Antibiotics prescribed for infectious diseases

The list of broad-spectrum antibiotics includes drugs from different groups. Drugs from a number of fluoroquinolones, nitroimidazoles, glycopeptides and from the phosphoric acid group have particularly high activity.

Below you can familiarize yourself with the characteristics of the best broad-spectrum antibiotics and methods of their use. Antibiotics are prescribed by the attending physician taking into account the sensitivity of the pathogen based on laboratory data. In some cases, urgent prescription of antibacterial agents is necessary, then the choice falls on broad-spectrum antibiotics.

With long-term treatment, bacterial resistance to antibiotics may develop; in this situation, it is necessary to change drugs to others or use a complex of several drugs. The duration of antibiotic therapy is determined by the severity of the disease, the presence of complications and concomitant pathologies. Doses of modern broad-spectrum antibiotics are selected by the attending physician individually, taking into account the patient’s age and possible contraindications.

How do new generation antibiotics work?

Unlike drugs from the antiseptic group, the antibiotic has a proper therapeutic effect not only after external application, but also acts systemically after oral, intravenous, and intramuscular use.

New generation antibiotics are capable of:

1. Affect the synthesis of cell walls by disrupting the production of vital peptide complexes.
2. Impair the functioning and integrity of the cell membrane.
3. Disturb the synthesis of protein necessary for the growth and functioning of the pathogenic pathogen.
4. Suppress nucleic acid synthesis.

Based on the nature of their effect on bacterial cells, antibiotics are divided into:

1. Bactericidal - the pathogen will die and will then be eliminated from the body.
2. Bacteriostatic - the active component does not kill bacteria, but disrupts their ability to reproduce.

It is important to determine how active the active substance of the drug is in relation to a particular pathogen of the pathological process. To do this, you need to undergo a series of laboratory tests prescribed by your doctor.

Antibiotics for influenza

Antibacterial agents do not have a therapeutic effect against influenza. Their pharmacological action is determined by their effect on pathogenic bacteria. In this case, they may cause more harm than good. By destroying the microflora in the intestines, medications reduce the body's protective functions, making it more vulnerable to viruses.

Antiviral drugs are used to combat the influenza pathogen. They have a wide range of effects, suppressing the development of various viral infections. Their use is indicated not only for treatment, but also for the prevention of influenza. However, their use without the prescription of a specialist is contraindicated in order to eliminate negative consequences.

Rules for prescribing antibiotics

In order for antibiotics to be as effective as possible and not give serious side effects, when selecting and prescribing them, it is necessary to take into account the form of the disease and its severity, as well as determine the cause of the pathology (ideally, using culture results, find out which microbe caused the inflammation).

In addition, it is important to determine the sensitivity of bacteria to certain antibiotics that are planned to be used. Naturally, this is difficult to do in pediatric practice, and there are conditions in which a delay of several days, which is spent on performing cultures and determining sensitivity to antibiotics, can become fatal.

These include acute otitis media, tonsillitis or pneumonia, pyelonephritis and some other conditions. In these cases, antimicrobial therapy is prescribed immediately, based on clinical recommendations and treatment protocols that have been developed over years of treatment. If necessary, therapy is adjusted based on culture results already during treatment, if it is ineffective.

What antibiotics are prescribed for coronavirus: list of tablets

Recommendations regarding the treatment of coronavirus infection indicate that it is more advisable to use oral antibacterial drugs. But at the same time, the doctor must take into account the well-being of the infected person and the test results.

Antibiotics for COVID-19 are used in different combinations and in several stages. This is especially important if, along with coronavirus, the patient suffers from an associated bacterial infection.

If the patient has a cough with sputum, elevated body temperature, but overall health is rather normal, you can limit yourself to tablets or capsules. In case of inflammation in the intestines or connection to a ventilator, injections cannot be avoided.

Diseases and spectrum of action of antibiotics

Back in the late 19th century, bacteriologist Hans Gram discovered that different bacteria react differently to staining. Some acquire a pronounced color, while others, on the contrary, quickly discolor. This simple experience was of great importance from a practical point of view. After all, different reactions to the dye spoke about the properties of the bacterial cell wall. This means that it suggested exactly how antibiotics should act on the microorganism.

