Antibacterial drugs. Latest generation broad-spectrum antibiotics
As is known, bacteria were the first to populate the Earth. There are millions of them, they are everywhere: in water, air, soil, inside and around each of us. “Good bacteria” help us, but “bad” ones often cause quite serious diseases. Today, everyone, even those far from medicine, has very specific ideas about antibiotics, and is familiar with at least several drug names. The term “broad-spectrum antibiotics” has also been heard. Let's figure out what it is and start from the very beginning.
A little history
The first antibiotic was obtained in 1928 by the Englishman Alexander Fleming. It was Penicillin, but it turned out to be rapidly degrading, and did not even pass the expert commission at the medical club. Only 10 years later, Americans Howard Flory and Ernst Chain isolated the antibiotic as a separate environmentally resistant species, and immediately tested it on the wounded in hospitals of the Second World War.
Beginning in 1943, penicillin was put into mass production, and 2 years later Flory and Chain were awarded the Nobel Prize.
Antibiotics are a group of substances (semi-synthetic, animal or plant) that can destroy bacteria, microorganisms, and fungi.
Antibiotics are conventionally divided into bactericidal and bacteriostatic. The first are guys with a lethal disposition, they immediately destroy the pest without unnecessary lyricism, the second are intellectuals, they have a scientific and long-term approach - they block the enemy’s ability to reproduce.
Some antibiotics are more effective against one type of bacteria, while others are more effective against another. But there are such “fighters” for our health who are capable of destroying completely different microbes. These are the same broad-spectrum antibiotics.
It is not always clear which bacteria, fungi or opportunistic flora caused the disease, and there is no time for laboratory tests: the child needs emergency care. In such cases, doctors prescribe broad-spectrum antibiotics. For example, with meningitis in a toddler, the issue of life and death can be resolved in a matter of hours, and laboratory samples will be ready only in 2-3 days. While doctors are figuring out what caused the baby’s serious illness, broad-spectrum antibiotics are immediately used to combat unknown pests.
Types of broad spectrum antibiotics
Penicillins
They have a mainly bactericidal effect. They destroy the cell walls of bacteria. Effectively and quickly destroy staphylococci, pathogens of gonorrhea, E. coli, salmonella, and whooping cough. The most notable representatives of the series are “Amoxicillin” and “Ampicillin”.
Cephalosporins
These antibiotics are different from the previous group by being more resistant to those enzymes that microbes produce in their defense. Where the penicillin fighter dies, the cephalosporin fighter will survive and finish the job. The most famous antibiotics of the series that are used in pediatrics are Ceftriaxone, Cefotaxime, Cephalexin, etc.
Carbapenems
These are relatively new antibiotics. Such drugs are used mainly for severe conditions and hospital-acquired infections. In ordinary life we rarely see these names. And this is good. But in fairness, I will call carbapanem antibiotics by name: “Meropenem”, “Ertapenem”, etc.
Tetracyclines
These antibiotics do an excellent job against various bacteria and even some protozoa. But they are not warriors against mold fungi and acid-fast bacteria. The most famous representatives of this series are “Tetracycline” and “Doxycycline”.
Monobactams
These antibiotics have a rather narrow “profile”. They are usually used to combat gram-negative pests - for infections of the skin, soft tissues, musculoskeletal system, and also for sespis. The most famous representative of the group, used in pediatrics, is Aztreonam.
Aminoglycosides
These “universal soldiers” are resistant not only to different types of bacteria, but also to other antibiotics. You are probably familiar with their names - “Streptomycin”, “Gentamicin”.
Amphelicols
Broad-spectrum antibiotics (ASSA) on the pharmacy counter have several pharmacological forms:
- drops;
- powders for suspensions;
- pills;
- dry substance for injections - intramuscular and intravenous injections.
But there are no antibiotics in the form of suppositories or syrup.
Benefit or harm?
There are definitely advantages: Broad-spectrum antibiotics quickly penetrate the body’s tissues and accumulate where they are most needed – at the site of the infection. Compared to other antibiotics (narrow focus), they are safer and less likely to cause allergic reactions. Manufacturers claim that they do not need to be taken simultaneously with drugs for the prevention of dysbiosis, although this point is questionable. And finally, broad-spectrum antibiotics are quite compatible with other medications.
But any antibiotic, even a low-toxic one of the latest generation, does not have intelligence and a “friend or foe” recognition system, and therefore effectively destroys both harmful and beneficial microorganisms. Therefore, a rare course of antibiotic treatment does not end with dysbacteriosis or thrush (in girls).
And also any antibiotic weakens the human immune system. Think for yourself, why should the immune system try and fight the infection if the “stray guys” will quickly do everything for it?
Well, another fly in the ointment. Bacteria do not sleep and do not give up without a fight, and therefore their resistance to antibiotics is constantly increasing. The more often a person uses antibiotics, the more resistant pathogens become to them. Recently, Russians have been eating antibiotics so often and completely uncontrollably, with or without reason, that scientists and the Ministry of Health have sounded the alarm. And now, or rather from January 1, 2017, all antibiotics without exception in Russian pharmacies are sold strictly according to prescriptions. This is a necessary measure that will not allow bacteria, with their significantly increased resistance, to win this war for the life of humanity.
