Article for the competition "bio/mol/text": Are there drugs that do not cause side effects and complications, are highly effective and safe? Closest to these ideal characteristics crept up probiotic preparations(from living microorganisms - human symbionts) and bacteriophages(viruses of bacteria). When introduced into the human body, they enter into a struggle for existence with pathogens of infectious diseases or, in the case of bacteriophages, decompose them from the inside in a guerrilla fashion. Probiotics and phages with different specificity affect pathogenic bacteria, all processes develop within the microbiocenosis of a certain area of ​​the human body and are aimed at preserving the habitat, in other words, at maintaining homeostasis. Probiotics and phages are usually used separately, but their combined use may be promising.

Note!

The sponsor of the nomination "The Best Article on the Mechanisms of Aging and Longevity" is the Science for Life Extension Foundation. The Audience Choice Award was sponsored by Helicon.

Contest sponsors: 3D Bioprinting Solutions Laboratory for Biotechnology Research and Visual Science Studio for Scientific Graphics, Animation and Modeling.

The wedge is knocked out with a wedge.

folk wisdom

Biotechnology - medicine

In modern medical practice, a large number of funds obtained through the vital activity of microorganisms are used. These include vitamins, enzymes, genetically engineered hormones and interferons, blood substitutes and, of course, antibiotics. Actually, even medical alcohol - this universal antiseptic, folk analgesic and antidepressant - is a product of the fermentative metabolism of yeast fungi. Traditional and new highly effective, different in structure and mechanism of action, natural and chemically modified drugs, in the creation of which microorganisms participated, are used to treat various diseases.

When the cure is worse than the disease

In the practice of using drugs, the doctor has to deal with the so-called side effects that can develop along with the main effect of the drug and limit the possibilities of its use. Adverse reactions especially often occur in cases of using drugs that have a multilateral pharmacological effect (recall the same ethyl alcohol), while the goal of treatment is achieved through the use of only some aspects of the pharmacodynamics of this drug.

In this sense, antibiotics deserve special attention, since they are the drugs of choice in the treatment of most infectious diseases, and the prescription of antibiotics is not always preceded by the necessary microbiological studies. There are frequent cases of irrational use of broad-spectrum antibiotics, violations of drug regimens by patients, and even uncontrolled self-medication. And even with proper use, the antibacterial effect of antibiotics extends not only to pathogenic, but also to the normal microbial flora of the body. Under the action of antibiotics, bifidobacteria, lactobacilli, symbiotic strains of Escherichia coli and other beneficial microbes die. The vacated ecological niches are immediately populated by opportunistic bacteria and fungi (usually resistant to antibiotics), which were previously present on the skin and in non-sterile cavities of the body in small quantities - their reproduction was restrained by normal microflora. Antibiotic therapy, for example, can promote the transformation of peaceful saprophytic yeast-like fungi candida albicans(Fig. 1), living on the mucous membranes of the oral cavity, trachea and intestines, into rapidly multiplying microorganisms that cause a number of local and general lesions.

Figure 1. Yeast-like fungi candida albicans and the consequences of their active reproduction. a - Cells candida albicans under an electron microscope. b - Manifestations of candidiasis. Pictures from velvet.by and www.medical-enc.ru.

Other side effects may be based on the individual characteristics of the interaction of the organism with the antibiotic: intolerance to the drug may be of an allergic or pseudo-allergic nature, be the result of fermentopathy, or fall into the mysterious category of idiosyncrasies (until the mechanism of intolerance is clarified).

Probiotics instead of antibiotics?

Currently, medical science and health authorities around the world are faced with a responsible task - the creation of effective antibacterial drugs that cause the least pronounced adverse reactions.

One of the possible solutions to the problem is the development and widespread pharmacotherapeutic use of drugs based on live cultures of representatives of normal microflora ( probiotics) for the correction of human microbiocenoses and for the treatment of pathological conditions. The use of bacterial preparations is based on understanding the role of the normal microflora of the body in the processes that provide nonspecific resistance to infections, in the formation of the immune response, as well as on the establishment of the antagonistic role of the normoflora and its participation in the regulation of metabolic processes.

The founder of the theory of probiotics is I.I. Mechnikov. He believed that the preservation of human health and the prolongation of youth largely depend on the lactic acid bacteria living in the intestines, which can suppress the processes of decay and the formation of toxic products. Back in 1903, Mechnikov proposed the practical use of microbial antagonist cultures to combat pathogenic bacteria.

According to some reports, the term "probiotics" was introduced by Werner Kollat ​​in 1953, then it has been repeatedly and differently interpreted by both scientists and regulatory organizations. Kollat ​​called probiotics substances necessary for the development of a healthy body, a kind of "life promoters" - as opposed to antibiotics. Lilly and Stilwell, who are often credited with inventing the term, also agreed with the ending of this statement, but they specified that probiotics are substances produced by some microorganisms that stimulate the growth of others. The vast majority of definitions revolved around the adoption of viable microbes in order to modulate the intestinal microflora. According to the consensus interpretation of the WHO and FAO expert council, Probiotics are live microorganisms that, when taken in adequate amounts, confer health benefits. A significant contribution to the development of the modern concept of probiotics was made by the famous biochemist, animal nutritionist Marcel Vanbelle. T.P. Lyons and R.J. Fallon in 1992 called our time "the coming era of probiotics" (and they were not mistaken, judging by the incredible growth in their sales - Ed.) .

Compared to traditional antibacterial drugs, probiotics have a number of advantages: harmlessness (however, not for all diagnoses and not for all patients - Ed.), the absence of adverse reactions, allergization and negative effects on the normal microflora. At the same time, the authors of a number of studies link the use of these biological products with a pronounced clinical effect in the treatment (treatment) of acute intestinal infections. An important feature of probiotics, according to some reports, is their ability to modulate immune responses, in some cases have an anti-allergic effect, and regulate digestion.

