Antibiotics for mastitis in women: with feeding, non-lactation, purulent

Many women are familiar with such a disease as mastitis. It has several separate species, but it is usually divided into a non-purulent and purulent form. It is from the form of pathology that the therapeutic method depends. Antibiotics for mastitis are prescribed to patients almost always, as in the case of a non-nasal type of disease they are used as a prophylaxis for the development of infection, and in a more severe form, they destroy the pathogenic microflora.

[1]

Indications of the antibiotics for mastitis

There are several indications, as well as conditions in patients with mastitis, which allow you to prescribe antibiotics for treatment:

• local or widespread purulent inflammatory process inside the breast tissue (such as phlegmon, abscess or necrosis);
• general health of the patient worsens, intoxication of the body and high temperature persist for more than 3 days, despite the therapy with other medications;
• mastitis in a chronic or recurrent form;
• regular microdamages (cracks or scratches) of the nipples in patients with reduced ability to heal tissues, as well as with immunodeficiency states;
• diseases of other systems and organs that can complicate the course of mastitis (such diseases as high blood pressure, heart or kidney failure, diabetes, etc.).

[2]

Release form

Produced in the form of tablets, capsules, injection solutions.

Names of antibiotics for mastitis

The most popular drugs that allow you to get rid of pathogenic microbes are:

• Ampicillin (such as Ampirex, Decapin, and in addition Pentarcin and Epicocillin), which is included in the category of penicillin. It is able to work effectively in an acidic gastric environment, as a result of which it can be used in tablet form;
• Amoxicillin (such drugs as Amoxicar with Amosin, and besides Ospamox, Hiconcil, Gonoform, Ranoxil, and Flemoxin-Solutab), which copes effectively with pyogenic staphylococci;
• Cefuroxime (such drugs as Aksetin with Multisef, in addition to Kefstar, Ucefaxim, Zinnat, etc.) is a cephalosporin drug that qualitatively eliminates staphylococci, as well as strains resistant to antibiotics from the penicillin group;
• Cefazolin (such as Zolphin and Horizolin, as well as Ancef and Cefopride with Cefamesin) is an antibiotic with a wide range of effects. This medicine is given in the form of injections IV or IM;
• Soluble Streptocide is sulfonamide. It is released in the form of an ointment, which is used externally.

[3], [4]

Antibiotics for Purulent Mastitis

All the above antibiotics (Amoxicillin, Ampicillin, as well as Cefazolin with Cefuroxime and soluble Streptocide) have the properties necessary to treat a purulent form of mastitis.

[5], [6]

Antibiotics for non-lactational mastitis

The infiltrative form of non-lactative mastitis is treated with tableted antibiotics:

• "Protected" and "unprotected" form of semi-synthetic type penicillins (such drugs as amoxicillin, as well as amoxiclav, etc.);
• cephalosporins of the 1st, and also of the 2nd generation (this cephalexin with cefuroxime and so on).

Antibiotics of other categories may be prescribed if resistance of pathogenic microbes to the above drugs has been identified. Among them: aminoglycosides (such as gentamicin), as well as fluoroquinolones (such as ciprofloxacin).

The properties of antibiotics for mastitis are examined using the example of Ampicillin.

[7], [8], [9], [10]

Pharmacodynamics

The medicine has antibacterial properties of a wide range, as well as bactericidal action.

It inhibits the activity of transpeptidase, prevents the formation of bonds between peptides, and also destroys the final stages of murein synthesis of the cell wall of the microorganism in the process of division, and provokes bacterial lysis.

Ampicillin also actively affects a large number of gram-positive microbes (α-, as well as β-hemolytic streptococci, and in addition pneumococcus, staphylococci, Bacillus anthrax and clostridia), Listeria spp., And besides gram-negative microbes (Influenza rod, meningococcus, gonococcus , Proteus mirabilis, Yersinia multocida (Pasteurella), Salmonella, Shigella, Bordetella spp., as well as Escherichia coli) and non-spore-forming aerobes. Moderately affects many enterococci, among which enterococcus fecal.

It has no effect on penicillinase-forming strains of staphylococci, all strains of Pseudomonas aeruginosa, most strains of Klebsiella, as well as enterobacteria and indole-positive Proteus vulgaris.

