Antibiotics (a / b) are substances that exist in nature or are synthesized by humans from natural raw materials, and suppress the growth of pathogenic bacteria that attack the body. Also antibiotics are used as antineoplastic drugs in oncology.

The discovery of penicillin and its properties

Many diseases before the discovery of antibiotics seemed incurable, doctors and scientists all over the world wanted to find a substance that would help defeat pathogenic microbes without harming the human body. People died from wounds infected with bacteria, sepsis, pneumonia, tuberculosis, gonorrhea and other equally dangerous diseases.

The turning point in the history of medicine is 1928 - the year of the discovery of penicillin. Millions of lives saved owe this discovery to Sir Alexander Fleming, whose name is known throughout the world. Accidentally growing mold of the species Penicillium notatum on a nutrient medium in Fleming's laboratory and the observation of the scientist himself gave a chance to victory over infectious diseases.

After the discovery of penicillin, scientists had one task - to isolate this substance in its purest form. It was not an easy matter, but in the early 40s of the XX century, two scientists Howard Flory and Ernst Chain managed to synthesize a drug with antibacterial properties.

Properties of penicillins

Antibiotics of the penicillin group inhibit the growth and development of microorganisms such as:

This is just a small list of those bacteria whose vital activity is suppressed by penicillin and drugs from this family.

Penicillin classification and list of drugs

The chemical formula of the penicillin family contains a beta-lactam ring, therefore they are referred to as beta-lactam antibiotics.

Since penicillin has been used in medicine for over 70 years, some bacteria have developed resistance to this substance in the form of the beta-lactamase enzyme.

The mechanism of action of the enzyme lies in the affinity of the beta-lactam ring to the hydrolytic enzyme of the bacterial cell, which facilitates their binding, and, as a consequence, inactivation of the antibiotic.

At the moment, semi-synthetic antibiotics are used to a greater extent: the chemical formula of a natural antibiotic is taken as a basis and undergoes useful modifications. Thanks to this, humanity is still able to resist bacteria, which every year develop their own antibiotic resistance mechanisms.

The current Federal Guidelines for the Use of Medicines provide the following classification of penicillins:

Let us dwell in a little more detail on each class of antibiotics and figure out in which cases they are used.

Natural short-acting antibiotics

Natural antibiotics do not have beta-lactamase inhibitors, so they are never used against infections caused by staphylococcus.

Benzylpenicillin is active in the treatment of anthrax, croupous pneumonia, pleurisy, bronchitis, sepsis, peritonitis, meningitis (in adults and in children from 2 years of age), diseases of the genitourinary system, ENT diseases, wound infections and skin infections.

Contraindications and restrictions for use: allergy to penicillin, hay fever, bronchial asthma, arrhythmia, impaired renal function.

Adverse reactions: for all antibiotics of the penicillin group, the main side effect is an allergic response in the form of anaphylactic shock, urticaria, Quincke's edema, hyperthermia, nephritis, and skin rashes. Failures in the work of the heart are possible. With the introduction of large doses - convulsions (in children).

Long-acting natural antibiotics

Benzylpenicillin benzathine is used in cases of syphilis, inflammation of the tonsils, scarlet fever, wound infections. It is used to prevent postoperative complications.

Contraindications: tendency to allergic reactions to penicillin, bronchial asthma, hay fever... Adverse reactions: allergic response, anemia, leukopenia and thrombocytopenia, headache, an abscess at the injection site.

Benzylpenicillin procaine is used in the treatment of acute inflammatory diseases of the respiratory system, septic endocarditis, meningitis, osteomyelitis, peritonitis, inflammatory processes of the genitourinary and biliary tract, wound infections, dermatoses, eye diseases. It is used for relapses of rheumatism and erysipelas.

Contraindications: hypersensitivity to penicillin and procaine. Side effect: allergic reaction, nausea, convulsions.

Antistaphylococcal drugs

Oxacillin is considered the main representative of this group of antibiotics. The spectrum of action is similar to Benzylpenicillin, but unlike the latter, this substance is capable of destroying staphylococcal infections.

Contraindications: Penicillin allergy. Adverse reactions: urticaria, skin rashes. Rarely - edema, anaphylactic shock.

Digestive disorders, fever, nausea, vomiting, jaundice, hematuria (in children).

Broad spectrum antibiotics

Ampicillin is used as an active ingredient in many antibiotics. It is used to treat infectious diseases digestive system, acute infections respiratory and urinary tract, meningitis, endocarditis, chlamydial infections.

List of drugs containing ampicillin: Ampicillin trihydrate, Ampicillin sodium salt, Ampicillin-AKOS, Ampicillin AMP-Forte, Ampicillin-Inotek and others.

Amoxicillin is an improved ampicillin derivative. It is the leading antibiotic taken orally, i.e. by mouth. It is used for acute respiratory diseases, meningococcal infections, inflammatory processes gastrointestinal tract, Lyme disease. It is used in the prevention of anthrax in children and pregnant women.

The list of drugs containing amoxicillin: Amoxicillin, Amoxicillin Sandoz, Amoxicillin-ratiopharm, Amoxicillin DS, etc.

Contraindications for this group a / b: hypersensitivity, pregnancy, abnormal liver function, mononucleosis. Ampicillin is contraindicated in children under 1 month of age.

Side effects: dyspeptic disorders, dysbiosis, candidiasis, allergies, central nervous system disorders, superinfection.

Antipseudomonal drugs

Carboxypenicillins contain an active substance - carbenicillin. In this case, the name of the drug coincides with the active substance. It is used in the treatment of diseases caused by Pseudomonas aeruginosa. Currently, it is practically not used in medicine due to the presence of more active drugs.

Ureidopenicillins include: Mezlocillin, Piperacillin, Azlocillin. Contraindications: hypersensitivity to penicillin, pregnancy.

Side effects: eating disorders, nausea, vomiting, urticaria. Possible drug fever, headache, impaired renal function, superinfection.

Features of the use of penicillin antibiotics in children.

Special attention is always paid to the use of antibiotics in pediatric therapy, since the child's body has not yet fully formed and many organ systems are not working at full strength. Therefore, to the choice of a drug for newborns and children younger age doctors should take responsibility.

In newborns, Penicillin is used for sepsis and toxic diseases. In children in the first years of life, it is used to treat pneumonia, otitis media, pleurisy, meningitis.

With ARVI, angina, sinusitis, bronchitis, cystitis, children are most often prescribed Amoxicillin, Flemoxin, Amoxiclav, Augmentin. These antibiotics are considered more effective and less toxic to the child's body.

Dysbacteriosis is one of the complications of antibiotic treatment, since the beneficial microflora of children dies along with pathogenic bacteria. Therefore, antibiotic treatment must be combined with the use of probiotics. A rare side effect is an allergic reaction to penicillin in the form of a rash.

In newborns and young children, the excretory function of the kidneys is insufficiently developed and the accumulation of penicillin in the body is possible. The consequence of this is the development of seizures.

Now it is difficult to imagine our life without antibiotics. With their help, it is possible to cure many diseases plaguing humanity. But you need to understand that the frequent use of antibiotic drugs is not only harmful to the human body, but also benefits the bacteria against which they are used. Always check with your doctor before using antibiotics.

Antibacterial drugs that are common today less than a century ago made a real revolution in medicine. Humanity has received a powerful weapon to fight infections that were previously considered fatal.

The first were the antibiotics penicillins, which saved many thousands of lives during the Second World War, and are relevant in modern medical practice. It was with them that the era of antibiotic therapy began and thanks to them all other antimicrobial drugs were obtained.

Main name	Antimicrobial activity	Analogs
Benzylpenicillin potassium and sodium salts	They mainly affect gram-positive microorganisms. Currently, most strains have developed resistance, but spirochetes are still sensitive to the substance.	Gramox-D, Ospin, Star-Pen, Ospamox
Benzylpenicillin procaine	It is indicated for the treatment of streptococcal and pneumococcal infections. Compared with potassium and sodium salts, it acts for a longer time, since it dissolves and is absorbed more slowly from the intramuscular depot.	Benzylpenicillin-KMP (-G, -Teva, -G 3 mega)
Bicillins (1, 3 and 5)	Used for chronic rheumatism with preventive purpose, as well as for the treatment of infectious diseases of moderate and mild severity caused by streptococci.	Benzicillin-1, Moldamin, Extincillin, Retarpin
Phenoxymethylpenicillin	It has a therapeutic effect similar to the previous groups, but does not break down in an acidic gastric environment. Available in pill form.	V-Penicillin, Cliacyl, Ospin, Penicillin-Fau, Vepikombin, Megacillin Oral, Pen-os, Star-Pen
Oxacillin	Active against staphylococci that produce penicillinase. It is characterized by low antimicrobial activity; it is completely ineffective against bacteria unstable to penicillin.	Oxamp, Ampiox, Oxamp-Sodium, Oxamsar
Ampicillin	Extended spectrum of antimicrobial activity. In addition to the main spectrum of inflammatory diseases of the gastrointestinal tract, it also treats those caused by Escherichia, Shigella, Salmonella.	Ampicillin AMP-KID (-AMP-Forte, -Ferein, -AKOS, -trihydrate, -Inotek), Zetsil, Pentrixil, Penodil, Standacillin
Amoxicillin	It is used to treat inflammation of the respiratory and urinary tract. After finding out the bacterial origin of the stomach ulcer, it is used for the eradication of Helicobacter Pylori.	Flemoxin solutab, Hikontsil, Amosin, Ospamox, Ecobol
Carbenicillin	The spectrum of antimicrobial action includes Pseudomonas aeruginosa and enterobacteria. The digestibility and bactericidal effect is higher than that of Carbenicillin.	Securopen
Piperacillin	Similar to the previous one, however, the level of toxicity is increased.	Isipen, Pipracil, Picillin, Piprax
Amoxicillin / clavulanate	Due to the inhibitor, the spectrum of antimicrobial activity is expanded in comparison with an unprotected agent.	Augmentin, Flemoklav Solutab, Amoxiclav, Amklav, Amovikomb, Verklav, Ranklav, Arlet, Klamosar, Rapiklav
Ampicillin / sulbactam		Sulacillin, Liboccil, Unazin, Sultasin
Ticarcillin / clavulanate	The main indication for use is nosocomial infections.	Hymentin
Piperacillin / tazobactam		Tazocin

The information provided is for informational purposes only and is not a guide to action. All appointments are made exclusively by the doctor, and the therapy takes place under his supervision.

Despite the low toxicity of penicillins, their uncontrolled use leads to serious consequences: the formation of resistance in the pathogen and the transition of the disease into a chronic form that is difficult to cure. It is for this reason that most strains of pathogenic bacteria are resistant to first-generation ABP today.