Currently, a number of such bacterial preparations are widely used in medicine. Some of them contain bacteria that constantly live in the human body (“Lactobacterin”, “Bifidumbacterin”, “Colibacterin”, “Bifikol”), others consist of microorganisms that are not “residents” of the human body, but are capable of colonizing the mucous membranes for a certain time or wound surfaces, creating a protective biofilm on them (Fig. 2) and producing substances that are harmful to pathogenic bacteria. These drugs include, in particular, Biosporin based on saprophytic bacteria Bacillus subtilis and "A-bacterin", consisting of living cells of the green aerococcus - Aerococcus viridans .

Beneficial microbe - aerococcus

Some aerococci (Figure 3) are classified as opportunistic microbes because they can cause disease in animals (eg haffkemia in lobsters) and immunocompromised humans. Aerococci are often found in the air of hospital wards and on medical supplies, isolated from patients with streptococcal and staphylococcal infections, and also have a certain morphological similarity with these dangerous bacteria.

Figure 3. Cells and colonies of aerococci. a - Bacteria under a conventional light microscope. b - Bacteria under an electron microscope. Rounded cells are visible, arranged in pairs and tetrads. v - Colonies of aerococci on a nutrient medium with the addition of blood. The green color around the colonies is the result of partial destruction of hemoglobin. Photo (a) from the site codeofconduc.com, (b) and (c) - made by the authors of the article.

Figure 4. Inhibition of growth of pathogenic bacteria by aerococci. Zones of significant growth retardation were registered during the cultivation of vibrios, staphylococci, diphtheria bacillus, and providence. Pseudomonas aeruginosa ( Pseudomonas aeruginosa) is resistant to the antagonistic action of aerococci. Photo of the authors of the article.

But the staff of the Department of Microbiology of the Dnepropetrovsk Medical Academy managed to identify among the aerococci a strain not only harmless to humans, but also showing pronounced antagonistic activity against a wide range of pathogens of infectious diseases. Thus, a drug was developed and introduced that has no analogues in world practice - the probiotic "A-bacterin" for external and oral use, which is not inferior in its effect on the human microflora to expensive antibiotic preparations (Fig. 4).

The antagonistic properties of aerococci are associated with the production of hydrogen peroxide (a substance widely used in medicine as an antiseptic) - a stable feature of the production strain A. viridans, from which "A-bacterin" is prepared. Another bactericidal substance, a metabolic product of aerococci, is the superoxide radical (Fig. 5), which is formed by these bacteria during the oxidation of lactic acid. Moreover, the ability of aerococci to oxidize lactic acid is very important in the case of using the drug in dentistry, since one of the causes of caries is lactic acid formed by streptococci.

Figure 5. Bactericidal substances produced by aerococci: hydrogen peroxide (a) and superoxide radical (b) . Figure from tofeelwell.ru.

A low molecular weight acid-resistant and thermostable peptide was found in the culture liquid of aerococci viridocin, which has a wide spectrum of antagonistic activity against those microorganisms that most often cause nosocomial infections and are involved in the formation of physiological and pathological microbiocenosis of the human intestine. Moreover, A. viridans produces a peptide in the external environment aerocin* capable of killing yeast-like fungi. The use of "A-bacterin" with potassium iodide and ethonium is effective in urogenital candidiasis, as it provides directed damage to candida membranes. The same effect is achieved when the drug is used as a means of preventing candidiasis, which occurs, for example, as a result of immunosuppression in HIV infection.

* - Along with the production of hydrogen peroxide (due to NAD-independent lactate dehydrogenase), and in the presence of potassium iodide and the formation of hypoiodide (due to glutathione peroxidase) with a more pronounced bactericidal effect than that of hydrogen peroxide, aerococci also have non-oxide components of antagonistic activity. They form a low molecular weight thermostable peptide aerocin, belonging to the class of microcins, active against Proteus, Staphylococcus, Escherichia and Salmonella. Aerocin was isolated from the culture fluid by salting out, electrodialysis, and paper chromatography, after which its amino acid composition was determined and therapeutic efficacy was shown in experimental salmonella infection in mice. Aerococci are also characterized by adhesion to epithelial and some other cells, that is, resistance to pathogenic bacteria occurs, including at the level of biofilms and colonization resistance.

In addition to the ability to suppress the reproduction of pathogenic bacteria, "A-bacterin" promotes the regeneration of damaged tissue, exhibits an adjuvant effect, stimulates phagocytosis and can be recommended to patients sensitized to antibiotics and chemotherapeutic agents. Today, "A-bacterin" is successfully used for the treatment of burn and surgical wounds, for the prevention and treatment of diarrhea, as well as in dental, urological and gynecological practice. Orally, "A-bacterin" is used to correct the intestinal microflora, prevent and treat intestinal infections, correct individual biochemical parameters (cholesterol profile and lactic acid level) and activate the immune system. Other probiotics are also widely used to treat and prevent intestinal infections, especially in formula-fed infants. Food products containing live probiotic cultures are also popular.

Healing viruses

In the treatment of infections, it is important to create a high concentration of the antimicrobial drug precisely at the site of the pathogen. Using antibiotics in the form of tablets or injections, this is quite difficult to achieve. But in the case of phage therapy, it is enough if at least single bacteriophages get to the infectious focus. Having found pathogenic bacteria and penetrated into them, phages begin to multiply very quickly. With each cycle of reproduction, which lasts about half an hour, the number of phages increases by tens or even hundreds of times. After the destruction of all cells of the pathogen, phages are no longer able to multiply and, due to their small size, are freely excreted from the body along with other decay products.

Probiotics and phages together

Bacteriophages have proven themselves in the prevention and treatment of intestinal infections and purulent-inflammatory processes. The causative agents of these diseases often acquire resistance to antibiotics but remain susceptible to phages. Recently, scientists have been interested in the prospect of the joint use of bacteriophages and probiotics. It is assumed that when prescribing such a complex preparation, the phage first destroys pathogenic bacteria, and then the vacated ecological niche is populated by beneficial microorganisms, forming a stable microbiocenosis with high protective properties. This approach has already been tested on farm animals. He will probably enter medical practice as well.

A closer interaction in the “bacteriophage + probiotic” system is also possible. It is known that bacteria - representatives of the normal human microflora - are able to adsorb various viruses on their surface, preventing them from penetrating into human cells. It turned out that bacteriophages can be adsorbed in the same way: they are not able to penetrate into the cell of a bacterium resistant to them, but use it as a “vehicle” for movement in the human body. This phenomenon is called bacteriophage translocations.

