Treatment of burns with antibiotics: when and how to take

Thermal and chemical burns at home and at work have long ceased to be considered something out of the ordinary. And in the age of the development of electronic technologies, electric burns are becoming increasingly "popular". Advances in the treatment of oncological diseases and nuclear energy have provoked the emergence of a new type of burn - radiation. The variety of types of burns and methods of their production lead to the fact that doctors encounter burn injuries every day and often several times a day. Moreover, these are not only minor burns, but also severe cases that require long-term and complex therapy, including antibiotic therapy. And antibiotics for such burns often save not only the health, but also the life of the patient.

Indications antibiotics for burns

Not all burns require antibiotics, whether they are topical antimicrobials or oral medications. Mild burns of 1 and 2 degrees of severity are treated without antibiotics, with preference given to antiseptic, anti-inflammatory and soothing agents.

Even treatment of 3A degree burns and relatively small deep burns (if their area does not exceed 10 of the entire surface of the skin) is rarely performed without antibiotics. In this situation, antibiotic therapy may be prescribed if the patient already has some chronic infectious process in the body that is not associated with burn damage to the skin and muscles, or this process has developed due to late treatment.

Antibiotic treatment for 2nd and 3rd degree burns is prescribed to elderly people, as well as patients diagnosed with diabetes, since their wounds take much longer to heal and there is a risk of developing sepsis.

Burns of 3B and 4 degrees require the use of antibacterial therapy in all groups of patients, including children.

Why are antibiotics used after burns?

The goal of antibiotic therapy for any pathologies in which a bacterial factor is present is the treatment and prevention of infection. The fact is that the penetration of pathogenic microorganisms into the wound and their proliferation in it not only negatively affects the rate of healing, but also provokes the appearance of large scars, creating difficulties in skin grafting after burns. And complications of burns caused by bacterial infection are often life-threatening, which is largely associated with a significant percentage of fatal outcomes in severe burn injuries.

Antibiotic therapy is a key part of a comprehensive treatment aimed at preventing or reducing the symptoms of burn disease, which develops against the background of severe tissue damage. And here, not only the depth of the burn or its location plays a role, but also the area of damage.

Antibiotics after 2-4 degree burns can prevent the occurrence of various complications associated with wound infection. Moreover, infection can enter the wound in various ways. In case of moderate burns, wound infection is most often caused by external factors, while in case of severe deep wounds, the process of tissue necrosis (death) is activated, which in itself carries the risk of toxic infection.

In severe burns with great depth and area of skin damage, pathological processes occur in the body tissues that contribute not only to the infection of the wound, but also to the spread of infection throughout the body. Therefore, in case of severe skin burns, the doctor may prescribe antibiotics not only for local, but also for systemic use.

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When should antibiotics be used for burns?

The body reacts to severe damage to the body with deep and extensive burns with burn shock, which develops as a result of impaired blood circulation and metabolic processes in the tissues. Depending on the severity of the damage, burn shock can manifest itself in the form of chills, pale skin, vomiting, increased temperature, tachycardia, decreased blood pressure, and leukocytosis of varying degrees. It is from this moment that it is advisable to begin using antibiotics for moderate and severe burns.

Antibiotics for burns are intended to prevent so-called microbial invasion and the life-threatening complications it causes.

Taking antibiotics helps to reduce the manifestation of intoxication of the body at the beginning of the disease and relieve the symptoms of septicotoxemia associated with the simultaneous impact on the body through the blood of both toxins and pathological microorganisms.

To treat burns, both external antibacterial agents (in the form of solutions and ointments) and systemic agents taken orally or by injection are used.

Antibacterial drugs are selected strictly individually, taking into account such factors as:

• general condition of the patient,
• depth of damage,
• burn area,
• stage of burn disease,
• complications after the burn, if any,
• concomitant diseases, their nature and severity,
• patient's age.

Anamnestic data indicating the patient's sensitivity to various medications must be taken into account.