[11], [12]

Pharmacokinetics

After oral administration, the drug is absorbed from the digestive tract (about 30-40% of the dosage), and the peak concentration reaches 1.5-2 hours later.

A small part of the active substance (approximately 10-30%) binds to plasma proteins. Distribution occurs in most tissues with organs. The therapeutic concentrations of the active ingredient are found in the synovial, peritoneal, and pleural fluids. Through GEB passes badly, but in case of inflammation of the membranes of the brain, permeability increases. The medicine almost does not pass biotransformation.

Excretion occurs mainly through the kidneys (unchanged substance), large concentrations of the substance are formed in the urine. Partially excreted together with bile, and lactating mothers - along with milk. Cumulation does not occur.

[13], [14], [15], [16],

Dosing and administration

The daily dosage of Ampicillin is 2-3 g. It should be divided into 4-6 receptions.

For treatment of mastitis, Amoxicillin should be taken for 5 days at a dosage of 0.5 g three times per day (it is recommended to do this through the same length of time intervals).

Soluble Streptocide is an ointment for external use - it should be applied to the affected area of the breast (for a day 1-2 times), and then apply a sterile bandage of gauze to the treated surface.

[26], [27],

Use of the antibiotics for mastitis during pregnancy

Pregnant and lactating women can be prescribed antibiotic Hiconcil. Also, during pregnancy, it is allowed to use Flemoxin-Solutab (but only in cases of detection of prenatal mastitis).

Preparations Cefuroxime and Cefazolin during lactation and pregnancy are contraindicated.

Antibiotics for mastitis during breastfeeding

In the lactation period antibiotics against mastitis can be injected in / in or / m, and also used orally in the form of tablets. This treatment course lasts for 5-10 days (the more accurate amount depends on the effectiveness of therapy, as well as the form of the disease).

[17], [18], [19], [20]

Contraindications

The main contraindication for any type of antibiotics is the individual intolerance of the components of drugs (penicillins, cephalosporins, sulfonamides, etc.) Ampicillin with Amoxyllicin can not be used in the presence of infectious mononucleosis.

Also, Ampicillin is prohibited if the patient has hepatic insufficiency, lymphocytic leukemia, gastrointestinal diseases in the anamnesis (in particular colitis caused by taking antibiotics).

Streptozid soluble can not be used in the presence of Graves' disease, as well as kidney pathologies and diseases associated with the hematopoiesis system.

[21], [22]

Side effects of the antibiotics for mastitis

After taking Ampicillin, such adverse reactions can develop:

• organs of the National Assembly: the development of seizures (as a result of treatment with large doses), tremors, and headaches;
• organs of the cardiovascular and hematopoietic systems: the development of anemia, agranulocytosis, neutro-, thrombocyto- and leukopenia.

Due to the use of Amoxicillin, the following side effects are possible:

• allergy: runny nose, cutaneous hyperemia, conjunctivitis, leafy dermatitis, and also MEE. In addition, anaphylaxis, angioedema, urticaria, malignant erythema multiforme, severe itching, maculopapular rash and reactions similar to serum sickness;
• organs of the digestive tract: vomiting with nausea, diarrhea, development of glossitis and stomatitis, and in addition pain sensations in the anus and changes in taste;
• organs of the National Assembly: feelings of anxiety, excitement, dizziness or headaches, in addition to convulsions, insomnia, changes in behavior and confusion;
• organs of the hematopoietic and cardiovascular systems: the development of tachycardia, transitional form of anemia, Verlhof disease, neutropenic or leukopenia, as well as agranulocytosis or eosinophilia;
• others: development of problems with breathing, arthralgia, tubulointerstitial nephritis, as well as a moderate increase in liver transaminases. There are also possible complications due to the chemotherapeutic effect - the development of dysbacteriosis, candidiasis in the vagina or oral cavity, and in addition to this superinfection (especially in patients who have chronic illnesses or decreased resistance of the body) and pseudomembranous or hemorrhagic form of colitis.

