Antibiotics : spectrum of activity , receiving treatment after antibiotic - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Medicine

no medicine does not save as many lives as antibiotics.

Therefore, we can call the creation of the greatest event of antibiotics and their creators - great.Alexander Fleming in 1928 was accidentally discovered penicillin.Extensive production of penicillin was discovered only in 1943.

What is an antibiotic?

Antibiotics - substances or biological or semi-synthetic origin, which can have a negative effect (inhibit vital functions or cause complete destruction) of different pathogenic microorganisms (usually bacteria, rarely simple, and others.).

main natural antibiotics producers are fungi - penitsilium, tsefalosporium and others (penicillin, cephalosporins);actinomycetes (tetratsitslin, streptomycin), some bacteria (gramicidin), higher plants (volatile).

There are two major mechanisms of action of antibiotics:

1) bactericidal mechanism - complete inhibition of bacterial growth by acting on the vital cell structures of microorganisms, therefore, their cause irreversible destruction.They are called

bactericidal, they kill germs.Thus may act, for example, penicillin, cephalexin, gentamicin.The effect of the germicide will come faster.

2) bacteriostatic mechanism - obstacle bacterial growth, inhibits the growth of colonies of microbes, and the devastating effect on them has already been the body itself, or rather, the immune system cells - the white blood cells.So acts erythromycin, tetracycline, chloramphenicol.If you do not take the full course of treatment and stop taking early bacteriostatic antibiotic, the symptoms will return.

What are antibiotics?

I. According to the mechanism of action:
- bactericidal antibiotics (penicillin, streptomycin, cephalosporins, aminoglycosides, polymyxin, gramicidin, rifampicin, ristomycin)
- Bacteriostatic antibiotics (macrolides, tetracycline, chloramphenicol, lincomycin)

II.According spectrum of action:
- Broad-spectrum (assigned when an unknown exciter, have a wide spectrum of antibacterial action of many pathogens, but there is a small probability of death of the representatives of the normal microflora of various body systems).Examples: ampicillin, cephalosporins, aminoglycosides, tetracycline, chloramphenicol, macrolides, carbapenems.
- narrow spectrum :
1) a primary effect on the g + cocci and bacteria - staphylococci, streptococci (penicillin, cephalosporins I-II generation, lincomycin, fuzidin-, vancomycin);
2) preferential action on Gr- bacteria, such as E. coli and other (III generation cephalosporins, aminoglycosides, aztreonam, polymyxin).
* - Gram + Gram or different from each other in color and Gram microscopy (gram + stained violet and gram-reddish).
- Other antibiotics are narrow-spectrum:
1) Tuberculosis (streptomycin, rifampicin, florimitsin)
2) Antifungal (Nystatin, Levorinum, amforteritsin B Batrafen)
3) against a plain (monomitsin)
4) Antitumor (actinomycins)

III. Generations: There are antibiotics 1, 2, 3, 4 generations.
example, cephalosporins, which are divided into 1, 2, 3, 4-generation drugs:
- 1st generation: cephalexin, tseporin, cephalothin;
- 2nd generation: tsefamezin, cefazolin (kefzol), cefamandole (mandola);
- 3rd generation: cefotaxime (klaforan), cefuroxime (ketotsef), ceftriaxone (longatsef), cefuroxime axetil (Zinnat), ceftazidime (Fortum);
- 4th generation: cefepime, cefpirome (tsefrom, Kate) and others.

newer generation of antibiotics is different from the previous broader spectrum of action on microorganisms, greater safety for the human body (ie, a lower incidence of adverse reactions), more comfortable reception (if the first generation of the drug should be administered 4 times a day, 3 or 4 generations- only 1-2 times a day), are considered to be more "robust" (higher efficiency in bacterial outbreaks, and, accordingly, early onset of therapeutic effect).Also, the latest generations of modern drugs are oral forms (tablets, syrups) with a single dose during the day, which is convenient for most people.

as antibiotics can be administered?