Dosing and administration

If light 1st degree burns are characterized by only superficial damage to the epidermal layer, accompanied by pain, redness and slight tissue swelling, then with 2nd (moderate) degree burns there is damage to the epidermis right down to the basal layer with the formation of blisters filled with liquid.

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Antibiotics for 2nd and 3rd degree burns

If such a burn covers an area of less than 10% of the entire body surface, its treatment can be carried out at home, observing sterility to prevent infection from entering the wound. Antibiotics for 2nd degree burns are not used in most cases, since our body is able to resist infection on its own.

Thermal burns are considered the most common in everyday life, in particular, a burn with boiling water, which affects both adults and children. Most often, after a short-term exposure to boiling water, light burns of the 1st degree remain. But if the effect of boiling water was quite long, and we are dealing with delicate children's skin, even burns of the 2nd and 3rd degree of severity are not excluded.

In case of burns with boiling water, antibiotics are used only in case of infection of the wound, which is possible at 3rd and sometimes at 2nd degree of severity, if the condition of sterility of the affected area is not met.

In case of extensive thermal and chemical burns of 2 and 3 A degrees, and also if the burn is localized on the legs, face, groin or hands and is accompanied by the formation of a large number of blisters with liquid, treatment should be carried out in a medical facility and often with the use of antibiotics. Large wounds weaken the body's immune system, and it can hardly cope with its responsibilities. But antibiotics are designed to help it fight pathogenic microorganisms, which in severe cases can provoke dangerous complications in the form of sepsis, pneumonia, myocarditis, infections of the excretory tract, lymphadenitis, etc.

If the burn covers a small area, preference is given to external antibacterial agents, which are available in the form of solutions (most often they are used to prepare the wound for treatment procedures) and wound-healing ointments.

In case of burns of significant depth and area with a high probability of wound infection, systemic therapy may be prescribed using broad-spectrum antibacterial drugs (semi-synthetic penicillin drugs, third-generation cephalosporins, fluoroquinolones and other antimicrobial agents effective against most pathogens known and unknown to medicine).

Antibiotics for 3B degree burns, when all layers of the skin are affected down to the subcutaneous fat, are prescribed regardless of the size of the affected area, since tissue necrosis simply attracts infection, being an ideal environment for the life and reproduction of bacteria that cause serious health problems.

Broad-spectrum antibiotics are considered the most effective for burns, since mixed infections are most common. This point is taken into account both when prescribing local agents (for example, chloramphenicol and silver sulfadiazine, which are broad-spectrum antibiotics) and in systemic antibiotic therapy, which is prescribed strictly individually.

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Antibiotics for external use for burns

Most often, for extensive burns of moderate severity (2 and 3A), treatment is limited to only antimicrobial agents for local use, which include:

• 1% solutions of iodopyrone or iodovidone, which are used to treat the wound after washing with antiseptics (solutions of chlorhexidine, miramistin, furacilin, hydrogen peroxide, etc.) or applying medicinal dressings,

• ointments based on chloramphenicol (Levomekol, Cloromykol, Levomycetin, Chloramphenicol, Levosin, etc.),
• antimicrobial agents in the form of ointments with silver sulfadiazine (Sulfadiazine, Dermazin, Silvederm, Argosulfan, etc.),
• sulfanilamide ointment for burns with the antibiotic nitazole "Streptonitol",
• antibacterial drugs for local use "Gentamicin ointment", "Dioxidine", etc.
• artificial coverings for burn wounds with bactericidal agents.

Antibiotics for burns accompanied by the appearance of fluid-filled blisters are prescribed only after the blisters have opened, to prevent infection of the wound under the film. Until then, there is no need for antibacterial drugs.

Combating possible infection in cases of extensive burns to the skin can be carried out using special isolators or Klinitron beds, which reduce the pressure on damaged tissue.

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Antibiotics for systemic use in burns

As already mentioned, in case of severe burns covering a large area, as well as deep burns prone to infection, in which there is a high probability of developing burn disease, the attending physician may prescribe antibiotics not only for local use, but also drugs for internal use with a broad spectrum of action.