Since then, there has been a basic division into gram-negative (non-staining) and gram-positive (staining) bacteria.

1. Gram (+) is the causative agent of most infections of the respiratory tract, nasopharynx, ear, and eye. These include, in particular, staphylococci and streptococci.
2. Gram (-) - Bacteria in this group can cause serious illness. These are Escherichia coli, Koch bacillus, salmonella, shigella (the causative agent of diphtheria), gonococcus, meningococcus.

The spectrum of action of antibiotics is determined by which bacteria are sensitive to a particular drug. And if narrow-spectrum antibiotics more often act on either Gram (+) or Gram (-), then a wide spectrum allows them to affect both.

Myth. Oral cephalosporins are as “strong” as parenteral ones

Cephalosporins (CS) are one of the most extensive classes of antimicrobial drugs, available in both oral and parenteral forms. In this case, the severity of the antibacterial effect is primarily determined by belonging to one of the four generations. 1st generation cephalosporin antibiotics—parenteral cefazolin and oral cephalexin—have the narrowest spectrum of activity, similar to the spectrum of aminopenicillins (ampicillin, amoxicillin) [3]. Second generation cephalosporins (parenteral cefuroxime, oral cefaclor) are active against gram-negative bacteria, while their effect on staphylococci and streptococci is close to their predecessors. Thus, the power of representatives of the first and second generation antibiotics is practically independent of the dosage form. But with subsequent generations of cephalosporins, things are not so simple.

It is known that 3rd generation antibiotics have higher activity against gram-negative bacteria, pneumococci and streptococci compared to CS-I and CS-II. However, their oral forms cefixime and ceftibuten clearly have a narrower spectrum of activity than parenteral ceftriaxone, ceftazidime and cefoperazone. In particular, oral drugs do not act against penicillin-resistant pneumococci, which is associated with their relatively low bioavailability. Thus, the bioavailability of cefixime is only 40–50%, while for parenteral forms it approaches 100% [3].

However, cefixime is considered a powerful antibiotic, the use of which is justified for urinary tract infections, as well as otitis media and pharyngitis. Ceftibuten is used much less frequently: it is indicated only for the treatment of acute bacterial complications of chronic bronchitis, otitis media, pharyngitis and tonsillitis. A significant drawback of this drug is its low activity against Staphylococcus aureus [4]. At the same time, third-generation parenteral cephalosporins are widely used to treat severe infections of the upper and lower respiratory tract, biliary tract, soft tissues, intestinal infections, sepsis and others [3].

Broad-spectrum antibiotics: list of drugs

Broad-spectrum antibiotics are universal bactericidal drugs that will help get rid of many diseases. Most often they are prescribed for the treatment of various infections, the causative agent of which remains unknown. They are also prescribed if a person has become infected with a fast-growing and dangerous virus.

The list of modern antibiotics is presented in the table below:

Also, such drugs may be indicated as prophylaxis after major surgical interventions. Remember that not all cheap drugs are so bad.

Cephalosporins

Active against staphylococcal infections, as well as Proteus, Klebsiella, E. coli, pathogens of sore throat and pneumonia, urinary tract diseases, osteomyelitis, meningitis.

Antibiotics in this group include:

Parenteral 3rd generation:

Parenteral 3rd generation:

5th generation (parenteral):

Macrolides

Macrolides tend to accumulate in tissues, and not in blood serum, like other groups. They are used in the treatment of bronchitis and community-acquired pneumonia as a monomedicine (in case of intolerance to penicillins), pathologies of the ENT organs (pharyngitis, sinusitis, otitis, laryngitis and others) and sexually transmitted diseases (syphilis, gonorrhea, benorrhea).

Antibiotics in this group include:

14-member:

15-member:

16-member:

Aminoglycosides

The first generation is used in the treatment of plague and tuberculosis only in combination with tetracycline. Third and fourth for tuberculosis, sepsis, severe hospital infections such as pneumonia.

Antibiotics in this group include:

1st generation:

2nd generation:

3rd generation:

Cordarone solution for intravenous administration 50 mg/ml ampoules of 3 ml 6 pcs.

