Erythromycin ointment for children with eye diseases. Which ointment is better tetracycline or erythromycin

Comparative characteristics of tetracycline and erythromycin ointments:

1. Contains antibiotics of different groups. Tetracycline - a group of tetracyclines, Erythromycin - a group of macrolides.
2. When administered to children and pregnant women. Tetracycline ointment is used with caution in children, pregnant women are not allowed, Erythromycin is allowed for children from birth and pregnant women.
3. The manifestation of adverse reactions in Tetracycline ointment is much higher
4. Tetracycline is used in the treatment of large, extensive eye infections.
5. Tetracycline copes with both the acute form of inflammatory diseases and the chronic form. Erythromycin manifests itself in the acute stage.
6. The cost is much higher than that of erythromycin.

Tetracycline is an antibacterial agent with a wide range of effects. The drug is often prescribed for the treatment of infectious diseases of the respiratory system.

Operating principle

Tetracycline is a bacteriostatic drug of the tetracycline group with a wide spectrum of action. Once in the body, the antibiotic disrupts the complex between the transfer RNA and ribosomes, which further stops protein synthesis by pathogenic cells. Tetracycline has a detrimental effect on a number of gram-positive and gram-negative microorganisms, enterobacteria, pathogens of lymphogarnuloma (venereal and inguinal).

Release form

An antibiotic of the tetracycline group is available in tablets with a dosage of 100 mg, oral suspensions, 1% and 3% ointments for external use.

Indications

The drug of the tetracycline group is indicated for use in such cases:

• Respiratory diseases (pneumonia, tonsillitis, bronchitis, pleurisy)
• Dysentery
• Meningitis
• Infectious and inflammatory diseases of the genitourinary system
• Endocarditis
• Infectious diseases of the digestive tract (typhus, scarlet fever, cholera, etc.)
• Pustular skin lesions, burns
• Ophthalmic diseases of infectious genesis.

Tetracycline can be used in the complex treatment of septic diseases.

Contraindications

• Leukopenia
• Pregnancy and lactation
• Excessive susceptibility to drugs of the tetracycline group
• Violation of the kidneys and liver.

Tetracycline is contraindicated in children under 8 years of age.

Dosage and method of application

The suspension should be taken three times or four times a day in a volume of 2 drops after meals. A single dose of syrup is from 15 to 18 ml (three times a day). The syrup must be diluted before taking in a small amount of water (no more than 50 ml). The drug should be taken immediately after a meal.

Antibacterial ointment is applied to the skin of the chest in an even layer or to another affected area. Then you need to gently rub it in until completely absorbed.

Side effects

While taking Tetracycline, the following side reactions may occur:

• Loss of appetite
• Nausea and urge to vomit after eating
• Dizziness along with headache
• Intestinal disorders (increased gas formation, diarrhea, proctitis)
• Exacerbation of existing ailments of the genitourinary system
• Inflammatory processes localized in the stomach.

Storage

Tetracycline must be stored at a temperature not exceeding 25 ° C, in a dry place, which is protected from direct sunlight. The antibiotic can be used for 2 years from the date of manufacture.

Price and country of origin

An antibiotic of the tetracycline group is produced in Russia. The price of Tetracycline varies depending on the dosage form and ranges from 11 to 120 rubles.

The presented characteristics of antibacterial drugs allow for their comparative analysis.

Composition

The composition of Tetracycline and Erythromycin includes various active ingredients. They can be used instead of penicillin drugs.

By action

The mechanism of these drugs is similar, since each of the antibiotics is active against gram-positive and gram-negative bacteria. Both Tetracycline and Erythromycin have a wide spectrum of action.

By release form

Antibiotics are available in similar dosage forms, the only difference is that Erythromycin can be administered intravenously.

According to contraindications

Antibiotics are not prescribed for pregnant and lactating women. And also with excessive sensitivity to their components. Tetracycline is not recommended for use in serious pathologies of the kidneys and liver, the possibility of treatment with this drug is determined after consultation with a specialist.

By price and country of origin

The price of antibiotics Tetracycline and Erythromycin is almost the same, since both drugs are made by a domestic manufacturer.

It is a thick, mustard-colored paste from the antibiotic group. It has an antimicrobial effect by reducing the reproduction of propionic bacteria. The recommended course should last at least 4 weeks.

Avoid applying the drug to damaged or irritated skin. In order not to stain the bed linen, it is better to put a bandage on top.

Causes of inflammation and redness of the eyes

Another cause of redness and inflammation of the eyes is anterior, posterior and purulent scleritis.

And in a neglected state, abscesses are not excluded and, as a result, irreversible loss of vision (complete or partial).

Ointments for inflammation of the eyes in children

It is a fairly safe drug for the human body among antibiotic-containing drugs. The use of erythromycin ophthalmic ointment is acceptable during pregnancy, during breastfeeding and for the treatment of newborns and children.

However, the rules of admission, the need to use erythromycin should be consulted with a doctor.

Therefore, erythromycin should not be used in the first half of pregnancy.

During lactation, treatment with the drug is not recommended. The antibiotic passes into breast milk. For women with infants, it is wiser to choose other drugs for the treatment of eye diseases with a doctor.

For children, erythromycin ointment is allowed almost at birth. An important circumstance will be the availability of medical permission. Erythromycin drug is acceptable for the treatment of eye inflammation in infants.

The actions rendered by him help in getting rid of infections received at the time the baby passes through the birth canal. But! Erythromycin - for topical use - is not prescribed for children suffering from jaundice.

Medical specialists say that medications should only be used when the risk of a possible complication from the drug is lower than the risk of the consequences of the disease.

For the treatment of inflammatory processes and redness of the eyes in children, not all ointments recommended for adult patients can be used.

In case of allergic manifestations of inflammatory processes, treatment should be approached with caution and only drugs should be used, the possibility of which for children is noted in the instructions for use.

Before using such products, you should read the instructions for use in order to avoid the development of side effects.

Erythromycin ointment for children is approved for treatment from the first days of life (if there is an indication and need). Erythromycin ointment for infants is prescribed for the treatment of skin and eye inflammation. It is used in the treatment of birth infections, when the baby was infected while passing through the birth canal. Often, an infection of the birth canal spreads to the skin of the face and mucous membranes of the eyes (causes conjunctivitis). For its treatment, erythromycin ointment is prescribed.

Use during pregnancy, lactation and children

Erythromycin ointment during pregnancy is used only as directed by a doctor. It is important to understand that this antibiotic crosses the placenta and passes into breast milk. Therefore, the appointment and use of this drug should be competent.

You can not use this remedy in the first half of pregnancy (topical application of a bacteriostatic substance is able to pass it into the general circulation and through the placenta). Due to the lack of systemic studies and sufficient data on the effect of erythromycin on the fetus, the drug is used with great caution. Even in the second half of pregnancy, erythromycin ointment is prescribed only in case of urgent need, when this remedy cannot be dispensed with.

Use of erythromycin ointment for eye treatment

The use of erythromycin ointment for acne is due to its anti-inflammatory and bactericidal effect. This tool helps with stable use (leads to the death of all pathogenic bacteria). Therefore, you should not hope for a quick effect, you need to smear acne, acne with ointment for one to two months.

In addition to acne, an ointment with an antibacterial composition can be used for other skin inflammations with abscesses and boils. The ointment is not used in the treatment of non-infectious inflammations (diaper rash, dermatitis), as well as for the treatment of skin rashes of viral origin (chickenpox, herpetic, rubella).

Erythromycin ointment for dermatitis can be used if a bacterial infection has joined the skin inflammation. A similar situation is with the treatment of burns and frostbite. They should be treated with erythromycin ointment, if an infection has joined, pus has appeared. In other cases, when there is no infection, you should not use a "weapon of mass destruction" - an ointment with an antibacterial composition (erythromycin).

