home Audience 2 Antibacterial drugs with anti-Helicobacter activity. Antibacterial drugs: names and characteristics

Antibacterial drugs with anti-Helicobacter activity. Antibacterial drugs: names and characteristics

Often, as soon as we notice a cough or a slight increase in temperature, we begin to study everything possible pills and medicines. Undoubtedly, knowledge good medicine will always come in handy. Therefore, searching for information about them on the Internet is a very useful pastime. However, any disease must be treated carefully, having thoroughly studied everything and, of course, in consultation with a doctor. Especially when it comes to antibiotics.

Antibiotics are strong and effective means from many diseases. These antibacterial substances are synthetic, half-synthetic or natural origin can stop growth quite quickly harmful microorganisms or destroy them completely.

They are especially often used in the treatment of such common diseases as:

Antibiotics are also used in a number of other cases, making them one of the most popular types of medicines. However, not everything and not always can be treated with these substances. For example, most antibiotics are usually of no use in treating viral diseases. Only tetracyclines and some other groups are used primarily against viruses.

In addition, despite their widespread use, antibiotics are by no means harmless. Some of them at long-term use can cause dysbacteriosis and skin rashes. Also, antibacterial drugs often have side effects, and if taken incorrectly, they can greatly weaken the body and make harmful bacteria resistant to treatment.

Therefore, for your reference, we have compiled a rating best antibiotics against specific diseases, in particular, sore throat, cough and some others. When choosing products, we were guided by the recommendations of experts, patient reviews and descriptions pharmacological action drugs. However, you should take antibiotics strictly as prescribed by your doctor!

There are contraindications. Consult your doctor.

The best antibiotics for sore throat, bronchitis and cough

Most antibiotics are designed to treat several different types microbes and have a fairly wide spectrum of action. However, only a few are truly effective against coughs and infections. respiratory tract.

3 Azithromycin

Best price
Country Russia
Average price: 160 rub.
Rating (2019): 4.0

Opens the ranking of the best budget antibiotics against colds domestic drug wide range actions. Despite the low price, it copes well with various respiratory tract infections, including bronchitis, laryngitis and pneumonia. Therefore, it is one of the most prescribed antibiotics.

However, he was prevented from getting a higher place in the ranking by a large number of side effects and contraindications, which, alas, are common to most similar drugs. In addition, it is not recommended for children under 16 years of age, as well as for adults who have arrhythmia, kidney or liver failure.

2 Macropen

The best antibiotic in tablet form
Country: Slovenia
Average price: 262 rub.
Rating (2019): 4.4

Slovenian coated tablets are good remedy from pathogenic intracellular microorganisms. This antibiotic is used primarily for bronchitis, stomatitis, pneumonia and other infections caused by certain pathogens. The drug can also be taken for the treatment and prevention of whooping cough and diphtheria.

The advantages of this antibiotic include effectiveness, few contraindications and minimal side effects. Plus, it's quite easy to take. It is usually prescribed 3 times a day, one tablet before meals.

The standard release form of the antibiotic is 16 tablets. However, the drug is also found in the form of a suspension, which is given even to the smallest children.

1 Fluimucil antibiotic IT

Best result
Country: Italy
Average price: 750 rub.
Rating (2019): 4.8

Fluimucil is one of the few truly effective antibiotics, suitable for both injection and inhalation. This antibiotic is used primarily for inhalation when wet cough, bronchitis, sore throat, tracheitis and a number of other respiratory diseases.

This solution can also be called one of the best means for washing or instillation for sinusitis, including sinusitis, and otitis media. Thanks to the successful combination of an antibiotic and a mucolytic, Fluimucil not only eliminates pathogenic microflora, but also helps cleanse the problem area. For example, in case of bronchitis, the drug accelerates the process of mucus removal.

Fluimucil antibiotic IT is dispensed in the form of a 500 mg solution for inhalation and injection. It should not be confused with the same name effervescent tablets and granules for preparing a solution that is taken orally.

The best antibiotics for sinusitis

2 Polydex with phenylephrine

Antibacterial and vasoconstrictor effect
Country: France
Average price: 320 rub.
Rating (2019): 4.7

Polydex spray is complex means, which is prescribed for a prolonged cold with purulent discharge from the nose. Thanks to the combination of two antibiotics and the vasoconstrictor phenylephrine, this antibiotic has a wide spectrum of action and is effective in combating sinusitis and other sinusitis, rhinitis and a number of different bacteria. These drops can be called the best drug that has an antibacterial and anti-inflammatory effect and helps improve breathing. The effect of their use is usually noticeable after 3 to 5 days. The full course of treatment takes no more than 10 days.

