Broad-spectrum antimicrobials in tablets. List of new generation broad-spectrum antibiotics and their uses

Despite the undoubted successes and achievements of modern medicine in the fight against infections, the causative agents of which are 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 of newborns are often recorded today.

Antimycotic drugs, used in the implementation of various schemes for the treatment and prevention of fungal infections, should be highly active against the pathogen, have a prolonged action, have a minimum frequency of formation of resistance of the pathogenic organism, be distinguished by good compatibility with pharmaceuticals from other groups, be effective, safe, and convenient 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, trichomonads, mycoplasmas, ureaplasmas, and fungi.

A person can be a carrier of pathogenic bacteria and not know about it. Often a person becomes infected with several types of microorganisms at once.

An integrated approach is required to treat these conditions. The drug Safocid includes three drugs of different spectrum of action.

For most infections, a single dose of the drug complex is sufficient. But only a doctor can determine the appropriateness of using Safocid.

Mycosist considered one of the most effective drugs for the treatment of fungal diseases.

The main active ingredient of the drug is

Often, as soon as we notice a cough or a slight increase in temperature, we begin to study all possible pills and potions. Undoubtedly, knowledge of good medicines will always come in handy. Therefore, searching for information about them on the Internet is a very useful pastime. However, any disease should be treated carefully, having thoroughly studied everything and, of course, consulting a doctor. Especially when it comes to antibiotics.

Antibiotics are a powerful and effective remedy for many diseases. These antibacterial substances of synthetic, semi-synthetic or natural origin can quickly stop the growth of harmful microorganisms or completely destroy them.

Especially often they are used in the treatment of such common diseases as:

angina;
bronchitis;
sinusitis;
intestinal infections;
otitis;
pneumonia.

Also, antibiotics are used in a number of other cases, due to which they are one of the most popular types of medicines. However, not all and not always treated with these substances. For example, most antibiotics are usually useless in the treatment of viral diseases. Against viruses, only tetracyclines and some other groups are mainly used.

In addition, despite their widespread use, antibiotics are by no means harmless. Some of them, with prolonged use, can cause dysbacteriosis and skin rashes. Also, antibacterial drugs often have side effects, and if taken incorrectly, they can greatly weaken the body and make harmful bacteria resistant to treatment.

Therefore, for review, we have compiled a rating of the best antibiotics against specific diseases, in particular, sore throats, coughs and some others. When choosing funds, we were guided by the recommendations of specialists, patient reviews and a description of the pharmacological action of drugs. However, antibiotics should be taken strictly according to the doctor's prescription!

There are contraindications. Check with your doctor.

The best antibiotics for sore throat, bronchitis and cough

Most antibiotics are designed to fight several different types of microbes at once and have a fairly wide spectrum of action. However, only a few of them are really effective for coughs and respiratory tract infections.

3 Azithromycin

Best price
Country Russia
Average price: 160 rubles.
Rating (2019): 4.0

The rating of the best antibiotics against colds is opened by a budget domestic broad-spectrum drug. Despite the low price, it copes well with various respiratory infections, including bronchitis, laryngitis and pneumonia. Therefore, it is one of the most prescribed antibiotics.

However, he was prevented from getting a higher place in the ranking by a large number of side effects and contraindications, alas, characteristic of most of these drugs. In addition, it is not recommended for children under 16 years of age, as well as for adults who have arrhythmias, kidney or liver failure.

2 Macrofoam

The best antibiotic tablets
Country: Slovenia
Average price: 262 rubles.
Rating (2019): 4.4

Coated Slovenian tablets are a good remedy for pathogenic intracellular microorganisms. This antibiotic is used mainly for bronchitis, stomatitis, pneumonia and other infections caused by certain pathogens. Also, the drug can be taken for the treatment and prevention of whooping cough and diphtheria.

The advantages of this antibiotic include efficiency, few contraindications and minimal side effects. Plus, it's pretty easy to take. Usually it is prescribed 3 times a day, one tablet before meals.

The standard form of release of the antibiotic is 16 tablets. However, the drug is also found in the form of a suspension, which is given even to the smallest children.