Conditions of appointment
Let's consider situations in which a doctor may prescribe broad-spectrum antibiotics to a child. Contrary to popular belief that influenza and acute respiratory viral infections are easy to defeat, thanks to antibiotics (this is what 46% of Russians believe, according to VTsIOM), In the case of diseases caused by viruses, antibiotics are completely powerless. These illnesses need to be treated with antiviral drugs.
And “universal” antibiotics will be prescribed to your child in the following cases:
- High body temperature of more than 39 degrees (more than 38 degrees for babies under one year old), caused by a bacterial infection,
- Bronchitis,
- Otitis,
- Sinusitis,
- Angina,
- Tonsillitis and paratonsillitis,
- Whooping cough,
- Pneumonia,
- Meningitis,
- Severe intestinal infection,
- Postoperative period (for prevention).
Let me emphasize once again that antibiotics are not prescribed for influenza, ARVI, chickenpox, measles and hepatitis, as well as rubella and herpes. The exception is when a child has a bacterial infection in addition to a viral infection; this usually becomes clear 4-5 days after the onset of the disease.
If the child, despite the prescribed antiviral treatment, does not feel better, one may suspect that bacteria are to blame. Doctors must confirm this by taking blood and swabs from the baby for analysis.
List of the most common drugs
Amoxicillin
An antibiotic of the penicillin group that successfully defeats staphylococci, streptococci, and E. coli. But some bacteria secrete a special enzyme that destroys the antibiotic. This drug may be prescribed to your child for colds, pharyngitis, tracheitis, and pneumonia. Sore throat and otitis media, cystitis and pyelonephritis cannot resist it. This antibiotic is also widely used to treat dysentery and salmonellosis. It is contraindicated in children with allergies to flowers (hay fever) and liver failure. All forms of this medicine are taken exclusively orally. For children from birth to 4 years - 5 years - it is preferable to give an antibiotic in suspension. The dosage and regimen are prescribed by the doctor, based on the age and weight of the baby, as well as the severity of the tiny disease. The starting price of the medicine in pharmacies is from 70 rubles.
Augmentin
This is the same “Amoxicillin”, only enhanced with clavulanic acid, which protects the antibiotic from enzymes produced by bacteria that are harmful to it. The antibiotic is available in powder for suspension and powder for injection. Tablet form - intended for adults. Approved for use even by newborns, however, in a dosage determined by the doctor and exclusively for vital indications. For babies over 2 months old, the dosage is calculated based on body weight. Children aged 2 to 3 years are given 5-7 ml (depending on the severity of the disease), from 3 years to 7 years - 5-10 ml, children aged 7 to 12 years - a single dose of 10-20 ml (depending on the severity of the diagnosis). The cost of the drug in pharmacies starts from 150 rubles for a suspension and 260 rubles for tablets.
Amoxiclav
This is another follower of Amoxicillin, also enhanced with clavulanic acid. According to reviews from parents and doctors, this is a very good children's antibiotic, which is easy for the baby to drink (in the form of a suspension) and helps quite quickly. Also The drug is approved for use by children under 1 year of age. The price of the drug is from 360 rubles for tablets, from 400 rubles for soluble tablets and from 150 rubles for powder for diluting the suspension.
Zinatsef
This is a cephalosporin antibiotic, a second generation drug. It is very effective for respiratory infections (bronchitis, lung abscess, pneumonia), and has proven itself as a treatment for otitis media, tonsillitis, furunculosis, meningitis, as well as joint diseases, including after injuries and surgeries. Release form: powder for injection. The doctor should calculate the pediatric dosage based on the patient’s age and weight. Approved for use in children under 1 year of age for special indications. Price in pharmacies - from 200 rubles per bottle.
Antibiotics are a broad group of medications that are used to treat various infections. The causative agents of diseases are fungi and pathogenic microorganisms. Antimicrobial drugs not only stop reproduction, but also kill harmful bacteria. All microorganisms are different, so not every antibiotic can cope with them.
Broad-spectrum antibiotics can destroy many types of pathogenic bacteria. These are new generation drugs that are used in various fields of medicine, including gynecology.
Features of antibiotics with a wide spectrum of activity
Broad-spectrum antibacterial drugs are universal drugs that act on a large number of pathogens. These medications are used in the following cases:
Antimicrobial drugs are divided into the following groups:
- Fluoroquinolones.
- Aminoglycosides.
- Amphenicols.
- Carbapenems.
A description of groups of antibacterial drugs and their representatives will follow.
Broad-spectrum antibiotics of the penicillin group are divided into 2 groups:
The most well-known antibacterial drugs include Ampicillin and Amoxicillin. They are able to fight:
- staphylococci;
- streptococci;
- gonococci;
- spirochetes;
- meningococci and other pathogens.
Ampicillin is a semi-synthetic antibacterial drug with a bactericidal effect that inhibits the biosynthesis of bacterial cell walls.
