For the first time, the idea of ​​​​searching for substances that have a detrimental effect on microorganisms, but are harmless to humans, was clearly formulated and implemented at the turn of the 19th - 20th centuries by Paul Ehrlich. Ehrlich compared such substances to a “magic bullet.” The first substances with the properties of a “magic bullet” were discovered among derivatives of synthetic dyes; they were used to treat syphilis and were called “chemotherapy”, and the treatment process was called chemotherapy. In everyday life today, chemotherapy is understood only as the treatment of cancer, which is not entirely true. It should be recognized that the ideal “magic bullet” is unlikely to be found, since in certain doses any substance (even table salt) can have an adverse effect on the human body. But the search for drugs capable of neutralizing microorganisms continued. Somewhat later, scientists learned to use for their own purposes such a phenomenon as opposition (antagonism) of bacteria. What is it? The fact is that bacteria are distributed almost everywhere in nature (in soil, water, etc.), just like other living beings, they are forced to fight among themselves for existence. And the main weapon in this fight are special substances produced by some types of bacteria that have a detrimental effect on other types. These substances are called antibiotics.

Features of medical terminology

So there are antibiotics- these are substances of natural origin and chemotherapy drugs are artificially created substances with a similar effect; they are combined under the general term “antibacterial drugs”. Features of terminology can cause difficulties for a non-specialist. Sometimes in a pharmacy you can hear how a buyer seeks an answer from the pharmacist: “Is BISEPTOL (or, for example, CIPROFLOXACIN) an antibiotic or not?” The fact is that both of these drugs are antibacterial drugs from the group of chemotherapy drugs. But for the patient the differences between antibiotics and chemotherapy drugs are not very important.

What are there antibiotics?

It is important to know that the life processes of human cells are fundamentally different from the life processes of a bacterial cell. Antibiotics, unlike hydrogen peroxide and ethyl alcohol, have a selective effect specifically on the vital processes of bacteria, suppressing them, and do not affect the processes occurring in the cells of the human body. Therefore, currently known antibiotics classified based on their mechanism of action and chemical structure. So alone antibiotics suppress the synthesis of the outer membrane (membrane) of the bacterial cell - a structure completely absent in the human cell. The most important of these drugs are antibiotics groups of penicillins, cephalosporins and some other drugs. Others antibiotics suppress various stages of protein synthesis by bacterial cells: these are drugs included in the group of tetracyclines (DOXYCYCLINE), macrolides (ERYTHROMYCIN, CLARITHROMYCIN, AZITHROMYCIN, etc.), aminoglycosides (STREPTOMYCIN, GENTAMICIN, AMICACIN). Antibiotics differ significantly in their main property - antibacterial activity. The instructions for each antibacterial drug contain a list of bacteria that the drug acts on - the spectrum of its activity; alone antibiotics act on many types of bacteria, others - only on certain types of microbes. Unfortunately, antibacterial drugs have not yet been discovered that would suppress the vital activity of both bacteria and viruses at the same time, since the differences in the structure and metabolic characteristics of these microorganisms are fundamental. Despite significant advances in recent years, drugs that can act on viruses are still clearly insufficient, and their effectiveness is relatively low.

How microorganisms develop resistance to antibiotics

All living things, including bacteria, quickly adapt to unfavorable environmental conditions. The development of antibiotic resistance is one of the most striking examples of such an adaptation. It can be argued that sooner or later any type of bacteria will be able to develop resistance to any antibacterial drug. The development of resistance occurs the faster the larger the volume of a given substance is used. As bacteria develop resistance to antibiotics, humanity is forced to invent new drugs. Therefore, we can assume that if today we uncontrollably prescribe antibacterial drugs to all children, then tomorrow we will simply have nothing to treat our grandchildren with. During this race, conflicts of interest arise in society. Society as a whole is interested in reducing the costs of antibacterial therapy and maintaining a balance between cost and effectiveness of treatment. To achieve this goal, it is necessary to limit the use antibiotics strict indications, which will avoid unnecessary costs for the development and manufacture of new drugs. Manufacturers antibiotics on the contrary, they are interested in increasing sales volume (by expanding the indications), which will inevitably lead to a more rapid spread of drug resistance in microorganisms and, as a consequence, the need to develop more and more new drugs. Unfortunately, massive and uncontrolled use antibiotics has already led to widespread resistance of microorganisms to them. Moreover, in Russia there is uncontrolled use antibiotics(pharmacies can sell them over-the-counter, which is unacceptable according to international rules) is combined with a shortage of funds for healthcare. Today in our country, most pathogens of the most common infections are resistant to drugs such as BISEPTOL, GENTAMICIN and drugs of the tetracycline group. The situation with PENICILLIN, AMPCILLIN and AMOXICILLIN is ambiguous; only one microorganism remains sensitive to these drugs - pneumococcus. Therefore, to select a drug for treatment, the doctor needs to know not only what pathogen is causing the infection, but also what drug this pathogen is sensitive to. It would seem that this problem can be easily solved by conducting laboratory studies. But, alas, with the use of modern research methods, the answer can be obtained only after 2 - 3 days. As a result, in real life antibiotics prescribed empirically, i.e. based on existing practical experience. But even the most brilliant doctor cannot independently accumulate experience in using all possible antibiotics and confidently say that drug A is better than drug B. In addition, it is necessary to take into account how widespread resistance to a particular drug is among bacteria in a particular geographic region. The doctor inevitably has to rely on the results of special studies, their critical analysis, global and national experience, as well as recommendations on treatment standards developed by experts.

