For diseases of the ENT organs and bronchi, four main groups of antibiotics are used. These are penicillins, cephalosporins, macrolides and fluoroquinolones. They are convenient because they are available in tablets and capsules, that is, for oral administration, and they can be taken at home. Each group has its own characteristics, but for all antibiotics there are rules of administration that must be followed.

• Antibiotics should only be prescribed by a doctor for specific indications. The choice of antibiotic depends on the nature and severity of the disease, as well as on what medications the patient has previously received.
• Antibiotics should not be used to treat viral diseases.
• The effectiveness of the antibiotic is assessed during the first three days of its use. If the antibiotic works well, you should not interrupt the course of treatment until the time recommended by your doctor. If the antibiotic is not effective (symptoms of the disease remain the same, the temperature remains high), tell your doctor. Only the doctor decides whether to replace the antimicrobial drug.
• Side effects (eg, mild nausea, bad taste in the mouth, dizziness) do not always require immediate discontinuation of the antibiotic. Often it is enough just to adjust the dose of the drug or additionally introduce drugs that reduce side effects. Measures to overcome side effects are determined by your doctor.
• The consequence of taking antibiotics may be the development of diarrhea. If you have large, loose stools, contact your doctor as soon as possible. Do not try to treat diarrhea caused by taking an antibiotic on your own.
• Do not reduce the dose of the medicine prescribed by your doctor. Antibiotics in small doses can be dangerous because after their use there is a high probability of the emergence of resistant bacteria.
• Strictly adhere to the time of taking the antibiotic - the concentration of the drug in the blood must be maintained.
• Some antibiotics must be taken before meals, others after. Otherwise, they are absorbed worse, so do not forget to check with your doctor about these features.

Cephalosporins

Peculiarities: broad-spectrum antibiotics. They are mainly used intramuscularly and intravenously for pneumonia and many other severe infections in surgery, urology, and gynecology. Of the oral medications, only cefixime is now widely used.

• They cause allergies less frequently than penicillins. But a person with an allergy to the penicillin group of antibiotics may develop a so-called cross-allergic reaction to cephalosporins.
• Can be used by pregnant women and children (each drug has its own age restrictions). Some cephalosporins are approved from birth.

Allergic reactions, nausea, diarrhea.

Main contraindications:

Trade name of the drug	Price range (Russia, rub.)
Active ingredient: Cefixime
Pantsef (Alkaloid) Suprax(various products) Ceforal Solutab (Astellas)		A widely used drug, especially in children. The main indications for use are tonsillitis and pharyngitis, acute otitis media, sinusitis, uncomplicated urinary tract infections. The suspension is allowed from 6 months, capsules - from 12 years. Breastfeeding women are advised to temporarily stop breastfeeding during the days of taking the drug.

Penicillins

Main indications:

• Angina
• Exacerbation of chronic
• Spicy medium
• Exacerbation of chronic
• Community-acquired pneumonia
• Scarlet fever
• Skin infections
• Acute cystitis, pyelonephritis and other infections

Peculiarities: are low-toxic, broad-spectrum antibiotics.

Most common side effects: allergic reactions.

Main contraindications: individual intolerance.

Important information for the patient:

• Drugs in this group are more likely than other antibiotics to cause allergies. It is possible to have an allergic reaction to several drugs from this group at once. If you experience a rash, hives, or other allergic reactions, stop taking the antibiotic and contact your doctor as soon as possible.
• Penicillins are one of the few groups of antibiotics that can be used by pregnant women and children from a very early age.
• Medicines containing amoxicillin reduce the effectiveness of birth control pills.

Trade name of the drug	Price range (Russia, rub.)	Features of the drug that are important for the patient to know about
Active ingredient: Amoxicillin
Amoxicillin(different produced) Amoxicillin DS(Mecofar Chemical-Pharmaceutical) Amosin (Sintez OJSC) Flemoxin Solutab (Astellas) Hiconcil(KRKA)		Widely used antibiotic. Particularly suitable for the treatment of sore throat. It is used not only for respiratory tract infections, but also in treatment regimens for gastric ulcers. Well absorbed when taken orally. It is usually used 2-3 times a day. However, sometimes it is ineffective. This is due to the fact that some bacteria are capable of producing substances that destroy this drug.
Active ingredient: Amoxicillin + clavulanic acid
Amoxiclav(Lek) Amoxiclav Quiktab (Lek d.d.) Augmentin (GlaxoSmithKline) Panclave (Hemofarm) Flemoklav Solutab(Astellas) Ecoclave (Ava Rus)		Clavulanic acid protects amoxicillin from resistant bacteria. Therefore, this drug is often prescribed to people who have already been treated with antibiotics more than once. It is also better suited for the treatment of sinusitis, kidney infections, biliary tract infections, and skin infections. It is usually used 2-3 times a day. More often than other drugs in this group, it causes diarrhea and liver dysfunction.

Macrolides

Main indications:

• Infection with mycoplasma and chlamydia (bronchitis, pneumonia in people over 5 years of age)
• Angina
• Exacerbation of chronic tonsillitis
• Acute otitis media
• Sinusitis
• Exacerbation of chronic bronchitis
• Whooping cough

Peculiarities: antibiotics, used mainly in the form of tablets and suspensions. They act a little slower than antibiotics from other groups. This is due to the fact that macrolides do not kill bacteria, but stop their reproduction. Relatively rarely cause allergies.

Most common side effects: allergic reactions, abdominal pain and discomfort, nausea, diarrhea.

Main contraindications: individual intolerance.

Important information for the patient:

• Resistance of microorganisms to macrolides develops quite quickly. Therefore, you should not repeat the course of treatment with drugs from this group for three months.
• Some of the drugs in this group may affect the activity of other drugs, and are also less well absorbed when interacting with food. Therefore, before using macrolides, you must carefully study the instructions.

Trade name of the drug	Price range (Russia, rub.)	Features of the drug that are important for the patient to know about
Active ingredient: Azithromycin
Azithromycin(different produced) Azitral(Shreya) Azitrox (Pharmstandard) Azicide (Zentiva) Zetamax retard (Pfizer) Z factor (Veropharm) Zitrolide (Valens) Zitrolide forte(Valens) Sumamed (Teva, Pliva) Sumamed forte(Teva, Pliva) Hemomycin (Hemofarm) Ecomed (Ava Rus)	168,03-275 80-197,6	One of the most commonly used drugs in this group. It is better tolerated and well absorbed than others. Unlike other macrolides, it inhibits the growth of Haemophilus influenzae, which often causes otitis media and sinusitis. It is advisable to take on an empty stomach. It circulates in the body for a long time, so it is taken once a day. Short courses of treatment are possible as prescribed by a doctor: from 3 to 5 days. If necessary, can be used with caution during pregnancy. Contraindicated in severe liver and kidney dysfunction.
Active ingredient: Erythromycin
Erythromycin(different produced)	26,1-58,8	An antibiotic that has been used for a long time, and therefore some bacteria are resistant to it. Nausea is caused somewhat more often than other representatives of this group of antibiotics. Inhibits the work of liver enzymes, which are responsible for the destruction of other drugs. Therefore, some drugs, when interacting with erythromycin, are retained in the body and cause toxic effects. It is very important to use the drug on an empty stomach. Can be used during pregnancy and breastfeeding.
Active ingredient: Clarithromycin
Clarithromycin(different produced) Clubax (Runbaxy) Clubax OD (Ranbaxy) Klacid(Abbott) Klacid SR (Abbott) Fromilid(KRKA) Fromilid Uno(KRKA) Ecositrin (Ava Rus)	773-979,5 424-551,4	It is used not only for the treatment of respiratory tract infections, but also in treatment regimens for peptic ulcers to destroy the bacterium Helicobacter pylori. It is active against chlamydia, therefore it is often included in treatment regimens for sexually transmitted diseases. Side effects and drug interactions are similar to those of erythromycin. Not for use in children under 6 months of age, during pregnancy and breastfeeding.
Active ingredient: Midecamycin/midecamycin acetate
Macropen(KRKA)	205,9-429	A classic macrolide antibiotic, often used in suspension form to treat infections in children. Well tolerated. It is advisable to take 1 hour before meals. It is eliminated from the body quite quickly, so the minimum frequency of administration is 3 times a day. Drug interactions are less likely. During pregnancy, it can be used only in exceptional cases; it is not used during breastfeeding.
Active ingredient: Roxithromycin
Rulid(Sanofi-Aventis)	509,6-1203	Well absorbed and well tolerated. Indications and side effects are standard. Not for use during pregnancy and breastfeeding.

Fluoroquinolones

Main indications:

• Severe otitis externa
• Sinusitis
• Exacerbation of chronic bronchitis
• Community-acquired pneumonia
• Dysentery
• Salmonellosis
• Cystitis, pyelonephritis
• Adnexit
• Chlamydia and other infections

Peculiarities: powerful antibiotics, most often used for severe infections. They can disrupt the formation of cartilage, and therefore are contraindicated for children and expectant mothers.

Most common side effects: allergic reactions, pain in tendons, muscles and joints, pain and discomfort in the abdomen, nausea, diarrhea, drowsiness, dizziness, increased sensitivity to ultraviolet rays.

