Antibiotics for burns of varying degrees: which ones are needed for a speedy recovery? Cooling of the burn surface.

Antibiotics for burns medications, which are prescribed for the healing of affected areas of the skin. They are aimed at suppressing infection in the wound. The spread of microbes slows down the restoration of the integument of the epidermis and leads to the formation of scars, which later remain unchanged.

Antibiotics are recommended only for 1-2 degree burn injuries. This method of treatment is inappropriate for stages 2-3, as well as with deep lesions, the localization of which exceeds 10-15% on the body.

You can not use drugs on their own, without a doctor's prescription. This can aggravate the situation and cause backfire, scars and scars.

In a hospital, the doctor will determine the stage of thermal damage to the epidermis and will make a comprehensive treatment.

The doctor decides whether to prescribe antibiotics for, referring to the following factors:

age;
chronic diseases (diabetes), infections;
the extent of thermal damage and the area of localization;
sensitivity and the presence of an allergy to a particular drug.

Features of use for burns 2 and 3 degrees

Antibiotics for burns of 2 and 3 degrees are allowed to be used if the affected area is small. For home treatment, it is necessary to observe sterility, to prevent infection.

In everyday life, antibiotics are used for. Unpleasant incidents are common in young children, less often in adolescents.

Treatment should consist of several methods. Damage to the mucous membranes of the body, as well as burns in the groin, genitals, and face are considered dangerous.

Antibiotics help boost the immune system pathogenic microorganisms. If they are not used, then it is possible to get complications in the form of pneumonia, sepsis, lymphadenitis.

For quick healing of wounds, they take external antibacterial ointments and creams, home tinctures, solutions.

Antibiotics for external use

Topical antibiotics (those that pass through the esophagus) antimicrobial action. Here is a list of the most popular drugs:

Ointments containing silver sulfadiazine. These include drugs such as Sulfadiazine, Silvederm, Dermazin.
Yodopirone and Yodovidone. They have a strengthening effect on the immune system, most often such solutions are prescribed with a 1% concentration. Apply after processing sunburn antiseptics such as Furacilin, Miramistin and Chlorhexidine.
, Levosin, Clormikol.
Drugs that eliminate the source of infection when the burn blisters begin to burst. These include Dioxidin, Streptonitol (contains nitazole) and gentamicin ointment.

All products are suitable for external use at home. Before use, it is necessary to consult a doctor for contraindications and allergic reactions.

Preparations for systemic use

Preparations for internal reception render more strong action than topical treatments.

With burns, the body's immunity decreases, as a result of which complications appear in the form of nausea and high temperature and scars may take a long time to heal. Antibiotics internal use are needed to normalize the functions of the immune system. They are prescribed by a doctor in a compartment with antiseptic ointments and creams.

Medicine offers many drugs in tablet form. We do not recommend taking pills on your own, consult your doctor.

List of the most effective antibiotics at various degrees thermal and chemical skin damage:

Ceclor, Cefuroxime, Cefazolin. The drugs are non-toxic and practically have no contraindications, they are used in the first and second stages, as well as in case of toxicemia.
Bicillin. Kills the root of the infection in the wound due to the main component in the composition - penicillin. Relieves swelling and itching.
Amoxicillin and di sodium salt, Ampicillin. Prevent the development of sepsis and promote speedy recovery skin on hands and feet.
Aminoglycosides, which belong to the second generation, contain a beta-lactam substance. In a pharmacy they are found under the name Unazin and Sulacillin.
Cefixime, Cefotaxime, Ceftriaxone. Treat the third stages of burn injuries.
Nystatin, Fluconazole. They are used for complications after healing, such as a fungal infection.
Clindamycin and Metronidazole. It is prescribed for an infection that quickly spreads throughout the body.

This is not the entire list of funds that are assigned when burn injuries. More often, the doctor recommends undergoing course therapy, which consists of taking several drugs. In the third stage of burns, when the wound localization area is too large, hospitalization is advised. home treatment in such cases will be ineffective and life-threatening.

Contraindications

If you act incorrectly with burn injuries, you can cause irreparable harm to health and appearance. To prevent this from happening, consider a few general contraindications:

it is forbidden to lubricate the wounds with greasy creams or oils;
it is not recommended to apply ice cubes to burns, this can cause frostbite of tissue integuments;
it is forbidden to press or independently open blisters on the body;
prescriptions are not allowed. alternative medicine without a doctor's approval;
it is forbidden to use external means for the eyes, throat and other mucous membranes;
It is not recommended to give antibiotics to a child under three years of age.

Burns do not always require application antibacterial drugs. Many people make the mistake of using these: antibiotics - potent substances having strict indications and contraindications.

Why use antibiotics for burns?

Antibacterial therapy is used in the treatment and prevention of various types of infections. The latter easily enter the body through open wounds. Dead tissue at the site of injury - ideal culture medium for pathogens.