The medication prescribed by the specialist should be used for antibiotic therapy. Independent attempts to find cheap analog and save money can worsen the condition.

For example, the dosage of an active substance in a generic drug may differ upward or downward, which will negatively affect the course of treatment.

When a medicine has to be replaced due to an acute shortage of finances, it is necessary to ask a doctor about it, since only a specialist will be able to choose the best option.

Penicillins: definition and properties

The drugs of the penicillin group belong to the so-called beta-lactams - chemical compounds that have a beta-lactam ring in their formula.

This structural component is of decisive importance in the treatment of bacterial infectious diseases: it prevents bacteria from producing a special biopolymer peptidoglycan, which is necessary for building the cell wall. As a result, the membrane cannot form and the microorganism dies. There is no destructive effect on human and animal cells for the reason that there is no peptidoglycan in them.

Medicines based on waste products of molds are widespread in all areas of medicine due to the following properties:

• High bioavailability - drugs are rapidly absorbed and distributed through tissues. The weakening of the blood-brain barrier with inflammation of the meninges of the brain also contributes to the penetration into the cerebrospinal fluid.
• Broad spectrum of antimicrobial action. Unlike the first generation of chemicals, modern penicillins are effective against the vast majority of gram-negative and positive bacteria. They are also resistant to penicillinase and the acidic environment of the stomach.
• The lowest toxicity among all ABP. They are allowed for use even during pregnancy, and the correct reception (as prescribed by the doctor and according to the instructions) almost completely eliminates the development of side effects.

In the process of research and experiments, many medications were obtained with different properties... For example, when belonging to a common series, penicillin and ampicillin are not the same thing. All penicillin antibiotics are well compatible with most other drugs. Concerning complex therapy with other species antibacterial drugs, then combined use with bacteriostatics weakens the effectiveness of penicillins.

Classification

A careful study of the properties of the first antibiotic showed its imperfection. Despite a fairly wide spectrum of antimicrobial action and low toxicity, natural penicillin was found to be sensitive to a special destructive enzyme (penicillinase) produced by some bacteria. In addition, it completely lost its qualities in an acidic gastric environment, therefore it was used exclusively in the form of injections. In search of more effective and stable compounds, various semi-synthetic medicines.

Today, penicillin antibiotics, full list which are listed below are subdivided into 4 main groups.

Biosynthetic

Produced by the molds Penicillium notatum and Penicillium chrysogenum, benzylpenicillin is an acid in molecular structure. For medical purposes, it chemically combines with sodium or potassium to form salts. The resulting compounds are used to prepare injection solutions which are rapidly absorbed.

The therapeutic effect is noted within 10-15 minutes after administration, however, it lasts no more than 4 hours, which requires frequent repeated injections into muscle tissue (in special cases, you can sodium salt administered intravenously).

These drugs penetrate well into the lungs and mucous membranes, and to a lesser extent into the cerebrospinal and synovial fluids, myocardium and bones. However, with inflammation meninges(meningitis) the permeability of the blood-brain barrier is increased, which allows for successful healing.

To prolong the effect of the drug, natural benzylpenicillin combines with novocaine and other substances. The obtained salts (novocainic, Bitsillin-1, 3 and 5) after intramuscular injection form a drug depot at the injection site, from where the active substance enters the bloodstream constantly and at a low speed. This property allows you to reduce the number of injections up to 2 times a day while maintaining therapeutic effect potassium and sodium salts.

These drugs are used for long-term antibiotic therapy of chronic rheumatism, syphilis, focal streptococcal infection.
Phenoxymethylpenicillin is another form of benzylpenicillin intended for the treatment of infectious diseases moderate... Differs from those described above in resistance to hydrochloric acid gastric juice.

This quality allows the drug to be produced in the form of tablets for oral administration (4 to 6 times a day). Most pathogenic bacteria, except for spirochetes, are currently resistant to biosynthetic penicillins.

See also: Instructions for the use of penicillin in injections and tablets

Semi-synthetic antistaphylococcal

Natural benzylpenicillin is inactive against staphylococcus strains that produce penicillinase (this enzyme destroys the beta-lactam ring of the active substance).

For a long time, penicillin was not used to treat staphylococcal infections, until oxacillin was synthesized on its basis in 1957. It inhibits the activity of beta-lactamases of the pathogen, but is ineffective against diseases caused by strains susceptible to benzylpenicillin. This group also includes cloxacillin, dicloxacillin, methicillin and others that are almost never used in modern medical practice due to increased toxicity.

Antibiotics of the penicillin group in broad-spectrum tablets

This includes two subgroups of antimicrobial agents intended for oral use and having a bactericidal effect against most pathogenic microorganisms (both gram + and gram-).

Aminopenicillins

Compared to the previous groups, these compounds have two significant advantages. Firstly, they are active against a wider range of pathogens, and secondly, they are available in tablet form, which greatly facilitates the use. The disadvantages include sensitivity to beta-lactamase, that is, aminopenicillins (ampicillin and amoxicillin) are unsuitable for the treatment of staphylococcal infections.

However, in combination with oxacillin (Ampiox), they become resistant.

The drugs are well absorbed and act for a long time, which reduces the frequency of use to 2-3 times in 24 hours. The main indications for use are meningitis, sinusitis, otitis media, infectious diseases urinary and upper respiratory tract, enterocolitis and eradication of Helicobacter (the causative agent of stomach ulcers). A common side effect of aminopenicillins is the characteristic non-allergic rash that disappears immediately after withdrawal.

Antipseudomonal

They are a separate penicillin series of antibiotics, from the name of which the purpose becomes clear. Antibacterial activity is similar to aminopenicillins (with the exception of pseudomonas) and is pronounced against Pseudomonas aeruginosa.

According to the degree of efficiency, they are subdivided into:

• Carboxypenicillins, the clinical significance of which has recently been decreasing. Carbenicillin, the first of this subgroup, is also effective against ampicillin-resistant proteus. Currently, almost all strains are resistant to carboxypenicillins.
• Ureidopenicillins are more effective against Pseudomonas aeruginosa, and may also be prescribed for inflammation caused by Klebsiella. The most effective are Piperacillin and Azlocillin, of which only the latter remains relevant in medical practice.

To date, the vast majority of Pseudomonas aeruginosa strains are resistant to carboxypenicillins and ureidopenicillins. For this reason, their clinical significance is diminishing.

Inhibitor-protected combined

The ampicillin group of antibiotics, highly active against most pathogens, is destroyed by penicillinase-forming bacteria. Since the bactericidal effect of oxacillin resistant to them is significantly weaker than that of ampicillin and amoxicillin, combined medications were synthesized.

In combination with sulbactam, clavulanate and tazobactam, antibiotics obtain a second beta-lactam ring and, accordingly, immunity to beta-lactamases. In addition, inhibitors have their own antibacterial effect, enhancing the main active ingredient.

Inhibitor-protected drugs successfully treat severe nosocomial infections, strains of which are resistant to most drugs.

See also: On the modern classification of antibiotics by a group of parameters

Penicillins in medical practice

The broad spectrum of action and good patient tolerance made penicillin the optimal treatment for infectious diseases. At the dawn of the era of antimicrobial drugs, benzylpenicillin and its salts were the drugs of choice, but at the moment most pathogens are resistant to them. Nevertheless, modern semi-synthetic penicillin antibiotics in tablets, injections and other dosage forms occupy one of the leading places in antibiotic therapy in various fields of medicine.

Pulmonology and Otolaryngology

The discoverer also noted the special effectiveness of penicillin against pathogens of respiratory diseases, therefore, the drug is most widely used in this area. Almost all of them are harmful to bacteria that cause sinusitis, meningitis, bronchitis, pneumonia and other diseases of the lower and upper respiratory tract.

Inhibitor-protected agents treat even especially dangerous and persistent nosocomial infections.

Venereology

Spirochetes are one of the few microorganisms that remain susceptible to benzylpenicillin and its derivatives. Benzylpenicillins are also effective against gonococci, which makes it possible to successfully treat syphilis and gonorrhea with minimal negative impact on the patient's body.

Gastroenterology

Intestinal inflammation caused by pathogenic microflora lends itself well to therapy with acid-resistant drugs.

Of particular importance are aminopenicillins, which are part of the complex eradication of Helicobacter.

Gynecology

In obstetric and gynecological practice, many penicillin preparations from the list are used both for the treatment of bacterial infections of the female reproductive system and for the prevention of infection in newborns.

Ophthalmology

Here, penicillin antibiotics also take their rightful place: eye drop, ointments and solutions for injections treat keratitis, abscesses, gonococcal conjunctivitis and other eye diseases.

Urology

Diseases of the urinary system, which are of bacterial origin, respond well to therapy only with inhibitor-protected medications. The rest of the subgroups are ineffective, since the pathogen strains are highly resistant to them.

Penicillins are used in almost all areas of medicine for inflammation caused by pathogenic microorganisms, and not only for treatment. For example, in surgical practice, they are prescribed to prevent postoperative complications.

Features of therapy

Treatment with antibacterial medications in general and penicillins in particular should be carried out only as directed by a doctor. Despite the minimal toxicity of the drug itself, misuse of it seriously harms the body. In order for antibiotic therapy to lead to recovery, one should follow medical recommendations and know the characteristics of the drug.

Indications

The scope of application of penicillin and various drugs on its basis in medicine is due to the activity of the substance relative to specific pathogens. Bacteriostatic and bactericidal effects are manifested in relation to:

• Gram-positive bacteria - gonococci and meningococci;
• Gram-negative - various staphylococci, streptococci and pneumococci, diphtheria, Pseudomonas aeruginosa and antiseptic bacilli, Proteus;
• Actinomycetes and spirochetes.

Low toxicity and broad spectrum of action make antibiotics of the penicillin group the optimal treatment for angina, pneumonia (both focal and croupous), scarlet fever, diphtheria, meningitis, blood poisoning, septicemia, pleurisy, pyemia, osteomyelitis in acute and chronic forms, septic endocarditis, various purulent infections of the skin, mucous membranes and soft tissues, erysipelas, anthrax, gonorrhea, actinomycosis, syphilis, blennorrhea, as well as eye diseases and ENT diseases.

Contraindications

Strict contraindications include only individual intolerance to benzylpenicillin and other drugs in this group. Also, endolumbar (injection into spinal cord) administration of drugs to patients with diagnosed epilepsy.

During pregnancy, antibiotic therapy with drugs penicillin should be treated with extreme caution. Despite the fact that they have a minimal teratogenic effect, it is worth prescribing pills and injections only in case of urgent need, assessing the degree of risk to the fetus and the pregnant woman herself.