The internal environment of the body, its tissues and blood are considered sterile. In fact, through microscopic damage to the mucous membranes, symbiont bacteria periodically penetrate into the bloodstream (Fig. 7), although they are quickly destroyed there by immune system cells and bactericidal substances. In the presence of an infectious focus, the barrier properties of the surrounding tissues are often impaired, their permeability increases. This increases the likelihood of penetration of circulating probiotic bacteria along with phages attached to them. In particular, in people with urinary tract infections who take A-bacterin orally, aerococci were found in the urine, and their number was consistently low, which indicated precisely transfer aerococci, and not about their reproduction in these organs. Aerococci and the most common pathogens of urological infections belong to completely different groups of bacteria, which means they are sensitive to different bacteriophages. This opens up interesting prospects for creating a complex drug, for example, based on A. viridans and phages that attack intestinal bacteria. Such developments are being carried out at the Department of Microbiology of the Dnepropetrovsk Medical Academy, but they have not yet gone beyond the stage of laboratory research.

The article was written with the participation of Yurgel L.G. and Kremenchuksky G.N.

Editorial

The editors of "Biomolecule" draws the attention of readers to the fact that the authors of articles from the nomination "Own work" share important and interesting details their research, lead own view on the situation in their industry. The Biomolecules team does not believe that the question of the advisability of using probiotics has already been resolved.

The results of research on such substances, no matter how amazing they are, must be confirmed accordingly: the drug must pass the necessary phases of clinical trials so that the medical community can recognize it as safe and effective. medicine, and only then recommend to patients. Naturally, we are talking about tests according to international standards, and not in the way that sometimes happens with us - on 12 patients of a rural infirmary who said that they, well, just horror-how-helped. A good guideline for doctors and patients would be the approval of any probiotic preparations, for example, by the US FDA, but alas...

In the meantime, oral probiotics should be considered not as drugs, but as nutritional supplements. Moreover, the properties of the drug declared by the manufacturer cannot be transferred to other probiotics: they are critical strain(not a genus or even a species) and number of colony forming units. And you also need to keep in mind that such products are influenced by many factors related to production, conditions and shelf life, consumption and digestion.

The world's largest nutrition and health organizations say: there is not enough evidence yet to state that probiotics have a positive effect on health(especially all without exception, regardless of the initial state of this very health). And it's not that the controllers were convinced of the ineffectiveness of these drugs - just, as a rule, in the conducted medical studies, they do not see a reliable causal relationship between the intake of probiotics and positive changes. And it’s also worth remembering those studies where some kind of probiotic turned out to be ineffective or even had a negative effect.

One way or another, the probiotic direction has potential - at least in the prevention and treatment of various enteritis (if we are talking about oral intake). It's just not that simple. Not as easy as the manufacturer, doctor and patient would like. Probably, the probiotics on the shelves of our stores and pharmacies were simply "born a little premature." So what are we waiting for from scientists, developers and manufacturers of killer evidence. And we wish the authors of the article success in this difficult field and, of course, in the search for new interesting properties of microorganisms.

Literature

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Improper nutrition, stress at work, the environment - all these factors can cause such an unpleasant disease as dysbacteriosis. The intestinal microflora is very susceptible to any changes in the body of an adult. It can take a long time to recover from a big feast, long-term use of antibiotics or strict diets.

With the following symptoms, you should immediately consult a doctor to prescribe medications for dysbacteriosis:

1. Frequent diarrhea or constipation. Often there can be an alternation.
2. Constant bloating and discomfort in it, pain or cramps.
3. Nausea and belching.
4. Possible itching in the anus.

It is quite difficult to find an effective drug for the prevention of dysbacteriosis. Based on user reviews, we have compiled a ranking of the top 10 drugs for intestinal diseases. Each of them is effective in its own way and has earned the respect of many gastroenterologist patients.

There are contraindications. Check with your doctor.

TOP 10 best drugs for the intestines

10 Polysorb

The best complex tool
Country Russia
Average price: 428 rubles
Rating (2019): 4.6

A universal and complex remedy can also help in the treatment of dysbacteriosis. The effectiveness of Polysorb is achieved due to the high concentration of absorbent substances. For intestinal infections, an emergency initiation of powder therapy is recommended. It is necessary to strictly follow the instructions, observe the proportions and use only fresh solution for greater effectiveness. The treatment helps to restore balance in the intestines through cleansing, and the powder formula allows you to relieve pain as early as the fourth minute after application.

Polysorb is approved for use by pregnant and lactating women. In addition, a convenient form of the solution is advised to be given to children from birth. People who have undergone therapy claim that the drug is useful only in the first stages of dysbacteriosis and will be effective only with the first symptoms. However, it should be used with caution and be sure to consult a specialist if the patient's health situation does not improve.

9 Hilak Forte

Strengthens the immune system
Country: Germany
Average price: 350 rubles.
Rating (2019): 4.7

Drops for oral administration are used mainly for the treatment of diarrhea and indigestion. Despite this, the list of indications for use includes the normalization of the composition of microflora. This process takes place in a biological way, which is facilitated by the formula of the drops. A complex positive effect on the body is also expressed in the normalization of the acidity of the stomach. During the reception, a noticeable strengthening of the patient's immunity is observed.

For the convenience of treatment, drops are advised to be diluted in any warm liquid, with the exception of all types of animal milk. Water will be the ideal environment for patients of all ages. Such a solution can be used even for the treatment of infants. Possible side effects include allergies, diarrhea and constipation. In this case, the use should be stopped and consult a doctor.

8 Duphalac

Effective action
Country: Italy
Average price: 516 rubles.
Rating (2019): 4.7

The effectiveness of this drug lies in lactulose. The substance at the chemical level helps the breakdown of the disaccharide. The process lowers blood pressure and has a positive effect on the mucous membranes. However, all representatives of this class, including Dufalac, cannot be used for intestinal obstruction. If the patient is diagnosed with diabetes mellitus, you should either refuse to use it or visit a doctor's consultation to indicate the required dosage.