Since the list of such drugs is quite large, the choice of an effective drug remains entirely within the competence of the doctor. Despite the fact that the selection criteria listed above are quite transparent, only a specialist can select a suitable drug taking into account the group affiliation of the drug, its action and the features of its use.

In mild cases of infectious processes, antibiotic therapy is carried out by oral administration of medications or intramuscular administration of antibacterial solutions, and doctors resort to intravenous infusions only in very severe cases.

Among broad-spectrum antibiotics, the most effective in the treatment of moderate and severe burns are:

• Antibiotics from the 1st or 2nd generation cephalosporin series, which have minimal nephrotoxicity and activity against gram-positive bacteria (Cefalexin, Cefazolin, Cefuroxime, Ceclor, etc.). They are used in the first and second periods of burn disease - in burn shock and toxicemia.
• Natural and semi-synthetic drugs of the penicillin series. Their use is indicative for extensive burns (20 percent or more of the skin) in the first, second and third periods of burn disease - in burn shock (natural penicillins), acute toxicemia and septicotoxicemia (semi-synthetic drugs).
• and the use of penicillins:
  • as a preventative measure against infectious complications, a natural penicillin called "Bicillin" is used,
  • in case of infection of a burn wound - "Amoxicillin", "Carbenicillin disodium salt",
  • in case of sepsis development – “Ampicillin”,
  • for intravenous infusions - "Methicillin sodium salt", etc.
• Second-generation aminoglycosides are combination antibiotics containing a beta-lactam antibiotic plus a protective drug that prevents beta-lactamase-producing bacteria from reducing the effectiveness of the antibiotic. These include: Unazin, Sulacillin, Gentamicin, Brulamycin, Tobramycin, Sizomycin, etc. They are effective in the third (with Pseudomonas aeruginosa) and fourth periods of burn disease - with acute toxicemia and septicotoxicemia.
• Third generation cephalosporins (Cefixime, Ceftriaxone, Cefotaxime, etc.) are used in the third period of burn disease after identifying the causative agent of the infectious process.
• Fluoroquinolones of the 2nd and 3rd generations (Ciprofloxacin, Levofloxacin, Ofloxacin, Pefloxacin, etc.) fight gram-negative bacteria, as well as infections resistant to penicillins.
• Lincosamides.
  • "Lincomycin" is a drug from the lincosamide group. It is prescribed if the infection process in a burn injury has spread to bone structures.
  • "Clindamycin" is a lincosamide indicated for the treatment of anaerobic infections that tend to spread rapidly throughout the body.
• Other antibiotics:
  • "Metronidazole" - for the same indications as "Clindamycin".
  • "Nystatin", "Fluconazole" - for fungal infections, which have recently been frequently detected in burn centers.

The doctor's prescriptions may change depending on the results of microbiological studies, which allow monitoring the relevance of antibiotic therapy. In case of generalized or mixed infection, the doctor may prescribe not one, but several drugs. Among them will be antibiotics for both local use and internal use (systemic drugs).

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Cephalosporin antibiotics

Pharmacodynamics. Many drugs in this group usually have the prefix "cef-", so they are easy enough to distinguish from others. The use of these antibiotics for burns is due to their bactericidal action. Cephalosporins are considered broad-spectrum antibiotics; only chlamydia, mycoplasma and some enterococci are not susceptible to their influence.

During the growth and development of a bacterial cell, among many processes, one can single out the formation of a rigid membrane with the participation of penicillin-binding protein. Cephalosporins are able to bind to this protein and prevent the synthesis of the cell membrane of microorganisms. They also activate proteolytic enzymes in bacterial cells, which destroy bacterial tissue and kill the microorganism itself.

Bacteria, in turn, produce a special enzyme, beta-lactamase, for self-defense, the action of which is aimed at combating antibiotics. Each type of bacteria secretes its own specific enzyme. The 1st generation of cephalosporins is resistant to the action of beta-lactamase of gram-positive bacteria, which include staphylococci and streptococci, which are associated with the processes occurring in the wound at the first stages of burn disease, the 2nd generation - gram-positive and some gram-negative bacteria, the 3rd and 4th generation - gram-negative bacteria.

