Benzylpenicillin - drugs (sodium salt, potassium salt, novocaine salt, benzathine benzylpenicillin, etc.), action, instructions for use (how to dilute, dosage, methods of administration), analogues, reviews, price. Penicillin: Instructions for use

The administration of antibacterial agents intravenously or intramuscularly is used for moderate and severe disease. Parenteral administration allows:

significantly increase the bioavailability of the product used;
accelerate the achievement of maximum therapeutic concentrations in plasma and obtain a visible therapeutic effect much faster;
exclude the effect of digestive system enzymes on the drug;
provide first aid to unconscious patients with uncontrollable vomiting or dysphagia (impaired swallowing);
use drugs that are poorly absorbed or destroyed in the gastrointestinal tract.

Antibiotic injections must be performed in a hospital setting. The attending physician must prescribe medications, as well as calculate the dosage of antibiotic required for administration. Antibiotic dosages are selected individually and depend on the age, weight and severity of the patient’s condition.

To prevent the development of allergic reactions (Quincke's edema, anaphylactic shock), all antibiotics are administered only after a sensitivity test.

Independent choice of the drug and selection of dosages can cause the development of severe side effects.

Before diluting the drug, the nurse should check the labels on the ampoule with the prescription sheet, and also check the expiration date of the ampoule. The packaging with the syringe must be checked for integrity and expiration date. Then a thorough hand hygiene is carried out. After the gloves are put on, they are treated with an alcohol ball.

The package with the syringe must be opened from the piston side. After opening the package, you should connect the needle to the syringe (the protective cap cannot be removed from the needle).

After opening the metal cap on the antibiotic bottle, you should also treat the rubber protective stopper with an alcohol ball.

Next, you need to remove the protective cap from the needle, draw the necessary solvent into the syringe (injection water, isotonic physiological solution). After piercing the rubber stopper with a needle, you need to carefully introduce the liquid into the bottle.

After disconnecting the syringe from the needle (the needle remains in the cap), the bottle must be thoroughly shaken until the antibiotic is completely dissolved.

The dissolved drug must be homogeneous, transparent and free of foreign matter. For some antibiotics, a yellowish tint of the solution is allowed.

After the antibiotic has completely dissolved, you need to connect the syringe back to the needle, turn the bottle over and draw out the required amount of medicine.

After collecting the solution, you need to make sure that there are no air bubbles in it. If necessary, turn the syringe over with the needle up, lightly tap the barrel (so that the bubbles rise up) and release the air bubbles.

How to calculate the dose of an antibiotic

Two dilution methods are used - 1:1 and 2:1.

In pediatric practice, a one-to-one dilution is used, and for adults, a two-to-one dilution.

To correctly calculate the dose, you must remember that 1,000,000 units of the drug is equal to 1,000 milligrams (1 gram). Accordingly, 0.5 grams = 500,000 units, 0.25 grams = 250,000 units.

When diluting an antibiotic using the one-to-one method, 1 milliliter of solvent is used per 100,000 units of antibiotic. Accordingly, to dilute 250 thousand units of the drug, add 2.5 milliliters, 500 thousand - five milliliters, 1 million units - 10 milliliters of solvent.

Dilution of antibiotics and calculation of the required dose in neonatology is also carried out on a one-to-one basis.

If an antibiotic is diluted at a rate of two to one, then 0.5 milliliters of solvent is used per hundred thousand units of the drug.

Accordingly, for 250 thousand units 1.25 of solvent is taken, for 500 thousand - 2.5 and for 1 million units - 5 milliliters of solvent.

Rules for diluting antibiotics

When using the one-to-one dilution method, it must be taken into account that each milliliter of the resulting solution will contain 100 thousand units or 100 milligrams of the drug. Accordingly, every 0.1 milliliter of solution contains 1000 units or ten milligrams of the drug.

The antibiotic solution must be prepared immediately before administration.
Calculation example:

The most popular antibiotic is penicillin (benzylpenicillin sodium or potassium salt). It is available in bottles of 250,000, 500,000, 1,000,000 units. Dosed in action units.

It is better to dissolve penicillin in 0.25% or 0.5% novocaine solution, since it is better retained in the body. In case of individual intolerance to novocaine, use saline solution or water for injection.

There is a rule: 1 ML of solution SHOULD CONTAIN 100,000 units. PENICILLIN

Thus, if the bottle contains 1,000,000 units, then you need to take 10 ml of novocaine.

Note. Antibiotics are released in ED (units of action), grams, milligrams and percentages.

1 g = 1,000,000 units

1. Take a bottle, check the name of the antibiotic, dose, expiration date of the drug, and integrity of the bottle.

2. Wash and disinfect your hands, put on sterile rubber gloves.

3. Add solvent to the bottle. To dilute antibiotics, dilutions of 1:1, 1:2, 1:4 are used.

Dilution 1:1

a) Add such a quantity of solvent into the bottle with the antibiotic that 1 ml of the solvent contains 100,000 units of antibiotic (or 100 mg of antibiotic).