Main contraindications: individual intolerance, pregnancy, breastfeeding, age under 18 years.

Important information for the patient:

• Fluoroquinolones for oral administration should be taken with a full glass of water, and in total, drink at least 1.5 liters per day during the treatment period.
• For complete absorption, you must take the medications at least 2 hours before or 6 hours after taking antacids (heartburn medications), iron, zinc, and bismuth supplements.
• It is important to avoid sunbathing while using the medications and for at least 3 days after finishing treatment.

Trade name of the drug	Price range (Russia, rub.)	Features of the drug that are important for the patient to know about
Active ingredient: Ofloxacin
Ofloxacin(various products) Zanotsin (Runbaxy) Zanotsin OD(Runbaxy) Zoflox (Mustafa nevzat ilach sanai) Ofloxin (Zentiva) Tariwid(Sanofi-Aventis)		Most often used in urology and gynecology. For respiratory tract infections it is not used in all cases. Indicated for sinusitis, bronchitis, but not recommended for sore throat and pneumococcal community-acquired pneumonia.
Active ingredient: Moxifloxacin
Avelox(Bayer)	719-1080	The most powerful antibiotic of this group. It is used for severe acute sinusitis, exacerbations of chronic bronchitis and community-acquired pneumonia. It can also be used in the treatment of drug-resistant forms of tuberculosis.
Active ingredient: Ciprofloxacin
Ciprofloxacin(various products) Tsiprinol(KRKA) Tsiprobay(Bayer) Tsiprolet (Dr. Reddy's) Tsipromed (Promed) Tsifran (Runbaxy) Tsifran OD(Runbaxy) Ecotsifol (Ava Rus)	46,6-81 295-701,5	The most widely used drug from the group of fluoroquinolones. It has a wide spectrum of action, including against pathogens of severe infections. Indications are the same as ofloxacin.
Active ingredient: Levofloxacin
Levofloxacin(various products) Levolet (Dr. Reddy's) Glevo (Glenmark) Lefoccin(Shreya) Tavanik(Sanofi-Aventis) Flexid(Lek) Floracid (Valence, Obolenskoe) Hyleflox(Higlans Laboratories) Ecolevid (Ava Rus) Eleflox (Runbaxy)	366-511 212,5-323	The drug has a very wide spectrum of action. Active against all pathogens of respiratory tract diseases. It is especially often prescribed for pneumonia and sinusitis. It is used when penicillins and macrolides are ineffective, as well as in cases of severe diseases of a bacterial nature.

Remember, self-medication is life-threatening; consult a doctor for advice on the use of any medications.

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

Antibiotics are a strong and effective remedy for many diseases. These antibacterial substances of synthetic, semi-synthetic or natural origin can quite quickly stop the growth of harmful microorganisms or completely destroy them. They are especially often used in the treatment of such common diseases as tonsillitis, bronchitis, sinusitis, intestinal infections, otitis media, and pneumonia.

Therefore, for your information, we have compiled a rating of the best antibiotics against specific diseases, in particular, sore throat, cough and some others. When choosing the products, we were guided by the recommendations of experts, patient reviews and descriptions of the pharmacological effects of the drugs. However, you should take antibiotics strictly as prescribed by your doctor!

There are contraindications. Consult your doctor.

The best antibiotics for sore throat, bronchitis and cough

Most antibiotics are designed to combat several different types of microbes at once and have a fairly broad spectrum of action. However, only a few are truly effective against coughs and respiratory tract infections.

4 Sumamed

Fast action and ease of administration
Country: Croatia
Average price: 350 rub.
Rating (2019): 4.6

A very effective broad-spectrum bacteriostatic antibiotic based on azithromycin. It acts against a wide variety of microorganisms that can cause sore throat, bronchitis and other diseases of the upper respiratory tract. Sumamed easily copes with even advanced cases of purulent tonsillitis, otitis, and in case of moderate illness, it removes all symptoms of acute respiratory infections literally within a day. It acts very quickly, so only three tablets are usually enough for treatment. Convenience of administration is one of the main advantages of this drug.

There are contraindications and side effects, but they are fewer than most cheaper antibiotics. Doctors love this drug very much and give it high marks, noting its high effectiveness in most cases. Children from three years of age are allowed to attend. But it is better to give it to children in the form of a suspension rather than tablets.

3 Azithromycin

Affordable price
Country: Russia
Average price: 160 rub.
Rating (2019): 4.0

A budget domestic drug with a wide spectrum of action is the most common medicine against colds. Despite the low price, it copes well with various respiratory tract infections, including bronchitis, laryngitis and pneumonia.

But in the instructions for use you can see a large number of side effects and contraindications, which, alas, are characteristic of most such drugs. In addition, it is not recommended for children under 16 years of age, as well as for adults who have arrhythmia, kidney or liver failure.

2 Macropen

The best antibiotic in tablet form
Country: Slovenia
Average price: 262 rub.
Rating (2019): 4.8

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

The advantages of this antibiotic include effectiveness, few contraindications and minimal side effects. Plus, it's quite easy to take. It is usually prescribed 3 times a day, one tablet before meals. The standard release form of the antibiotic is 16 tablets. However, the drug is also found in the form of a suspension, which is given even to the smallest children.

1 Fluimucil antibiotic IT

The most effective antibiotic for coughs
Country: Italy
Average price: 750 rub.
Rating (2019): 4.9

Fluimucil is one of the few truly effective antibiotics suitable for both injection and inhalation. This antibiotic is used primarily for inhalation for wet coughs, bronchitis, sore throat, tracheitis and a number of other respiratory diseases. This solution can also be called one of the best means for rinsing or instilling in case of sinusitis, including sinusitis, and otitis media.

Thanks to the successful combination of an antibiotic and a mucolytic, Fluimucil not only eliminates pathogenic microflora, but also helps cleanse the problem area. For example, in case of bronchitis, the drug accelerates the process of mucus removal. Fluimucil antibiotic IT is dispensed in the form of a 500 mg solution for inhalation and injection. It should not be confused with the effervescent tablets and granules of the same name for the preparation of a solution that is taken orally.

The best antibiotics for sinusitis

Treatment of sinusitis is carried out according to different schemes, but antibiotics are prescribed in most cases. These can be tablets, solutions for intramuscular administration and local use. Sometimes a combined treatment regimen is used.

4 EcoClav

Large list of indications
Country: Russia
Average price: 250 rub.
Rating (2019): 4.7

In this drug, the effect of amoxicillin is enhanced by clavulanic acid. The antibiotic has a bactericidal effect, and the acid supports it, ensuring greater effectiveness of the drug. The product has a wide spectrum of action, so it helps with almost any sore throat and bronchitis, regardless of what microorganisms they are caused by. Due to its high effectiveness, the drug is often prescribed for diseases of the upper and lower respiratory tract, skin infections, osteomyelitis and other serious diseases.

Contraindications for use are children under 12 years of age, renal failure, severe liver disease, intolerance to cephalosporins. The drug is allowed to be used during breastfeeding. There are side effects, but to a lesser extent compared to many other antibiotics.

3 Vilprafen® solutab

The safest drug during pregnancy
Country: Italy
Average price: 500 rub.
Rating (2019): 4.8

Vilprofen Solutab is a fairly large tablet with a sweet taste and a pleasant strawberry aroma. The main active ingredient is josamycin, which is effective against bacterial infections caused by a wide variety of pathogens. The drug is often prescribed for sore throat, bronchitis, otitis, pneumonia, as well as dental infections, furunculosis and diseases of the genitourinary system.

The main feature of the antibiotic is that it can be taken during pregnancy and breastfeeding without fear of serious consequences for the child. In general, this drug can be called one of the safest. Contraindications include intolerance to macrolide antibiotics and severe liver disease. There are minimal side effects. The only drawback of the product, doctors and patients call its high cost.

2 Polydex with phenylephrine

Antibacterial and vasoconstrictor effect
Country: France
Average price: 320 rub.
Rating (2019): 4.9

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

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

1 Isofra

Best local antibiotic
Country: France
Average price: 300 rub.
Rating (2019): 5.0

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

The drug is considered one of the most harmless antibiotics, combines well with other medications, and has virtually no contraindications. Possible side effects include only allergies to individual components and some deterioration of the microflora of the nasopharynx with prolonged use. However, it is important to remember that this is still an antibiotic that should be used as prescribed by a doctor. In addition, it is strictly not recommended for use for allergic rhinitis or as a remedy for allergies.

The best broad-spectrum antibiotics

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

4 Clubax

Minimum contraindications and side effects
Country: India
Average price: 250 rub.
Rating (2019): 4.6

An effective drug based on clarithromycin, which has high activity against a huge number of microorganisms. Klabaks is resistant to acids, so you can drink it at any time, regardless of meals. A long-term post-antibiotic effect due to the maintenance of the substance in the body ensures the complete destruction of bacteria.

Doctors recommend taking this drug for various ENT diseases, infections of the gastrointestinal tract, genitourinary system, and skin. Provided the dosage is correctly calculated, children from six months of age are allowed to take it. The only contraindication is intolerance to macrolide antibiotics - clarithromycin, erythromycin and others. The safety of the drug has been proven by numerous tests - it causes the minimum number of side effects compared to antibiotics.