The drug has a fairly wide list of side effects. It can negatively affect both the digestive and central nervous systems. Simultaneous administration with antibiotics is also not recommended. The latter can reduce the effectiveness of Duphalac at times. Release form - syrup with a measuring cup.

7 Bifiform

Wide range of applications
Country: Denmark
Average price: 471 rubles.
Rating (2019): 4.7

The capsules of this medicine contain not only bifidobacteria. They also contain other bacteria that help restore comfort in the abdomen. In addition to the elimination of dysbacteriosis, Bifiform is recommended to be taken against diarrhea, rotavirus infections and acute intestinal diseases. A convenient capsule form of release allows you to combine private intake with activity - it is necessary to repeat therapy every four hours in case of exacerbation of diseases.

Reviews that this product is the best in the class against dysbacteriosis can be found almost everywhere. Bifiform is prescribed to patients with lactose intolerance. Some note the convenience of use in combination with antibiotics. The disadvantages may be the duration of therapy - 21 days for diseases of the microflora of the digestive tract. In addition, the treatment of children under three years of age with these capsules is prohibited.

6 Florin forte

The best quality
Country Russia
Average price: 635 rubles.
Rating (2019): 4.8

The prebiotic is available as a powder for suspension and oral administration. The drug should be diluted in liquid food. To speed up the action, pharmacists advise mixing the contents of the sachet with a fermented milk product, kefir is ideal. To normalize the health of babies, Florin forte is bred in breast milk. This type of application restores the intestinal microflora, has an immunomodulatory, antidiarrheal and digestive effect. Many note that the solution works great when paired with antihistamine tablets to combat allergies.

Bulk medicine is characterized by low price and availability. Users highly appreciate its quality in the fight against diseases of the mucous membranes, and also note the local strengthening of immunity. The downside, according to many people conducting therapy with Florin Forte, is an inconvenient release form. The sachets are difficult to open without the danger of losing valuable milligrams of the drug. In addition, the temperature standards for storing the powder (from +10 to 0 degrees) become an obstacle for treatment outside the home.

5 Linex

most popular drug
Country: Slovenia
Average price: 534 rubles.
Rating (2019): 4.8

One of the most popular products for dysbacteriosis contains eubiotics. This type of microorganism affects the active production of lactic acid, which helps in the fight against various types of intestinal problems and diseases of other mucous membranes of the human body. The work of the component is to shift to the acid side, in which harmful bacteria die and beneficial bacteria multiply. In addition, Linex helps to synthesize vitamin B, ascorbic acid and generally strengthen the oppressed immune system.

The drug is well tolerated by pregnant and lactating women. In general, it has no contraindications, except for unpredictable reactions to lactic acid. Usually this type of medication is contraindicated in patients with lactose allergy. For the treatment of children under 3 years of age, it is recommended to dilute the powder from the open Linex capsule in breast milk or its substitute.

4 Probifor

Quick result
Country Russia
Average price: 692 rubles.
Rating (2019): 4.8

Bifidobacterium class product. Its active action, aimed at restoring the intestines, is associated with activated charcoal, to which bifidobacteria are attached. Thus, they penetrate faster, begin cleansing and directly combat dysbacteriosis, which brings results sooner. Probifor can also be used to get rid of diarrhea and ARVI, when the patient's immunity is weakened, and the mucous membranes are prone to inflammation and ulcers.

The drug receives a positive assessment from users. Young mothers note its effectiveness in the treatment of intestinal diseases in children and even infants. The use can be started even in old age, but a doctor's consultation is necessary. The only significant disadvantage when buying can be the overpriced price of tablets.

3 Bifidumbacterin

Affordable price
Country Russia
Average price: 88 rubles.
Rating (2019): 4.9

The probiotic is available in two forms - capsules and powder for suspension. The biological origin of the drug is due to the presence of bifidobacteria in it - a long-standing fighter for the stabilization of the intestinal microflora. For a long time, this type of tablet is considered the best of its kind. The medicine will be an excellent choice for cleansing the body. Activated charcoal in the composition will help with severe intoxication. Ideal for getting rid of problems with the digestive system in expectant mothers.

A significant disadvantage may be the content of lactose in the structure of the capsules. In case of individual lactose intolerance, the medication is not recommended. According to reviews, Bifidumbacterin is basically suitable for all categories of patients. It is praised for its versatility (can be taken by children), for its active work with antibiotics and for its availability.

2 Acylact

Suitable for pregnant and lactating
Country Russia
Average price: 93 rubles.
Rating (2019): 4.9

The suppository version of the product perfectly fights any kind of dysbacteriosis. The powder helps to cope with the problems of all the mucous membranes in the body. In addition, it will help restore the patient's immunity and help with the acceleration of metabolism. The drug can be used to treat people of all ages, it is universal. It has no side effects and contraindications, and can also be prescribed for pregnant women and nursing mothers.

A significant disadvantage may be the form of release. The solution allows you to use the medicine on different parts of the body - in the form of tampons, inside and for rinsing. Nevertheless, its use in the middle of the working day may seem to someone inconvenient and difficult. An indisputable plus will be the low price of Atsilact.

1 Lactobacterin

The best all-rounder
Country Russia
Average price: 170 rubles.
Rating (2019): 5.0

The drug is available in two different forms - tablets and suppositories. The main task is to effectively combat the restoration of beneficial bacteria on different mucous membranes. Lactobacterin is usually taken for dysbacteriosis of the oral cavity and intestines. The obvious advantage of the drug is not only its versatility, but also the possibility of using it for the treatment of babies. Tablets can be given to children from the first days of life, and suppositories are intended for adult use only.

The main active ingredient in the formula are lactobacilli. They go well with antibiotics and do not have a negative effect on the liver. Nevertheless, due to only one necessary term, the remedy cannot be called a complex medicine that helps cleanse the body. This inexpensive drug will not help patients with severe disease.

Probiotics are live bacteria - microorganisms that live in the human body and positively affect its vital activity. Probiotic preparations contain various strains of bacteria.

There are bifid-containing, coli-containing, lacto-containing preparations. Also, the composition may contain yeast-like fungi, enterococci, aerococci, depending on the manufacturer and purpose. Probiotics are available in liquid and dry form.