It is important to remember that this is not only a nasal spray, but also strong antibiotic, which has a number of contraindications. In addition to pregnant women and children under 2.5 years of age, Polydexa is not suitable for adults suffering from glaucoma. renal failure And kidney diseases. Therefore, it is often replaced with a more gentle analogue.

1 Isofra

Best local antibiotic
Country: France
Average price: 300 rub.
Rating (2019): 5.0

The first place among the best remedies for sinusitis goes to a fairly powerful local antibiotic in the form of a nasal spray. Although this French drug is quite inexpensive and does not have the widest spectrum of action, it is literally indispensable in the treatment of lingering cold with rhinitis, sinusitis or nasopharyngitis. In addition, this antibiotic is used to treat both adults and children.

The drug is considered one of the most harmless antibiotics, combines well with other medications, and has virtually no contraindications. Possible side effects include only allergies to individual components and some deterioration of the microflora of the nasopharynx with prolonged use.

However, it is important to remember that this is still an antibiotic that should be used as prescribed by a doctor. In addition, it is strictly not recommended for use when allergic rhinitis or as a remedy for allergies.

The best broad-spectrum antibiotics

Although in most cases the use of narrowly targeted antibiotics is preferable because they have fewer side effects, recovery is often impossible without a broad-spectrum antibiotic. For example, some diseases can be caused by several types of bacteria at once. In addition, not all pathogenic microflora can be eliminated by taking a specialized antibiotic.

3 Tetracycline

The widest spectrum of action
Country Russia
Average price: 76 rub.
Rating (2019): 4.2

Almost every adult probably knows this frequently prescribed drug. Graduating in various forms, the antibiotic is almost universal.

In most cases, Tetracycline is taken in tablet form, including for bronchitis, tonsillitis, pharyngitis, prostatitis, eczema and various infections of the gastrointestinal tract and soft tissues. Acting comprehensively, this antibiotic quickly copes with most infectious causes cough, fever and other ailments. The antibiotic is also available in the form of an ointment for external use and an eye ointment, which helps eliminate some problems locally.

However, the antibiotic has many contraindications and is not suitable for children under 8 years of age, as well as for women during pregnancy or lactation. Moreover, like many others strong drugs, it may cause serious side effects.

2 Avelox

Better effectiveness in acute and chronic diseases
Country: Germany
Average price: 773 rub.
Rating (2019): 4.5

Avelox tablets from the famous German company Bayer are one of the most serious antibiotics used primarily to combat acute and chronic diseases resistant to treatment with most other means. Therefore, since 2012, it has been included by the Russian government in the List of Essential Medicines.

One of the best drugs For adults, it is also highly effective and convenient and easy to take, so it does not depend on meals and does not require any additional actions. In addition, the antibiotic has been studied quite well and, according to numerous studies, rarely causes side effects.

The antibiotic is also found in the form of an injection solution, which is often used during exacerbations. chronic bronchitis. In some cases, a course of Avelox injections precedes a course of the same antibiotic in tablets.

1 Amoxicillin

The most harmless universal antibiotic
Country: Slovenia
Average price: 44 rub.
Rating (2019): 4.9

The leader in the ranking of the best broad-spectrum antibiotics is a time-tested, popular drug. It is taken for a variety of diseases occurring both with and without fever, in particular:

infections of the respiratory tract and ENT organs (including sinusitis, bronchitis, tonsillitis, otitis media);
gastrointestinal infections;
skin and soft tissue infections;
genitourinary system infections;
Lyme disease;
dysentery;
meningitis;
salmonellosis;
sepsis.

Amoxicillin is perhaps one of the most popular antibiotics for adults and children. Availability different forms release, including tablets and suspensions, as well as a relatively small list of possible side effects allow even pregnant women and babies over 1 month to take the medicine.

The best antibiotics for children

A child's illness in itself is not an easy test. However, the situation is often complicated by the fact that children do not want to take an antibiotic, or it has many side effects that are extremely harmful to them. child's body. Therefore, we have selected several of the most harmless and pleasant-tasting effective drugs from sore throat, bronchitis and other common diseases.

2 Augmentin

The best complex antibiotic
Country: UK
Average price: 150 rub.
Rating (2019): 4.4

Augmentin is one of the few antibiotics that is safe enough to be given to small children, even infants. Despite the relatively small number of side effects, the drug, unlike some analogues, can still have Negative influence on the kidneys and intestines. Therefore, it should be taken with caution, especially at an early age.

In general, the antibiotic is effective and good composition. This antibacterial agent is especially often prescribed for the treatment of bronchitis, tonsillitis, sinusitis, as well as various infections respiratory tract. In addition, thanks to the advanced complex action This antibiotic is also effective in the fight against various mixed infections.

In addition to the suspension, Augmentin is also available in the form of tablets that can be taken by children school age and adults.