Purpose antibiotics

After all that has been said, it is quite obvious that antibiotics should only be used for infections caused by bacteria. In a hospital for severe and life-threatening infectious diseases (for example, meningitis - inflammation of the membranes of the brain, pneumonia - pneumonia, etc.), responsibility for making the right choice lies entirely with the doctor, who is based on observation data of the patient and the results of special studies. For mild infections occurring in “home” (outpatient) conditions, the situation is fundamentally different. The doctor examines the child and prescribes medications, sometimes this is accompanied by explanations and answers to questions, sometimes not. Often the doctor is asked to prescribe an antibiotic. In such situations, it is sometimes psychologically easier for a doctor to write a prescription rather than risk his reputation and waste time explaining the inappropriateness of such a prescription. Therefore, never ask your doctor to prescribe antibiotics, especially since after the doctor leaves, there is usually home advice, calls to relatives and friends, and only then is the decision made to give the child antibiotics or not.

How and when to use antibiotics

Let's look at some situations that undoubtedly interest all parents. Antibiotics for respiratory tract infections. In this situation, first of all, parents must clearly understand that:

• the natural incidence of respiratory tract infections in preschool children is 6–10 episodes per year;
• appointment antibiotics Each episode of infection places an excessive burden on the child’s body.

Unfortunately, there are no reliable external signs or simple and cheap laboratory methods to distinguish between the viral and bacterial nature of respiratory tract infections. At the same time, it is known that acute rhinitis (runny nose) and acute bronchitis (inflammation of the bronchial mucosa) are almost always caused by viruses, and tonsillitis (inflammation of the tonsils and pharynx), acute otitis (inflammation of the ear) and sinusitis (inflammation of the mucous membrane of the paranasal sinuses) ) in a significant part of cases - bacteria. It is natural to assume that approaches to antibacterial therapy for individual acute upper respiratory tract infections should be somewhat different. For acute rhinitis (runny nose) and bronchitis antibiotics not shown. In practice, everything happens differently: parents, as a rule, can easily withstand one or two days of fever and cough in a child without giving the child antibiotics. But subsequently the tension increases; parents are most worried about the question of whether bronchitis will be complicated by pneumonia. It is worth noting here that the development of such a complication is possible, but its frequency practically does not depend on the previous dose antibiotics. The main signs of the development of a complication are deterioration of the condition (further increase in body temperature, increased cough, the appearance of shortness of breath); in such a situation, you should immediately call a doctor, who will decide whether the treatment needs to be adjusted. If the condition does not worsen, but does not improve significantly, then there is no obvious reason to prescribe antibiotics no, nevertheless, it is during this period that some parents cannot stand it and begin to give drugs to their children “just in case.” What can be said in this case? Purpose antibiotics Children should not replace the prescription of “valerian” to their parents! It should be especially noted that this very popular appointment criterion antibiotics for viral infections - maintaining an elevated temperature for 3 days - there is absolutely no justification. The natural duration of the febrile period during viral respiratory tract infections in children varies significantly; fluctuations are possible from 3 to 7 days, but sometimes longer. Longer persistence of the so-called subfebrile temperature (37.0-37.5° degrees C) can be associated with many reasons. In such situations, attempts to achieve normalization of body temperature by prescribing successive courses of various antibiotics are doomed to failure and delay finding out the true cause of the pathological condition. A typical course of a viral infection is also the persistence of a cough while the general condition improves and body temperature normalizes. It must be remembered that antibiotics– are not antitussives. Parents in this situation have ample opportunities to use folk antitussives. Cough is a natural defense mechanism and is the last of all symptoms of the disease to disappear. However, if a child’s intense cough persists for 3–4 or more weeks, then it is necessary to look for its cause. In acute otitis, the tactics of antibacterial therapy are different, since the probability of the bacterial nature of this disease reaches 40–60%. Given this, one possible approach might be to assign antibiotics to all sick people (this approach was widespread in North America until recently). Acute otitis is characterized by intense pain in the first 24-48 hours, then in most children the condition improves significantly and the disease resolves on its own; only in some patients the symptoms of the disease persist. There are interesting calculations showing that if antibiotics prescribed to all children with acute otitis, then they can provide some help (reducing the feverish period and duration of pain) only to those patients who were not supposed to have an independent rapid resolution of the disease. Only 1 child out of 20 can be like this. What will happen to the remaining 19 children? When taking modern drugs of the penicillin group, such as AMOXICILLIN or AMOXICILLIN/CLAVULANATE, nothing bad will happen; 2-3 children may develop diarrhea or skin rashes that will quickly disappear after stopping the drugs, but recovery will not be accelerated. As in the case of bronchitis, the purpose antibiotics for otitis media does not prevent the development of purulent complications. Complicated forms of otitis develop with the same frequency as in children who received antibiotics, and those who did not receive them. To date, a different tactic of appointment has been developed antibiotics with acute otitis media. It is advisable to prescribe antibiotics to all children under the age of 6 months, even if the diagnosis of acute otitis is questionable (it is not so easy to find out that a small child has a pain in the ear). At the age of 6 months to 2 years, with a questionable diagnosis (or extremely mild course), prescribing antibiotics can be postponed and limited to observation - this is the so-called wait-and-see approach. If the condition does not improve within 24-48 hours, then antibiotic therapy should be started. Of course, in this case, increased demands are placed on parents. First of all, you need to discuss your behavior with your doctor and clarify what signs of the disease you need to pay attention to. The main thing is to be able to objectively assess the dynamics of pain, its increase or decrease, and notice in time the appearance of new signs of the disease - cough, rash, etc. Parents should have the opportunity to contact a doctor by phone and should be prepared antibiotics wide spectrum of action, for example, antibiotics penicillin series (in addition, this issue should be discussed with your doctor). In children over 2 years of age, initial observation is the most preferable tactic, except in cases of the most severe course of the disease (temperature above 39 degrees C, intense pain). Naturally, during observation, children must be given painkillers and, if necessary, antipyretics. If pneumonia is diagnosed or there is serious suspicion of this pathology, the tactics of antibacterial therapy differ from the two previous cases. Certain age groups of children are characterized by certain features of the predominant pathogens. Thus, at the age of 5–6 years, according to some researchers, up to 50% of cases of pneumonia can be caused by viruses. At an older age, the likelihood of the viral nature of pneumonia decreases significantly and the role of bacteria in the development of pneumonia increases. However, in all age groups, pneumococcus is a common causative agent of this disease. It is precisely due to the high probability of pneumococcal nature and the risk of severe disease that pneumonia is an absolute indication for the prescription of antibacterial therapy. For mild bacterial infections that tend to resolve on their own, positive effects antibiotics expressed to a small extent