3 Tetracycline

The widest spectrum of action
Country: Russia
Average price: 76 rub.
Rating (2019): 4.7

Almost every adult probably knows this frequently prescribed drug. Available in various forms, the antibiotic is almost universal. In most cases, Tetracycline is taken in tablet form, including for bronchitis, tonsillitis, pharyngitis, prostatitis, eczema and various infections of the gastrointestinal tract and soft tissues. Acting comprehensively, this antibiotic quickly copes with most infectious causes of cough, fever and other ailments. The antibiotic is also available in the form of an ointment for external use and an eye ointment, which helps eliminate some problems locally.

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

2 Avelox

Better effectiveness in acute and chronic diseases
Country: Germany
Average price: 773 rub.
Rating (2019): 4.8

Avelox tablets from the famous German company Bayer are one of the most serious antibiotics, used primarily to combat acute and chronic diseases that are not treatable by most other means. Therefore, since 2012, it has been included by the Russian government in the List of Essential Medicines.

What also makes it one of the best drugs for adults is its high efficiency and the fact that it is convenient and easy to take, as it does not depend on meals and does not require any additional actions. In addition, the antibiotic has been studied quite well and, according to numerous studies, rarely causes side effects. The antibiotic is also found in the form of an injection solution, which is often used for exacerbation of chronic bronchitis. In some cases, a course of Avelox injections precedes a course of the same antibiotic in tablets.

1 Amoxicillin

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

A broad-spectrum antibiotic, a time-tested, popular drug is very inexpensive, but works quite effectively. It can be taken for a variety of diseases, occurring both with and without fever - from sore throat and otitis media to Lyme disease, meningitis and sepsis.

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

The best antibiotics for children

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

4 Meronem

An effective antibiotic for severe diseases
Country: UK
Average price: 7000 rub.
Rating (2019): 4.7

In cases where standard inexpensive antibiotics are powerless, it is not advisable to risk the child’s health; the use of a drug such as Meronem is considered. It has a powerful antibacterial effect against a variety of pathogens and is prescribed for severe diseases - pneumonia, abdominal infections, septicemia, meningitis.

The drug is officially approved for use in children from the age of three months, its effectiveness has been confirmed by numerous laboratory studies. But there are a number of contraindications. The drug is very serious, prescribed in extreme cases, usually used in a hospital setting, since it does not need to be drunk, but administered intravenously. The big disadvantage of antibiotics is the very high cost.

3 Ospamox

Most affordable price
Country: Germany
Average price: 50 rub.
Rating (2019): 4.8

The drug based on amoxicillin is available in various dosage forms, but in pediatrics it is used mainly in the form of granules for the preparation of a suspension. In addition to time-tested effectiveness, it is characterized by low cost. It is a broad-spectrum antibacterial drug, effective for sore throat, bronchitis, as well as infectious diseases of the gastrointestinal tract, soft tissues and skin.

The drug is quite strong; when treating children with it, the dosage must be strictly selected, so it should not be taken without a doctor’s prescription. There are also a number of side effects and incompatibility with some other medications.

2 Augmentin

The best complex antibiotic
Country: UK
Average price: 150 rub.
Rating (2019): 4.9

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

In general, the antibiotic is effective and has a good composition. This antibacterial agent is especially often prescribed for the treatment of bronchitis, tonsillitis, sinusitis, as well as various respiratory tract infections. In addition, thanks to its expanded complex action, this antibiotic is also effective in the fight against various mixed infections. In addition to the suspension, Augmentin is also available in the form of tablets that can be taken by school-age children and adults.

1 Amoxiclav

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

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

In addition to the convenient release form and versatility, the advantages of the drug include a minimal number of contraindications and side effects, affordable cost, and quick effect from administration. It is easy for children to drink due to its pleasant taste. Despite the mild effect of the drug, it, like other antibiotics, can only be taken as prescribed by a doctor. In addition, Amoxiclav cannot be combined with certain other medications.

The best antibiotics for gynecological diseases

Women have to deal with gynecological diseases quite often, and treatment is usually prescribed specific, different from the treatment of other inflammatory processes. Many drugs are quite expensive, but quickly cope with common “female” diseases - endometritis, adnexitis and other inflammatory processes.

4 Tsiprolet

Ease of administration and quick relief of inflammation
Country: India
Average price: 110 rub.
Rating (2019): 4.7

A widely used drug not only in gynecology, but also in other areas of medicine. A broad-spectrum antibiotic, despite its very affordable cost, has a lot of advantages - it needs to be taken twice a day, the average course duration is 5 days, the effect of taking it is felt quite quickly. An additional advantage of the drug is that it has almost no effect on the intestinal microflora.

An antibiotic is prescribed for infections of the pelvic organs, including adnexitis, as well as any inflammatory “female” diseases. There are few contraindications - childhood and adolescence, pregnancy and breastfeeding, hypersensitivity to drugs of the quinolone group. The drug is usually well tolerated by patients, but the development of side effects indicated in the instructions is possible.

3 Cefotaxime

The best combination of price and efficiency
Country: Russia
Average price: 40 rub.
Rating (2019): 4.8

A third-generation cephalosporin antibiotic in gynecology is prescribed for inflammatory and infectious diseases. Since the drug has a wide spectrum of action, it shows effectiveness in combating a wide variety of pathogens. In addition to treatment, it is used after obstetric and gynecological operations to prevent infection.

The drug is not intended for independent use - it is administered intravenously or intramuscularly. Usually prescribed in serious cases when antibiotic tablets may not be effective enough. The main contraindication is hypersensitivity to penicillins; caution must also be exercised in case of serious liver and kidney diseases. Despite its low cost, the drug is popular among gynecologists; they often use it in their medical practice.

2 Unidox Solutab

One of the most common antibiotics in gynecology
Country: Netherlands
Average price: 320 rub.
Rating (2019): 4.9

Bacteriostatic, antibacterial agent based on doxycycline. The antibiotic has a wide spectrum of action and affects the most common pathogens of diseases of the pelvic organs in women. In gynecology, the drug is prescribed for endometritis, endocervitis, chlamydia, mycoplasmosis. It is also used for diseases of a different nature that occur with inflammatory processes.

There are few contraindications, they boil down to porphyria, hypersensitivity to tetracyclines, serious liver and kidney diseases. But there are plenty of possible side effects, so, like all antibiotics, you need to take the drug with caution and only on the recommendation of a doctor. The duration of treatment is usually from 5 to 10 days, depending on the nature and severity of the disease.

1 Rulid

The best antibiotic for serious inflammatory processes
Country: France
Average price: 950 rub.
Rating (2019): 5.0

A semi-synthetic antibiotic of the macrolide group is more stable in the acidic environment of the stomach compared to other antibiotics of the same type, and therefore has a more pronounced effect. It is often used in gynecology in the treatment of various inflammatory processes caused by bacteria and infections. The drug is quite strong - self-medication is unacceptable. There are a number of contraindications and side effects. Do not use it during pregnancy and breastfeeding.

The antibiotic comes in the form of tablets that need to be taken twice a day. According to gynecologists, this is one of the most effective drugs - it provides rapid and stable improvement even in severe inflammatory processes. Some patients are dissatisfied with the high cost, but in reality this antibiotic turns out to be much more effective than its analogues.

Patients, according to reviews, note a noticeable relief of their condition already on the second day of use, and due to the prolonged action, a three-day course is enough to treat mild to moderate diseases.

However, at the first sign of a cold, you should not rush to the pharmacy for a miracle remedy. First you need to understand what kind of drug it is, how it works and what its purpose is. In addition, a visit to a therapist is required, who will prescribe the appropriate medication.

Azithromycin

This is the name of the drug that allows you to quickly get rid of respiratory diseases.

It is an antibiotic, three tablets of which constitute a full course of treatment.

Belongs to the class of macrolides that are active against a greater number of pathogens than penicillins or fluoroquinolones. The first generations of these antibacterial agents were designed for long-term use, and at least 2 doses must be taken per day. The formula of Azithromycin, allocated to a separate subclass of azalides, due to some structural differences, provides a prolonged effect. Thanks to this, only three times of use is enough, since the therapeutic concentration of the antibiotic in the blood remains for up to 5-7 days.

Operating principle

The drug has a bacteriostatic effect, that is, it stops the development of pathogenic microorganisms. This happens due to the introduction of the active substance into the cell, joining its ribosomes and blocking the synthesis of the protein necessary for growth. As the concentration increases, the medicine acquires bactericidal properties, killing the pathogen. The therapeutic effect develops within the first 2 hours after administration and lasts about a day.

An antibiotic course of 3 tablets is active against the following intra- and extracellular pathogenic bacteria:

• gram-positive streptococci causing pneumonia, scarlet fever, endocarditis, rheumatism, postpartum blood poisoning, nephritis, inflammation of the larynx, epidermis and soft tissues;
• pneumococci, which cause inflammation of the lungs, middle ear, paranasal sinuses and meninges;
• Staphylococcus aureus - the cause of a wide variety of diseases (from aesthetically unpleasant acne to deadly sepsis and meningitis) and persistent nosocomial infections;
• gram-negative Legionella, Gardnerella, gonococci, Haemophilus influenzae and pertussis, chlamydia, mycoplasma and Treponema pallidum.

