home Endocrinology Broad-spectrum antibiotics: no chance for bacteria! List and description of drugs…. New generation broad-spectrum antibiotics for adults and children: a list. new generation broad-spectrum antibiotics for infections, colds

Broad-spectrum antibiotics: no chance for bacteria! List and description of drugs…. New generation broad-spectrum antibiotics for adults and children: a list. new generation broad-spectrum antibiotics for infections, colds

Antibiotics are a broad group medicines designed to kill viral bacteria.

The very first drug of this kind is penicillin, discovered by Alexander Fleming. Year of discovery - 1928. On the basis of this substance, antibiotics of the extended spectrum of action of the newest generation were invented.

Most often, strong fast-acting antibiotics are administered as injections intramuscularly or intravenously. This is due to the fact that they can disrupt the microflora of the stomach. In addition, this way they quickly get into the focus of infection, starting work almost immediately after the injection.

The list of new antibiotics as solutions or powders for injection is quite extensive.

Such medicines include:

cephalosporins, including "Cefpirom", "Cefotaxime", "Ceftazidime", "Cefoperazone";
beta-lactamase-resistant aminopenicillins "Sulbactam" and others;
aminoglycoside antibiotics, such as Amikacin and Netilmicin;
carbapenems, which are represented by the drugs "Ertapenem", "Meropenem", "Imipinem-cilastatin".

They are prescribed depending on the complexity of the case and the characteristics of the infectious agents.

List of new tablets and capsules

There are antibiotics in the form of capsules and tablets. They are often prescribed for children and pregnant women, as they are more gentle. It is believed that they do not harm the human body.

The list of tablets and capsules of new generation antibiotics is no less wide than the list of injections.

The first ones include:

nitrofurans - "Nitrofurantoin", "Ersefuril", etc.;
fluoroquinolones, including Gatifloxacin, Moxifloxacin;
macrolides, representatives of which are "Azithromycin", "Clarithromycin", "Roxithromycin", "Amoxicillin";
natural macrolide antibiotics - "Sparfloxacin", "Levofloxacin", "Midecamycin" and others.

The last - fourth generation antibiotics include Voriconazole, Posaconazole, Ravuconazole and many other names.

New Broad Spectrum Drugs

Some doctors prefer narrowly targeted drugs, as they do not affect the integrity of the microflora of the human body.

For colds, SARS

For colds, flu and SARS, doctors prescribe macrolides, which are considered the safest among antibiotics.

These include the following drugs:

Cefalexin or Cefamandol, which are characterized by a powerful bactericidal effect and a high degree of absorption from the gastrointestinal tract, can also be prescribed.

For bronchitis and pneumonia

Combinations of antibiotics are used to treat bronchitis or pneumonia.

At possible complications in the course of the disease, a cephalosporin (Ceftriaxone or Cefepime) with a macrolide or fluoroquinolone (Ciprofloxacin or Levofloxacin) is used. Moxifloxacin or Cefuroxime also effectively help with bronchitis and pneumonia.

New generation antibiotics for children

Scientists have done a lot of research on the reaction child's body on antibiotics and found out that not all medicines are useful for children.

They can only be used:

macrolides, representatives of which are the drugs "Azithromycin", "Midecamycin", "Clarithromycin", "Roxithromycin";
aminopenicillins, including "Amoxicillin", "Clavulanate";
cephalosporins - "Ceftriaxone", "Cefepime".

Fluoroquinolones and carbapenems inhibit bone growth and lead to liver or kidney failure, so children and pregnant women are prohibited. Of the nitrofurans, only "Furacillin" can be used for local processing wounds.

Features of broad-spectrum antibiotics

They are divided into two groups - the first suppresses the effect of viruses on human cells and deprives them of the opportunity to multiply, and the second destroys them. In any case, the drugs act selectively, without affecting healthy human cells. The spectrum of action of drugs can be both wide and narrowly focused.

In dentistry

Dentists prescribe antibiotics for inflammation in the acute stage as well as for the prevention of infectious inflammatory process before surgical intervention if the patient is seriously ill internal organs(diabetes, vascular problems, kidney failure, ulcers, and others).

The most commonly used drugs are:

The latter is the most common in the field of dentistry. It accumulates in bone tissue and has a long-term effect, which is convenient for complex operations.

In urology

Antibiotics are widely used in urology, as they can get rid of infections quickly and without complications. Previously, people suffering from urological problems could die, but today such diseases are treated with literally one drug.

"Kanefron" is suitable for the treatment of cystitis, glomerulonephritis, pyelonephritis. "Palin" is prescribed for cystitis, urethritis, pyelonephritis, cystopyelitis, pyelitis. "Nolitsin" relieves acute and chronic infections in the urological area.

In gynecology

Antibiotics are also used in gynecology to treat a variety of diseases caused by the inflammatory process, from thrush to acute vaginitis.

The drug "Unidox Solutab" easily copes with cystitis, "Monural" and "Furamag" are effective in various infections. In the presence of complications, gynecologists prescribe Ofloxacin, Ciprofloxacin, Levofloxacin.

To destroy pathogens urinary infections sometimes Nalidixic acid, Metronidazole, Ceftriaxone are prescribed.

For various infections

Antibiotics are aimed at fighting inflammation pathogens, so they all help with various infections. The doctor only selects the right course and combination of drugs to increase the effectiveness of treatment. Important to consider individual characteristics patient, the stage of the disease and the presence or absence of progress in its course.

The average course of treatment is from 7 to 10 days, depending on the above features. During treatment, do not take alcohol or drugs.

Estimated prices for new antibiotics

Prices for medicines are constantly rising. On this moment current estimated prices for new generation antibiotics are as follows:

"Sumamed" - 300 rubles / 6 tablets;
"Azithromycin" - 100 rubles / 6 capsules;
"Amoxiclav" - 300 rubles / 25 grams of powder;
"Ampicillin" - 30 rubles / 20 tablets;
Unidox Solutab - 350 rubles / 10 tablets;
"Clindamycin" - 180 rubles / 8 capsules;
"Nystatin" - 40 rubles / 20 tablets;
"Tetracycline" - 80 rubles / 20 tablets;
"Cefalexin" - 100 rubles / 16 capsules;
"Erythromycin" - 120 rubles / 10 tablets.

There are original drugs and generics. The latter are cheaper, as they are only a copy and differ in the presence of impurities in the composition, as well as serious side effects. It is better not to risk your health and buy an expensive, but high-quality original.

Do you know? - Who invented antibiotics?

What are antibiotics, today even the youngest children know school age. However, the term "antibiotics" a wide range actions" sometimes baffles even adults and raises many questions. How wide is the spectrum? What are these antibiotics? And, yes, it looks like there are drugs narrow spectrum which may not help?

The most amazing thing is that even the omniscient Internet often cannot help and dispel the fog of doubt. In this article, we will slowly and methodically try to figure out what kind of broad-spectrum antibiotics they are, what bacteria they act on, and also when, how and how many times a day they are used.

