Treatment of joint and heart rheumatism with antibiotics and other agents

A common systemic disease of connective tissue and vessels is rheumatism. Consider the features of his treatment with antibiotics, types of drugs.

Most often rheumatism has an infectious-allergic origin. The disease can develop as a result of complications of acute streptococcal infection in children and adolescents 7-15 years old, people with weakened immune system, elderly patients.

The main factors in the development of rheumatism:

• Hereditary predisposition.
• The age of patients is from 3 to 15 years.
• Frequent infectious diseases of the nasopharynx and diseases of streptococcal etiology.
• Female.
• The presence of protein B-cell marker D8 / 17 in the body.

In most cases, rheumatism occurs because of a previous acute or chronic infection of the nasopharynx caused by streptococcal microorganisms and their toxins.

There are such basic variants of localization of the inflammatory process:

• Rheumatic carditis - pathology affects the membranes of the heart (myocardium, pericardium, endocardium).
• Rheumatic fever is a disease of the lungs, pleura and bronchi.
• Rheumoeritis is a cutaneous form of rheumatism.
• Rheumatic polyarthritis - joint damage.
• Rheumatic cholera is a rheumatic form of vasculitis of small vessels of the brain.

In rare cases, rheumatic lesions of internal organs are diagnosed, as well as rheumatic fever and rheumohepatitis. To identify connective tissue and vascular diseases, diagnostic methods are used: ECG, X-ray, ultrasound, various laboratory tests.

At the first suspicions of rheumatism, it is necessary to begin treatment. Without proper diagnosis and timely therapy, pathology can lead to serious problems. The most serious complication is the severe heart disease. The treatment is done by a rheumatologist.

Indications of the antibiotics for rheumatism

The main indications for the use of antibiotics for rheumatism are based on infectious lesions of connective tissue and blood vessels.

The main stages of treatment:

1. Since all forms of the disease are associated with streptococcal infection, all forces go to suppress it. To do this, use a variety of antibacterial drugs.
2. At the second stage, hormonal drugs are used that stop the intensive inflammatory process and prevent destructive changes.
3. At the last stage, immunomodulatory therapy is performed. Physiotherapeutic, sanatorium-resort and dispensary treatment can be prescribed.

In this case, the first stage lasts 1-3 months and can take place in a hospital. If rheumatism of the heart is diagnosed, then the treatment is carried out in cardiorheumatological clinics. The medicinal basis of antirheumatic therapy is antimicrobial, antibiotic, anti-inflammatory, corticosteroid, analgesic and antihistamines.

To eliminate streptococcal infection, that is, the root causes of rheumatism, most commonly used antibiotics beta-lactam series: Amoxicillin, Phenoxymethylpenicillin, Cefadroxil, Benzatinpenicillin and others. If the disease is protracted or has a chronic form, then use cytostatics: Endoxane, Azathioprine, 6-mercaptopurine, Chlorbutin and others. In especially severe cases, immunosuppressants are indicated. They suppress the hyperreaction of immunity to the causative agent of infection.

[1]

Release form

Antibiotics for rheumatism have several forms of release. Depending on the type of disease and its location, the doctor selects the drugs. The main forms of medicines:

• Tablets, capsules, suspension and granules for the preparation of a solution for oral administration.
• Injections are intravenous and intramuscular.
• Ointment, cream and gel for topical application.

Focusing on the stage of the rheumatic process and the peculiarities of the patient's organism, the doctor prescribes a medicine. Correctly selected drug eliminates the causative agent of infection and prevents the development of complications.

Titles

There are many antibiotic drugs for the treatment of rheumatic diseases of connective tissue and vessels. Names of drugs in most cases are based on the active components that make up their composition or depending on the pharmacotherapeutic group.

Consider the names of the most effective drugs and the features of their use:

1. Oxacillin

Antibiotic drug of the penicillin group. Effective against microorganisms that are resistant to benzylpenienylline and phenoxymethylpenicillin. Malotoxic. Produced in the form of tablets and capsules of 250 mg, in bottles of 250 mg complete with distilled water 500 mg.

• Indications for use: various infectious diseases caused by bacteria resistant to benzylpenicillin and phenoxymethylpeniiillin. Inflammation of bone marrow and adjacent bone tissue, pneumonia, empyema, phlegmon, cholecystitis, wound infections, pyelitis, cystitis, infected burns. The way of application and dosage is individual for each patient. Duration of treatment is usually 7-10 days, but if necessary, can be extended to 2-3 weeks.
• Side effects: skin allergic reactions, various disorders of the gastrointestinal tract.
• Contraindications: hypersensitivity to the components of the drug, allergic reactions in the anamnesis.

2. Penicillin

Antibiotic with bactericidal properties. Has a wide range of activities. It is active against streptococci and treponem. It is available in the form of a dry substance for injection in vials. Comes with the powder is a solvent.

• Indications for use: various infectious and inflammatory diseases, treatment and prevention of rheumatism, scarlet fever, erysipelas, tonsillitis and other pathologies.

• Method of administration: for children under 12 years of age, 1-2 injections of 0.6 million units every 4 weeks. Children over 12 years of age and adults 1-2 injections of 1.2 million units every 4 weeks. The course of treatment is individual for each patient and is determined by the doctor.
• Side effects: various allergic reactions, stomatitis, erythema multiforme, local reactions.
• Contraindications: hypersensitivity to penicillin antibiotics, allergic reactions in anamnesis.