For example:

– if the bottle contains 0.5 g, which is 500,000 units, to get 100,000 units in 1 ml, you need to take 5 ml of solvent;

If 1 g (1,000,000 units) – 10 ml of solvent;

If 0.25 g (250,000 units) - 2.5 ml of solvent.

b) When diluted 1:1, all prescribed doses of antibiotics must be divided by 100,000.

For example:

Antibiotic dose 150,000 units - after dilution, draw 1.5 ml into a syringe;

The antibiotic dose is 80,000 units - after dilution, draw 0.8 ml into the syringe.

Dilution 1:2

a) Introduce such a quantity of solvent into the bottle with the antibiotic that 1 ml of solution contains 200,000 units of antibiotic (or 200 mg of antibiotic).

For example:

5 ml of solvent must be added to a bottle with 1,000,000 units of antibiotic;

2.5 ml of solvent must be added to a bottle with 500,000 units of antibiotic;

1.25 ml of solvent must be added to a bottle with 250,000 units of antibiotic.

b) At a dilution of 1:2, all prescribed doses of antibiotics must be divided by 200,000.

For example:

Antibiotic dose 200,000 units - after dilution, draw 1 ml into a syringe;

The antibiotic dose is 350,000 units - after dilution, draw 1.75 ml into the syringe.

Dilution 1:4 (rarely used in pediatric practice)

a) Add such a quantity of solvent into the bottle with the antibiotic that 1 ml of solution contains 400,000 units of antibiotic (or 400 mg of antibiotic).

For example:

2.5 ml of solvent must be added to a bottle with 1,000,000 units of antibiotic.

b) At a dilution of 1:4, all prescribed doses of antibiotics must be divided by 400,000.

For example:

Antibiotic dose 400,000 units - after dilution, draw 1 ml into a syringe;

The antibiotic dose is 600,000 units - after dilution, draw 1.5 ml into a syringe.

4. Indicate on the bottle the date, time of dilution, dose of antibiotic in 1 ml, and sign.

Note. Store the diluted antibiotic in the refrigerator for 24 hours!

5. Test for penicillin. To test for penicillin, draw 0.1 ml of diluted antibiotic into a syringe and add 0.9 ml of isotonic sodium chloride solution or water for injection. Carry out the test using the scarification method.

Benzylpenicillin - drugs (sodium salt, potassium salt, novocaine salt, benzathine benzylpenicillin, etc.), action, instructions for use (how to dilute, dosage, methods of administration), analogues, reviews, price

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Benzylpenicillin is an antibiotic of the group penicillins, intended for injection. The drug is used to treat various infections caused by bacteria sensitive to its action, such as, for example, pneumonia, bronchitis and other severe infectious diseases of the ENT organs and respiratory tract, meningitis, syphilis, endocarditis, purulent infections, etc.

Varieties, names, composition, release forms and general characteristics

Benzylpenicillin is one of the oldest antibiotics penicillin group and, despite the long period of its use, has a wide spectrum of action, killing a large number of varieties of pathogenic bacteria. For example, Benzylpenicillin is effective against the pathogens of anthrax, syphilis, meningococci, gas gangrene, as well as many staphylococci and streptococci.

Since benzylpenicillin is practically not absorbed in the digestive tract, it is administered exclusively by injection. Most often, drug solutions are administered intramuscularly or intravenously. However, in addition to this, it is possible to administer benzylpenicillin into the spinal canal (for meningitis), under the skin or directly into the wound area.

Benzylpenicillin is an antibiotic that contains the active substance of the same name. However, in medicines benzylpenicillin is not contained in its pure form, but in the form of salts. Benzylpenicillin salts are stable and can be stored, unlike the pure active substance, which disintegrates quickly. In the body, benzylpenicillin is released from salts and has a detrimental effect on bacteria.

Depending on the form of which salt benzylpenicillin is in a particular drug, varieties of benzylpenicillin are distinguished. In principle, all types of benzylpenicillin are the same in their spectrum of action, but differ in the duration of the effect and methods of administration. Therefore, for various diseases, it is recommended to select the type of drug that optimally suits the requirements of therapy.

The following types of benzylpenicillin are currently available:

Benzylpenicillin sodium salt (trade names of drugs - “Benzylpenicillin sodium salt”, “Novocin”, Penicillin G);
Benzylpenicillin potassium salt (trade name of the drugs is “Benzylpenicillin potassium salt”);
Benzylpenicillin novocaine salt (trade name of the drugs is “Benzylpenicillin novocaine salt”);
Benzylpenicillin procaine salt (trade name of the drugs is “Procaine Penicillin”);
Benzathine benzylpenicillin (trade names of drugs - “Retarpen”, Extensillin, Bicillin-1, Benzathine benzylpenicillin, Moldamine);
Bicillin-5 (a mixture of benzathine and procaine salt of benzylpenicillin).

All of these varieties of benzylpenicillin contain benzylpenicillin as the active substance in the form of various salts. The dosage of any type of drug is indicated in IU (international unit) or ED - units of action of pure benzylpenicillin. Since the dosage for all types of the drug is universal, they can be easily compared with each other and, if necessary, replace one with another.