Probiotics not only allow you to populate the intestines with the right microorganisms and overcome the pathogenic flora that causes various unpleasant symptoms, but also make it possible to increase immunity and effectively fight ailments. In this article, we look at inexpensive yet effective probiotics for the gut. Reviews, as well as a list of drugs with prices, you will find below.

When are probiotics prescribed?

According to the American Gastroenterological Association, probiotics are currently most commonly prescribed in the treatment of the following diseases and conditions:

1. infectious diarrhea caused by rotavirus infection, including in infants and young children - strains of lactobacilli species Lactobacillus rhamnosus and Lactobacillus casei.
2. - probiotic strains of lactic acid bacteria Bifidobacterium infantis and Lactobacillus plantarum and fungi Sacchromyces boulardii, as well as a combination of probiotics can help with bowel movements.
3. Antibiotic-associated diarrhea- Saccharomyces boulardii can prevent recurrence of the most dangerous and most common antibiotic-associated diarrhea caused by Clostridium difficile.

In addition, a gastroenterologist can prescribe probiotics for patient complaints of stool disorders, colic and frequent bloating and flatulence, a feeling of heaviness in the stomach, as well as other conditions.

How to take it right?

It is very important to choose the right probiotic for the treatment of a particular condition. To select a probiotic, you can use the following simple rules:

1. If you suspect a bacterial infection of the intestine(acute or chronic), it is recommended to take complex preparations containing lactobacilli and bifidobacteria at the same time (for example, Bacteriobalance, Bifidin, Linex, etc.).
2. If you suspect a viral infection of the intestine(acute or chronic), it is recommended to take drugs containing lactobacilli (for example, Lactobacterin, Narine, Biobacton, Primadophilus, etc.).
3. If you suspect a fungal infection of the intestine and genital organs (candidiasis of the intestine and vagina), it is recommended to take preparations containing bifidobacteria (for example, Probiform, Biovestin, Bifidumbacterin, etc.).

During therapy, it is recommended to first drink preparations with lactobacilli, then with bifidobacteria, and only after that with colibacteria (for example, Colibacterin). You can start taking immediately complex preparations that simultaneously contain bifidobacteria and lactobacilli.

Probiotics vs Prebiotics: What's the Difference?

The names of these two groups of drugs are very similar, so they are often confused.

• Probiotics are live microorganisms that belong to the normal intestinal microflora.
• Prebiotics are organic chemicals that have the ability to create excellent conditions for the reproduction of normal intestinal microflora.

It should be noted that the action of both prebiotics and probiotics is similar, because each of the groups of these agents normalizes the intestinal microflora.

Beneficial features

Most probiotic bacteria belong to two genera: lactobacilli (lat. Lactobacillus) and bifidobacteria (lat. Bifidobacterium), although you need to know that there are many other types of probiotic bacteria.

These drugs are capable of:

1. Produce substances that prevent various infections.
2. Prevent bacteria harmful to humans from attaching to the intestinal wall and inhibit their growth.
3. Inhibit the secretion or destroy toxins produced by some “bad” bacteria for the human body.
4. Stimulate the strengthening of the mucous layer in the intestines as a barrier against infections.
5. Increase the efficiency of the immune system by secreting antibodies to certain viruses.
6. Produce B vitamins necessary for food metabolism, preventing anemia that occurs when there is a lack of vitamins
7. B6 and B12, as well as maintaining the health of the skin and nervous system.

The described effects are more or less characteristic of all microorganisms related to probiotics. However, the mechanisms of these effects have not yet been fully elucidated.

Probiotics for the intestines: list and prices

To maintain intestinal health, the following drugs may be prescribed:

• Linex is one of the most famous probiotics that are common in Russia. It contains three components of the microflora, which are located in different parts of the intestine. Price 350-500 rubles.
• . It is often used in pediatrics for conditions characteristic of a violation of the colonization of the intestine by flora, in combination with antibiotics and other drugs. It contains Bifidobacterium bifidum N1 in dry powder form. Price 350-400 rubles.
• More concentrated bifidobacteria are contained in Probifor - one sachet contains about 10 servings of bacteria that are in Bifidumbacterin. Price 500-600 rubles.
• . In addition to probiotic strains of lacto- and bifidobacteria, it contains Escherichia coli. Combined with antibiotic therapy, thanks to the protective capsule, it easily overcomes the acidic environment of the stomach. It is one of the best encapsulated probiotics for adults. Price 350-400 rubles.
• Florin forte. It is a powder containing lacto- and bifidobacteria. It is prescribed for both adults and children and newborns. Due to the combination of bacteria, it has a complex effect, but it does not combine well with some antibiotics. Price 500-550 rubles.

Depending on the time of creation and improvement, several generations of probiotics are distinguished:

• I generation - classic monocomponent preparations, consisting of one strain of microorganisms - typical inhabitants of the intestine (bifidumbacterin, lactobacterin, etc.);
• II generation - self-eliminating antagonists (bactisubtil, enterol, biosporin, etc.);
• III generation - polycomponent preparations (symbiotics), consisting of several (from 2 to 30) bacterial strains (bifilong, etc.) or several types of bacteria (linex, bifikol, etc.);
• IV generation - combined preparations (synbiotics), consisting of a strain of bacteria and ingredients that promote their growth, reproduction and metabolic activity (bifilis, kipacid, etc.);
• V generation - multicomponent combined preparations (synbiotics), consisting of several types of bacteria and ingredients that promote their growth, reproduction and metabolic activity (floristin, bifiform, etc.).

In addition, the form of the probiotic must be considered. All of them are divided into:

• Dry probiotics(lactobacterin, bifidumbacterin, colibacterin, etc.);
• Liquid forms (biovestin, biovestin-lacto, floristin, trilact, bifidum No. 791 BAG, liquid bifido- and lactobacterins, lactoflor, etc.);
• Sorption forms s (ecoflor, probifor, bifidobacterin forte, bifikol forte, etc.);
• Enteric coated capsules(linex, bifiform).