The drug is used for diseases of the respiratory tract, genitourinary system, ENT diseases, rheumatism, purulent infections, etc. The medication is poorly absorbed and has a short half-life. Dosage form: tablets and powder.
Amoxicillin is an antimicrobial drug that is used to treat infections of bacterial origin. The medication is quickly absorbed and has a long half-life.
Amoxicillin is most suitable for the treatment of bronchitis and pneumonia. Other indications: sore throat, diseases of the genitourinary system, skin infections.
Used as part of complex therapy for ulcers. Available in the form of capsules and chewable tablets. List of parenteral penicillins:
There are also combination medications that suppress the effect of β-lactamases (bacterial enzymes that destroy penicillins):
Tetracycline group
Tetracyclines are broad-spectrum antibiotics that have a similar chemical structure and biological properties. Their structure lacks a β-lactam ring, and therefore they are not susceptible to the influence of β-lactamases. These antimicrobial drugs are able to fight gram-positive and gram-negative microorganisms.
These antibiotics are capable of destroying intracellular pathogens due to the fact that they can penetrate the bacterial cell. Tetracyclines cannot cope with the causative agent of Pseudomonas aeruginosa infection.
List of commonly prescribed tetracyclines:
- Meropenem. This is a synthetic antimicrobial drug that is available in the form of lyophilisate and powder. Indications: pneumonia, complex form of appendicitis, pyelitis, various skin infections.
- Ertapenem. Intended for the treatment of severe abdominal, genitourinary, skin, and postoperative infections.
- Imipenem. An antimicrobial drug that has a bactericidal effect.
This is an antimicrobial drug for internal and external use.
Indications: pneumonia, bronchitis, purulent pleurisy, endocarditis, tonsillitis, whooping cough, purulent meningitis, cholecystitis, burns, etc. Dosage form: tablets, suspensions, ointment. Tablets negatively affect intestinal flora. Eye ointment is considered the most effective and safe drug from this subgroup.
Doxycycline. This is a medicine with a bacteriostatic effect. Used to treat respiratory, genitourinary, and intestinal infectious diseases.
Available in the form of tablets, capsules, powder. This drug is much more effective than Tetracycline, is absorbed faster, and inhibits the intestinal bacterial flora least of all representatives of the class.
Fluoroquinolones
Fluoroquinolones are broad-spectrum antibiotics with a pronounced antimicrobial effect. Norfloxacin, Ofloxacin, Ciprofloxacin are the first representatives of fluoroquinolones that are capable of destroying Escherichiosis, Klebsiella, gonococcus, the causative agent of Pseudomonas aeruginosa, etc.
Staphylococci, streptococci, euirichiosis, Pfeiffer bacilli, gonococci, chlamydia, etc. are sensitive to modern fluoroquinolones.
Important! These drugs are strictly prohibited for children under 18 years of age, as they can change cartilage tissue.
List of popular drugs:
Aminoglycoside drugs
Aminoglycosides are natural semisynthetic antibiotics that have similar structure and properties. They inhibit protein synthesis in bacteria. Their influence is aimed at destroying streptococci, staphylococci, escherichiosis, Klebsiella, salmonella, etc.
List of commonly prescribed aminoglycosides:
Amphenicols
The main representative of this class is the widely known Levomycetin. This antibiotic is active against staphylococci, streptococci, gonococci, salmonella, etc.
Indications: typhoid fever, dysentery, whooping cough, etc. The ointment is used to treat skin infections.
The medicine is available in the following forms:
Drops are used to treat infectious eye diseases.
Few people know that this drug must be taken in a course, because Levomycetin is an antibiotic. Most patients take it for diarrhea, believing that 3 tablets is the maximum.
After such a dose, only weak bacteria die, while others survive and even become stronger. After this, the drug can no longer cope with persistent microbes. The recommended daily dose is 0.5 g 3 times a day. The duration of the minimum therapeutic course is 7 days.
Carbapenem group
Carbapenems are beta-lactam antimicrobial drugs that inhibit the growth and reproduction of pathogens. These medications are intended to treat severe hospital-acquired infectious diseases that are life-threatening. They are active against most bacteria, including resistant ones.
List of effective carbapenems:
Important! All the medications described above are prescription medications and can only be prescribed by the attending physician. The drugs are administered only intravenously.
Antibacterial medications in gynecology
List of broad-spectrum antibiotics used in gynecology:
These names are known to many. Antimicrobial drugs interfere with the development of bacteria, displace them, and destroy them.
Since the spectrum of their activity is quite wide, in addition to pathogenic microorganisms, they also destroy beneficial ones. As a result, the intestinal flora is disrupted and immunity is reduced.
That is why after a course of treatment it is necessary to restore the body with the help of vitamin complexes.
To treat gynecological diseases, vaginal or rectal suppositories, as well as intramuscular and intravenous medications are most often used. Types of candles:
Broad-spectrum antibacterial drugs can be used alone or as part of complex therapy.
It is important to remember that antibiotics are a last resort for infectious and inflammatory diseases. Do not self-medicate, as this can lead to irreparable consequences! Follow your doctor's recommendations.