All varieties of benzylpenicillin are available in a single dosage form - powder for the preparation of solution for injection. The powder is placed in glass bottles, sealed with rubber caps, covered with dense aluminum foil on top. The bottles in which the antibiotic powder is packaged are commonly called “penicillin”.

Benzylpenicillin - drugs

Currently, the following drugs are available on the pharmaceutical market of the CIS countries, containing benzylpenicillin salts as an active component:

Benzylpenicillin potassium salt;
Benzylpenicillin sodium salt;
Benzylpenicillin novocaine salt;
Benzathinebenzylpenicillin;
Bicillin-1 (benzathine benzylpenicillin);
Bicillin-3 (a mixture of benzathine, sodium and procaine salts of benzylpenicillin);
Bicillin-5 (a mixture of benzathine and procaine salt of benzylpenicillin);
Moldamine (benzathine benzylpenicillin);
Novocin (benzylpenicillin sodium salt);
Penicillin G (benzylpenicillin sodium salt);
Procaine Penicillin (benzylpenicillin procaine salt);
Retarpen (benzathine benzylpenicillin);
Extensillin (benzathine benzylpenicillin).

Action

Benzylpenicillin has a detrimental effect on a wide range of bacteria that are causative agents of infectious and inflammatory diseases of various organs and systems. Benzylpenicillin disrupts the process of bacterial cell wall synthesis, resulting in their death. However, the effect on the synthesis of cell wall components leads to the fact that the drug destroys only bacteria that are in the process of reproduction. And therefore, to completely destroy the entire pool of microbes that have entered the body, penicillin drugs must be used for at least 5 days so that all bacteria enter the reproduction stage.

Benzylpenicillin penetrates all organs and tissues, and therefore can be used to treat infectious diseases of various localizations if they are caused by bacteria sensitive to its action.

All varieties of benzylpenicillin have a detrimental effect on the following types of pathogenic microorganisms:

Gonococci (Neisseria gonorrheae);
Meningococci (Neisseria meningitidis);
Staphylococci that do not produce penicillinase;
Streptococci of groups A, B, C, G, L and M;
Enterococci;
Alcaligenes faecalis;
Actinomycetes;
Bacillus anthracis;
Clostridiae;
Corynebacterium diphtheriae;
Erysipelothrix insidosa;
Fusobacterium fusiforme;
Leptospirae;
Pasteurella multocida;
Spirilllim minus;
Spirochaetaceae (causative agents of syphilis, yaws, Lyme borreliosis, etc.);
Streptobacillus moniliformis;
Treponema pallidum.

Indications for use

Sodium, potassium, novocaine and procaine salts of benzylpenicillin

Sodium, potassium, novocaine and procaine salts of benzylpenicillin are indicated for use in the treatment of the following infectious and inflammatory diseases of various organs and systems:

Infectious diseases of the respiratory system (pneumonia, pleurisy, pleural empyema, bronchitis, etc.);
Infectious diseases of the ENT organs (tonsillitis, scarlet fever, otitis media, sinusitis, laryngitis, sinusitis, etc.);
Infections of the genitourinary tract (gonorrhea, syphilis, cystitis, urethritis, adnexitis, salpingitis);
Purulent infections of the eye, mucous membranes, skin and bones (for example, blenorrhea, blepharitis, dacryocystitis, mediastinitis, osteomyelitis, cellulitis, erysipelas, wound infection, gas gangrene, etc.);
Purulent meningitis or brain abscess;
Sepsis or septicemia;
Treatment of diseases caused by spirochetes, such as syphilis, yaws, pinta, anthrax, etc.;
Treatment of fever caused by rat bites;
Treatment of infections caused by clostridia, listeria and pasteurella;
Prevention and treatment of diphtheria;
Prevention and treatment of complications of streptococcal infections, such as rheumatism, endocarditis and glomerulonephritis.

Preparations containing benzylpenicillin benzathine

Preparations containing benzylpenicillin benzathine are indicated for use in the treatment of the following infectious diseases of various organs and systems:

Long-term prevention of relapses of rheumatism;
Syphilis;
Yaws;
Infections caused by group B streptococci, such as tonsillitis, scarlet fever, wound infections, erysipelas;
Prevention of postoperative infections.

In general, the main difference between benzathine benzylpenicillin preparations and other salts of this substance is that they are optimal for long-term therapy, since they have a long-lasting effect and are therefore recommended for the treatment of chronic diseases. All other benzylpenicillin salts (potassium, sodium, novocaine and procaine) have a short duration of action and are therefore optimal for the treatment of acute infections.

Instructions for use

Rules for choosing benzylpenicillin salt

Novocaine, procaine, potassium and sodium salts of benzylpenicillin are optimal for the treatment of acute infections of any location. Therefore, in the presence of an acute infectious-inflammatory process, any specified benzylpenicillin salt should be chosen. However, it must be remembered that Novocaine and Procaine have a powerful allergenic effect, so people prone to allergic reactions should avoid using novocaine and procaine salts of benzylpenicillin.

Benzylpenicillin benzathine is optimal for the treatment of chronic infections and the prevention of various infectious complications. Therefore, preparations containing this salt should be used for long-term therapy of various chronic diseases.