Basic principles of antibacterial therapy

A quick glance at the features of antibacterial therapy in the above examples is enough to highlight the basic principles of antibacterial therapy:

• Rapid prescription of the most effective drugs in cases where their effect has been proven.
• Maximum Application Reduction antibiotics in all other cases.

Choice antibiotics

According to the logic of events, after determining the indications for prescribing antibacterial therapy, the stage of drug selection follows. Currently, about 50 different antibacterial drugs are approved for medical use in Russia. It is quite obvious that choosing the right drug for the treatment of individual diseases requires significant professional knowledge, firstly, about the spectrum of action of each drug, and secondly, about the most likely causative agents of individual infectious diseases. But there are general provisions that both doctors and parents of young patients need to know. We will talk about the possibility of developing adverse events after taking the medication and restrictions or prohibitions on taking certain medications. It is immediately necessary to make a reservation that all prohibitions are relative, since in critical situations, if there is a real threat to life, the doctor may even prescribe a drug prohibited for children. For new drugs, as a rule, there are restrictions on their use in newborns and children under the age of 2 - 6 months. Such limitations are explained by the lack of experience in using new drugs in children of younger age groups and the risk of developing undesirable effects associated with the characteristics of age-related physiology. In such situations, the instructions for medications simply indicate that there is no data on the safety of the drug for children of younger age groups. The doctor must independently assess the balance of benefit and possible harm when prescribing the drug. The most common adverse events, occurring in 10–15% of patients when taking all antibiotics, include gastrointestinal disorders (nausea, vomiting, loose stools - diarrhea, abdominal pain), headache, various skin rashes. These phenomena usually disappear without consequences after stopping the medication. The second group of adverse events includes allergic reactions (from skin rash to anaphylactic shock), they are most typical for drugs of the penicillin group; they occur extremely rarely with drugs of other groups. Sometimes parents say that their child is allergic to “everything.” Upon careful analysis of each specific situation, it almost always turns out that this is not so. The most serious adverse events include specific damage to organs and systems that develop under the influence of individual drugs. Despite the fact that modern drugs undergo extremely strict control at the development stage, sometimes the ability to cause such lesions can only be revealed several years after the start of drug use. That is why only drugs that have been well studied for many years are approved for use in children of younger age groups (and pregnant women).

Antibacterial drugs that are especially dangerous for children

Among all the variety of modern antibiotics Three groups of drugs should be distinguished, the prescription of which is possible only in extreme situations. First of all, we are talking about LEVOMYCETIN. When taking this drug (sometimes one tablet is enough), it is possible to develop aplastic anemia (total inhibition of hematopoietic processes in the bone marrow), which inevitably leads to death. Despite the fact that this complication develops extremely rarely, the modern level of medical development does not allow exposing children to even minimal risk. Currently, there are no situations in which chloramphenicol could not be replaced with a more effective and safe drug. Antibacterial drugs of the tetracycline group (TETRACYCLINE, DOXYCYCLINE, MINOCYCLINE), which disrupt the formation of tooth enamel, should not be used in children. Preparations from an important and promising group of fluorinated quinolones, which are easily identified by their names, are not approved for use in children - they all contain the ending “-floxacin” (NORFLOXACIN, PEFLOXACIN, CIPROFLOXACIN, OFLOXACIN, etc.). Drugs in this group are preferred (drugs of choice) in the treatment of urinary tract infections and intestinal infections. The newest fluoroquinolones (LEVOFLOXACIN, MOXIFLOXACIN) are highly effective against respiratory tract infections. The reason for limiting the use of fluoroquinolones in children is an experimental finding: they were found to disrupt the formation of articular cartilage in immature animals (dogs). In this regard, from the moment fluoroquinolones appeared in medical practice, their use in children was prohibited. Subsequently, fluoroquinolones began to be gradually used in children of all age groups for life-threatening infections, if the pathogens turned out to be resistant to all other drugs. However, fluoroquinolones were not used in large quantities in children, perhaps due to this, damage to cartilage tissue was not recorded in them. Despite the importance and promise of the group of fluoroquinolones for the treatment of infectious diseases, their unlimited use in children is out of the question. Less categorically, but still, it should be strongly recommended to limit the use of sulfonamides and the combination drug trimethoprim + sulfamethoxazole, commonly known as BISEPTOL, in children. While sulfonamides in their pure form have almost disappeared from practice, biseptol is still very popular. There are several reasons to limit the use of this drug in all age groups: the drug only inhibits the growth of bacteria, but does not destroy them. Among the vast majority of bacteria that cause infectious diseases, their resistance to BISEPTOLE is widespread. And finally, this drug, although extremely rare, can still cause severe damage to the skin and liver, as well as inhibit hematopoiesis. It can be said that the likelihood of negative effects of BISEPTOL outweighs its extremely dubious positive properties.