Since penicillin and its derivatives pass freely from the bloodstream into breast milk, at the time of therapy, it is advisable to refuse breastfeeding. The medicine can provoke a severe allergic reaction in a baby even at the first use. To prevent lactation from stopping, milk must be expressed regularly.

Side effect

Among other antibacterial agents, penicillins stand out favorably with low toxicity.

The undesirable consequences of use include:

• Allergic reactions. The most common manifestations are skin rash, itching, hives, fever and swelling. It is extremely rare in severe cases that anaphylactic shock is possible, requiring the immediate administration of an antidote (adrenaline).
• Dysbacteriosis. Disruption of the balance of natural microflora leads to digestive disorders (flatulence, bloating, constipation, diarrhea, abdominal pain) and the development of candidiasis. In the latter case, the mucous membranes are affected. oral cavity(in children) or the vagina.
• Neurotoxic reactions. The negative effect of penicillin on the central nervous system manifested by increased reflex excitability, nausea and vomiting, convulsions, and sometimes coma.

Timely drug support for the body will help prevent the development of dysbiosis and avoid allergies. It is advisable to combine antibiotic therapy with the intake of pre- and probiotics, as well as desensitizers (if sensitivity is increased).

Penicillin antibiotics for children: application features

For children, pills and injections should be prescribed carefully, taking into account the possible negative reaction, and the choice of a particular drug should be approached deliberately.

In the first years of life, benzylpenicillin is used in cases of sepsis, pneumonia, meningitis, otitis media. For the treatment of respiratory infections, tonsillitis, bronchitis and sinusitis, the safest antibiotics from the list are selected: Amoxicillin, Augmentin, Amoxiclav.

A child's body is much more sensitive to drugs than an adult's. Therefore, you should carefully monitor the condition of the baby (penicillin is excreted slowly and, accumulating, can cause convulsions), and also take preventive measures... The latter include the use of pre- and probiotics to protect the intestinal microflora, diet and comprehensive strengthening of the immune system.

A bit of theory:

Historical background

The discovery that made a real revolution in medicine at the beginning of the 20th century was made by accident. I must say that the antibacterial properties of molds were noticed by people in ancient times.

Alexander Fleming - the discoverer of penicillin

The Egyptians, for example, even 2500 years ago treated inflamed wounds with compresses from moldy bread, but scientists only took up the theoretical side of the issue in the 19th century. European and Russian researchers and doctors, studying antibiosis (the property of some microorganisms to destroy others), attempted to extract practical benefits from it.

It was succeeded by Alexander Fleming, a British microbiologist, who in 1928, on September 28, discovered mold in Petri dishes with colonies of staphylococcus aureus. Her spores, caught on crops through the negligence of the laboratory staff, germinated and destroyed the pathogenic bacteria. The concerned Fleming carefully studied this phenomenon and isolated a bactericidal substance called penicillin. For many years, the discoverer worked on obtaining a chemically pure stable compound suitable for treating people, but others invented it.

In 1941, Ernst Chain and Howard Flory were able to purify impurities from penicillin and conducted clinical trials with Fleming. The results were so successful that by the year 43 in the United States, mass production of the drug was organized, which saved many hundreds of thousands of lives during the war. The merits of Fleming, Cheyne and Flory to humanity were appreciated in 1945: the discoverer and developers became Nobel Prize winners.

Subsequently, the original chemical product was constantly improved. This is how modern penicillins appeared, resistant to the acidic environment of the stomach, immune to penicillinase and more effective in general.

Read the fascinating article: The Inventor of Antibiotics or the Story of Human Rescue!

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Mushrooms are the kingdom of living organisms. Mushrooms are different: some of them get into our diet, some cause skin diseases, some are so poisonous that they can lead to death. But fungi of the genus Penicillium save millions of human lives from pathogenic bacteria.

Penicillin antibiotics based on this mold (mold is also a fungus) are still used in medicine.

The discovery of penicillin and its properties

In the 30s of the last century, Alexander Fleming conducted experiments with staphylococci. He studied bacterial infections... Having grown a group of these pathogens in a nutrient medium, the scientist noticed that there are areas in the dish around which there are no living bacteria. An investigation has shown that common green mold, which loves to settle on stale bread, is to blame for these spots. The mold was called Penicillium and, as it turned out, produced a substance that kills staphylococci.

Fleming studied the matter deeper and soon isolated pure penicillin, which became the world's first antibiotic... The principle of action of the drug is as follows: when a bacterial cell divides, each half restores its cell membrane with the help of a special chemical element, peptidoglycan. Penicillin blocks the formation of this element, and the bacterial cell is simply "absorbed" in the environment.

But difficulties soon arose. Bacterial cells have learned to resist the drug - they began to produce an enzyme called beta-lactamase, which breaks down beta-lactams (the basis of penicillin).

For the next 10 years, there was an invisible war between the pathogens that destroy penicillin and the scientists who modify this penicillin. This is how many modifications of penicillin were born, which now form the entire penicillin range of antibiotics.

Pharmacokinetics and principle of action

The drug for any kind of application quickly spreads throughout the body, penetrating almost all of its parts. Exceptions: cerebrospinal fluid, prostate and the visual system. In these places, the concentration is very low, under normal conditions it does not exceed 1 percent. With inflammation, an increase of up to 5% is possible.

Antibiotics do not affect the cells of the human body, since the latter do not contain peptidoglycan.

The drug is quickly excreted from the body, after 1-3 hours most of it is excreted through the kidneys.

Watch a video on this topic

Classification of antibiotics

All drugs are divided into: natural (short and prolonged action) and semi-synthetic (antistaphylococcal, broad-spectrum drugs, antipseudomonal).

Natural

These drugs obtained directly from mold... At the moment, most of them are outdated, since pathogens have acquired immunity to them. In medicine, benzylpenicillin and Bicillin are most often used, which are effective against gram-positive bacteria and cocci, some anaerobic and spirochetes. All these antibiotics are used only in the form of injections into the muscles, since the acidic environment of the stomach quickly destroys them.

Benzylpenicillin in the form of sodium and potassium salts belongs to natural antibiotics short acting... Its effect wears off after 3-4 hours, so repeated injections must be done frequently.

Trying to eliminate this shortcoming, pharmacists have created natural antibiotics of prolonged action: Bicillin and novocaine salt of benzylpenicillin. These drugs are called "depot forms", because after being injected into the muscle, they form a "depot" in it, from which the drug is slowly absorbed into the body.

Examples of drugs: benzylpenicillin salt (sodium, potassium or novocainic), Bicillin-1, Bicillin-3, Bicillin-5.

Semi-synthetic antibiotics of the penicillin group

Several decades after receiving penicillin pharmacists were able to isolate its main active ingredient, and the modification process began... After improvement, most drugs acquired resistance to the acidic environment of the stomach, and semi-synthetic penicillins began to be produced in tablets.

Isoxazolepenicillins are medicines that are effective against staphylococci. The latter have learned to produce an enzyme that destroys benzylpenicillin, and drugs from this group interfere with the production of the enzyme. But you have to pay for the improvement - drugs of this type are less absorbed into the body and have a smaller spectrum of action compared to natural penicillins. Examples of drugs: Oxacillin, Nafcillin.

Aminopenicillins are broad-spectrum drugs. They are inferior to benzylpenicillins in strength in the fight against gram-positive bacteria, but they capture a wider range of infections. Compared to other drugs, they stay in the body longer and better penetrate some of the body's barriers. Examples of drugs: Ampicillin, Amoxicillin. You can often find Ampiox - Ampicillin + Oxacillin.

Carboxypenicillins and ureidopenicillins - antibiotics effective against Pseudomonas aeruginosa... At the moment, they are practically not used, since infections quickly become resistant to them. Occasionally you can find them as part of complex treatment.

Examples of drugs: Ticarcillin, Piperacillin

List of drugs

Pills

Sumamed

Active substance: azithromycin.

Indications: respiratory tract infections.

Contraindications: intolerance, severe renal failure, childhood up to 6 months.

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: drug-sensitive infections.

Price: 30-60 rubles.

Amoxicillin Sandoz

Indications: infections of the respiratory tract (including tonsillitis, bronchitis), infections of the genitourinary system, skin infections, and other infections.

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

Indications: streptococcal diseases, infections of mild to moderate severity.

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

Indications: infections of the respiratory tract, urinary system, infections in gynecology, other infections sensitive to amoxicillin.

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

Injections

Bitsillin-1

Active ingredient: benzathine benzylpenicillin.

Indications: acute tonsillitis, scarlet fever, wound infections, erysipelas, syphilis, leishmaniasis.

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

Indications: infections of the lower and upper respiratory tract, gastrointestinal tract, genitourinary system, gynecological and surgical infections.

Contraindications: hypersensitivity, severe infections Gastrointestinal tract, lymphocytic leukemia, mononucleosis.

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

Indications: infections of the respiratory and urinary tract, gastrointestinal tract, meningitis, endocarditis, sepsis, whooping cough.

Contraindications: hypersensitivity, renal dysfunction, childhood, pregnancy.

Price: 163 rubles.

Benzylpenicillin

Indications: severe infections, congenital syphilis, abscesses, pneumonia, erysipelas, anthrax, tetanus.

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

Amoxiclav, Ospamox, Oxacillin are suitable for the treatment of children. But before using the medicine, you must definitely consult with your doctor to adjust the dose.

Indications for use

Antibiotics of the penicillin group are prescribed for infections, the type of antibiotics is selected based on the type of infection. These can be various cocci, bacilli, anaerobic bacteria, and so on.

Most often, antibiotics are used to treat infections of the respiratory tract and genitourinary system.

Application features

In the case of treating children, you need to follow the instructions of the doctor, who will prescribe the desired antibiotic and adjust the dose.

In case of pregnancy, antibiotics must be used with extreme caution, as they penetrate the fetus. During lactation, it is better to switch to mixtures, since the medicine also penetrates into the milk.

For seniors no special instructions, although the doctor should take into account the condition of the patient's kidneys and liver when prescribing treatment.

Contraindications and side effects

The main and, often, the only contraindication is individual intolerance. It is common - in about 10% of patients. Additional contraindications depend on the specific antibiotic and are prescribed in the instructions for use.

List of side effects

• The development of allergies, from itching and fever to anaphylactic shock and coma.
• Instant development allergic reaction in response to the introduction of the drug into a vein.
• Dysbacteriosis, candidiasis.

In case of occurrence side effects you need to immediately apply for medical help, cancel the drug and carry out symptomatic treatment.

FAQ

Where does penicillin mold grow?

Almost everywhere. This mold includes dozens of subspecies, and each of them has its own habitat. The most notable representatives are penicillin mold, which grows on bread (it also infects apples, causing them to rot quickly) and mold used in the production of some cheeses.