Conjunctivitis in most cases is caused by various bacteria, viruses, fungi. The disease is characterized by very unpleasant symptoms, and without treatment leads to various negative consequences for vision.

It is possible to stop the reproduction of pathogens and remove them from the conjunctiva only through the use of antibacterial drugs - drops or ointments.

One of the most effective medicines in the treatment of eye inflammation is considered by ophthalmologists Erythromycin ointment - a time-tested remedy with a pronounced therapeutic effect.

It has a wide spectrum of activity, including both gram-positive (staphylococci producing and not producing penicillinase; streptococci, pneumococci, clostridia, Bacillus anthracis, Corynebacterium diphtheriae), and gram-negative microorganisms (gonococci, hemophilic and pertussis bacilli, brucella, legionella), mycoplasmas, chlamydia , spirochetes, rickettsia.

Resistant to erythromycin Gram-negative rods: coli, Pseudomonas aeruginosa, as well as Shigella, Salmonella, etc.

Indications:
Bacterial infections: diphtheria (including diphtheria carriage), whooping cough (including disease prevention in susceptible individuals at risk of infection), trachoma, brucellosis, legionnaires' disease, scarlet fever, amoebic dysentery, gonorrhea; neonatal conjunctivitis, pneumonia in children and urinary infections in pregnant women caused by Chlamydia trachomatis; primary syphilis (in patients allergic to penicillins), uncomplicated.
drug-resistant pathogens; prevention of exacerbations of streptococcal infection (tonsillitis, pharyngitis) in patients with rheumatism, infectious complications during dental interventions in patients with heart defects. It is a reserve antibiotic for the treatment of bacterial infections caused by strains of gram-positive pathogens (in particular staphylococci) resistant to penicillin. In severe forms of infectious diseases, when oral administration of the drug is ineffective or impossible, resort to the / in the introduction of a soluble form of erythromycin - erythromycin phosphate. Erythromycin in suppositories is prescribed in cases where ingestion is difficult.

Rp.:Erythromycini 0.25

D.t.d. N.20 in tab.

S. 2 tablets 4 times a day.

within 14 days

With legionellosis.

Azithromycin(sumamed)

In high concentrations, it has a bactericidal effect against gram-positive.
oniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi. Not active against Gram-positive bacteria resistant to erythromycin.

Indications:

Infections of the upper respiratory tract and ENT organs caused by sensitive microflora: tonsillitis, sinusitis, tonsillitis, otitis media; scarlet fever; infections of the lower respiratory tract: bacterial and atypical pneumonia, bronchitis; skin and soft tissue infections: erysipelas, impetigo, secondarily infected dermatoses; infections of the urogenital tract: gonorrheal and non-gonorrheal urethritis and / or cervicitis; Lyme disease (borreliosis).

Rp.:Azithromycini 0.25

D.t.d. N.10 in caps.

S. On the first day, 1 capsule

morning and evening, from 2nd to

5th day 1 capsule 1 time

in a day. For infections

upper and lower divisions

respiratory tract.

Roxithromycin(rulid)

Sensitive to the drug: Streptococcii groups A and B, incl. Str. pyogenes, Str. agalactiae, Str. mitis, saunguis, viridans, Streptococcus pneumoniae; Neisseria meningitidis; Branhamellacatarrhalis; Bordetella pertussis; Listeria monocytogenes; Corynebacterium diphtheriae; Clostridium; Mycoplasma pneumoniae; Pasteurella multocida; Ureaplasma urealyticum; Clamydia trachomatis, pneumoniae and psittaci; Legionella pneumophila; Campylobacter; Gardnerella vaginalis. Intermittently sensitive: Naemophilus influenzae; Bacteroides fragilis and Vibrio cholerae. Resistant: Enterobacteriaceae, Pseudomonas, Acinetobacter.

Indications:

Treatment of drug-sensitive infections of the upper and lower respiratory tract, skin and soft tissues, genitourinary tract (including sexually transmitted infections, except gonorrhea), infections in dentistry (bronchitis, pneumonia, tonsillitis, scarlet fever, otitis media, sinusitis, diphtheria, whooping cough, trachoma, brucellosis, legionnaires' disease, etc.). Prevention of meningococcal meningitis in persons who have been in contact with the diseased.

Rp.:Tab. Roxithromycini 0.15 N.20

D.S. 1 tablet 2 times a day

day, morning and evening before

food.

alexmed.info

Instructions for use Tetracycline

Tetracycline is an antibacterial agent with a wide range of effects. The drug is often prescribed for the treatment of infectious diseases of the respiratory system.

Operating principle

Tetracycline is a bacteriostatic drug of the tetracycline group with a wide spectrum of action. Once in the body, the antibiotic disrupts the complex between the transfer RNA and ribosomes, which further stops protein synthesis by pathogenic cells. Tetracycline has a detrimental effect on a number of gram-positive and gram-negative microorganisms, enterobacteria, pathogens of lymphogarnuloma (venereal and inguinal).

Release form

An antibiotic of the tetracycline group is available in tablets with a dosage of 100 mg, oral suspensions, 1% and 3% ointments for external use.

Indications

The drug of the tetracycline group is indicated for use in such cases:

• Respiratory diseases (pneumonia, tonsillitis, bronchitis, pleurisy)
• Dysentery
• Meningitis
• Infectious and inflammatory diseases of the genitourinary system
• Endocarditis
• Infectious diseases of the digestive tract (typhus, scarlet fever, cholera, etc.)
• Pustular skin lesions, burns
• Ophthalmic diseases of infectious genesis.

Tetracycline can be used in the complex treatment of septic diseases.

Contraindications

• Leukopenia
• Pregnancy and lactation
• Excessive susceptibility to drugs of the tetracycline group
• Violation of the kidneys and liver.

Tetracycline is contraindicated in children under 8 years of age.

Dosage and method of application

The suspension should be taken three times or four times a day in a volume of 2 drops after meals. A single dose of syrup is from 15 to 18 ml (three times a day). The syrup must be diluted before taking in a small amount of water (no more than 50 ml). The drug should be taken immediately after a meal.

Antibacterial ointment is applied to the skin of the chest in an even layer or to another affected area. Then you need to gently rub it in until completely absorbed.

Side effects

While taking Tetracycline, the following side reactions may occur:

• Loss of appetite
• Nausea and urge to vomit after eating
• Dizziness along with headache
• Intestinal disorders (increased gas formation, diarrhea, proctitis)
• Exacerbation of existing ailments of the genitourinary system
• Inflammatory processes localized in the stomach.

Storage

Tetracycline must be stored at a temperature not exceeding 25 ° C, in a dry place, which is protected from direct sunlight. The antibiotic can be used for 2 years from the date of manufacture.

Price and country of origin

An antibiotic of the tetracycline group is produced in Russia. The price of Tetracycline varies depending on the dosage form and ranges from 11 to 120 rubles.

Application instruction of Erythromycin

Erythromycin belongs to the microlide group of antibacterial agents, which is synthesized by Streptomyces erythreus.

You can find full instructions here.

Operating principle

The action of the antibiotic is based on the disruption of the peptide bond between the amino acids of pathogenic cells, which leads to the blockade of protein synthesis.

The antibacterial effect of the drug is similar to that of the penicillin series. Erythromycin is active against gram-positive and harmonic flora (including rickettsia, trachoma, brucella, syphilis pathogens). The destructive effect of the drug does not apply to mycobacteria, fungal flora, as well as a number of viruses.

After taking a therapeutic dose, a bacteriostatic effect of Erythromycin is observed.