The drug Cordarone, a solution for intravenous administration, is intended for use in cases where rapid achievement of an antiarrhythmic effect is required, or if it is impossible to administer the drug orally. With the exception of emergency clinical situations, the drug should be used only in a hospital in an intensive care unit under constant monitoring of ECG and blood pressure! When administered intravenously, Cordarone should not be mixed with other drugs. Other drugs should not be administered into the same infusion line as Cordarone. Use only in diluted form. To dilute the drug Cordarone, only a 5% dextrose (glucose) solution should be used. Due to the characteristics of the dosage form of the drug, it is not recommended to administer an infusion solution with a concentration less than the concentration of the infusion solution obtained by diluting 2 ampoules in 500 ml of 5% dextrose (glucose). To avoid injection site reactions, Cordarone should be administered through a central venous catheter, except in cases of cardiac resuscitation for defibrillation-resistant ventricular fibrillation, when, in the absence of central venous access, it is possible to administer the drug into peripheral veins (usually the largest peripheral vein with maximum blood flow). Severe cardiac arrhythmias, in cases where it is impossible to take the drug orally (except in cases of cardiac resuscitation for cardiac arrest caused by ventricular fibrillation resistant to defibrillation). Intravenous drip through a central venous catheter. Typically the loading dose is 5 mg/kg body weight in 250 ml of 5% dextrose (glucose) solution, administered, if possible, using an electronic pump over 20-120 minutes. Intravenous drip administration can be repeated 2-3 times within 24 hours. The rate of drug administration is adjusted depending on the clinical effect. The therapeutic effect appears within the first minutes of administration and gradually decreases after stopping the infusion, therefore, if it is necessary to continue treatment with Cordarone, a solution for intravenous administration, it is recommended to switch to continuous intravenous drip administration of the drug. Maintenance doses: 10-20 mg/kg/24 hours (usually 600-800 mg, but can be increased to 1200 mg over 24 hours) in 250 ml of 5% dextrose (glucose) solution for several days. From the first day of infusion, a gradual transition to taking the drug Cordarone should begin orally (3 tablets of 200 mg per day). The dose can be increased to 4 or even 5 tablets of 200 mg per day. Intravenous bolus administration. Intravenous fluid management is usually not recommended due to hemodynamic risk (possible sharp decrease in blood pressure, collapse); Infusion administration of the drug is preferable whenever possible. Intravenous jet administration should be carried out only in emergency cases when other types of treatment are ineffective and only in the intensive care unit under constant monitoring of ECG and blood pressure. The dose is 5 mg/kg body weight. With the exception of cases of cardiac resuscitation for ventricular fibrillation resistant to defibrillation, intravenous bolus administration of the drug Cordarone should be carried out for at least 3 minutes. Repeated administration of the drug Cordarone should not be carried out earlier than 15 minutes after the first injection, even if the contents of only one ampoule were administered during the first injection (the possibility of developing irreversible collapse). If there is a need to continue administration of the drug Cordarone, it should be administered as an infusion. Cardiac resuscitation for cardiac arrest caused by ventricular fibrillation resistant to defibrillation. Intravenous bolus administration. The first dose is 300 mg (or 5 mg/kg of the drug Cordarone) after dilution in 20 ml of a 5% dextrose (glucose) solution and is administered intravenously. If fibrillation does not stop, then additional intravenous jet administration of the drug Cordarone at a dose of 150 mg (or 2.5 mg/kg) is possible.

Carbapenems

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

Antibiotics in this group include:

Penicillins

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

Fluoroquinolones

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

Antibiotics in this group include:

When to take antibiotics

It is advisable to start taking antibiotics for mixed infections, when other pathogens are added to the flu. This occurs with complications such as bronchitis, pneumonia, laryngitis.

Then the patient is prescribed additional medical examinations to determine the sensitivity of the pathogen to the antibiotic. In this case, Amoxicillin, Augmentin, Ceftriaxone, Amoxiclav may be prescribed.

Prolonged high temperature is also a clear sign of a complicated course of influenza and requires the use of antibacterial agents.

To treat a viral infection, depending on the severity of the disease, drugs are prescribed both orally and by injection.