3. Piperacillin

Bactericidal antibiotic from the group of penicillins of parenteral application. Has a wide spectrum of action, is active against most gram-positive, gram-negative, aerobic and anaerobic microorganisms. Produced in ampoules in the form of powder for injection.

• Indications for use: infections of bones, joints, skin and soft tissues, sepsis, peritonitis, meningitis, gallbladder empyema and pleura, endometritis, cholangitis, abscess, prevention of postoperative infections.
• Method of administration: medication is administered intravenously (by drip or jet). In case of an average infection, 100-200 mg / kg of body weight are administered in 2-4 injections. With infections of severe course up to 200-300 mg / kg body weight in 3-4 injections. The maximum daily dose is 24 g. Children are administered 100-200 mg / kg body weight 2-4 times a day. In especially severe cases, the daily dose can be increased to 200-300 mg / kg of body weight in 2-4 injections.
• Side effects: allergic reactions, bronchospasm, conjunctivitis, rhinitis, nausea, vomiting, stool disorders, changes in blood picture. Local reactions are also possible: phlebitis, inflammation.
• Contraindications: hypersensitivity to penicillins. With special care is prescribed during pregnancy and lactation, for patients prone to allergic reactions.

4. Phenoxymethylpenicillin

Antimicrobial agent, which by its mechanism of action is similar to benzylpenicillin preparations. It is well absorbed when administered orally, is slightly toxic and does not possess cumulative properties. Produced in the form of tablets, powder for the preparation of a suspension.

• Indications for use: rheumatism, infections of bones and soft tissues, scarlet fever, inflammation of the bronchi and lungs, tonsillitis, erysipelas and other diseases caused by microorganisms that are sensitive to the drug. Dosage is established by the attending physician, individually for each patient.
• Side effects: irritation of the oral mucosa and gastrointestinal tract, stomatitis, pharyngitis.
• Contraindications: intolerance of the drug components and diseases with a violation of absorption from the gastrointestinal tract. With caution is prescribed for allergic reactions in the anamnesis.

5. Erythromycin

Antimicrobial agent, which in its effect is similar to penicillins. It is active against gram-positive and gram-negative microorganisms. It is transferred better, than penicillins, therefore can apply at an allergy on the given type of antibiotics. Therapeutic doses have a bacteriostatic effect. The antibiotic is rapidly developing resistance. It is available in the form of tablets with an enteric coating and an ointment of 1%.

• Indications for use: various infectious diseases, inflammation of the bone marrow and adjacent bone tissue, peritonitis, purulent inflammatory processes, pneumonia, lung diseases, septic conditions, erysipelas, syphilis, meningitis. Ointment is used for pustular lesions of the skin, infected wounds, bedsores.
• Dosing: for patients over 14 years of age, 250 mg, for severe diseases of 500 mg, every 4-6 hours for 1-1.5 hours before meals. Patients of childhood are prescribed a daily dose of 20-40 mg / kg (in 4 divided doses).
• Side effects: nausea, vomiting, stool disorders, liver function disorders, allergic reactions.
• Contraindications: hypersensitivity to the components of the drug, severe liver dysfunction, allergic reactions in the anamnesis.

6. Naproxen (not an antibiotic)

Proprionic acid derivative with anti-inflammatory, antipyretic and analgesic properties. It has several forms of release: tablets, suspension for oral administration, suppository rectal.

• Indications for use: various inflammatory and degenerative diseases of the musculoskeletal system. It is prescribed for rheumatoid arthritis, osteoarthritis, severe pain syndrome, infectious and inflammatory diseases of ENT organs, febrile syndrome.
• Usage: 500-750 mg twice a day, the maximum daily dosage should not exceed 1.75 g. If the drug is used as maintenance therapy, then appoint 500 mg twice a day. For children, the preferred dosage form is a suspension.
• Side effects: erythema of the mucosa, nausea, vomiting, pain in the epigastrium, skin allergic reactions, headaches, drowsiness and noise in the ears, erosive and ulcerative lesions of the digestive tract, hearing loss, heartburn. For treatment, gastric lavage is shown, dialysis is ineffective.
• Contraindications: intolerance of the drug components, erosive and ulcerative lesions of the gastrointestinal tract, recurrent polyposis of the nose and paranasal sinuses, pregnancy and lactation, patients under 1 year of age, oppression of bone marrow hematopoiesis.
• Overdose: nausea, vomiting, increased drowsiness, dyspeptic disorders. For treatment, gastric lavage and activated charcoal are indicated.

7. Nimesil (not an antibiotic)

Anti-inflammatory, analgesic and antipyretic. The principle of its action is based on the inhibition of the synthesis of prostaglandins. The drug inhibits the synthesis of prostaglandins at the site of inflammation. Nimesil is available in the form of granules for the preparation of a medical suspension.

• Indications for use: pain syndromes of various origin, degenerative-inflammatory diseases of the musculoskeletal system, vascular, gynecological and urological pathologies, infectious and inflammatory diseases.
• Method of administration: the drug is prescribed only to patients of adult age. Nimesil is taken orally 200 mg per day, divided into two doses. The course of treatment is determined by the attending physician.
• Side effects: dizziness and headaches, increased drowsiness, nervousness, tachycardia, hot flashes, nausea, vomiting, stool disorders, respiratory and vision disturbances, increased liver enzymes, dysuria, anemia, thrombocytopenia.
• Contraindications: gastric and duodenal ulcers, gastrointestinal bleeding, pregnancy and lactation, intolerance of the drug components, diabetes mellitus type 2, heartburn, nausea, diarrhea, congestive heart failure, arterial hypertension, children of childhood.
• Overdose manifests more pronounced adverse reactions. To eliminate them, gastric lavage and enterosorbents are indicated. In the future, symptomatic and supportive therapy is indicated.