1 Amoxiclav

Maximum benefits - minimum contraindications
Country: Slovenia
Average price: 220 rub.
Rating (2019): 5.0

The leader among the best children's antibiotics can confidently be called a universal drug with a wide spectrum of action, suitable for both adults and children. The most popular form of Amoxiclav are tablets, but in pharmacies you can easily find a suspension, which is usually given to children younger age and even newborns severe cold, cough and fever caused by various infections.

In addition to the convenient release form and versatility, the advantages of the drug include:

minimum contraindications and side effects;
pleasant taste;
performance;
does not contain dyes;
affordable price.

Despite soft action drug, it can be taken, like other antibiotics, only as prescribed by a doctor. In addition, Amoxiclav cannot be combined with certain other medications.

The term “antibacterial drugs” itself shows the principle of action directed against bacteria. They are prescribed only for infectious processes; using them for allergies and viruses is useless.

Antibacterial chemicals was originally called synthetic drugs, which are created artificially, but have a similar effect to antibiotics in suppressing bacteria.

At that time only sulfonamides were classified as such. With the creation of antibiotics, they were also included in this class.

With the creation of the strongest antibacterial drugs, similar to antibiotics and even superior to them, the concept of antibiotic has expanded and today is used as a synonym for antibacterial agents, which includes everything.

It is not right; antibacterial drugs and antibiotics are different things. Antibiotics are only a component of antibacterial ones.

Antibiotics are essentially substances that some microorganisms produce against others to destroy them. These are natural substances originally.

Antibacterial agents include antibiotics, antiseptics, antimicrobials and antibacterials. Their purpose is destruction pathogenic microorganisms(microbes).

These smallest forms of life arose long before the advent of man and are thriving to this day. All environment populated by billions of bacteria that live both outside and inside the human body.

Microbes include bacteria (they do not have a nucleus), some fungi, protists (they have a nucleus and are familiar to everyone since school curriculum- for example, ciliates), archaea. They are not necessarily single-celled, but they are all living.

This is in contrast to viruses and prions (protein structures in tissues that have the ability to reproduce), which can only develop in living host cells. This is why antibiotics cannot affect viruses. They can only be affected antiviral drugs and some antiseptics. In turn, antiviral drugs are useless for bacterial infections.

Antiseptics - act on all microorganisms, but are used only externally. These include iodine, alcohol, potassium permanganate. They disinfect wounds and prevent decomposition processes.

Antimicrobial agents - can be used both externally and internally (orally, by injection, in suppositories, etc.). These include sulfonamides.

Antibiotics are a narrower group of drugs that are effective against bacteria and protozoa (for example, malarial plasmodia, chlamydia, etc.). They are divided this way: antibacterial and antiprotozoal.

According to the method of use, they also include antiseptics and antimicrobials; for example, Levomycetin, Amoxicillin.

Those antimicrobial and antiseptic drugs that act on fungi are antifungal or antimycotic drugs.

All antibacterial drugs include 6 groups:

Their action will be discussed below.

A little history

In 1928, penicillin was discovered by A. Fleming, who discovered it by accident on bread mold and gave it its name. The mold of this fungus destroyed the staphylococcus colonies in the Petri dish. But no one was delighted, because the drug turned out to be very unstable and quickly deteriorated.

But only 10 years later, in 1938, a drug was created in which penicillin was preserved in active form. This was done by the Englishmen from Oxford, Howard Flory and Ernst Chain; they isolated it in its pure form.

The production of this drug began in 1943, and saved the lives of millions of people in the war, turning the course of history. And in 1945 these three scientists received the Nobel Prize.

In the USSR, Krustozin was created in 1942, which turned out to be one and a half times more effective than foreign penicillin. It was created by microbiologist Zinaida Ermolyeva.

Classification

Today, a lot of antibiotics have been created and their classifications are based on the principle of action and chemical structure.

Based on their effects, all antibiotic agents are divided into bacteriostatic and bactericidal. Bacteriostatics – stop the proliferation of bacteria, but do not destroy them.

In the second group, bacteria die and are excreted through the kidneys and feces. Bactericidal activity manifests itself in the suppression of all types of synthesis: proteins, DNA, bacterial cell membranes.

The concept of antibacterial drugs

So, antibacterial agents can be divided as follows:

Quinolones are antibacterial agents, and this also includes fluoroquinolones. They are used successfully for various systemic infectious pathologies.
Fluoroquinolones have a wide spectrum of action. They are not purely antibiotics, although they are close in action. But they have a different origin and structure. Many antibiotics are of natural origin or close to natural analogues. Fluoroquinolones do not have this.
There are 2 generations of these drugs. Some of them are included in the List of Essential Drugs: Ciprofloxacin, Levofloxacin, Moxifloxacin, Lomefloxacin, Ofloxacin.
Nitrofurans are also not antibiotics, although they have a bacteriostatic effect. They are used for chlamydia, trichomonas, lamblia, some gram-positive and gram-negative bacteria. IN high doses bactericidal. Resistance to them rarely develops.
Sulfonamides - have a bacteriostatic effect; They are not antibiotics; they are often prescribed to enhance their effect.
Hydroxyquinolines – inhibit gram-negative bacteria by inhibiting the activity of their enzymes. Used for intestinal and kidney infections, leprosy
Quinoxalines are bactericidal substances with poorly studied effects.