Release form

An antibiotic based on erythromycin is available in the form of tablets (dosage 100 mg, 250 mg, 500 mg), ointment for external use, ophthalmic ointment, lyophilisate for the manufacture of an injection solution.

Indications

A wide spectrum of action of Erythromycin allows it to be used for the treatment of infectious diseases of bacterial origin:

• Trachoma
• Brucellosis
• Whooping cough
• Listeriosis
• erythrasma
• Legionnaires' disease
• erythrasma
• Syphilis (primary form)
• Chlamydia uncomplicated
• ENT diseases
• Cholecystitis
• Acne lesions of the skin.

An antibacterial agent can be used to prevent the development of streptococcal infection in a number of patients suffering from rheumatism.

Contraindications

Erythromycin is contraindicated for use in such cases:

• Excessive susceptibility to drugs of a number of microlides
• Simultaneous administration of the drug Terfenadine or Astemizol
• Hearing loss
• Pregnancy and lactation.

Dosage and method of application

The antibiotic should best be taken one hour before a meal with the required amount of liquid.

Adults are usually prescribed a dose of 200-400 mg every 6 hours before meals. The highest daily dosage of Erythromycin should not exceed 4 g.

For children, the dose calculation is carried out taking into account the ratio of 40 mg per 1 kg of body weight. The drug must be taken in 4 divided doses one hour before meals or two hours after meals. The duration of therapy is from 7 to 10 days. After completing the course of treatment, you must consult a doctor.

The ointment is applied to the affected area of ​​the skin up to three times a day. For the treatment of burns, it is recommended to use the ointment up to 3 times a week. The drug can be used to treat newborns. The course of treatment with Erythromycin in the form of an ointment is 1.5-2 months.

Side effects

Adverse reactions during antibiotic treatment are observed quite rarely and often there are violations of the digestive tract. Long-term treatment with Erythromycin can cause liver problems, namely jaundice. Perhaps the development of excessive sensitivity to the drug in the form of an ointment and the appearance of allergies.

With prolonged use of the drug, resistance to pathogenic bacterial flora may develop.

Storage

Erythromycin should be stored at room temperature.

Shelf life is no more than 3 years.

Price and country of origin

Erythromycin is manufactured in Russia. The cost of the medicine is 8 - 157 rubles.

Comparison of antibacterial drugs Tetracycline and Erythromycin

The presented characteristics of antibacterial drugs allow for their comparative analysis.

Composition

The composition of Tetracycline and Erythromycin includes various active ingredients. They can be used instead of penicillin drugs.

By action

The mechanism of these drugs is similar, since each of the antibiotics is active against gram-positive and gram-negative bacteria. Both Tetracycline and Erythromycin have a wide spectrum of action.

By release form

Antibiotics are available in similar dosage forms, the only difference is that Erythromycin can be administered intravenously.

According to contraindications

Antibiotics are not prescribed for pregnant and lactating women. And also with excessive sensitivity to their components. Tetracycline is not recommended for use in serious pathologies of the kidneys and liver, the possibility of treatment with this drug is determined after consultation with a specialist.

By price and country of origin

The price of antibiotics Tetracycline and Erythromycin is almost the same, since both drugs are made by a domestic manufacturer.

For children

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11. CLINICAL AND PHARMACOLOGICAL CHARACTERISTICS OF ANTIBIOTICS OF THE MACROLIDE GROUP

Macrolide antibiotics are a group of antimicrobial drugs of natural and semi-synthetic origin, united by the presence of a macrolide lactone ring in their structure.

The mechanism of action of macrolides

Bacterial ribosomes consist of 2 subunits: a small 30S and a large 50S. The mechanism of action of macrolides is to inhibit RNA-dependent protein synthesis by reversibly binding to the 50S ribosomal subunit of susceptible microorganisms. Inhibition of protein synthesis results in

growth and reproduction of bacteria and indicates that macrolides are predominantly bacteriostatic antibiotics. In some cases, with high bacterial susceptibility and high antibiotic concentration, they

may exhibit bactericidal activity. In addition to the antibacterial action, macrolides have immunomodulatory and moderate anti-inflammatory activity.

Macrolide classifications

Macrolides are classified according to:

– According to the chemical structure (the number of carbon atoms in the macrolide lactone ring and the method of preparation (Table 1).

- According to the duration of action (Table 2).

– According to generations, macrolides are subdivided into I, II, III generations and ketolides (Table 3).

Table 1

Classification of macrolides by chemical structure

table 2

Classification of macrolides by duration of action

The only representative of the III generation is azithromycin. It is also assigned to the azalide subgroup, since a nitrogen atom has been introduced into the lactone ring. Due to the fact that in recent years, antibiotic resistance of some pathogens to macrolides has been observed, macrolides were synthesized based on the 14-membered lactone ring, in which

keto group - the so-called ketolides, which do not belong to any of the generations of macrolides and are considered separately.

Table 3

Classification of macrolides by generation

Pharmacokinetics

Macrolides are classified as tissue antibiotics, since their concentrations in blood serum are much lower than in tissues. This is due to their ability get inside the cells!!! and create high concentrations of the substance there. Macrolides do not penetrate well through the blood-brain and blood-ophthalmic barriers, but they penetrate well through the placenta and into breast milk, and therefore potentially embryotoxic and are restricted to breastfeeding.

The degree of binding of macrolides to plasma proteins varies: the highest degree of binding is observed in roxithromycin (more than 90%), the lowest in spiramycin (less than 20%).

Macrolides are metabolized in the liver with the participation of the microsomal system of cytochrome P-450, metabolites excreted primarily in bile ; with cirrhosis of the liver, a significant increase in the half-life of erythromycin and josamycin is possible. Renal excretion is 5-10%. The half-life of drugs ranges from 1 hour (josamycin) to 55 hours (azithromycin).

The parameters of the pharmacokinetics of macrolides depend on the classification. 14-membered macrolides (especially erythromycin) have a stimulating effect on gastrointestinal motility, which can lead to dyspeptic disorders. 14-mer macrolides are destroyed in the liver with the formation of hepatotoxic nitrosoalkane forms, while they are not formed during the metabolism of 16-mer macrolides, which leads to the absence of a hepatotoxic effect when taking 16-mer macrolides.

14-mer macrolides inhibit the activity of cytochrome P-450 enzymes in the liver, which leads to an increased risk of drug interactions, while 16-mer preparations have little effect on the activity of cytochrome P-450 and have a minimum number of drug interactions.

Azithromycin has the highest activity against gram-negative pathogens, clarithromycin against Helicobacter pylori, spiramycin against toxoplasma and cryptosporidium. 16-mer macrolides retain

activity against a number of strains of staphylococci and streptococci resistant to 14- and 15-membered macrolides.

Erythromycin

Absorbed in the gastrointestinal tract is not completely. Bioavailability varies from 30 to 65%, and is significantly reduced in the presence of food. It penetrates well into bronchial secretions and bile. Poorly passes through the blood-brain, blood-ophthalmic barrier. It is excreted mainly through the gastrointestinal tract.

Roxithromycin

Differences from erythromycin: stable bioavailability up to 50%, which is practically independent of food; high concentrations in the blood and tissues; long half-life; better tolerance; less likely drug interactions.

Clarithromycin

Differences from erythromycin: has an active metabolite - 14-hydroxy-clarithromycin, due to which it has increased activity against H. influenzae; the most active of all macrolides in relation to Helicobacter pylori; acts on atypical mycobacteria ( M. avium etc.), causing opportunistic infections in AIDS. Also, clarithromycin is characterized by greater acid resistance and

bioavailability of 50-55%, independent of food intake; high concentrations in tissues; long half-life; better tolerance.