8. Prednisolone (not an antibiotic)

Synthetic analogue of cortisone and hydrocortisone. It has pronounced anti-inflammatory, anti-shock, antitoxic and antiexudative, antiallergic properties. It has several forms of release: tablets, ampoules with suspension for injections, ointment in tubes 0.5%.

• Indications for use: diffuse lesions of connective tissue and vessels, rheumatism, infectious nonspecific polyarthritis, leukemia, bronchial asthma, neurodermatitis, eczema, hemolytic anemia, shock and collapse. The drug is used for chronic and atypical conjunctivitis, inflammation of the cornea, symptomatic inflammation of the eyeball.
• Method of application: dosage is set individually for each patient. In acute conditions, appoint 20-30 mg per day. A maintenance dose of 5-10 mg per day. Suspension for injection is used intraarticular, intramuscular and infiltration (tissue impregnation). The introduction should be with strict adherence to asepsis (sterility). The course of treatment should not exceed 10-14 days.
• Side effects: hirsutism, osteoporosis, hemorrhagic pancreatitis, hyperglycemia, a decrease in resistance to infections, withdrawal syndrome, adrenal insufficiency.
• Contraindications: severe forms of hypertension, pregnancy, diabetes, peptic ulcer and duodenal ulcer, active form of tuberculosis.
• Overdose: no toxic effects found. Possible mild violations of the gastrointestinal tract, neuralgia, allergic reactions. Symptomatic therapy is indicated for treatment.

9. Triamcinolone (not an antibiotic)

Glucocorticosteroid with anti-inflammatory, antiallergic and immunosuppressive properties. Produced in the form of tablets, ointments and cream 0.1%.

• Indications for use: rheumatism, acute allergic reactions, skin allergic diseases, erythema multiforme, bronchial asthma, hematopoietic system diseases, nephrotic syndrome, rheumatoid arthritis, collagenoses, viral hepatitis, acute pancreatitis.
• Method of administration: patients of adult age are prescribed 4-40 mg per day. After improving the patient's condition, the dose is reduced by 1-2 mg every 2-3 days to achieve minimum maintenance values. Children are prescribed 0.5-1 mg / kg body weight per day.
• Side effects: increased blood pressure, exacerbation of peptic ulcer, myopathy, osteoporosis, gastrointestinal ulceration, increased blood glucose levels, headaches and dizziness.
• Contraindications: myasthenia gravis, metastases, peptic ulcer and stomach ulcer, hypertension, renal failure, acute psychosis, active tuberculosis, diabetes, pregnancy, syphilis, viral diseases, fungal infections.

For the treatment of rheumatism most often use such antibacterial agents: Azithromycin, Amoxicillin, Clarithromycin, Erythromycin, Bicillin-5. It is often used drugs penicillin series. They are used for a long period of time and very often to prevent complications of rheumatic heart disease.

In addition to antibiotics, hormones glucocorticosteroids in combination with non-steroidal anti-inflammatory drugs are used for treatment. In this case, the more acute the disease, the better the effect of glucocorticosteroids. Anti-inflammatory drugs: Brufen, Aspirin, Butadion, Indomethacin are used throughout the course of therapy. Complex treatment makes it possible to achieve a pronounced and persistent therapeutic effect, both in the defeat of joints and in the cardiovascular system.

[2], [3], [4], [5], [6], [7]

Pharmacodynamics

The mechanism of action of antibiotics for rheumatism depends on the components that make up its composition. Pharmacodynamics of most drugs is represented by the following algorithm:

• Stabilization of lysosome membranes.
• Separation of oxidative phosphorylation and reduction of the inflammatory process.
• Inhibition of proteolytic activity.
• Kupirovanie proliferation of cellular elements in the lesion.
• The effect of active components on the metabolism of collagen proteins and mucopolysaccharides.

Medications used to treat the damage to connective tissue, joints and vessels have a wide range of effects. This ensures rapid destruction of the pathogenic infection.

[8], [9], [10], [11]

Pharmacokinetics

The clinical effectiveness of antibiotics used to treat rheumatism depends on their composition. Pharmacokinetics is represented by the processes of absorption, distribution, metabolism and excretion of active components. Most antibiotics penetrate the physiological barriers of the body, that is, it gets into all organs, tissues and fluids.

Regardless of the form of release, antibiotics are rapidly absorbed and distributed throughout the body, providing therapeutic effects. The rate of metabolism and excretion depends on the degree of binding to plasma proteins. Antibiotics are subjected to enzymatic action, that is, metabolize, forming inactive metabolites and toxic products. A number of drugs have a prolonged action.

[12], [13], [14]

Dosing and administration

Before the appointment of an antibiotic, it is necessary to determine the sensitivity of the microflora that caused the disease to it. The method of application and dose depend on the stage of rheumatic disease, its location, the patient's age and other individual characteristics of his organism. Dosage is prescribed by a doctor.