Myths about antibiotics

So, antibiotics, of course, can cause very specific undesirable reactions. But in addition to their true sins, sometimes we hear clearly undeserved accusations. Quite often, not only in popular science, but also in special articles, as something completely obvious, they talk about the ability antibiotics suppress immunity. Such statements are absolutely unsubstantiated. Numerous studies have clearly established that none of those approved for use in medical practice antibiotics when used in therapeutic doses, it does not suppress the immune system. The next extremely painful problem: influence antibiotics on intestinal microflora and dysbacteriosis. Here it is worth saying a few words on an issue that goes beyond the scope of this article. A more or less constant composition of a child’s intestinal microflora is formed during the first 6–12 months of life, and sometimes longer, depending on the type of feeding. During this period, the function of the gastrointestinal tract is characterized by instability and frequent disturbances (pain, bloating, diarrhea), and the species and quantitative composition of the intestinal microflora is characterized by more or less pronounced deviations from the average values. In its most general form, the described changes in the composition of microflora are called dysbiosis. However, to date there has been no convincing evidence as to which changes in the composition of the intestinal microflora should be considered pathological. The criteria of norm and pathology used today are arbitrary, and the extraordinary public interest in the problem of dysbiosis has no serious basis. Against the background of the reception antibiotics the composition of the intestinal microflora inevitably changes, moreover, while taking the most powerful antibacterial agents (drugs of the cephalosporin group of III - IV generations, carbapenems - IMIPENEM or MEROPENEM) you can even sterilize the intestines for a short period of time. This can probably be called dysbacteriosis, but does this have any practical significance? If nothing bothers the child, then absolutely nothing. If the child while taking antibiotics If diarrhea has developed, it is necessary to compare the severity of the underlying disease and the need for antibacterial therapy with the severity of the gastrointestinal disorder. You will either have to endure and complete the course of treatment, or cancel antibiotic until the diarrhea ends. After discontinuation of the antibacterial drug, intestinal function almost always quickly returns to normal, but in very young children the recovery process may be delayed. The main method of correction should be optimization of nutrition; it is possible to take biological products containing “useful” lacto- and bifidobacteria, but in no case should you try to correct the situation by prescribing new ones antibiotics. The concept of dysbiosis is also associated with the idea of ​​the inevitable activation of the growth of fungi living in the intestines and potentially capable of causing infectious diseases when taken antibiotics. For example, an easily removable loose plaque, similar to cottage cheese, may appear on the mucous membrane of the genital organs or on the tonsils, and the person’s well-being worsens. Indeed, in patients with immune deficiency, suffering from blood cancer or in patients with AIDS, against the background of long-term intensive therapy antibiotics a fungal infection may develop. Therefore, they sometimes need to be prescribed preventive courses of antifungal drugs. In other situations, prevention of fungal infections (especially with NISTATIN) is meaningless, since such infections almost never occur. In conclusion, it must be emphasized once again that antibacterial drugs are the only effective means of treating infectious diseases. But, unfortunately, the rapid formation of resistance by bacteria to antibiotics, caused by the irrational use of bacterial preparations, leads to a rapid loss of the effectiveness of the latter. Therefore, along with the search for drugs with fundamentally new mechanisms of action, joint efforts of doctors, pharmacists and patients are necessary to streamline the use of antibiotics and preserving them for the future.

After doctors began using various antibiotics, medicine entered a new stage of development. These drugs have unique properties that destroy or slow down the development of dangerous microorganisms, which allows them to be widely used in the treatment of infectious diseases.

Pharmacists are creating more and more medicines, and today it is very difficult to find a family that does not have antibiotics in their medicine cabinet. Some people, having fallen ill with the flu or acute respiratory infections, manage to prescribe medications for themselves, thereby causing irreparable harm to their health. Can you take antibiotics for a cold? For what diseases is it better to avoid using them?

Rules and patterns

You should know that antibiotics are not as harmless as they seem at first glance. These drugs can only be prescribed by a doctor, and they must be taken with great caution. Especially when antibiotics are used for colds in children. When using any medications, you must carefully read the instructions and be sure to pay attention to their expiration date.

If you are going to take antibiotics, you should know that they only help with bacterial infections. They will not bring any effect against influenza and ARVI, since these diseases occur in the body due to the activity of viruses. Antibiotics are powerless against them.