Azithromycin

Differences from erythromycin: active against H.influenzae, N.gonorrhoeae and H.pylori; bioavailability of about 40%, not dependent on food; high concentrations in tissues (the highest among macrolides); has a significantly longer half-life, which allows you to prescribe the drug once a day and use short courses (1-3-5 days) while maintaining the therapeutic effect for 5-7 days

after cancellation; better tolerance; less likely drug interactions.

Spiramycin

Differences from erythromycin: active against some pneumococci and group A beta-hemolytic streptococcus resistant to 14- and 15-membered macrolides; acts on toxoplasma and cryptosporidium; bioavailability of 30-40%, independent of food intake; creates high concentrations in tissues; better tolerated.

Josamycin

Differences from erythromycin: less active against most erythromycin-sensitive microorganisms; acts on a number of staphylococci, pneumococci and beta-hemolytic streptococci of group A, resistant to 14- and 15-membered macrolides; more acid-resistant, bioavailability independent of food; rarely causes unwanted reactions from the gastrointestinal tract.

Pharmacodynamics

The pharmacodynamics of macrolides is due to their bacteriostatic, and in high doses bactericidal action (against Streptococcus pneumoniae and β-hemolytic Streptococcus group A), as well as anti-inflammatory and immunomodulatory effects. Do not affect the intestinal flora!

1. Antimicrobial effects

The spectrum of action of macrolides is quite wide and includes a large number of gram-positive and gram-negative microorganisms ( Haemophilus influenzae, Moraxella, Pneumococcus, Gonococcus, Meningococcus, Helicobacter, Legionella and etc.). Macrolides are very effective in infections caused by intracellular pathogens.

lyami ( chlamydia, mycoplasma etc.), are highly active against the main pathogens of community-acquired infections of the lower respiratory tract. Macrolides are somewhat less active against anaerobes. All macrolides are characterized by a post-antibiotic effect, i.e., the preservation of the antimicrobial effect of the drug after its removal from the environment. This is due to irreversible changes

ribosomes of the pathogen under the action of macrolides.

2. Anti-inflammatory and immunomodulatory effects

It has been proven that macrolides are able to accumulate in neutrophils and macrophages and be transported with them to the focus of inflammation. The interaction of macrolide antibiotics with macrophages manifests itself in the form of a decrease in the activity of free radical oxidation, a decrease in the release of inflammatory and an increase in the release of anti-inflammatory cytokines, activation of chemotaxis and phagocytosis, an improvement in mucociliary clearance, and a decrease in mucus secretion. The use of macrolides leads to a decrease in the concentration of immune complexes in the blood serum, accelerates apoptosis of neutrophils, weakens the antigen-antibody reaction, inhibits the secretion of IL-1-5, tumor necrosis factors, inhibits the production and release of nitric oxide by alveolar macrophages and enhances the production of endogenous cortisol. These features, together with activity against Chlamydia pneumoniae and Mycoplasma pneumoniae, were the basis for studying the effectiveness of these drugs in bronchial asthma, brochiolitis, atherosclerosis, and cystic acidosis.

The spectrum of action of macrolides includes many clinically significant pathogens, some of which are listed below:

– Gram-positive aerobes: Enterococcus faecalis (including vancomycin-resistant strains), Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae (penicillin-susceptible only); Streptococcus pyogenes.

– Gram-negative aerobes: Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrhalis, Neisseria meningitides, Pseudomonas aeruginosa, Proteus mirabilis.

– Gram-positive anaerobes: Clostridium perfringens.

– Gram-negative anaerobes: Fusobacterium spp., Prevotella spp.

– Others: Borrelia burgdorferi, Treponema pallidum; Campylobacter; Chlamydia trachomatis

Do not affect the intestinal flora!

Mechanisms of bacterial resistance to macrolides

There are two main mechanisms of bacterial resistance to macrolides.

1. Modification of the action target

occurs due to the production of methylase by bacteria. Under the action of methylase, macrolides lose their ability to bind to ribosomes.

2. Efflux or M-phenotype

Another mechanism - the M-phenotype - is associated with the active removal of the drug from the cell (efflux), as a result of which the resistance of bacteria to 14- and 15-membered macrolides is formed.

Indications and principles for the use of macrolides in therapeutic

practice

Macrolides are the drugs of choice:

- ARF in case of allergy to penicillins;

- in patients with community-acquired pneumonia in the form of monotherapy

(azithromycin, clarithromycin, midecamycin, spiramycin) and as part of combination therapy.

- parenteral forms of macrolides in monotherapy or in combination with other antibiotics are used for infectious diseases of the pelvis(limited peritonitis, endometritis, etc.).

Other indications for taking macrolides:

- infections of the upper respiratory tract and ENT organs (tonsilopharyngitis, sinusitis, otitis, laryngitis) with allergies to penicillins;

- urogenital infections caused by C. trachomatis, U. urealyticum, Mycoplasma spp.;

- sexually transmitted diseases (with intolerance to b-lactam antibiotics) - syphilis, gonorrhea, blennorrhea, soft chancre, venereal lymphogranulomatosis;

- infections of the skin and soft tissues (wound infection, mastitis, acne, furunculosis, folliculitis, erysipelas, erythrasma);

- some contagious infections (scarlet fever, whooping cough, diphtheria, legionnaires' disease, ornithosis, trachoma , listeriosis, meningococcal carriage);

– Orodental infections (periodontitis, periostitis);

- eradication of Helicobacter pylori in patients with peptic ulcer of the stomach or duodenum;

- atypical mycobacteriosis (tuberculosis, leprosy);

- intestinal infections caused by Campylobacter spp..;

- cryptosporidiosis;

- annual prevention of rheumatism in case of allergy to penicillin.

Daily doses and frequency of intake of macrolides

The pharmacokinetics of parenteral macrolides practically does not differ from oral forms, as a result of which injectable drugs should be used as monotherapy according to indications (severe pneumonia, pelvic infections) or in cases where the use of oral antibiotics is impossible for various reasons.

Daily doses of macrolides

macrolide	Dosage form	Dosing regimen
Clarithromycin	Tab. 0.25 g and 0.5 g. Since. for susp. 0.125 g/5 ml. Since. d / in. 0.5 g in vial.	Adults: 0.25–0.5 g every 12 hours. Children: over 6 months 15 mg/kg/day. in 2 doses. Adults: 0.5 g every 12 hours. Before intravenous administration, a single dose is diluted in 250 ml of 0.9% sodium chloride solution, injected into within 45–60 min.
Azithromycin	Caps. 0.25 g Tab. 0.125 g; 0.5 g Since. for susp. 0.2 g/5 ml in a flask. 15 ml and 0.1 g/5 ml in vial. 20 ml. Syrup 100 mg/5 ml; Lyophilisate for preparation. r-ra d / inf. 500 mg	Adults: 0.5 g/day. within 3 days, or 1st day 0.5 g, 2-5th days - 0.25 g in one Children: 10 mg/kg/day. within 3 days or in the 1st day - 10 mg / kg, 2-5th days - 5 mg / kg in one In / in infusion or drip. Nota bene! Sumamed should not be administered intravenously jet or w / m! In infectious and inflammatory diseases of the pelvic organs, 500 mg is prescribed 1 time / day within 2 days. After graduation azithromycin orally at a dose of 250 mg to complete completion of the 7-day general course of treatment.

Side effect

Macrolides are one of the safest groups of antimicrobials. other than erythromycin! Most often, the side effect of macrolides is associated with the use of erythromycin (highlighted). However, despite the relative safety of macrolides, all representatives of this group are capable of causing adverse reactions.