Treatment can last from 5 to 10 days. In especially severe cases, therapy is prolonged to two weeks. To achieve effective results, complex treatment, that is, the use of several agents of different pharmacotherapeutic groups and release forms, can be prescribed. After taking antibiotics, the patient is prescribed drugs to restore intestinal microflora, drugs containing live bacteria.

[20], [21], [22], [23], [24]

Antibiotics for rheumatism of joints

Inflammatory lesions of joints, arising against the background of many infections, is rheumatism. Treatment of this pathology is based on the suppression of the pathogen and restoration of motor activity. Antibiotics for rheumatism of joints are better than other drugs to cope with this task.

This pathology, as a rule, is infectious-allergic in nature and is characterized by destruction of the connective tissue of muscles, joints, internal organs and even the cardiovascular system. The first signs of the disease manifest themselves in adolescence and begin with discomfort and crunch in the joints. Very often such symptoms are not paid attention, and they begin to progress. Most often, an exacerbation begins with the onset of the cold season, since hypothermia is one of the factors that provoke pathology.

The main symptoms of joint rheumatism:

• A sharp increase in body temperature to 39 ° C.
• Increased weakness and sweating.
• Painful sensations and crunching in the joints.
• Redness and swelling of the skin over the joint.
• Stiffness of movements.
• Deformation of small joints.

The disease is characterized by a symmetrical lesion of large joints: knee, elbow, ankle. The very first and most important stage of treatment is medical therapy.

Consider the most effective antibiotics for joint rheumatism:

1. Amoxicillin

Bactericidal antibiotic agent from the group of semisynthetic penicillins. Has a wide spectrum of action against Gram-positive and Gram-negative microorganisms. Acid-resistant, quickly and completely absorbed in the intestines. It is available in the form of enteric-coated tablets, capsules, solution and suspension for oral administration, dry substance for injection.

• Indications for use: infections caused by bacteria sensitive to the drug, bronchitis, pneumonia, pyelonephritis, inflammation of the urethra and small intestine, gonorrhea.
• Method of application: dosage is set individually for each patient. Patients of adult age and for children older than 10 years are prescribed 500 mg 2-3 times a day. For children under 10 years and less than 40 kg of weight 250-125 mg 2-3 times a day.
• Side effects: skin allergic reactions, conjunctivitis, joint pain, fever, nausea, vomiting, stool disorders. In rare cases, the development of superinfection is possible.
• Contraindications: penicillin intolerance, infectious mononucleosis. With special care, the drug is prescribed during pregnancy and lactation, with a tendency to allergic reactions to cephalosporins.

1. Ampicillin

Semisynthetic antibiotic, does not break down in an acidic environment and is well absorbed after ingestion. Effects on Gram-positive microorganisms that are sensitive to benzylpenicillin. Also active against a number of gram-negative microorganisms. Can be used for diseases caused by a mixed infection. Produced in the form of tablets and capsules for oral administration, powder for the preparation of a suspension.

• Indications for use: pneumonia, bronchopneumonia, tonsillitis, peritonitis, cholecystitis, sepsis, urinary tract infections, purulent lesions and other inflammatory reactions caused by drug-sensitive microorganisms.
• Usage: for adults, 500 mg 4-6 times a day, for children at 100 / mg kg. The duration of treatment, as a rule, takes 5-10 days, but for severe infections the drug takes 2-3 weeks.
• Side effects: skin allergic reactions, in rare cases - anaphylactic shock. To eliminate them, desensitizing therapy is necessary.
• Contraindications: hypersensitivity to penicillins, hepatic insufficiency, bronchial asthma, hay fever.

3. Benzathine penicillin

A bactericidal agent of prolonged action. It acts on sensitive microorganisms, is active against staphylococci, treponem, streptococci. It is available in the form of a dry substance for injection, complete with a special solvent.

• Indications for use: treatment and prevention of exacerbations of rheumatism, scarlet fever, erysipelas, syphilis, tonsillitis, wound infections, infectious complications in tonsillectomy and after extraction of teeth.
• Method of administration: the drug is administered intramuscularly. For rheumatism, for patients over 12 years of age, 1-2 injections of 1.2 million units every 4 weeks are prescribed. Patients younger than 12 years of 1-2 injections of 0.6 million ED every 4 weeks.
• Side effects: various allergic reactions, stomatitis, dermatitis, erythema multiforme, local reactions.
• Contraindications: hypersensitivity to penicillin antibiotics. With caution, the drug is prescribed for patients with intolerance to cephalosporins and allergic reactions in the history.

4. Binoclar

Semisynthetic antibiotic from the group of macrolides. It has bactericidal and bacteriostatic action. It is active against gram-positive and gram-negative bacteria, anaerobes and intracellular microorganisms.

• Indications: infectious and inflammatory diseases, sinusitis, otitis media, tonsillopharyngitis, lower respiratory tract infections, skin and soft tissue infections, mycobacterial infections. Dosage is individual for each patient, therefore it is prescribed by a doctor.

• Contraindications: severe liver damage, hepatitis, porphyria, early pregnancy, hypersensitivity to the active components of the drug.

• Side effects: nausea, vomiting, stools, stomatitis, abdominal pain, jaundice, dizziness and headaches, insomnia, skin allergic reactions. It is also possible a temporary change in taste sensations.

5. Brufen (not an antibiotic)

NSAIDs with analgesic, analgesic, anti-inflammatory and antipyretic properties. The mechanism of its action is based on inhibition of the synthesis of prostaglandins. The drug is available in the form of tablets with an enteric coating, dragees, capsules, cream and rectal suppositories.