For high fever or inflammatory processes, these drugs are also not prescribed. They are not antipyretics, so taking them will not have any effect in case of high temperature.

Antibiotics for colds

Today, many drugs are advertised on TV, but this does not mean that during illness you can prescribe them yourself. If you have a question about what antibiotics to take for a cold, you should contact your doctor, not your best friend or mother.

After a complete examination and receipt of test results, the specialist may prescribe the following medications:

• macrolides (Clarithromycin, Azithromycin, Roxithromycin);
• penicillins (Augmentin, Ampiox, Amoxiclav);
• cephalosporins (Cefiprom, Cefotaxime, Cefazolin).

Antibiotics for colds are prescribed according to the type of disease, its severity and other characteristics. If side effects or allergic reactions are detected, the drug may be replaced with another.

Some features of diseases

When a cold (or acute respiratory infection) occurs, the body is attacked by viruses. Nasal congestion appears, the throat becomes sore and red, and a runny nose overcomes. During this period, the immune system actively fights the disease, fever and chills appear.

The best treatment at this time is not antibiotics. For flu and colds, antiviral drugs are used at the initial stage. The most common of them are “Anaferon”, “Laferon”, “Reaferon”, drops and suppositories. Medicines containing natural herbal ingredients include “Proteflazid” and “Immunoflazid”.

When are antibiotics prescribed?

Usually within a week the patient's condition improves. If this does not happen, based on the tests, the doctor concludes that a bacterial infection has joined the disease. In this case, antibiotics for colds are prescribed.

This is very important, since the patient’s condition may become more complicated, and the flu or acute respiratory infections may take on a dangerous form - it could be pneumonia, acute bronchitis or purulent tonsillitis. Only strong antibiotics will help the body cope with the attack of bacteria.

In this case, it is very important to choose the right drugs. Which? Antibiotics for colds are prescribed based on bacteriological examination of the patient's sputum. The laboratory, after performing the analysis, provides results on the resistance of bacteria to certain drugs.

Having determined the most suitable antibiotics, the doctor prescribes them to the patient. If you are allergic to this medicine or have side effects, another medicine is prescribed. You should know that you cannot suddenly stop taking an antibiotic. If you have a cold, an adult needs to use it for another two to three days. Even after a visible improvement in the general condition, it is not recommended to stop therapy.

Antibiotics for colds for children

All parents should know that medications in this category are prescribed to children in extreme cases and only by a specialist. Do not use medications without the consent of your doctor!

The best cold remedies for a child are drinking plenty of fluids, antipyretics (if the temperature is above 38 degrees) and antiviral syrups.

If the baby's condition does not improve, stronger medications are prescribed. A good antibiotic for colds is Amoxiclav. It is used for bacterial infection in the respiratory tract. For pneumonia, the drug "Avelox" can be prescribed, for pleurisy - "Suprax", for fungal atypical pneumonia, "Hemomycin" helps well. However, remember that medicine can only be prescribed by a doctor after reviewing the test results!

Strictly contraindicated for children!

Many antibiotics for colds can cause side effects in a child’s fragile body. This may include decreased appetite, unstable stools, abdominal pain, nausea, and anxiety.

Therefore, there are a number of antibiotics that are not prescribed to children; their use can cause terrible harm to the child’s health. These include:

• "Levomycetin";
• "Ceftriaxone";
• aminoglycosides and tetracyclines (contraindicated in children under 8 years of age).

Uncontrolled use of these drugs can lead to liver damage, disruptions in the nervous system, and dysbacteriosis. Some medications have irreparable effects on hearing and can even lead to complete deafness in a child. Cases of toxic shock and even death are common. Therefore, do not self-medicate under any circumstances and always seek help from a specialist.

Effective drugs for bronchitis

If you have an acute respiratory infection, you need to stay in bed, take a sufficient amount of warm liquid and try to do everything to make the disease go away. If the general condition worsens, an adult may be prescribed appropriate potent drugs. The name of antibiotics for colds (in the case of bronchitis) will be determined by your doctor. Often prescribed:

• "Macropen";
• "Lendatsin";
• "Rovamycin";
• Azithromycin.

Complication of sore throat

It is very bad if the patient’s condition does not improve within four to six days. It’s even worse if the disease takes on a dangerous form in the form of a purulent sore throat.

The name of antibiotics taken for colds will be different in this case. Drugs used:

• "Spiramycin";
• "Cefradine";
• "Oxacillin";
• "Clarithromycin."

There are many more effective medications that successfully destroy bacteria in the human body. However, they are prescribed only by a doctor and taken strictly as recommended.

In what cases are antibiotics necessary?

For mild forms of acute respiratory infections, laryngitis, rhinitis, and viral tonsillitis, these drugs are not prescribed. Antibiotics for flu and colds can only be used in extreme cases, if there are frequently recurring diseases, prolonged fever, as well as in patients with cancer or HIV infection.

Potent drugs are indicated if:

• purulent complications of acute respiratory infections;
• acute otitis;
• severe sinusitis lasting more than 14 days;
• streptococcal sore throat;
• pneumonia.

How to take antibiotics?

For adults, medications in this group are mainly produced in tablets or capsules, for children - in the form of syrup. The drug is taken orally. It is advisable not to combine antibiotics for colds, preferring monotherapy (use of one drug).