Microorganisms resistant to erythromycin are also resistant to Azithromycin.

At the moment, macrolides in general and azalides in particular occupy one of the leading places in the treatment of infectious diseases in adults and children. This is explained by their high efficiency and at the same time very low toxicity. In addition, most strains of pathogenic bacteria have become resistant to penicillins, which were widely used previously.

A little history

The “fastest” three-day antibiotic - three tablets for three days - was first synthesized in 1980 by employees of the pharmaceutical laboratory of the Croatian company Pliva. It was obtained by modifying the 14-membered structure of erythromycin and became a representative of the third generation of macrolides. At the same time, the peculiarities of the chemical structure made it possible to classify it as a separate subgroup - azalides.

The prerequisite for the emergence of such a powerful and effective remedy was the invention of erythromycin by American researchers back in 1952. The drug, which became the founder of the group of macrolides, was obtained from an actinomycete living in the soil. A medicine similar in its spectrum of antimicrobial action to penicillins has become an alternative for patients with allergies.

The promise of a new class of ABPs has inspired scientists to further develop and create more effective medications. The latest achievement in this direction was Azithromycin, which is almost 300 times more acid-resistant than erythromycin.

The American pharmaceutical company Pfizer introduced it in the United States and Western Europe under the trade name Zithromax. In Eastern Europe the drug is known as Sumamed. Currently, there are more than 20 medicines based on Azithromycin.

Antibiotic, three tablets per package: name, analogues, application

The active ingredient of all medications belonging to the azalide subclass is azithromycin. This name is also registered as a trademark, but different manufacturers produce analogues under other names. The complete list includes the following medications:

To confirm the accuracy of the list, we attach a photo gallery with these medications.

All medications included in the list have similar effects and general rules of administration.

Indications

The drug Azithromycin is produced in different dosage forms: there are granules from which a suspension is prepared, special powders for injection solutions, and lyophilisate. However, the most popular type of antibiotic is three capsules or tablets, which make up a full course of treatment for respiratory infections of the respiratory system.

To cure mild forms of sinusitis, pharyngitis and laryngitis, you need to take 1 tablet of 0.5 g every 24 hours for three days (1 hour before or 2 hours after meals). For otitis, moderate sinusitis, tonsillitis and scarlet fever, a five-day course is indicated. The duration of therapy for NDP infections depends on the severity of the disease and the sensitivity of the pathogen.

Inflammations of the epidermis and soft tissues, organs of the genitourinary system and pelvis, as well as stomach ulcers are treated according to a different scheme. For example, for urethritis, a single dose of 1 gram of the drug is enough, for borelliosis, a five-day course is required, and as part of the complex eradication of Helicobacter, Azithromycin is taken for three days, but 1 gram each. For antibiotic therapy for pneumonia, intravenous administration is initially recommended, with a further transition to tablets. The duration of treatment depends on the sensitivity of the pathogen, the severity of the condition and the rate of resorption of the inflammatory focus.

The dosages given indicate how to take azithromycin in adults. For children, the required amount of medicine is calculated based on their weight. So, for every kilogram of a child’s body weight there should be a mg of active substance, depending on the duration of the course (3 or 5 days). Most often in this case, powders or granules are prescribed, from which a suspension is prepared. In addition, there are a number of age restrictions for certain dosage forms.

Contraindications

Azithromycin should not be taken by persons with hypersensitivity to macrolides, as well as liver and kidney failure, or arrhythmia. Strict contraindications include the age of children under 6 months. After six months and up to 12 years, the drug can be used only in the form of a suspension, since the effect of other dosage forms on children has not been reliably studied.

With caution, 3 tablets of an antibiotic called Azithromycin or another brand are prescribed during pregnancy. Despite the low toxicity, there is no complete information about the safety of macrolides for the developing fetus. In this regard, the drug can be used by pregnant women only in cases where the undoubted benefit to the health of the expectant mother is higher than the potential harm to the child. During antibiotic therapy during lactation, treatment is carried out strictly under the supervision of the attending physician; if necessary (long course), it is recommended to temporarily stop breastfeeding and express milk.

Side effect

The low toxicity of Azithromycin and analogues determines the frequency of side effects.

Dysbacteriosis and allergies characteristic of taking antibiotics are observed in less than 5% of cases.

Even less frequently, disturbances in the activity of the heart, nervous and genitourinary systems occur. For example, dizziness, tachycardia and candidiasis develop in only 1% of patients.

Antibiotic therapy for influenza and respiratory diseases

Will the magic three pills help against a cold or is the antibiotic ineffective in this case? Of course, it is very convenient to recover from a cough and runny nose in just a couple of days, rather than taking medications for a week without noticing significant improvements. But before taking Azithromycin or its analogues, you should definitely go to the doctor.

Self-medication is unacceptable for several reasons:

• All antibacterial drugs are designed to fight infections caused solely by bacteria, as the name suggests. That is, for a cold or flu caused by a virus, ABPs simply will not help. Moreover, side effects worsen the general condition and often provoke complications.
• Despite a very wide spectrum of antimicrobial action, an antibiotic for 3 days called Azithromycin or its analogues is not a panacea for infectious diseases. It is likely that the inflammation was caused by a strain resistant to this drug. In this case, as in the previous one, treatment will only bring harm.
• Only a doctor can reliably identify the pathogen and prescribe adequate therapy. This is done based on the results of a laboratory test, which provides information about the specific bacterium that caused the disease.
• Again, only a specialist is able to select the optimal antibiotic therapy regimen, taking into account contraindications, the patient’s age and his individual characteristics.

Flu and colds are treated with antiviral medications, bed rest and symptomatic medications (antipyretic tablets, cough syrups and runny nose drops).

It is advisable to use antibiotics for acute respiratory viral infections if there are bacterial complications. However, even here, going to a medical facility is mandatory, since only a doctor can correctly select the antibacterial drug, its dosage and duration of treatment.

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Antibiotic Sumamed - review

The antibiotic "Sumamed" will save you from many troubles. Indications, contraindications, as well as detailed instructions for use. Price in pharmacies. Cautions regarding purchase and doctor's recommendations on treatment rules. Photo.

Let me make a reservation right away that I am not a supporter of the frequent use of antibacterial agents, so I will recommend the antibiotic “Sumamed” only as a last resort, when taking it is really necessary and justified.

I am generally confused by the availability of antibiotics in our pharmacies, when not only pharmacists heartily prescribe them to customers, but people themselves choose the drug based on the recommendations of friends, the Internet, the same customers in line, based on whether they like the color of the box or not, whether they are afraid of side effects from taking the drug or believe that this cup will pass them by.

Any antibiotics should be prescribed after consultation with a specialist, preferably after determining the sensitivity of bacteria to them and carefully weighing all possible side effects. If you are not one in this area, then it is better to refrain from purchasing.

I took Sumamed, having prescribed it to myself, to which I actually have every legal right, being the proud owner of a diploma of higher medical education, so I immediately inform everyone reading that this review will be useful for you if the drug was prescribed to you by a doctor. It is better not to take it on your own, because it is still a serious medicine that has a lot of side effects and can potentially cause the emergence of antibiotic-resistant strains of bacteria, as a result of which subsequent bacterial infections will be much more difficult to treat.

The active ingredient in the drug "Sumamed" is azithromycin.

Azithromycin is a broad-spectrum bacteriostatic antibiotic from the macrolide-azalide group. Has a wide spectrum of antimicrobial action. The mechanism of action of azithromycin is associated with the suppression of protein synthesis in microbial cells.

It is active against a number of gram-positive, gram-negative, anaerobes, intracellular and other microorganisms.

Microorganisms may initially be resistant to the action of an antibiotic or become resistant to it.

In most cases, sensitive microorganisms: gram-positive aerobes - Staphylococcus aureus (methicillin-sensitive strains), Streptococcus pneumoniae (penicillin-sensitive strains), Streptococcus pyogenes; gram-negative aerobes - Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrhalis, Pasteurella multocida, Neisseria gonorrhoeae; anaerobes - Clostridium perfringens, Fusobacterium spp., Prevotella spp., Porphyromonas spp.; other microorganisms - Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi.

Microorganisms that can develop resistance to azithromycin: gram-positive aerobes - Streptococcus pneumoniae (penicillin-resistant strains).

Initially resistant microorganisms: gram-positive aerobes - Enterococcus faecalis, Staphylococci (methicillin-resistant staphylococci show a very high degree of resistance to macrolides), gram-positive bacteria resistant to erythromycin; anaerobes - Bacteroides fragilis.

As can be seen from the list of bacteria on which the drug acts, not all of them are sensitive to it. A person cannot know in advance what kind of infection has ruined his health, so in some cases the drug may not be effective. And this is not the fault of the drug itself, but the oversight of the patient who purchased a deliberately inappropriate drug that can only harm, but cannot cure.

Due to the broad spectrum of action, there are quite a few indications for use of the drug.