• Indications for use: rheumatoid arthritis, osteoarthritis, articular syndrome, non-rheumatic rheumatism, soft tissue, tendon, ligament, moderate pain syndrome, dental and postoperative pains, migraine, fever, polymyositis, arthrosis, inflammation of soft tissues and joints, lumbago , sports injuries, stretching.
• Dosage: adults 1.2-1.8 grams in a few doses, the maximum daily dose should not exceed 2.4 g. Children are prescribed 20 mg / kg body weight in several doses. In severe cases of juvenile rheumatoid arthritis, the dosage can be increased to 40 mg / kg per day in several doses. The course of treatment takes 2-3 weeks.
• Side effects: digestive disorders, skin allergic reactions, gastrointestinal bleeding, nephrotic syndrome, thrombocytopenia.
• Contraindications: peptic ulcer of the stomach and duodenum, bronchial asthma, bronchospasm, rhinitis, urticaria, pregnancy and lactation. With caution is prescribed to patients with kidney and liver diseases, heart failure.

6. Butadione (not an antibiotic)

Analgesic, anti-inflammatory and antipyretic. It is available in the form of tablets with an enteric coating. It is used for rheumatism, infectious nonspecific polyarthritis, small chorea, Bechterew's disease, nodal erythema. The drug is taken at 100-150 mg 2-4 times a day, the duration of treatment is 2-5 weeks.

Side effects are manifested in the form of pain in the stomach, skin rashes, anemia. Also, ulceration of the mucous membrane of the gastrointestinal tract, hematuria. Butadione is contraindicated in peptic ulcer of stomach and duodenum, violations of liver and kidney function, damage to the blood-forming organs, arrhythmia and circulatory insufficiency.

7. Voltaren (not an antibiotic)

Anti-inflammatory, analgesic and antipyretic agents from the NSAID group. Contains active ingredient - diclofenac. The mechanism of its action is associated with a violation of the metabolism of arachidonic acid and a decrease in the synthesis of prostaglandins. It has several release forms: injection, intestinal-soluble tablets and rectal suppositories.

• Indications for use: osteoarthritis, pain in the spine, rheumatoid arthritis, spondylitis, gout, extra-articular soft tissue rheumatic diseases, primary dysmenorrhea and other gynecological diseases, migraine attacks. Dosage is selected individually for each patient.
• Side effects: various violations of the gastrointestinal tract, skin allergic reactions, headache and dizziness, increased levels of hepatic enzymes, hypertension, tachycardia, violations of dry and vision, changes in taste.
• Contraindications: hypersensitivity to the components of the drug, intolerance to analgin, ulcerative lesions of the stomach, irregularities in the work of the hematopoiesis system, bronchospasm, late gestation, patients under 6 years of age, severe disorders of kidney, liver, cardiovascular system.
• Overdose: pain in the epigastric region, nausea, vomiting, convulsions. To eliminate them shows the reception of enterosorbents, gastric lavage and further symptomatic therapy.

8. Diclofenac (not an antibiotic)

A non-steroidal anti-inflammatory agent from the pharmacotherapeutic group of phenylacetic acid derivatives. It has pronounced anti-inflammatory, analgesic and antipyretic properties. Effectively weakens the painful sensations that arise in a state of rest and movement in rheumatic diseases of the joints. A persistent curative effect develops after 10-14 days of use. It is available in the form of a solution for injection.

• Indications for use: rheumatism, ankylosing spondylitis, rheumatoid arthritis, inflammation of soft tissues and joints, traumas of the musculoskeletal system, arthrosis, gout, bursitis, postoperative pain syndrome, radiculitis, neuralgia, neuritis, primary dysmenorrhea.

• Method of administration: patients of adult age are prescribed intramuscularly 75 mg 1-2 times a day. For children older than 6 years, the dosage is 2 mg / kg 2-3 times per day. The course of treatment is 4-5 days.
• Side effects: various dyspeptic disorders, drowsiness, increased irritability, headaches and dizziness, bleeding in the gastrointestinal tract and erosive and ulcerative lesions. Local reactions, phlebitis, a burning sensation during the administration of the drug, necrosis of adipose tissue are also possible. In the case of an overdose, these effects are enhanced.
• Contraindications: gastric ulcer and duodenal ulcer, gastrointestinal bleeding, kidney and liver diseases, third trimester of pregnancy and lactation, hypersensitivity to the drug components, hives, rhinitis, patients under 6 years of age.

9. Ibuprofen (not an antibiotic)

A drug with analgesic, antipyretic and anti-inflammatory properties. The mechanism of its action is based on inhibition of biosynthesis of prostaglandins through inhibition of the enzyme cyclooxygenase. It is available in the form of tablets with an enteric coating. After ingestion, the drug is rapidly absorbed from the digestive tract. The maximum concentration in the blood plasma develops in 1-2 hours. Active components accumulate in the synovial fluid and are metabolized in the liver. Half-life is 1.5-2 hours. It is excreted by the kidneys unchanged.