Pharmacokinetics. Bioavailability of cephalosporins, depending on the generation, ranges from 50 to 95%. Maximum concentration in blood plasma is observed after 1-3 hours (with oral administration) or in the range from 15 minutes to 3 hours (with intramuscular administration). The duration of action ranges from 4 to 12 hours.

The majority of cephalosporins penetrate well into various tissues and body fluids and are excreted in the urine (“Ceftriaxone” is also excreted in the bile).

Cephalosporin antibiotics for burns are well tolerated by most patients. They have relatively few contraindications for use and side effects. The 1st generation of cephalosporins is considered the least toxic.

Release form. The most common forms of cephalosporin drugs used for burns are tablets (capsules) for adults and syrups for children. Most antibiotics are also available in powder form, from which a solution is subsequently prepared for intramuscular injections (less often for intravenous administration).

A number of drugs are also available in the form of granules or powder for the preparation of a suspension for oral administration.

Contraindications for use. Mainly individual intolerance to drugs of this group.

The use of cephalosporins is considered acceptable during pregnancy, in the treatment of newborns and even during breastfeeding, although some concentration of the drug is observed in breast milk. In case of renal failure, a dose adjustment is required.

Side effects. Adverse reactions during the use of cephalosporins are rare, and are usually associated with individual characteristics of the body.

Most often, allergic reactions (skin rashes, fever, bronchospasms, edema syndrome, anaphylactic shock) can be seen due to individual intolerance to the components of the drug.

Sometimes changes in the blood composition, convulsive syndrome (with impaired renal function), and disturbances in the microflora, manifested in the form of candidiasis, affecting the oral mucosa and vagina in women, may be observed.

Oral administration may be accompanied by nausea and abdominal pain, diarrhea, sometimes with blood.

Method of administration and dosage. The dosage regimen of the drugs can always be found in the instructions for them. We will list only some of the above drugs.

• "Cephalexin" (1st generation).

Oral administration: from 0.5 to 1 g with an interval of 6 hours (the daily dosage for children is 45 mg per kilogram of the patient’s weight, the frequency of administration is 3 times a day).

• "Cefuroxime" (2nd generation).

Oral administration: 0.25 to 0.5 g with an interval of 12 hours (the daily dose for children is 30 mg per 1 kg of weight, the frequency of administration is 2 times a day). Taken during meals.

Intravenous and intramuscular administration: from 2.25 to 4.5 g per day, administered 3 times a day (children – from 50 to 100 mg per 1 kg of weight, administered 3 or 4 times a day).

• "Cefixime" (3rd generation).

Oral administration: daily dose - 0.4 g. Frequency of administration - 1 or 2 times a day. Children from six months: 8 mg per 1 kg of weight.

• "Ceftriaxone" (3rd generation).

Intravenous and intramuscular administration: 1 to 2 g once a day. Children over 1 month: 20 to 75 mg per 1 kg of weight (twice administered).

Overdose. Failure to comply with the dosage regimen and long-term use of drugs can cause such a phenomenon as drug overdose. In the case of cephalosporins, it is accompanied by nausea, often accompanied by vomiting, and diarrhea.

First aid measures: gastric lavage if taken orally, drinking large amounts of fluid and activated charcoal or other enterosorbents.

Interaction with other drugs. It is not advisable to take cephalosporins orally at the same time as taking antacids that reduce stomach acidity. The interval between taking medications should be at least 2 hours.

The nephrotoxicity of cephalosporins increases when taken together with aminoglycosides. This should be taken into account when treating patients with renal impairment.

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Penicillin antibiotics

Pharmacodynamics. Natural and semi-synthetic penicillins are considered active against gram-positive and gram-negative microorganisms. They have a bactericidal effect on bacterial cells in the growth phase.