And if earlier liquid probiotics for the intestines were considered the best, today capsule preparations are increasingly common. Modern technologies allow you to effectively store all the necessary bacteria in the capsule. Those who take probiotics unanimously declare that it is much more convenient to drink drugs in capsules, like a vitamin: I took it out of the package, washed it down with water and forgot ...

Probiotics in foods

Sources of prebiotics are: dairy products, bread, cereals, peas, corn flakes, garlic, bananas, onions, beans and some other types of foods. One of the most popular foods that provide probiotic intake is yogurt.

In addition, their sources are: most dairy products, such as cheese, kefir, cottage cheese, buttermilk. There are several other examples of probiotics: sauerkraut, kimchi, pickles, bread, wine, soy sauce.

Dysbacteriosis is a problem of many people, imperceptible from the outside, but it brings severe discomfort and makes serious changes in habitual life. Drugs that get rid of dysbacteriosis are advertised everywhere, but in order to choose exactly the medicine that will really help eliminate this disease, you need to understand their varieties and properties.

Tablet preparations for the treatment of dysbacteriosis can be divided into two main groups - antibacterial (eliminate the main cause of the disease - pathogenic microorganisms) and probiotic (promote the reproduction of intestinal normal flora, increase immunity).

The cause of dysbacteriosis may be enterococcal, candidiasis and other infections. Common drugs for drug treatment are Levomycetin, Streptomycin, Nystatin, Intetrix, Pifamucin, Furazolin, Enteroseptol.

A doctor can prescribe drugs for the treatment of dysbacteriosis only after bacterial seeding and determining the sensitivity of the pathogen to the selected agent.

Drugs that increase immunity, normalize the microflora and eliminate the negative symptoms of dysbacteriosis:

Sorbents. Polypefan, activated charcoal, Pepidol are sorbent preparations that bind toxic substances and prevent the spread of putrefactive processes in the intestine. Used at the first stage of treatment of dysbacteriosis.

BS from live strains. Bificol, Bactisubtil, Enterol, Colibacterin - are used in the first and second stages of dysbacteriosis, are made on the basis of microorganisms that form the intestinal normal flora.

Prebiotics. Duphalac, Normaza, Hilak-Forte belong to the group of prebiotics that do not contain strains of microorganisms, but create favorable conditions for the development of beneficial microorganisms, and can be used at any stage of the treatment of dysbacteriosis.

Bifidumbacterin, Linex, Narine, Lactobacterin, Bifiform are probiotics that represent an extensive group of drugs used to treat dysbacteriosis of any stage. They contain live strains of beneficial bacteria that normalize the intestinal microflora and inhibit pathological microorganisms.

Enzymes. Mezim-Forte, Polyzyme, Digestal, Panzinorm-Forte belong to a group of enzymes that help normalize digestive processes, digest food and absorb useful components in the stomach and intestines.

Immunomodulators. Levomizol, Decaris are immunomodulators, contribute to the normalization of local immunity of the gastrointestinal tract, are used at the final stages of treatment to consolidate positive results.

Restorers of motor functions. Duspalatin, Trimedat, Meteospasmil, Immudon - these drugs restore normal intestinal motility, which helps to remove symptoms such as diarrhea, bloating, flatulence.

Stimulants of the intestinal epithelium. Essentiale and other drugs that stimulate the work of intestinal epithelial cells help get rid of intestinal colic.

7 best drugs for dysbacteriosis

The emergence of a wide variety of remedies for dysbacteriosis is due to different criteria for evaluating their effectiveness, which makes it difficult to find one best medicine.

Consider several well-known drugs according to these criteria:

Lactobacterin, available in the form of tablets and powder - does not have a capsular shell, is not used for candidiasis or hypersensitivity, allergic reactions are possible as a side effect, can be taken with an antibiotic, there are no contraindications for pregnant women, storage in the refrigerator is required.

Acylact (suspension, tablets), contraindicated in candidiasis, possible allergy to the drug, simultaneous administration with antibiotics is allowed, pregnant women are prescribed as directed by a doctor, contraindicated in children under 3 years old, stored in the refrigerator for up to 12 months.

BioBacton - not available in capsules, prohibited for candidiasis, there is a possibility of an allergic reaction, compatible with antibiotics, suitable for children, stored in the refrigerator.

BifidumBacterin- powder and solution in ampoules, cancellation if hypersensitivity or candidiasis is detected, incompatible with antibiotics, prescribed for children from 3 years old, pregnant and lactating mothers - only according to indications, storage is carried out in a refrigerator.

Probifor - without a capsule shell, without contraindications, without side effects, compatible with antibiotics, regular use of the drug during pregnancy and lactation is possible, suitable for children older than six months, store in the refrigerator.

Hilak forte - there is no capsule shell, as well as contraindications and side effects, it can be taken with antibiotics, during pregnancy and lactation, it is universal for any age, it is stored at a temperature of less than 10 ° C.

Linex - is available in a capsule shell, has no contraindications and any side effects, can act in parallel with antibiotics, without age restrictions, can be stored in a dry room with an air temperature of no more than 25 ° C.

Probiotics based on lactobacilli

Distinguish tablet and powder form of drugs in this group. The first includes Lactobacterin, the second is represented by Biobacton and Atsilact. Acylact is also available in the form of suppositories, which is considered safer to use, as it does not inhibit beneficial microorganisms that live in the intestines. The above funds can be taken together with antibacterial drugs, but they are not suitable as the only treatment for complex dysbacteriosis, as they are monopreparations, that is, they contain a medicinal substance of the same type.

Probiotics based on bifidobacteria

Probiotic preparations based on bifidobacteria have a variety of forms of release and are among the very first means of treating dysbacteriosis. So, there are tablet form (Bifidobacterin forte) and powder form (Probifor) of medicines. There are contraindications for the use of suppositories and tablets with bifodobacteria for children under the age of three, and drugs in this group are not combined with antibiotics.

Probiotics - a combination of bifido- and lactobacilli

This type includes the powdered probiotic Florin Forte, suitable for children from infancy and adults. For infants, the drug is mixed in the proportion indicated by the doctor with a formula for feeding or breast milk, older children and adults take the drug with food. Florin Forte requires special storage conditions that are easily observed in the refrigerator: 0 - 10 ° C. Some antibiotics can worsen or change the work of Florin, therefore, for the simultaneous use of these drugs, it is necessary to consult a doctor who will help you choose an effective combination of drugs.