Pain and inflammation at the injection site;

Dizziness/vertigo, headache, drowsiness, convulsions;

Nausea, vomiting, frequent loose stools, abdominal pain and spasms.

Uncommon (> 1/1000–< 1/100):

Paresthesia, asthenia, insomnia, irritability, fainting, aggressiveness, anxiety, nervousness;

Palpitations, arrhythmia, including ventricular tachycardia, an increase in the QT interval, a decrease in blood pressure;

Diarrhea, flatulence, digestive disorders, cholestatic jaundice, hepatitis, changes in the values ​​of laboratory tests of liver functions, constipation, discoloration of the tongue;

Noise in ears, reversible hearing loss up to deafness(when taken in high doses for a long time, reversible ototoxicity), visual impairment, impaired taste perception and

Leukopenia, neutropenia, eosinophilia, thrombocytopenia;

Skin rashes, itching, urticaria.

Very rare (≥ 1/100,000–< 1/10 000):

Nephritis, acute renal failure;

Angioedema, photosensitivity, and naphylactic reaction;

Pseudomembranous colitis, pancreatitis, liver necrosis, liver failure; pyloric stenosis in children.

Contraindications to the use of macrolides

– History of immediate-type hypersensitivity to any of the macrolides.

- Pregnancy - midecamycin, roxithromycin, azithromycin, clarithromycin (you can: erythromycin for chlamydial urogenital infection, spiramycin-toxoplasmosis in pregnant women).

- Children's age: up to 2 months - roxithromycin, up to 6 months - clarithromycin, up to 14 years - dirithromycin, up to 16 years - azithromycin, since their safety at these ages has not been established.

- Breastfeeding - azithromycin, clarithromycin, midecamycin, erythromycin, roxithromycin.

– Severe renal dysfunction (creatinine clearance –< 30 мл/мин.).

– Severe hepatic dysfunction – azithromycin, erythromycin,

roxithromycin, midecamycin, clarithromycin.

- Arrhythmias or predisposition to arrhythmias and prolongation of the QT interval - azithromycin, erythromycin.

– Significant hearing loss – erythromycin.

- Hereditary lactase deficiency, galactosemia or glucose and galactose malabsorption syndrome - clarithromycin.

Interaction of macrolides with other drugs

Consideration should be given to the possibility of inhibition of the CYP3A4 isoenzyme by azithromycin when co-administered with cyclosporine, terfenadine, ergot alkaloids, cisapride, pimozide, quinidine, astemizole and other drugs, the metabolism of which occurs with the participation of this isoenzyme.

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Indications for use

The main active ingredient of the drug

• magnesium stearate;
• milk sugar monohydrate;
• microcrystalline cellulose;
• aerosil;
• povidone.

Antibiotic Azithromycin is prescribed for infection of the respiratory tract, skin, soft tissues with harmful microbes. It can be used to treat an infectious disease of the ENT organs and the genitourinary system.

This antibiotic reduces the process of translation to complete elimination, due to which microorganisms stop growing and multiplying. The bactericidal action of the drug is aimed at the destruction of intracellular and extracellular pathogenic bacteria.

When swallowed, the medicinal substance is rapidly absorbed from the digestive organ, since the digestive juice does not adversely affect it. Further, the drug enters the tissues through the barriers of cell membranes. The drug leaves the body through the intestines and kidneys in the same form. The antibacterial effect of the drug lasts about 5-7 days after its application.

Similar funds

Pharmacy chains provide a large selection of products containing the active substance of the drug Azithromycin. Their difference lies solely in the concentration of the active ingredient, form of release, name, pricing policy.

The most popular of them are the following drugs:

• "Sumamoks";
• "Zitrocin";
• "Sumamed";
• "Azivok";
• "Hemomycin";
• Azitrox.

The dosage form in which they are produced is different. The drugs have less effect on the liver and digestive system.

When choosing, for example, drugs Azithromycin or Azitrox, it should be noted that one drug is a budget substitute for the second. There are other analogues of the antibiotic: "Sumametsin", "Azitsid", "Zetamax retard", "Zitromax". These drugs act even more effectively on diseased cells, quickly penetrating through their sealed membranes. These medicines are considered the best generics.

Other substitutes for Azithromycin are antibiotics: Defens, Zit, Sumatrolide Solutab, Clubax, Sumazil, Ketek, Fromilid, Starket, Erythromycin, Aziklar, Clarithromycin " and many others. Each drug is accompanied by instructions for use, in which you can find out all the features of the drug.

Their application is carried out in a similar way. It is advisable to take the medicine on an empty stomach (one hour before or 2 hours after a meal). For the treatment of diseases of the upper respiratory tract and ENT organs, take one tablet (500 mg) of Azithromycin or its analogue per day for three days. For skin diseases, the initial intake reaches 1000 mg, and then the patient needs to switch to 500 mg.

The duration of therapy is determined by the severity of the disease, the general well-being of the patient and some physiological factors. The use of a potent drug implies the mandatory simultaneous use of a probiotic. This medication maintains the normal state of the intestinal microflora, which prevents the appearance of dysbacteriosis.

Colds

Penicillin antibiotics (Azithromycin, Augmentin

or Amoxiclav and their substitutes) effectively resist bacteria that cause inflammation of the respiratory tract. Respiratory infection, like pneumonia, is caused by a variety of microbes, most of which are resistant to penicillin. In this situation, Levofloxacin, Moxifloxacin will have the most effective effect.

The class of cephalosporins is represented by the following antibiotics: Suprax, Zinacef, Zinnat. They can help:

• with inflammation of the lungs;
• with inflammation of the pleura - the outer lining of the lungs;
• with inflammation of the bronchial mucosa.

As for atypical pneumonia, the causative agents of which are chlamydia, mycoplasmas, it is better to resort to the help of a macrolide group of drugs (Hemomycin or Sumamed).

Advantages and disadvantages

Azithromycin, in comparison with its analogues, has the following advantages:

• affordable price (it is more profitable to use Azithromycin - an analogue of Sumamed);
• the half-life is quite long in comparison with other similar means;
• the presence of a small number of adverse reactions that are extremely rare.

The disadvantages include:

• the level of bioavailability of the drug is lower than that of other antibiotics;
• the release form of the drug in the form of a solution for injection and for children does not exist.

The difference between Azithromycin and Sumamed

The most well-known and commonly prescribed substitute for Azithromycin is Sumamed. In fact, the drug Azithromycin is the first analogue of Sumamed. Therefore, their difference is only in cost and name. Moreover, Sumamed has been subject to clinical and laboratory studies. Azithromycin has not been tested because it is not required by the release of substitutes. In fact, the effect of both drugs is the same.

Instructions for use states that Sumamed is prescribed for the treatment of all pathologies of the respiratory tract, urinary tract infections, skin diseases, etc. They also prescribe a medication to eliminate duodenal ulcer and stomach ulcers. Prescribe medicine for women with sexually transmitted diseases.

In this case, the use of an antibiotic is possible for pregnant women. Sumamed is also used to treat childhood diseases (suspension). Adults are prescribed a solid dosage form.

It has the fact that the antibiotic is taken once a day. The therapeutic course does not last long (maximum 5 days).

Difference between Azithromycin and Amoxicillin

The impact of Amoxicillin is aimed at curing inflammation of the mucous membrane of the pharynx, frontal sinus, mucous membrane of the throat. Azithromycin is used to treat inflammation of the paranasal sinuses, ear, pharyngitis. The effectiveness of the two drugs is quite high. Only the attending physician can make a choice between Azithromycin and Amoxicillin in favor of one of them on an individual basis.