A disadvantage of penicillins is that some of them are not resistant to the action of beta-lactamase, which is produced by many bacteria.

Pharmacokinetics. Penicillin antibiotics used for burns easily penetrate into most tissues and body fluids. They are excreted mainly by the kidneys. The half-life ranges from half an hour to an hour.

Release form. Penicillin antibiotics are released in the same forms as cephalosporins.

Contraindications for use. Depending on the drug, contraindications may include individual intolerance to penicillins and cephalosporins, infectious mononucleosis, ulcerative colitis, increased bleeding, lymphocytic leukemia, severe liver and kidney pathologies, pregnancy, breastfeeding. Some penicillins are not used in pediatrics, while others may require dose adjustments and careful monitoring of the small patient.

Penicillins have the ability to pass through the placental barrier, so they are prescribed with great caution during pregnancy.

Method of administration and dosage. Use strictly as prescribed by a doctor with a frequency of administration from 2 to 4 times a day.

Side effects. Penicillins are considered the least toxic drugs among antibiotics. However, their use is a common cause of allergic reactions, regardless of the dose and form of release.

In addition to allergic reactions, penicillin antibiotics can cause increased sensitivity to sunlight, neurotoxic effects in the form of hallucinations, seizures, blood pressure fluctuations, and disruption of the body's microflora. Natural penicillins can cause vascular complications.

Interaction with other drugs. It is prohibited to mix penicillins and aminoglycosides in one syringe, since these groups are considered incompatible.

"Bicillin" and "Ampicillin" in combination with "Allopurinol" cause the appearance of a specific rash.

The use of penicillins with antiplatelet agents and anticoagulants increases the risk of bleeding. And parallel use with sulfonamides reduces the bactericidal effect of the drugs.

"Cholestyramine" reduces the bioavailability of penicillins when taken orally. At the same time, oral penicillins themselves are capable of reducing the effectiveness of some drugs, in particular oral contraceptives.

Penicillins slow down the metabolism and excretion of methotrexate.

If penicillins, which have a bactericidal effect, are used together with other drugs with the same effect, the effect of taking the medicines is enhanced. If bacteriostatic drugs are used in parallel with bactericidal agents, the treatment can be reduced to "nothing".

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Aminoglycosides

Pharmacodynamics. Aminoglycosides, like the above-described groups of antibiotics, have a pronounced bactericidal effect. They are combination drugs, since they contain an antibiotic that is subject to destruction by beta-lactamases, and a protective component to it, which also has insignificant antimicrobial activity. Such components include sulbactam, tazobactam, clavulanic acid.

The drugs are effective against gram-positive and gram-negative bacteria, with the exception of non-spore-forming gram-negative anaerobes. The 2nd generation of the above antibiotics is effective against Pseudomonas aeruginosa, which makes them especially useful for burns.

Aminoglycosides have a bactericidal effect not only on growing cells, but also on mature bacteria.

Pharmacokinetics. When taken orally, aminoglycosides have very low bioavailability, so the following are considered effective routes of drug administration: intravenous and intramuscular administration and external application (drugs in the form of ointments).

When administered intramuscularly, the maximum concentration in the blood plasma is reached after half an hour, but sometimes this time can be extended to 1.5 hours. The duration of action will vary from 8 to 12 hours.

Aminoglycosides are excreted virtually unchanged through the kidneys. The half-life is 2–3.5 hours (in newborns – from 5 to 8 hours).

The disadvantage of aminoglycosides is that after 5-7 days of therapy, addiction to the drug may occur, and its effectiveness will decrease significantly. The advantage is painless administration and greater effectiveness against most bacteria.

Release form. Since oral administration of drugs of this group is considered ineffective, antibiotics are released in the form of solutions placed in ampoules with a certain dosage, or in the form of powder for the preparation of an injection solution. Some aminoglycoside antibiotics (for example, "Gentamicin") are also released in the form of an ointment for external use, which is especially important for burns, when the fight against infection is carried out both from the outside and from the inside.