The medicine should be taken in such a way that its maximum concentration is at the site of infection. For example, for upper respiratory tract disease, an antibiotic is prescribed in the form of aerosols or drops. This is how the components of the medicine instantly manifest their effect and quickly have an effect.

The effectiveness of the drug is judged by the decrease in body temperature within 36-48 hours after taking it. If this does not happen, use another antibiotic. It is not recommended to combine the drug with an antipyretic drug. In severe cases of the disease, immediate hospitalization is recommended.

Treatment regimen

The dosage of the antibiotic depends on the causative agent of the disease, the form of the disease, its severity and the age of the patient. If the drug is prescribed to a child, his weight is also taken into account. When administering antibacterial therapy to a newborn, the gestational age is taken into account: for a child born at term and a premature baby, the doses of the medicine will be different.

The drug dosage regimen is strictly followed throughout the entire course of treatment. Usually it is recommended to take the medicine for at least 5-10 days. Continuing treatment beyond the prescribed period is strictly prohibited, as is stopping the drug on your own.

A good antibiotic for colds can kill bacteria within a few days. However, it should be remembered that in combination therapy, drugs with similar composition and effects are not prescribed. This can lead to toxic liver damage.

Possible side effects

A prescribed antibiotic for a cold will certainly harm an adult less than a child. However, this potent drug can cause a number of side effects, such as rash, nausea, vomiting, headaches and other unpleasant symptoms.

If an antibiotic is used uncontrolled, it can cause the following reactions in the body:

• allergic rashes;
• intestinal dysbiosis;
• resistance of bacteria to a certain type of drug.

Most often, allergic manifestations occur after taking penicillin antibiotics. If a rash or other discomfort occurs after taking the medicine, it is better to stop taking it and consult a doctor.

Interaction with other drugs

Combining several medications is undesirable, especially if one of them is an antibiotic. If you are taking any medicine, be sure to tell your doctor. He will select the best treatment option. But in any case, the antibiotic is taken at a different time and preferably without combining it with other medications.

Special instructions should be given to women taking hormonal contraceptives. When interacting with some antibiotics, their effect is reduced, which can lead to unwanted pregnancy.

Also, any medications are not recommended for use during lactation. Antibiotics can penetrate into mother's milk and have a negative effect on the baby, causing dysbacteriosis or allergic rashes. It is strictly forbidden to take any medications while carrying a child.

Be careful!

Our body is inhabited by many beneficial bacteria that perform a number of necessary functions. Remember that when taking an antibiotic, they die at the same time as harmful microorganisms. Most potent drugs destroy the normal microflora of the intestines, stomach and other organs, provoking the appearance of fungus. Therefore, candidiasis can often develop after taking antibiotics.

You should also think about it if you are experiencing allergic reactions. Maybe the uncontrolled use of antibiotics is to blame? People who use these drugs for a long time are very likely to develop an allergy to any irritant: dust, odors, flowering plants, detergents.

The fact is that antibiotics weaken our immunity, preventing it from coping with the infection on its own. Without natural stimulation, the body's normal defenses deteriorate, and it reacts painfully to any irritant.

You should not take one type of drug for a long time. Pathogens can quickly develop resistance to this drug and may not be easy to get rid of in the future.

Now you know what antibiotics are and when it is advisable to use them. The free sale of these drugs in pharmacies cannot be a guide to action. Any medications can only be prescribed by a specialist, and your doctor will decide which antibiotic is best for a cold.

Treatment with antibiotics in our country, unfortunately, is not only a matter for doctors. The Internet is replete with queries: “What antibiotics to take for a sore throat?”, “Should I take antibiotics for a cold?”, “What to choose - antibiotic tablets or injections?” Dr. Anton Rodionov, in his book about medications, talks in detail about the acceptable use of antibiotics for bronchitis, sinusitis and other respiratory diseases - and only as prescribed by a doctor!

Antibiotic translated from Greek means “against life.” On the one hand, these are drugs that, perhaps, saved a record number of lives on earth; in any case, the widespread introduction of antibiotics into clinical practice in the second half of the 20th century made it possible to radically change the structure of morbidity and mortality, displacing infectious pathology from the first positions. On the other hand, this is a group of drugs in the prescription of which a record number of errors occur.

I usually began my lectures on antibiotics with data that was presented back in 2001 by the legendary professor L.S. Strachunsky is a leading figure in Russian antibiotic therapy. So, when analyzing outpatient records in children's clinics, it turned out that about 90% of antibiotics were prescribed not according to indications. More than half of the prescriptions were for ARVI (and you know very well that antibiotics for ARVI are not prescribed for either treatment or prevention). I don’t think that statistics have changed radically in 15 years.

In the second slide I show 4 general principles of antibiotic treatment. They are formulated for doctors and represent the 4 most common mistakes. However, I am sure they will be useful to you too. So:

1. There is no need to prescribe antibiotics if they can be avoided. This is the most important rule
2. There is no need to “expand” the spectrum of action of the antibiotic unnecessarily. When you are sick, you really want a stronger medicine so that it will kill everything for sure. So there’s no need to be “stronger”. If an antibiotic is really needed, then it should not “burn out all living things, leaving behind a desert,” but act in a targeted manner, taking into account the sensitivity of the pathogen. For example, oddly enough, classical streptococcal infection, just like 60 years ago, can still be perfectly treated with simple penicillins.
3. There is no need to prescribe antibiotics intravenously or intramuscularly if they can be prescribed in tablets.
4. There is no need to routinely prescribe antifungal drugs with a short course of antibiotics - 5-7 days. It's useless at best.