Application restrictions

The instructions for use indicate that the main limitation to the use of the drug Azithromycin and its substitutes is the individual intolerance of the active ingredient. Contraindications for use: diseases of the kidneys and liver, heart rhythm disturbances.

It is forbidden to take an antibiotic with the simultaneous use of the following drugs:

• "Digoxin";
• "Warfarin";
• Teldan.

The suspension is prohibited for use by patients under six months of age. Women during the period of bearing a child can use the drug only as directed and under the strict supervision of the attending physician. Women during breastfeeding from the influence of the drug should be abandoned.

Adverse reactions

The drug Azithromycin and its substitutes can adversely affect the body in the form of the following reactions:

• vertigo, sleep disorder, impaired skin sensitivity, diarrhea, excessive accumulation of gases in the intestines, abdominal pain;
• tachycardia, pain in the chest;
• extremely rare: Botkin's disease, disruption of the intestines, discoloration of the tongue, inflammation of the kidneys, hepatic encephalopathy.

In case of overdose, the instructions for use strongly recommend gastric lavage and symptomatic treatment.

parazitycheloveka.ru

1 Macrolides: erythromycin, oleandomycin, azithromycin (sumamed), clarithromycin, roxithromycin (rulid);

2. Tetracyclines: tetracycline, oxytetracycline, metacycline, doxycycline.

3 Levomycetins: chloramphenicol stearate, chloramphenicol succinate, corticomycetin;

4 Antibiotics of different groups: ristomycin, lincomycin, clindamycin, fusidine..

Principles of chemotherapy and rationale for combined antibiotic therapy.

Characteristics of the interaction of antibiotics. Influence of individual factors on the pharmacokinetics of antibiotics (age, pharmacogenetic, etc.).

Make tables indicating the spectrum of antimicrobial activity, clinical efficacy and safety of the use of drugs: erythromycin, azithromycin, rulid, tetracycline, doxycycline, chloramphenicol, lincomycin, clindamycin.

Drug group	Spectrum of antimicrobial activity	Indications for use	Preparations
macrolides	It has a wide spectrum of activity, including both gram-positive (staphylococci producing and not producing penicillinase; streptococci, pneumococci, clostridia, Bacillus anthracis, Corynebacterium diphtheriae), and gram-negative microorganisms (gonococci, hemophilic and pertussis bacilli, brucella, legionella), mycoplasmas, chlamydia , spirochetes, rickettsia. Resistant to erythromycin Gram-negative rods: coli, Pseudomonas aeruginosa, as well as Shigella, Salmonella, etc.		Erythromycin
	In high concentrations, it has a bactericidal effect against gram-positive cocci: Streptococcus pneumoniae, S.pyogenes, S.agalactiae, streptococci of groups C, F and G, S.viridans, Staphylococcus aureus; gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, B.parapertussis, Legionella pneumophila, H.ducrei, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; as well as Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi. Not active against Gram-positive bacteria resistant to erythromycin.		Azithromycin (sumamed)
	Sensitive to the drug: Streptococcii groups A and B, incl. Str. pyogenes, Str. agalactiae, Str. mitis, saunguis, viridans, Streptococcus pneumoniae; Neisseria meningitidis; Branhamellacatarrhalis; Bordetella pertussis; Listeria monocytogenes; Corynebacterium diphtheriae; Clostridium; Mycoplasma pneumoniae; Pasteurella multocida; Ureaplasma urealyticum; Clamydia trachomatis, pneumoniae and psittaci; Legionella pneumophila; Campylobacter; Gardnerella vaginalis. Intermittently sensitive: Naemophilus influenzae; Bacteroides fragilis and Vibrio cholerae. Resistant: Enterobacteriaceae, Pseudomonas, Acinetobacter.		Roxithromycin (rulid)
Tetracyclines	It has a wide spectrum of antimicrobial activity, is active against Escherichia coli, dysentery bacteria, typhoid bacillus and other types of Salmonella, acts on staphylococci, streptococci, gonococci, pneumococci, meningococci, a number of Proteus strains, on some strains of Pseudomonas aeruginosa; active against rickettsia, spirochetes, leptospira, the causative agent of trachoma and other chlamydia. The drug does not affect tubercle bacillus, pathogenic protozoa and fungi. Levomycetin is active against strains of bacteria resistant to penicillin, tetracyclines, sulfonamides. Microorganisms can develop drug resistance to chloramphenicol, but compared to other antibiotics and sulfonamides, resistance to chloramphenicol develops much more slowly. Levomycetin has a bacteriostatic effect on the microbial cell, inhibits its growth and reproduction, disrupting the process of protein synthesis in the microbial cell.		Levomycetin
	Different	On microorganisms that are in the resting phase, lincomycin has little effect. The drug is active against gram-positive cocci (staphylococci, pneumococci, streptococci); haemophilus influenzae; Bacillus anthracis, mycoplasmas, bacteroids, diphtheria bacillus, causative agents of gas gangrene and tetanus. Unlike erythromycin, lincomycin has no effect on enterococci.; inferior to it in activity against spore-forming anaerobes, Neisseria, corynebacteria. Gram-negative microorganisms, fungi, viruses, protozoa are resistant to lincomycin. Lincomycin is active against strains of staphylococci resistant to penicillin, tetracyclines, chloramphenicol, streptomycin, cephalosporins, and therefore lincomycin can be considered as a reserve drug.		Lincomycin
It has a wide spectrum of action, bacteriostatic, inhibits protein synthesis in a microbial cell. In relation to a number of gram-positive cocci, a bactericidal effect is possible. Active against staphylococci (including St. epidermalis, producing penicillinase), streptococci (excluding enterococci), pneumococci, anaerobic and microaerophilic gram-positive cocci (including peptococci and peptostreptococci), diphtheria bacilli, pathogens of gas gangrene and tetanus, mycoplasmas, bacteroids (including Bact.fragilis and Bact.melaningenicus), anaerobic gram-negative bacilli (including Fusobacterium), nomycetes and clostridia, anaerobic gram-positive non-spore forming bacilli (including propionibacterium, eubacterium and actinomycetes). Most strains of Clostridium perfringens are susceptible to clindamycin, however, since other types of Clostridium (Clostridium sporogenes, Clostridium tertium) are resistant to the action of clindamycin, then in infections caused by Clostridium, it is recommended to determine the antibiogram. Cross-resistance exists between clindamycin and lincomycin. It is effective in the treatment of asymptomatic diphtheria carriage (a weekly course of therapy, orally).		Bacterial infections caused by susceptible microorganisms: pneumonia, lung abscess, pleural empyema, fibrosing alveolitis, osteomyelitis, joint infections; purulent infections of the skin and soft tissues (infected wounds, abscesses; acute and chronic osteomyelitis; septicemia (primarily anaerobic); infections of the pelvic organs and intraperitoneal infections (subject to the simultaneous use of drugs active against gram-negative aerobic microbes), gynecological diseases (endometritis, adnexitis); sepsis; endocarditis.	Clindamycin

Characteristics of the safety of the use of drugs

				Contraindications to the appointment
Erythromycin
Azithromycin (sumamed)			liver damage,
Roxithromycin (rulid)
Tetracycline
Doxycycline
Levomycetin
Lincomycin
Clindamycin

be able to choose group and specific drug, its dosage form, dose, route of administration, dosing regimen for the treatment of infectious diseases and write in prescriptions: erythromycin, azithromycin, rulid, tetracycline, doxycycline, levomycetin, lincomycin, ristomycin.

