Penicillin depot. List of penicillin antibiotics, indications for taking drugs. Contraindications and side effects

Content

Penicillins were discovered at the beginning of the 20th century, but medical science has continuously improved their properties. Thus, modern drugs have become resistant to penicillinase, which previously deactivated them, and have become immune to the acidic gastric environment.

Classification of penicillins

A group of antibiotics produced by molds of the genus Penicillium are called penicillins. They are active against most gram-positive and some gram-negative microbes, gonococci, spirochetes, and meningococci. Penicillins are part of a large group of beta-lactam antibiotics. They are divided into natural and semi-synthetic, have the general properties of low toxicity, and a wide range of dosages.

Classification of antibiotics:

1. Natural (benzylpenicillins, bicillins, phenoxymethylpenicillin).
2. Isoxazolepenicillins (oxacillin, flucloxacillin).
3. Amidinopenicillins (amdinocillin, acidocillin).
4. Aminopenicillins (ampicillin, amoxicillin, pivampicillin).
5. Carboxypenicillins (carbenicillin, carindacillin, ticarcillin).
6. Ureidopenicillins (azlocillin, piperacillin, mezlocillin).

According to the source of production, spectrum of action and combination with beta-lactamases, antibiotics are divided into:

1. Natural: benzylpenicillin, phenoxymethylpenicillin.
2. Antistaphylococcal: oxacillin.
3. Extended spectrum (aminopenicillins): ampicillin, amoxicillin.
4. Active against Pseudomonas aeruginosa (Pseudomonas aeruginosa): carboxypenicillins (ticarcillin), ureidopenicillins (azlocillin, piperacillin).
5. Combined with beta-lactamase inhibitors (inhibitor-protected): in combination with amoxicillin, ticarcillin, ampicillin/sulbactam clavunate.

	Drug names	Spectrum of action
Natural	Bicillin, Benzathine, Penicillin, Ecobol	Streptococci, staphylococci, bacilli, enterococci, listeria, corynebacteria, neisseria, clostridia, actinomycetes, spirochetes
Semi-synthetic	Oxacillin, Ticarcillin, Methicillin, Mecillam, Nafcillin	Enterobacteriaceae, Haemophilus influenzae, spirochetes
With an extended spectrum of action (antipseudomonas)	Amoxicillin, Augmentin, Ampicillin trihydrate	Klebsiella, Proteus, Clostridia, Staphylococcus, Gonococcus
With a broad antibacterial spectrum	Carbenicillin, Azlocillin, Piperacillin, Azithromycin	Enterobacteriaceae, Klebsiella, Proteus

Penicillin group drugs

Antibiotics of a number of penicillins are available in the form of tablets and injections, sold with a prescription from a doctor, but over-the-counter drugs are also available.

They are used in dentistry, otorhinolaryngology, surgery, urology, gynecology, ophthalmology, and venereology.

Pills

The penicillin series of antibiotics is represented by popular tablets:

Drug name	Indications for use	Method of administration	Side effects	Contraindications
Amoxicar	Pharyngitis, bronchitis, pneumonia, cystitis, osteomyelitis	1 piece each every 8 hours for no longer than 14 days in a row	Vomiting, dyspepsia, diarrhea, hepatitis, leukopenia, itching, urticaria, dizziness, superinfection, convulsions	Intolerance to the components of the composition, history of cholestatic jaundice, phenylketonuria
Amoxiclav	Sinusitis, otitis, abscess, tonsillitis, pharyngitis, acute cholangitis	1 piece each every 8 hours for 5–45 days	Loss of appetite, vomiting, nausea, hepatitis, colitis, erythema, dermatitis, candidiasis	Jaundice, allergy to the components of the composition
Ampicillin	Cholangitis, cholecystitis, pneumonia, bronchitis, abscess, meningitis, gastroenteritis, typhoid fever, paratyphoid fever, endocarditis, peritonitis, septicemia, pyelitis, gonorrhea	Half an hour before or 2 hours after meals, 250–1000 mg every 6 hours	Allergy, skin rash, itching, rhinitis, urticaria, conjunctivitis, erythema, nausea, diarrhea, vomiting, fever, joint pain, hepatitis, tremor, convulsions	Intolerance to the components of the composition, severe impairment of the kidneys, liver, leukemia, HIV infection
Augmentin	Pneumonia, bronchitis, bronchopneumonia, cystitis, urethritis, pyelonephritis, gonorrhea, osteomyelitis, periodontitis, septic abortion	1 piece each three times a day for a course of 5–14 days	Candidiasis, anemia, vasculitis, dizziness, convulsions, diarrhea, vomiting, nausea, gastritis, stomatitis, colitis, itching, rash, urticaria, crystalluria	Intolerance to the components of the composition, history of jaundice, phenylketonuria
Flemoklav Solutab	Otitis, sinusitis, pharyngitis, tonsillitis, bronchitis, community-acquired pneumonia	1 piece each three times a day for a course of 5–14 days	Allergy, nausea, diarrhea, vomiting, superinfection, urticaria	Jaundice, mononucleosis, lymphocytic leukemia, age up to 2 years
	Pneumonia, bronchitis, pyelitis, cystitis, gonorrhea, cervicitis, peritonitis, enterocolitis, borreliosis, erysipelas, meningitis, salmonellosis		Urticaria, erythema, fever, edema, rhinitis, dermatitis, dysbacteriosis, enterocolitis, agitation, insomnia, leukopenia, candidiasis, tachycardia	Allergic diathesis, hay fever, bronchial asthma, lactation, liver failure