1 Fluimucil-antibiotic IT

Best result
Country: Italy
Average price: 750 rubles.
Rating (2019): 4.8

Fluimucil is one of the few truly effective antibiotics suitable for both injection and inhalation. This antibiotic is used mainly for inhalation with a wet cough, bronchitis, tonsillitis, tracheitis and a number of other respiratory diseases.

Also, this solution can be called one of the best means for washing or instillation for sinusitis, including sinusitis, and otitis media. Due to the successful combination of antibiotic and mucolytic, Fluimucil not only eliminates pathogenic microflora, but also helps to cleanse the problem area. For example, with bronchitis, the drug accelerates the process of sputum excretion.

Fluimucil-antibiotic IT is released in the form of a solution of 500 mg for inhalation and injection. It should not be confused with the effervescent tablets and granules of the same name for the preparation of a solution that is taken orally.

The best antibiotics for sinusitis

2 Polydex with phenylephrine

Antibacterial and vasoconstrictive action
Country: France
Average price: 320 rubles.
Rating (2019): 4.7

Polydex spray is a complex remedy that is prescribed for a protracted cold with purulent discharge from the nose. Thanks to the combination of two antibiotics and the vasoconstrictor phenylephrine, this antibiotic has a wide spectrum of action and is effective in the fight against sinusitis and other sinusitis, rhinitis and a number of different bacteria. These drops can be called the best drug that has an antibacterial and anti-inflammatory effect and improves breathing. The effect of their application, as a rule, is noticeable after 3-5 days. The full course of treatment takes no more than 10 days.

It is important to remember that this is not only a nasal spray, but also a strong antibiotic that has a number of contraindications. In addition to pregnant women and children under 2.5 years old, Polydex is not suitable for adults suffering from glaucoma, kidney failure and kidney disease. Therefore, it is often replaced with a more gentle analogue.

1 Isofra

Best topical antibiotic
Country: France
Average price: 300 rubles.
Rating (2019): 5.0

The first place among the best remedies for sinusitis goes to a fairly powerful local antibiotic in the form of a nasal spray. Although this French drug is quite inexpensive and does not have the widest spectrum of action, it is literally indispensable in the treatment of a protracted cold with rhinitis, sinusitis or nasopharyngitis. In addition, this antibiotic is used to treat both adults and children.

The drug is considered one of the most harmless antibiotics, goes well with other drugs, has virtually no contraindications. Possible side effects include only an allergy to individual components and some deterioration in the microflora of the nasopharynx with prolonged use.

However, it is important to remember that this is still an antibiotic that must be used as prescribed by a doctor. In addition, it is categorically not recommended for use in allergic rhinitis or as a remedy for allergies.

Best Broad Spectrum Antibiotics

Although in most cases the use of narrowly targeted antibiotics is preferable, as they have fewer side effects, often recovery is not possible without a broad-spectrum antibiotic. For example, some diseases can be caused by several types of bacteria at once. In addition, not all pathogenic microflora can be eliminated by taking a specialized antibiotic.

3 Tetracycline

The widest range of action
Country Russia
Average price: 76 rubles.
Rating (2019): 4.2

Probably almost every adult knows this frequently prescribed drug. Produced in various forms, the antibiotic is almost universal.

In most cases, tetracycline is taken in the form of tablets, including bronchitis, tonsillitis, pharyngitis, prostatitis, eczema, and various infections of the gastrointestinal tract and soft tissues. Acting in a complex way, this antibiotic quickly copes with most infectious causes of cough, fever and other ailments. Also, the antibiotic is available in the form of an ointment for external use and eye ointment, which helps to eliminate some problems locally.

However, the antibiotic has many contraindications and is not suitable for children under 8 years of age, as well as women during pregnancy or lactation. Also, like many strong drugs, it can cause serious side effects.

2 Avelox

Better efficacy in acute and chronic diseases
Country: Germany
Average price: 773 rubles.
Rating (2019): 4.5

Avelox tablets from the well-known German company Bayer are one of the most serious antibiotics used primarily to combat acute and chronic diseases that cannot be treated by most other means. Therefore, since 2012, it has been included by the Government of the Russian Federation in the List of Essential Medicines.