When using benzylpenicillin in high dosages (above 20,000,000 units per day) for more than five days, it is necessary to monitor the concentration of blood electrolytes (potassium, calcium, sodium, chlorine), liver function (AST, ALT, alkaline phosphatase, bilirubin, etc.) and blood picture (complete blood count with leukocyte formula).

People using benzylpenicillin may have a false positive urine test for sugar.

In people suffering from diabetes, the absorption of the antibiotic into the blood from the muscle is slower, so the effect of the drug in them begins more slowly.

Since the use of benzylpenicillin can lead to the development of a fungal infection, it is recommended to take it prophylactically during antibiotic treatment

Penicillin- a legendary drug. It began the era of antibiotics, which saved millions of human lives. This remedy is still used in the treatment of certain infections. Today it is fashionable to criticize antibiotics, attributing to them all conceivable and inconceivable shortcomings. But with the advent of penicillin, the world changed forever and certainly became a better place.

Who discovered Penicillin?

At the beginning of the 20th century, a means to combat infections became a necessity. The population grew, especially in industrial cities. And with such crowding, any infection threatened a large-scale epidemic.

Scientists already knew a lot about bacteria, the causative agents of the most common and dangerous diseases were isolated and studied, and some drugs were used. But there was no truly effective medicine.

At the end of the 20s of the last century (1881 - 1955), he actively studied pathogenic microorganisms, including staphylococci - the cause of many diseases.

History of discovery

The literature, including fiction, colorfully describes that the Scottish scientist was careless and did not deactivate the bacterial cultures immediately after working with them. And one day he noticed that the growing mold had dissolved the colonies in one of the Petri dishes.

You need to understand that this was not ordinary mold, but brought from a neighboring laboratory. It turned out that it belongs to the genus Penicillium (penicillum). There were doubts about its variety, but experts determined that it was penicillium notatum.

Fleming began growing this fungus in bottles of nutrient broth and conducting tests. It turned out that even with strong dilution, this antiseptic is able to suppress the growth and reproduction of not only staphylococcus, but also other pathogenic cocci (gonococcus, pneumococcus), and diphtheria bacillus. At the same time, cholera virions, typhus and paratyphoid pathogens did not respond to the action of penicillium notatum.

But the main questions were how to isolate a pure substance that destroys bacteria, how to maintain its activity for a long time? - There was no answer to them. Fleming tried to use the broth topically - for treating purulent wounds, for instillation into the eyes and nose (for rhinitis). But massive research has reached a dead end.

In the 40s, attempts to isolate pure penicillin were continued by the so-called Oxford group of microbiologists. Howard Walter Florey and Ernest Chain obtained a powder that could be diluted and injected.

Research was spurred by the Second World War. In 1941, the Americans joined the research and invented a more effective technology for producing penicillin. This medicine was necessary at the fronts, where any wound and even just abrasion threatened blood poisoning and death.

The Soviet government asked the Allies to provide a new medicine, but received no response. Then the Institute of Experimental Medicine, headed by Z. V. Ermolyeva. Several dozen variants of the Penicillium fungus were studied and the most active one was isolated - Penicillium crustosum. In 1943, domestic “penicillin-crustosin” began to be produced on an industrial scale.

This drug turned out to be more effective than the American one. Flory himself visited Moscow to verify this. He, too, wanted to get the original culture of our antibiotic. He was not refused, but was given Penicillium notatum, already known in the West.

Modern concept of antibiotics

Antimicrobial drugs today are divided into many groups. According to the production method they are divided into:

Biosynthetic - natural - they are isolated from cultures of microorganisms;
Semi-synthetic - they are obtained by chemical modification of substances secreted by microorganisms.

The classification by chemical composition is widely used:

β-lactams - penicillin, cephalosporin, etc.;
Macrolides - erythromycin, etc.;
Tetracyclines and so on.

Antibiotics are also divided according to their spectrum of action: broad spectrum, narrow spectrum. By predominant effect:

bacteriostatic - stop bacterial division;
bactericidal - destroy adult forms of bacteria.

Modern penicillin and natural antibiotics

Today the ancestor of all antibiotics is called benzylpenicillin. This is a β-lactam natural bactericidal drug. In its pure form it does not have a wide spectrum of action. Some types of gram-negative bacteria, anaerobes, spirochetes and some other pathogens are sensitive to it.

Most of the “claims” that people now like to make about all antibiotics can be attributed to natural penicillins:

They often cause allergies - immediate and delayed reactions. Moreover, this applies to any products that contain penicillin, including cosmetics and food products.
The toxic effect of penicillins on the nervous system, mucous membranes (inflammation occurs), and kidneys has also been described.
When some microorganisms are suppressed, others can multiply enormously. This is how superinfections arise - for example,.
This medicine must be administered in injections - it is destroyed in the stomach. In addition, the drug is eliminated quickly, requiring frequent injections.
Many strains of microorganisms have or are developing resistance to its action. People who misuse the antibiotic are often to blame.

But it is important to understand that such (and a wider) list of undesirable effects of penicillins appeared thanks to their excellent study. All these disadvantages do not make this drug “poisonous” and do not cover up the obvious benefits that it still brings to patients.