The classification by chemical structure currently used looks like this:

Beta-lactam antibiotics; they combine 3 subgroups - penicillins, cephalosporins, carbapenems.
Macrolides are a large group of bacteriostatic antibiotics; the safest in terms of side properties.
Tetracyclines are also bacteriostatic; are still at the forefront of treatment anthrax, tularemia, cholera, brucellosis.
Aminoglycosides - have bactericidal properties. Prescribed for sepsis, peritonitis. Highly toxic.
Levomycetins are bacteriostatics; they are toxic to bone marrow, therefore they are used to a limited extent.
Glycopeptide antibiotics are bactericidal; but on known cocci they act only bacteriostatically.
Lincosamides are bacteriostatic agents in therapeutic dose. In high doses they exhibit a bactericidal effect.
Anti-tuberculosis drugs are effective against Koch's bacillus. Based on the strength of action, they are divided into most, moderately and lowly effective.
Antibiotics different groups- Fusidine sodium, PolymyxinM, Gramicidin, Rifamycin, etc. They are used quite infrequently, therefore they remain effective in the treatment of intestinal infections, throat infections, etc.
Antifungal antibiotics - the spectrum of action is limited to fungi, they destroy the membrane of fungal cells. They have no effect on other pathogens.
Anti-leprosy drugs - rarely used, only for the treatment of leprosy - Diucifon, Solusulfon, etc.

Methods of administration

Antibiotics are available in tablets, ampoules, ointments, sprays, drops, suppositories and syrup. Accordingly, and different ways applications.

The frequency of administration and duration are prescribed by the doctor. Syrups are mainly prescribed to young children. Methods of administration: oral; injection; local.

Local application can be external, intranasal, intravaginal, rectal. Injection forms are used for moderate to severe infections. In these cases, the antibiotic enters the blood quickly, bypassing the gastrointestinal tract.

All details are discussed by the doctor and do not depend on the patient’s knowledge. For example, Abaktal is diluted before administration with glucose; physical the antibiotic solution destroys, and, therefore, the treatment will not be effective.

Otherwise, it is unacceptable to self-medicate, although there are detailed instructions to their use.

The duration of treatment is at least 7-10 days, even despite the improvement in health.

Antibiotic sensitivity

Uncontrolled use of antibiotics today has led to the fact that they are often ineffective. This happens because bacteria become resistant to these agents.

Therefore, in order to immediately get into the top ten, it is necessary to identify the type of pathogen and the sensitivity of the pathogen to a particular antibiotic.

For this purpose, a cultural diagnostic method is used using the method of bacterial inoculation. This is ideal. But it often happens that help is needed quickly, and culture will reveal the result in a few days.

In such cases, the doctor empirically, assuming a possible pathogen, prescribes the antibiotic that has proven to be the most effective in the given region.

Most often, broad-spectrum antibiotics are used for this. If the analysis is ready by then, it becomes possible to replace the antibiotic with the desired one if the prescribed one did not produce an effect within 3 days.

Possible mechanisms of resistance

The mechanism of resistance may be as follows:

Microorganisms can mutate if not properly treated, and the reactions that the antibiotic blocks become indifferent to the pathogen.
The pathogen can surround itself with a protective capsule and become impenetrable to the antibiotic.
The bacterium does not have a structure vulnerable to antibiotics.
The bacterium may have an enzyme that destroys the antibiotic at the level chemical formula, which converts the drug into a latent form (staphylococci, for example, contain lactamase that destroys penicillins).

Are antibiotics always effective?

Antibiotics can only destroy bacteria, fungi and protozoa; for viruses, their use is inappropriate. That is why antibiotics do not work for ARVI, since 99% of ARVI are viral in origin.

And this is also why antibiotics are effective for sore throats, since they are caused by streptococci and staphylococci. The same picture is observed with pneumonia. 80% of them are caused by bacteria. At viral pneumonia the doctor may prescribe antibiotics to prevent a secondary infection at the end of antiviral therapy.

Antibiotics and alcohol

If a person uses alcohol and antibiotics together, he, first of all, attacks his liver, since all antibacterial agents are decomposed by the liver, like alcohol.

In addition, some drugs themselves may, by chemical reactions combine with alcohol and reduce its effectiveness. Among such agents are Trichopolum, Cefaperazone, Levomycetin, etc.