№	Recipe	Indication for the use of the drug
1	Rp.:Erythromycini 0.25 D.t.d. N.20 in tab. S. 2 tablets 4 times a day. within 14 days With legionellosis.	Bacterial infections: diphtheria (including diphtheria carriage), whooping cough (including disease prevention in susceptible individuals at risk of infection), trachoma, brucellosis, legionnaires' disease, scarlet fever, amoebic dysentery, gonorrhea; neonatal conjunctivitis, pneumonia in children and urinary infections in pregnant women caused by Chlamydia trachomatis; primary syphilis (in patients allergic to penicillins), uncomplicated chlamydia in adults (with localization in the lower urinary tract and rectum) with intolerance or ineffectiveness of tetracyclines, etc.; ENT infections (tonsillitis, otitis media, sinusitis), biliary tract infections (cholecystitis), upper and lower respiratory tract infections (tracheitis, bronchitis, pneumonia), skin and soft tissue infections, pustular skin diseases, infected wounds, bedsores, burns II and III stage, trophic ulcers, infections of the mucous membrane of the eyes - caused by pathogens sensitive to the drug; prevention of exacerbations of streptococcal infection (tonsillitis, pharyngitis) in patients with rheumatism, infectious complications during dental interventions in patients with heart defects. It is a reserve antibiotic for the treatment of bacterial infections caused by strains of gram-positive pathogens (in particular staphylococci) resistant to penicillin. In severe forms of infectious diseases, when oral administration of the drug is ineffective or impossible, resort to the / in the introduction of a soluble form of erythromycin - erythromycin phosphate. Erythromycin in suppositories is prescribed in cases where ingestion is difficult.
2	Rp.:Azithromycini 0.25 D.t.d. N.10 in caps. S. On the first day, 1 capsule morning and evening, from 2nd to 5th day 1 capsule 1 time in a day. For infections upper and lower divisions respiratory tract.	Infections of the upper respiratory tract and ENT organs caused by sensitive microflora: tonsillitis, sinusitis, tonsillitis, otitis media; scarlet fever; infections of the lower respiratory tract: bacterial and atypical pneumonia, bronchitis; skin and soft tissue infections: erysipelas, impetigo, secondarily infected dermatoses; infections of the urogenital tract: gonorrheal and non-gonorrheal urethritis and / or cervicitis; Lyme disease (borreliosis).
3	Rp.:Tab. Roxithromycini 0.15 N.20 D.S. 1 tablet 2 times a day day, morning and evening before	Treatment of drug-sensitive infections of the upper and lower respiratory tract, skin and soft tissues, genitourinary tract (including sexually transmitted infections, except gonorrhea), infections in dentistry (bronchitis, pneumonia, tonsillitis, scarlet fever, otitis media, sinusitis, diphtheria, whooping cough, trachoma, brucellosis, legionnaires' disease, etc.). Prevention of meningococcal meningitis in persons who have been in contact with the diseased.
4	Rp.: Tetracyclini hydrochloridi 0.1 S. Dissolve the contents of the vial in 25 ml of 1% novocaine solution and injected intramuscularly 3 times a day day for 5 days.	Bacterial infections: pneumonia, bronchitis, pleural empyema, tonsillitis, cholecystitis, pyelonephritis, intestinal infections, whooping cough, endocarditis, endometritis, prostatitis, syphilis, gonorrhea, whooping cough, brucellosis, rickettsiosis, purulent infections of soft tissues, osteomyelitis, etc., caused by sensitive to preparation by microorganisms. Prevention of postoperative infections.
5	Rp.:Doxycyclini hydrochloridi 0.1 D.t.d. N.30 in caps. S. 1 capsule every 12 hours. For chronic infections urinary system. Within 5 days	Bronchopneumonia, lobar pneumonia, bronchitis, pleural empyema, tonsillitis, cholecystitis, pyelonephritis, endometritis, prostatitis, urethritis, syphilis, gonorrhea, whooping cough, brucellosis, rickettsiosis, purulent soft tissue infections, osteomyelitis, cystitis, eye infections, tonsillitis, otitis media, pharyngitis , tracheitis, purulent skin diseases - furunculosis, abscesses, infected wounds.
6	Rp.:Tab. Laevomycetini 0.5 S. 2 tablets 4 times a day	Treatment of infections caused by microorganisms sensitive to it, including strains of bacteria resistant to other drugs. Typhoid fever and paratyphoid fever, salmonellosis (mainly generalized forms), dysentery, brucellosis, tularemia, gonorrhea, whooping cough, meningococcal infection, typhus and other rickettsiosis, trachoma, chlamydia. The drug is used to treat various forms of purulent infection caused by gram-positive and gram-negative bacteria: urinary tract infections, purulent wound infection, bacterial pneumonia, purulent peritonitis, biliary tract infections, purulent otitis media, conjunctivitis, keratitis, blepharitis, purulent processes of other localizations. Levomycetin is prescribed for moderate and severe forms of infectious diseases, mainly in cases where the use of other chemotherapeutic drugs is ineffective.
7	Rp.:Lincomycini hydrochloridi 0.25 D.t.d. N.20 in caps. gelat. S. 2 capsules 3 times a day through every 8 hours 1 hour before meals	Lincomycin hydrochloride is used for diseases caused by strains of microorganisms resistant to other antibiotics: septicemia, subacute septic endocarditis, acute and exacerbations of chronic pneumonia, pleural empyema, pleurisy, osteomyelitis, postoperative purulent complications, infections of the skin and soft tissues (pyoderma, furunculosis, phlegmon ).
8	Rp.:Ristomycini sulfatis 250 000 ED S. Contents of the vial Immediately before use, dissolve in 125 ml of sterile NaCl solution (based on 0.5 ml of solvent per 2000 ED of antibiotic). Introduce 125 ml 2 times a day only intravenously by drip (child 5 years old). At the end of the infusion, without removing the needle, inject 20 ml of isotonic NaCl solution (to flush the vein and prevent the development of phlebitis). The course is 7 days. With pneumonia.	Septic diseases caused by gram-positive microorganisms, especially staphylococci resistant to other antibiotics: septic endocarditis, staphylococcal, streptococcal and pneumococcal sepsis, hematogenous osteomyelitis, purulent meningitis, and other severe coccal infections that cannot be treated with other antibiotics.

Classroom work

1. Complete test tasks
2. For levomycetin, all of the following complications are characteristic, with the exception of:

A. Blood damage A. Dermatitis B. Acute productive psychosis D. Myocarditis D. Osteoporosis

1. Which of the following is not a macrolide antibiotic?

A. oleandomycin B. erythromycin C. Vancomycin D. Nystatin

1. The safest drugs from the tetracycline group for renal failure:

A. Oxytetracycline B. Doxycycline C. Chlortetracycline

1. The drug of choice for the treatment of infections caused by Brucella is:

A. Tetracycline B. Ampicillin C. Gentamicin D. Sulfonamides

1. Choose a drug for the treatment of mycoplasmal pneumonia:

A. Penicillin B. Tetracycline C. Vancomycin D. Gentamicin

2.1. Specify the binding site of tetracycline

Aminoacyl-tRNA

Aminoacyl

tRNA

mRNA

DNA supercoil

DNA gyrase

Despiralized DNA

Peptidyl -

transferase

Peptide chain formation

Peptide extension

1. 3 . solve problems

Task #1

Patient K., aged 63, has been suffering from diabetes mellitus for 6 years, of moderate severity. Constantly takes maninil, bukarban. In the last 3 months revealed furunculosis. Was admitted to the department with complaints of cough with scanty mucus sputum, fever up to 37.2. On the 2nd day of the disease, a cough appeared, pain in the right half of the chest during breathing. Physical examination revealed physical signs of right-sided lower lobe pneumonia, confirmed by x-ray.