How to replace penicillin antibiotics?

If the patient is allergic to penicillin, non-penicillin antibiotics can be used. Drug names: Cefadroxil, Cephalexin, Azithromycin. The most popular option is Erythromycin. But you need to know that Erythromycin often causes dysbiosis and indigestion.

Penicillin antibiotics are powerful agents against infections caused by various bacteria. There are quite a few types of them, and the treatment must be selected in accordance with the type of pathogen.

They seem harmless to the body due to the fact that the only contraindication is a hypersensitivity reaction, but improper treatment or self-medication can provoke resistance of the pathogen to an antibiotic, and another treatment, more dangerous and less effective, will have to be selected.

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Penicillin antibiotics are the first drugs created from the waste products of certain types of bacteria. V general classification penicillin antibiotics belong to the beta-lactam class of drugs. In addition to them, non-penicillin antibiotics are also included here: monobactams, cephalosporins and carbapenems.

The similarity is due to the fact that these preparations contain four-membered ring... All antibiotics of this group are used in chemotherapy and play an important role in the treatment of infectious diseases.

Penicillin properties and its discovery

Before the discovery of antibiotics, many diseases seemed simply incurable, scientists and doctors all over the world wanted to find such a substance that could help defeat pathogenic microorganisms, while not causing damage to human health. People died from sepsis, wounds infected with bacteria, gonorrhea, tuberculosis, pneumonia and other dangerous and serious diseases.

A key point in medical history is 1928- it was in this year that penicillin was discovered. Millions of human lives for this discovery are indebted to Sir Alexander Fleming. The accidental appearance of mold on the culture medium of the Penicillium notatum group in Fleming's laboratory and the observation of the scientist himself gave a chance to fight infectious diseases.

After the discovery of penicillin, scientists had only one task - to isolate this substance in its pure form. This business turned out to be rather complicated, but in the late 30s of the 20th century, two scientists Ernst Chain and Howard Flory managed to create a drug with an antibacterial effect.

Properties of antibiotics of the penicillin group

Antibiotic penicillin suppresses the emergence and development pathogenic organisms such as:

• meningococci;
• gonococci;
• streptococci;
• staphylococci;
• tetanus bacillus;
• pneumococci;
• anthrax stick;
• bacillus bacillus;
• diphtheria bacillus, etc.

This is just a small list of those pathogenic bacteria in which penicillin and all drugs of the penicillin series suppress vital activity.

The antibiotic effects of penicillin are bactericidal or bacteriostatic... In the latter case, we are talking about the complete destruction of pathogenic organisms that caused the disease, which is most often acute and extremely severe. For diseases of moderate severity, antibiotics with a bacteriostatic effect are used - they do not allow bacteria to divide.

Penicillin is an antibiotic with a bactericidal effect. Microbes in their structure have a cell wall, in which the main substance is peptidoglycan. This substance gives the bacterial cell resistance, preventing it from dying even in very unsuitable conditions for life. By acting on the cell wall, penicillin destroys its integrity and disables its work.

In the human body, cell membranes do not contain peptidoglycan and therefore antibiotics of the penicillin group do not have a negative effect on our body. Also, at the same time, we can talk about the slight toxicity of these funds.

Penicillins have a wide range of dosages used, this is safer for the human body, since it makes it possible to choose a therapeutic dosage for a specific patient with minimal side effects.

The main part of penicillin is excreted by the kidneys in the urine (more than 70%). Some antibiotics of the penicillin group are secreted using the biliary system, that is, they are excreted in the bile.

List of drugs and classification of penicillins

The chemical compound of the penicillin group is based on beta lactam ring, therefore, they belong to beta-lactamam drugs.

Since penicillin has been used in medical practice for more than 80 years, some microorganisms have developed resistance to this antibiotic in the form of the beta-lactamase enzyme. The mechanism of the enzyme's work consists in combining the hydrolytic enzyme of the pathogenic bacterium with the beta-lactam ring, which in turn facilitates their binding, and as a result, inactivation of the drug.

Today, semi-synthetic antibiotics are most often used: it is taken as a basis chemical composition natural antibiotic and undergoes beneficial modifications. Due to this, humanity can still resist various bacteria that constantly produce different mechanisms of antibiotic resistance.

As of today, the Federal Application Guidelines drugs such a classification of penicillins is given.

Short-acting natural antibiotics

Natural antibiotics do not contain beta-lactamase inhibitors, therefore they are never used against diseases that are caused by staphylococcus.

Benzylpenicillin is active during treatment:

• croupous pneumonia;
• anthrax;
• bronchitis;
• pleurisy;
• peritonitis;
• sepsis;
• diseases of the genitourinary system;
• meningitis (in adults and in children from 2 years of age);
• skin infections;
• wound infections;
• ENT diseases.

Side effects: for all antibiotics of the penicillin series, the main side effect is the body's allergic response in the form of urticaria, anaphylactic shock, hyperthermia, Quincke's edema, skin rashes, and nephritis. Heart failure is likely. During the introduction of significant dosages - convulsions (in children).

Restrictions on use and contraindications: hay fever, allergy to penicillin, impaired renal function, arrhythmia, bronchial asthma.

Long-acting natural antibiotics

Benzylpenicillin benzathine is used in the following cases:

• inflammation of the tonsils;
• syphilis;
• wound infections;
• scarlet fever.

It is also used to prevent complications after surgery.

Side effects: anemia, allergic response, abscess at the injection site of the antibiotic, headache, thrombocytopenia and leukopenia.

Contraindications: hay fever, bronchial asthma, penicillin allergy tendency.

Benzylpenicillin procaine is used in the treatment of:

• septic endocarditis,
• acute inflammatory diseases of the respiratory organs;
• osteomyelitis;
• meningitis;
• processes of inflammation of the biliary and genitourinary tract;
• peritonitis;
• eye diseases;
• dermatoses;
• wound infections.

It is used for relapses of erysipelas and rheumatism.

Side effect: convulsions, nausea, allergic reaction.

Contraindications: hypersensitivity to procaine and penicillin.

Antistaphylococcal drugs

Oxacillin is the main representative of this group of antibiotics. The result of treatment is similar to Benzylpenicillin, however, unlike the second, this drug can destroy staphylococcal infections.

Side effects: skin rashes, urticaria. Rarely - anaphylactic shock, edema, fever, indigestion, vomiting, nausea, hematuria (in children), jaundice.

Contraindications: allergic reactions to penicillin.

Broad-acting drugs

As an active ingredient, ampicillin is used in many antibiotics. It is used to treat acute urinary and respiratory tract infections, infectious diseases of the digestive system, chlamydial infections, endocarditis, meningitis.

List of antibiotics that contain ampicillin: Ampicillin sodium salt, Ampicillin trihydrate, Ampicillin-Inotek, Ampicillin AMP-Forte, Ampicillin-AKOS, etc.

Amoxicillin is modified ampicillin derivative... It is considered the main antibiotic that is taken by mouth only. It is used for meningococcal infections, acute respiratory diseases, Lyme disease, inflammation of the gastrointestinal tract. It is used to prevent anthrax in women during pregnancy and children.

The list of antibiotics that contain amoxicillin: Amoxicillin Sandoz, Amoxisar, Amoxicillin DS, Amoxicillin-ratiopharm, etc.

Side effects: dysbiosis, dyspeptic disorders, allergies, candidiasis, superinfection, central nervous system disorders.

Contraindications for this group of penicillins: hypersensitivity, mononucleosis, abnormal liver function. Ampicillin is prohibited in newborns up to one month of age.

Antipseudomonal antibiotics

In their composition, carboxypenicillins have active ingredient- carbenicillin... In this case, the name of the antibiotic coincides with the active ingredient. It is used in the treatment of diseases caused by Pseudomonas aeruginosa. Today in medicine, they are almost never used due to the presence of stronger drugs.

Ureidopenicillins include: Azlocillin, Piperacillin, Mezlocillin.

Side effect: nausea, eating disorders, urticaria, vomiting. Probable headache, drug fever, superinfection, impaired renal function.

Contraindications: pregnancy, high sensitivity to penicillin.

Features of the use of antibiotics of the penicillin group in children

The use of antibiotics in pediatric treatment great attention is constantly paid, since the child's body has not yet been fully formed and most of the organs and systems are not yet fully functional... Therefore, doctors must take great responsibility in the choice of antibiotics for infants and growing children.

Penicillin in newborns is used for toxic diseases and sepsis. In the first years of life in children, it is used to treat otitis media, pneumonia, meningitis, pleurisy.

For angina, acute respiratory viral infections, cystitis, bronchitis, sinusitis, as a rule, children are prescribed Flemoxin, Amoxicillin, Augmentin, Amoxiclav. These antibiotics are the least toxic and most effective in relation to the child's body.

Dysbacteriosis is one of the complications of antibiotic therapy, since beneficial microflora in children dies simultaneously with pathogenic microorganisms. Therefore, antibiotic treatment must certainly be combined with the intake of probiotics. A rare side effect is penicillin allergy. in the form of a skin rash.

In infants, the excretory work of the kidneys is underdeveloped and it is likely that there is an accumulation of penicillin in the body. This results in seizures.

Treatment with any antibiotics, even last generation always significantly affects health. Naturally, they relieve the main infectious disease, however, the general immunity is also significantly reduced. Since not only pathogenic bacteria die, but also healthy microflora. Therefore, it will take some time to restore the protective forces. If pronounced side effects, especially those associated with the gastrointestinal tract, a sparing diet is required.

Be sure to use probiotics and prebiotics (Bifidumbacterin, Linex, Bifiform, Acipol, etc.). The beginning of the reception must occur simultaneously with the beginning of the use of the antibacterial agent. At the same time, after a course of antibiotics, prebiotics and probiotics must be used for about 14 more days to populate the stomach with beneficial bacteria.

When antibiotics have a toxic effect on the liver, then the use of hepatoprotectors can be recommended. These drugs will protect healthy liver cells and repair damaged ones.

Since immunity decreases, the body is especially exposed to colds. Therefore, you need to take care of yourself and not overcool. Use immunomodulators, while it is desirable that they be vegetable origin(purple Echinacea, Immunal).

If the disease is of viral etiology, then in this case antibiotics are powerless, even of the latest generation and a wide spectrum of action. They can only serve as a prophylaxis in joining viral infection bacterial. Antiviral agents are used to treat viruses.

To reduce the use of antibiotics and less often get sick, it is necessary to conduct healthy image life. The most important thing is not to overdo the use of antibacterial agents in order to prevent bacteria from developing resistance to them. Otherwise, it will be impossible to cure any infection. Therefore, always consult your doctor before using any antibiotic.