Diverse world of bacteria

And we will start from the very beginning - with microbes. Bacteria make up the majority of prokaryotes - unicellular living organisms without a clearly defined nucleus. It was bacteria that first populated the lonely Earth millions of years ago. They live everywhere: in soil, water, acidic hot springs and radioactive waste. Descriptions of about 10 thousand species of bacteria are known, but it is assumed that their number reaches a million.

And of course, bacteria live in organisms of plants, animals and humans. Relations between lower unicellular and higher multicellular are different - both friendly, mutually beneficial for partners, and openly hostile.

A person cannot exist without “good”, correct bacteria that form the microflora. However, along with valuable bifido- and lactobacilli, microbes that cause a variety of diseases enter our bodies.

The composition of the microflora also includes the so-called conditionally pathogenic microorganisms. At favorable conditions they do not do any harm, but it is worth lowering our immunity, and these yesterday's friends turn into vicious enemies. In order to somehow understand the host of bacteria, doctors proposed to classify them.

Gram- and Gram+: decoding the puzzle

The most famous division of microbes is very often mentioned in pharmacies, clinics, and annotations to medicines. And just as often, a living average patient does not understand what, in fact, they are talking about. Let's figure it out together, what do these mysterious expressions gram + and gram- mean, without which not a single description of the action of antibiotics can do?

Back in 1885, the Dane Hans Gram decided to stain the sections lung tissue to make bacteria more visible. The scientist found that the typhoid pathogen Salmonella typhi did not change color, while the rest of the microorganisms were exposed to the chemical.

Based on the ability of bacteria to stain according to Gram, the most famous classification is now adopted. The group of bacteria that do not change color is called gram-negative. The second category is called gram-positive, that is, Gram-staining microorganisms.

Gram-positive and gram-negative pathogens: who is who?

Another equally important classification of antibiotics breaks down drugs according to their spectrum of action and structure. And again, to understand the complex paragraphs of instructions explaining the spectrum of activity and belonging to a particular group, you should get to know the microbes better.

Gram-positive bacteria include cocci, that is, microorganisms in the form of a ball, among which there are numerous families of staphylococci and streptococci. In addition, this group includes clostridia, corynebacteria, listeria, enterococci. Gram-positive pathogens are most often the cause of infectious diseases of the nasopharynx, respiratory tract, ear, as well as inflammatory processes of the eye.

Gram-negative bacteria are a less numerous group of microorganisms that mainly cause intestinal infections, as well as diseases of the genitourinary tract. Much less often, gram-negative pathogens are responsible for respiratory pathologies. These include E. coli, Salmonella, Shigella (the causative agent of diphtheria), Pseudomonas, Moraxella, Legionella, Klebsiella, Proteus.

Among gram-negative microorganisms there are also causative agents of severe nosocomial infections. These microbes are difficult to treat - in a hospital environment, they develop a special resistance to most antibiotics. Therefore, for the treatment of such infectious diseases, special, often intramuscular or intravenous broad-spectrum antibiotics are also used.

On the basis of such a “separation” of gram-negative and gram-positive bacteria, empirical therapy is based, which involves the selection of an antibiotic without prior seeding, that is, practically “by eye”. As practice shows, in the case of "standard" diseases, this approach to the choice of the drug justifies itself. If the doctor has doubts about the belonging of the pathogen to one or another group, the prescription of broad-spectrum antibiotics will help to “get a finger in the sky”.

Broad-spectrum antibiotics: the whole army under the gun

So, we come to the most interesting. Broad-spectrum antibiotics are a versatile antibacterial medicine. Whatever the pathogen is the source of the disease, broad-spectrum antibacterial agents will have a bactericidal effect and overcome the microbe.

As a rule, broad-spectrum drugs are used when:

Treatment is given empirically, that is, based on clinical symptoms. With the empirical selection of an antibiotic, time and money are not wasted on identifying the pathogen. The microbe that caused the disease will forever remain unknown. This approach is appropriate in the case of common infections, as well as in fast-flowing dangerous diseases. For example, with meningitis death can be resolved literally within a few hours if antibiotic therapy is not started immediately after the first signs of the disease;
causative agents of the disease are resistant to the action of narrow-spectrum antibiotics;
diagnosed with superinfection, in which the culprits of the disease are several types of bacteria at once;
prevention of infection after surgical interventions.

List of broad-spectrum antibiotics

Let's try to name them antibacterial drugs, which have a wide spectrum of activity:

antibiotics of the penicillin group: Ampicillin, Ticarcycline;
antibiotics of the tetracycline group: Tetracycline;
fluoroquinolones: Levofloxacin, Gatifloxacin, Moxifloxacin, Ciprofloxacin;
Aminoglycosides: Streptomycin;
Amphenicols: Chloramphenicol (Levomycetin);
Carbapenems: Imipenem, Meropenem, Ertapenem.

As you can see, the list of broad-spectrum antibiotics is not very large. AND detailed description we will start with the most popular group of drugs - penicillin antibiotics.

Penicillins - drugs that are known and loved

With the discovery of the antibiotic of this particular group - Benzylpenicillin - doctors realized that microbes can be defeated. Despite its venerable age, benzylpenicillin is still used, and in some cases is a first-line drug. However, broad-spectrum agents include other, newer penicillin antibiotics, which can be divided into two groups:

preparations for parenteral (injection) and enteral administration, which endure the acidic environment of the stomach;
injectable antibiotics that do not withstand the action of hydrochloric acid - Carbenicillin, Ticarcillin.

Ampicillin and Amoxicillin are popular broad spectrum penicillins

Ampicillin and Amoxicillin occupy a special place of honor among penicillin antibiotics. The spectrum and effect on the human body of these two antibiotics are almost the same. Among the microorganisms sensitive to Ampicillin and Amoxicillin, the most famous infectious agents are:

gram-positive bacteria: staphylococci and streptococci, enterococci, listeria;
gram-negative bacteria: the causative agent of gonorrhea Neisseria gonorrhoeae, Escherichia coli, Shigella, Salmonella, Haemophilus influenzae, whooping cough pathogen Bordetella pertussis.

With an identical spectrum, Ampicillin and Amoxicillin significantly differ in pharmacokinetic properties.

Ampicillin

Ampicillin was synthesized in the early 60s of the last century. The drug immediately won the hearts of doctors: its spectrum of action compares favorably with the antibiotics of the 50s, to which persistence, that is, addiction, has already developed.

However, Ampicillin has significant drawbacks - low bioavailability and a short half-life. The antibiotic is absorbed only by 35-50%, and the half-life is several hours. In this regard, the course of treatment with Ampicillin is quite intensive: tablets should be taken at a dose of 250-500 mg four times a day.

A feature of Ampicillin, which is considered an advantage over Amoxicillin, is the possibility of parenteral administration of the drug. The antibiotic is produced in the form of a lyophilized powder, from which a solution is prepared before administration. Ampicillin is prescribed 250-1000 mg every 4-6 hours intramuscularly or intravenously.

Amoxicillin is slightly younger than its predecessor - it went on sale in the 70s of the XX century. Nevertheless, this antibiotic is still one of the most popular and effective means a wide range, including for children. And this became possible thanks to the undoubted advantages of the drug.