Chapter 7. Antimicrobials
Containing or stopping the growth of microbes is achieved by various methods (sets of measures): antiseptics, sterilization, disinfection, chemotherapy. Accordingly, the chemicals that are used to implement these measures are called sterilizing agents, disinfectants, antiseptics and antimicrobial chemotherapy. Antimicrobial chemicals are divided into two groups: 1) non-selective- destructive to most microbes (antiseptics and disinfectants), but at the same time toxic to the cells of the macroorganism, and (2) I haveselective actions(chemotherapeutic agents)..
7.1. Chemotherapy drugs
Chemotherapeutic antimicrobialsmedicines- This chemicals that are used to treat infectious diseases etiotropic
treatment (i.e., directed at the microbe as the cause of the disease), as well as (rarely and sharplyhorny!) to prevent infections.
Chemotherapy drugs are administered inside the body, so they must have a detrimental effect on infectious agents, but at the same time be non-toxic to humans and animals, i.e. have selectivity of action.
Currently, thousands of chemical compounds with antimicrobial activity are known, but only a few dozen of them are used as chemotherapeutic agents.
Based on which microbes chemotherapy drugs act on, they determine range their activities:
acting on cellular forms of microorganisms (antibacterial, antifungalhigh, antiprotozoal).Antibacterial, in turn, are usually divided into drugs narrow And wide action spectrum: narrow- when the drug is active against only a small number of varieties of either gram-positive or gram-negative bacteria, and wide - if the drug acts on a sufficiently large number of species of representatives of both groups.
antiviral chemotherapy drugs.
In addition, there are some antimicrobial chemotherapeutic drugs that also have againsttumoral activity.
By type of action chemotherapy drugs are distinguished:
"Microbicidal"(bactericidal, fungicidal, etc.), i.e., having a detrimental effect on microbes due to irreversible damage;
"Microbostatic" i.e., inhibiting the growth and reproduction of microbes.
Antimicrobial chemotherapeutic agents include the following groups of drugs:
Antibiotics(act only on cellular forms of microorganisms; antitumor antibiotics are also known).
Synthetic chemotherapy drugs of different chemical structures (among them there are drugs that act either on cellular microorganisms or on non-cellular forms of microbes).
7.1.1. Antibiotics
The fact that some microbes can somehow inhibit the growth of others has been well known for a long time. Back in 1871-1872. Russian scientists V. A Manassein and A. G. Polotebnov observed the effect when treating infected wounds by applying mold. Observations by L. Pasteur (1887) confirmed that antagonism in the microbial world is a common phenomenon, but its nature was unclear. In 1928-1929 Fleming discovered a strain of the mold fungus penicillium (Penicillium notatum), releasing a chemical that inhibits the growth of staphylococcus. The substance was named “penicillin,” but only in 1940 were H. Flory and E. Chain able to obtain a stable preparation of purified penicillin - the first antibiotic to find widespread clinical use. In 1945, A. Fleming, H. Florey and E. Chain were awarded the Nobel Prize. In our country, a great contribution to the doctrine of antibiotics was made by Z. V. Ermolyeva and G. F. Gause.
The term “antibiotic” itself (from the Greek. anti, bios- against life) was proposed by S. Waksman in 1942 to designate natural substances, produced microorganisms and in low concentrations antagonistic to the growth of other bacteria.
Antibiotics- these are chemotherapeutic drugs made from chemical compounds of biological origin (natural), as well as their semi-synthetic derivatives and synthetic analogues, which in low concentrations have a selective damaging or destructive effect on microorganisms and tumors.
7.1.1.1. Sources and methods of obtaining antibiotics
The main producers of natural antibiotics are microorganisms that, being in their natural environment (mainly in the soil), synthesize antibiotics as a means of survival in the struggle for existence. Animal and plant cells can also produce some substances with a selective antimicrobial effect (for example, phytoncides), but they have not received widespread use in medicine as antibiotic producers
Thus, the main sources for obtaining natural and semi-synthetic antibiotics were:
Actinomycetes(especially streptomycetes) are branching bacteria. They synthesize the majority of natural antibiotics (80%).
Molds- synthesize natural beta-lactams (fungi of the genus Cephalosporiurr, And Penicillium) n fusidic acid.
Typical bacteria- for example, eubacteria, bacilli, pseudomonads - produce bacitracin, polymyxins and other substances that have an antibacterial effect.
There are three main ways to obtain antibiotics:
biological synthesis (this is how natural antibiotics are obtained - natural fermentation products, when producing microbes that secrete antibiotics during their life processes are cultivated under optimal conditions);
biosynthesis with subsequent chemical modifications(this is how semi-synthetic antibiotics are created). First, a natural antibiotic is obtained through biosynthesis, and then its original molecule is modified by chemical modifications, for example, certain radicals are added, as a result of which the antimicrobial and pharmacological characteristics of the drug are improved;
chemical synthesis (this is how synthetic products are obtained analogues natural antibiotics, for example chloramphenicol/chloramphenicol). These are substances that have the same structure.
like a natural antibiotic, but their molecules are chemically synthesized.