Bacteria interfere with wound healing, contribute to excessive scarring, and sometimes pose a threat to the life of the victim.

However, strong drugs are not always appropriate. Human skin has powerful protective properties and in most cases can deal with infections on its own.

But in some cases, antibiotic therapy is necessary:

Deep and large-scale lesions of mucous membranes, skin, internal organs. Loss large area tissues leads to disruption of the metabolic functions of the body, immune protection, in particular anti-infectious;
Elderly age;
The presence of chronic infections;
Diabetes;
Lack of burn treatment and, as a result, its complication.

But antibiotics are not used in the following situations:

deep but limited damage;
the burn is less than 10% of the body surface;
1st degree burns (epidermal).

The doctor, assessing the need for antibiotic therapy, takes into account the following factors:

Depth, vastness of the wound;
Burn degree;
The presence of complications;
Age, immune status the victim;
Type, severity of complications;
The patient's sensitivity to antibacterial agents.

What antibiotics are used for burns?

The vast majority of drugs based on silver sulfadiazine are used.

Therapy can be local (external), systemic and, in especially severe cases, combined.

External treatment involves dressings with solutions of iodopyrone and iodovidone 1%. Ointments based on dioxidine and levomycetin are also used.

Systemic therapy involves oral and/or intravenous/intramuscular administration of drugs. Such treatment is carried out only in a hospital under the supervision of doctors.

Systemic therapy is carried out only if there is deep wounds occupying more than 10% of the body area. If the infection is mild, limited to intramuscular injections.

Otherwise, apply intravenous administration medicines. Systemic treatment carried out with the following medicines:

semi-synthetic penicillins;
sulbactam and cefoperazone (often a combination);
aminoglycosides and fluoroquinolones;
latest generation cephalosporins;
lincomycin for bone disease;
« Nystatin" or " Fluconazole» with a fungal infection.

Refusal of antibiotic treatment of burns

Without therapy, the infection will not disappear without a trace. If the doctor prescribed antibiotic therapy, and the patient refused them, the following complications may occur:

lymphadenitis;
sepsis;
myocarditis;
purulent arthritis;
lung/bronchial diseases;
urinary tract infections.

Basically, therapy involves the use of a drug of one type. Several different medicines are prescribed only when there is an infection, it severe course.

Local treatment of burns: basic principles

The funds used are divided into several groups according to the current principle:

Modern means: antibacterial / antiseptic drugs

Ointment "Betadine"

Based on povidone-iodine - a modern alternative to traditional iodine. "Betadine" is a broad-spectrum agent, active against many pathogens. Treatment involves treating the wound thin layer ointment several times a day.

"Katapol"

It includes a copolymer with crotonic acid and benzalkonium chloride in the composition of povidone. Like the previous drug, it is active against many bacteria. Burns are treated aqueous solution 1% (dilute the solution with 10% distilled water). Medicinal solution soak tampons, wipes and gauze bandages to protect the wound.

Silvederm

Broad spectrum antibacterial drug. For ease of use, it is produced in the form of an aerosol, cream and ointment. The drug belongs to sulfanilamide, the active substance in the composition is sulfadiazine. Antibacterial activity is provided by silver ions.

Healing agents

Solcoseryl

On this moment he is the most popular means to accelerate the regeneration of damaged tissues. In the treatment of burns, two forms of the drug are used: ointment and gel. The healing edges of the wound are treated with ointment, and the gel itself wound surface. Processing is carried out up to 2 times a day. After the wetness has passed, you can use only the ointment.

"Panthenol"

Another popular tissue regeneration stimulant. The composition of the drug includes B vitamins and dexpanthenol. " Panthenol» improves cell regeneration, stimulates metabolic processes in tissues, and also has a slight anti-inflammatory effect. You can use a cream or spray. The cream is easily absorbed, so it is more convenient to use for painful sunburns and light burns. The aerosol is sprayed from a short distance.

Composite medicines

"Argakol"

The drug is in the form of a hydrogel, based on antiseptic substances: catapole, dioxidine, poviargol (silver preparation). " Argakol"- a potent antibacterial agent that can treat not only burns, but also abrasions / cuts.

After treatment, an air- and water-permeable elastic film is formed on the body, which is easily washed off with water.

Aerosol "Amprovizol"

Includes menthol, anestezin, propolis and vitamin D. Thanks to the combination active substances, the drug has a cooling, antiseptic, anti-inflammatory effect, accelerates regeneration. The aerosol is recommended for use in solar / thermal burns of the 1st degree.

Olazol

Positioned as a wound healing agent; combined foam preparation, which includes sea buckthorn oil. " Olazol» is available in aerosol form for ease of use. The agent has an antibacterial and anesthetic effect, and also improves regeneration, accelerates epithelialization and reduces exudation.

For non-infected 2nd degree burns, atraumatic and wet-drying dressings with antiseptic or antibiotic solutions are required. You can also use hydrogel coatings.