The analogue of Florin Forte in terms of the composition of bacteria is Linex.

Compared with the first drug, it has undeniable advantages:

An additional enterococcus in the composition of the drug enhances the complex effect;

There are no special requirements for storage conditions;

Easily combined with other antibiotics;

It has no contraindications for pregnant and lactating mothers.

It has no contraindications for age - infants do not have to mix the product into milk, but you can simply dissolve the contents of the capsule in warm water.

Probiotics with bifidus and lactobacilli can be dangerous for patients in an immunodeficient state or excessive allergic sensitivity. In the presence of these health defects, you should consult a doctor for the correct calculation of doses and the possibility of taking probiotics.

Probiotics based on bifidobacteria in combination with other bacteria

An interesting combination is the drug Bifikol, which contains, in addition to the standard set of bifidobacteria, opportunistic E. coli, which is also normally found in the intestinal microflora and is able to suppress microbes with greater pathogenicity. Unfortunately, the simultaneous administration of a course of antibiotics and Bificol can be harmful to the body, which cannot be said about its counterpart Bifiform with enterococci.

Prebiotics based on lactulose

It is known that simple, rapidly digestible carbohydrates are the main resource for the development of pathogenic intestinal microflora. Lactulose prebiotics contain a special enzyme that breaks down carbohydrates into organic acids that inhibit the development of microbes and reduce blood pressure.

Known drugs from this group:

• Portalac;

  Romfalac.

Prebiotic preparations

To maintain and restore the balance of the intestinal microflora, medicines with light acid and fatty acids have been invented, which contribute to the regeneration of the natural microflora. Hilak forte, for example, helps to strictly maintain the balance of electrolytes and restore the epithelial cells of the intestinal mucosa. Lactobacilli in its composition secrete lactic acid, which regulates acidity, favorable for the development of beneficial microflora.

Drug treatment of dysbacteriosis is carried out not only with preparations in the form of capsules and tablets, but also in the form of suppositories, which differ in composition (antibiotics, probiotics) and in the method of use (vaginal, rectal). The advantages of this dosage form of drugs include local effects, which allows you to normalize the microflora locally, without affecting the entire body in general.

Vaginal

Vaginal suppositories are used to treat bacterial vaginosis in women, to restore the normal microflora of the vagina.

Polygynax, Terzhinan, Betadine - antibacterial suppositories inhibit the development of pathogenic microorganisms (bacteria and fungi), prevent trichomoniasis and other infections. Contraindication for use is pregnancy, especially in the later stages.

Labilact, Acilact, Vagilact, Gynoflor - candles with a probiotic complex, which is made up of lactobacilli, bifidobacteria, as well as estriol, lactose and other ingredients. These drugs restore the normal microflora of the vagina after antibiotic treatment, with excessive reproduction of pathogenic microorganisms due to hormonal imbalance, with weakened immunity, diabetes and thrush.

Rectal

Rectal suppositories restore the normal intestinal microflora in adults and children, there are two groups of agents - antibacterial and probiotic.

Apis, Kipferon, Prostopin, Anuzol, Nilegan, Genferon, Levomycetin, Procto, Viferon - antibacterial, antimycotic rectal suppositories contain local antibiotics, antiviral and antifungal agents, glucocorticosteroids can be included in their composition, which prevents inflammation of the intestinal walls. The local method of using suppositories eliminates side effects, while maintaining the maximum effectiveness of the remedy for dysbacteriosis of any complexity. However, rectal antibacterial suppositories should not be used during pregnancy.

Bifinorm, Laktonorm, Lactobacterin, Bifidumbacterin are suppositories with a probiotic complex that supply the intestines with beneficial microorganisms, restoring its normal microflora. The use of probiotics in the form of suppositories is more effective than in the form of tablets or capsules, since lacto- and bifidobacteria are not destroyed during the passage of the gastrointestinal tract, but are immediately delivered to their usual habitat.

Orthoprebio - the best dietary supplement for dysbacteriosis

Among dietary supplements for improving gut health in dysbacteriosis, the prebiotic OrthoPrebio gives the best results. Its effectiveness is explained by the uniqueness of the main ingredient of the drug - inulin enriched with oligofructose. This is an original patented product manufactured in Belgium under the trade name Raftilose Synergy1.

Among the unique properties of this drug:

Protection of the large intestine along the entire length;

Not able to cause an allergic reaction, as sometimes occurs with milk-based prebiotics;

It is not absorbed through the intestinal mucosa, therefore it does not enter the bloodstream and does not require filtration and excretion by the kidneys;

Works in combination with Fibregum acacia resin produced in France by ColloidesNaturels International;

Pleasant to eat due to the sweet taste that oligofructose gives.

A detailed study of the properties of the complex preparation of inulin and oligofructose is devoted to many studies by international scientists from advanced scientific institutions of the most developed countries. The Synergy1 formula is heavily used in the pharmaceutical industry in Japan, the European Union, the USA and more than 50 countries.

The practice of using OrthoPrebio shows that natural plant inulin with oligofructose works several times more efficiently than similar preparations with lower quality ingredients.

Education: Diploma in the specialty "Medicine" received at the Russian State Medical University. N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.

Bacterial preparations(lat. praeparatum cooked) - bacterial cells, their metabolic products or antibodies against them, used for the prevention, diagnosis and treatment of infectious diseases. They are suspensions of live or inactivated bacteria in various ways (vaccines, bifidumbacterin, colibacterin, lactobacterin, diagnosticums, etc.); individual components of microbial cells (protective antigens, allergens, etc.); bacterial waste products (enzymes, native and neutralized toxins, restrictases, antibiotics, bacteriocins, etc.); Serums or their individual fractions obtained by hyperimmunization of animals with bacteria or bacterial waste products.