Antibiotics throughout the world are strictly prescription drugs. Do not self-diagnose or self-medicate. I present here standard generally accepted approaches to treatment, but, of course, the characteristics of your particular disease may become the basis for prescribing a different therapy. In addition, allergies and other types of individual intolerance are possible. Pay more attention to what not to do. Let your doctor take care of how to do it.

Antibiotics for bronchitis, sinusitis and other diseases of the respiratory tract and ENT organs

When we, I repeated more than once that an uncomplicated cold can never be treated with antibiotics under any circumstances. Moreover, antibiotics are not used to prevent complications from colds.

The only reason for prescribing antibiotics is the development of complications (purulent sinusitis, otitis media) or bacterial tonsillitis.

At sinusitis Antibiotics are prescribed when purulent nasal discharge, fever, headache, and pain or a feeling of fullness in the sinus projection persist for several days. Antibiotics are used to treat fever, purulent discharge from the ear (if the eardrum is defective), and severe pain in the ear. The diagnosis, of course, must be made by a doctor.

We have already talked about this. Before prescribing an antibiotic, it is necessary to prove the presence of streptococcus; There are express tests for this.

In some cases, antibiotics are appropriate for treatment exacerbations of chronic(or chronic obstructive pulmonary disease); As a rule, this is the lot of smokers. The basis for treatment is fever, increasing shortness of breath, increasing the amount and purulence of sputum. Let me remind you that just a cough, even with sputum, during a cold is not an indication for prescribing an antibiotic.

The most serious lung disease is pneumonia(pneumonia). Pneumonia can be suspected independently, but it must be confirmed by a doctor by listening to the lungs (auscultation) and x-ray examination. Here are the main signs that should be a reason to see a doctor:

1st option: a sharp rise in temperature to 39-40 °C, accompanied by poor health, shortness of breath; chest pain that gets worse with coughing.

2nd option: the beginning is like an acute respiratory viral infection with a runny nose and cough, a slight temperature, then normal, and then again rising to 38 ° C and above.

In children: duration of temperature up to 38 °C and above for more than 3 days, rapid breathing, severe lethargy, drowsiness.

Three groups of drugs are most often used to treat respiratory diseases:

• penicillins - amoxicillin, amoxicillin/clavulanate;
• macrolides - azithromycin, clarithromycin;
• fluoroquinolones (respiratory) - levofloxacin, moxifloxacin.

Common mistakes when treating respiratory tract infections with antibiotics

1. The use of antibiotics by injection in an outpatient (home) setting. All of these drugs, and many others, exist in tablet form.
2. Use of co-trimoxazole (Biseptol). This is a very unsafe medicine with a narrow spectrum of use. For some reason, they really like to use it for self-medication, considering it the safest antibiotic. This is absolutely not true.

• To prefer co-trimoxazole to other antibiotics, there must be very serious reasons. It is advisable to conduct short (no more than 5-7 days) courses of therapy.
• Co-trimoxazole is used for specific diseases, for example, Pneumocystis pneumonia in HIV-infected people and for the treatment of certain forms of nosocomial infections with insensitivity to other antibiotics.
• The use of co-trimoxazole requires careful monitoring of side effects, the underestimation of which can lead to death. For example, the risk of a severe toxic reaction (Lyell's syndrome) when prescribing this drug is 10-20 times higher than when using conventional antibiotics.

1. Routine use of antifungal drugs. You don't have to do this.
2. Late initiation of antibiotic therapy for pneumonia. Unfortunately, people die from pneumonia even in the 21st century. The later treatment begins, the higher the mortality rate - such a disappointing statistic.
3. Frequent changes of antibiotics during treatment, which are explained by the “danger of developing resistance.” There is a general rule of antibiotic therapy: effectiveness is assessed within 48-72 hours. If during this time the temperature normalizes and the symptoms decrease, then the drug is effective, and its use is continued for as long as the course of treatment is designed for. If the temperature persists, the antibiotic is considered ineffective and is replaced with a drug from another group.
4. Too long or too short, incl. independently interrupted course of treatment. We must understand that we are treating a disease, not tests or x-ray changes. For example, after suffering from pneumonia, changes on an x-ray can last up to a month, and sometimes longer. This does not mean at all that you need to swallow antibiotics all this time. However, there is also no need to stop treatment on your own on the first day of normal temperature - this is a sure way to ensure that the antibiotic will not work next time.

The optimal duration of therapy for certain respiratory diseases:

• Community-acquired pneumonia - at least 5 days (+2-3 days after temperature normalization)
• Acute bacterial bronchitis – 5-7 days
• Exacerbation of chronic bronchitis - 7-10 days
• Streptococcal tonsillopharyngitis (angina) - 7-10 days
• Acute sinusitis – 10-14 days
• Chronic sinusitis - 21-28 days.

Dysbacteriosis after antibiotics: what really happens

Western doctors are very surprised when they find out that Russians somehow manage to diagnose “intestinal”, and then also treat it. The notorious “stool test for dysbacteriosis” is obscurantism, widespread on a national scale. Several thousand microbes live in the intestines, the laboratory identifies only two dozen, and not at all those that are on the walls of the intestines, but those that move with feces. If your doctor suggests you take this test, think seriously...