Contraindications for use. Antiglycosides are not as safe drugs as penicillins or cephalosporins. They can negatively affect the functioning of the kidneys and vestibular apparatus. It is clear that such drugs will have more contraindications for use.

Thus, aminoglycosides are not used in cases of hypersensitivity to the components of the drug, severe renal dysfunction, difficulty breathing, dysfunction of the vestibular apparatus and hearing, neutropenia, myasthenia, parkinsonism. These drugs are also not used in cases of botulism.

Side effects. Taking aminoglycosides can cause the following disorders: hearing problems (noise and ringing in the ears, ear congestion and hearing loss), thirst, changes in the volume of excreted urine, worsening glomerular filtration (in kidney pathologies), difficulty breathing up to paralysis of the respiratory muscles, problems with coordination of movements, dizziness. Allergic reactions when using aminoglycosides are very rare and manifest themselves in the form of skin rashes.

Method of administration and dosage. In the treatment of burns, aminoglycosides of the 2nd generation are used in a daily dosage of 3 to 5 mg per 1 kg of weight with a frequency of administration of 1 or 2 times (in newborns - from 5 to 7.5 mg 2 or 3 times a day). The drugs are administered parenterally. In case of a single dose, it is advisable to administer the drugs using a dropper.

Overdose. Side effects of drugs in this group occur either against the background of existing pathologies or as a result of taking large doses of the drug, which leads to an overdose. If adverse reactions occur, the drug should be discontinued and measures taken to eliminate unpleasant symptoms. It should be noted that hearing impairment after taking aminoglycosides is irreversible, but the kidneys will need to be treated.

For patients with neuromuscular block, which involves breathing problems and paralysis of the respiratory muscles, the antidote is calcium chloride given intravenously.

Drug interactions with other drugs. When aminoglycosides are used in combination with penicillins or cephalosporins, the effect of all drugs is enhanced. But this does not mean that they should be administered in one syringe. After all, mixing aminoglycosides and beta-lactam antibiotics in a syringe leads to a noticeable decrease in the effectiveness of antibiotics. The same applies to heparin.

The negative impact on the kidneys and vestibular system is enhanced if aminoglycosides are used in combination with other drugs with increased nephro- and ototoxicity.

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Fluoroquinolones

Pharmacodynamics. These are synthetic antibiotics with excellent bactericidal action, which is also quite long-lasting. Most bacteria are sensitive to them. The high efficiency of fluoroquinolone antibiotics in the treatment of severe infectious pathologies, including deep and extensive burns, has been repeatedly proven.

The drugs have a unique pharmacological effect, suppressing the production of enzymes vital for microorganisms, which leads to the suppression of DNA synthesis. The drugs also have a negative effect on the ribosomes of cells. All this leads to the death of microorganisms.

Some of them are effective against pneumococci, non-spore-forming anaerobes and staphylococci that are not sensitive to penicillin.

Pharmacokinetics. Fluoroquinolones are well absorbed by the gastrointestinal mucosa, providing high concentrations of the active substance in the tissues and body fluids. The long half-life of the drugs provides them with prolonged action.

The disadvantage of drugs in this group is their ability to penetrate the placental barrier and into breast milk, which is why their use during pregnancy and breastfeeding is limited.

Release form. Second-generation fluoroquinolones, which are used for burns, are available in the form of tablets and injection solution in ampoules or vials.

Contraindications for use. In addition to individual intolerance, pregnancy, lactation and childhood (for some drugs), fluoroquinolones have several more contraindications. These include: vascular atherosclerosis and a deficiency of glucose-6-phosphate dehydrogenase in the patient's body.

Side effects. Adverse reactions that occur as a result of taking fluoroquinolones are usually not associated with serious organ damage. These may include both gastrointestinal reactions (dyspeptic symptoms, heartburn and abdominal pain), and reversible hearing and vision impairment, poor sleep quality, headaches and dizziness, paresthesia, convulsions, tremors, increased heart rate, disruption of the body's microflora, and increased photosensitivity.