7.1.1.2. Classification of antibiotics by chemical structure
Based on their chemical structure, antibiotics are grouped into families (classes):
beta-lactams(penicillins, cephalosporins, carbapenems, monobactams)
glycopeptides
* aminoglycosides
tetracyclines
macrolides (and azalides)
lincosamides
chloramphenicol (chloramphenicol)
rifamycins
polypeptides
polyenes
different antibiotics(fusidic acid, ruzafungin, etc.)
Beta-lactams. The basis of the molecule is a beta-lactam ring, when destroyed, drugs lose their activity; type of action - bactericidal. Antibiotics in this group are divided into penicillins, cephalosporins, carbapenems and monobactams.
Penicillins. Natural drug - benzylpene-nicillin(penicillin G) - is active against gram-positive bacteria, but has many disadvantages: it is quickly eliminated from the body, destroyed in the acidic environment of the stomach, and inactivated by penicillinases - bacterial enzymes that destroy the beta-lactam ring. Semi-synthetic penicillins, obtained by adding various radicals to the base of natural penicillin - 6-aminopenicillanic acid - have advantages over the natural drug, including a wide spectrum of action:
depot preparations(bicillin), lasts about 4 weeks (creates a depot in the muscles), is used to treat syphilis, prevent relapses of rheumatism;
acid-resistant(phenoxymethylpenicillin), oral administration;
penicillinase-resistant(methicillin, oxacyl-pl), but they have a rather narrow spectrum;
wide range(ampicillin, amoxicillin);
antipseudomonas(carboxypenicillins- carbe-nicillin, ureidopenicillins- piperacillin, azlo-cillin);
combined(amoxicillin + clavulanic acid, ampicillin + sulbactam). These drugs contain inhibitors enzymes - beta-lactamases(clavulanic acid, etc.), which also contain a beta-lactam ring in their molecule; their antimicrobial activity is very low, but they easily bind to these enzymes, inhibit them and thus protect the antibiotic molecule from destruction.
V Cephalosporins. The spectrum of action is wide, but they are more active against gram-negative bacteria. According to the sequence of introduction, 4 generations (generations) of drugs are distinguished, which differ in the spectra of activity, resistance to beta-lactamases and some pharmacological properties, therefore drugs of the same generation Not replace drugs of another generation, but complement them.
1st generation(cefazolin, cephalothin, etc.)- more active against gram-positive bacteria, destroyed by beta-lactamases;
2nd generation(cefuroxime, cefaclor, etc.)- more active against gram-negative bacteria, more resistant to beta-lactamases;
3rd generation(cefotaxime, ceftazidime, etc.) - more active against gram-negative bacteria, highly resistant to beta-lactamases;
4th generation(cefepime, etc.)- act mainly on gram-positive, some gram-negative bacteria and Pseudomonas aeruginosa, resistant to the action of beta-lactamases.
Carbapenems(imipenem, etc.)- of all beta-lactams they have the widest spectrum of action and are resistant to beta-lactamases.
Monobactams(aztreonam, etc.) - resistant to beta-lactamases. The spectrum of action is narrow (very active against gram-negative bacteria, including Pseudomonas aeruginosa).
GLYCOPEPTIDES(vancomycin and teicoplanin) - These are large molecules that have difficulty passing through the pores of gram-negative bacteria. As a result, the spectrum of action is limited to gram-positive bacteria. They are used for resistance or allergy to beta-lactams, for pseudomembranous colitis caused by Clostridium difficile.
AMINOGLICOSIDES- compounds whose molecules include amino sugars. The first drug, streptomycin, was obtained in 1943 by Vaksman as a treatment for tuberculosis.
Now there are several generations of drugs: (1) streptomycin, kanamycin, etc., (2) gentamicin,(3) sisomycin, tobramycin, etc. The drugs are bactericidal, the spectrum of action is wide (especially active against gram-negative bacteria, they act on some protozoa).
TETRACYCLINES is a family of large molecular drugs containing four cyclic compounds. Currently, semi-synthetics are mainly used, for example doxycycline. Action type - static. The spectrum of action is wide (especially often used to treat infections caused by intracellular microbes: rickettsia, chlamydia, mycoplasma, brucella, legionella).
MACROLIDES(and azalides) are a family of large macrocyclic molecules. Erythromycin- the most famous and widely used antibiotic. Newer drugs: azithromycin, clarithromycinmycin(they can be used only 1-2 times a day). The spectrum of action is wide, including intracellular microorganisms, legionella, hemophilus influenzae. The type of action is static (although, depending on the type of microbe, it can also be cidal).
LINCOSAMIDES(lincomycin and its chlorinated derivative - clindamycin). Bacteriostatics. Their spectrum of action is similar to macrolides; clindamycin is especially active against anaerobes.
POLYPEPTIDES(polymyxins). The spectrum of antimicrobial action is narrow (Gram-negative bacteria), the type of action is bactericidal. Very toxic. Application - external; currently not in use.
POLYENES(amphotericin B, nystatin and etc.). Antifungal drugs, the toxicity of which is quite high, are therefore often used topically (nystatin), and for systemic mycoses, the drug of choice is amphotericin B.