Damage of the 2nd degree can be treated with ointments / emulsions that have an analgesic and bactericidal effect (ex. "Agrosulfan", silver sulfazine 1%, "Levosin", "Levomekol").

If light burns of the 1st degree are characterized only by superficial damage to the epidermal layer, accompanied by painful sensations, redness and slight swelling of the tissues, then with 2 (medium) severity of burns, damage to the epidermis occurs up to the basal layer with the formation of blisters filled with liquid.

Antibiotics for 2nd and 3rd degree burns

If such a burn covers an area of \u200b\u200bless than 10% of the entire surface of the body, it can be treated at home, observing sterility, to prevent infection from entering the wound. Antibiotics for burns of the 2nd degree in most cases are not used, since our body itself is able to resist the infection.

The most common in everyday life are thermal burns, in particular, a burn with boiling water, which affects both adults and children. Most often, after a short exposure to boiling water, light burns of the 1st degree remain. But if the action of boiling water was quite long, and we are dealing with delicate children's skin, even burns of 2 and 3 degrees of severity are not excluded.

For burns with boiling water, antibiotics are used only in case of infection of the wound, which is possible with 3, and sometimes with the second degree of severity, if the condition of sterility of the lesion site is not observed.

With extensive thermal and chemical burns 2 and 3 A degrees, and also, if the burn is localized on the legs, face, groin or hands and is accompanied by the formation of a large number of bubbles with liquid, it is advisable to treat it in medical institution and often with antibiotics. Large wounds weaken the body's immune system, and it is already struggling to cope with its duties. But antibiotics are just designed to help her in the fight against pathogenic microorganisms, which in severe cases can provoke dangerous complications in the form of sepsis, pneumonia, myocarditis, infections of the excretory tract, lymphadenitis, etc.

If the burn occupies a small area, preference is given to external antibacterial agents, which are available in the form of solutions (most often they are used to prepare the wound for medical procedures) and wound healing ointments.

For burns of significant depth and area with highly likely wound infections can be prescribed systemic therapy with the use of broad-spectrum antibacterial drugs (semi-synthetic drugs penicillin series, 3rd generation cephalosporins, fluoroquinolones, and other antimicrobial agents that are effective against most pathogens known and unknown to medicine).

Antibiotics for burns of 3 B degree, when all layers of the skin are affected up to the subcutaneous fat, are prescribed regardless of the size of the affected area, since tissue necrosis simply attracts the infection, being an ideal environment for the life and reproduction of bacteria that cause serious violations health.

Broad-spectrum antibiotics for burns are considered the most effective, since mixed infection is most common. This moment is taken into account as when assigning local funds(take, for example, chloramphenicol and silver sulfadiazine, which are broad-spectrum antibiotics), and in systemic antibiotic therapy, which is prescribed strictly individually.

Antibiotics for external use for burns

Most common with extensive burns medium degree severity (2 and 3A) are limited only to antimicrobial agents for local application, which include:

1% solutions of iodopyrone or iodovidone, which are used to treat the wound after washing with antiseptics (solutions of chlorhexidine, miramistin, furacilin, hydrogen peroxide, etc.) or applying medical dressings,

ointments based on chloramphenicol ("Levomekol", "Kloromikol", "Levomycetin", "Chloramphenicol", "Levosin", etc.),
antimicrobial agents in the form of ointments with silver sulfadiazine (Sulfadiazine, Dermazin, Silvederm, Argosulfan, etc.),
sulfanilamide ointment for burns with antibiotic nitazole "Streptonitol",
antibacterial preparations for local use "Gentamicin ointment", "Dioxidin", etc.
artificial coverings for burn wounds with bactericidal agents.

Antibiotics for burns, accompanied by the appearance of blisters filled with liquid, are prescribed only after opening the blisters to prevent infection of the wound under the film. Until that time, there is no need for antibacterial drugs.

Fighting possible infection in case of extensive burn skin lesions, it can be carried out using special insulators or Klinitron beds, which reduce pressure on damaged tissues.

Antibiotics for systemic use in burns

As already mentioned, for severe burns that occupy a large area, as well as burns of great depth, prone to infection, in which there is a high probability of developing a burn disease, antibiotics can be prescribed by the attending physician not only for topical use, but also drugs for internal use with a wide spectrum actions.

Since the list of such drugs is quite large, the choice effective medicine remains entirely in the hands of the physician. Despite the fact that the selection criteria listed above are quite transparent, only a specialist can choose the appropriate drug, taking into account the group affiliation of the drug, its action and application features.

At easy course In the infectious process, antibiotic therapy is carried out by oral administration of drugs or intramuscular administration of antibacterial solutions, and doctors resort to intravenous infusions only in very severe cases.