These include the high bioavailability of Amoxicillin tablets, which reaches 75-90%, against the background of a fairly long half-life. At the same time, the degree of absorption does not depend on food intake. The medicine has a high degree affinity to the tissues of the respiratory tract: the concentration of Amoxicillin in the lungs and bronchi exceeds the content in other tissues and blood almost twice. Not surprisingly, Amoxicillin is considered the drug of choice for uncomplicated forms of bacterial bronchitis and pneumonia.

In addition, the drug is indicated for sore throat, infections of the urinary and genital tract, infectious diseases skin. Amoxicillin is a component of eradication therapy for peptic ulcer stomach and duodenum.

The drug is taken orally at a dosage of 250-1000 mg twice a day for 5-10 days.

Broad spectrum parenteral penicillins

Penicillins that are used for parenteral administration differ from Ampicillin and Amoxicillin known to us in their additional activity against Pseudomonas aeruginosa. This microorganism causes soft tissue infections - abscesses, festering wounds. Pseudomonas also act as causative agents of cystitis - inflammation Bladder, as well as inflammation of the intestine - enteritis.

In addition, broad-spectrum parenteral penicillin antibiotics have a bactericidal and bacteriostatic effect on:

gram-positive microorganisms: staphylococci, streptococci (with the exception of strains that form penicillinase), as well as enterobacteria;
Gram-negative microorganisms: Proteus, Salmonella, Shigella, Escherichia coli, Haemophilus influenzae and others.

Broad-spectrum parenteral penicillins include Carbenicillin, Ticarcillin, Carfecillin, Piperacillin and others.

Consider the most known antibiotics- Carbenicillin, Ticarcillin and Piperacillin.

Carbenicillin

In medicine, the disodium salt of carbenicillin is used, which is White powder, dissolved before use.

Carbenicillin is indicated for infections abdominal cavity, including peritonitis, genitourinary system, respiratory tract, as well as meningitis, sepsis, infections of bone tissue, skin.

The drug is administered intramuscularly severe cases intravenous drip.

Ticarcillin

Unprotected Ticarcillin is prescribed for severe infections caused by strains of bacteria that do not produce penicillinase: sepsis, septicemia, peritonitis, postoperative infections. Antibiotics are also used for gynecological infections, including endometritis, as well as infections of the respiratory tract, ENT organs, and skin. In addition, Ticarcillin is used for infectious diseases in patients with a reduced immune response.

Piperacillin

Piperacillin is mainly used in conjunction with the beta-lactamase inhibitor tazobactam. However, if it is established that the causative agent of the disease does not produce penicillinase, it is possible to prescribe an unprotected antibiotic.

Indications for the use of Piperacillin are severe purulent-inflammatory infections of the genitourinary system, abdominal cavity, respiratory and ENT organs, skin, bones and joints, as well as sepsis, meningitis, postoperative infections and other diseases.

Protected broad-spectrum penicillins: antibiotics to fight resistance!

Amoxicillin and Ampicillin are far from omnipotent. Both drugs are destroyed by the action of beta-lactamases, which are produced by some strains of bacteria. Such "malicious" pathogens include many types of staphylococcus, including aureus, Haemophilus influenzae, Moraxella, Escherichia coli, Klebsiella and other bacteria.

If the infection is caused by beta-lactamase-producing pathogens, Amoxicillin, Ampicillin and some other antibiotics are simply destroyed without causing any harm to the bacteria. Scientists have found a way out of the situation by creating complexes of penicillin antibiotics with substances that inhibit beta-lactamase. In addition to the most famous clavulanic acid, inhibitors of destructive enzymes include sulbactam and tazobactam.

Protected antibiotics are able to effectively fight an infection that is not subject to fragile and lonely penicillin. Therefore, combined drugs are often the drugs of choice for a variety of diseases caused by bacterial infection, including hospital ones. The leading places in this list of broad-spectrum antibiotics are occupied by two or three drugs, and some injectable drugs used in hospitals remain “behind the scenes”. Paying tribute to the spectrum of each combined penicillin, we will open the veil of secrecy and list these, of course, the most worthy drugs.

Amoxicillin + clavulanic acid. The most famous combined broad-spectrum antibiotic, which has dozens of generics: Augmentin, Amoxiclav, Flemoclav. There are both oral and injectable forms of this antibiotic.

Amoxicillin and sulbactam. Trade name - Trifamox, is available in the form of tablets. The parenteral form of Trifamox is also available.

ampicillin and sulbactam. The trade name is Ampisid, it is used for injections, more often in hospitals.

Ticarcillin + clavulanic acid. Trade name Timentin, available only in parenteral form. Indicated for the treatment of severe infections caused by resistant, hospital-acquired strains.

Piperacillin + tazobactam. Trade names Piperacillin-tazobactam-Teva, Tazatsin, Santaz, Tazrobida, Tacillin J, etc. The antibiotic is used infusion drip, that is, in the form of intravenous infusions for moderate and severe polyinfections.

Broad-spectrum tetracyclines: time-tested

To the number known drugs wide spectrum of action include tetracycline antibiotics. This group of drugs is united by a common structure, which is based on a four-cyclic system ("tetra" in Greek - four).

Tetracycline antibiotics do not have a beta-lactam ring in their structure, and, therefore, are not subject to the destructive action of beta-lactamase. The tetracycline group has a common spectrum of action that includes:

gram-positive microorganisms: staphylococci, streptococci, clostridia, listeria, actinomycetes;
gram-negative microorganisms: the causative agent of gonorrhea Neisseria gonorrhoeae, Haemophilus influenzae, Klebsiella, E. coli, Shigella (the causative agent of dysentery), Salmonella, the causative agent of whooping cough Bordetella pertussis, as well as bacteria of the genus Treponema, including the causative agent of syphilis - pale spirochete.

hallmark tetracyclines is their ability to penetrate into the bacterial cell. Therefore, these funds do an excellent job with intracellular pathogens - chlamydia, mycoplasmas, ureaplasmas. Pseudomonas aeruginosa and Proteus do not respond to the bactericidal action of tetracyclines.

The two most commonly used tetracyclines today are tetracycline and doxycycline.

Tetracycline

One of the founders of the tetracycline group, discovered back in 1952, is still used, despite its advanced age and side effects. However, the prescription of tetracycline tablets can be criticized, given the existence of more modern and effective antibiotics wide spectrum of activity.

TO negative aspects oral tetracycline, of course, includes a rather limited therapeutic activity, as well as the ability to change the composition of the intestinal flora. In this regard, when prescribing tetracycline tablets, an increased risk of antibiotic-associated diarrhea should be taken into account.

Much more effective and safe is the appointment of external and local forms of tetracycline. Yes, tetracycline eye ointment is included in the Russian list of essential drugs and is an excellent example of a broad-spectrum local antibacterial drug.

doxycycline

Doxycycline is distinguished by therapeutic activity (almost 10 times higher than Tetracycline) and impressive bioavailability. In addition, Doxycycline has a much lesser effect on the intestinal microflora than other drugs of the tetracycline group.