7.1.2. Synthetic antimicrobial chemotherapy drugs
Using chemical synthesis methods, many substances have been created that are not found in living nature, but are similar to antibiotics in mechanism, type and spectrum of action. In 1908, P. Ehrlich synthesized salvarsan, a drug for the treatment of syphilis, based on organic arsenic compounds. However, the scientist’s further attempts to create similar drugs - “magic bullets” - against other bacteria were unsuccessful. In 1935, Gerhardt Domagk proposed pron-tosil (“red streptocide”) for the treatment of bacterial infections. The active principle of Prontosil was sulfonamide, which was released when Prontosil decomposed in the body.
To date, many varieties of antibacterial, antifungal, antiprotozoal synthetic chemotherapeutic drugs of different chemical structures have been created. The most significant groups include: sulfonamides, nitroimidazoles, quinolones and fluoroquinolones, imidazoles, nitrofurans, etc.
A special group consists of antiviral drugs (see section 7.6).
SULPHANAMIDES. The basis of the molecule of these drugs is the para-amino group, therefore they act as analogues and competitive antagonists of para-aminobenzoic acid, which is necessary for bacteria to synthesize vital folic (tetrahydrofolic) acid - a precursor of purine and pyrimidine bases. Bacteriostatics, the spectrum of action is wide. The role of sulfonamides in the treatment of infections has recently declined because there are many resistant strains, side effects are serious, and the activity of sulfonamides is generally lower than that of antibiotics. The only drug in this group that continues to be widely used in clinical practice is its co-trimoxazole analogues. Co-trimoxazole (bactrim, 6ucenmok)- a combination drug that consists of sulfamethoxazole and trimethoprim. Both components act synergistically, potentiating each other's action. Acts bactericidal. Trimethoprim blocks-
Table 7.1. Classification of antimicrobial chemotherapy drugs by mechanism of action
Cell wall synthesis inhibitors
Beta-lactams (penicillins, cephalosporins, carbapenems, monobactams)
Glycopeptides
Synthesis inhibitors
Aminodicosides
Tetracyclines
Chloramphenicol
Lincosamides
Macrolides
Fusidic acid
Nucleic acid synthesis inhibitors
Inhibitors of nucleic acid precursor synthesis
Sulfonamides
Trimethoprim DNA replication inhibitors
Quinolones
Nitroimidazoles
Nitrofurans RNA polymerase inhibitors
Rifamycins
Function inhibitors
cell membranes
Imidazoles
Polymyxins
synthesizes folic acid, but at the level of another enzyme. Used for urinary tract infections caused by gram-negative bacteria.
QUINOLONES. The first drug of this class is nalidixic acid (1962). She has limited
The spectrum of action, resistance to it quickly develops, is used in the treatment of urinary tract infections caused by gram-negative bacteria. Nowadays, so-called fluoroquinolones are used, i.e., fundamentally new fluorinated compounds. Advantages of fluoroquinolones - different routes of administration, bactericidal
action, good tolerability, high activity at the injection site, good permeability through the histohematic barrier, fairly low risk of developing resistance. In fluoroquinolones (qi-profloxacin, norfloxacin etc.) the spectrum is wide, the type of action is cidial. Used for infections caused by gram-negative bacteria (including Pseudomonas aeruginosa), intracellular
They are especially active against anaerobic bacteria, since only these microbes are able to activate metronidazole through reduction. Action type -
cidal, spectrum - anaerobic bacteria and protozoa (Trichomonas, Giardia, dysenteric amoeba). IMIDAZOLES (clotrimazole and etc.). Antifungal drugs act at the level of the cytoplasmic membrane. NITROFURANS (furazolidone and etc.). Action type
twiya - cidal, spectrum - wide. Are accumulating
in urine in high concentrations. They are used as uroseptics for the treatment of urinary tract infections.
Despite the undoubted successes and achievements of modern medicine in the fight against infections caused by pathogenic fungi, the number of people suffering from such diseases is not decreasing.
In addition to superficial and urogenital mycoses, deep lesions associated with HIV, organ donation, hemato-oncology, and nursing newborns are quite often recorded today.
Antimycotic drugs, used in various regimens for the treatment and prevention of fungal infections, must exhibit high activity against the pathogen, have a prolonged effect, have a minimal frequency of formation of resistance of the pathogenic organism, have good compatibility with pharmaceuticals of other groups, be effective, safe, and easy to use.
These requirements are met, in particular, by an antimycotic from the azole group - fluconazole, which acts as the active substance of broad-spectrum antifungal drugs. One of them is a drug Diflucan.
Inflammatory diseases of the genitourinary system most often occur due to pathogenic microorganisms.
The most common pathogens are chlamydia, trichomonas, mycoplasma, ureaplasma, and fungi.
A person can be a carrier of pathogenic bacteria and not know it. Often a person becomes infected with several types of microorganisms at once.
Treatment of such conditions requires a comprehensive approach. The drug Safotsid includes three drugs with different spectrum of action.
For most infections, a single dose of the drug complex is sufficient. But only a doctor can determine the advisability of using Safocid.
Mikosist It is considered one of the most effective drugs for the treatment of fungal diseases.