Suffice it to say that all international medical organizations have recognized the possibility of treating pregnant women with penicillin.

To expand the spectrum of action of a natural antibiotic, it is combined with substances that destroy bacterial defenses - β-lactamase inhibitors (sulbactam, clavulonic acid, etc.). Long-acting forms have also been developed.

Modern semi-synthetic modifications help overcome the disadvantages of natural penicillin.

Antibiotics of the penicillin group

Natural penicillins:

benzylpenicillin (penicillin G);
phenoxymethylpenicillin (penicillin V);
benzathine benzylpenicillin;
benzylpenicillin procaine;
benzathine phenoxymethylpenicillin.

Semi-synthetic penicillins:

Extended spectrum of action -

Against Pseudomonas aeruginosa -

Ticarcillin;
Azlocillin;
Piperacillin;

Against staphylococcus -

Oxacillin;

Combined with beta-lactamase inhibitors -

Ampicillin/sulbactam.

How to dilute penicillin

Whenever an antibiotic is prescribed, the doctor must indicate the exact dose and dilution ratio. Trying to “guess” them on your own will lead to dire consequences.

The dilution standard for penicillin is 100,000 units per 1 ml of solvent (this can be sterile water for injection or saline). Different solvents are recommended for different drugs.

For the procedure you will need 2 syringes (or 2 needles) - for dilution and for injection.

Following the rules of asepsis and antiseptics, open the ampoule with the solvent and draw the required amount of liquid.
Puncture the rubber cap of the bottle with penicillin powder with a needle at a 90-degree angle. The tip of the needle should appear no more than 2 mm from the inside of the cap. Add the solvent (required amount) into the bottle. Disconnect the syringe from the needle.
Shake the bottle until the powder is completely dissolved. Place the syringe on the needle. Turn the bottle upside down and draw the required dose of medication into the syringe. Remove the bottle from the needle.
Change the needle to a new one - sterile, closed with a cap. Give an injection.

It is necessary to prepare the drug immediately before the injection - the activity of penicillin in the solution decreases sharply.

Inject sodium salt only endolumbarally. For injection under the skin or into muscles, make the solution with 1% novocaine.

Use benzylpenicillin novocaine salt in the form of a suspension, prepare it with isotonic sodium chloride solution or sterile water for injection. Administer the drug once a day, only intramuscularly.

A suspension of novocaine salt of benzylpenicillin with aqueous soluble ecmoline is also administered intramuscularly once a day. It comes in 2 bottles, which must be mixed according to the instructions and stored at room temperature.

A long-acting drug is bicillin 1, it is injected for diseases caused by pathogens sensitive to penicillin. Prepare the suspension with isotonic solution.

ED - 1 ml of solvent

Solvents for antibiotics:

0.25% and 0.5% novocaine

Water for injections

Dose ratio a/b in g. and ED:

In a bottle of penicillin units.

We know that for a standard a/b dilution, you need to take 1 ml of solvent for every unit, so for this bottle we will need: UNIT: UNIT = 10 ml of solvent.

In a bottle of penicillin.

U:U = 5 ml of solvent.

In a bottle of penicillin.

For this bottle we need a solvent:

U:U = 2.5 ml of solvent.

The patient must be given a unit of penicillin. There are 0.25 g bottles in the treatment room. How many bottles should I take? How many ml.

Synonyms: Baclofen, Lioresal, Penbak, Penglob.

Pharmachologic effect. Semi-synthetic antibiotic from the penicillin group for oral administration. It has a bacteriolytic (bacteria-destroying) effect. Has a wide spectrum of action, including gram-positive (streptococci, pneumococci, staphylococci that do not produce penicillinase -

an enzyme that destroys penicillins) and gram-negative microorganisms (enterococci, gonococci, Escherichia coli and Haemophilus influenzae, as well as Branhamella catarralis, Proteus mirabilis, Shigella species). Acid-resistant, does not break down in the intestines.

Indications for use. Bacterial infections: bronchitis (inflammation of the bronchi), pneumonia (inflammation of the lungs), dysentery, salmonellosis, colienteritis (inflammation of the small intestine caused by E. coli), pyelonephritis (inflammation of the kidney tissue and renal pelvis), purulent infections of the skin and soft tissues.

Purpose: parenteral administration of drugs.

Indications: doctor's prescription.

Contraindications: expired medicinal product, violation of the sterility of the bottle.

Equipment: bottle of medicines, syringe with needle; 70% alcohol, cotton balls, scissors.

Rules for diluting antibiotics:

Solvents: 0.25% or 0.5% novocaine solution, 0.9% sodium chloride solution, sterile water for injection.

The most popular antibiotic is penicillin (benzylpenicillin sodium or potassium salt). It is available in bottles, units. Dosed in action units.

1 ml of solution should contain a unit of penicillin

Thus, if the bottle contains ED, then you need to take 5 ml of novocaine.