Antibiotics during pregnancy

Treatment of pregnant women with antibiotics is always difficult, since the teratogenicity of the prescribed drug is taken into account. In the 1st trimester, their use is completely excluded; in the 2nd and 3rd trimesters they can be prescribed, but with caution and in exceptional cases. During these weeks, the baby’s main organs are already formed, but there is always a risk of adverse effects.

Do not use antibiotics to the expectant mother impossible if diagnosed with: tonsillitis, pyelonephritis, infected wound, sepsis, pneumonia, STIs; specific infections: borelliosis, brucellosis, TB, etc.

Can be prescribed during pregnancy

Penicillins, cephalosporins, Josamycin and Erythromycin, Azithromycin, Gentamicin do not have a teratogenic effect (the last 2 drugs can be used for health reasons). Cephalosporins cross the placenta very little to harm the fetus.

Not prescribed during pregnancy:

aminoglycosides (can cause congenital deafness);
clarithromycin and roxithromycin (toxic to the fetus);
fluoroquinolones;
metronidazole (teratogenic);
amphotericin (causes fetal growth retardation and miscarriages);
tetracyclines (disturbs the formation skeletal system fetus);
chloramphenicol (inhibits fetal bone marrow).

Why is there so little information about the effects of antibiotics on the fetus? Because such experiments on humans are prohibited. And the metabolism of humans and laboratory animals is not 100% the same, so the results may vary.

What are the consequences?

In addition to the antibacterial effect, antibiotics have a systemic effect on the body, so there are always side effects.

These include:

hepatotoxicity;
toxic-allergic reactions; dysbacteriosis;
decreased immunity (this is especially important in children);
effects on the kidneys;
development of pathogen resistance, especially with inadequate treatment;
superinfection - when, in response to the introduction of an antibiotic, those microorganisms that were resistant to it are activated and they cause a new disease in addition to the existing one.

Also, during antibacterial therapy, vitamin metabolism is disrupted due to inhibition of the microflora of the large intestine, where some vitamins are synthesized.

More rare, but complex and dangerous reaction- Jarisch-Herxheimer bacteriolysis – reaction. It can occur with the massive death of bacteria from a bactericidal antibiotic with the same massive release of their toxins into the blood. The downstream reaction resembles ITS.

Allergic reactions can lead to anaphylactic shock; that's why it's dangerous to inject antibiotics at home; you won't be able to help here. emergency assistance to the patient.

Taking antibacterial drugs affects the gastrointestinal tract and most often this manifests itself in the inhibition of intestinal microflora, which is expressed by diarrhea syndrome and disrupts metabolism in general. This is dysbacteriosis, the scientific name of which is antibiotic-associated diarrhea. Therefore, along with antibacterial therapy, pre- and probiotics should always be prescribed.

Antibiotics for prophylactic purposes

Many internet-savvy young mothers the slightest sign If you have a cold, you immediately start taking antibiotics yourself and give them to your children. This is a grave mistake.

Antibiotics do not have preventive action. If there is no pathogen, you will get nothing except side effects. Antibacterial and antimicrobial drugs for children in the treatment of infections are used today unambiguously, but only when its bacterial origin is identified.

Preventive antibiotics can be prescribed in a hospital only when surgical operations to prevent the development of secondary infection; introduced maximum dose half an hour before surgery once. Without purulent complications Antibacterial therapy is not prescribed after surgery.

The second case is the administration of an antibiotic if there is infected wound. The purpose of this is to suppress the infection before it manifests itself.

And the third point is for emergency prevention (unprotected sex- for the prevention of syphilis and gonorrhea).

Rules for antibiotic treatment:

Treatment is prescribed only by a doctor.
At viral infections antibiotics are not indicated.
Completely comply with the course of treatment; don't stop on your own. Take at the same time of day.
Do not adjust the dosage yourself.
Take antibiotic tablets with water only; milk, tea, soda - do not use.
There should be an equal time interval between doses of the drug.
During treatment are excluded physical exercise and training.
Antibacterial drugs for a child is prescribed only taking into account his body weight and age. This is the prerogative of the pediatrician.

Treatment of Helicobacter pylori infection

It is carried out only when the specified bacteria is detected on the gastric mucosa:

Powerful drugs against this type of bacteria are: Clarithromycin - a macrolide with high anti-Helicobacter activity; dissolves in the stomach environment and blocks bacterial synthesis processes. Also has an anti-inflammatory effect. It has a minimum of side effects and is well tolerated. Its analogues are Macropen, Fromilid, Binoclair, etc.
Amoxicillin is a bactericidal drug. For Helicobacter, it is combined with Metronidazole. Analogs - Augmentin, Amoxil.
Azithromycin is a 3rd generation macrolide. Has solubility in acidic environment stomach and is well tolerated. Analogues - Azamax, Brilid, Sumamed, etc.
Levofloxacin is a fluoroquinolone; bactericidal drug against Helicobacter. Analogues - Glevo, Lebel, Ivacin, Levoxin. They are quite toxic and therefore require careful use.
Metronidazole – antimicrobial agent, not an antibiotic. Bactericidal, prescribed in combination with other antibiotics.
Pilobact – combination drug for the treatment of pylori. It contains Clarithromycin, Tinidazole and Omez (antacid). Each component suppresses the vital activity of Helicobacter pylori.