Penicillin antibiotics are several types of drugs that are divided into groups. In medicine, drugs are used to treat various diseases infectious and bacterial origin. The drugs have a minimal number of contraindications and are still used to treat various patients.

Discovery history

Once, Alexander Fleming in his laboratory was engaged in the study of pathogens. He created a nutrient medium and grew staphylococcus. The scientist was not particularly clean, he simply put the beakers and cones in the sink and forgot to wash them.

When Fleming needed the dishes again, he found that they were covered with mold. The scientist decided to test the guess and examined one of the containers under a microscope. He noticed that where there is mold, there is no staphylococcus.

Alexander Fleming continued his research, he began to study the effect of mold on pathogenic microorganisms and found that the fungus destructively affects the membranes of bacteria and leads to their death. The public could not be skeptical about the research.

The discovery helped save many lives. Delivered humanity from those diseases that previously caused panic among the population. Naturally, modern medicines are relatively similar to those drugs that were used at the end of the 19th century. But the essence of medicines, their action has not changed so dramatically.

Penicillin antibiotics were able to revolutionize medicine. But the joy of the discovery did not last long. It turned out that pathogens, bacteria can mutate. They mutate and become insensitive to drugs. This has led to significant changes in antibiotics such as penicillin.

Scientists have been fighting against microorganisms and bacteria for almost the entire XX century, trying to create an ideal drug. The efforts were not in vain, but improvements like these have led to significant changes in antibiotics.

New generation drugs are more expensive, act faster, and have a number of contraindications. If we talk about those preparations that were obtained from mold, then they have a number of disadvantages:

• Poorly absorbed. Gastric juice acts on the fungus in a special way, reduces its effectiveness, which undoubtedly affects the result of treatment.
• Penicillin antibiotics are drugs of natural origin, for this reason they do not differ in a wide spectrum of action.
• Medicines are quickly eliminated from the body, approximately 3-4 hours after the injection.

Important: These medicines have practically no contraindications. It is not recommended to take them if there is an individual intolerance to antibiotics, as well as in the case of an allergic reaction.

Modern antibacterial agents differ significantly from the familiar penicillin. In addition to the fact that today it is easy to purchase medicines of this class in tablets, there are a great many varieties of them. To understand the drugs will help the classification, the generally accepted division into groups.

Antibiotics: classification

Antibiotics of the penicillin group are conventionally divided into:

1. Natural.
2. Semi-synthetic.

All medicines based on mold are antibiotics of natural origin. Today, such medicines are practically not used in medicine. The reason is that pathogenic microorganisms have acquired immunity to them. That is, the antibiotic does not act on the bacteria to the extent that it should be; the desired result in the treatment can be achieved only with the introduction of a high dose of the drug. The funds in this group include: Benzylpenicillin and Bicillin.

The drugs are available in powder form for injection. They effectively act on: anaerobic microorganisms, gram-positive bacteria, cocci, etc. Since medicines are of natural origin, they cannot boast of a long-term effect, injections are often done every 3-4 hours. This makes it possible not to reduce the concentration of the antibacterial agent in the blood.

Penicillin antibiotics of semisynthetic origin are the result of modification of drugs made from mold. Medicines belonging to this group managed to give some properties, first of all, they became insensitive to acid-base medium. That made it possible to produce antibiotics in tablets.

And also medicines appeared that affected staphylococci. This class of drugs is different from natural antibiotics. But the improvements have had a significant impact on the quality of the drugs. They are poorly absorbed, do not have such a wide sector of action, and have contraindications.

Semi-synthetic drugs can be divided into:

• Isoxazolepenicillins are a group of drugs that act on staphylococci, as an example, the names the following drugs: Oxacillin, Nafcillin.
• Aminopenicillins - Several drugs belong to this group. They differ in a wide sector of action, but in terms of strength they are significantly inferior to antibiotics of natural origin. But they can fight a large number of infections. Funds from this group remain in the blood longer. Such antibiotics are often used to treat various diseases, for example 2 very well-known drugs: Ampicillin and Amoxicillin.

Attention! The list of medicines is quite large, they have a number of indications and contraindications. For this reason, it is worth consulting a doctor before starting antibiotics.

Indications and contraindications for taking medications

Antibiotics belonging to the penicillin group are prescribed by a doctor. The drugs are recommended to be taken if you have:

1. Diseases of an infectious or bacterial nature (pneumonia, meningitis, etc.).
2. Respiratory tract infections.
3. Diseases of the inflammatory and bacterial nature of the genitourinary system (pyelonephritis).
4. Diseases of the skin of various origins (erysipelas, caused by staphylococcus).
5. Intestinal infections and many other diseases of an infectious, bacterial or inflammatory nature.

Note: Antibiotics are prescribed for extensive burns and deep wounds, gunshot or stab wounds.

In some cases, taking medication can help save a person's life. But you should not prescribe yourself such drugs on your own, as this can lead to the development of addiction.

What are the contraindications for drugs:

• You should not take medication during pregnancy or lactation. The drugs can affect the growth and development of the child. They are able to change the quality of milk and its taste characteristics. There are a number of drugs that are conditionally approved for the treatment of pregnant women, but the doctor must prescribe such an antibiotic. Since only a doctor will be able to determine the acceptable dosage and duration of the course of treatment.
• The use of antibiotics from the groups of natural and synthetic penicillins for treatment is not recommended for the treatment of children. Drugs of these classes can have a toxic effect on the child's body. For this reason, medications are prescribed with caution in determining the optimal dosage.
• Do not use medications without visible indications. Use drugs for a long period of time.

Direct contraindications for the use of antibiotics:

1. Individual intolerance to drugs of this class.
2. Propensity to allergic reactions of various kinds.

Attention! Long-term diarrhea and candidiasis are considered to be the main side effects of medication. They are associated with the fact that drugs have an effect not only on pathogens, but also on beneficial microflora.

The penicillin series of antibiotics is characterized by the presence of a small number of contraindications. For this reason, drugs of this class are prescribed very often. They help to quickly cope with the disease and return to a normal rhythm of life.

Medicines of the latest generation are distinguished by a wide spectrum of action. Such antibiotics do not have to be taken for a long time, they are well absorbed and, with adequate therapy, they can "put a person on his feet" in 3-5 days.

List of drugs that doctors prescribe to patients

The question is which antibiotics are best? can be considered rhetorical. There are a number of drugs that doctors, for one reason or another, prescribe more often than others. In most cases, drug names are well known to the general public. But it is still worth studying the list of medicines:

1. Sumamed is a drug used to treat infectious diseases of the upper respiratory tract. The active ingredient is erythromycin. The medication is not used to treat patients with acute or chronic renal failure, it is not prescribed for children under 6 months of age. The main contraindication to the use of Sumamed is nevertheless the individual intolerance to the antibiotic.
2. Oxacillin - Available in powder form. The powder is diluted, and then the solution is used for intramuscular injections. The main indication for the use of the drug should be considered infections sensitive to this drug. Hypersensitivity should be considered a contraindication to the use of Oxacillin.
3. Amoxicillin belongs to the series synthetic antibiotics... The drug is quite famous, it is prescribed for angina, bronchitis and other respiratory tract infections. Amoxicillin can be taken for pyelonephritis (inflammation of the kidneys) and other diseases of the genitourinary system. The antibiotic is not prescribed for children under 3 years of age. Drug intolerance is also considered a direct contraindication.
4. Ampicillin - the full name of the drug: Ampicillin trihydrate. An indication for the use of the drug should be considered infectious diseases of the respiratory tract (tonsillitis, bronchitis, pneumonia). The antibiotic is excreted from the body by the kidneys and liver, for this reason Ampicillin is not prescribed for people with acute liver failure. Can be used to treat children.
5. Amoxiclav is a drug that has a combined composition. It belongs to the latest generation of antibiotics. Amoxiclav is used to treat infectious diseases of the respiratory system, genitourinary system. It is also used in gynecology. A contraindication to the use of a medication should be considered hypersensitivity, jaundice, mononucleosis, etc.

List or list of penicillin antibiotics, which are available in powder form:

1. Benzylpenicillin novocaine salt is an antibiotic of natural origin. Indications for the use of the drug can be considered serious infectious diseases, including congenital syphilis, abscesses of various etiologies, tetanus, anthrax and pneumonia. The drug has practically no contraindications, but in modern medicine it is used extremely rarely.
2. Ampicillin - used to treat the following infectious diseases: sepsis (blood poisoning), whooping cough, endocarditis, meningitis, pneumonia, bronchitis. Ampicillin is not used to treat children, people with severe renal failure. Pregnancy can also be considered a direct contraindication to the use of this antibiotic.
3. Ospamox is prescribed for the treatment of diseases of the genitourinary system, infections of a gynecological and other nature. It is prescribed in the postoperative period if there is a high risk of developing inflammatory process... An antibiotic is not prescribed for severe infectious diseases of the gastrointestinal tract, in the presence of an individual intolerance to the drug.

Important: A drug called an antibiotic must have an antibacterial effect on the body. All those medicines that affect viruses have nothing to do with antibiotics.

Medicines prices

Sumamed - the cost varies from 300 to 500 rubles.

Amoxicillin tablets - the price is about 159 rubles. per packing.

Ampicillin trihydrate - the cost of tablets is 20-30 rubles.

Ampicillin in powder form for injection - 170 rubles

Oxacillin - the average price for the drug varies from 40 to 60 rubles.

Amoxiclav - the cost is 120 rubles.

Ospamox - the price varies from 65 to 100 rubles.

Benzylpenicillin novocaine salt - 50 rubles

Benzylpenicillin - 30 rubles

Antibiotics for a child

Preparations based on penicillin (mold) for the treatment of children are used only if indicated.

Most often, doctors prescribe to young patients:

• Amoxiclav can be prescribed to a newborn child, as well as an infant under the age of 3 months. The dosage is calculated according to the scheme, based on the condition of the child, his weight and the severity of symptoms.
• Oxacillin - the drug is taken under the supervision of a doctor, it can be prescribed to a newborn if indicated. Antibiotic therapy is carried out under the supervision of a physician.
• Ospamox - the doctor calculates the dosage for children. It is determined according to the scheme (30-60 mg is divided by kg of weight and the number of doses per day).

Carefully! Antibiotic therapy in children has its own nuances. For this reason, you should not independently prescribe such medicines to a child. There is a risk of making a mistake with the dosage and causing serious harm to the baby's health.

Antibiotics related to penicillins are quite effective. They were discovered at the end of the 19th century and are widely used in medicine. Despite the fact that pathogenic microorganisms often mutate, drugs of this class are still in demand.