Fluoroquinolones are essential broad spectrum antibiotics.

Probably no doctor can imagine his medical practice without fluoroquinolone antibiotics. The first synthesized representatives of this group were distinguished by a narrow spectrum of action. With the development of pharmaceuticals, new generations of fluoroquinolone antibacterial agents and expanded their range of activities.

So, antibiotics of the first generation - Norfloxacin, Ofloxacin, Ciprofloxacin - work mainly against gram-negative flora.

Modern fluoroquinolones II, III and IV generations, unlike their predecessors, are antibiotics of the broadest, so to speak, spectrum of action. These include Levofloxacin, Moxifloxacin, Gatifloxacin, and other medicines active against:

Note that without exception, all fluoroquinolones are contraindicated for use in children under 18 years of age. This is due to the ability of antibiotics of this group to disrupt the synthesis of peptidoglycan, a substance that is part of the tendon structure. Therefore, the use of fluoroquinolones in children is associated with the risk of changes in cartilage tissue.

Fluoroquinolone II generation, Levofloxacin is prescribed for respiratory tract infections - pneumonia, bronchitis, ENT organs - sinusitis, otitis media, as well as diseases urinary tract, genital tract, including urogenital chlamydia, infections of the skin (furunculosis) and soft tissues (atheromas, abscesses).

Levofloxacin is prescribed 500 mg per day at one time for seven, less often for 10 days. In severe cases, the antibiotic is administered intravenously.

Many drugs containing lomefloxacin are registered on the Russian pharmaceutical market. Original remedy- brand - is German Tavanik. Its generics include Levofloxacin Teva, Levolet, Glevo, Flexil, Ecolevid, Hailefloks and other drugs.

Moxifloxacin

Moxifloxacin belongs to the highly active fluoroquinolone antibiotics III broad spectrum generation, indicated for infections of the upper respiratory tract, respiratory tract, skin, soft tissues, postoperative infections. The drug is prescribed in tablets of 400 mg once a day. The course of treatment ranges from 7 to 10 days.

The original drug of moxifloxacin, which is most often used, is Avelox manufactured by Bayer. There are very few generics of Avelox, and it is quite difficult to find them in pharmacies. Moxifloxacin is part of eye drops Vigamox, indicated for infectious inflammatory processes of the conjunctiva of the eye and other diseases.

Gatifloxacin

The drug of the last, IV generation of fluoroquinolones is prescribed for severe, including nosocomial diseases of the respiratory tract, ophthalmic pathologies, infections of the ENT organs, the urogenital tract. The antibacterial effect of Gatifloxacin also extends to the causative agents of the infection, which is sexually transmitted.

Gatifloxacin is prescribed at 200 or 400 mg per day once.

Most drugs containing gatifloxacin are produced by Indian companies. More often than others in pharmacies you can find Tebris, Gafloks, Gatispan.

Aminoglycosides: essential antibiotics

Aminoglycosides combine a group of antibacterial drugs that have similar properties in structure and, of course, the spectrum of action. Aminoglycosides inhibit protein synthesis in microbes, providing a pronounced bactericidal effect against sensitive microorganisms.

The first aminoglycoside is a natural antibiotic isolated during World War II. Surprisingly, modern phthisiology still cannot do without the same Streptomycin, which was discovered back in 1943 - an antibiotic is still being used with might and main in phthisiology for the treatment of tuberculosis.

All four generations of aminoglycosides, which have been gradually isolated and synthesized over more than half a century, have an equally wide spectrum of antibacterial action. Antibiotics of this group act on:

gram-positive cocci: streptococci and staphylococci;
Gram-negative microorganisms: coli, Klebsiella, Salmonella, Shigella, Moraxella, Pseudomonas and others.

Aminoglycosides different generations have some individual traits, which we will try to trace on examples of specific drugs.

The oldest broad-acting aminoglycoside of the 1st generation in injections, which is favorably distinguished by its high antibacterial activity to Mycobacterium tuberculosis. Indications for the use of Streptomycin are primary tuberculosis of any localization, plague, brucellosis and tularemia. The antibiotic is administered intramuscularly, intratracheally, and also intracavernously.

A very controversial antibiotic of the second generation, which is gradually being forgotten, is Gentamicin. Like other aminoglycosides II and older generations, Gentamicin is active against Pseudomonas aeruginosa. The antibiotic exists in three forms: injectable, external in the form of ointments and local ( eye drops).

Interestingly, unlike the vast majority of antibiotics, Gentamicin perfectly retains its properties in dissolved form. Therefore, the injection form of the drug is a ready-made solution in ampoules.

Gentamicin is used for infectious inflammatory diseases biliary tract - cholecystitis, cholangitis, urinary tract - cystitis, pyelonephritis, as well as infections of the skin, soft tissues. In ophthalmic practice, eye drops with Gentamicin are prescribed for blepharitis, conjunctivitis, keratitis and other infectious eye lesions.

The reason for the cautious attitude towards Gentamicin is the data on side effects antibiotic, in particular ototoxicity. In recent years, there has been ample evidence of hearing loss due to Gentamicin therapy. There are even cases of complete deafness that developed against the background of the introduction of an antibiotic. The danger is that, as a rule, the ototoxic effect of Gentamicin is irreversible, that is, hearing is not restored after the antibiotic is discontinued.

Based on such a sad trend, most doctors prefer to opt for other, safer aminoglycosides.

Amikacin

An excellent alternative to Gentamicin is the III generation broad-spectrum antibiotic Amikacin, which is available as a powder for preparation. injection solution. Indications for the appointment of Amikacin are peritonitis, meningitis, endocarditis, sepsis, pneumonia and other severe infectious diseases.

Amphenicols: let's talk about the good old Levomycetin

The main representative of the amphenicol group is the broad-spectrum natural antibiotic chloramphenicol, which is known to almost every our compatriot under the name Levomycetin. The drug is a structural levorotatory isomer chloramphenicol (hence the prefix "levo").

The spectrum of action of Levomycetin covers:

gram-positive cocci: staphylococci and streptococci;
Gram-negative bacteria: pathogens of gonorrhea, Escherichia and Haemophilus influenzae, Salmonella, Shigella, Yersinia, Proteus, Rickettsia.

In addition, Levomycetin is active against spirochetes and even some large viruses.

Indications for the appointment of Levomycetin are typhoid fever and paratyphoid, dysentery, brucellosis, whooping cough, typhus, various intestinal infections.

External forms of Levomycetin (ointment) are prescribed for purulent diseases skin, trophic ulcers. So, in Russia, an ointment containing Levomycetin, which is produced under the name Levomekol, is very popular.

In addition, Levomycetin is used in ophthalmology for inflammatory eye diseases.

The course of treatment with Levomycetin or How to harm your body?

Levomycetin is an affordable, effective, and therefore a broad-spectrum intestinal antibiotic beloved by many. So beloved that you can often find a patient in a pharmacy buying those same diarrhea pills and praising their effectiveness. Still: I drank two or three pills - and the problems were no matter how it happened. It is in this approach to treatment with Levomycetin that the danger lurks.