Antibiotics for sore throat, bronchitis and cough

Inflammatory diseases of the upper respiratory tract are among the most common in clinical practice. Both children and adults are susceptible to diseases such as tonsillitis and bronchitis. Sometimes these pathological conditions can be caused by viruses, but often a bacterial infection is also associated. In this case, it is necessary to use antibacterial drugs (antibiotics). It should be recalled that antibiotic therapy should be carried out only after a complete examination of the patient, diagnosis and testing of the sensitivity of the flora to a particular antibiotic.

The following medications may be prescribed to treat these diseases:

The addition of a bacterial infection may be indicated by a sharp increase in body temperature, an increase in signs of general intoxication (weakness, headache and muscle pain, dizziness), cough with the discharge of purulent sputum.

When to start taking antibiotics for coronavirus

Not all infected people understand when they can take antibacterial drugs for coronavirus infection and what symptoms should appear. You cannot choose and take medications on your own: uncontrolled use of antibiotics can only cause harm. By killing beneficial bacteria along with pathogens, these drugs weaken the body, which is already stunned by the effects of the virus. The consequences can be the most tragic.

A doctor may prescribe a drug based on certain indications:

• bacterial microflora develops in the respiratory tract - this can be understood by the release of yellow or green sputum when coughing;
• elevated body temperature more than 38.5°C for at least 4 days;
• weakness of the body persists even with long-term treatment with antiviral and symptomatic medications;
• discharge of feces with areas of purulent mucus.

Even if symptoms appear, this still does not guarantee that the doctor will prescribe an antibiotic. It is prescribed for proven bacterial infection. Bacteriological culture will help with this: a smear is taken from the nasopharynx, oral cavity, and a section of mucus is taken from the stool. Inoculate on a nutrient medium, determining the type of microorganism. Additionally, a group of antibiotic is determined that will help destroy bacteria.

The use of an antibiotic does not mean that you should exclude the use of an antiviral drug. As part of complex therapy, it will be possible to achieve the greatest effect, since the bacterial flora will be quickly eliminated from the digestive tract and respiratory tract. After completing the course of treatment, a PCR test and bacterial culture are done again: if COVID-19 and its complications are not detected, the patient is discharged.

Principles for selecting the best antibiotics for children

In order for antibiotics to be as effective, safe and free of side effects as possible, it is important to follow certain principles and rules when prescribing them.

Then the antibiotics selected by the doctor will be the best in treating the pathology:

• antibiotics are prescribed only for a proven microbial infection or with a high chance of its development, for complicated forms of pathologies, when the risks of adverse outcomes of the disease are high
• drugs are selected according to the most likely pathogens in a given region and for a given age, based on their resistance to certain drugs
• it is important to take into account previous episodes of antibiotic treatment, if they were carried out in the previous three months, to exclude carriage of resistant strains
• When prescribing drugs in outpatient practice, only oral forms are applicable; injections are prescribed only for special indications.

Drugs that have potentially toxic effects are prohibited for home treatment - a group of aminoglycosides, chloramphenicol, fluoroquinolone drugs and biseptol. When selecting antibiotics for complex clinical situations, it is also important to take into account age restrictions - for example, for tetracyclines, which are permissible only from 12 years of age, since earlier periods of their use threaten serious health consequences.

Antibiotics for children

A special group of new generation antibiotics consists of children's drugs

.
They are prescribed only after 3 days of treatment with antiviral drugs have not brought any effect. Remember that only the attending physician can prescribe such medications. Among the safest children's antibiotics of the latest generation are
:

• Ampicillin-based drugs
  . They are prescribed for the treatment of sore throat, otitis media, sinusitis, pneumonia or pharyngitis. Ampoules and suspensions are most effective.

• Susamed Forte
  - tablets for the treatment of sinusitis, skin infections, otitis media, pneumonia and bronchitis. Prescribed only to children over 5 years of age.

• Flemoxin Solutab
  - tablet form, which is suitable for the treatment of children under one year of age. Suitable for the treatment of infections of the gastrointestinal tract, ENT organs, genitourinary system and soft tissues.

• Zinnat
  - product for children over 3 months. It suppresses the activity of gonococcal infections, relieves bronchitis, pharyngitis, rhinitis, tonsillitis, pneumonia and other diseases.