It is also one of the best drugs for adults due to its high efficiency and the fact that it is convenient and easy to take, so it does not depend on meals and does not require any additional actions. In addition, the antibiotic is well studied and, according to numerous studies, rarely causes side effects.

Also, the antibiotic is found in the form of an injection solution, which is often used for exacerbation of chronic bronchitis. In some cases, the course of injections of Avelox precedes the course of the same antibiotic in tablets.

1 Amoxicillin

The most harmless universal antibiotic
Country: Slovenia
Average price: 44 rubles.
Rating (2019): 4.9

The time-tested popular drug becomes the leader in the ranking of the best broad-spectrum antibiotics. It is taken for many diseases that occur both with and without temperature, in particular:

infections of the respiratory tract and ENT organs (including sinusitis, bronchitis, tonsillitis, otitis media);
gastrointestinal infections;
skin and soft tissue infections;
infections of the genitourinary system;
Lyme disease;
dysentery;
meningitis;
salmonellosis;
sepsis.

Amoxicillin is perhaps one of the most popular antibiotics for adults and children. The presence of different forms of release, including tablets and suspensions, as well as a relatively small list of possible side effects, allow even pregnant women and babies aged 1 month to take the medicine.

Best antibiotics for kids

The illness of a child in itself is not an easy test. However, the situation is often complicated by the fact that children do not want to take an antibiotic, or it has many side effects that are extremely harmful to the child's body. Therefore, we have selected some of the most harmless and palatable effective drugs for sore throats, bronchitis and other common diseases.

2 Augmentin

The best complex antibiotic
Country: UK
Average price: 150 rubles.
Rating (2019): 4.4

Augmentin is one of the few antibiotics safe enough to be given to young children, even infants. Despite the relatively small number of side effects, the drug, unlike some analogues, can still have a negative effect on the kidneys and intestines. Therefore, it should be taken with caution, especially at an early age.

In general, the antibiotic is effective and has a good composition. Especially often this antibacterial agent is prescribed in the treatment of bronchitis, tonsillitis, sinusitis, as well as various respiratory tract infections. In addition, due to the extended complex action, this antibiotic is also effective in the fight against various mixed infections.

In addition to the suspension, Augmentin is also available in the form of tablets that school-age children and adults can take.

1 Amoxiclav

Maximum benefit - minimum contraindications
Country: Slovenia
Average price: 220 rubles.
Rating (2019): 5.0

The leader among the best children's antibiotics can be confidently called a universal broad-spectrum drug, suitable for both adults and children. The most popular form of Amoxiclav is tablets, but in pharmacies you can easily find a suspension, which is usually given to young children and even newborns with severe colds, coughs and fever caused by various infections.

In addition to the convenient form of release and versatility, the advantages of the drug include:

minimum contraindications and side effects;
pleasant taste;
speed;
does not contain dyes;
affordable price.

Despite the mild effect of the drug, you can take it, like other antibiotics, only as directed by a doctor. In addition, Amoxiclav cannot be combined with certain other medicines.

These funds are able to block the spread of disease-causing agents or have a detrimental effect on them. But in order for the fight against them to be successful, it is necessary to establish exactly which ones. In some cases, it is impossible to determine the diagnosis and the best way out is broad-spectrum antimicrobials.

Features of the fight against pathogens

It is important to consider that many antimicrobial drugs have a powerful effect not only on foreign agents, but also on the patient's body. So, they have a detrimental effect on the microflora of the gastric region and some other organs. To cause minimal damage, it is important to start treatment immediately, because microorganisms spread at a tremendous speed. If you miss this moment, the fight against them will be longer and more exhausting.

In addition, if antimicrobials are to be used for treatment, they should be prescribed in the maximum amount so that the microorganisms do not have time to adapt. The assigned course cannot be interrupted, even if improvements are noticed.

Also, in the treatment it is recommended to use different antimicrobials, and not just one type. This is necessary so that after the therapy there are no foreign agents left that have adapted to a particular drug.

In addition to this, be sure to take a course that will strengthen the body. Because many drugs can cause serious allergic reactions, they should only be taken as directed by your doctor.