• infectious diseases caused by pathogens sensitive to the drug: infections of the upper respiratory tract and ENT organs - tonsillitis, sinusitis (inflammation of the paranasal sinuses), tonsillitis (inflammation of the tonsils), otitis media (inflammation of the middle ear cavity); scarlet fever;
• infections of the lower respiratory tract - bacterial and atypical pneumonia (pneumonia), bronchitis (inflammation of the bronchi);
• infections of the skin and soft tissues - erysipelas, impetigo (superficial pustular skin lesions with the formation of purulent crusts), secondary infected dermatoses (skin diseases);
• genitourinary tract infections - gonorrheal and non-gonorrheal urethritis (inflammation of the urethra) and/or cervicitis (inflammation of the cervix);
• Lyme disease (borreliosis - an infectious disease caused by the Borrelia spirochete);
• diseases of the stomach and duodenum associated with Helicobacter pylori.

However, since Sumamed is a fairly serious drug, there are plenty of contraindications to its use.

• hypersensitivity to macrolide antibiotics;
• severe dysfunction of the liver and kidneys;
• children's age for tablets 500 mg up to 12 years, for tablets 125 mg up to 3 years. There is a special dosage form for children.

There are also side effects.

For adults, the drug is available in the form of tablets of 500 mg - 3 pieces per package or capsules of 250 mg - 6 pieces per package. Which form to choose depends on the disease, the expected duration of treatment and the presence of chronic infection. But if the tablets can be replaced with capsules and simply taken two at a time to get the required dosage of 500 mg, then dividing the tablets in half to get 250 mg is strongly not recommended, since there is no guarantee that when dividing the tablet in each half you will get exactly 250 mg. One may contain 200 mg, and the other 300 mg, which will negatively affect the results of treatment. Therefore, immediately buy the dosage that is required.

There are also different regimens for taking the drug; one or another regimen is selected by the doctor, but most often they prescribe 500 mg daily for three days. People love short courses of treatment, so very often when choosing antibiotics they choose this drug. It is recommended to take Sumamed 1 hour before or 2 hours after meals with plenty of water. The tablets are not large, swallowing them will not be difficult.

All packages of the drug have a protective valve, which must be sealed; when purchasing, you should pay attention to this and, if the package is open, ask for another one.

The package contains a blister with capsules or tablets, as well as detailed instructions for use, which I strongly recommend studying.

My experience of taking the drug “Sumamed” was associated with a not very pleasant event when, before a long train journey (I had to travel for two days), I felt that my runny nose was no longer just a runny nose, but a potential sinusitis. My head was simply splitting, it was impossible to breathe, greenish-colored contents came out of my nose, when I tilted my head, I felt heaviness in the frontal part and the headache intensified. The departure was planned for the next day, so it was necessary to take any action to heal quickly.

Since I, as a rule, do not use antibiotics, for treatment I chose one to which there is unlikely to be resistance, but with a wide spectrum of action, so as to definitely hit the target. I took 3 tablets of 500 mg each to start treatment before leaving, and continue on the train; upon arrival, I expected to be an absolutely healthy person.

For any treatment regimen, it is recommended to take the drug at the same time with equal intervals in order to maintain the same high concentration of the active substance in the bloodstream. In this case, the bacteria do not have time to adapt and the drug works well.

The first pill did not have a pronounced effect, but after the second I felt much better, and the third finally got me back on my feet. Naturally, all treatment was accompanied by the use of vasoconstrictor drops into the nose to ensure the outflow of the contents of the sinuses along with the bacteria that died there. This is a prerequisite for the treatment of any sinusitis.

The drug helped perfectly and did not cause any side effects (this is generally typical for short-course drugs). However, I was lucky that this packaging was not counterfeit. Such expensive drugs (costing rubles for a pack of three 500 mg tablets) are very often subject to falsification, so it is advisable to ask the pharmacy for certificates of conformity, since we are not talking about cough tablets, but about more serious treatment.

So, to summarize, I would like to bring together all the important points:

1. It is advisable to purchase any antibiotics after consultation with a specialist, who is only a doctor.
2. Purchase drugs from trusted places, require certificates of conformity, and check the integrity of the packaging.
3. Take the drug according to the manufacturer's recommended schedule, at the same time at equal intervals, without splitting the tablets so as not to change the dosage.
4. Carry out the course of treatment completely, and do not abandon it in the middle; in this case there will be no effect.
5. If necessary, take medications that help normalize intestinal microflora.

READ ALSO ABOUT OTHER DRUGS USED FOR RHINITIS AND SINUSITIS:

I have never bought such an antibiotic, I hope there will be no reason to buy it)

and may your family never get sick

Ideally, the composition of generics should completely replicate the original composition of the drug, however, different manufacturing technologies and some other production features do not allow achieving complete identity.

Sumamed is more expensive than Azithromycin.

Sumamed was required to undergo clinical and laboratory tests, Azithromycin was not. I often save on drugs by buying cheaper analogues. But you need to understand that there are certain risks.

As for doctors’ prescriptions, I can say that here they just prescribe “out of the blue”, even pharmacists are more attentive.

I wish everyone health and good, attentive doctors.

An effective drug, but there are side effects. I do not recommend taking it without consulting a doctor! My experience of admission and what followed.

Hello girls! Something drew me to medicinal topics and I remembered another old friend with whom I have a difficult relationship. I don't get colds very often. But a couple of times I was so sick that it was impossible to do without an antibiotic. And Sumamed helped me a lot then.

Sumamed - we treat a persistent cough in a child in three days. How to avoid dysbacteriosis when taking it. When can antibiotics be prescribed?

My 2-year-old son had to become familiar with antibiotics when he fell ill with bronchitis last winter. That time we cured bronchitis, but of course we had to restore the intestinal microflora with Linex.

Guys, this is terrible!

Like many people write here, I got sick. Very much. The temperature was below 40, which didn’t even drop; cough, throat. We bought three treasured tablets.

SUMAMED helped with bronchitis and sinusitis, as well as a nice bonus after treatment. After my review, you definitely won’t buy cheap Azithromycin. Detailed and honest review.

Greetings, dear reader! ATTENTION, MY REVIEW IS DEDICATED TO SUMAMED AND ITS ORIGINALITY! THERE IS NO TALK ABOUT ANY GROUP OF PRODUCTS HERE! Today I’ll tell you about the antibiotic “Sumamed”. Price. About ten dollars for three tablets. On the side of the package there is dosage information.

What is the name of an antibiotic with three tablets in a package?

Three years ago I fell ill with acute bronchitis. Then my local doctor prescribed me some kind of antibiotic, the package of which contained only 3 tablets. I took the course and quickly recovered. Now I’m frozen again at work and have been coughing and having a fever for more than 4 days, but I can’t remember the name of this antibiotic. What kind of drug was this?

Most likely, when we talk about the name of an antibiotic with three tablets in a package, we mean the drug azithromycin. It belongs to the group of macrolide antibacterial agents, is very often used for bacterial diseases of the respiratory tract and is available in 3 tablets in one package.

Azithromycin - release forms

This form of drug release is due to the fact that this is usually sufficient for one course of successful treatment of most respiratory tract infections (except pneumonia).

Azithromycin is unique in that it only needs to be used once a day, regardless of food. It accumulates in the respiratory epithelium, where its effective concentration remains for another 3 days after the last dose.

Today Azithromycin is produced under various trade names, among which are the following:

However, you should not rush to take antibiotic tablets on your own. A significant part of respiratory tract diseases is caused not by bacterial, but by viral flora. Taking Azithromycin in such situations is absolutely not indicated, since the drug does not give the required result.

Only a doctor, having collected a sufficient amount of information from the patient’s medical history and examined the results of laboratory tests, can make a qualified decision on prescribing one or another antibacterial agent. It has been proven that uncontrolled self-administration of antibiotics is much more likely to lead to the development of side effects.

In this case, there is not enough data to have grounds for prescribing Azithromycin.

It is imperative to take a general blood test, in which, with a bacterial etiology of the process, an increase in the number of leukocytes can be detected due to the fraction of neutrophils and “young” cells.

Patients with cough and fever are required to undergo an X-ray examination of the chest organs. This is done to exclude the possibility of developing pneumonia or tuberculosis.

The most accurate method for determining the pathogen that caused the infectious process is bacteriological examination. Its implementation allows you to accurately determine the type and strain of the microbe, and also shows which antibacterial agents will be most effective against it.

The characteristics of Azithromycin will be discussed using the example of Azitrox

Pharmacological features of Azitrox

Azitrox is a bacteriostatic drug. Its molecules are able to penetrate the source of inflammation, where they block the activity of the microbial ribosome subunit. By doing this, they make it impossible for further protein synthesis and reproduction of pathogenic pathogens. At the same time, the resistance of bacteria to the specific protective reactions of the patient’s immune system decreases.

The spectrum of action of Azitrox includes most pathogens of bacterial inflammation of the lower and upper respiratory tract.

The unique properties of the drug are clearly demonstrated in pharmacodynamics. Azitrox is available exclusively in the form of tablets for oral use. In the intestinal lumen, its particles are almost completely quickly absorbed.

The drug accumulates very well in the respiratory epithelium and alveolocytes of the lungs, where its concentration is several tens of times higher than that in blood plasma.