We must not forget that Levomycetin is an antibiotic that must be taken in a course. We know that, for example, the antibiotic Amoxicillin should not be drunk for less than five days, but, drinking two tablets of Levomycetin, we manage to completely forget about the antibacterial origin of the drug. But what happens in this case with bacteria?

It's simple: the weakest enterobacteria, of course, die after two or three doses of Levomycetin. The diarrhea stops, and we, giving glory to the power of bitter pills, forget about the troubles. Meanwhile, strong and resistant microorganisms survive and continue their vital activity. Often as conditional pathogens, which, at the slightest decrease in immunity, are activated and show us where the crayfish hibernate. That's when Levomycetin may no longer be able to cope with selected microbes.

To prevent this from happening, you should adhere to the recommended course of antibiotic therapy. For the treatment of acute intestinal infections the drug is taken at a dosage of 500 mg three to four times a day for at least a week. If you are not ready to follow a sufficiently intensive course, it is better to give preference to other antimicrobials, for example, nitrofuran derivatives.

Carbapenems: reserve antibiotics

As a rule, we encounter carbapenems extremely rarely or not at all. And this is wonderful - after all, these antibiotics are indicated for the treatment of severe hospital infections, life threatening. The spectrum of action of carabapenems includes most of the existing pathological strains, including resistant ones.

Antibiotics in this group include:

Meropenem. The most common carbapenem, which is produced under the trade names Meronem, Meropenem, Cyronem, Dzhenem and others;
Ertapenem, tradename Invanz;
Imipenem.

Carbapenems are administered only intravenously, intravenously by infusion and bolus, that is, using a special dispenser.

Antibiotic therapy: the golden rule of safety

At the end of our excursion into the world of broad-spectrum antibiotics, we cannot ignore the most important aspect on which drug safety and ultimately our health is based. Each patient - present or potential - should know and remember that the right to prescribe antibiotics belongs exclusively to the doctor.

No matter how much knowledge you have in the field of medicine, you should not give in to the temptation to “treat yourself”. Moreover, one should not rely on the hypothetical pharmaceutical abilities of neighbors, friends and colleagues.

Only a good doctor can assess the risks and benefits of using a broad-spectrum antibiotic, choose a drug that can cover the spectrum of exactly “your” microorganisms and prevent possible side effects. Trust the knowledge and experience of a great specialist, and this will help maintain health for many years.

And antibacterial drugs are classified into narrow-spectrum drugs (destroy only one type of bacteria) and broad-spectrum drugs (effective against most microorganisms at the same time).

Their mechanism of action is to block vital important functions the causative agent of the disease. At the same time, new generation broad-spectrum antibiotics are designed in such a way that they do not have a similar effect on the cells of the affected organ.

Such selectivity of exposure is due to the fact that the bacteria form cell walls, the structure of which differs from human ones. The active components of the drug contribute to the violation of the integrity of the walls of bacterial cells, without affecting the cell membranes of the patient's organs.

Unlike medicines from the group of antiseptics, the antibiotic has the proper therapeutic effect not only after external application, but also acts systemically after oral, intravenous, intramuscular use.

New generation antibiotics are capable of:

Influence the synthesis of cell walls by disrupting the production of vital peptide complexes.
Disrupt the functioning and integrity of the cell membrane.
Disrupt the synthesis of a protein necessary for the growth and vital activity of a pathogenic pathogen.
Inhibit nucleic acid synthesis.

By the nature of the effect on bacterial cells, antibiotics are divided into:

Bactericidal - the pathogen will die and then be removed from the body.
Bacteriostatic - active ingredient does not kill bacteria, but disrupts their ability to reproduce.

It is important to determine how actively active substance medicines for a particular pathogen pathological process. To do this, you must undergo a series of laboratory tests prescribed by a doctor.

Features of the action of drugs

The advantages of broad-spectrum antibiotics are due to their ability to destroy most pathogens.

The drugs of this group include drugs of the tetracycline, cephalosporin series, aminopenicillins, aminoglycosides, as well as drugs from the group of macrolides, carbapenems.

New generations of drugs are less toxic, the risk of developing unwanted side effects is much lower.

Broad-spectrum antibiotics are distinguished by their ability to effectively deal with complicated colds, inflammatory processes affecting the area of the ENT organs, lymph nodes, genitourinary system, skin etc.

List of new generation broad spectrum antibiotics

If we consider new generation antibiotics, the list is as follows:

When 3rd and 4th generation cephalosporins fail, as in the case of infectious diseases provoked by exposure to anaerobes and enterobacteria, patients are shown taking carbopenems: Ertpenem and Meropenem (these are a kind of reserve drugs).

Use of penicillins useful for organ infections gastrointestinal tract, respiration and genitourinary system, skin. Only the third generation has a wide spectrum of activity, which includes: Ampicillin, Amoxicillin, Ampiox and Bakampicillin.

The drugs described are not intended for self-medication. When identifying the first signs of the disease, you should consult a doctor for advice and selection of a suitable, comprehensive treatment regimen.

Narrowly targeted strong antibiotics

Narrow-spectrum antibiotics are active against a few types of bacteria.

These drugs include the following groups:

Macrolides based on erythromycin, triacetyloleandomycin, oleandomycin.
Cephalosporins based on cefazolin, cephalexin, cephaloridine.
Penicillins.
Streptomycins.
Antibacterial reserve drugs that act on gram-positive pathogens that are resistant to penicillins. In this case, the doctor may recommend the use of semi-synthetic penicillins: ampicillin, carbenicillin, dicloxacillin.
Various other drugs based on rifampicin, lincomycin, fusidine.

The use of a narrowly targeted drug is advisable in the case when the causative agent of the pathological process is reliably known.

Broad-spectrum drugs for bronchitis

Bronchitis is treated with a new generation of antibiotics because laboratory testing can take days and treatment is recommended to start as soon as possible.

During complex therapy the following may be assigned:

There is no such thing as the best antibiotic because each tool has its own extensive list pharmacological properties, indications and contraindications, possible adverse reactions and recommendations for administration, as well as drug interactions.

The selection of an antibacterial drug is carried out only by a qualified, experienced specialist which will take into account the nature of the origin of the disease, the individual characteristics of the patient's body, his age, weight, accompanying illnesses. Read more about treating bronchitis with antibiotics.

Treatment of pneumonia

In the treatment of pneumonia, antibiotics of a new generation from the group are used:

Cephalosporins: Nacef, Ceclor, Maximim, Liforan, Cefabol, Tamycin, etc.
Combined fluoroquinolones: Tsiprolet A.
Quinolones: Glevo, Tavanik, Zanotsin, Abaktal, Tsiprolet, Tsifran.
Combined penicillins: Augmentin, Amoxiclav, Panklav.

The described drugs can be used until the results of laboratory tests are obtained, with pneumonia without specifying the pathogen.