Sulfanilamide funds

We can say that they are divided into three types - these are nitrofurans, antibiotics and sulfonamides. The latter means have their detrimental effect in that they do not allow microbes to receive folic acid and other components that are important for their reproduction and life. But the premature termination of the treatment course or a small amount of the drug makes it possible for microorganisms to adapt to new conditions. In the future, sulfonamides are no longer able to fight.

This group includes well-absorbed drugs: "Norsulfazol", "Streptocid", "Sulfadimezin", "Etazol". It should also be noted that drugs that are difficult to absorb: "Sulgin", "Ftalazol" and others.

If necessary, for the best result, the doctor may recommend combining these two types of sulfa drugs. It is also possible to combine them with antibiotics. Some antimicrobials are described below.

"Streptocide"

Basically, this drug is prescribed for the treatment of tonsillitis, cystitis, pyelitis, erysipelas. In some cases, the medicine can cause side effects such as headache, severe nausea accompanied by vomiting, some complications from the nervous, hematopoietic or cardiovascular systems. But medicine does not stand still, and in practice such drugs are used, but they have fewer adverse reactions. These drugs include "Etazol" and "Sulfadimezin".

Also, "Streptocid" can be applied topically for burns, festering wounds, skin ulcers. In addition, you can inhale the powder through your nose if you have an acute runny nose.

"Norsulfazol"

This drug is effective in cerebral meningitis, pneumonia, sepsis, gonorrhea, etc. This antimicrobial agent is quickly excreted from the body, but it is necessary to drink large amounts of water per day.

"Ingalipt"

Good antimicrobials for the throat, which are prescribed for laryngitis, ulcerative stomatitis, pharyngitis, are those that contain streptocide and norsulfazol. Such means include "Ingalipt". Among other things, it contains thymol, alcohol, mint and eucalyptus oil. It is an antiseptic and anti-inflammatory agent.

"Furacilin"

This is an antibacterial liquid known to many, which has a detrimental effect on various microbes. You can use the medicine externally, treating wounds, washing the nasal and auditory passages, as well as internally for bacillary dysentery. On the basis of "Furacilin" some antibacterial and antimicrobial drugs are produced.

"Ftalazol"

This slowly absorbed drug can be combined with antibiotics. It is also combined with "Etazol", "Sulfadimezin" and other drugs. It actively works, inhibiting intestinal infections. Effective in dysentery, gastroenteritis, colitis.

Nitrofuran

In medicine, there are many drugs that are derivatives of "Nitrofuran". Such funds have a wide range of effects. For example, "Furagin" and "Furadonin" are often prescribed for cystitis, urethritis, pyelonephritis and other infectious diseases of the genitourinary system.

"Penicillin"

The drug is an antibiotic that has a detrimental effect on young microbes. In the fight against influenza, smallpox and other viral diseases, it is ineffective. But with pneumonia, peritonitis, abscess, sepsis, meningitis "Penicillin" is a good helper. Various drugs are obtained from it, which are superior in action, for example, "Benzylpenicillin". These medications are low-toxic, they practically do not cause complications. That is why it is considered that these are strong antimicrobials for children.

But still it is worth considering that a low-quality medicine can cause intense allergies. It can also suppress the natural intestinal microflora in the elderly and newborns. Weakened people or in childhood simultaneously with "Penicillin" are prescribed vitamins of groups C and B.

"Levomitsetin"

Strains resistant to Penicillin are inhibited by Levomycetin. It has no effect on protozoa, acid-fast bacteria, anaerobes. In psoriasis and skin diseases, this drug is contraindicated. It is also forbidden to take it with oppression of hematopoiesis.

"Streptomycin"

This antibiotic has several derivatives that help in different situations. For example, some can treat pneumonia, others are effective for peritonitis, and others cope with an infection of the genitourinary system. Note that the use of "Streptomycin" and its derivatives is permissible only after a doctor's prescription, since overdose does not exclude such a serious complication as hearing loss.

"Tetracycline"

This antibiotic is able to cope with many bacteria that cannot be treated with other drugs. Side effects may occur. "Tetracycline" can be combined with "Penicillin" in case of a severe septic condition. There is also an ointment that copes with skin diseases.