The drug is metabolized in the liver and is also partially eliminated from the body by renal filtration. However, due to its ability to accumulate, Azitrox retains its antimicrobial effect for another 3 days after taking the last tablet.

Rules for taking antibacterial medications

When prescribing Azitrox, you need to follow a few simple rules for taking antibacterial agents. The antibiotic tablet should be taken at the same time every day. This is carried out in order to maintain the concentration of the drug in a stable amount in the blood plasma.

If you missed taking Azitrox, you need to take it as quickly as possible, and then continue therapy as usual.

It is best to take the antibiotic tablet with a glass of plain water. If the patient uses soda, dairy products (kefir, yogurt), juices (especially citrus fruits), then this can affect the absorption process of Azitrox molecules and reduce its bioavailability. Taking alcoholic beverages with the medication tablet is strictly prohibited.

The course of treatment with Azitrox lasts at least 3 days. This is usually sufficient for most uses of the drug. After completion of this period, it is necessary to evaluate the effectiveness of the treatment. To do this, pay attention to the regression of disease symptoms and changes in laboratory parameters. In case of pneumonia, it is also necessary to repeat radiography to assess the decrease in infiltration of lung tissue.

Sometimes side effects develop when taking Azitrox. If the patient notices them, then it is necessary to inform the attending physician about this as soon as possible. Depending on the severity of the symptoms, he decides whether to continue drug therapy or whether to discontinue the antibiotic.

Indications for use of Azitrox

Azitrox is used for bacterial infectious processes. The instructions indicate its use for:

• bronchitis;
• tracheitis;
• otitis media;
• sinusitis;
• pharyngitis;
• laryngitis;
• tonsillitis;
• community-acquired pneumonia;
• chlamydia lesions of the genitourinary system;
• bacterial infections of soft tissues and skin;
• for the prevention of complications during surgical interventions in thoracic surgery and otolaryngology.

Side effects when using Azitrox

Azitrox is considered a safe medication for the treatment of bacterial pathologies in various groups of patients. However, even when taking it, the appearance of unwanted symptoms was noted:

• functional disorders of the digestive system with the development of nausea, a feeling of heaviness in the abdomen, painful sensations, a sharp decrease in appetite, diarrhea, vomiting;
• tachyarrhythmias in patients with a congenital tendency to rhythm disturbances;
• aggravation of heart failure in uncompensated patients;
• temporary increase in hepatocyte cytolysis enzymes, as well as bilirubin with symptoms of jaundice;
• fulminant development of toxic hepatitis with functional failure of this organ;
• allergic reactions of varying severity and severity;
• blurred vision, development of tinnitus;
• increased sensitivity to sunlight (photosensitivity);
• feeling of palpitations, heaviness in the chest, development of shortness of breath during physical exertion;
• nervous lability, agitation;
• sleep disturbance.

You should not prescribe Azitrox simultaneously with drugs for myasthenia gravis. Cases have been described of a decrease in their effectiveness, which led to the progression of disease symptoms. It is necessary to approach the prescription of medication with caution in case of functional liver or kidney failure. In this situation, daily monitoring of their condition is necessary to avoid the possible development of their underlying pathology.

It is also advisable to carry out regular measurements of the concentration of the drug in the blood plasma.

Don't be too alarmed by the long list of possible side effects. It was compiled based on many years of observation of patients who took azithromycin. At the same time, the frequency of unwanted symptoms remains at a fairly low level.

Features of taking Azitrox in various categories of patients

During pregnancy, drug molecules pass well through the placental barrier and can be detected in the fetal bloodstream. However, there is no data on the toxic effect of the antibiotic on the child. Therefore, the drug is allowed to be prescribed for bacterial pathologies during pregnancy and lactation in women. This has also been confirmed by the authoritative American organization FDA, which regulates the use of antibiotics in the United States.

Azithromycin preparations are also allowed to be used from the first year of a child’s life, since they do not have any toxic effect on his body. This is especially important in situations where there is evidence of allergic reactions to beta-lactam drugs (penicillins, cephalosporins, carbapenems, monobactams). In this case, Azitrox remains the only true option.

There is also no information about any peculiarities of drug metabolism in older people. Taking Azitrox, if there is no concomitant cardiovascular, renal or hepatic pathology, is not accompanied by an increase in side effects.

A separate issue is the possibility of taking a combination of antibacterial agents with Azitrox. The most effective is the simultaneous use of the drug azithromycin with a third-generation cephalosporin antibiotic (mostly ceftriaxone). This combination is fixed in the treatment strategy for community-acquired pneumonia, when individual medications are ineffective, or in the presence of factors for severe course of the disease.

In some cases, it is possible to take fluoroquinolones together with Azitrox in the treatment of bacterial diseases of the respiratory system.

Instructions for using the medication

Azitrox is available in the form of tablets of 250, 500 mg and syrup for oral use. In the vast majority of cases, taking one tablet once a day is sufficient. Eating does not affect the absorption of the antibacterial agent, however, as a precaution, the instructions indicate that it is advisable to take Azitrox no earlier than 2 hours after or 30 minutes before meals.

Tablet forms of Azitrox are recommended for use in children over 8 years of age. Until this age, it is advisable to give preference to suspension. It is good because it allows you to select an individual dose of an antibacterial agent for a child, based on his age, body weight and pathology. The amount of the drug must be calculated based on the ratio of 10 mg per 1 kg per day.

In the initial form of Lyme disease, you can double the dosage of the drug. The duration of Azitrox therapy in this case is at least 5-7 days.

A unique feature of dispersible tablets of the antibiotic in question from the penicillin group is the ability to choose the method of their use: pills. What is the name of an antibiotic with three tablets in a package?

Sumamed and Amoxiclav belong to different groups of antibacterial drugs and there are many differences between them. . What is the name of an antibiotic with three tablets in a package?

No. Although the drugs have similar indications, they belong to different groups of antibacterial agents. . What is the name of an antibiotic with three tablets in a package?

Is it safe to switch from Sumamed to Hemomycin after starting antibiotic therapy? . What is the name of an antibiotic with three tablets in a package?

A huge list of antimicrobial and antibacterial drugs used is classified by specialists according to mechanisms and. Combination broad-spectrum antibiotics are available in tablets and injections

Antibiotics are a huge group of bactericidal drugs, each of which is characterized by its own spectrum of action, indications for use and the presence of certain consequences

Antibiotics are substances that can inhibit the growth of microorganisms or destroy them. According to the GOST definition, antibiotics include substances of plant, animal or microbial origin. Currently, this definition is somewhat outdated, since a huge number of synthetic drugs have been created, but natural antibiotics served as the prototype for their creation.

The history of antimicrobial drugs begins in 1928, when A. Fleming first discovered penicillin. This substance was discovered, and not created, since it has always existed in nature. In living nature, it is produced by microscopic fungi of the genus Penicillium, protecting themselves from other microorganisms.

In less than 100 years, more than a hundred different antibacterial drugs have been created. Some of them are already outdated and are not used in treatment, and some are just being introduced into clinical practice.

How do antibiotics work?

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All antibacterial drugs can be divided into two large groups according to their effect on microorganisms:

• bactericidal– directly cause the death of microbes;
• bacteriostatic– prevent the proliferation of microorganisms. Unable to grow and reproduce, bacteria are destroyed by the immune system of a sick person.

Antibiotics exert their effects in many ways: some of them interfere with the synthesis of microbial nucleic acids; others interfere with the synthesis of bacterial cell walls, others disrupt protein synthesis, and others block the functions of respiratory enzymes.

Antibiotic groups

Despite the diversity of this group of drugs, all of them can be classified into several main types. This classification is based on chemical structure - drugs from the same group have a similar chemical formula, differing from each other in the presence or absence of certain molecular fragments.

The classification of antibiotics implies the presence of groups:

1. Penicillin derivatives. This includes all drugs created on the basis of the very first antibiotic. In this group, the following subgroups or generations of penicillin drugs are distinguished:

• Natural benzylpenicillin, which is synthesized by fungi, and semi-synthetic drugs: methicillin, nafcillin.
• Synthetic drugs: carbpenicillin and ticarcillin, which have a wider spectrum of action.
• Mecillam and azlocillin, which have an even wider spectrum of action.

1. Cephalosporins- Closest relatives of penicillins. The very first antibiotic of this group, cefazolin C, is produced by fungi of the genus Cephalosporium. Most drugs in this group have a bactericidal effect, that is, they kill microorganisms. There are several generations of cephalosporins:

• I generation: cefazolin, cephalexin, cefradine, etc.
• II generation: cefsulodin, cefamandole, cefuroxime.
• III generation: cefotaxime, ceftazidime, cefodizime.
• IV generation: cefpirom.
• V generation: ceftolozane, ceftopibrol.

The differences between the different groups are mainly in their effectiveness - later generations have a greater spectrum of action and are more effective. 1st and 2nd generation cephalosporins are now used extremely rarely in clinical practice, most of them are not even produced.

1. – drugs with a complex chemical structure that have a bacteriostatic effect on a wide range of microbes. Representatives: azithromycin, rovamycin, josamycin, leucomycin and a number of others. Macrolides are considered one of the safest antibacterial drugs - they can even be used by pregnant women. Azalides and ketolides are varieties of macorlides that have differences in the structure of the active molecules.