The main active ingredient of the medicine is
Broad-spectrum antibiotics of the new generation, the list of which is growing every year, are a group of medications whose purpose is to destroy bacteria and viruses. The most famous antibiotic is penicillin, which was discovered by A. Fleming back in 1928. Gradually, new antibacterial agents were created based on penicillin. They are currently used to treat diseases that were considered incurable several decades ago.
Effect of new drugs
Broad-spectrum antibiotics of the newest generation are medications aimed at eliminating infections and the diseases that these infections caused. They allow you to speed up the treatment of the disease, alleviate the course of the disease, and reduce the number of deaths. Some drugs (penicillin, ) block the development of the outer cell membrane of bacteria. Other antibiotics (tetracyclines and) completely stop protein production in bacterial cells.
The list of medications is divided according to the principle of antibacteriality of drugs. The annotation must indicate in which area the antibiotic is most active. Some drugs are aimed at destroying a specific bacterium, while others are active in many cases of infection by various bacteria. If the disease develops too actively or the nature of the infection is not known, then a drug with a wide spectrum of effects is prescribed.
IMPORTANT! From all the variety of antibiotics, it is impossible to choose the right one on your own. This should only be done by the attending physician, otherwise self-prescribing antibiotics can cause significant harm to your health.
There are two types of bacteria that antibiotics can treat:
- Gram-negative. They become the cause of diseases of the genitourinary, respiratory and intestinal systems.
- Gram-positive. Provoke infection of wounds. Because of them, inflammatory processes occur after surgery.
Antibacterial agents are divided into 2 groups. One destroys bacteria and viruses, and the second suppresses their effect on the human body and prevents them from multiplying. Both groups of drugs act selectively and do not affect healthy cells.
List of antibiotics
There are original drugs and their copies (so-called generics). It's better to choose originals. Although they are more expensive, they are safe and the treatment will be effective.
There is no doubt that antibiotics are effective in treating diseases that caused death just a few decades ago. This is man's greatest discovery. But viruses and bacteria are able to adapt to therapy with old drugs. Therefore, we have to invent new generations of medicines.
New generation antibacterial agents with a wide spectrum of action have fewer side effects, they are safe, easy to use, and are available in various forms.
It is impossible to single out the most effective drug; all of them will be effective in a certain situation.
The list of broad-spectrum antibiotics includes the following medications:
- Antipseudomonas and natural penicillins;
- macrolides;
- nitrofurans;
- sulfonamides;
- tetracyclines;
- quinolones;
- fluoride;
- 3rd and 4th generation cephalosporins.
This list includes the oldest generation of drugs and the newest very strong drugs.
Forms of release of antibacterial drugs
Antibiotics are prescribed for periodonitis, syphilis, boils, pneumonia, and skin infections. They are produced in tablet form, in the form of suppositories, powders, capsules.
List of new antibiotics in powder and injection forms
Strong, fast-acting medications are most often administered either intravenously or intramuscularly. Due to the injection, the medicine does not enter the stomach, the effect on its mucous membrane is prevented and the microflora is not destroyed. This is how the medicine immediately begins to act. The list of new medications for injection is extensive.
These include:
- aminopenicillins resistant to beta-lactamase, for example Sulbactam;
- carbapenems (Imipinem-cilastatin, Ertapenem);
- third and fourth generation cephalosporins Cefoperazone; Cefotaxime, Ceftazidime, Cefpirome;
- 3rd generation aminoglycoside antibiotics Amikacin and Netilmicin.
Tablets and capsules
Such drugs are prescribed during pregnancy and childhood. It is believed that they are not harmful to health; the use of the tablet form is more gentle than injections. Modern antibiotics of the latest generation in capsules or tablets are produced in almost the same quantities as powders and injection solutions. These include:
- fluoroquinols 3 and 4 generations (Moxifloxacin, Gatifloxacin);
- macrolides (Azithromycin, Clarithromycin, Roxithromycin, Amoxicillin);
- macrolides of natural origin (Sparfloxacin, Levofloxacin, Midecamycin);
- nitrofurans – (Nitrofurantoin, Ersefuril);
- 4th generation antibiotics (Posaconazole, Voriconazole, Ravuconazole).
Sometimes doctors prefer narrow-spectrum antibiotics, since they do not affect the integrity of the intestinal microflora and have fewer side effects.
Use of antibiotics for various diseases
There is a huge list of antibiotics for adults. The table shows the main medications used in the treatment of various diseases.
Disease. Names of antibiotics used
Diseases of the female urinary and reproductive system
Antibacterial agents are used in gynecology to treat inflammatory processes associated with the female genital area. Thrush and vaginitis are treated with Monural, Furamag. If the disease is accompanied by complications, then Levofloxacin and Ofloxacin are prescribed. To eliminate a urinary tract infection, you need to take a course of Metronidazole and Nalidixic acid.
Inflammation of the maxillary sinuses
For sinusitis, Cefachlor and Cefixime are prescribed. If the disease is accompanied by complications, the doctor prescribes Azithromycin, Macropen.