Adverse reactions to reception of Cefuroxime:

• organs of the National Assembly: drowsiness, headaches, and hearing impairment;
• organs of the cardiovascular and hematopoietic systems: a decrease in the level of hemoglobin, as well as hematocrit, the development of transient forms of eosinophilia, and also neutro- or leukopenia, hemolytic or aplastic anemia, agranulocytosis, thrombocytopenia, hypoprothrombinemia, and in addition prothrombin time increase;
• organs of the digestive tract: vomiting with nausea, diarrhea or constipation, swelling, pain or abdominal cramps, dyspepsia. In addition, the appearance of ulcers in the oral cavity, the development of glossitis, anorexia, pseudomembranous colitis and thirst, a transient increase in the activity of transaminases, LDH, APF or bilirubin. It is also possible to develop cholestasis or a disorder in the functioning of the liver;
• organs of the genitourinary system: a disorder in the work of the kidneys, an increase in the level of creatinine or urea nitrogen in the blood serum, a decrease in the coefficient of cleansing of creatinine, the appearance of itching in the perineum, the development of vaginitis or dysuria;
• allergy: itching, rashes on the skin and urticaria, and in addition to spasms of the bronchi, the appearance of chills or drug fever, the development of serum sickness, tubulointerstitial nephritis, erythema multiforme, anaphylaxis, and malignant exudative erythema;
• other: pain in the sternum, shortening of the respiratory process, development of superinfection, dysbacteriosis or candidiasis (also in the oral cavity), seizures (in the presence of kidney failure), determination of positive Coombs test. Among the local reactions: compaction or pain at the injection site or thrombophlebitis after intravenous administration.

When using soluble Streptocide, the following reactions are possible: dizziness or headaches, vomiting with nausea, development of cyanosis, allergies, leukopenia or agranulocytosis. There may also be tachycardia or paresthesia.

[23], [24], [25]

Overdose

In case of an overdose, Ampicillin has a poisoning effect on the function of the central nervous system (especially in patients with renal insufficiency). Among the symptoms - vomiting with nausea, diarrhea, as well as destabilization of the water-electrolyte balance.

Gastric lavage is prescribed and saline laxatives are taken along with activated charcoal. Symptomatic treatment is also carried out and a normal water-electrolyte balance is maintained. Removal of the substance is carried out through hemodialysis.

In case of an overdose with Cefuroxime, convulsions and symptoms of CNS excitation are observed. To eliminate violations are prescribed anticonvulsants, peritoneal dialysis with hemodialysis, and also maintains important for life functions of the body.

[28], [29],

Interactions with other drugs

Ampicillin has a pharmaceutical incompatibility with aminoglycosides. Due to the compound with allopurinol, the risk of rashes on the skin increases. The combination with oral estrogen containing drugs weakens the effectiveness of oral contraceptives, and the compound with ethinyl estradiol weakens the effect of the latter, thereby reducing the risk of breakthrough bleeding.

Ampicillin increases the effectiveness of oral anticoagulants, as well as aminoglycoside antibiotics. In combination with antibiotics with bactericidal properties (such as cephalosporins, rifampicin, as well as vancomycin and aminoglycosides), synergism of their action is observed, and antibiotic with bacteriostatic properties (such as lincosamides, macrolides, as well as tetracyclines, chloramphenicol and sulfonamides), antagonism is observed .

Diuretics, tubular secretion blockers, probenecid, allopurinol and NSAIDs (also phenylbutazone) weaken tubular secretion processes and increase the levels of ampicillin.

Cefuroxime, combined with diuretics, as well as nephrotoxic antibiotics, increases the risk of negative effects on the kidneys; in conjunction with NSAIDs - increases the risk of bleeding.

Probenecid weakens tubular secretion and reduces the coefficient of cleansing of the kidneys (approximately -40%). In addition, it also increases the peak concentration of cefuroxime (about + 30%), the half-life of the serum (about + 30%), and in addition its toxic properties.

Drugs that reduce gastric acidity, reduce the rate of absorption, as well as bioavailability of cefuroxime.

[30], [31]

Storage conditions

The conditions of antibiotics from mastitis are standard for medicines (a dark dry place with a temperature of no more than 25 ° C, inaccessible to children).

[32], [33], [34], [35], [36]

Shelf life

Antibiotics for mastitis are recommended to be used within 2-4 years from the date of manufacture.

[37], [38], [39]