Algorithm of actions of the nurse:

1. Read the name on the bottle.

Intramuscular administration of penicillin, especially in massive doses and for a long time, can lead to aseptic infiltrates at the injection site. Aseptic infiltrates occur as a result of hemorrhages at the injection site and compression of the vessels feeding the tissue. In the latter cases, tissue necrosis develops. More often, necrosis is observed in infants and when the depth of needle insertion is insufficient (when solutions enter the subcutaneous fatty tissue). Therefore, injections should be done slowly. The occurrence of infiltrates is usually not a contraindication for further injections, but it requires appropriate measures to be taken. Thermal procedures promote the resorption of infiltrates: paraffin and ozokerite applications and UHF. The use of compresses is undesirable, as they lead to maceration of the skin in the injection area. Less commonly, septic abscesses occur at injection sites of penicillin or other antibiotics, caused by resistant staphylococci that fall on the needle.

Most often, antibiotics are administered intramuscularly. Antibiotics for injection are produced in the form of crystalline powder in special bottles. Before use, it is dissolved in a sterile isotonic solution of sodium chloride (saline solution 0.9% sodium chloride), water for injection or 0.5% novocaine solution.

Let's look at the rules for diluting antibiotics.

The most popular antibiotic is penicillin (benzylpenicillin sodium or potassium salt). It is available in bottles, units. Dosed in action units.

Cefotaxime is used to treat pneumonia, meningitis, blood poisoning, endocarditis, infections of the genitourinary system, bones and joints. The use of this antibiotic in patients with immunodeficiency is also effective.

Dosage and dilution of cefotaxime

Before diluting cefotaxime, its dose is calculated, it depends.

Penicillin: history of creation and modernity

Penicillin is a legendary drug. It began the era of antibiotics, which saved millions of human lives. This remedy is still used in the treatment of certain infections. Today it is fashionable to criticize antibiotics, attributing to them all conceivable and inconceivable shortcomings. But with the advent of penicillin, the world changed forever and certainly became a better place.

Who discovered Penicillin?

At the end of the 20s of the last century, Alexander Fleming (1881 - 1955) actively studied pathogenic microorganisms, including staphylococci - the cause of many diseases.

History of discovery

Fleming began growing this fungus in bottles of nutrient broth and conducting tests. It turned out that even with strong dilution, this antiseptic is able to suppress the growth and reproduction of not only staphylococcus, but also other pathogenic cocci (gonococcus, pneumococcus), and diphtheria bacillus. At the same time, E. coli, cholera virions, typhus and paratyphoid pathogens did not respond to the action of penicillium notatum.

But the main questions were how to isolate a pure substance that destroys bacteria, how to maintain its activity for a long time? - There was no answer to them. Fleming tried to use the broth topically - for treating purulent wounds, for instillation into the eyes and nose (for conjunctivitis, rhinitis). But massive research has reached a dead end.

The Soviet government asked the Allies to provide a new medicine, but received no response. Then the Institute of Experimental Medicine, headed by Z. V. Ermolyeva, began its own work. Several dozen variants of the Penicillium fungus were studied and the most active one, Penicillium crustosum, was isolated. In 1943, domestic “penicillin-crustosin” began to be produced on an industrial scale.

Modern concept of antibiotics

Antimicrobial drugs today are divided into many groups. According to the production method they are divided into:

Biosynthetic - natural - they are isolated from microorganism cultures;
Semi-synthetic - they are obtained by chemical modification of substances secreted by microorganisms.

The classification by chemical composition is widely used:

β-lactams - penicillin, cephalosporin, etc.;
Macrolides – erythromycin, etc.;
Tetracyclines and so on.

Antibiotics are also divided according to their spectrum of action: broad spectrum, narrow spectrum. By predominant effect:

bacteriostatic – stop bacterial division;
bactericidal - destroy adult forms of bacteria.

Modern penicillin and natural antibiotics

Today the ancestor of all antibiotics is called benzylpenicillin. This is a β-lactam natural bactericidal drug. In its pure form it does not have a wide spectrum of action. Some types of gram-negative bacteria, anaerobes, spirochetes and some other pathogens are sensitive to it.

Most of the “claims” that people now like to make about all antibiotics can be attributed to natural penicillins:

They often cause allergies - immediate and delayed reactions. Moreover, this applies to any products that contain penicillin, including cosmetics and food products.
The toxic effect of penicillins on the nervous system, mucous membranes (inflammation occurs), and kidneys has also been described.
When some microorganisms are suppressed, others can multiply enormously. This is how superinfections arise - for example, thrush.
This medicine must be administered in injections - it is destroyed in the stomach. In addition, the drug is eliminated quickly, requiring frequent injections.
Many strains of microorganisms have or are developing resistance to its action. People who misuse the antibiotic are often to blame.

Suffice it to say that all international medical organizations have recognized the possibility of treating pregnant women with penicillin.

Modern semi-synthetic modifications help overcome the disadvantages of natural penicillin.

Antibiotics of the penicillin group

benzylpenicillin (penicillin G);
phenoxymethylpenicillin (penicillin V);
benzathine benzylpenicillin;
benzylpenicillin procaine;
benzathine phenoxymethylpenicillin.