Staphylococcus
When the body is affected by staphylococcus, Bactroban ointment is used. It prevents the appearance of new bacteria, and those that live inside the body become weak and die.
Angina
For tonsillitis, Azitral, Spiramycin, and Erythromycin are used.
Colds, flu, ARVI
Macrolides are prescribed, which are considered the safest among antibiotics. These are Erythromycin, Leukomycin, Rulid, Sumamed, Clarithromycin, Aziromycin. Cefamandole is also prescribed, which has a powerful bactericidal effect and is highly absorbed from the gastrointestinal tract.
Dental problems
Dentists prescribe antibacterial agents for acute inflammation and to prevent purulent processes, if the patient undergoing surgery suffers from vascular problems, decompensated diabetes, or renal failure. Ampiox, Gentamicin, Syntomycin, Doxycycline are usually prescribed. The most commonly used drug in dentistry is the long-acting drug Lincomycin. It accumulates in the bones and acts for a long time, which is very good when performing complex operations.
Diseases of the urinary system
Cystitis, pyelonephritis, glomerulonephritis are treated with Canephron, Palin, Nolicin. These same drugs are also suitable for eliminating other urological problems. For cystitis, Ionural, Norbactin, Unidox Solutab are prescribed.
For urinary tract infections, Miconazole, Fluconazole, Ketoconazole are prescribed. For pyelonephritis, an antibiotic consisting of nitrofurans, cephalosporins, and fluoroquinolones is prescribed. If the disease proceeds normally, cephalosporins are used, if the condition worsens, then cephalosporins are used.
Pneumonia and bronchitis
For bronchitis, Erythromycin and Penicillin are prescribed. But other components must be added to Penicillin, since it has long been used for treatment and bacteria have adapted to it.
Penicillin is usually used in conjunction with Augmentin and Cefuroxime. For bronchitis and pneumonia, an individual treatment regimen is drawn up, which combines different types of medications to kill more bacteria. Most often, bronchodilators are added.
In case of complicated and prolonged course of bronchitis, Ceftriaxone plus Azithromycin is prescribed, which is sometimes replaced with Clarithromycin, Midecamycin.
Eye inflammation
For eye infections, Eubetal and Tobrex drops are used.
New generations of broad-spectrum antibiotics, which include Ciprofloxacin, Cefepime, Levofloxacin, Ceftriaxone, inhibit pathogenic microflora and the day after taking them, a person already feels the effect of treatment. In case of pneumonia, these drugs quickly suppress the pathogen and its pathogenic effect.
If medications are combined, then the ratio of bacteriostatic to bactericidal drugs should be one to one.
Limitations of antibacterial therapy for children and pregnant women
Since “adult” antibiotics are often not suitable for children, scientists, after conducting many studies, experimentally found out which antibiotics are best for children to take if necessary. As a result, it was proven that the best antibacterial agents in childhood are macrolides (Roxithromycin, Azithromycin), aminopenicillins (Clavulanate), cephalosporins (Ceftriaxone). It is not recommended to use carbapenes and fluoroquinols. These medications provoke the development of problems with the kidneys and liver, and prevent children’s bones from growing normally.
During pregnancy, the list of antibiotics approved for use is very limited. It is recommended to use Amoxiclav, Cefazolin, Ceftriaxone. In the 3rd trimester, Clarithromycin, Midecamycin, Azithromycin are also added to the drugs. Of course, all prescriptions are made by the doctor.
Features of therapy
New generation antibiotics do an excellent job against any pathogens of inflammatory processes. It is important to choose the optimal combination of drugs to increase the effectiveness of therapy. Only a doctor can prescribe such a combination, taking into account the individual course of the disease, the presence or absence of progress in treatment.
Basically, the course lasts 7-10 days. Treatment with antibiotics is carried out in several ways: through the mouth (oral), through the rectum (rectal), intravenously, intramuscularly, into the spinal cord. You should not drink alcohol or use drugs during this time. Before use, you should read the instructions for use and strictly follow the instructions for use.
The new generation of antibiotics has the same serious impact on health as the old one. The newest remedies help to recover, but at the same time destroy beneficial intestinal microflora and reduce immunity. Therefore, you need to take such medications strictly on the recommendation of a doctor according to the instructions. After a course of therapy, to protect and restore the microflora of the gastrointestinal tract, it is necessary to take pribiotics and probiotics, and immunomodulators. It is important to follow a diet with big amount lactic acid products, vegetables and fruits. Spicy, fatty, smoked, salty foods are excluded.
Macrolides should not be used during pregnancy, people with impaired kidney or liver function, or those with allergic reactions to a certain type of antibiotic. If a broad-spectrum antibiotic was chosen incorrectly or the patient does not follow the rules for its use, then headaches, nausea, rash, vomiting, diarrhea, fever, loss of coordination and even anaphylactic shock may occur. In this case, you should stop taking the medication and consult a doctor.
Therapy with a new generation of broad-spectrum antibacterial drugs helps cure most ailments that are caused by pathogenic bacteria. But treatment should be taken with great responsibility, fully following the doctor’s advice. Otherwise, there is a possibility of further harm to your health.