1) Oral or orally (tablets, capsules, drops, syrups).It should be borne in mind that some drugs are poorly absorbed in the stomach or simply destroyed (penicillin, aminoglycoside, karbapinemy).
2) in the internal environment of the body or parenterally (intramuscularly, intravenously, into the spinal canal)
3) directly into the rectum or rectal (enemas)
onset of effect with antibiotics by mouth (oral) is expected to last longer thanat parenteral administration.Accordingly, in severe diseases parenteral administration is given absolute priority.Upon receiving

antibiotic is blood, then in a certain organ.There is a favorite localization of certain drugs in certain organs and systems.Accordingly, in a particular disease based prescribers of antibiotic properties.For example, in the pathology of bone appointed lincomycin, hearing - semisynthetic penicillins and other Azithromycin has the unique ability to be distributed:. With pneumonia - accumulates in the lung tissue, and pyelonephritis - kidney.

antibiotics are derived from the body in several ways: in the urine in unchanged form - displays all the water-soluble antibiotics (example: penicillins, cephalosporins);urine in a modified form (example: tetracyclines, aminoglycosides);urine and bile (example: tetracycline, rifampin, chloramphenicol, erythromycin).

reminder to the patient before receiving antibiotic

Before you appoint an antibiotic, tell your doctor:
- The presence of you in the past, side effects of medications.
- On the development in the past allergic reactions to medications.
- Admission at the moment of treatment and other compatible products already assigned with the required medicines are now.
- The presence of pregnancy or breast-feeding need.

you need to know (ask your doctor or found in the instructions to the drug):
- What is the dose and dosing frequency during the day?
- whether special food required during treatment?
- The course of treatment (how long to take an antibiotic)?
- Possible side effects of the drug.
- For oral dosage forms - communication taking the drug with food intake.
- whether prevention of adverse effects is required (eg, intestinal dysbiosis, the purpose of which shall be appointed probiotics prophylaxis).

prokonsultivatsya When you need a doctor during treatment with antibiotics:
- If signs of allergic reaction (skin rash, itching, shortness of breath, swelling of the throat, etc.).
- If within 3 days of no improvement, but on the contrary, were joined by new symptoms.Features

antibiotics:

Oral administration is set while taking the drug (antibiotics may bind food components in the digestive tract and subsequent formation of the insoluble and poorly soluble compounds which are poorly absorbed into the bloodstream, respectively, the drug effect will be poor).

important condition is the creation of an average therapeutic concentration of antibiotic in the blood, that is of sufficient concentration to achieve the desired result.That is why it is important to comply with all doses and dosing frequency for a day, prescribed by a doctor.

Currently acute problem of antibiotic resistance of microorganisms (microbial resistance to antibacterial drugs).The causes of antibiotic resistance are self without the participation of a physician;interruption of treatment (it definitely affects the absence of the full effect and "coached" germ);antibiotics for viral infections (This group of drugs has no effect on intracellular organisms, which include viruses, so wrong antibiotikolechenie viral diseases only cause more pronounced immunodeficiency).

Another important issue is the development of adverse reactions in antibiotic therapy (digestive disorders, goiter, idiosyncrasy, etc.).

data Addressing the possibility of holding a rational antibiotic therapy (competent use of the drug for a particular disease, taking into account his favorite concentrations in specific organs and systems, as well as the appointment of a professional therapeutic dose and adequate course of treatment).Creates new antibacterial drugs.

General rules for taking antibiotics:

1) Any antibiotic should be administered only by a physician!

2) Strongly recommended self antibiotics for viral infections (usually citing the prevention of complications).You can exacerbate during a viral infection.Think about taking only need at the continuing fever for more than 3 days or bacterial exacerbation of chronic hearth.Obvious evidence determines a doctor!

3) Carefully observe the prescribed course of antibiotics prescribed by your doctor.In no case do not stop taking it after you feel better.The disease would return.

4) Do not adjust the dosage of the drug in the treatment process.Small doses of antibiotics and dangerous effect on the formation of bacterial resistance.For example, if you think the 2 tablets 4 times a day - as something too much, it is better to 1 tablet 3 times a day, then it is likely that it will soon need a shot 1 to 4 times a day as tablets cease to act.

5) Take antibiotics should be washed down with a glass of water 0.5-1.Do not try to experiment and drink their tea, juice, milk and even more.You will drink it "wasted."Milk and dairy products should be taken no earlier than 4 hours after taking an antibiotic or entirely abandon them in the course of therapy.

6) Be specific frequency and all the food and drug administration (different drugs are taken in different ways: before, during, after the meal).

7) Obey certain time of antibiotics.If one time a day, the same time, if 2 times a day, 12 strictly through hours if three times - that after 8 hours if 4 times - after 6 hours and so on.It is important to create a certain concentration of the drug in the body.If you suddenly missed the reception, take the medication as soon as possible.