Among broad-spectrum antibiotics, the most effective in the treatment of burns of medium and to a large extent gravity are:

Antibiotics from a number of cephalosporins of the 1st or 2nd generation with minimal nephrotoxicity and activity against gram-positive bacteria ("Cefalexin", "Cefazolin", "Cefuroxime", "Ceclor", etc.). They are used in the first and second periods of burn disease - with burn shock and toxicemia.
Natural and semi-synthetic preparations of the penicillin series. Their use is indicative for extensive burns (20 percent or more of the skin) in the first, second and third periods of burn disease - with burn shock (natural penicillins), acute toxicemia and septicotoxemia (semi-synthetic drugs).
and the use of penicillins:
- as a preventive measure infectious complications use a natural penicillin called "Bicillin",
- in case of infection of a burn wound - "Amoxicillin", "Carbenicillin disodium salt",
- with the development of sepsis - "Ampicillin",
- For intravenous infusion- "Methicillin sodium salt", etc.
2nd generation aminoglycosides are combination antibiotics containing a beta-lactam antibiotic plus a protector drug that prevents beta-lactamase-producing bacteria from reducing the effectiveness of the antibiotic. These include: "Unazine", "Sulacillin", "Gentamicin", "Brulamycin", "Tobramycin", "Sizomycin", etc. They are effective in the third (with Pseudomonas aeruginosa) and the fourth period of burn disease - with acute toxicemia and septicotoxemia.
3rd generation cephalosporins ("Cefixime", "Ceftriaxone", "Cefotaxime", etc.) are used in the third period of burn disease after determining the causative agent of the infectious process.
Fluoroquinolones of the 2nd and 3rd generations (Ciprofloxacin, Levofloxacin, Ofloxacin, Pefloxacin, etc.) fight gram-negative bacteria, as well as penicillin-resistant infections.
Lincosamides.
- "Lincomycin" is a drug from the group of lincosamides. It is assigned if infectious process with a burn injury, it spread to the bone structures.
- "Clindamycin" - lincosamide, indicated when attached anaerobic infection prone to rapid distribution throughout the body.
Other antibiotics:
- "Metronidazole" - according to the same indications as "Clindamycin".
- "Nystatin", "Fluconazole" - with a fungal infection, in Lately often found in burn centers.

Doctor's prescriptions may vary depending on the indicators microbiological research to control the relevance of antibiotic therapy. With generalized or mixed infection The doctor may prescribe not one, but several drugs. Among them will be antibiotics for both topical use and for internal use (systemic drugs).

Cephalosporin antibiotics

Pharmacodynamics. Many drugs in this group usually have the prefix "cef-", so they are quite easy to distinguish from others. The use of these antibiotics for burns is due to their bactericidal action. Cephalosporins are considered broad-spectrum antibiotics, only chlamydia, mycoplasma and some enterococci are not affected by them.

During the growth and development of a bacterial cell, among the many processes, the formation of a rigid (hard) shell with the participation of a penicillin-binding protein can be distinguished. Cephalosporins are able to bind to this protein and interfere with the synthesis cell wall microorganisms. They also activate proteolytic enzymes in bacterial cells, which destroy bacterial tissues and kill the microorganism itself.

Bacteria, in order to protect themselves, in turn produce a special enzyme beta-lactamase, the action of which is aimed at combating antibiotics. Each type of bacteria secretes its own specific enzyme. The 1st generation of cephalosporins is resistant to the action of beta-lactamase gram-positive bacteria, which include staphylococci and streptococci, which are associated with the processes occurring in the wound in the early stages of burn disease, 2nd generation - gram-positive and some Gram-negative bacteria, 3rd and 4th generation - gram-negative bacteria.

Pharmacokinetics. The bioavailability of cephalosporins, depending on the generation, ranges from 50 to 95%. The maximum concentration in blood plasma is observed after 1-3 hours (when taken orally) or in the interval from 15 minutes to 3 hours (when administered intramuscularly). The duration of action ranges from 4 to 12 hours.

The bulk of cephalosporins penetrate well into various tissues and body fluids and are excreted in the urine ("Ceftriaxone" is also excreted in the bile).

Cephalosporin antibiotics for burns are well tolerated by most patients. They have relatively few contraindications for use and side effects. The 1st generation of cephalosporins is considered the least toxic.

Release form. The most common forms of cephalosporin preparations used for burns are tablets (capsules) for adults and syrups for children. Most antibiotics are also available in the form of a powder, from which a solution is subsequently prepared, used for intramuscular injections(less often for intravenous administration).

A number of preparations are also available in the form of granules or powder for the preparation of a suspension for oral administration.

. Predominantly individual intolerance to drugs of this group.

The use of cephalosporins is considered acceptable during pregnancy, in neonatal therapy, and even during breastfeeding, although some concentrations of the drug are observed in breast milk. At kidney failure dose adjustment is required.

Side effects. Adverse reactions cephalosporins are rare during treatment and are usually associated with individual features organism.

Most often, you can see allergic reactions (skin rash, fever, bronchospasm, edematous syndrome, anaphylactic shock) on the background individual intolerance drug components.