- penicillins, cephalosporins, carbopenems - form the basis of modern chemotherapy. They have a bactericidal effect due to the destruction of peptidoglycan, a mucopeptide of the bacterial cell wall. The drugs have synergism in relation to gram-negative flora with aminoglycosides and fluoroquinolones, but they cannot be mixed in the same syringe or infusion system due to their physicochemical incompatibility. To overcome resistance, they are combined with beta-lactamase inhibitors.

Side effects: allergic rashes, eosinophilia, rarely other immediate hypersensitivity reactions (angioedema, urticaria), anaphylactic shock in children is extremely rare, as are neutro- and thrombocytopenia, hemolytic anemia, interstitial nephritis, phlebitis at the injection site. Ampicillin and cephalosporins rarely cause. Only benzylpenicillin sodium salt is administered endolumbar - extremely carefully for health reasons. When prescribing to patients with renal failure, the content of potassium and sodium in the preparations is taken into account.

Contraindications Individuals with a history of anaphylaxis, urticaria, or a profuse rash immediately after penicillin administration are at risk of developing an immediate reaction to other drugs in this group and should not be given them. Patients who are allergic to a penicillin drug will be allergic to all penicillins, but only 10% of them to cephalosporins and other beta-lactams. Individuals with a history of minimal rash (non-confluent rash on a small surface of the body) or rash that occurs 72 hours or more after penicillin administration may not be allergic to penicillins; they should not abandon its use for serious infections, providing everything for the treatment of anaphylaxis.

Penicillins

Penicillins penetrate well into tissues and body fluids, incl. in CSF with inflammation of the meninges and the introduction of high doses. They are excreted mainly in the urine. Carbenicillin has lost its importance, ticarcillin and ureidopenicillins are used only in combination with lactamase inhibitors.

Drug interactions. Increase the risk of bleeding when used with direct and indirect action, NSAIDs, salicylates. When taken together with potassium supplements, potassium-sparing diuretics, ACE inhibitors hyperkalemia is possible. Increase the toxicity of methotrexate.

Natural penicillins

Benzylpenicillin(in Russia it is more often called penicillin) - a low-toxic drug that creates high concentrations(at a dose of 50 mg / kg IM - 15-25 μg / ml in blood and 60-70% of it in tissues). Pneumococci in Russia retain 90-95% sensitivity to penicillin, lower sensitivity in children in preschool institutions and, especially, in boarding schools. Benzylpenicillin derivatives have the same antibacterial spectrum; phenoxymethylpenicillin, due to its lower efficacy, should not be used to treat serious infections. In children with otitis media and uncomplicated phenoxymethylpenicillin-benzathine (Ospen syrup), its concentration in the blood at a dose of 50 mg / kg is 4-6 μg / ml.

Benzathine benzylpenicillin provides a prolonged effect when administered intramuscularly; it is used for infections caused by highly sensitive pathogens (GABHS, spirochete pallidum) to maintain a low therapeutic concentration for a long time.

Side effects. Jarisch-Herzheimer reaction (treatment of syphilis and other infections caused by spirochetes) - associated with the release of endotoxins.

Benzylpenicillin

Indications. Acute otitis media, pneumococcal infection (, meningitis), streptococcal infections(acute, erysipelas, scarlet fever, endocarditis, necrotizing fasciitis), meningococcal infection, tick-borne borreliosis, leptospirosis, anthrax; actinomycosis, gas gangrene, syphilis.

Dosage: intramuscular or intravenous slowly or by infusion: children from 1 month to 12 years old, 100-200 thousand U / kg per day in 2-3 doses, in case of severe diseases - up to 500,000 U / kg / day by vital indications (see below). Syphilis - See Section 6.3.

Side effects. At doses> 20 million U / day - disorders of the DNS, an increase in the level of creatinine.

Release form: powder for preparation of solution for intravenous and intramuscular injections of 250,000, 500,000 and 1 million units (1 mg = 1610 units) (Benzylpenicillin - Russia)

Phenoxymethylpenicillin - Penicillin V (phenoxymethylpenicillin)

Indications: Streptococcal pharyngitis, secondary prevention of rheumatism; prevention of recurrence of pneumococcal meningitis after traumatic brain injury, pneumococcal infection in children after splenectomy or with hypogammaglobulinemia; for the treatment of acute otitis media; erysipelas.

Dosage: by mouth, children over 12 years old - 500 mg every 6 hours, children under 1 year old - 50 mg / kg / day, from 1 to 6 years old - 30 mg / kg / day, 6-12 years old - 20-30 mg / kg / day in 3-4 doses. Secondary prevention of rheumatism: inside, children - 500 mg 1-2 times a day.

Side effects: See above, plus nausea and diarrhea.

Release form: Phenoxymethylpenicillin-benzathine syrup 750 mg / 5 ml (Ospen-750 - Sandoz, Austria), table. 100 mg, 250 mg, dragees 100,000 U, powder for suspension preparation: 250 mg / 5 ml, 60 mg / ml (Phenoxymethylpenicillin - Russia).

Benzathine benzylpenicillin

Indications: acute group A streptococcal, erysipelas, prevention of rheumatism, treatment of carriers of diphtheria; syphilis.

Contraindications: neurosyphilis. Do not administer intravenously or intra-arterially.

Carefully: renal failure.

Dosing. In the treatment of acute tonsillitis, scarlet fever, erysipelas, wound infections in the acute phase, therapy begins with penicillin, benzathine is continued with benzyl-penicillin: 1-2 injections of 1.2 million U once a week. With rheumatism in / m 2.4 million units every 15 days. For the prevention of scarlet fever for children under 7 years of age (or weighing up to 25 kg) 600,000 U, over 7 years (or weighing more than 25 kg) - 1,200,000 same doses every 2 weeks, Syphilis: see section 6.3.

Side effects: Rarely, embolism; pain and inflammation at the injection site.

Release form: Por. d / inv. solution for i / m injections, benzathine benzylpenicillin in vials: 300, 600 thousand, 1.2 and 2.4 million units. (Bitsillin-1 (Russia); 1.2 and 2.4 million U (Retarpen, Extensillin - Sandoz, Austria).

Anti-staphylococcal penicillins

Oxacillin

Oxacillin is used to treat infections caused by staphylococci, incl. producing beta-lactamase, but not MRSA. The rest of the spectrum of action is the same as that of natural penicillins, but the sensitivity of pneumococci and streptococci to it is lower than to penicillin. Oral bioavailability is low.

Indications: Infectious diseases caused by staphylococci, incl. producing beta-lactamase: acute sinusitis, septicemia, abscesses, phlegmon, cholecystitis, infected burns, bacterial endocarditis.

Carefully: bronchial asthma, chronic renal failure; liver failure.

Dosage: i / m or i / v newborns - 20-40 mg / kg / day for 2 injections, children 100-150 (up to 200) mg / kg / day - max, up to 12 g / day for 2-4 injections.

Side effects. Rarely - abnormal liver function, jaundice at high doses (in adults> 12 g / day). Fever, nausea, vomiting, eosinophilia, anemia, neutropenia, transient hematuria in children.

Release form: Lyophilisate d / prig. solution for intravenous and intramuscular administration 250 mg, 500 mg (Oxacillin - Russia).

Aminopenicillins

Ampicillin and amoxicillin, in contrast to natural pencillins, act on some gram-negative microorganisms, in particular, on H. influenzae, which in Russia remains sensitive to aminopenicillins due to the low frequency of beta-lactamase production. Ampicillin acts on E. fecalis, which in Russia is 90% sensitive to it. Activity against Salmonella and Shigella is geographically distinct. Value at empirical therapy IMG1 is limited due to the high frequency of secondary resistance of E. coli. The drugs are inactivated by beta-lactamase produced by S. aureus, M. catarrhalis, N. gonorrhoeae, enterobacteria.

Amoxicillin acts better than ampicillin and penicillin; when taken orally, it has a 2-2.5 times greater bioavailability than ampicillin (especially in the form of dispersible tablets Solutab), gives higher concentrations in plasma and tissues and causes diarrhea less often. Ampicillin is used only parenterally.

Contraindications Leukemoid reactions of the lymphatic type, lymphocytic leukemia.

Carefully. Acute (possibly mononucleosis), erythematous rash, characteristic of infectious mononucleosis, lactation. Strengthening diaper rash - does not prevent re-use.

Side effects. The peculiarity of aminopenicillins is the development (about 7% of courses) of maculopapular ("ampicillin") rash (especially against the background of infection with the Einstein-Barr virus - most of them recognize its non-allergic nature) on 3-5 days of treatment; the rash disappears without discontinuing the drug. Rarely vomiting, diarrhea, very rarely -.

Interaction. Reduce the contraceptive effect of estrogen-containing drugs. Allopurinol increases the risk of an "ampicillin" rash.

Ampicillin (ampicillin)

Indications. Acute otitis media, acute sinusitis, community-acquired, UTI, IVI, shigellosis, salmonellosis, meningitis, bacterial endocarditis, septic infection of newborns (in combination with gentamicin), erysipelas.

Dosing, intramuscularly, intravenously slowly or intravenously by infusion. 100-200 mg / kg / day, meningitis, endocarditis - 200-300 mg / kg / day. (up to 8-12 g / day).

Release form: Powder for preparation of injection solution 250 mg, 500 mg, 1 and 2 g (Ampicillin - Russia).

Amoxicillin (amoxicillin)

Indications: upper respiratory tract infections (sinusitis, acute otitis media),: UTI. systemic tick-borne borreliosis (Lyme disease); prevention of endocarditis: eradication of H. pylori, dysentery, salmonellosis, salmonella carriage in the presence of sensitivity.

Dosage: by mouth, children 45 mg / kg / day, the dose with the likelihood of resistance of pneumococci (antibiotic treatment, visiting a child care facility) - 80-100 mg / kg / day. The course of treatment is 5-12 days.

Release form: dispersible table. 0.125, 025, 0.5 and 1 g caps., Table. 0.25 and 0.5 g; tab., p / obol. 0.5 and 1.0 g; since. and grand, d / prig. suspension 125 mg / 5 ml and 250 mg / 5 ml: por. d / inv. drops, 0.1 g / ml (Flemoxin Solutab - Astellas Pharma Europe BB .. Netherlands. Amoxicillin - Russia Ospamox - Sanoz, Austria. Hikontsil - Krka, Slovenia).

Inhibitor-protected penicillins

They are a combination of a penicillin drug and an inhibitor (beta-lactamase. The most widely used is amoxicillin / clavulanate, active against resistant H. influenzae, E. coli, M. catarrhalis, S. aureus, (but not MRSA); more active against pneumococci ticarcillin / clavulanate is effective against Serratia, Citrobacter, as well as some strains of P. aeruginosa and Acinetobacter. The addition of beta-lactamase inhibitors does not lead to overcoming Pseudomonas aeruginosa resistance. aeruginosa All drugs are bactericidal against anaerobes, including B. fragilis, Prevotella melaninogenicus Used for perioperative prophylaxis in abdominal surgery Sulbactam has its own clinically significant antibacterial activity against Neisseria and Acinetobacter.