"Erythromycin"

This antibiotic is considered a "fallback" option, which is resorted to if other antimicrobial agents have not done their job. He successfully defeats diseases that have appeared due to the action of resistant strains of staphylococci. There is also erythromycin ointment, which helps with bedsores, burns, purulent or infected wounds, trophic ulcers.

The main broad-spectrum antimicrobials are listed below:

"Tetracycline".
"Levomycetin".
"Ampicillin".
"Rifampicin".
"Neomycin".
"Monomycin".
"Rifamcin".
"Imipenem".
"Cephalosporins".

Gynecology and antibacterial treatment

If in any other area it is permissible to attack the disease with broad-spectrum antibacterial drugs, then in gynecology it is required to strike with a well-chosen, narrowly targeted remedy. Depending on the microflora, not only drugs are prescribed, but also their dosage and duration of the course.

Most often, antimicrobial drugs in gynecology are used externally. It can be suppositories, ointments, capsules. In some cases, if the need arises, treatment is supplemented with broad-spectrum drugs. These may include "Terzhinan", "Polizhinaks" and others. A faster result can be achieved if you take two or three drugs at the same time. In any case, a preliminary consultation with a doctor is important.

In the medical literature and among doctors, you can hear the term "broad-spectrum antibacterial drugs." What does it mean?

Any antibacterial drug (ABP) has a spectrum of action. These are the microorganisms on which it acts. The more bacteria sensitive to the drug, the wider its spectrum.

Generally, such antibiotics are drugs that kill or inhibit the growth of Gram-negative and Gram-positive bacteria. These pathogens cause most of the inflammatory diseases in the body.

Most often, ABP is prescribed for such diseases:

pneumonia and bronchitis;
sinusitis and frontitis;
streptococcal angina;
otitis;
pyelonephritis.

Broad-spectrum antimicrobials are indicated when the exact causative agent is unknown and there is no time for bacteriological culture to determine drug susceptibility.

For example, pneumonia requires therapy on the day of diagnosis, and the only way out is the use of broad-spectrum antibiotics.

With this approach, there is always the possibility of choosing an ineffective drug, to which a specific pathogen is resistant. But this does not happen so often and in any case it is preferable to wait for the results of bakposev.

The following groups of such antibiotics are distinguished:

penicillins;
cephalosporins;
macrolides;
fluoroquinolones.

Penicillins

Penicillin is the first antibiotic that began to be used in the fight against purulent infection. Thanks to its action, the survival rate of patients in the postoperative period has increased dramatically. The mortality of patients from pneumonia, which was common at all times, also decreased.

The group of penicillins includes the following representatives:

benzylpenicillin;
bicillin;
oxacillin;
ampicillin;
amoxicillin.

One, due to the widespread and often unjustified prescription of these antibiotics, most microbes have developed resistance to them, and penicillins have practically ceased to be used. Also, a significant drawback of this group was the inability to withstand the destructive action of beta-lactamases - bacterial enzymes.

However, modern penicillins are protected from microbial influence due to the combination with clavulanic acid.

The most popular drug amoxiclav (Augmentin, Amoxiclav Quiktab) is widely used by doctors of all specialties and is the gold standard in the treatment of infectious and purulent diseases.

Cephalosporins

In terms of their spectrum of action, cephalosporins are not much different from penicillins. Moreover, these groups are characterized by cross-sensitivity.

Allergies to these drugs occur quite often. And if the patient has hypersensitivity to antibiotics of the penicillin series, the appointment of drugs of the second group should be approached with caution. The likelihood of an allergy in such a patient will be increased.

There are four generations of cephalosporins, the first does not differ in a wide spectrum of action. In routine practice, the most commonly prescribed third-generation drugs are ceftriaxone (Medaxone) and cefixime (Cefix).

Cephalosporins are available in tablets and ampoules. Parenteral forms are widely used in surgical, therapeutic and pulmonological (pneumonia, COPD, pleurisy) hospitals.

Macrolides

Given that the proportion of these pathogens in the development of diseases of the respiratory system has increased significantly, the relevance of macrolides is increasing every year.

This group is represented by:

azithromycin;
clarithromycin;
erythromycin.