Sometimes there may be changes in the composition of the blood, convulsive syndrome(with impaired renal function), microflora disorders, manifested in the form of candidiasis, covering the oral mucosa and vagina in women.

oral intake may be accompanied by nausea and abdominal pain, diarrhea, sometimes with an admixture of blood.

Dosage and administration. The dosage regimen of drugs can always be found in the instructions for them. Here are just a few of the above.

"Cephalexin" (1st generation).

Oral intake: from 0.5 to 1 g with an interval of 6 hours (daily dosage for children is 45 mg per kilogram of the patient's weight, the frequency of administration is 3 times a day).

"Cefuroxime" (2nd generation).

Oral: 0.25 to 0.5 g 12 hours apart ( daily dose for children is 30 mg per 1 kg of weight, the frequency of administration is 2 times a day). Taken with meals.

Intravenous and intramuscular administration: from 2.25 to 4.5 g per day with a multiplicity of 3 injections (children - from 50 to 100 mg per 1 kg of weight, multiplicity - 3 or 4 times a day).

"Cefixime" (3rd generation).

Oral administration: daily dose - 0.4 g. Frequency of administration - 1 or 2 times a day. Children from six months: 8 mg per 1 kg of body weight.

"Ceftriaxone" (3rd generation).

Intravenous and intramuscular administration: from 1 to 2 g 1 time per day. Children older than 1 month: 20 to 75 mg per 1 kg of body weight (two doses).

Overdose. Non-compliance with the dosing regimen and long-term use drugs can cause such a phenomenon as an overdose medicines. In the case of cephalosporins, it is accompanied by nausea, often accompanied by vomiting, and diarrhea.

First aid measures: gastric lavage when taken orally, drinking plenty of fluids and activated carbon or other enterosorbents.

. It is undesirable to carry out oral administration of cephalosporins at the same time as taking antacids that reduce the acidity of the stomach. The interval between taking medications should be at least 2 hours.

The nephrotoxicity of cephalosporins is increased when taken with aminoglycosides. This should be taken into account in the treatment of patients with impaired renal function.

Antibiotics of the penicillin series

Pharmacodynamics. Natural and semi-synthetic penicillins are considered active against gram-positive and gram-negative microorganisms. In relation to bacterial cells, they have a bactericidal effect in the phase of their growth.

The disadvantage of penicillins is that some of them are not resistant to the effects of beta-lactamase produced by many bacteria.

Pharmacokinetics. Antibiotics of the penicillin series, used for burns, easily penetrate into most tissues and body fluids. Excreted mainly by the kidneys. The elimination half-life ranges from half an hour to an hour.

Release form. Penicillin antibiotics are available in the same forms as cephalosporins.

Contraindications for use. Depending on the drug, individual intolerance to penicillins and cephalosporins may be contraindications, Infectious mononucleosis, ulcerative colitis, increased bleeding, lymphocytic leukemia, severe pathologies liver and kidney, pregnancy, breastfeeding. Some penicillins are not used in pediatrics, while others may require dosage adjustments and careful monitoring of the small patient.

Penicillins tend to pass through the placental barrier, so during pregnancy they are prescribed with great care.

Dosage and administration. They are used strictly according to the doctor's prescription with a frequency of admission from 2 to 4 times a day.

Side effect. Penicillins among antibiotics are considered the least toxic drugs. However, their reception is common cause the appearance of allergic reactions, regardless of the dose and form of release.

In addition to allergy symptoms penicillin antibiotics may cause sensitivity to sunlight, neurotoxic effects in the form of hallucinations, convulsions, fluctuations in blood pressure, violation of the microflora of the body. Natural penicillins can cause vascular complications.

Interaction with other drugs. It is forbidden to mix penicillins and aminoglycosides in the same syringe, since these groups are considered incompatible.

"Bicillin" and "Ampicillin" in combination with "Allopurinol" cause the appearance of a specific rash.

The use of penicillins with antiplatelet agents and anticoagulants increases the risk of bleeding. A parallel reception with sulfonamides reduces the bactericidal effect of drugs.

Colestyramine reduces the bioavailability of penicillins when taken orally. At the same time, oral penicillins themselves can reduce the effectiveness of certain drugs, in particular oral contraceptives.

Penicillins slow down the metabolism and excretion of metatrexate.

If penicillins, which have a bactericidal effect, are used in conjunction with other drugs with the same effect, the effect of taking the drugs is enhanced. If, in parallel with bactericidal agents, bacteriostatic drugs are used, treatment can be reduced to "no".

Aminoglycosides

Pharmacodynamics. Aminoglycosides, like the above groups of antibiotics, have a pronounced bactericidal effect. They are combination drugs, because they contain an antibiotic susceptible to destruction by beta-lactamases, and protective component to him, also possessing a slight antimicrobial activity. These components include sulbactam, tazobactam, clavulanic acid.

The drugs are effective against gram-positive and gram-negative bacteria, with the exception of non-spore-forming gram-negative anaerobes. The 2nd generation of the above antibiotics is effective against Pseudomonas aeruginosa, which makes them especially useful for burns.