Injections

Antibiotics of the penicillin group in the form of injections:

Drug name	Indications for use	Method of administration	Side effects	Contraindications
Ospamox	Bronchitis, pneumonia, whooping cough, pyelonephritis, gonorrhea, adnexitis, paratyphoid fever, shigellosis, leptospirosis, listeriosis, septicemia	1.5-2 g per day in 2-3 injections for 10 days	Nausea, glossitis, stomatitis, urticaria, joint pain, erythema, headache, fatigue	Respiratory viral infections
Timentin	Sepsis, bacteremia, endometritis, pyelonephritis	Intravenous 1.6-3.2 g every 6-8 hours	Necrolysis, vomiting, diarrhea, colitis, hypokalemia	Prematurity of children, intolerance to the components of the composition
Hiconcil	Borreliosis, Lyme disease, gonorrhea, endocarditis	500 mg three times a day for 5–12 days	Nausea, allergies, diarrhea	Hypersensitivity to the components of the composition

Penicillin antibiotics for children

Doctors prescribe penicillin antibiotics to children with caution because they are at increased risk of developing negative effects. In the first years of life, the child is given benzylpenicillins to treat sepsis, meningitis, and pneumonia. Contraindications include: intolerance to the components of the composition, insufficiency of the kidneys and liver.

Children's bodies are more sensitive to antibiotics. Penicillins can accumulate, causing seizures. List of oral medications used for the treatment of bacterial diseases for children:

• Amoxicillin;
• Augmentin;
• Amoxiclav.

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Today, not a single medical institution can do without an antibiotic. Successful treatment of various diseases is possible only through the administration of effective antibacterial therapy. Antibiotics today are represented by a wide range of different drugs aimed at the destruction of the pathogenic environment of a bacterial nature.

The first antibiotic created was penicillin, which defeated some epidemics and fatal diseases in the 20th century. Today, antibiotics of the penicillin group are rarely used in medical practice due to the high sensitivity of patients and the risk of developing allergies.

Groups of antibiotics without penicillin

Antibacterial therapy without the use of penicillin components involves the prescription of alternative medicines of other pharmacological groups. Antibiotics without penicillin are available in a wide range for the treatment of various diseases in hospital and outpatient practice in children or adults.

Group of cephalosporins

Cephalosporins are broad-spectrum antibiotics, which is due to their detrimental effects on many groups of microorganisms, strains and other pathogenic environments. Drugs of the cephalosporin group are available in the form of intramuscular or intravenous injections. Antibiotics of this group are prescribed for the following conditions:

Well-known cephalosporins include Ceforal, Suprax, Pancef. All antibiotics in this series have similar side effects, for example, dyspeptic disorders (stool upset, skin rashes, nausea). The main advantage of antibiotics is not only the detrimental effect on many strains, but also the possibility of treating children (including the neonatal period). Cephalosporin antibiotics are classified into the following groups:

I generation

Cephalosporin antibiotics include Cefadroxil and Cephalexin, Cefazolin, Cefuroxime.

They are used for inflammatory diseases caused by many anaerobic bacteria, staphylococcal infections, streptococci and others.

The drug comes in a variety of forms: from tablets to solutions for parenteral administration.

II generation

Well-known drugs in this group: Cefuroxime (injections), Cefaclor, Cefuroxime axetil. The drugs are especially active against many gram-positive and gram-negative bacteria. The drugs are available both in the form of solutions and in tablet form.

III generation

Antibiotics of this series are broad-spectrum. The drugs affect almost all microorganisms and are known under the following names:

• Ceftriaxone;
• Ceftazidime;
• Cefoperazone;
• Cefixime and Ceftibuten.

Release forms: injections for intravenous or intramuscular administration. When the drug is administered, it is often mixed with saline or lidocaine solution to reduce pain. The drug and additional components are mixed in one syringe.

IV generation

The group is represented by only one drug - Cefepime. The pharmacological industry produces the drug in powder form, which is diluted just before administration through the parenteral or intramuscular route.

The destructive effect of the antibiotic is to disrupt the synthesis of the body wall of the microbial unit at the cellular level. The main advantages include the possibility of treatment on an outpatient basis, ease of use, use in young children, minimal risks of side effects and complications.

Macrolide group

Antibiotics from the macrolide group are a new generation of drugs, the structure of which is a full-fledged macrocyclic lactone ring. Based on the type of molecular-atomic structure, this group received its name. Depending on the number of carbon atoms in the molecular composition, several types of macrolides are distinguished:

• 14, 15-membered;
• 15-membered.