Antibiotics in gynecology

Only broad-spectrum antibacterial drugs are used. They are used in conjunction with other medications to avoid side effects. For example, the use of antibiotics and OCs leads to unplanned pregnancy.

This is the largest group pharmacological drugs, consisting of drugs that have a selective effect on pathogens infectious diseases caused by certain types microorganisms that infect the body: bacteria, viruses, fungi, protozoa. Today, the medical network has more than 200 original antimicrobial drugs, not counting generics, grouped into 30 groups. They all differ in their mechanism of action, chemical composition, but have common characteristic features:

The main point of application of these drugs is not the host cell, but the microbial cell.
Their activity in relation to the causative agent of the disease is not a constant value, but changes over time, since microbes are able to adapt to antimicrobial drugs.
Drugs can affect pathogenic microorganisms, causing their death (bactericidal, fungicidal), or disrupting any vital processes, thereby slowing down their growth and reproduction. (bacteriostatic, vistatic, fungistatic).

The difference in how the concept of “antimicrobial agent” differs from the narrower “antibacterial drug” is as follows: the first includes not only therapeutic agents, but also prophylactic ones. For example, a solution of iodine, chlorine, potassium permanganate, used in practical medicine, has antimicrobial effect, but are not antibacterial.

Drugs with an antimicrobial effect include disinfectants and antiseptics, used for treating surfaces and cavities, which do not have a pronounced selective effect, but effectively influence pathogenic microorganisms.

Antibiotics

They represent a fairly large group of drugs.

An antibiotic is also an antimicrobial drug.

The difference is a narrower, directional spectrum therapeutic action. The first generations of such drugs were active primarily against bacteria.

Destruction of the membrane of a pathogenic microbe, which leads to its death.
Violation of the synthesis of protein molecules, which inhibits the vital processes of bacteria. This is the main effect of tetracyclines, aminoglycosides, and macrolides.
Violation of the cellular framework due to irreversible changes in the structure of organic molecules. This is how penicillin and cephalosporins work.

Any antibacterial agent causes death or inhibition of vital processes only of cellular pathogenic microorganisms. Antibiotics are completely ineffective in suppressing the growth and reproduction of viruses.

Correct treatment

Most important characteristic When choosing an antibiotic, the spectrum of its action against pathogenic microbes is considered. For successful treatment it is very important that the prescribed drug reaches its point of application, and the microbe is sensitive to the effects medicine. There are broad- or narrow-spectrum antibiotics. Modern criteria for choosing antibacterial drugs are:

Type and properties of the causative agent of the disease. Bacteriological research determining the cause of the disease and the sensitivity of the microbe to drugs is extremely important for effective treatment.
Selection optimal dose, regimen, duration of administration. Compliance with this norm prevents the emergence of resistant forms of microorganisms.
Using a combination of several drugs with different mechanisms of action on individual species microbes characterized by an increased ability to transform into stable forms, difficult to treat (for example, Mycobacterium tuberculosis).
If the pathogen infectious process unknown, broad-spectrum agents are prescribed until the results of a bacteriological study are obtained.
When choosing a drug, not only clinical manifestations disease, but also the patient’s condition, his age characteristics, severity concomitant pathology. The assessment of these factors is especially important, since it reflects the state of the immune system and allows one to determine the likelihood of unwanted side reactions.

There is no fundamental difference between these terms “antibacterial” and “antimicrobial”. Antibacterial therapy is integral part a broader concept of antimicrobial treatment, including not only the fight against bacteria, but also against viruses, protozoa, and fungal infections.

Antimicrobial drugs are mostly antibiotics, the appearance of which opened a new era in practical medicine and led to a number of specific consequences both in the existence of microorganisms and in the course of various diseases. The main problem in the use of these drugs is the formation of adaptive mechanisms in bacteria. Mainly this is enzymatic activity against antibiotics and immunity to these agents. Insensitivity can be isolated and cross, when one type of microbe is resistant to several groups of antibacterial agents. The problem of allergies to antibiotics and intolerance to them has also become relevant. Extreme degree Such a phenomenon is polyallergy, when it is generally impossible to treat the patient with drugs of this class.
An alternative direction was the use bacteriophages. This extracellular life form is akin to viruses. Each type of bacteriophage devours its own type of bacteria, causing microbial addiction to a lesser extent. Phages exist both in isolation and in mixed solutions supplied with a preservative.
The practice should be considered completely vicious self-treatment antibiotics, which has slowed down somewhat in last years thanks to the transfer of these drugs to the prescription class. Any antibiotic should be prescribed according to indications, taking into account not only the sensitivity of infectious agents, but also taking into account the characteristics of the patient. The doctor also takes into account the frequency of use of certain drugs in a given country or locality, which leads to differences in the immunity of the same microbes in different regions.