Aminoglycosides have a bactericidal effect not only on growing cells, but also on mature bacteria.

Pharmacokinetics. When taken orally, aminoglycosides have very low bioavailability, therefore effective ways taking the drug are considered: intravenous and intramuscular administration and external application (drugs in the form of ointments).

With intramuscular injection, the maximum concentration in the blood plasma is reached after half an hour, but sometimes this time can be delayed up to 1.5 hours. The duration of action in this case will vary from 8 to 12 hours.

Aminoglycosides are excreted almost unchanged by the kidneys. The half-life is 2 - 3.5 hours (in newborns - from 5 to 8 hours).

The disadvantage of aminoglycosides is that after 5-7 days of therapy, addiction to the drug may occur, and its effectiveness will noticeably decrease. The advantage is painless administration and greater efficacy against most bacteria.

Release form. Since the oral administration of drugs of this group is considered ineffective, antibiotics are produced in the form of solutions placed in ampoules with a certain dosage, or in the form of a powder for preparation. injection solution. Some aminoglycoside antibiotics (for example, "Gentamicin") are also available in the form of an ointment for external use, which is especially important for burns, when the infection is fought both from the outside and from the inside.

Contraindications for use. Antiglycosides are not safe drugs like penicillins or cephalosporins. They can adversely affect the functioning of the kidneys and the vestibular apparatus. It is clear that such drugs will have more contraindications for use.

Therefore, aminoglycosides are not used for hypersensitivity to drug ingredients severe violations kidney function, shortness of breath, impaired functioning of the vestibular apparatus and hearing, with neutropenia, myasthenia gravis, parkinsonism. Do not use these drugs for botulism.

Side effects. Aminoglycosides may cause the following problems: hearing problems (tinnitus and ringing in the ears, ear congestion and hearing loss), thirst, changes in urine output, worsening glomerular filtration(with pathologies of the kidneys), shortness of breath up to paralysis respiratory muscles, problems with coordination of movements, dizziness. allergic reactions when using aminoglycosides are very rare, and appear as skin rashes.

Dosage and administration. In the treatment of burns, aminoglycosides of the 2nd generation are used in daily dosage from 3 to 5 mg per 1 kg of body weight with a frequency of admission 1 or 2 times (in newborns - from 5 to 7.5 mg 2 or 3 times a day). The drugs are administered parenterally. With a single dose, it is desirable to administer the drugs with a dropper.

Overdose. Side effects drugs in this group occur either against the background of existing pathologies, or as a result of taking large doses drug leading to overdose. If adverse reactions occur, the drug should be discontinued and measures taken to eliminate unpleasant symptoms. It should be noted that hearing impairment after taking aminoglycosides is irreversible, but the kidneys will need to be treated.

For patients with neuromuscular blockade, in which breathing problems and paralysis of the respiratory muscles are observed, the antidote will be calcium chloride, which is administered intravenously.

Drug interactions with other drugs. During therapy with aminoglycosides in combination with penicillins or cephalosporins, an increase in the action of all drugs is observed. But this does not mean that they need to be administered in one syringe. After all, mixing aminoglycosides in a syringe and beta-lactam antibiotics leads to a marked decrease effectiveness of antibiotics. The same applies to heparin.

negative effect on the kidneys and vestibular apparatus increases if aminoglycosides are used in conjunction with other drugs with increased nephro- and ototoxicity.

Fluoroquinolones

Pharmacodynamics. These are synthetic antibiotics with excellent bactericidal action, which is also quite long. Most bacteria are sensitive to them. Repeatedly proven high efficiency antibiotics fluoroquinolones in the treatment of severe infectious pathologies, including deep and extensive burns.

The drugs have a unique pharmacological action, suppressing the production of enzymes vital for microorganisms, which leads to the arrest of DNA synthesis. Drugs also have a negative effect on cell ribosomes. All this leads to the death of microorganisms.

Some of them are effective against pneumococci, non-spore-forming anaerobes and staphylococci that are not sensitive to penicillin.

Pharmacokinetics. Fluoroquinolones are well absorbed by the gastrointestinal mucosa, providing high concentrations active substance in tissues and body fluids. The long half-life of the drugs provides them with a prolonged action.

The disadvantage of this group of drugs is the ability to penetrate the placental barrier and into breast milk, in connection with which their use during pregnancy and breastfeeding limited.

Release form. Fluoroquinolones of the 2nd generation, which are used for burns, are available in the form of tablets and an injection solution in ampoules or vials.

Contraindications for use. In addition to individual intolerance, pregnancy, lactation and childhood(for some drugs) fluoroquinolones have several other contraindications. These include: vascular atherosclerosis and lack of glucose-6-phosphate dehydrogenase in the patient's body.