Therapy of sinusitis

The structure of cephalosporins and macrolides are similar to drugs penicillin series, however, they have the ability to inhibit the development and complete destruction of pathogenic microorganisms.

Additionally, anticongestants, antiseptics, secretolytics can be prescribed.

In severe cases of the disease, macrolides are used: Macropen and Azithromycin.
The use of combined fluoroquinolones based on tinidazole and ciprofloxacin (Ciprolet A) may also be recommended.

Treatment of angina

Complex treatment acute tonsillitis(tonsillitis) involves the use of antiseptics, local anesthetics, as well as antibacterial agents.

Antibiotics for systemic exposure are:

Preparations of the cephalosporin series based on cefixime (Pancef) and cefuroxime (Zinnat).
Previously, treatment was carried out mainly with penicillins. IN modern medicine preference is given to new generation cephalosporins, as they show greater efficacy in the treatment bacterial infections affecting the nasopharynx.
Combined fluoroquinolones based on ciprofloxacin in combination with tinidazole (Ciprolet A).
Multicomponent preparations of the penicillin series: Panklav, Amoxiclav.
Medicines from the group of macrolides based on azithromycin ( Azitral, Sumamox). They are one of the most safe antibiotics, since the practical ones do not provoke unwanted adverse reactions from the digestive tract, as well as toxic effects on the central nervous system.

Colds and flu

With a confirmed need to prescribe antibiotics during the treatment of colds, the doctor prescribes:

Even drugs with a wide range of pharmacological activity do not affect the vital activity of viruses, so their use is not advisable in the course of complex therapy for measles, rubella, viral hepatitis, herpes, chicken pox as well as the flu.

Urinary tract infections: cystitis, pyelonephritis

Unidox Solutab - the drug is easy to use: 1 time per day.
Norbactin is recommended to be used twice a day, the drug has a list of contraindications and side effects.
Monural is an antibiotic in the form of a powder for oral administration. It is a long-acting drug that promotes prompt elimination pathogenic microorganisms.

Pending laboratory results for pyelonephritis, start with fluoroquinlones (Glevo, Abaktal, Tsiprobid), V further treatment can be adjusted. Cephalosporins and aminoglycosides may also be prescribed.

Antifungal drugs in the form of tablets

Taking into account a large number various kinds fungal infections, the doctor prescribes one or another antibiotic based on the results of a comprehensive examination.

The drug of choice may be:

Medicines that belong to the 1st generation based on nystatin.
Antibiotics of the 2nd generation, which are used for infections of the genitourinary system. Among them: Clotrimazole, Ketoconazole, and Miconazole.
Among 3rd generation drugs, the use of Fluconazole, Antraconazole, Terbinafine.

The 4th generation drugs include Caspofungin, Ravuconazole and Posaconazole.

Antibiotics for diseases of the organs of vision

With bacterial keratitis and chlamydial conjunctivitis, it is advisable to use Maxakvin, a systemic therapy agent.

Antibiotics for topical use include Vitabact, Tobrex, Okatsin.

Let's summarize

Antibiotics are powerful substances of natural, synthetic or semi-synthetic origin, which help to suppress the growth and vital activity of pathogenic microorganisms.

List of new generation broad-spectrum antibiotics and their uses

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To date, antibiotics that can defeat the disease infectious nature, a bunch of.

Some of them have a narrow focus and fight a specific disease, and there are those that allow you to get rid of several pathogens. Let's figure out what modern broad-spectrum antibiotics are.

The principle of influence on the body of the main groups of drugs

Antibiotics of the new generation affect only the pathogenic microorganism, while not affecting a healthy cell.

Broad-spectrum drugs are effective against many pathogens. Are used:

Antibiotic Precautions:

Let's take a closer look at the types of broad-spectrum antibiotics.

Macrolides

Modern antibiotics of a new generation, belonging to the group of macrolides, are able to destroy protein synthesis and affect the cellular ribosome of a pathogenic bacterium. At the same time, the drugs have a beneficial effect on the functioning of the immune system.

Advantages:

The list of drugs is presented in the table.

Name	Purpose
Azithromax. Azithromycin. Zomax. Clindamycin. Lincomycin. Summed. Fusidin.	Acute and chronic form bronchitis
	Pneumonia
	Tuberculosis
	Whooping cough
	Ulcer
	Diseases of the biliary tract
	Diphtheria
	Dental diseases
	Mastitis
	Infectious eye diseases
	severe acne
	Furunculosis
	Otitis
	Infectious lesions of a gynecological nature
	Urological diseases
	Venereological diseases

Contraindications to the use of macrolides are:

Penicillin group

Antibiotics of this group of a wide spectrum of action can be divided into two groups:

Tablets and injections immune to the effects of gastric juice.
Drugs that break down hydrochloric acid, – Ticarcillin and Carbenicillin.

List of commonly used medicines:

Preparations penicillin group a wide spectrum of action can cure:

Diseases of urological and gynecological nature.
Infectious lesions of the respiratory system.
Diseases of the abdominal cavity.
Infectious diseases of the visual organs.
Viral lesions of ENT organs and others.

Contraindications:

Pregnancy.
breastfeeding period.
Certain drugs are prohibited until the age of 12.
Poor blood clotting.
Allergy.

Tetracycline group

Antibiotics can affect gram-positive and gram-negative bacteria. A distinctive feature of the broad-spectrum tetracycline group is the ability to penetrate the bacterial cell. Therefore, broad-spectrum drugs are often used to treat ureaplasmosis, mycoplasmosis and chlamydia.

Note that tetracyclines do not affect Pseudomonas aeruginosa.

The most popular drugs:

Fluoroquinols

Modern drugs belonging to this group of the second, third and last - fourth generation allow you to treat a huge number of diseases.

Affect:

for Gram-positive microorganisms.
Gram-negative microorganisms.
intracellular pathogens.

It should be borne in mind that any agent related to fluoroquinols is prohibited for persons under 18 years of age. Since drugs in this group can change cartilage tissue in children.

List of the most common broad-spectrum antibiotics:

latest generation cephalosporins

Broad spectrum antibiotics latest generation cephalosporin group are used only in hospital treatment. The drugs are concentrated and have a toxic effect on the liver and kidneys, therefore, when they are prescribed, medical supervision is required.

The mechanism of work - the substance penetrates the membranes of pathogenic bacteria and inhibits the synthesis of the protein-glycan layer. As a result of the release of enzymes, microorganisms die.

Preparations of this series are prescribed for severe infectious diseases, when it is necessary to destroy the pathogen, and not to suspend its influence. Name of drugs: Cefepime and Cefpir.

The benefits of the latest generation of antibiotics are as follows:

Low toxicity.
Excellent penetration into tissues, even bone.
Due to the high concentration active substance differs in the prolonged influence on an organism.

Contraindications:

Individual intolerance to the drug.
Heart and kidney failure.
Severe liver damage.
Pregnancy.
During lactation, you should temporarily stop feeding the baby.

Aminoglycosides

Aminoglycosides of different generations have some differences. Let's get acquainted with them, using the example of certain drugs:

Do not use these drugs during pregnancy and lactation, patients with cardiac and kidney failure. With caution are prescribed in the treatment of elderly patients.

