which means that these medicines can also be classified as relatively safe.

The safety of drugs can be judged by the frequency of their prescriptions for the therapy of children and pregnant women. Drugs of choice in this regard have been and remain penicillins in the absence of allergic reactions.

If there is intolerance to penicillins, they are replaced with cephalosporins and macrolides. The most safe macrolides in pregnancy are preparations based on erythromycin, in second place are active substances such as clarithromycin, azithromycin, josamycin and roxithromycin.

In the treatment of tuberculosis in pregnant women, the use of tetracyclines is permissible. The drug of choice in this case is Rifampicin.

The danger of antibiotics usually lies in their incorrect application. Many broad-spectrum antibiotics are sold without a prescription. Basically, these are the drugs most often used in the therapy of respiratory diseases. Some people think that if the drug can be bought without a prescription, then it is generally safe and it is possible not to follow the instructions. This is fundamentally wrong. With this approach to antibiotic therapy, even the safest drug can cause harm to health.

Natural broad-spectrum antibiotic

The fact that in nature there are products and plants that are able to kill disease-causing bacteria is known to people for a long time. This fact is confirmed even by the history of the appearance of the first antibiotic, penicillin, the prototype of which was mold.

Many herbs and plants are natural antibiotics. Among herbs, the renowned bactericidal and bacteriostatic effects are famous: yarrow, wormwood, rosemary, tansy, plantain, motherwort. Antimicrobial properties also have chamomile, calendula, celandine, eucalyptus, eleutherococcus, sage, and also Kalanchoe and aloe. All these plants are active against several groups of bacteria, and the collection of such herbs can be considered a full-scale AMP of a wide spectrum of action.

Antibacterial properties are also characteristic of many plants that we are used to seeing on our table. These are garlic, ginger, onions, horseradish, pomegranate, cranberries), cowberry. A cranberry is not only an antibiotic, but an indispensable vitamin and mineral complex.

Yet, beekeeping products such as honey and propolis are considered to be the strongest natural antibiotics of a wide spectrum of action.

Honey itself is effective against white and golden staphylococcus, protea, enterobacteria, E. Coli. But in a mixture with broths and juices of herbs, which have antibacterial action, it becomes an inveterate killer of pathogenic microorganisms.

Yes, only herbs, plants, honey can not be compared in their strength with propolis, which is deservedly considered the strongest antimicrobial drug. Propolis is used in its natural form (chewed), and in the form of ointments and infusions. Tincture of propolis can even be bought in a pharmacy, because its medicinal properties are not rejected and traditional medicine.

Propolis is used to treat various infectious pathologies of the oral cavity and ENT organs. As a curative and preventive remedy, he has proven himself in the treatment of wounds, burns, frostbite (in the form of ointments and infusions). Propolis also effectively fights with a fungal infection.

Like propolis, there is also a mountain tar - the mummy. Especially popular is the Altai mummy from fans of alternative medicine who purchase the product through the Internet. However, it can be bought in pharmacies, both in kind and in capsules for oral administration.

Which broad-spectrum antibiotic to choose (natural or synthetic) is, of course, decided by the patient himself. At the same time, one should always be guided by the principle "do no harm!". And it will be much easier to follow this principle if the patient is consulted by the attending physician about taking any antibacterial agent and not making a decision on his own.