For its intended purpose bacterial preparations subdivided into therapeutic and prophylactic vaccines, toxoids, sera, immunoglobulins (see Immunotherapy), antibiotics , enzymes, tomicid, bifidumbacterin, fibrinolysin, medicinal bacteriophages and etc.; diagnostic - agglutinating, precipitating, luminescent sera, diagnosticums, toxins, allergens, restrictases, bacteriophages, etc.

Bifidumbacterin, colibacterin, bifikol, lactobacterin, etc. are used to treat chronic colitis of various etiologies and other dysfunctions of the gastrointestinal tract against the background of dysbacteriosis in order to correct the intestinal microflora.

Bifidumbacterin is a freeze-dried suspension of living bacteria of an antagonistically active strain of Bifidobacterium bifidum I. Bifidumbacterin can be prescribed to children from the first days of life: with early transfer of children to artificial feeding; in the complex treatment of patients with sepsis, pneumonia and other infectious diseases, children with malnutrition, premature babies. For adults, the drug is indicated for chronic inflammatory diseases of the large and small intestines, with bacterial colpitis of staphylococcal and Escherichia etiology, senile colpitis of a hormonal nature. Bifidumbacterin is used orally, in obstetric and gynecological practice - intravaginally. There are no contraindications. Release form: vials and ampoules of 2, 5, 10, 20, 50 and 100 doses.

Colibacterin is a freeze-dried suspension of live bacteria of an antagonistically active strain of Escherichia coli - Escherichia coli M-17. It is intended for the treatment of patients with chronic colitis of various etiologies and aftercare of persons who have had acute intestinal diseases in the presence of intestinal dysfunction or severe dysbacteriosis without clinical manifestations. Assign the drug orally to adults and children from 6 months of age (in ampoules or vials), from 3 years - in tablets. In the treatment of colibacterin, vitamins are recommended. Sulfonamides and other anti bacterial preparations during treatment with colibacterin should not be used. There are no contraindications to the use of colibacterin. Release form: ampoules and vials of 2-30 doses, tablets.

Bifikol is a mixture of live bacteria of antagonistically active strains of B. bifidum I and E. coli M-17. Assign and apply in the same way as colibacterin. Release form: 2-100 doses.

Lactobacterin is a suspension of live freeze-dried bacteria of an antagonistically active strain of Lactobacillus plantanim. Release form: in dry form in ampoules (3 doses), vials (up to 30 doses), tablets.

For the treatment of infections caused by gram-positive cocci (tonsillitis, pyoderma, suppuration of wounds), as well as for the prevention of suppuration of postoperative wounds, tomicid is intended - a sterile product of the metabolism of non-pathogenic streptococcus.

Has a bactericidal effect against gram-positive cocci. Applied externally. Before use, the vial with tomicid is shaken and the transparency of the liquid is checked; cloudy preparation is not suitable for use. For rinsing, the preparation is heated to t° 37-42°. If the tomicid comes into contact with the affected area of ​​the skin, a short-term burning sensation may occur. There are no contraindications to the use of tomicid. Release form: hermetically sealed bottles of neutral glass with a capacity of 100, 250, 500 ml.

For the diagnosis of infectious diseases, diagnosticums are used - suspensions of bacterial cultures (as antigens for detecting antibodies in agglutination reactions) or erythrocytes sensitized by bacterial antigens (erythrocyte diagnosticums). Instead of erythrocytes, latex particles, a suspension of staphylococci with expressed protein A can be used. In the reaction of passive hemagglutination, latex agglutination, co-agglutination, not only antibodies can be determined using antigenic diagnosticums, but also antigens in macroorganism fluids using antibody diagnosticums, in which the active the beginning is a certain diagnostic serum. Diagnostic kits are produced for the serodiagnosis of brucellosis, gonorrhea, intestinal infections (salmonella and dysentery), whooping cough and parapertussis, meningococcal infection, tularemia, anthrax, scleroma, to determine tetanus and diphtheria toxins in the blood, etc.

In enzyme-linked immunosorbent assay, the enzyme peroxidase from horseradish root, alkaline phosphatase, b-galactosidase, and inorganic pyrophosphatase are used as a marker of diagnosticum. ELISA systems are being created to detect antibodies to whooping cough, pneumococcus, teichoic acids, staphylococcus, Pseudomonas aeruginosa, for the serodiagnosis of syphilis, for the diagnosis of diphtheria (detection of toxigenic strains based on the use of monocloial antibodies), for the detection of antigens A and C of meningococcus, antigens and antibodies to tularemia and brucella microbes.

Establishing the source of infectious agents, ways of their transmission in acute intestinal and nosocomial infections is impossible without marking isolated strains for O-, H-, K-antigens, etc., since the antigenic structure of bacteria is one of the stable markers that allow intrageneric and species differentiation of microorganisms . For these purposes, diagnostic agglutinating sera are produced (diagnostic O-serum of citrobacter, proteic diagnostic O- and H-serum, sera against Pseudomonas aeruginosa).

One of the important steps in the bacteriological diagnosis of acute intestinal diseases is the serological typing of enterobacteria isolated from patients for O-, H-, K-antigens, etc. in the agglutination reaction with the corresponding diagnostic sera.

For serological typing for O-, OK- and H-antigens of Escherichia, poly- and monovalent agglutinating sera, OK-immunoglobulins, as well as rapid systems have been developed that allow one-stage determination of O- or H-antigens, while the number of necessary preparations is reduced . There is a significant range of diagnostic agglutinating sera intended for serotyping of Salmonella and Shigella.

The production, control and use of bacterial preparations are regulated by production regulations, pharmacopoeial articles, instructions for use approved by the USSR Ministry of Health.

Release bacterial preparations in liquid or dry form in ampoules or vials, as well as in tablets and dragees. Each ampoule, vial, jar (package) with tablets must be labeled or have a label. The label (marking) must contain the name of the drug and the company that manufactured it, the batch number, the state control number, the expiration date, the amount of the drug. Additional information on the labels depends on the type of drug and its purpose. Bacterial preparations should be stored in a dark dry place t° from +2° to +10°. Drugs with erased markings or without labels, with foreign inclusions, changed their appearance, expired should not be used.

Bibliography: Handbook on the use of bacterial and viral preparations, ed. S.G. Dzagurova and F.F. Rezepova, M., 1975.