Macrolides are especially active against many gram-positive coccal bacteria, as well as pathogens acting at the cellular level (for example, mycoplasma, legionella, campylobacter). Macrolides have the least toxicity and are suitable for the treatment of inflammatory diseases of the ENT organs (sinusitis, whooping cough, otitis of various classifications). The list of macrolide drugs is as follows:

Numerous medical studies have confirmed the low likelihood of side effects. The main disadvantage can be considered the rapid development of resistance of various groups of microorganisms, which explains the lack of therapeutic results in some patients.

Fluoroquinolone group

Antibiotics from the fluoroquinol group do not contain penicillin or its components, but are used to treat the most acute and severe inflammatory diseases.

These include purulent bilateral otitis media, severe bilateral pneumonia, pyelonephritis (including chronic forms), salmonellosis, cystitis, dysentery and others.

Fluoroquinols include the following drugs:

• Ofloxacin;
• Levofloxacin;
• Ciprofloxacin.

The very first developments of this group of antibiotics date back to the 20th century. The most famous fluoroquinols can belong to different generations and solve separate clinical problems.

I generation

Well-known drugs from this group are Negram and Nevigramon. The basis of antibiotics is nalidixic acid. The drugs have a detrimental effect on the following types of bacteria:

• Protea and Klebsiella;
• shigella and salmonella.

Antibiotics of this group are characterized by strong permeability and a sufficient number of negative consequences of taking them. According to the results of clinical and laboratory studies, the antibiotic confirmed its absolute uselessness in the treatment of gram-positive cocci, some anaerobic microorganisms, and Pseudomonas aeruginosa (including the nosocomial type).

II generation

Second generation antibiotics are obtained through a combination of chlorine atoms and quinoline molecules. Hence the name - a group of fluoroquinolones. The list of antibiotics in this group is represented by the following drugs:

Second generation antibiotics are prescribed for serious surgical situations and are used in patients of any age group. The main factor here is the risk of death, not the occurrence of any side effects.

III, IV generation

The main pharmacological drugs of the 3rd generation include Levofloxacin (otherwise known as Tavanic), used for chronic bronchitis, severe bronchial obstruction in other pathologies, anthrax, and diseases of the ENT organs.

Moxifloxacin (pharmacol. Avelox), known for its inhibitory effect on staphylococcal microorganisms, is rightfully considered to be the 4th generation. Avelox is the only drug that is effective against non-spore-forming anaerobic microorganisms.

Antibiotics of various groups have special instructions, indications, and also contraindications for use. Due to the uncontrolled use of antibiotics without penicillin and others, a law was passed on prescription dispensing from pharmacy chains.

Such introductions are very necessary for medicine due to the resistance of many pathogenic environments to modern antibiotics. Penicillins have not been widely used in medical practice for more than 25 years, so it can be assumed that this group of drugs will effectively affect new types of bacterial microflora.

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Penicillin antibiotics are characterized by low toxicity and an extended spectrum of action. Penicillin antibiotics have a bactericidal effect on most strains of gram-positive and gram-negative bacteria, Pseudomonas aeruginosa.

The effect of drugs from the list of penicillin antibiotics is determined by their ability to cause the death of pathogenic microflora. Penicillins act bactericidal by interacting with bacterial enzymes, disrupting the synthesis of the bacterial wall.

The targets for penicillins are reproducing bacterial cells. Antibiotics of the penicillin group are safe for humans, since the membranes of human cells do not contain bacterial peptidoglycan.

Classification

Based on the production method and properties, there are two main groups of penicillin antibiotics:

• natural - discovered in 1928 by Flemming;
• semisynthetic - created for the first time in 1957, when the active core of the antibiotic 6-APA was isolated.

A number of natural penicillins obtained from the Penicillum microfungus are not resistant to bacterial penicillinase enzymes. Because of this, the spectrum of activity of the natural penicillin series is narrowed compared to the group of semisynthetic drugs.

Classification of the penicillin series:

• natural;
  • phenoxymethylpenicillin – Ospen and analogues;
  • benzathine benzylpenicillin - Retarpen;
  • benzylpenicillin – Procaine penicillin;
• semi-synthetic;
  • aminopenicillins – amoxicillins, ampicillins;
  • antistaphylococcal;
  • antipseudomonas;
    • carboxypenicillins;
    • ureidopenicillins;
  • inhibitor-protected;
  • combined.

Under the influence of the widespread use of antibiotics, bacteria have learned to produce beta-lactamase enzymes, which destroy penicillins in the stomach.

To overcome the ability of bacteria that produce beta-lactamases to destroy antibiotics, combined inhibitor-protected agents were created.

Spectrum of action

Natural penicillins are active against bacteria:

• gram-positive - staphylococci, streptococci, pneumococci, listeria, bacilli;
• gram-negative - meningococci, gonococci, Haemophilus ducreyi - causing chancroid, Pasteurella multocida - causing pasteurellosis;
• anaerobes – clostridia, fusobacteria, actinomycetes;
• spirochetes - Leptospira, Borrelia, spirochete pallidum.