• Augmentit
  is an antifungal drug that is also effective in combating fungal infections. The dosage is determined depending on the child’s weight.

Children can use many antibiotics, but the dose of the active substance for them should be less than for adults. The advantage is that they are also available as suspensions for internal use and ampoules for intramuscular use.

Possible complications

Despite all the benefits that a broad spectrum of antibiotics provides, such medications cannot be considered a panacea. Their uncontrolled use can affect health.

In particular, the following complications arise:

1. According to some data, children who took broad-spectrum antibiotics in the first year of life are more susceptible to developing asthma.
2. Improper use of antibiotics can lead to decreased sensitivity to drugs. This is often observed in people who did not complete the full course of therapy, but stopped treatment before the period specified by the doctor. In this case, the antibiotic managed to kill only weak and sensitive bacteria. The remaining ones begin to multiply, cause a new round of disease, but can no longer be treated with the original antibiotic.
3. Long-term use of some drugs leads to serious complications. Penicillins can have a toxic effect on the central nervous system, and streptomycin can damage the auditory nerve.
4. Destruction of beneficial microflora and subsequent problems with the gastrointestinal tract. Broad-spectrum antibiotics destroy all bacteria, including those we need. Therefore, probiotics or prebiotics are often prescribed along with them, which help maintain normal intestinal health.

Therefore, the universal spectrum of action of antibiotics is not at all a reason to treat them yourself. Only a doctor can select the appropriate drug, prescribe doses, and prescribe the duration of the course. And, of course, it is the specialist who determines the advisability of taking antibiotics as such.

Myth. Chloramphenicol is a “strong” safe antibiotic for intestinal infections

Is it true.

On the one hand, chloramphenicol really has a wide spectrum of activity, including gram-positive and gram-negative cocci, gram-negative bacilli, including coliform and hemophilus influenzae, as well as other pathogens of intestinal infections - salmonella, shigella, and so on. But, on the other hand, the drug is associated with an equally wide range of adverse reactions.

Chloramphenicol is known to inhibit hematopoiesis, causing thrombocytopenia, anemia, and even fatal aplastic anemia (albeit in only 1 case in 10,000–40,000 patients) [3]. In addition, it has hepatotoxic, neurotoxic and other side effects. Due to its extremely unfavorable safety profile, chloramphenicol is considered a reserve antibiotic and is prescribed only in cases where the benefit of its use outweighs the risk of side effects. This usually happens if for some reason it is not possible to select another antibacterial drug [3, 5].

Bottom line

Antibiotics are powerful substances of natural, synthetic or semi-synthetic origin that help suppress the growth and activity of pathogenic microorganisms.

Broad-spectrum drugs are effective against most bacteria at the same time, and their new generation causes minimal harm to the body.

The selection of a suitable drug depends first of all on the diagnosis, then on its mechanism of action, the degree of toxicity and pharmacokinetic properties. Independent selection and use of antibacterial drugs is dangerous and unacceptable.

Antibiotics for complications of influenza

Depending on the severity and type of complications, the use of the following antibacterial groups of drugs is recommended for influenza:

1. Penicillins are used to treat consequences in the form of otorhinolaryngological diseases, damage to the lower and upper respiratory tract.
2. Fluoroquinolones are effective in the development of symptoms of pharyngitis, sinusitis, otitis, and sinusitis. Representatives of Oflosaccin, Ciprofloxacin and others.
3. Cephalosporins are prescribed for prolonged and acute flu, when the risk of complications is high.
4. Levomycetin agents have a wide spectrum of action. This group of drugs has a strong therapeutic effect, so it is used strictly for its intended purpose. Self-medication can cause negative consequences.
5. Macrolides are indicated when upper respiratory tract infections are associated with influenza.
6. Anti-tuberculosis antibiotics - the pharmacological activity of the group is aimed at combating the causative agent of tuberculosis and preventing complications.
7. Aminoglycosides are effective for severe influenza infection. Help prevent infection of the bloodstream and peritonitis. They have pronounced toxicity and are used strictly as indicated.
8. Antifungal drugs - used in case of fungal pathology.
9. Actinomycetes - the main indication for use is a neoplasm in the patient.