In rare cases, inflammation of the tendons and joints, kidney and liver dysfunction, and vascular thrombosis are observed.

Method of administration and dosage. Let's consider several popular drugs.

• "Ciprofloxacin". Oral administration: adults - from 0.5 to 0.75 g with an interval of 12 hours (children - from 10 to 15 mg per 1 kg of weight in 2 doses).

Intravenous administration. Drip from 0.4 to 0.6 g with an interval of 12 hours (children - from 7.5 to 10 mg per 1 kg of weight divided into 2 doses).

• "Ofloxacin". Oral administration: 0.4 g every 12 hours (children - 7.5 mg per 1 kg of weight, divided into 2 doses).

Intravenous administration. Drip 0.4 g at 12-hour intervals (children - 5 mg per 1 kg of weight divided into 2 doses).

• "Levofloxacin". Oral administration and intravenous drip: 0.5 g at 12-hour intervals. Not used in pediatrics.
• "Pefloxacin". Oral administration and intravenous drips with 5% glucose: initial dose - 0.8 g, subsequent - 0.4 g at 12-hour intervals. Not used to treat children.

All medications can be taken at any time of the day, adhering to a 12-hour interval. Food intake does not affect the effectiveness of the antibiotic.

Interaction with other drugs. Food intake does not affect the absorption of fluoroquinolones, but antacids, sucralfate and drugs containing aluminum, zinc, magnesium, calcium and iron compounds reduce the absorption of antibiotics in the gastrointestinal tract.

Some fluoroquinolones increase the blood concentration of theophylline.

Concomitant use of fluoroquinolones and nonsteroidal anti-inflammatory drugs increases the risk of neurotoxicity, which leads to the development of convulsive syndrome.

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"Children's" antibiotics

Burns in children are no less rare than in adults. But even the same “popular” among children burn with boiling water can be a serious disease requiring the use of antibiotics. The immune system of a child is not yet fully formed, so even a small burn (2-5%) is more severe than in adults, often causing complications. To prevent complications after burns caused by infection in the wound, antibiotics are used.

Many will say, but how is that possible, because there is an opinion that these drugs are dangerous for children and you should try to do without them by any means. This is fundamentally wrong. There are many drugs that help a small organism cope with an infection, and when used correctly, they do not cause significant harm to the child's body. Moreover, these are not special children's drugs, but general antimicrobial drugs.

When asked what antibiotics are prescribed to children for burns, the answer is that almost all groups of antimicrobial agents contain drugs approved for use in pediatrics (Ampicillin, Cefuroxime, Ceftriaxone, Ofloxacin, Gentamicin, etc.).

Prescribing antibiotics to children requires special attention and knowledge of the drugs from the doctor. After all, not all drugs can be used to treat newborns and infants. Some antibiotics are prescribed to children only from the age of 12 or 14. An important aspect is also taking into account the child's body weight, because the effective and safe dose of the drug depends on it. All this must be taken into account when prescribing antibiotics.

When treating small children, preference is, of course, given to drugs in the form of ointments, oral suspensions or syrup. Older children with burns can be given antibiotics in tablet form.

Intramuscular and intravenous administration of drugs is allowed only in severe cases. But subsequently, small patients are transferred to therapy with other forms of drugs.

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Shelf life

And finally…

I think it is not worth dwelling on the fact that antibiotics, like any medicines, should not only be used correctly, but also stored according to the instructions for them. Compliance with the storage conditions of drugs will help prevent premature spoilage of the drug and accidents in the family, which are often associated with unsupervised parental use of drugs by children that are not intended for them.

But sometimes even adults themselves suffer from taking expired drugs or those that were stored in inappropriate conditions.

Antibiotics used for severe burns have different shelf lives, which are indicated on the packaging and in the annotation to the drug. There is also information on how to properly store the medicine. And although room temperature and a secluded place protected from sunlight are sufficient for most antibiotics in tablets, the drug in ampoules and vials may require different storage conditions, for example, lower temperatures.

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