In reality, the problem is a condition called antibiotic associated diarrhea, i.e. diarrhea that develops as a result of taking antibiotics. The mechanisms of its development can be different; not everything comes down to a violation of the composition of the microflora. For example, macrolides, as well as clavulanate, cause diarrhea by increasing intestinal motility. There is no need to treat such antibiotic-associated diarrhea; it stops on its own a couple of days after stopping the drug.

The main problem is diarrhea associated with the colonization of a microorganism called clostridium (Clostridium dii cile). In this case, despite stopping antibiotic therapy, stool frequency increases and severe dehydration develops. Possible complications include ulceration and perforation of the colon and death.

Based on this, let's formulate the following rule: if after stopping the antibiotic, diarrhea not only does not go away, but, on the contrary, the condition worsens, you need to consult a doctor and have a stool test done to determine the Clostridium dii cile toxin. If the diagnosis is confirmed, treatment with other antibiotics (metronidazole and vancomycin) is prescribed.

For a cold, the doctor prescribes it to the patient only if the human body really cannot cope with the infection on its own. The most dangerous signals of a viral infection are a rapid increase in a person’s body temperature to 38 degrees. When a person has a cold, the body temperature rises, the throat begins to turn red and itchy. This may result in a dry cough, shortness of breath, and severe headache. The purpose of antibiotics in this case is to directly combat bacteria and infections.

Treatment of colds with antibiotics

A person urgently needs to start antibiotics if his immune system is not able to independently cope with bacteria that are gradually attacking the body. Most of us, at the first symptom of a cold, start looking on the Internet for information about which antibiotics to take so that the cold will magically go away. But you shouldn’t resort to strong medications on the first day. The body needs to be given a day or two to come to its senses and begin to fight the infection. If he doesn’t succeed, then antibiotics can be added. So, the first question has been answered. It is not recommended to take antibiotics for colds in the first 2 days.

If your condition does not improve, then you need to consult a doctor so that, through diagnosis, he can determine the severity of the sick patient and, as a result, prescribe the most correct and appropriate treatment that will be effective in this particular pathological case.

Main symptoms of a cold

Colds, namely, are a rather insidious disease that affects the human body regardless of age, health status, time, etc. A cold or ARVI lasts on average up to 7 days. At the end of these 7 days, the person’s well-being should improve significantly. On average, if we look at medical statistics, a person gets a cold about 3 times a year. Colds are caught through airborne droplets. In this case, the virus affects the bronchi, trachea, and lungs. For a long time, a viral infection can live in the mucus of the upper respiratory tract.

ABOUT The main pathological symptoms of a cold are the following:

• Inflammatory process of lymph nodes that hurt and become denser. If you press on the lymph nodes behind the neck, on the back of the head, behind the ears, and also under the lower jaw, they begin to hurt;
• Excessive mucus discharge from the nose - runny nose. Drying of the mucous membranes;
• Severe sore throat, redness of the upper respiratory tract;
• A person has a hoarse voice;
• Redness of the eyes and the onset of watery eyes;
• Increase in body temperature to 39-40 degrees Celsius;
• Severe stomach upset, manifested by nausea and vomiting. As a rule, this condition occurs when the body is infected with rotavirus.

No cold in humans is asymptomatic. That is why any experienced general practitioner will be able to determine whether you are suffering from a cold or some other pathological disease. Depending on the complexity of the pathology and the patient’s immunity, the doctor will prescribe one or another antibiotic. For example, if the inflammatory process began in the upper respiratory tract, then in this case antibiotics such as Amoxiclav, Amoxicillin, Augmentin are prescribed. These antibiotics also belong to the penicillin group.

For pneumonia, penicillin antibiotics are not suitable. The bacteria that caused this pathological condition must be treated with antibiotics in the form of Levofloxacin and Avelox.

If a patient is diagnosed with bronchitis, pneumonia, or pleurisy, then macrolides in the form of Sumamed and Hemomycin are used.

Indications for the use of antibiotics

Antibiotics for colds should only be taken if the diagnosis is reliably known. This can be explained by the fact that there is not a single antibiotic that would be suitable for absolutely all pathological conditions. The use of antibiotics must be taken quite seriously, since they can not only help cure a particular disease, but also cause a number of side effects. If the wrong selection of antibiotics is carried out, then this can harm a person.

Indications for the use of antibiotic therapy are:

• Purulent tonsillitis or in simple words sore throat;
• Inflammatory process of the middle ear or purulent otitis media;
• Pneumonia;
• Pneumonia.

Antibiotics for colds

The first thing you need to do when you have a cold is to start taking decades-tested folk remedies in the form of hot tea with lemon and honey, rosehip decoction, vitamin C. You should not prescribe antibiotics yourself if you do not know the true cause of the pathology. Be sure to consider all the side effects of the antibiotics you start taking.

In short, antibiotics in the form of Augmentin and Ampicilinn are used to treat tonsillitis, purulent otitis, sinusitis and pneumonia. Erythromycin will help with atypical pneumonia. In order to destroy mycoplasmas, pneumococci, chlamydia, and E. coli, Levofloxacin is used.

To treat infectious processes, the patient is prescribed Flemoxin or Solutab. It is not recommended to use the antibiotic Suprax, as it may cause adverse reactions in the form of severe intestinal upset.