The spectrum of action of semisynthetic penicillins is wider than that of natural ones.

Semi-synthetic groups of antibiotics from the penicillin series are classified according to their spectrum of action as:

• not active against Pseudomonas aeruginosa;
• antipseudomonas drugs.

Indications

Penicillin antibiotics are used as first-line drugs for the treatment of bacterial infections in the treatment of:

• diseases of the respiratory system - pneumonia, bronchitis;
• ENT diseases - otitis media, tonsillitis, tonsillopharyngitis, scarlet fever;
• diseases of the urinary system – cystitis, pyelonephoritis
• gonorrhea, syphilis;
• skin infections;
• osteomyelitis;
• blenorrhea of ​​newborns;
• bacterial lesions of mucous membranes, connective tissue;
• leptospirosis, actinomycosis;
• meningitis.

Natural penicillins

Natural benzylpenicillins are destroyed by both beta-lactamases and gastric juice. Drugs of this group are produced as injection drugs:

• prolonged action - analogues with the names Bicillins numbered 1 and 5, novocaine salt of benzylpennicillin;
• short-acting - sodium, potassium salts of benzylpenicillin.

Depot forms of penicillins are released into the blood for a long time when administered intramuscularly, and are slowly released from the muscle into the blood after an injection:

• Bicellins 1 and 5 are prescribed once a day;
• Benzylpenicillin novocaine salt – 2 – 3 times a day.

Aminopenicillins

Antibiotics from the list of aminopenicillins are effective against most infections caused by bacteria Enterobacteriaceae, Helicobacter pylori, Haemophilus influenzae and other names of predominantly gram-negative bacteria.

The list of aminopenicillin antibiotics of the penicillin series includes the following drugs:

• ampicillin series;
  • Ampicillin trihydrate;
  • Ampicillin;
• amoxicillin;
  • Flemoxin Solutab;
  • Ospamox;
  • Amosin;
  • Ecobol.

The activity of antibiotics from the list of ampicillins and amoxicillins, the action spectra of drugs from these groups of penicillins are similar.

Antibiotics of the ampicillin series have a weaker effect on pneumococci, however, the activity of Ampicillin and its analogues with the names Ampicillin Akos, Ampicillin trihydrate is higher in relation to Shigella.

Antibiotics of the following groups are prescribed:

• ampicillins - orally in tablets and injections IM, IV;
• amoxicillin - for oral administration.

The amoxicillin series is effective against Pseudomonas aeruginosa, but some members of the group are destroyed by bacterial penicillinases. Penicillins from the group of ampicillin antibiotics are resistant to penicillinase enzymes.

Antistaphylococcal penicillins

The group of antistaphylococcal penicillins includes antibiotics with the following names:

• oxacillin;
• dicloxacillin;
• nafcillin;
• methicillin.

The drugs are resistant to staphylococcal penicillinases, which destroy other penicillin antibiotics. The most famous of this group is the antistaphylococcal drug Oxacillin.

Antipseudomonas penicillins

Antibiotics of this group have a wider spectrum of action than aminopenicillins and are effective against Pseudomonas aeruginosa, which causes severe cystitis, purulent tonsillitis, and skin infections.

The list of the group of antipseudomonas penicillins includes:

• carboxypenicillins – drugs;
  • Carbecin;
  • Piopen;
  • Carbenicillin disodium;
  • Timentin;
• ureidopenicillin group;
  • Securopen;
  • Azlin;
  • Baypen;
  • piperacillin Picillin.

Carbenicillin is available only in powder form for intramuscular and intravenous injections. Antibiotics of this group are prescribed to adults.

Timentin is prescribed for severe infections of the genitourinary and respiratory systems. Azlocillin and analogs are prescribed by injection for purulent-septic conditions:

• peritonitis;
• septic endocarditis;
• sepsis;
• lung abscess;
• severe infections of the genitourinary system.

Piperacillin is prescribed primarily for infections caused by Klebsiella spp.

Inhibitor-protected, combined agents

Inhibitor-protected penicillins include combination drugs that include an antibiotic and a substance that blocks the activity of bacterial beta-lactamases.

The following are beta-lactamase inhibitors, of which there are about 500 varieties:

• clavulanic acid;
• tazobactam;
• sulbactam.

For the treatment of respiratory and genitourinary infections, mainly protected penicillin antibiotics are used with the names:

• amoxicillin + clavunate;
  • Augmentin;
  • Amoxiclav;
  • Amoxil;
• ampicillin + sulbactam - Unazine.

For infections occurring against a background of weakened immunity, the following is prescribed:

• ticarcillin + clavunate - Timentin;
• piperacillin + tazobactam - Tazocin.

Combined-action drugs include the antibacterial agent Ampiox and its analogue Ampiox-sodium, including ampicillin + oxacillin.

Ampiox is available in tablets and powder form for injection. Ampiox is used in the treatment of children and adults from severe sepsis, septic endocarditis, and postpartum infection.