Another advantage of this group of drugs is that they are able to penetrate the cells of the human body, which makes them effective in the treatment of intracellular infections:,.

1. Aminoglycosides. Representatives: gentamicin, amikacin, kanamycin. Effective against a large number of aerobic gram-negative microorganisms. These drugs are considered the most toxic and can lead to quite serious complications. Used to treat genitourinary tract infections.
2. Tetracyclines. These are mainly semi-synthetic and synthetic drugs, which include: tetracycline, doxycycline, minocycline. Effective against many bacteria. The disadvantage of these drugs is cross-resistance, that is, microorganisms that have developed resistance to one drug will be insensitive to others from this group.
3. Fluoroquinolones. These are completely synthetic drugs that do not have their natural counterpart. All drugs in this group are divided into first generation (pefloxacin, ciprofloxacin, norfloxacin) and second generation (levofloxacin, moxifloxacin). They are most often used to treat infections of the ENT organs (,) and respiratory tract (,).
4. Lincosamides. This group includes the natural antibiotic lincomycin and its derivative clindamycin. They have both bacteriostatic and bactericidal effects, the effect depends on the concentration.
5. Carbapenems. These are one of the most modern antibiotics that act on a large number of microorganisms. Drugs in this group belong to reserve antibiotics, that is, they are used in the most difficult cases when other drugs are ineffective. Representatives: imipenem, meropenem, ertapenem.
6. Polymyxins. These are highly specialized drugs used to treat infections caused by. Polymyxins include polymyxin M and B. The disadvantage of these drugs is their toxic effect on the nervous system and kidneys.
7. Antituberculosis drugs. This is a separate group of drugs that have a pronounced effect on. These include rifampicin, isoniazid and PAS. Other antibiotics are also used to treat tuberculosis, but only if resistance to the drugs mentioned has developed.
8. Antifungal agents. This group includes drugs used to treat mycoses - fungal infections: amphothirecin B, nystatin, fluconazole.

Methods of using antibiotics

Antibacterial drugs are available in different forms: tablets, powder from which an injection solution is prepared, ointments, drops, spray, syrup, suppositories. The main uses of antibiotics:

1. Oral- oral administration. You can take the medicine in the form of a tablet, capsule, syrup or powder. The frequency of administration depends on the type of antibiotic, for example, azithromycin is taken once a day, and tetracycline is taken 4 times a day. For each type of antibiotic there are recommendations that indicate when it should be taken - before, during or after meals. The effectiveness of treatment and the severity of side effects depend on this. Antibiotics are sometimes prescribed to young children in the form of syrup - it is easier for children to drink the liquid than to swallow a tablet or capsule. In addition, the syrup can be sweetened to get rid of the unpleasant or bitter taste of the medicine itself.
2. Injectable– in the form of intramuscular or intravenous injections. With this method, the drug reaches the site of infection faster and is more active. The disadvantage of this method of administration is that the injection is painful. Injections are used for moderate and severe diseases.

Important:Only a nurse should give injections in a clinic or hospital setting! It is strictly not recommended to inject antibiotics at home.

1. Local– applying ointments or creams directly to the site of infection. This method of drug delivery is mainly used for skin infections - erysipelas, as well as in ophthalmology - for infections of the eye, for example, tetracycline ointment for conjunctivitis.

The route of administration is determined only by the doctor. In this case, many factors are taken into account: the absorption of the drug in the gastrointestinal tract, the state of the digestive system as a whole (in some diseases, the absorption rate decreases and the effectiveness of treatment decreases). Some drugs can only be administered one way.

When injecting, you need to know what you can use to dissolve the powder. For example, Abactal can only be diluted with glucose, since when sodium chloride is used it is destroyed, which means the treatment will be ineffective.

Antibiotic sensitivity

Any organism sooner or later gets used to the harshest conditions. This statement is also true in relation to microorganisms - in response to prolonged exposure to antibiotics, microbes develop resistance to them. The concept of sensitivity to antibiotics was introduced into medical practice - the effectiveness with which a particular drug affects the pathogen.

Any prescription of antibiotics should be based on knowledge of the sensitivity of the pathogen. Ideally, before prescribing a drug, the doctor should conduct a sensitivity test and prescribe the most effective drug. But the time required to carry out such an analysis is, in the best case, several days, and during this time the infection can lead to the most disastrous result.

Therefore, in case of infection with an unknown pathogen, doctors prescribe drugs empirically - taking into account the most likely pathogen, with knowledge of the epidemiological situation in a particular region and medical institution. For this purpose, broad-spectrum antibiotics are used.

After performing a sensitivity test, the doctor has the opportunity to change the drug to a more effective one. The drug can be replaced if there is no effect from treatment for 3-5 days.

Etiotropic (targeted) prescription of antibiotics is more effective. At the same time, it becomes clear what caused the disease - using bacteriological research, the type of pathogen is established. Then the doctor selects a specific drug to which the microbe does not have resistance (resistance).

Are antibiotics always effective?

Antibiotics only act on bacteria and fungi! Bacteria are considered single-celled microorganisms. There are several thousand species of bacteria, some of which coexist quite normally with humans—more than 20 species of bacteria live in the large intestine. Some bacteria are opportunistic - they cause disease only under certain conditions, for example, when they enter an atypical habitat. For example, very often prostatitis is caused by E. coli, which enters through the ascending route from the rectum.

Please note: Antibiotics are absolutely ineffective for viral diseases. Viruses are many times smaller than bacteria, and antibiotics simply do not have a point of application for their ability. That's why antibiotics have no effect on colds, since colds in 99% of cases are caused by viruses.

Antibiotics for coughs and bronchitis may be effective if they are caused by bacteria. Only a doctor can figure out what causes the disease - for this he prescribes blood tests, and, if necessary, an examination of sputum if it comes out.

Important:Prescribing antibiotics to yourself is unacceptable! This will only lead to the fact that some of the pathogens will develop resistance, and next time the disease will be much more difficult to cure.

Of course, antibiotics are effective for - this disease is exclusively bacterial in nature, caused by streptococci or staphylococci. To treat sore throat, the simplest antibiotics are used - penicillin, erythromycin. The most important thing in the treatment of angina is compliance with the frequency of dosing and the duration of treatment - at least 7 days. You should not stop taking the medicine immediately after the onset of the condition, which is usually noted on the 3-4th day. True tonsillitis should not be confused with tonsillitis, which can be of viral origin.

Please note: untreated sore throat can cause acute rheumatic fever or!

Pneumonia (pneumonia) can be of both bacterial and viral origin. Bacteria cause pneumonia in 80% of cases, so even when prescribed empirically, antibiotics for pneumonia have a good effect. For viral pneumonia, antibiotics do not have a therapeutic effect, although they prevent the bacterial flora from joining the inflammatory process.

Antibiotics and alcohol

Taking alcohol and antibiotics at the same time in a short period of time does not lead to anything good. Some drugs are broken down in the liver, just like alcohol. The presence of antibiotics and alcohol in the blood puts a strong strain on the liver - it simply does not have time to neutralize ethyl alcohol. As a result, the likelihood of developing unpleasant symptoms increases: nausea, vomiting, and intestinal disorders.

Important: a number of drugs interact with alcohol at the chemical level, as a result of which the therapeutic effect is directly reduced. These drugs include metronidazole, chloramphenicol, cefoperazone and a number of others. Concomitant use of alcohol and these drugs can not only reduce the therapeutic effect, but also lead to shortness of breath, seizures and death.

Of course, some antibiotics can be taken while drinking alcohol, but why risk your health? It is better to abstain from alcoholic beverages for a short time - the course of antibacterial therapy rarely exceeds 1.5-2 weeks.

Antibiotics during pregnancy

Pregnant women suffer from infectious diseases no less often than everyone else. But treating pregnant women with antibiotics is very difficult. In the body of a pregnant woman, the fetus grows and develops - the unborn child, which is very sensitive to many chemicals. The entry of antibiotics into the developing body can provoke the development of fetal malformations and toxic damage to the central nervous system of the fetus.

During the first trimester, it is advisable to avoid the use of antibiotics altogether. In the second and third trimesters, their use is safer, but should also be limited, if possible.

A pregnant woman cannot refuse to prescribe antibiotics for the following diseases:

• Pneumonia;
• angina;
• infected wounds;
• specific infections: brucellosis, borelliosis;
• sexually transmitted infections: , .

What antibiotics can be prescribed to a pregnant woman?

Penicillin, cephalosporin drugs, erythromycin, and josamycin have almost no effect on the fetus. Penicillin, although it passes through the placenta, does not have a negative effect on the fetus. Cephalosporin and other named drugs penetrate the placenta in extremely low concentrations and are not capable of harming the unborn child.

Conditionally safe drugs include metronidazole, gentamicin and azithromycin. They are prescribed only for health reasons, when the benefit to the woman outweighs the risk to the child. Such situations include severe pneumonia, sepsis, and other severe infections, in which, without antibiotics, a woman can simply die.

Which drugs should not be prescribed during pregnancy?