Carbapenems

Broad-spectrum antibiotics used for serious infections that threaten a person's life. Carbapenems are prescribed for the treatment of pathological strains, including those resistant to certain drugs.

List of medicines:

The drug is administered intravenously. The dosage and course of treatment is selected by the doctor based on the severity of the disease. Analogues: Meronem, Jenem, Cyronem and others.
Invanz - is administered intravenously by drip and intramuscularly. The active substance is ertapenem.

Treatment is carried out under the supervision of a physician. Do not use drugs in case of:

Pregnancy.
During lactation breastfeeding stop.
With heart and kidney failure.
Severe arterial hypotension.
Allergies.

It should be remembered that only a specialist should prescribe antibiotics based on the specifics of the disease and the state of the body.

One of critical issues antimicrobial therapy is the irrational use of antibacterial drugs, contributing to the widespread spread of drug-resistant flora.

New mechanisms of bacterial resistance and the lack of results from the use of classical, previously effective drugs, forces pharmacologists to constantly work on new, effective antibiotics.

The advantage of using a wide range of agents is explained by the fact that they can be prescribed as a starting therapy for infections with an unspecified pathogen. This is especially important in severe, complicated diseases, when days or even hours are counted and the doctor does not have the opportunity to wait for the results of cultures for the pathogen and sensitivity.

A selection of antibiotics in alphabetical order:

Zerbaxa ®

is the trade name for a combination of ceftolosan (5th generation) and tazobactam (a beta-lactamase inhibitor).

It will be used to eradicate highly resistant Pseudomonas aeruginosa species. The conducted studies have proved its high efficiency in the treatment of severe complicated inf. urinary tract and intra-abdominal infections. Wed has low levels toxicity in comparison with polymyxins and . With mixed flora, its combination with metronidazole is possible.

Avikaz ®

is a combination (3rd generation antipseudomonal cephalosporin) and avibactam (a beta-lactamase inhibitor).

It will be prescribed in the absence of an alternative for intra-abdominal infections, as well as inf. urinary tract and kidneys. Highly effective against gram pathogens. It also goes well with metronidazole. Studies have confirmed its high efficacy against strains resistant to carbapenems and capable of producing extended spectrum beta-lactamase.

Of the newest cephalosporins in Russia, Zefter ® was registered

Wed is highly effective against methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and gram pathogens.

Can be used as monotherapy for severe community-acquired and hospital-acquired pneumonia. Zeftera ® is also used for severe infections. skin, including diabetic foot.

Cyclic lipopeptides

A new class represented by the natural antimicrobial agent Daptomycin ® (trade name - Cubicin ®).

Daptomycin ® is highly effective in endocarditis, meningitis, osteomyelitis, staphylococcal sepsis and complicated infections of the skin and subcutaneous fat.

Active against MSSA and MRSA strains. That is, it can be used in diseases caused by gram + polyresistant flora resistant to methicillin, vancomycin and linezolid preparations.

Broad spectrum antibiotic tablets

Lincosamides

New antibiotics of the lincosamide class are represented by a chlorinated derivative of lincomycin - clindamycin:

Dalacin C ® (in addition to oral, it also has an injectable release form);
ClindaGeksal ® .

Depending on the concentration, they can act both bacteriostatically and bactericidal. The spectrum of activity includes most of the Gram+ and Gram-pathogens. The drug does not affect enterococci, hemolytic bacillus, legionella and mycoplasma.

Macrolides

Now there are 3 generations of antibiotics of the macrolide class. Of the representatives of the third, apply:

Josamycin (Vilprafen ®);
Midecamycin (Macropen ®);
Spiramycin (Rovamycin ®).

Despite the fact that Azithromycin ®, a broad-spectrum antibiotic prescribed in short courses (3 tablets), cannot be called a representative of the new generation, its effectiveness still allows it to be on the list of the most consumed antimicrobial drugs.

Representatives of the class obtained as a result of a change in the marolide molecule are:

ketolides;
streptogramins.

The group of ketolides is represented by telithromycin (trade name Ketek ®). Sensitive flora is similar to classical macrolides, however, the medium is more active in relation to cocci that are insensitive to lincosamines and streptogramins. Used for respiratory infections.

Streptogramins are active in diseases caused by staphylo- and streptococci, Haemophilus influenzae, methicillin-resistant staphylococci, and vancomycin-resistant enterococci. Are shown at outside and nosocomial pneumonias, and also inf. skin and subcutaneous fat associated with multidrug-resistant Gram+ bacteria.

Class members:

Quinupristin ® + Dalfopristin ® (combination of two streptogramins);
Pristinamycin ® (Piostacin ®) is an antistaphylococcal agent.

The newest macrolide, solithromycin ® (Cempra ® ), claimed to be effective in the treatment of community-acquired pneumonia, has not yet been registered.

If the FDA approves its release, it will be able to give rise to a new, fourth generation of macrolides.

The best broad-spectrum antibiotics for empiric treatment of life-threatening diseases with an unspecified causative agent.

Carbapenems

They have only an injection form of release. They belong to the group of beta-lactams, have structural similarities with penicillins and cephalosporins, but are distinguished by a high level of resistance to the action of extended-spectrum beta-lactamases and high efficiency against Pseudomonas aeruginosa, non-spore-forming anaerobes and bacteria resistant to representatives of the third and fourth generations of cephalosporins.

These are powerful drugs that belong to the reserve group and are prescribed for severe nosocomial infections. As empirical therapy the first line can be prescribed only for life-threatening diseases, with an unspecified pathogen.

However, they are not effective against:

MRSA (methicillin-resistant Staphylococcus aureus);
Stenotrophomonas maltophilia (gram-negative non-fermentative bacteria that cause nosocomial infections);
Burkholderia cepacia (opportunistic pathogens that cause severe out-of-hospital and nosocomial infections).

by the most strong antibiotics broad spectrum carbapenems are Ertapenem ® and Doripenem ® .

Broad-spectrum antibiotics in ampoules (injections)

Invanz ® (Ertapenem-Eleas ®)

The active ingredient is Ertapenem ® . The area of antimicrobial influence includes gram + aerobes and facultative gram - anaerobes.

It is resistant to penicillinases, cephalosporinases and extended spectrum beta-lactamases. Highly active against staphylo- (including penicillinase-producing strains) and streptococci, Haemophilus influenzae, Klebsiella, Proteus, Moraxella, Escherichia coli, etc.

May be considered universal remedy against strains resistant to penicillins, cephalosporins, aminoglycosides. The mechanism of bactericidal effect is due to its ability to bind to penicillin-binding proteins and irreversibly inhibit the synthesis of the cell wall of pathogens.

Cmax plasma concentrations are observed 50 minutes after the end of the infusion, with a / m administration - after 1.5-2 hours.

The half-life is about 4 hours. In patients with renal insufficiency, it is almost twice as long. It is excreted mainly in the urine, up to ten percent is excreted in the feces.