Penicillins for adults

The list of semi-synthetic penicillins, which are widely used for sore throats, otitis, pharyngitis, sinusitis, pneumonia, includes medications in tablets and injections:

• Hiconcil;
• Ospamox;
• Amoxiclav;
• Amoxicar;
• Ampicillin;
• Augmentin;
• Flemoxin Solutab;
• Amoxiclav;
• Piperacillin;
• Ticarcillin;

Penicillins are prescribed against purulent, chronic pyelonephritis, bacterial cystitis, urethritis, endometritis, and salpingitis in women:

• Augmentin;
• Amoxiclav;
• Ampicillin + sulbactam;
• Honeyclave;
• Piperacillin + tazobactam;
• Ticarcillin with clavulanate.

Penicillins are not used against prostatitis, since they do not penetrate the prostate tissue.

If you are allergic to penicillins, the patient may experience urticaria, anaphylactic shock, and in case of treatment with cephalosporins.

To avoid an allergic reaction, if you are allergic to beta-lactam antibiotics, which are penicillins and cephalosporins, macrolide antibiotics are prescribed.

Exacerbation of chronic pyelonephritis in pregnant women is treated:

• Ampicillin;
• Amoxicillin + clavulanate;
• Ticarcillin + clavulanate;
• Oxacillin - for staphylococcal infections.

The list of non-penicillin antibiotics that a doctor can prescribe during pregnancy for sore throat, bronchitis or pneumonia includes the following medications:

• cephalosporins;
  • Cefazolin;
  • Ceftriaxone;
• macrolides;
  • Azithromycin;
  • Clarithromycin.

Penicillins for the treatment of children

Penicillins are low-toxic antibiotics, which is why they are often prescribed to children for infectious diseases.

Preference when treating children is given to inhibitor-protected penicillins intended for oral administration.

The list of penicillin antibiotics intended for the treatment of children includes Amoxicillin and analogues, Augmentin, Amoxiclav, Flemoxin and Flemoclav Solutab.

Non-penicillin forms of the antibiotic Solutab are also used to treat children; the list includes analogues with the names:

• Vilprafen Solutab;
• Unidox Solutab.

Medicines in the form of Solutab dispersible tablets are no less effective than injections and cause less child grief and tears during the treatment process. You can read about antibiotics in the form of dispersible effervescent tablets on the Antibiotic Solutab page.

Since birth, the drug Ospamox and a number of its analogues, which are produced in soluble tablets, granules and powder for the preparation of suspension, have been used to treat children. The dosage is prescribed by the doctor based on the age and weight of the child.

In children, penicillin may accumulate in the body due to immaturity of the urinary system or kidney disease. An increased concentration of antibiotic in the blood has a toxic effect on nerve cells, which is manifested by seizures.

If such symptoms appear, treatment is stopped, and the penicillin antibiotic is replaced for the child with a drug from another group.

Contraindications, side effects of penicillins

Contraindications for the use of penicillins include allergies to penicillin analogues and cephalosporins. If a rash or skin itching appears during treatment, you should stop taking the medications and consult a doctor.

An allergy to penicillins can manifest as angioedema and anaphylaxis.

The list of side effects of penicillins is small. The main negative manifestation is the suppression of beneficial intestinal microflora.

Diarrhea, candidiasis, skin rash - these are the main side effects from the use of penicillins. Less commonly, side effects of drugs in this series appear:

• nausea, vomiting;
• headache;
• pseudomembranous colitis;
• swelling.

The use of certain groups of the penicillin series - benzylpenicillins, carbenicillins, can cause electrolyte imbalance with the occurrence of hyperkalemia or hypernatremia, which increases the risk of a heart attack and increased blood pressure.

A wider list of adverse reactions for oxacillin and analogues:

• violation of the leukocyte formula - low hemoglobin, low neutrophils;
• from the kidneys in children - the appearance of blood in the urine;
• fever, vomiting, nausea.

To prevent the development of undesirable effects, you must follow the instructions for use and take the medicine in the dosage prescribed by your doctor.

Read more complete information about each group of penicillin antibiotics in the “Drugs” section.

Penicillin antibiotics are considered the first AMPs that were developed from waste products of certain bacteria. In the general classification they are in the class of beta-lactams. In addition to penicillins, this also includes carbapenems, cephalosporins and monobactams. The similarity is due to the fact that there is a four-membered ring. All drugs from this group are used in chemotherapy. They play an important role in the treatment of infectious diseases.

Initially, all drugs of the penicillin group came from ordinary penicillin. It has been used in medicine since the 1940s. Nowadays many subgroups of both natural and synthetic origin have been created:

1. Natural penicillins.
2. Oxacillin.
3. Aminopenicillin.

Natural penicillin medicines are used in a number of cases. For example, medications that belong to the natural group of penicillins are recommended only for the treatment of those infections whose etiology is already known. For example, this can be confirmed during diagnostic procedures or by characteristic symptoms. Depending on the form and how severely the disease develops, medications are prescribed for internal or parenteral use. Penicillins from the natural group help in the treatment of rheumatism, scarlet fever, tonsillopharyngitis, erysipelas, sepsis, and pneumonia.