Side effects. Nausea and vomiting, diarrhea, rarely - hepatitis, cholestatic jaundice. There have been cases of vasculitis, serum sickness, erythema multiforme (including Stevens-Johnson syndrome), exfoliative; possible surface plaque on the teeth when using the suspension.

Interaction. Antacids, laxatives, glucosamine reduce the absorption of protected penicillins.

Amoxicillin / clavulanic acid

Indications. Respiratory tract, skin and soft tissue, bone, genitourinary and abdominal infections caused by beta-lactamase-producing microorganisms. It is used as the first choice drug in children recently discharged from a hospital or treated with antibiotics for a period of 3 months before the present disease, as well as in groups at increased risk for the resistance of the pneumotropic flora (boarding schools, preschool institutions). The drug of choice for anaerobic infections (Vincent, lung abscess, deep wounds), abscesses, fasciitis and phlegmon, animal bites, dental infections, as well as for antibacterial prophylaxis in organ operations abdominal cavity and small pelvis.

Contraindications History of jaundice or hepatic dysfunction associated with the use of clavulanic acid. Strengthening diaper rash - does not prevent re-use.

Carefully. Renal, hepatic impairment; erythematous rash characteristic of infectious mononucleosis, chronic lymphocytic leukemia.

Dosing (for amoxicillin): Orally for children under 12 years old - 45 mg / kg / day in 2 doses (up to 750 mg / day), over 12 years old and for adults - 1750 mg per day in 2 doses (875 × 2). If necessary, the dose is increased to 80-100 mg / kg / day, preferably using drugs with a ratio of amoxicillin and clavulanate 7: 1 and higher. IV in newborns - 60 mg / kg / day for 2 injections, children from 1 month. up to 12 years old - 40-60 (up to 90-120) mg / kg / day, over 12 years old and adults - 3-4 (up to 6) g / day for 3-4 injections.

Release form. The ratio of amoxicillin to clavulanate:

• 2: 1 - tab. 0.25 / 0.125 g (Augmentin - the original amoxicillin / clavulanate produced by GlaxoSmithKline, Great Britain, Medoklav - Medohsmi, Cyprus, Amoxiclav - Lek, Slovenia);
• 4: 1 - tab. 500/125 mg pore d / inv. suspension 125 mg / 31.25 mg / 5 ml, 250 mg / 62.5 mg / 5 ml (Amoxiclav, Augmentin, Medoklav);
• 4: 1 - tab. dispersible 125 mg / 31.25 mg; 250 mg / 62.5 mg and 500 mg / 125 mg (Flemoklav Solutab - Astellas Pharma Europe B.V., Netherlands). 5: 1 - por. for i.v. solution 500/100 mg, 1000/200 mg (Augmentin, Amoxiclav, Medoklav) 7: 1 - tab. 0.875 / 0.125 g (Amoxiclav)
• 7: 1 - tab. 0.875 / 0.125 g, por. d / inv. suspension 200 / 28.5 mg / 5 ml and 400/57 mg / 5 ml (Augmentin - dosage forms 2 times a day with the best ratio of amoxicillin and clavulanate).

Ampicillin / sulbactam (ampicillin / sulbactam)

Indications and contraindications. The same as for amoxicillin / clavulanate, hypersensitivity to sulbactam.

Dosing. Children of all ages, including newborns - 150 mg / kg / day, (100 mg / kg / day of ampicillin and 50 mg / kg / essence of sulbactam) for 3-4 (newborns - for 2) injections, for adults - 1.5-12 g per day for 2-4 intramuscular or intravenous infusions.

Form of issue: pore. d / inv. solution 0.5 / 0.25 g, 1 / 0.5 g, 2/1 g (Unazine-Pfizer, USA).

Ticarcillin + clavulanic acid (ticarcilliri / clavulanic acid)

Indications. Severe (lung, abdominal, bone, soft tissue, urinary tract) caused by multiresistant gram-negative flora, including anaerobic.

Dosage (for ticarcillin): children over 3 months. weighing up to 60 kg - 200-300 mg / kg / day for 4-6 injections, for children weighing 60 kg or more, as well as for adults - 12-18 g for 4-6 intravenous drip injections (for 30 minutes) ...

Side effects: dizziness, neutropenia, hypokalemia.

Release form: lyoph. since. d / inv. 1500/100 mg and 3000/200 mg (15: 1) (Tymentin-GlaxoSmith-Klein, UK).

Antibiotics owe their appearance to the Scottish scientist Alexander Fleming. More precisely, his slovenliness. In September 1928, he returned to his laboratory from a long trip. During this time, in a Petri dish forgotten on the table, an area with mold has grown, and a ring of dead microbes has formed around it. It was this phenomenon that the microbiologist noticed and began to investigate.

The mold in the test tube contained a substance that Fleming called penicillin. However, as many as 13 years passed before penicillin was obtained in its pure form, and its action was first tested on humans. The mass production of new drugs began in 1943, at the distillery where whiskey was previously brewed.

Today there are about several thousand natural and synthetic substances with antimicrobial effect. However, the most popular of them are still drugs of the penicillin series.

Any pathogenic microorganism entering the blood or tissue begins to divide and grow. The effectiveness of penicillins is based on their ability to disrupt the formation of bacterial cell walls.

Antibiotics of the penicillin group block special enzymes that are responsible for the synthesis of a protective, peptidoglycan layer in the bacterial membrane. It is thanks to this layer that they remain insensitive to aggressive environmental influences.

The result of the impaired synthesis is the inability of the membrane to withstand the difference between external pressure and the pressure inside the cell itself, due to which the microorganism swells and simply bursts.

Penicillins are antibiotics with a bacteriostatic effect, that is, they affect only active microorganisms that are in the stage of division and the formation of new cell membranes.

Classification

According to the chemical classification, antibiotics of the penicillin series are β-lactam antibiotics. In their structure, they contain a special beta-lactam ring, which determines their main action. Today, the list of such drugs is quite large.

The first, natural penicillin, despite all its effectiveness, had one significant drawback. He was not resistant to the enzyme penicillinase, which was produced by almost all microorganisms. Therefore, scientists have created semi-synthetic and synthetic analogs. Today, antibiotics of the penicillin group include three main types.

Natural penicillins

As many years ago, they are obtained using the molds Penicillium notatum and Penicillium chrysogenum. The main representatives of this group today are benzylpenicillin sodium or potassium salt, as well as their analogs Bicillins -1, 3 and 5, which are novocaine salt of penicillin. These drugs are not resistant to the aggressive environment of the stomach and therefore are used only in the form of injections.

Benzylpenicillins are characterized by a rapid onset of the therapeutic effect, which develops literally in 10-15 minutes. However, its duration is quite short, only 4 hours. Bitsillin can boast of greater stability, due to its connection with novocaine, its action lasts for 8 hours.

Another representative on the list of this group, phenoxymethylpenicillin, is resistant to an acidic environment, therefore it is available in tablets and suspensions that can be used by children. However, it also does not differ in the duration of action and can be prescribed from 4 to 6 times a day.

Natural penicillins are used very rarely today due to the fact that most pathological microorganisms have developed resistance to them.

Semi-synthetic

This penicillin group of antibiotics was obtained using various chemical reactions, attaching additional radicals to the main molecule. The slightly altered chemical structure has endowed these substances with new properties, such as resistance to penicillinase and a broader spectrum of action.

Semisynthetic penicillins include:

• Antistaphylococcal drugs, such as Oxacillin obtained in 1957 and still used today, and cloxacillin, flucloxacillin, and dicloxacillin, which are not used due to their high toxicity.
• Antipseudomonal, special group penicillins, which was created to fight infections caused by Pseudomonas aeruginosa. These include Carbenicillin, Piperacillin, and Azlocillin. Unfortunately, today these antibiotics are used very rarely, and due to the resistance of microorganisms to them, new drugs are not added to their list.
• Penicillin range of broad-spectrum antibiotics. This group acts on many microorganisms and at the same time is resistant to an acidic environment, which means that it is produced not only in injection solutions, but also in tablets and suspensions for children. These include the most commonly used aminopenicillins, such as Ampicillin, Ampiox, and Amoxicillin. The drugs have long-term action and are usually applied 2-3 times a day.

Of the entire group of semi-synthetic drugs, it is penicillin antibiotics of a wide spectrum of action that are the most popular and are used both in inpatient and outpatient treatment.

Inhibitor-protected

Once upon a time, injections of penicillin could cure blood poisoning. Today, most antibiotics are ineffective even for simple infections. The reason for this is resistance, that is, the resistance to drugs that the microorganisms have acquired. One of its mechanisms is the destruction of antibiotics by the enzyme beta-lactamase.

In order to avoid this, scientists have created a combination of penicillins with special substances - beta-lactamase inhibitors, namely with clavulanic acid, sulbactam or tazobactam. Such antibiotics were called protected and today the list of this group is the most extensive.

In addition to the fact that inhibitors protect penicillins from the destructive action of beta-lactamases, they also have their own antimicrobial action. The most common of this group of antibiotics is Amoxiclav, which is a combination of amoxicillin and clavulanic acid, and Ampisid, a combination of ampicillin and sulbactam. Doctors and their analogues are prescribed - drugs Augmentin or Flemoklav. Protected antibiotics are used to treat children and adults, and they are also the drugs of first choice in the treatment of infections during pregnancy.

Antibiotics protected by beta-lactamase inhibitors are used successfully even to treat severe infections that are resistant to most other drugs.

Application features

Statistics claim that antibiotics are in second place after pain relievers in terms of the prevalence of use. According to the analytical company DSM Group, 55.46 million packs were sold in one quarter of 2016 alone. Today pharmacies sell about 370 different brands of drugs, which are produced by 240 companies.

The entire list of antibiotics, including those of the penicillin series, refers to drugs of strict dispensing. Therefore, you need a doctor's prescription to purchase them.

Indications

An indication for the use of penicillins can be any infectious diseases that are sensitive to them. Usually doctors prescribe penicillin antibiotics:

1. For diseases caused by gram-positive bacteria, such as meningococci, which can cause meningitis, and gonococci, which trigger the development of gonorrhea.
2. With pathologies that are provoked by gram-negative bacteria, such as pneumococci, staphylococci or streptococci, which are often the causes of infections of the upper and lower respiratory tract, genitourinary system and many others.
3. For infections caused by actinomycetes and spirochetes.