The following drugs should not be used in pregnant women:

• aminoglycosides– can lead to congenital deafness (with the exception of gentamicin);
• clarithromycin, roxithromycin– in experiments they had a toxic effect on animal embryos;
• fluoroquinolones;
• tetracycline– disrupts the formation of the skeletal system and teeth;
• chloramphenicol– dangerous in late pregnancy due to inhibition of bone marrow functions in the child.

For some antibacterial drugs there is no data on negative effects on the fetus. This is explained simply - experiments are not carried out on pregnant women to determine the toxicity of drugs. Experiments on animals do not allow us to exclude all negative effects with 100% certainty, since the metabolism of drugs in humans and animals can differ significantly.

Please note that you should also stop taking antibiotics or change your plans for conception. Some drugs have a cumulative effect - they can accumulate in a woman’s body, and for some time after the end of the course of treatment they are gradually metabolized and eliminated. It is recommended to become pregnant no earlier than 2-3 weeks after finishing taking antibiotics.

Consequences of taking antibiotics

The entry of antibiotics into the human body leads not only to the destruction of pathogenic bacteria. Like all foreign chemicals, antibiotics have a systemic effect - to one degree or another they affect all systems of the body.

There are several groups of side effects of antibiotics:

Allergic reactions

Almost any antibiotic can cause allergies. The severity of the reaction varies: rash on the body, Quincke's edema (angioedema), anaphylactic shock. While an allergic rash is practically harmless, anaphylactic shock can be fatal. The risk of shock is much higher with antibiotic injections, which is why injections should only be done in medical institutions - emergency care can be provided there.

Antibiotics and other antimicrobial drugs that cause cross-allergic reactions:

Toxic reactions

Antibiotics can damage many organs, but the liver is most susceptible to their effects - toxic hepatitis can occur during antibiotic therapy. Certain drugs have a selective toxic effect on other organs: aminoglycosides - on the hearing aid (cause deafness); tetracyclines inhibit bone growth in children.

Please note: The toxicity of a drug usually depends on its dose, but in case of individual intolerance, sometimes smaller doses are sufficient to produce an effect.

Effects on the gastrointestinal tract

When taking certain antibiotics, patients often complain of stomach pain, nausea, vomiting, and stool disorders (diarrhea). These reactions are most often caused by the locally irritating effect of the drugs. The specific effect of antibiotics on the intestinal flora leads to functional disorders of its activity, which is most often accompanied by diarrhea. This condition is called antibiotic-associated diarrhea, which is popularly known as dysbiosis after antibiotics.

Other side effects

Other side effects include:

• immunosuppression;
• emergence of antibiotic-resistant strains of microorganisms;
• superinfection – a condition in which microbes resistant to a given antibiotic are activated, leading to the emergence of a new disease;
• violation of vitamin metabolism - caused by inhibition of the natural flora of the colon, which synthesizes some B vitamins;
• Jarisch-Herxheimer bacteriolysis is a reaction that occurs when using bactericidal drugs, when, as a result of the simultaneous death of a large number of bacteria, a large amount of toxins are released into the blood. The reaction is clinically similar to shock.

Can antibiotics be used prophylactically?

Self-education in the field of treatment has led to the fact that many patients, especially young mothers, try to prescribe themselves (or their child) an antibiotic at the slightest sign of a cold. Antibiotics do not have a prophylactic effect - they treat the cause of the disease, that is, they eliminate microorganisms, and in their absence, only side effects of the drugs appear.

There are a limited number of situations where antibiotics are administered before clinical manifestations of infection, in order to prevent it:

• surgery– in this case, the antibiotic present in the blood and tissues prevents the development of infection. As a rule, a single dose of the drug administered 30-40 minutes before the intervention is sufficient. Sometimes even after an appendectomy, antibiotics are not injected in the postoperative period. After “clean” surgical operations, antibiotics are not prescribed at all.
• major injuries or wounds(open fractures, soil contamination of the wound). In this case, it is absolutely obvious that an infection has entered the wound and it should be “crushed” before it manifests itself;
• emergency prevention of syphilis carried out during unprotected sexual contact with a potentially sick person, as well as among health workers who have had the blood of an infected person or other biological fluid come into contact with the mucous membrane;
• penicillin can be prescribed to children for the prevention of rheumatic fever, which is a complication of tonsillitis.

Antibiotics for children

The use of antibiotics in children is generally no different from their use in other groups of people. For young children, pediatricians most often prescribe antibiotics in syrup. This dosage form is more convenient to take and, unlike injections, is completely painless. Older children may be prescribed antibiotics in tablets and capsules. In severe cases of infection, they switch to the parenteral route of administration - injections.

Important: The main feature in the use of antibiotics in pediatrics is the dosage - children are prescribed smaller doses, since the drug is calculated in terms of per kilogram of body weight.

Antibiotics are very effective drugs, but at the same time they have a large number of side effects. In order to be cured with their help and not harm your body, they should be taken only as prescribed by a doctor.

What types of antibiotics are there? In what cases is taking antibiotics necessary and in what cases is it dangerous? The main rules of antibiotic treatment are explained by pediatrician Dr. Komarovsky:

Gudkov Roman, resuscitator

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

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

The diverse world of bacteria

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

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

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

The microflora also includes so-called opportunistic microorganisms. Under favorable conditions, they do no harm, but as soon as our immunity decreases, these yesterday’s friends turn into vicious enemies. In order to somehow understand the host of bacteria, doctors proposed classifying them.

Gram- and Gram+: deciphering the puzzle

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

Back in 1885, the Dane Hans Gram decided to stain sections of lung tissue to make the bacteria more visible. The scientist found that the causative agent of typhus, Salmonella typhi, did not change color, while other microorganisms were exposed to the chemical.

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

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

Another, no less important classification of antibiotics breaks down drugs according to their spectrum of action and structure. Again, to understand the complex paragraphs of instructions explaining the spectrum of activity and belonging to a particular group, you need to get to know the microbes better.

Gram-positive bacteria include cocci, that is, spherical microorganisms, including numerous families of staphylococci and streptococci. In addition, clostridia, corynebacteria, listeria, and enterococci belong to this group. Gram-positive pathogens most often cause infectious diseases of the nasopharynx, respiratory tract, ear, as well as inflammatory processes of the eye.

Gram-negative bacteria are a not so numerous group of microorganisms that mainly cause intestinal infections, as well as diseases of the genitourinary tract. Much less commonly, gram-negative pathogens are responsible for respiratory tract pathologies. These include Escherichia coli, Salmonella, Shigella (the causative agent of diphtheria), Pseudomonas, Moraxella, Legionella, Klebsiella, Proteus.

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

Empirical therapy is based on this “separation” of gram-negative and gram-positive bacteria, which involves selecting an antibiotic without prior culture, that is, practically “by eye.” As practice shows, in the case of “standard” diseases, this approach to choosing a drug is completely justified. If the doctor has doubts about whether the pathogen belongs to one group or another, prescribing broad-spectrum antibiotics will help “get the ball in the air.”

Broad spectrum antibiotics: the whole army is at gunpoint

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

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

• treatment is prescribed empirically, that is, based on clinical symptoms. When selecting an antibiotic empirically, time and money are not wasted on identifying the pathogen. The microbe that caused the disease will forever remain unknown. This approach is appropriate in the case of common infections, as well as fast-acting dangerous diseases. For example, with purulent meningitis, death can be a foregone conclusion literally within a few hours if antibiotic therapy is not started immediately after the first signs of the disease;
• pathogens are resistant to narrow-spectrum antibiotics;
• a superinfection has been diagnosed, in which several types of bacteria are the culprits of the disease;
• infection prevention after surgery is carried out.

List of broad-spectrum antibiotics

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

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

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

Penicillins - drugs that people know and love

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 two groups:

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

Ampicillin and Amoxicillin are popular broad-spectrum penicillins

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

• gram-positive bacteria: staphylococci and streptococci, enterococci, listeria;
• gram-negative bacteria: gonorrhea pathogen Neisseria gonorrhoeae, E. coli, Shigella, salmonella, Haemophilus influenzae, whooping cough pathogen Bordetella pertussis.

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

Ampicillin

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

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

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

Amoxicillin is slightly younger than its predecessor - it went on sale in the 70s of the 20th century. Nevertheless, this antibiotic is still one of the most popular and effective broad-spectrum drugs, including for children. And this became possible thanks to the undoubted advantages of the drug.

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

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

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

Broad-spectrum parenteral penicillins

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

In addition, broad-spectrum parenteral penicillin antibiotics have bactericidal and bacteriostatic effects against:

• gram-positive microorganisms: staphylococci, streptococci (except for strains that form penicillinase), as well as enterobacteria;
• gram-negative microorganisms: Proteus, Salmonella, Shigella, Escherichia coli, Haemophilus influenzae and others.

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

Let's look at the most well-known antibiotics - Carbenicillin, Ticarcillin and Piperacillin.

Carbenicillin

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

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

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

Ticarcillin

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

Piperacillin

Piperacillin is mainly used together with the beta-lactamase inhibitor tazobactam. However, if it is determined that the causative agent of the disease does not produce penicillinase, an unprotected antibiotic may be prescribed.

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

Protected broad-spectrum penicillins: antibiotics to fight resistance!

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

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

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

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