In addition, such drugs are prescribed for the treatment of other diseases that are caused by streptococcus. For example, this applies to infectious endocarditis. For this disease, not only antibiotics from this group are used, but also drugs that have the following names: streptomycin, gentamicin, etc. Diseases that are caused by meningococcal type infections can also be cured with natural penicillins. Indications for their use are leptospirosis, gangrene, Lyme disease, syphilis, actinomycosis.

By the way, it is necessary to take into account the fact that medications with a prolonged effect do not have a high concentration in the blood, so they are not prescribed for the treatment of severe forms of the disease. The only exceptions are syphilis, tonsillopharyngitis, rheumatism and scarlet fever. If previously medications from this group were used to treat gonorrhea, now the causative agents of the disease quickly adapted and became resistant to these drugs.

As for oxacillin, it is prescribed only when the disease is caused by a staphylococcal infection, and this does not depend on its location. The infection may already be laboratory confirmed or only suspected.

However, in any case, before prescribing such drugs to a patient, it is necessary to check whether bacteria are susceptible to their action. Medicines from the oxacillin group are prescribed in cases of sepsis, pneumonia, meningitis, endocarditis caused by bacterial infection, as well as various lesions of the bones, skin, joints, and soft tissues caused by infections.

Aminopenicillins are prescribed in cases where the disease occurs in a fairly mild form, and without any complications in the form of other infections. Inhibitor-protective forms of aminopenicillins are used in cases of relapses in severe diseases. There are many medications, including antibiotic tablets. Substances are administered either orally or parenterally. Such drugs are prescribed for acute cystitis, pyelonephritis, pneumonia, sinusitis, exacerbation of chronic bronchitis.

In addition, indications for use are intestinal diseases that are caused by infections, endocarditis, meningitis. Sometimes inhibitor-protective derivatives are prescribed by doctors for a preoperative form of prevention and in the treatment of infectious diseases of the skin and soft tissues.

What else applies?

The following drugs are also used:

1. Carboxypenicillin. Drugs from the carboxypenicillin group are now used less and less in medicine. They can be prescribed only in cases of nosocomial infections. Such medications should be used only in complex therapy, along with medications that can affect Pseudomonas aeruginosa. As for indications for use, carboxypenicillins are prescribed for infections on the skin, bones, soft tissues, and joints. These medications will also be needed for abscess, pneumonia, sepsis, and infections in the pelvic organs.
2. Ureidopenicillin. Drugs from the ureidopenicillin group are often prescribed only together with aminoglycosides. This combination helps to cope with Pseudomonas aeruginosa. Indications for use are infectious diseases of the pelvic organs, soft tissues, and skin (diabetic foot is also included). In addition, such funds will be needed for peritonitis, liver abscess, pneumonia, and lung abscess.

Mechanism of action

Drugs from the penicillin group have a bactericidal effect. They specifically affect penicillin-binding proteins, which are found in all bacteria. These compounds act as enzymes that participate already in the final stage of synthesis of the walls of the microorganism. As a result, the production of the substance is blocked and the bacterium dies. In addition, clavulonic acid, tazobactam and sulbactam have been developed to inhibit certain enzymatic substances. They are part of the drugs that belong to complex penicillins.

As for the effect on the human body, carboxypenicillins, benzylpenicillins and ureidopenicillins are destroyed in the human body due to hydrochloric acid, which is part of the gastric juice. In this regard, they can only be used parenterally. Drugs that contain oxacillin, phenoxymethylpenicillin and aminopenicillin, on the contrary, are resistant to acidic conditions and can be used orally. By the way, amoxicillin is best absorbed through the gastrointestinal tract. As for the worst indicators of digestibility, oxacillin and ampicillin have parameters of only 30%.

The substances that make up penicillin drugs spread well throughout the body, affecting tissues, biological fluids, and organs. High concentrations will occur in the kidneys, mucous membranes, intestines, lungs, genitals, and fluids. A small dose may pass through breast milk and the placenta. They practically do not enter the prostate gland. Significant transformation in the liver is characteristic of ureidopenicillins and oxacillins. Other substances from this group are excreted from the body practically unchanged. In most cases, excretion is carried out by the kidneys. The time it takes to remove the substance is approximately an hour. If the patient is diagnosed with kidney failure, the time will increase. Almost all types of penicillins are eliminated from the body through hemodialysis.

Contraindications and side effects

Like all drugs, medications containing penicillin have their contraindications. Basically, this only applies to allergies to penicillin. People who are at risk of an allergic reaction due to intolerance to certain components should not use these medications. The same applies to an allergic reaction to novocaine.

As for side effects, if the drugs are overdosed or used incorrectly, there is a risk of an allergic reaction. This could be dermatitis, rash, urticaria. In rare cases, Quincke's edema, anaphylactic shock, bronchospasms, and fever appear. If a person experiences anaphylactic shock, then glucocorticoids, adrenaline, and oxygen therapy will be required. It is also urgent to ensure the functioning of the respiratory tubular organs.

As for problems with the functioning of the central nervous system, in rare cases tremors and mental disorders appear.