The low toxicity that the penicillin group has in comparison with other antibiotics makes them the most prescribed drugs for the treatment of tonsillitis, pneumonia, various infections of the skin and bone tissue, diseases of the eyes and ENT organs.

Contraindications

This group of antibiotics is relatively safe. In some cases, when the benefits of their use outweigh the risk, they are prescribed even during pregnancy. Especially when non-penicillin antibiotics are ineffective.

They are also used during lactation. However, doctors still advise to stop breastfeeding while taking antibiotics, as they can penetrate into milk and can cause allergies in the baby.

The only absolute contraindication to the use of penicillin drugs is individual intolerance to both the main substance and auxiliary components. For example, benzylpenicillin novocaine salt is contraindicated for allergies to novocaine.

Side effect

Antibiotics are quite aggressive drugs. Even though they have no effect on the cells of the human body, there can be unpleasant effects from their use.

Most often these are:

1. Allergic reactions, manifested mainly in the form itchy skin, redness and rashes. Less often, edema may occur, the temperature rises. In some cases, anaphylactic shock may develop.
2. Disruption of the balance of natural microflora, which provokes disorders, abdominal pain, bloating and nausea. In rare cases, candidiasis may develop.
3. A negative effect on the nervous system, the signs of which are irritability, excitability, convulsions can rarely occur.

Treatment rules

To date, of the entire variety of open antibiotics, only 5% are used. The reason for this lies in the development of resistance in microorganisms, which often arises from improper use of drugs. Antibiotic resistance is already killing 700,000 people every year.

In order for the antibiotic to be as effective as possible and not cause the development of resistance in the future, it must be drunk in the dosage prescribed by the doctor and always the full course!

If your doctor has prescribed penicillins or any other antibiotics for you, be sure to follow these rules:

• Strictly observe the time and frequency of taking the drug. Try to drink the medicine at the same time, so you will ensure a constant concentration of the active substance in the blood.
• If the dosage of penicillin is small and the drug needs to be drunk three times a day, then the time between doses should be 8 hours. If the dose prescribed by the doctor is calculated to be taken twice a day - up to 12 hours.
• The course of taking the drug can range from 5 to 14 days and is determined by your diagnosis. Always completely drink the entire course prescribed by your doctor, even if the symptoms of the disease no longer bother you.
• If you do not feel any improvement within 72 hours, be sure to tell your doctor about it. Perhaps the drug he chose was not effective enough.
• Do not swap one antibiotic for another yourself. Do not change dosage or dosage form. If the doctor has prescribed injections, then the pills in your case will not be effective enough.
• Be sure to follow the instructions for admission. There are antibiotics that you need to drink with meals, there are those that you drink immediately after. Drink the drug only with plain, non-carbonated water.
• For the duration of antibiotic treatment, give up alcohol, fatty, smoked and fried foods. Antibiotics are mainly excreted by the liver, so there is no need to load it additionally during this period.

If antibiotics-penicillins are prescribed to a child, then you should be especially careful about taking them. Children's organism is much more sensitive to these drugs than an adult, so babies may experience allergies more often. Penicillins for children are produced, as a rule, in a special dosage form, in the form of suspensions, so you should not give your child pills. Drink antibiotics correctly and only as directed by your doctor when needed.

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Mushrooms are the kingdom of living organisms. Mushrooms are different: some of them get into our diet, others cause skin diseases, others are so poisonous that they can lead to death. But fungi of the genus Penicillium save millions of human lives from pathogenic bacteria.

Penicillin antibiotics are still used in medicine.

The discovery of penicillin and its properties

In the 30s of the last century, Alexander Fleming conducted experiments with staphylococci. He studied bacterial infections. Having grown a group of these pathogens in a nutrient medium, the scientist noticed that there are areas in the dish around which there are no living bacteria. The investigation has shown that ordinary green mold, which likes to settle on stale bread, is "to blame" for these spots. The mold was called Penicillium and, as it turned out, produced a substance that kills staphylococci.

Fleming took a deeper look at this issue and soon isolated pure penicillin, which became the world's first antibiotic... The principle of action of the drug is as follows: when a bacterial cell divides, each half restores its cell membrane with the help of a special chemical element - peptidoglycan. Penicillin blocks the formation of this element, and the bacterial cell is simply "absorbed" in the environment.

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State medical University them. N.N. Burdenko. Clinical resident and neurologist BUZ VO \ "Moscow polyclinic \".

But difficulties soon arose. Bacterial cells have learned to resist the drug - they began to produce an enzyme called beta-lactamase, which breaks down beta-lactams (the basis of penicillin).

Expert opinion

Astafiev Igor Valentinovich

Physician - neurologist - Pokrovskaya city hospital. Education: Volgograd State Medical University, Volgograd. Kabardino-Balkarian State University named after HM. Berbekova, Nalchik.

For the next 10 years, there was an invisible war between the pathogens that destroy penicillin and the scientists who modify this penicillin. This is how many modifications of penicillin were born, which now form the entire penicillin range of antibiotics.

Pharmacokinetics and principle of action

The drug for any method of application quickly spreads throughout the body, penetrating almost all of its parts. Exceptions: cerebrospinal fluid, prostate and visual system. In these places, the concentration is very low, under normal conditions it does not exceed 1%. With inflammation, an increase of up to 5% is possible.

Antibiotics do not affect the cells of the human body, since the latter do not contain peptidoglycan.

The drug is quickly excreted from the body, after 1-3 hours most of it is excreted through the kidneys.

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Classification of antibiotics

All drugs are divided into: natural (short and prolonged action) and semi-synthetic (antistaphylococcal, broad-spectrum drugs, antipseudomonal).

Natural

These drugs obtained directly from mold... At the moment, most of them are outdated, as pathogens have developed immunity to them. In medicine, benzylpenicillin and Bicillin are most often used, which are effective against gram-positive bacteria and cocci, some anaerobic bacteria and spirochetes. All these antibiotics are used only in the form of injections into the muscles, since the acidic environment of the stomach quickly destroys them.

Benzylpenicillin in the form of sodium and potassium salts belongs to natural short-acting antibiotics. Its effect wears off after 3-4 hours, so repeated injections must be done frequently.

Trying to eliminate this shortcoming, pharmacists have created natural antibiotics of prolonged action: Bicillin and novocaine salt of benzylpenicillin. These drugs are called "depot forms" because, after being injected into a muscle, they form a "depot" in it, from which the drug is slowly absorbed into the body.

Expert opinion

Mitrukhanov Eduard Petrovich

Doctor - neurologist, city polyclinic, Moscow. Education: Russian State Medical University, GBOU DPO Russian medical Academy postgraduate education of the Ministry of Health of the Russian Federation, Volgograd State Medical University, Volgograd.

Examples of drugs: benzylpenicillin salt (sodium, potassium or novocainic), Bicillin-1, Bicillin-3, Bicillin-5.

Semi-synthetic antibiotics of the penicillin group

Several decades after receiving penicillin pharmacists were able to isolate its main active ingredient, and the modification process began... After improvement, most drugs acquired resistance to the acidic environment of the stomach, and semi-synthetic penicillins began to be produced in tablets.

Isoxazolepenicillins are medicines that are effective against staphylococci. The latter have learned to produce an enzyme that destroys benzylpenicillin, and drugs from this group prevent them from producing the enzyme. But you have to pay for the improvement - drugs of this type are less absorbed in the body and have a smaller spectrum of action compared to natural penicillins. Examples of drugs: Oxacillin, Nafcillin.

Aminopenicillins are broad-spectrum drugs. They are inferior to benzylpenicillins in strength in the fight against gram-positive bacteria, but cover a wider spectrum of infections. Compared to other drugs, they stay in the body longer and better penetrate some of the body's barriers. Examples of drugs: Ampicillin, Amoxicillin. You can often find Ampiox - Ampicillin + Oxacillin.

Carboxypenicillins and ureidopenicillins - antibiotics effective against Pseudomonas aeruginosa... At the moment, they are practically not used, since infections quickly become resistant to them. Occasionally you can find them as part of a comprehensive treatment.

Examples of drugs: Ticarcillin, Piperacillin

List of drugs

Pills

Sumamed

Active ingredient: azithromycin.

Indications: respiratory tract infections.

Contraindications: intolerance, severe renal failure, children under 6 months of age.

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: drug-sensitive infections.

Price: 30-60 rubles.

Amoxicillin Sandoz

Indications: respiratory tract infections (including tonsillitis, bronchitis), infections of the genitourinary system, skin infections, and other infections.

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

Indications: streptococcal diseases, infections of mild to moderate severity.

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

Indications: infections of the respiratory tract, urinary system, infections in gynecology, other infections sensitive to amoxicillin.

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

Injections

Bitsillin-1

Active ingredient: benzathine benzylpenicillin.

Indications: acute tonsillitis, scarlet fever, wound infections, erysipelas, syphilis, leishmaniasis.

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

Indications: infections of the lower and upper respiratory tract, gastrointestinal tract, genitourinary system, gynecological and surgical infections.

Contraindications: hypersensitivity, severe gastrointestinal tract infections, lymphocytic leukemia, mononucleosis.

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

Indications: infections of the respiratory and urinary tract, gastrointestinal tract, meningitis, endocarditis, sepsis, whooping cough.

Contraindications: hypersensitivity, renal dysfunction, childhood, pregnancy.

Price: 163 rubles.

Benzylpenicillin

Indications: severe infections, congenital syphilis, abscesses, pneumonia, erysipelas, anthrax, tetanus.

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

Amoxiclav, Ospamox, Oxacillin are suitable for the treatment of children. But before using the medicine, you must definitely consult with your doctor to adjust the dose.

Indications for use

Antibiotics of the penicillin group are prescribed for infections, the type of antibiotics is selected based on the type of infection. These can be various cocci, bacilli, anaerobic bacteria, and so on.

Most often, antibiotics are used to treat infections of the respiratory tract and genitourinary system.

Application features

In the case of treating children, you need to follow the instructions of the doctor, who will prescribe the desired antibiotic and adjust the dose.

In case of pregnancy, antibiotics must be used with extreme caution, as they penetrate the fetus. During lactation, it is better to switch to mixtures, since the medicine also penetrates into the milk.

There are no special instructions for the elderly, although the doctor should take into account the condition of the patient's kidneys and liver when prescribing treatment.

Contraindications and side effects

The main and, often, the only contraindication is individual intolerance. It is common - in about 10% of patients. Additional contraindications depend on the specific antibiotic and are prescribed in its instructions for use.

List of side effects

• The development of allergies - from itching and fever to anaphylactic shock and coma.
• Instantaneous development of an allergic reaction in response to the introduction of the drug into a vein.
• Dysbacteriosis, candidiasis.

In case of side effects, you should immediately seek medical help, discontinue the drug and carry out symptomatic treatment.