Extended spectrum of action -

Against Pseudomonas aeruginosa -

Combined with beta-lactamase inhibitors –

How to dilute penicillin

Whenever an antibiotic is prescribed, the doctor must indicate the exact dose and dilution ratio. Trying to “guess” them on your own will lead to dire consequences.

The dilution standard for penicillin is ED per 1 ml of solvent (this can be sterile water for injection or saline). Different solvents are recommended for different drugs.

For the procedure you will need 2 syringes (or 2 needles) - for dilution and for injection.

Following the rules of asepsis and antiseptics, open the ampoule with the solvent and draw the required amount of liquid.
Puncture the rubber cap of the bottle with penicillin powder with a needle at a 90-degree angle. The tip of the needle should appear no more than 2 mm from the inside of the cap. Add the solvent (required amount) into the bottle. Disconnect the syringe from the needle.
Shake the bottle until the powder is completely dissolved. Place the syringe on the needle. Turn the bottle upside down and draw the required dose of medication into the syringe. Remove the bottle from the needle.
Change the needle to a new one - sterile, closed with a cap. Give an injection.

It is necessary to prepare the drug immediately before the injection - the activity of penicillin in the solution decreases sharply.

How to dilute penicillin correctly

Typically, penicillin antibiotics are produced in powder form, packaged in special bottles and supplied to pharmacies and medical institutions in this form. As a rule, any solution prepared from these powders is subject to rapid decomposition, so it is usually recommended to dilute penicillin immediately before using it. At the same time, it is not allowed to dilute penicillin with other drugs, except for the liquid in which its powder was mixed. The rule is relevant even when such drugs are used together in complex therapy.

Before asking a patient to dilute penicillin for appropriate injections, the doctor will most likely weigh the possible risks, the hypothetical harm of using this particular antibiotic and the benefits that it can bring. If the former are outweighed, another antibiotic will almost certainly be prescribed. In the event that such injections are recognized as the best option, penicillin for their implementation can be diluted in novocaine, the so-called. injection water and saline solution (water with sodium chloride). Each of them has its own dosage prescribed.

If it is intended to dilute penicillin with novocaine, it is permissible to use a 0.25-, 0.5- or 1% solution of the latter, depending on medical prescriptions. For one-time mixing, thousand are taken. units of the antibiotic itself. The dosage in each case is prescribed strictly individually, based on the age of the sick person and the nature of the course of the disease. Don’t worry if you dilute penicillin with novocaine and the resulting solution becomes slightly cloudy. Such a reaction in this case is considered normal.

As for the volume of novocaine in which penicillin should be diluted, these drugs are usually combined at the rate of 5-10 thousand units of the latter per milliliter of the former. By the way, approximately the same proportion is observed when it is prescribed to dilute penicillin with other substances: sterile injection water or saline solution. In this case, you should definitely adhere to a certain daily dosage of the drug. For adults, its maximum is 500 thousand-2 million units, based on the characteristics of the disease, for children - no more than 60 thousand units. for every kilogram of body weight.

For some ailments: inflammation of the brain or spinal cord, etc., endolumbar (into the spine) injections are required. In this case, it is also recommended to dilute penicillin with cerebrospinal fluid - the spinal cord fluid of the patient himself. For 3-4 ml of a regular penicillin solution, a similar volume of cerebrospinal fluid is taken, and thus an injection is given, strictly according to medical instructions and only by medical personnel. Penicillin is also diluted to create eye drops. Then fill the bottle with penicillin completely, but without the top, with saline solution or injection water and stir well.

Talk to the master and ask him how and with what needles he works. Ask for a portfolio; a good specialist is always happy to show it to clients. If the explanations are too vague or the master offers to do the piercing with a special gun, it is better to refuse his services and continue the search.

Alexander Fleming

It was this Scottish scientist who discovered penicillin. Born August 6, 1881. After leaving school he graduated from the Royal College of Surgeons, after which he remained to work there. After England entered the First World War, he became captain of the Royal Army military hospital. After the war, he worked on isolating pathogens of infectious diseases, as well as on methods of combating them.

History of the discovery of penicillin

Fleming's worst enemy in his laboratory was mold. A common gray-green mold that affects walls and corners of poorly ventilated and damp rooms. More than once, Fleming lifted the lid of a Petri dish and then noticed with annoyance that the streptococcal cultures he was growing were covered with a layer of mold. As soon as the bowl with the biomaterial was left in the laboratory for a few hours, the nutrient layer on which the bacteria grew immediately became covered with mold. As soon as the scientist did not fight with her, everything was in vain. But one day, on one of the moldy bowls, he noticed a strange phenomenon. A small bald patch has formed around the colony of bacteria. He was under the impression that bacteria simply could not multiply in moldy areas. The antibacterial effect of mold has been known since ancient times. The first mention of the use of mold to treat purulent diseases was mentioned in the writings of Avicenna.