The latter drug is currently practically not used. Doctors can prescribe it only for strict indications - for example, with confirmed sensitivity of microbes to this antibiotic.

Fluoroquinolones

Fluoroquinolones are the antibiotics of the reserve due to the large number of side effects. They affect the liver and kidneys, the blood system, the central nervous system.

However, the effectiveness of these drugs is quite high, and there are not so many bacteria resistant to them.

Currently, fluoroquinolones are beginning to displace even penicillins and cephalosporins from practice. If at first these drugs were prescribed only for diseases of the urinary system, now a group of respiratory fluoroquinolones has been identified. They are widely used in such pathologies:

bronchitis;
inflammation of the lungs;
COPD;
pleurisy;
exacerbation of bronchiectasis.

However, when prescribing fluoroquinolones, one should keep in mind their various side effects and warn patients about this.

Antimicrobial medicines in children

What antimicrobial agent can be freely used in pediatrics? Most often, pediatricians recommend antibiotics from the group of penicillins, cephalosporins, or macrolides for children. The latter are used most often due to their high efficiency and ease of use.

Fluoroquinolones, according to the manufacturer's instructions, are not used in children under 14 years of age. This is due to their negative effect on the cartilaginous tissue of the child.

However, in recent years, pediatricians have begun to use these antibiotics in children with cystic fibrosis. The disease is extremely difficult to treat and is characterized by frequent exacerbations, while the pathogens are resistant to most drugs.

Modern medicine cannot do without broad-spectrum antibiotics. However, they should not be abused, which does not form drug resistance in microbes. These drugs are prescribed only by a doctor.

Today even children of primary school age know what antibiotics are. However, the term "broad-spectrum antibiotics" sometimes confuses even adults and raises many questions. How wide is the spectrum? What are these antibiotics? And, yes, it looks like there are narrow-spectrum drugs that may not help?

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

Diverse world of bacteria

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

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

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

The composition of the microflora also includes the so-called conditionally pathogenic microorganisms. Under favorable conditions, they do no harm, but it is worth lowering our immunity, and these yesterday's friends turn into vicious enemies. In order to somehow understand the host of bacteria, doctors proposed to classify them.

Gram- and Gram+: decoding the puzzle

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

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

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

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

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

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

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

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

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

Broad-spectrum antibiotics: the whole army under the gun

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

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

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

List of broad-spectrum antibiotics

Let's try to name those antibacterial drugs that have a wide spectrum of activity:

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

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

Penicillins - drugs that are known and loved

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

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

Ampicillin and Amoxicillin are popular broad spectrum penicillins

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

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

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

Ampicillin

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

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

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

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

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

In addition, the drug is indicated for sore throat, infections of the urinary and genital tract, infectious diseases of the skin. Amoxicillin is a component of eradication therapy for gastric and duodenal ulcers.

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

Broad spectrum parenteral penicillins

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

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

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

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

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

Carbenicillin

In medicine, the disodium salt of carbenicillin is used, which is a white powder that dissolves before use.

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

The drug is administered intramuscularly, and in severe cases intravenously.

Ticarcillin

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

Piperacillin

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

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

Protected broad-spectrum penicillins: antibiotics to fight resistance!

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

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

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

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

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

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

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

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

Broad-spectrum tetracyclines: time-tested

Tetracycline antibiotics are among the well-known broad-spectrum drugs. This group of drugs is united by a common structure, which is based on a four-cyclic system ("tetra" in Greek - four).

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

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

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

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

Tetracycline

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

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

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

Doxycycline

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

Fluoroquinolones are essential broad spectrum antibiotics.

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

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

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

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

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

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

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

Moxifloxacin

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

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

Gatifloxacin

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

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

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

Aminoglycosides: essential antibiotics

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

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

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

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

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

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

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

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

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

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

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

Amikacin

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

Amphenicols: let's talk about the good old Levomycetin

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

The spectrum of action of Levomycetin covers:

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

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

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

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

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

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

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

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

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

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

Carbapenems: reserve antibiotics

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

Antibiotics in this group include:

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

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

Antibiotic therapy: the golden rule of safety

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

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

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