Side effects. Adverse reactions that occur as a result of taking fluoroquinolones are usually not associated with serious organ damage. These can be both reactions from the gastrointestinal tract (dyspepsia, heartburn and abdominal pain), as well as reversible hearing and vision impairment, deterioration in sleep quality, headaches and dizziness, paresthesia, convulsions, tremor, increased heart rate, impaired microflora in body, increased photosensitivity.

IN rare cases inflammation of the tendons and joints, disorders of the kidneys and liver, vascular thrombosis are observed.

Dosage and administration. Consider a few popular drugs.

"Ciprofoloxacin". Oral administration: adults - from 0.5 to 0.75 g with an interval of 12 hours (children - from 10 to 15 mg per 1 kg of body weight in 2 divided doses).

Intravenous administration. Drip from 0.4 to 0.6 g with an interval of 12 hours (children - from 7.5 to 10 mg per 1 kg of weight divided into 2 doses).

Ofloxacin. Oral administration: 0.4 g every 12 hours (children - 7.5 mg per 1 kg of body weight, divided into 2 doses).

Intravenous administration. Drip 0.4 g with an interval of 12 hours (children - 5 mg per 1 kg of body weight divided into 2 doses).

Levofloxacin. Oral administration and intravenous drip introduction: 0.5 g at 12 hour intervals. Not applicable in pediatrics.
"Pefloxacin". Oral administration and intravenous administration in the form of droppers with 5% glucose: initial dose - 0.8 g, subsequent - 0.4 g with an interval of 12 hours. Not applicable to the treatment of children.

All drugs can be taken at any time of the day, adhering to the 12-hour interval. Eating does not affect the effectiveness of the antibiotic.

Interaction with other drugs. Food intake does not affect the absorption of fluoroquinolones, but antacids, sucralfate and drugs containing compounds of aluminum, zinc, magnesium, calcium and iron reduce the absorption of antibiotics in the gastrointestinal tract.

Some fluoroquinolones increase the concentration of theophylline in the blood.

Concomitant use of fluoroquinolones and non-steroidal anti-inflammatory drugs increases the risk of neurotoxicity, which leads to the appearance of a convulsive syndrome.

"Children's" antibiotics

Burns in children at least a rare event than in adults. But even the same “popular” among kids burn with boiling water can turn out to be serious illness requiring the use of antibiotics. The immune system the child is still not sufficiently formed, so even a small area burn (2-5%) is more severe than in adults, often causing complications. To prevent complications after burns caused by an infection in the wound, antibiotics are used.

Many will say, but how is it, because there is an opinion that these drugs are dangerous for children and you need to try to do without them by any means. This is fundamentally wrong. There are many drugs that help a small body cope with an infection, and if used correctly, they do not cause significant harm. children's body. Moreover, these are not special, children's drugs, but general antimicrobial drugs.

To the question what antibiotics are prescribed for children with burns, we can answer that in almost all groups antimicrobial agents there are drugs approved for use in pediatrics (Ampicillin, Cefuroxime, Ceftriaxone, Ofloxacin, Gentamicin, etc.).

Prescribing antibiotics to children requires special care and knowledge of the drugs from the doctor. After all, not all drugs can be used to treat newborns and infants. Some antibiotics are prescribed to children only from the age of 12 or 14. An important aspect is also taking into account the body weight of the child, because the effective and safe dose drug. All this must be taken into account when prescribing antibiotics.

In the treatment of young children, preference, of course, is given to preparations in the form of ointments, suspensions for oral administration or syrup. Older children with burns can be given antibiotics in the form of tablets.

Intramuscular and intravenous administration of drugs is allowed only in severe cases. But subsequently, small patients are transferred to therapy with other forms of drugs.

If more serious medical preparations in case of burns, their appointment is carried out by the attending physician. Antibiotics for burns can be taken. Antibiotic prescription is based on integrated assessment the patient's condition, taking into account the vastness of skin defects, the depth of the burn, the stage of the burn disease, its complications, the state of the immune status, as well as the patient's age and the severity of the comorbidity.

Can antibiotics be used for burns?

Victims with various burns of 2-3 stages, as well as patients with limited solid burns, occupying a maximum of ten% of the body plane, the appointment of antibiotics, as a rule, seems inappropriate. If we talk about exceptions for taking antibiotics for burns, then people can be attributed to them. old age who are sick diabetes, infections that have passed into chronic condition, also victims who did not apply for medical care.

Other patients are prescribed district bactericidal therapy for burns: dressings with 1% substance of iodovidone or iodopyrone, ointments, which include levomycetin or dioxidine, silver sulfadiazine. How excellent tool the composition of Levomekol's ointment dressing with powdered gentamicin or neobacitracin with gram-negative flora showed itself. The use of artificial coatings containing bactericidal substances is promising. When curing these patients, daily treatment of diseased areas with the substance of iodovidone or iodopyrone will be appropriate and effective.