Determine the antibiotic of first choice:

1. Levomycetin 2. Benzylpenicillin 3. Gentamicin 4. Erythromycin 5. Cefazolin

Task #2

The child was admitted to the infectious diseases hospital with a diagnosis of whooping cough. She has a history of hypochromic iron deficiency anemia. The child was injected with benzylpenicillin, which caused skin rashes. Penicillin was cancelled.

Select drugs that can be prescribed to the child:

1. Erythromycin 2. Penicillin 3. Tetracycline 4. Levomycetin

Task #3

A mother with a 2-year-old child consulted a dentist. The child's teeth erupted in time, but the enamel is yellow, the teeth are affected by caries. From the anamnesis, it was established that the mother received an antibiotic during pregnancy for the disease.

What antibiotic did the mother receive?

1. Penicillin 2. Streptomycin 3. Tetracycline 4. Cefazolin 5. Levomycetin

Task #4

A 6-month-old child had an infectious disease (enterocolitis). Received intensive therapy, including antibiotics.

On examination, marked pallor of the skin and mucous membranes, pastosity, large belly, weight loss, hypochromic anemia, reticulocytosis. Complaints about poor sleep, decreased appetite.

What antibiotic did the child receive?

1. Penicillin 2. Streptomycin 3. Tetracycline 4. Cefazolin 5. Levomycetin 6. Lincomycin

Tetracycline, erythromycin, oleandomycin cannot be recommended for the treatment of angina (Yu. I. Leshchenko, 1970; I. I. Bondarenko, 1976), since in the usual doses they do not always create a bacteriostatic concentration even in the blood, and even more so in the tissue of the tonsils.

They can be used to treat angina caused by streptococcus only in cases where the patient does not tolerate penicillin preparations, and it is necessary to increase single doses and the frequency of administration. Thus, the therapeutic concentration of macrofaces in the blood and tissue of the tonsils is created only with repeated administration - at least 4 times a day in a single dose of 6000 μg / kg of erythromycin and 7000 μg / kg of oleandomycin (Yu. I. Lyashchenko, 1970). The concentration of tetracycline in the blood serum of patients with angina is several times lower than in healthy people, and in 2/3 it does not reach -1 μg / ml both in the blood serum and in the tissue of the tonsils (Yu. I. Leshchenko, 1976), therefore, often there is no way to create a bacteriostatic concentration in the breeding grounds of β-hemolytic streptococcus.

In addition, not all strains of β-hemolytic streptococcus (60-80%) are sensitive even to relatively high concentrations (1–3 μg/ml) of tetracycline. In recent years, staphylococcus plays an increasing role in the etiology of angina, especially sporadic, which should not be called in the etiotropic therapy of patients with angina. The tactics of treatment should be as follows: first prescribe antistreptococcal agents (best benzylpenicillin), but if after 1-2 days there is no improvement, antistaphylococcal drugs.

Of these, oxacillin is the most effective - within an hour after administration in a single dose of 0.5 g, a concentration in blood serum of 1.1 - 5.5 μg / ml is created, in mucus from the surface of the tonsils 0.88 - 8.5 μg / ml and in the tissue of the tonsils 0.24 - 0.51 μg / ml, then gradually decreases and after 6 hours is not determined in any of these media. It is important to emphasize that 15-30 minutes after intramuscular injection of the same dose, approximately the same concentrations are created in the blood, mucus and tonsil tissue (respectively 3.5-5.3; 0.86-1.24 and 0.31-0 .44 µg/ml).

Due to the fact that all strains of β-hemolytic streptococcus are sensitive to the concentration of oxacillin 0.01 - 0.4 μg / ml and most staphylococci are also sensitive to it, this drug has an advantage over many other etiotropic drugs (Yu. I. Lyashchenko, 1975).

Metacillin can also be successfully used to treat patients with angina: intramuscularly 0.5 g every 6 hours, which creates a bactericidal concentration in all three media (blood, mucus from the surface of the tonsils, tonsil tissue) and cleans the tonsils from the pathogen. Unfortunately, it is not yet known how long and in what form the causative agents of angina in general and group A streptococcus in particular remain in the lymph nodes regional to the tonsils. When angina is complicated by paratonsillitis, conservative therapy is carried out, and in the case of the formation of a paratopsillar abscess, the latter is opened by a laryngologist.

"Guide to airborne infections", I.K.Musabaev

The eyelids perform a protective function for the eyes. They reduce the likelihood of the eyeball drying out, provide protection from adverse environmental factors, and help the visual muscles and nerves to function. Medical statistics show that about 10% of diseases of the organs of vision occur in the eyelids. In this article, we will consider what diseases of the eyelids exist and how to deal with them.

Types of inflammation of the eyelids

Inflammation of the eyelid is a process that has a different etiology and affects the upper or lower eyelids of one or both eyes.

The main symptoms of eyelid inflammation:

• redness;
• swelling.

Normally, the skin of the eyelids should be pale pink, thin, tender. The slightest change in color, structure of the skin of the eyelids indicates the presence of inflammation.

What could it be?

Edema

Slight swelling of the eyelid may occur as a result of excess water in the body. This case occurs infrequently and is not a disease.

But swelling can also happen for other reasons: inflammation, trauma, or an allergic reaction. In the first case, it is inflammatory in nature and may be accompanied by hyperemia, fever, pain.

If the cause is an allergic reaction, then itching, induration, redness (or blanching) of the skin will appear at the site of the edema.

Edema can also occur against the background of chronic diseases. In this case, it is bilateral in nature and is accompanied by dropsy and swelling of the legs. The skin of the eyelids will be pale, and there may not be a temperature. Another reason may be.

Abscess

When the infection enters the wound surface of the skin of the eyelid, an abscess is obtained, called an abscess. Sometimes this inflammation of the eyelid is a consequence of barley.

Inflammation of the glands and edges of the eyelids

Such diseases include:

• blepharitis;
• herpes;
• barley;
• chalazion.

• weakening of the protective functions of the body;
• chronic infections;
• demodicosis of the eyelids;
• pathology of the gastrointestinal tract;
• sanitary and hygienic conditions of human life;
• vitamin deficiency;
• purulent inflammation of the paranasal sinuses.

Symptoms of eyelid inflammation:

• burning;
• redness;
• lacrimation;
• the appearance of a liquid gluing eyelashes;
• feeling of a foreign body in the eye;
• foamy or purulent discharge.

There are several types of blepharitis: simple, scaly, ulcerative. Each of these forms in a recurrent form is very dangerous for human health.

demodicosis

Demodicosis of the eyelids is a very common and extremely unpleasant disease of the organs of vision. Patients with this disease complain of severe itching, swelling of the eyelids, redness of the eyes, loss of eyelashes.

Scales and crusts may appear on the edges of the eyelids, causing discomfort. Demodicosis affects the mucous membrane of the eye, dries it out, as a result of which the eye muscles quickly get tired. At the first symptoms, you should immediately contact a specialist and. The disease is recurrent.

Conjunctivitis

Treatment Methods

With inflammation of the eyelid, treatment is mainly aimed at eliminating the causes of the development of the process. In most cases, patients receive symptomatic treatment.

Hygiene plays a key role in the treatment of inflammation of the eyelids.

To suppress the inflammatory process, the doctor prescribes topical antibiotics: ointments, drops. With ulcerative, scaly blepharitis, the treatment is more complicated: regular treatment of the affected areas of the eyelid is necessary to eliminate scales and purulent discharge.

Types of ointments

Treatment of inflammation of the eyelid, as a rule, includes the use of ointments. What ointments are most common for the treatment of inflammatory processes in the eyelid?

• Actovegin- a medicinal ointment that helps in the treatment of various skin lesions, including inflammatory processes that have arisen in the area of ​​\u200b\u200bthe eyelids.

Price: about 150 rubles.