Dose adjustment is carried out in renal failure. liver failure and elderly age does not require changes in recommended dosages.

Used for severe

pyelonephritis and inf. urinary tract;
infect. diseases of the small pelvis, endometritis, postoperative inf-yah and septic abortions;
bacterial lesions of the skin and soft tissues, including diabetic foot;
pneumonia;
septicemia;
abdominal infections.

Invanz is contraindicated:

with intolerance to beta-lactams;
up to eighteen years of age;
with diarrhea;
during breastfeeding.

Intramuscular administration of lidocaine is prohibited in patients with hypersensitivity to amide anesthetics, reduced blood pressure and impaired intracardiac conduction.

When using Invanza ®, the risk of developing severe pseudomembranous colitis must be taken into account, therefore, if diarrhea occurs, the drug is immediately canceled.

The safety of use during childbearing has not been studied, therefore, the appointment of pregnant women is permissible only in last resort, in the absence of a safe alternative.

There are also no adequate studies on the safe use of children, so the use of up to 18 years of age is possible strictly for health reasons, in the absence of alternative drugs. It is used for a minimum course until the condition stabilizes, at a dosage of 15 mg / kg per day, divided into two injections (up to 12 years old) and 1 gram once a day for children over 12 years old.

Side effects of Ertapenem ® may occur:

antibiotic-associated diarrhea and pseudomembranous colitis;
post-infusion phlebitis;
dyspeptic disorders;
allergic (anaphylactic) reactions;
arterial hypotension;
dysbacteriosis and candidiasis;
change in taste;
increased liver transaminases;
hyperglycemia;
thrombocytopenia, neutropenia, anemia, monocytosis;
erythrocyturia, bacteriuria.

Dosages of Invanza ®

With intravenous infusion, it is diluted with 0.9% saline, the minimum administration time is half an hour. For intramuscular injections use 1-2% lidocaine ® .

It is administered once a day at a dose of 1 gram. The duration of treatment ranges from three to 14 days and depends on the severity of the inflammatory process and its localization. When the condition stabilizes, a transfer to tableted antibiotics is indicated.

Doriprex ® (Doribax ®)

The active substance is Doripenem ® . It's synthetic antimicrobial drug with bactericidal activity.

It is structurally similar to other beta-lactams. The mechanism of activity is due to the inactivation of penicillin-binding proteins and inhibition of the synthesis of cell wall components. Effective against gram + aerobes and gram - anaerobes.

Resistant to the action of beta-lactamases and penicillinases, weakly resistant to hydrolysis by extended spectrum beta-lactamases. The resistance of some strains is due to enzymatic inactivation of Doripenem and a decrease in the permeability of the bacterial wall.

Enterococcus facium, legionella, methicillin-resistant staphylococci are resistant to the drug. Acquired resistance can be developed by Acinetobacter and Pseudomonas aeruginosa.

Doripenem is prescribed for:

nosocomial pneumonia;
severe intra-abdominal infections;
complicated inf. urinary system;
pyelonephritis, with a complicated course and bacteremia.

Contraindicated:

children under eighteen years of age;
with hypersensitivity to beta-lactams;
with diarrhea and colitis;
breastfeeding.

Pregnant women are prescribed with caution, according to vital indications in the absence of an alternative.

Side effects may appear:

headache;
vomiting, nausea;
phlebitis at the injection site;
increase in liver transaminases;
colitis and diarrhea;
anaphylactic shock, itching, rash, toxic epidermal necrolysis;
dysbacteriosis, fungal infection of the mucosa oral cavity and vagina;
neutropenia and thrombocytopenia.

Dosages and duration of treatment with Doriprex ®

Doripenem is applied at five hundred milligrams every eight hours. The duration of the infusion should be at least an hour. With nosocomial pneumonia, it is possible to increase the dose to 1000 mg. Doriprex ® is administered in 0.9% saline or 5% glucose.

The duration of treatment ranges from five to 14 days and depends on the severity of the disease and the localization of the bacterial focus.

When the patient's condition stabilizes, a transition to tableted antibacterial drugs is carried out. Dose adjustment is necessary for patients with impaired renal function. Liver failure and advanced age are not indications for dose reduction.

Cheap broad spectrum antibiotics

Cepim ®

The Russian drug, produced by the Sintez AKOMP ® campaign, will cost the buyer about 120 rubles per bottle. This is a fairly inexpensive analogue of Maximim ® , made in the USA (400 rubles per 1 gram bottle).

The active substance is cefepime ® . It belongs to the 4th generation cephalosporins. and has broad bactericidal activity. The mechanism of influence on pathogens is due to a violation of the processes of synthesis of the components of the microbial wall.

Cefepime ® is effective against gram- and gram+ pathogens that are resistant to aminoglycoside preparations and third-generation cephalosporins. Of staphylococci, only methicillin-sensitive types are sensitive, other strains are resistant to its action. Also, wed-in does not work on enterococci and clostridia.

The drug is resistant to bacterial beta-lactamases.

Able to create high concentrations in:

bronchial secretions and sputum;
bile and walls of the gallbladder;
appendix and peritoneal fluid;
prostate.

The drug has a high bioavailability and absorption. The half-life is about two hours. Dose adjustment is carried out only in patients with renal insufficiency.

The list of indications for the appointment of Tsepim are:

moderate to severe pneumonia;
febrile fever;
complicated urinary tract infections;
heavy pyelonephritis;
intra-abdominal inf. with complications (combined with 5-nitroimidazal derivatives - metronidazole);
infect. skin and subcutaneous fat caused by drug-sensitive staphylo- and streptococci;
meningitis;
sepsis.

Also, it can be prescribed to prevent septic postoperative complications.

Tsepim ® can be used for empirical therapy of diseases caused by an unspecified pathogen. It is also prescribed for mixed infections (anaerobic-aerobic flora) in combination with antianaerobic drugs.

Cefepime ® is contraindicated:

persons with intolerance to beta-lactams and L-arginine;
children up to two months of life (intravenously);
patients under 12 years of age (intramuscularly).

Be wary appoint patients with pseudomembranous colitis in history, ulcerative colitis, renal failure, pregnant and lactating.

Possible side effects in the form of:

phlebitis at the injection site;
dyspeptic disorders;
anxiety, headache;
thrombocytopenia, leukopenia, neutropenia;
jaundice, increased hepatic transaminases;
allergies;
tremor and convulsions;
candidiasis and dysbacteriosis.

Doses of the drug

Dosage, route of administration and duration of therapy depend on the severity of the disease, the location of the bacterial focus and the state of kidney function.

As a rule, one to two grams of the drug is administered intravenously, every 12 hours. With inf. urinary tract possible intramuscular injection.

With febrile fever, 2 grams are prescribed every eight hours. It is applied from seven to 10 days. With infection. with a severe course, it is possible to lengthen the course.

Babies older than two months are prescribed 50 mg / kg twice a day. With neutropenia - three times a day.

On our site you can get acquainted with most groups of antibiotics, complete lists of the drugs included in them, classifications, history and other important information. For this, a section "" has been created in the top menu of the site.