Sometimes the patient has a headache and seizures.

Basically, this happens in those people who suffer from kidney failure.

Problems with the functioning of the digestive tract appear more often. A person may feel sick, have vomiting attacks, abdominal pain, and colitis. In this case, it is necessary to abandon such medications. Additionally, if colitis is suspected, sigmoidoscopy is prescribed. To restore your health, you need to return your water and electrolyte balance to normal. Sometimes taking drugs from the penicillin group also leads to disruption of these processes.

This leads to hyperkalemia, hypernatremia. As a result, blood pressure changes and swelling appears. In some cases, problems may arise in the functioning of the liver, kidneys, various hematological reactions, and complications of the condition of the blood vessels. In rare cases, oral or vaginal candidiasis develops.

groups penicillins , depends on what kind of medicine we are talking about.

Currently, four groups are used:

• natural penicillins;
• semisynthetic penicillins;
• aminopenicillins, which have an extended spectrum of action;
• penicillins, which have a wide antibacterial spectrum of influence.

Release form

Injectable preparations are available, as well as penicillin tablets.

The injection product is produced in glass bottles, which are closed with rubber stoppers and metal caps. The vials contain different doses of penicillin. It is dissolved before administration.

Penicillin-ecmoline tablets are also produced for resorption and oral administration. Sucking tablets contain 5000 units of penicillin. In tablets for oral administration - 50,000 units.

Penicillin tablets with sodium citrate may contain 50,000 and 100,000 units.

pharmachologic effect

Penicillin - this is the first antimicrobial agent that was obtained using waste products of microorganisms as a basis. The history of this medicine begins in 1928, when the inventor of the antibiotic Alexander Fleming isolated it from a strain of the fungus species Penicillium notatum. In the chapter that describes the history of the discovery of penicillin, Wikipedia testifies that the antibiotic was discovered by accident; after the bacteria entered the culture from the external environment of a mold fungus, its bactericidal effect was noted. Later, the formula of penicillin was determined, and other specialists began to study how to obtain penicillin. However, the answer to the questions of what year this drug was invented and who invented the antibiotic is clear.

The further description of penicillin on Wikipedia testifies to who created and improved the drugs. In the forties of the twentieth century, scientists in the USA and Great Britain worked on the industrial production process of penicillin. The first use of this antibacterial drug for the treatment of bacterial infections occurred in 1941. And in 1945, for the invention of penicillin, the Nobel Prize was received by its creator Fleming (the one who invented penicillin), as well as by the scientists who worked on its further improvement - Flory and Chain.

Speaking about who discovered penicillin in Russia, it should be noted that the first samples were obtained in the Soviet Union in 1942 by microbiologists Balezina And Ermolyeva. Then industrial production of the antibiotic began in the country. In the late fifties, synthetic penicillins appeared.

When this drug was invented, for a long time it remained the main antibiotic used clinically throughout the world. And even after other antibiotics without penicillin were invented, this antibiotic remained an important drug for the treatment of infectious diseases. There is a claim that the medicine is obtained using cap mushrooms, but today there are different methods for its production. Currently, so-called protected penicillins are widely used.

The chemical composition of penicillin indicates that the drug is an acid, from which various salts are subsequently obtained. Penicillin antibiotics include Phenoxymethylpenicillin (penicillin V), Benzylpenicillin (penicillin G), etc. The classification of penicillins involves their division into natural and semi-synthetic.

Biosynthetic penicillins provide bactericidal and bacteriostatic effects, inhibiting the synthesis of the cell wall of microorganisms. They act on some gram-positive bacteria ( Streptococcus spp., Staphylococcus spp., Bacillus anthracis, Corynebacterium diphtheria), some gram-negative bacteria ( Neisseria meningitidis, Neisseria gonorrhoeae), into anaerobic spore-forming rods ( Spirochaetaceae Actinomyces spp.) and etc.

The most active of penicillin drugs is . Strains demonstrate resistance to the influence of benzylpenicillin Staphylococcus spp., which produce penicillinase.

Penicillin is not effective against bacteria of the enteric-typhoid-dysenteric group, causative agents of tularemia, brucellosis, plague, cholera, as well as whooping cough, tuberculosis, Friedlander's, Pseudomonas aeruginosa and viruses, rickettsia, fungi, protozoa.

Pharmacokinetics and pharmacodynamics

The most effective method is intramuscular administration. After such use, the active component reaches the patient very quickly. The highest concentration of the product is observed 30-60 minutes after application. After a single administration, only trace concentrations are determined.

It is quickly detected in muscles, wound exudate, in joint cavities, and in muscles.

A small amount of it is observed in the cerebrospinal fluid. A small amount will also enter the pleural cavities and abdominal cavity, so direct local action of the drug is required if necessary.

Penetrates to the fetus through the placenta. It is excreted from the body through the kidneys, so about 50% of the drug is eliminated. Also, part of it is excreted in bile.

If a patient takes penicillin tablets, he needs to take into account that when taken orally, the antibiotic is poorly absorbed, and part of it is destroyed under the influence of gastric juice and beta-lactamase, which is produced by intestines .