Discovery of penicillin

Having saved the “strange” mold, Fleming grew an entire colony from it. His research showed that streptococci and staphylococci were unable to develop in the presence of this mold. Having previously carried out various experiments, Fleming concluded that under the influence of some bacteria others die. He called this phenomenon antibiosis. He had no doubt that in the case of mold, he had encountered the phenomenon of antibiosis with his own eyes. After careful research, he was finally able to isolate an antimicrobial drug from the mold. Fleming named the substance penicillin after the Latin name of the type of mold from which he isolated it. Thus, in 1929, in the dark laboratory of St. Mary's Hospital, the well-known penicillin was born. In 1945, Alexander Fleming, as well as the scientists who established the industrial production of penicillin, Howard Frey and Ernest Chain, were awarded the Nobel Prize.

Industrial production of the drug

Fleming's attempts to establish industrial production of penicillin were in vain. Only in 1939, two Oxford scientists, Howard Frey and Ernest Chain, after several years of work, were able to achieve noticeable success. They obtained a few grams of crystalline penicillin, after which they began the first tests. The first person whose life was saved by administering penicillin was a 15-year-old boy suffering from blood poisoning.

Rules for diluting antibiotics

The most popular antibiotic is PENICILLIN (benzylpenicillin sodium or potassium salt). It is available in bottles of ED. Dosed in action units.

It is better to dissolve penicillin in a 0.25% or 0.5% solution of novocaine, because it is better retained in the body. In case of individual intolerance to novocaine, use saline solution or water for injection.

There is a rule: For 100 thousand units (0.1 g) of penicillin (benzylpenicillin sodium salt), take 1 ml of solvent.

Thus, if the bottle contains ED, then you need to take 10 ml of novocaine.

The penicillin solution cannot be heated, because under the influence of high temperature it is destroyed. Penicillin can be stored in diluted form for no more than a day. Penicillin should be kept in a cool and dark place. Iodine also destroys penicillin, so iodine tinctures are not used to treat the rubber stopper of the bottle and the skin at the puncture site.

Penicillin is administered 4-6 times a day every 4 hours. If the contents of the bottle are intended for one patient, penicillin is diluted randomly with 2-3 ml of novocaine or water for injection (if there is an allergy).

STREPTOMYCIN can be dosed both in grams and in units (units of action). Bottles of streptomycin are available in 1.0 g, 0.5 g, 0.25 g. Therefore, in order to dilute it correctly, you need to know TWO RULES:

1.0 gr. corresponds to ED.

A unit of streptomycin is diluted with 1 ml of 0.5% novocaine

IU - 2 ml 0.5% novocaine

IU - 4 ml 0.5% novocaine _

BICILLIN is an antibiotic of prolonged (extended) action. Bicilin - 1, Bicilin - 3, Bicilin - 5. It is produced in bottles of ED, ED, ED, ED.

The solvent used is isotonic sodium chloride solution, water for injection. It is necessary to REMEMBER that ED take 2.5 ml of diluent

Rules for performing bicillin injections:

1. The injection is performed as quickly as possible, because the suspension crystallizes. The injection needle should have a wide bore. Air from the syringe should only be released through the needle cone.

2. The patient must be fully prepared for the injection. We dilute carefully in the presence of the patient. When diluting the suspension, there should be no foaming.

3. The suspension is quickly drawn into the syringe.

4. The drug is administered only IM, deep into the muscle , it is better to use the 2-step method in the thigh: before insertion, after puncturing the skin, pull the plunger towards you and make sure that there is no blood in the syringe. Add the suspension.

Penicillin: how to dilute correctly?

In modern times, penicillin is widely used in the fight against various diseases, including purulent ones. This drug is obtained from an extract of mold fungi, and its effectiveness has already been proven.

Penicillin is an antibiotic, that is, a broad-spectrum antiviral and antimicrobial agent. It is produced in powder form. This begs the question, if the powder on sale is penicillin, how to dilute such a drug. In diluted form, penicillin does not participate in cell breakdown processes and is not adsorbed in the liver. It is these properties that distinguish it from many other medications. Therefore, penicillin is the most effective remedy that is not harmful to health.

This medicine is widely used for purulent inflammation, conjunctivitis, and infections. Few people know how to make penicillin. Penicillin is mainly used intramuscularly. Of course, we can take it orally in a diluted form, but only under the supervision of a doctor. Penicillin is diluted immediately before use. Depending on the severity and nature of the inflammatory process, the dosage of the drug dilution may vary. For example, for each disease, penicillin, how to inject and in what dosage is prescribed by the doctor, and you must follow his recommendations when using this drug. Penicillin is always diluted with saline solution (sodium chloride) and novocaine. When administering the drug drip, penicillin is diluted with glucose.

If it is necessary to use penicillin intramuscularly, it is necessary to clearly take into account the possible harm to health and its fundamental benefits. Therefore, before you get penicillin at the pharmacy, you should read the instructions. The standard penicillin dilution scheme looks like this: 1:1/3:1/3. That is, one dose of penicillin, one third of the dosage of antibiotic, sodium chloride and one third of novocaine. Changes in the dosage of the drug can only be adjusted by a doctor.

Each person was directly exposed to penicillin at home. What is penicillin, how to get this miracle drug, many would like to know. In principle, penicillin is a mold fungus that everyone has repeatedly encountered when bread and other products spoil, but the use of such penicillin is not safe. It is important to remember that for any disease, you must contact a specialist; you should not self-medicate.