Antimicrobial drugs

I. Betalactam antibiotics.
Medications with a bacteriostatic effect and a wide spectrum of activity. Block the exchange of proteins in microbial cell membranes. They block the transport of substances and weaken the protection of bacteria.
1. Natural (sodium and potassium salts of benzylpenicillin and phenoxymethylpenicillin). Used parenterally.
2. Semi-synthetic (flemoxin, ampicillin, amoxicillin, oxacillin, ticarcillin, carbenicillin). Tablet and injection forms.
3. Combined penicillins. Ampiox.
4. Inhibitor-protected (amoxicillin clavulonate: flemoclav, panclave, amoxiclav, augmentin; ampicillin sulbactam: unasin, sultamicillin, ampixide).
To protect against bacterial enzymes they contain clavulanic acid.
Bactericidal betalactam agents. These antibiotics act similarly to penicillins, disrupting the structure of the cell wall of microbes. Currently they are inferior to the group of macrolides, maintaining their positions in the treatment of the urinary and upper respiratory tract.
First generation: cefazolin, cephalexin.
Second generation: cefuroxime, cefaclor.
Third generation: cefoperazone, ceftibuten, ceftriaxone, cefixime, cefotaxime, cefazidime.
Fourth generation: cefepime.
Resistant to betalactamases. Biapenem, imipenem, faropenem, ertapenem, doripenem, meropenem.
II. Tetracyclines. Bacteriostatics, the mechanism of action of which is based on the inhibition of protein synthesis. Tetracycline hydrochloride (tablets, ointment), doxycycline (capsules), oletethrin (tablets)
III. Macrolides. By binding to fats in the membranes, they disrupt the integrity of the latter. Clarithromycin, josamycin, azithromycin (azithromycin, azitral, hemomycin, sumamed).
IV. Aminoglycosides. As a result of disruption of protein synthesis in ribosomes, they have a bactericidal effect.
First generation: streptomycin, kanamycin, neomycin.
Second generation: sisomycin, tobramycin, gentamicin, netilmicin.
Third generation: amikacin.
V. Fluoroquinolones. The bactericidal effect is carried out on the basis of a block of bacterial enzymes. They also disrupt the synthesis of microbial DNA. Ciprofloxacin (Zindolin, Quintor, Ificipro), ofloxacin (Kirol, Glaufos, Zanocin), lomefloxacin (Lomacin, Lomeflox, Xenaquin), norfloxacin (Loxon, Negaflox, Quinolox), levofloxacin, lefloxacin, moxifloxacin, gatifloxacin, sparfloxacin (Sparflo).
Drugs to which microorganisms of different groups are less resistant. Ideally, they should be treated as reserve antibiotics along with anti-tuberculosis drugs. However, the commercial interests of pharmaceutical companies have brought them into the wider arena.
VI. Lincosamides. Bacteriostatic agents. Lincomycin, clindamycin. They act by binding to a component of the ribosomal membrane.
VII. Chloramphenicol (chloramphenicol). Due to its high toxicity to blood and bone marrow, it is mainly used topically (levomekol ointment).
VIII. Polymyxinv. bactericidal selectively against gram-negative flora. Polymyxin M, polymyxin B.
IX. Antituberculosis antibiotics. They are used against Pmycobacterium tuberculosis, although they are effective against a wide range of bacteria. Reserve drugs, that is, they try not to treat anything other than tuberculosis. Rifampicin, isoniazid.
X. Sulfonamides. Sulfamidic acid amine derivatives. Today they are practically not used due to side effects.
XI. Nitrofurans. They have bacteriostatic and high concentrations and bactericidal effect. Affects gram-negative and gram-positive flora. The main areas of application are intestinal infections (furazolidone, enterofuril, nifuroxazide) and infections urinary tract(furomak, furomax, furadonin).
in the form of solutions are used for local (rinsing, washing, lotions) and systemic oral administration. Choices when allergic reactions for antibiotics and for dysbacteriosis. Klebsiella, staphylococcal, intestinal, pyobacteriophage, salmonella.
in solutions and sprays are widely used for disinfection of the oral cavity, skin, and wound treatment.
Self-medication antimicrobials harmful by the development of multiple allergies, the cultivation in one’s own body of populations of microbes that are insensitive to many antibacterial agents, the risk of dysbacteriosis. Bacteria that survive inadequate therapy are capable of transforming any acute inflammation in a long-term chronic infection and cause immune diseases.