Indications for use

Antibiotics of the penicillin group, the names of which will be prompted directly by the attending physician, are used to treat diseases caused by microorganisms sensitive to penicillin:

• pneumonia (lobar and focal);
• pleural empyema;
• septic endocarditis in acute and subacute forms;
• sepsis ;
• pyemia;
• septicemia;
• in acute and chronic form;
• infectious diseases of the biliary and urinary tract;
• purulent infectious diseases of the skin, mucous membranes, soft tissues;
• erysipelas;
• anthrax;
• actinomycosis;
• gynecological purulent-inflammatory diseases;
• ENT diseases;
• eye diseases;
• gonorrhea, , blenorrhea.

Contraindications

Tablets and injections are not used in the following cases:

• with high sensitivity to this antibiotic;
• at , , and others;
• when patients exhibit high sensitivity to sulfonamides, antibiotics, as well as other drugs.

Side effects

During use, the patient must understand what penicillin is and what side effects it can cause. During treatment, allergy symptoms sometimes appear. As a rule, such manifestations are associated with sensitization of the body due to earlier use of these drugs. Also may occur due to prolonged use of the drug. When using the medicine for the first time, allergies are observed less frequently. There is a possibility of sensitization of the fetus during pregnancy if a woman takes penicillin.

The following side effects may also develop during the course of treatment:

• Digestive system: nausea, , vomit.
• central nervous system: neurotoxic reactions, signs of meningism, convulsions .
• Allergy:, fever, rash on mucous membranes and skin, eosinophilia,. Cases recorded and death. If such manifestations occur, you should immediately administer intravenously.
• Manifestations associated with chemotherapeutic effects: oral cavity, vaginal candidiasis.

Instructions for use of penicillin (Method and dosage)

Antimicrobial action is observed with local and resorptive action of penicillin.

Instructions for the use of penicillin in injections

The drug can be administered subcutaneously, intramuscularly, or intravenously. The drug is also injected into the spinal canal. For therapy to be as effective as possible, the dose must be calculated so that there is 0.1–0.3 units of penicillin in 1 ml of blood. Therefore, the drug is administered every 3-4 hours.

For treatment pneumonia , , cerebrospinal meningitis, etc. a special regimen is prescribed by the doctor.

Instructions for use of penicillin tablets

The dosage of penicillin tablets depends on the disease and on the treatment regimen prescribed by the attending physician. As a rule, patients are prescribed 250-500 mg, the drug should be taken every 8 hours. If necessary, the dose is increased to 750 mg. It is recommended to take tablets half an hour before meals or two hours after meals. The duration of treatment depends on the disease.

Overdose

It should be borne in mind that when taking large doses of penicillin, an overdose can occur, which can cause unpleasant symptoms such as nausea, vomiting, diarrhea . But this condition is not life-threatening.

With intravenous administration of potassium salt in patients suffering from renal failure , can develop hyperkalemia .

When large doses of the drug are administered intraventricularly or intravenously, epileptic seizures may occur. But such a symptom appears in adult patients only after administration of at least 50 million units. medicines. In this case, the patient is prescribed barbiturates or benzodiazepines.

Interaction

When taking an antibiotic, the elimination process may slow down from the body due to inhibition of its tubular secretion.

Terms of sale

The drugs are sold by prescription; the doctor writes a prescription to the patient in Latin.

Storage conditions

It should be stored at a temperature of no more than 25 degrees, in a dry place.

Best before date

The shelf life of penicillin is 5 years.

special instructions

Before using penicillin, it is important to conduct tests and determine sensitivity to the antibiotic.

Prescribe the medicine with caution to people who have impaired renal function, as well as to patients with acute heart failure , people who have a tendency to allergic manifestations or severe sensitivity to cephalosporins .

If 3-5 days after the start of treatment there is no improvement in the patient’s condition, it is important to consult a doctor who will prescribe other antibiotics or combination treatment.

Since in the process of taking antibiotics there is a high probability of manifestations fungal superinfection , it is important to take antifungal medications during treatment. It is also important to consider that when using subtherapeutic doses of the drug or with an incomplete course of therapy, the emergence of resistant strains of pathogens is possible.

When taking the drug orally, you should take it with plenty of liquid. It is important to strictly follow the instructions on how to dilute the product.

During treatment with penicillins, it is necessary to strictly follow the prescribed treatment regimen and not skip doses. If a dose is missed, the dose should be taken as soon as possible. You cannot interrupt the course of treatment.

Since expired medicine may be toxic, it should not be taken.

Analogs

Level 4 ATX code matches:

There are a number of penicillin drugs; the most optimal antibiotic is determined by the doctor individually.

With alcohol

For children

It is used to treat children only after a doctor’s prescription and under his supervision.

Penicillin during pregnancy and lactation

It is advisable to prescribe an antibiotic during pregnancy only if the expected benefit outweighs the likelihood of negative effects. Lactation should be stopped during the period of taking the drugs, since the substance passes into the milk and can provoke the development of severe allergic manifestations in the child.