• Indications for use: rheumatoid arthritis, gout, osteoarthritis, neuralgia, bursitis, sciatica, ankylosing spondylitis, myalgia, adnexitis, proctitis, ENT diseases, headache and toothache, traumatic inflammations of soft tissues and musculoskeletal system.
• Usage: for rheumatoid arthritis, 800 mg 3 times a day is prescribed, for osteoarthritis and ankylosing spondylitis 400-600 mg 2-4 times a day, for juvenile rheumatoid arthritis, 40 mg / kg body weight per day, for moderate-intensity pain 400 mg 3 times a day.
• Side effects: nausea, vomiting, stool disorders, headaches and dizziness, sleep disorders, skin allergic reactions, bleeding from the gastrointestinal tract, bronchospasm.
• Contraindications: the age of patients younger than 6 years, hypersensitivity to the components of the drug, hematopoiesis disorders, renal and hepatic dysfunction, optic nerve disease, ulcerative colitis, erosive-ulcerative gastrointestinal lesions.
• Overdose: abdominal pain, nausea and vomiting, retardation, drowsiness, headaches, tinnitus, hypotension, tachycardia, bradycardia, acute renal failure. For treatment, gastric lavage, reception of enterosorbents and further symptomatic therapy are indicated.

Therapy begins with the use of broad-spectrum antibiotics, NSAIDs, vitamins and desensitizing medications. To fight infection, antibiotics of the penicillin series can be prescribed: Amoxicillin, Carbenicillin, Piperacillin or macrolides: Binoklar, Vilprafen, Grunamycin. The course of antibiotic use lasts 5-10 days. Many doctors claim that within 5 years after the diagnosis of the disease, the patient should periodically take a wide range of drugs.

An important component of drug therapy are non-steroidal anti-inflammatory drugs, for example, Diclofenac and Ibuprofen. They reduce the severity of the inflammatory process. If the inflammatory process is accompanied by swelling, then take diuretics, that is diuretics: Acrypas, Bufenox and others. For the removal of severe pain, antibiotics are used: Nimesil, Ibuprofen, Diclofenac and others.

Duration of treatment and dosage are set by the doctor, for each patient individually. After drug therapy, additional procedures can be prescribed: paraffin applications for heating the affected joints, UHF, heating with infrared rays, electrophoresis. Physiotherapy allows to consolidate the results of the main therapy, eliminate pain syndrome and improve motor activity.

[25], [26], [27]

Antibiotics for rheumatism of the heart

Some streptococcal infections lead to rheumatic lesions of the cardiovascular system. Most often rheumatic heart disease develops after the tonsillitis, pharyngitis, sinusitis and nasopharyngeal diseases. In this case, if the disease occurs in an acute form, then rheumatism of the heart occurs in 5% of patients. Getting on the cardiac membrane, the infection causes pathological changes that lead to changes in the functioning of the whole heart apparatus.

The main lesions are:

• Myocarditis - muscular tissues are affected.
• Pericarditis is an external tissue envelope.
• Pancarditis - all tissues of the heart are affected.
• Endocarditis is a lesion of the inner tissue membrane.

Depending on which shell was infected, select certain antibiotics. With rheumatism of the heart, such drugs can be prescribed:

1. Wilprafen

Antibiotic from the group of macrolides. It has bacteriostatic properties, which are based on the inhibition of protein synthesis by bacteria. Creates high concentrations in the inflammation focus, providing bactericidal activity. Highly active against intracellular microorganisms, Gram-positive and Gram-negative aerobic bacteria and some anaerobes. The preparation has several forms of release: tablets and suspension for oral administration.

• Indications for use: infectious and inflammatory diseases caused by microorganisms sensitive to the preparation. Otitis, sinusitis, bronchitis, pneumonia, gingivitis, diphtheria, scarlet fever, erysipelatous inflammation, infections of the urinary tract and genital organs, joint and soft tissue damage. Dosage is individual for each patient, therefore it is appointed by the attending physician.
• The drug is contraindicated in hypersensitivity to macrolides and components of the drug, severe violations of liver function.
• Side effects: lack of appetite, nausea, vomiting, hearing impairment, candidiasis, increased activity of hepatic transaminases, violation of outflow of bile. Similar reactions are observed in overdose. Symptomatic therapy is indicated for their elimination.

2. Aspirin Cardio

Antibiotic agent with the active substance - acetylsalicylic acid. It belongs to the category of non-steroidal anti-inflammatory drugs, the action of which is based on the blocking of prostaglandin synthetase and inhibition of inflammatory hormones. After taking, the tablets are quickly and completely absorbed, food slows down this process.

• Indications for use: diseases with a high risk of thrombosis, unstable angina, rheumatic carditis, myocardial infarction, heart and vascular surgery. Neurological pathologies, transient disorders of cerebral circulation, cerebral ischemia, pulmonary infarction.
• How to use: tablets should be taken before meals, drinking water at 100-300 mg per day. As a rule, the drug is taken within 1-2 days, but if necessary, the course of treatment can be extended.
• Side effects: various violations of the gastrointestinal tract, hepatitis, pancreatitis, dizziness and headaches, skin allergic reactions, decreased excretory function of the kidneys, bronchospasm.
• Contraindications: intolerance NSAIDs, thrombocytopenia, asthma, peptic ulcer, pregnancy, lactation, renal and hepatic insufficiency. With caution, the drug is prescribed for patients with genitourinary diseases, gout, hepatitis, bronchial asthma.
• Overdose: nausea, vomiting, diarrhea, allergic reactions. For treatment, hemodialysis, oral sorbents and further symptomatic therapy are indicated.

3. Bicillin

Antimicrobial agent, which by its mechanism of action is similar to benzylpenicillin. Produced in vials of 300 000 units and 600 000 units.