IN medical literature and among doctors you can hear the term “broad-spectrum antibacterial drugs.” What does it mean?

Any antibacterial drug (ABP) has a spectrum of action. These are the microorganisms on which it acts. The more bacteria are sensitive to a drug, the wider its spectrum.

Typically, such antibiotics are drugs that destroy or inhibit the growth of gram-negative and gram-positive bacteria. These pathogens cause most inflammatory diseases in organism.

Most often, ABPs are prescribed for the following diseases:

pneumonia and bronchitis;
sinusitis and frontal sinusitis;
streptococcal sore throat;
otitis;
pyelonephritis.

Broad-spectrum antimicrobials are indicated in situations where the exact pathogen is unknown and there is no time to carry out culture tests to determine drug sensitivity.

For example, pneumonia requires treatment on the day of diagnosis, and the only solution is the use of broad-spectrum antibiotics.

With this approach, there is always the possibility of choosing ineffective drug, to which a particular pathogen is resistant. But this does not happen so often and in any case is preferable to waiting for the results of bacterial culture.

The following groups of such antibiotics are distinguished:

penicillins;
cephalosporins;
macrolides;
fluoroquinolones.

Penicillins

Penicillin is the first antibiotic to be used in the fight against purulent infection. Thanks to its action, patient survival in postoperative period has risen sharply. The mortality rate of patients from pneumonia, which was common at all times, has also decreased.

The group of penicillins includes the following representatives:

benzylpenicillin;
bicillin;
oxacillin;
ampicillin;
amoxicillin.

One, due to the widespread and often unjustified use of these antibiotics, most microbes have developed resistance to them, and penicillins have practically ceased to be used. Another significant drawback of this group was its inability to resist destructive action beta-lactamases – bacterial enzymes.

However, modern penicillins are protected from microbial influence due to their combination with clavulanic acid.

The most popular drug amoxiclav (Augmentin, Amoxiclav Quiktab) is widely used by doctors of all specialties and is the gold standard in the treatment of infectious and purulent diseases.

Cephalosporins

In terms of their spectrum of action, cephalosporins are not much different from penicillins. Moreover, these groups are characterized by cross-sensitivity.

Allergies to these medications occur quite often. And if the patient has hypersensitivity to antibiotics penicillin series, the prescription of drugs of the second group should be approached with caution. The likelihood of allergies in such a patient will be increased.

There are four generations of cephalosporins, the first does not have a wide spectrum of action. In routine practice, the third generation drugs most often prescribed are ceftriaxone (Medaxon) and cefixime (Cefix).

Cephalosporins are available in tablets and ampoules. Parenteral forms are widely used in surgical, therapeutic and pulmonology (pneumonia, COPD, pleurisy) hospitals.

Macrolides

Considering that the proportion of these pathogens in the development of diseases respiratory system has increased significantly, the relevance of macrolides is increasing every year.

Representatives of this group are:

azithromycin;
clarithromycin;
erythromycin.

The latter drug is currently practically not used. Doctors can prescribe it only for strict indications - for example, with confirmed sensitivity of microbes to this antibiotic.

Fluoroquinolones

Fluoroquinolones are reserve antibiotics due to large quantity side effects. They affect the liver and kidneys, the blood system, and the central nervous system.

However, the effectiveness of these drugs is quite high, and there are still not many bacteria resistant to them.

Currently, fluoroquinolones are beginning to displace even penicillins and cephalosporins from practice. If at first these drugs were prescribed only for diseases of the urinary system, now a group of respiratory fluoroquinolones has been identified. They are widely used for the following pathologies:

bronchitis;
pneumonia;
COPD;
pleurisy;
exacerbation of bronchiectasis.

However, when prescribing fluoroquinolones, their various side effects should be kept in mind and patients should be warned about this.

Antimicrobial drugs in children

Which antimicrobial agent can be freely used in pediatrics? Most often, pediatricians recommend antibiotics from the group of penicillins, cephalosporins or macrolides for children. The latter are used most often due to high efficiency and ease of use.

Fluoroquinolones, according to the manufacturer's instructions, are not used in children under 14 years of age. This is due to their negative influence on cartilage tissue child.

However, in recent years, pediatricians have begun to use these antibiotics in children with cystic fibrosis. The disease is extremely difficult to treat and is characterized by frequent exacerbations, while the pathogens are resistant to most drugs.

No broad spectrum antibiotics modern medicine can't get by. However, they should not be abused to avoid developing drug resistance in microbes. These drugs are prescribed only by a doctor.