When to prescribe antibiotics for burns

With the development of a burn in the victims, antibiotics are used for burns. This treatment will be appropriate and effective for large areas of damaged skin. In this case, antibiotics are prescribed to prevent and treat infection after burn wounds and infectious complications that can cause a burn. One of the significant events is considered to be early immunotherapy and immunoprophylaxis.

The most effective is the use of antibiotics for burns. It should be noted that in addition to the use of medicinal substances, in order to cure the patient, it is necessary to use "Clinitron", as well as antibacterial insulators, and more physical ways improving the state of the disease: laser therapy, ultraviolet radiation, ozone therapy and other procedures prescribed by a doctor. All these procedures after full course facilitate passage pain syndrome, prevent infection and, as a result, contribute to the restoration of the skin. This therapy with the chain of a speedy cure is being conducted on 2 fronts: systemic bactericidal therapy and local use antibiotics.

But write out necessary antibiotics in case of burns, only the attending physician will be able to help you, depending on the degree of damage, as well as your sensitivity to the drug.

In this article:

Antibacterial therapy occupies an important place in the complex of measures aimed at eliminating and preventing various infections developing in burn wounds. Dead tissues present in the area of any burn injury serve as a favorable environment for the reproduction of pathogens.

Why antibiotics are prescribed

Antibiotics for burns are prescribed to suppress the so-called microbial invasion, which not only slows down the wound healing process, but also contributes to excessive scarring, creates certain difficulties in the plastic closure of burn wounds, and also poses a direct threat to the life of the injured person. In the structure of mortality in burn patients, infections account for more than 75%.

Deep and extensive burn lesions, entailing a number of pathological processes and accompanying burn disease, create additional prerequisites for the generalization of the infectious process and are the reason for prescribing antibiotics. In addition to the loss of a large area of the protective skin, there is a disintegration of the most important metabolic and neurotrophic functions in the body, leading to the destruction of anti-infective protection factors.

Who needs antibiotic therapy

The use of antibacterial drugs for the treatment of victims with burns or, as well as with deep, but limited wounds, the area of \u200b\u200bwhich does not exceed 10% of the body surface, is considered inappropriate. The only exceptions are some patients:

Elderly people;
Injured with chronic infections and diabetes;
Patients admitted for treatment later dates With pronounced signs infections.

The burn severity levels listed above typically include:

almost all household thermal burns - with boiling water, household items (, a frying pan, a saucepan, etc.);
electrical - by current;
chemical - iodine, brilliant green, mustard, etc.

accompanied by redness of the skin and the appearance.

And even more so, you should not “stuff” the victims of a burn with antibiotics, which can also be obtained in all of the above cases.

Antibiotics for burns are prescribed by the attending physician on the basis of comprehensive examination the condition of the victim, if the degree of damage has a fourth or 3B degree. It takes into account the following parameters:

Depth and extent of the lesion;
The stage of the burn disease;
The presence of complications;
Age and immune status of the victim;
The nature and severity of comorbidities;
Sensitivity to a particular prescribed drug.

Treatment tactics

Antibacterial therapy aimed at the treatment and prevention of infections is an integral part of the complex of measures prescribed for the development of burn disease. To prevent the occurrence of infectious complications, the treatment of victims begins in the period burn shock and continue with acute burn toxemia and septicotoxemia. Except medications local application and systemic antibiotic therapy, can be used common methods treatment in an abacterial environment: insulators and beds "Clinitron".

The choice of drug for local antibiotic therapy requires individual approach and depends on the characteristics of the wound process. Most often, silver sulfadiazine preparations, dressings with a 1% solution of iodopyrone and iodovidone, water-soluble ointments based on chloramphenicol or dioxidine are used. Systemic antibiotic therapy is also strictly individual character and is prescribed for patients with deep burns, the area of which exceeds 10% of the body surface. With a mild course of the infectious process, they are limited intramuscular injection drugs, in more severe cases resort to intravenous infusions.

Systemic antibiotic therapy is carried out using drugs that have wide range actions: combinations of cefoperazone with sulbactam, semi-synthetic penicillins, cephalosporins III generation, aminoglycosides and fluoroquinolones. For bone lesions, lincomycin is used. If during treatment an anaerobic non-clostridial infection is detected, metronidazole or clindamycin is prescribed, for a fungal infection, nystatin or fluconazole.

Any infectious process originating in a burn wound can provoke the development severe complications: sepsis, pneumonia, tracheobronchitis, purulent arthritis, infections urinary tract, as well as myocarditis, endocarditis, lymphadenitis and lymphangitis.

The main importance in the fight against generalized infection is given to rational antibiotic therapy, which involves weekly microbiological monitoring. In severe cases of the disease, combined antibiotic therapy is used, which involves the simultaneous use of two or three drugs.

The use of antibiotics in complex treatment burn injuries can reduce the severity of various infectious complications that pose a threat to the lives of affected people. What antibiotics to drink for burns? The answer to this question can only be given by a specialist who made an appointment on the basis of a comprehensive examination of the victim.