• It is used for diseases caused by microorganisms sensitive to the preparation. Bicillin is effective in the treatment and prevention of rheumatism, syphilis and gonorrhea.
• The recommended dosage is 2 400 000 units 2 times a month. For the prevention of rheumatism, 600 000 units are administered once a week, the injections are repeated 6 times. The injections are combined with the intake of acetylsalicylic acid and other NSAIDs. Children are prescribed once a week at a rate of 5000-10 000 units / kg or 20 000 units / kg 2 times a month.
• Contraindications: bronchial asthma, allergic diseases, intolerance to benzylpenicillin preparations, hay fever. Side-effects are manifested in the form of various allergic reactions.

4. Grunamycin

Antibiotic from the group of macrolides, has bacteriostatic properties. Its mechanism of action is based on the destruction of peptide bonds between molecules of amino acids and blocking the synthesis of proteins of microorganisms. High doses of the drug have a bactericidal effect. Has a wide spectrum of action: Gram-positive, Gram-negative microorganisms.

Contains the active ingredient - erythromycin. It is available in the form of tablets, granules for the preparation of an oral suspension, lyophilizate for the preparation of a solution for intravenous administration, rectal suppositories and powder for the preparation of a solution for injection.

• Indications for use: various bacterial infections caused by drug-susceptible pathogens. Genitourinary infections, defeat of ENT organs, whooping cough, diphtheria, trachoma, infectious and inflammatory diseases of the skin, soft tissues, bones and joints, infected wounds, bedsores, burns, exacerbation of streptococcal infection.
• Dosing and Administration: single dose for adults and children over 14 years for 250-500 mg every 6 hours. Duration of treatment is 5-14 days.
• Contraindications: intolerance of the components of the drug, pregnancy, hearing loss. Caution is prescribed for renal or liver failure, breastfeeding, jaundice, arrhythmia, lengthening of the QT interval.
• Side effects: nausea, vomiting, stool disorders, headaches and dizziness, reduced visual acuity and hearing, skin allergic reactions. For treatment, careful monitoring of the state of the respiratory system, the reception of enterosorbents, and gastric lavage are shown.

5. Indomethacin (not an antibacterial agent)

Active NSAIDs, a strong inhibitor of prostaglandin biosynthesis. Has a strong analgesic activity. Produced in the form of tablets, capsules, rectal suppositories and solution for injection.

• Indications for use: rheumatoid arthritis, periarthritis, spondylitis, thrombophlebitis, osteoarthritis. Nephrotic syndrome, pain in the spine, neuralgia, myalgia, traumatic inflammation of the soft tissues, rheumatism, diffuse connective tissue diseases, infectious and inflammatory diseases of the ENT organs, cystitis, adnexitis, prostatitis.
• Method of use: the drug is recommended after meals, the initial dosage of 25 mg 2-3 times a day with a gradual increase to 100-150 mg in 3-4 divided doses per day.
• Side effects: headaches and dizziness, drowsiness, nausea, vomiting, stool disorders. Symptomatic therapy is indicated for treatment.
• Contraindications: intolerance of the components of the drug, peptic ulcer of the stomach and duodenum, bronchial asthma, pregnancy and breastfeeding.

6. Ketanol (not an antibacterial agent)

A drug with anti-inflammatory, antipyretic and analgesic properties. Produced in the form of capsules and tablets for oral administration, solution for injection, suppository.

• Indications for use: rheumatoid arthritis, psoriatic and reactive arthritis, gout, bursitis, spondyloarthritis, tendonitis, severe pain syndrome with algodismenosis, after surgery and trauma. The dosage and form of the preparation are individual for each patient, therefore they are appointed by the attending physician.
• Side effects: various dyspeptic disorders, headaches and dizziness, suppression of hematopoiesis, anemia, bronchospasm, insomnia, asthenia, visual impairment and tinnitus, violations of the liver and kidneys.
• Contraindications: intolerance of the drug components, peptic ulcer of the stomach and duodenum, nonulcer dyspepsia, bleeding, renal and hepatic insufficiency, asthma attacks, pregnancy and lactation, patients under 14 years of age.
• Overdose: various disorders of the digestive tract, confusion, impaired renal function. Treatment consists of washing the stomach and taking sorbents.

7. Meloksikam (not an antibacterial agent)

A drug from the pharmacotherapeutic group of oxicams. NSAIDs have a pronounced anti-inflammatory effect. It has several forms of release: tablets for oral use and ampoules for intramuscular injection.

• Indications for use: rheumatoid arthritis, Bechterew's disease, chronic polyarthritis, exacerbations of arthrosis. Tablets are taken once a day for 15 mg. The course of treatment is individual for each patient.
• Side effects: blood disorder, changes in visual acuity, headaches and dizziness, tinnitus, nausea, vomiting, pain in the epigastric region, cardiovascular disorders, skin allergic reactions.
• Contraindications: ulcers in the digestive system, intolerance of the drug components, gastrointestinal bleeding, pregnancy and lactation, the age of patients under 15, severe renal or hepatic insufficiency, cerebrovascular bleeding.
• Overdose: nausea, vomiting, increased drowsiness, abdominal pain. For treatment symptomatic therapy, gastric lavage, reception of enterosorbents is shown.

8. Naise (is not an antibacterial agent)

Anti-inflammatory with analgesic and antiplatelet properties. Suppress prostaglandin formation in the inflammatory focus. Produced in the form of tablets, dispersible capsules, suspension and gel 1%.