8) antibiotics requires a significant reduction in exercise and complete renunciation of sports.

9) There is some interaction of certain drugs with each other.For example, the effect of hormonal contraceptives decreases with antibiotics.Receiving antacid (Maalox, Rennie, almagel and others), as well as enterosorbents (activated charcoal, white charcoal, enterosgel, polifepam, etc.) can affect the absorption of the antibiotic, so it is not recommended concomitant use of these drugs.

10) Do not drink alcoholic beverages (alcohol) during a course of antibiotic treatment.

possibility of using antibiotics in pregnant and lactating

Safe at indications (ie there is a clear benefit with minimum harm): penicillins, cephalosporins, during the whole period of pregnancy and lactation (however, the child may develop intestinal dysbiosis).After the 12th week of pregnancy may prescriptions macrolide.Contraindicated in pregnancy, aminoglycosides, tetracyclines, chloramphenicol, rifampin, fluoroquinolones.

necessity of antibiotic treatment in children

Statistically antibiotics in Russia to receive 70-85% of children with purely viral infections, ie, antibiotics have not been shown to these kids.However it is known that antibiotics trigger development in children with bronchial asthma!In fact, antibiotics need to assign only 5-10% of children with SARS, and only in the event of complications in the form of a bacterial outbreak.According to statistics, only 2.5% of children are not treated with antibiotics revealed complications, and have treated them without reason complications recorded twice as frequently.

doctor and a doctor brings evidence from a sick child for the purpose of antibiotics: they may be exacerbation of chronic bronchitis, chronic otitis media, sinusitis and sinusitis, developing pneumonia and the like.Also it is impossible to delay the appointment of antibiotics for mycobacterial infections (tuberculosis), where specific antibiotics are the key to the treatment regimen.

Side effects of antibiotics:

1. Allergic reactions (anaphylaxis, allergodermatoses, angioneurotic edema, asthmatic bronchitis)
2. Toxic effects on the liver (tetracycline, rifampicin, erythromycin, sulfonamides)
3. Toxic effects on the hematopoietic system (chloramphenicol, rifampin, streptomycin)
4. toxic effects on the digestive system (tetracycline, erythromycin)
5. Integrated toxic - neuritis of the auditory nerve, optic nerve damage, vestibular disorders, possible development of polyneuritis, toxic damage to the kidneys (aminoglycosides)
6. Jarisch-Geytsgeymera (endotoxic shock) - arises when assigning a bactericidal antibiotic which leads to "endotoxin shock" as a result of a massive destruction of the bacteria.It develops most often in the following infections (meningococcemia, typhoid fever, leptospirosis, etc..).
7. intestinal dysbiosis - a violation of the balance of the normal flora of the intestine.

Antibiotics besides pathogens are killed and representatives of the normal microflora and opportunistic microorganisms with which your immune system has been "familiar" and restrain their growth.After antibiotic treatment the body is actively populated by new microorganisms in the recognition that the immune system needs time to the same activated those microbes that are used antibiotics do not work.Hence, the symptoms of low immunity in antibiotic therapy.

Advise patients after a course of antibiotic therapy:

After any treatment necessary to restore antibiotics.This is due, primarily, with the inevitable side effects of drugs of any severity.

1. Comply with sparing diet avoiding spicy, fried, salted, and frequent (5 times a day) taking small portions within 14 days.
2. With enzyme preparations (Creon, mikrazim, ermital, pantsitrat 10 thousand. IU or 1 caps. 3 times a day 10-14 days) are recommended for the correction of digestive disorders.
3. For the purpose of correction of intestinal dysbiosis (violation of the ratio of representatives of the normal flora) are recommended probiotics.
- Baktisubtil 1 caps 3 p / day for 7-10 days,
- Bifiform 1 tab 2 p / day for 10 days,
- Linneks1 capsules 2-3 p / day 7-10 days,
- Fort Bifidumbacterin 5-10doses of 2 p / day 10 days,
- Atsipol 1 caps 3-4 p / day 10-14 days.
4. After receiving hepatotoxic drugs (eg, tetracycline, erythromycin, sulfonamides, rifampicin) are advised to take gepatoprotektory plant-based: gepatrin, Ovesol (1 capsule or Table 2-3 times a day), Kars (2 tablets 3 times a day.) for 14-21 days.
5. After a course of antibiotics is recommended vegetable intake immunomodulators (immunal, solutions of Echinacea) and avoid hypothermia.

infectious disease doctor Bykov NI