• Indications for use: osteoarthritis, bursitis, osteoarthritis, tendovaginitis, rheumatism, muscle pain, post-traumatic pain syndrome, vertebral pain, infectious and inflammatory diseases, fever, neuralgia, myalgia. With degenerative and inflammatory diseases of the musculoskeletal system, the gel is most often used.
• Method of use: 100 mg per day, if necessary, daily dosage can be increased to 400 mg. The gel is applied to the skin, evenly distributed over a painful patch. The procedure can be carried out 3-4 times a day. The course of treatment is up to 10 days.
• Side effects: drowsiness, dizziness, nausea and vomiting, heartburn, ulceration of the mucous membrane of the gastrointestinal tract, purpura, anemia, leukopenia, high activity of hepatic transaminases, skin allergic reactions. When using the gel, local allergic reactions may occur.
• Contraindications: gastrointestinal ulcer, hypersensitivity to the components of the drug, hepatic insufficiency, asthma, congestive heart failure, pregnancy and lactation, type 2 diabetes, arterial hypertension.
• Overdose: renal dysfunction, hepatic insufficiency, gastrointestinal irritation, convulsions, increased blood pressure, respiratory depression. Antidote does not exist. Hemodialysis and diuresis do not bring the desired results.

Rheumatic carditis is classified according to the severity of the course. The disease has several forms: acute, subacute, prolonged and latent. In this acute stage has a sudden onset and severe symptoms. The incubation period of lingering form lasts about 12 months. The latent form does not appear in any way, therefore it is very difficult to diagnose it. It is this form that leads to the development of vice.

[28], [29], [30],

Use of the antibiotics for rheumatism during pregnancy

Rheumatism during pregnancy can not be ignored. Since hormonal changes in the female body can exacerbate and even exacerbate the course of the disease. Also, it is possible that the pathology will affect the outcome of pregnancy. The most frequent exacerbation is observed in the early stages and in the last weeks of gestation.

The use of antibiotics during pregnancy is not desirable. Antirheumatic treatment is determined individually for each patient. It is acceptable to carry out therapy with pyrazolone drugs, steroid hormones, salicylates. All medicines are prescribed by a rheumatologist, taking into account the form of the disease, the gestational age and a number of other features.

Contraindications

Antibiotics, prescribed for the treatment of rheumatism, have certain contraindications to the use. Preparations are not used for individual intolerance of their components, severe violations of liver function. With extreme caution, antibiotic therapy is used for allergic reactions in the anamnesis, for patients of children and senile age.

[15], [16], [17], [18]

Side effects of the antibiotics for rheumatism

Non-compliance with medical recommendations for the use of antibiotics, can cause various violations. Side effects are most often manifested by such symptoms:

• Dizziness and headaches.
• Noise in the ears and decreased visual acuity.
• Bronchospasm.
• Violations of the stool, nausea, vomiting.
• Violation of the function of the liver.
• Skin allergic reactions.

In rare cases, there is a development of superinfection. To eliminate adverse reactions, you must stop taking the drug and seek medical help.

[19]

Overdose

The use of increased doses of medication, not rarely causes symptoms of an overdose. Most often it manifests as follows:

• Disorders from the digestive tract: nausea, vomiting, diarrhea.
• Dizziness.
• Skin rashes.
• Change in water-electrolyte equilibrium.
• Renal failure.

Symptomatic therapy is indicated for the overdose elimination. In some cases, hemodialysis, gastric lavage and the intake of enterosorbents are effective.

[31],

Interactions with other drugs

To achieve a positive result of treating rheumatism, antibiotics are often combined with other types of medications. Complex therapy more effectively affects the causative agent and contributes to the recovery of the body. All interactions with other drugs should be controlled by the attending physician. This is associated with the risk of developing adverse reactions.

Most often, patients are prescribed antibiotics from the penicillin group. They are not used simultaneously with aminoglycosides, since it is possible to inactivate the active components. Macrolides and tetracyclines act as antagonists. NSAIDs and diuretics reduce the excretion of penicillins, which increases the risk of adverse reactions.

[32], [33]

Storage conditions

According to storage conditions, tablets, capsules, granules, suspensions and other oral forms should be kept in a place protected from sunlight, moisture and inaccessible to children. The same conditions must be observed when storing the ointment, cream and gel. The temperature should not be above 25 ° C. Injectable forms of the preparations can be kept at room temperature.

[34], [35], [36], [37]

Shelf life

The form of release of an antibiotic depends on its shelf life. Tablets and capsules should be used within 24-36 months from the date of their production. Ready-made suspensions can be stored for no more than a week, with a temperature of 25 ° C and no more than two weeks at 2-8 ° C. Injectable solutions can be kept at room temperature, but in a place protected from sunlight. Prepared injections should be used within 6-8 hours.

If you leave the first symptoms of rheumatism without attention, then this can lead to serious complications. Most often, patients face such pathologies:

• The disease goes into a chronic form, the treatment of which can last several years.
• Heart disease and heart failure.
• Violations in the work of the circulatory system, which entail a number of other diseases: varicose veins, stroke, pathology of internal organs, respiratory organs and eyesight.

Antibiotics for rheumatism can prevent all of the above complications, which can lead to death. Timely begun therapy facilitates discomfort and restores normal motor activity of the joints.

[38], [39], [40]