In modern medicine, antibiotics of the penicillin group are widely used for standard forms of inflammatory diseases. Although semi-synthetic penicillins have recently been used more often, a simple version of this drug is often indispensable for otitis, cystitis and sore throats in children.

The antibiotic penicillin is one of the first forms of targeted antibacterial agents invented by man. At the time of its discovery, it was a powerful drug that helped save the lives of patients with pneumonia and. Before the invention of penicillin, pneumonia was a fatal disease in almost 90% of cases. But, a few years later, doctors began to notice a decrease in the activity of the antibiotic penicillin against the vast majority of pathogens. This was the impetus for the development of new antibacterial agents.

However, with each new generation, antibiotics acquired not only powerful antibacterial properties, but also severe side effects. At the same time, simple, completely natural penicillin was gradually forgotten. Today, the use of first generation penicillin is recommended by all foreign microbiologists. The point is simple. Immediately after the invention of penicillin, a gradual decrease in its activity began to appear due to bacterial mutations. They began to adapt to this antibiotic and develop a kind of immunity against it. Subsequently, this process progressed. Man invented new bacteria - new forms of adaptation.

According to recent microbiological studies, resistance to the antibiotic penicillin in bacteria is low. This means that it can be successfully used in the treatment of bacterial infections caused by bacteria sensitive to this drug.

The main pharmacological action of penicillin is aimed at disrupting protein synthesis in bacterial cells. As a result of disruption of the permeability of the cell membrane, it causes destruction and death of bacteria. This determines its rapid bactericidal effect. Unlike other antibiotics, it does not slow down the reproduction of pathogens, but provokes their disappearance.

Low resistance to penicillin has been experimentally proven in:

1. gram-positive bacteria that cause inflammation of the respiratory system and urinary system;
2. gram-negative bacteria of the cocci group, including those causing meningitis, gonorrhea, syphilis;
3. bacteria of the actinomycete group.

The maximum concentration in the biological media of the human body is achieved with intramuscular administration of the drug. In this case, the increase in percentage begins 5 minutes after the injection of penicillin and reaches its maximum after 30 minutes. The antibiotic penicillin freely penetrates into the blood, urine, and bile, binding to blood plasma proteins. Cerebrospinal fluid, tissue in the eye area and the prostate gland are inaccessible to him. Therefore, in the treatment of gonorrhea in men, penicillin is used in combination with other drugs.

The antibiotic penicillin is available in tablets and vials for injection in the form of a dry powder. Before use, it is diluted with physiological sodium chloride solution or novocaine.

Where is penicillin used?

Penicillin is used in the treatment of inflammatory bacterial infections of the upper respiratory tract. In particular, it gives good results in the treatment of catarrhal and lacunar tonsillitis. The drug is effective in combination with sulfonamides in the treatment of uncomplicated forms of pneumonia. Used in the treatment of pyelonephritis, consequences of urolithiasis, cystitis in combination with nitrofuran drugs.

Other indications for the use of penicillin include:

• inflammation and purulent lesions of the epidermis, including erysipelas;
• otitis and sinusitis;
• chronic and acute forms of pleurisy with effusion;
• endocarditis, pericarditis, rheumatic heart defects;
• some sexually transmitted infections (syphilis, ureaplasmosis, toxicoplasmosis);
• infectious diseases, among which scarlet fever and anthrax are most successfully treated with penicillin.

Penicillin is not effective for intestinal infections, in particular dysentery and salmonellosis. This drug is not stable in an acidic environment and is quickly destroyed in the intestine by penicillinase.

Treatment of inflammatory diseases with penicillin

For effective treatment of inflammatory diseases with penicillin, two factors are important. This is the correct selection of the method of administration and the exact determination of the daily and single dosage. It is recommended that the course of treatment for acute conditions and severe diseases begin with intramuscular administration. The half-life of penicillin in human tissues and body fluids is just over 4 hours. Therefore, to maintain maximum concentration, injections should be given at intervals of 4 hours. Those. 6 times daily administration of penicillin is necessary to obtain a high-quality treatment result.

The dosage is calculated based on the patient’s weight, the severity of his condition and the type of pathogen. Approximate dosages can be seen in the table below; the course of treatment is at least 10 days.

Can children take penicillin?

Penicillin can be prescribed to children from 1 year of age. At an earlier age, this drug can have an otogenic effect, which in the future will negatively affect the development of hearing in the baby. Penicillin injections to children can only be given in a hospital setting. At home, only oral administration of the drug is allowed.

Use of penicillin during pregnancy and lactation

During pregnancy, penicillin is strictly prohibited for intramuscular and internal use. Can be used as an ointment on limited areas of the skin.

Penicillin should also be avoided during breastfeeding. It easily passes into breast milk and has an extremely negative effect on the infant.

Allergy to penicillin

Allergies to penicillin are quite common. In this case, an allergic reaction after intramuscular injection often develops like anaphylactic shock, which is dangerous for the patient’s life. Therefore, before prescribing penicillin, a skin test is mandatory.

To do this, the nurse makes a small scratch on the inside of the patient's forearm. A penicillin solution prepared for injection is applied to the wound surface. After 30 minutes the reaction is checked. If there is even slight redness at the scratch site, penicillin cannot be used in this patient.

To reduce the level of local irritation, penicillin should be diluted with a solution of novocaine before injection. Although dilution with sodium chloride solution is usually recommended.

Penicillin is the first artificially synthesized antibiotic. It was isolated by the famous British bacteriologist Alexander Fleming in 1928. Penicillin is a beta-lactam drug. It is capable of inhibiting the synthesis of the cell membrane of microorganisms, which leads to their destruction and death (bactericidal effect).

For a long time, this antibiotic was the drug of choice for a variety of bacterial infections caused by staphylococci, streptococci, corynebacteria, neisseria, anaerobic pathogens, actinomycetes and spirochetes. Now penicillin is mainly used for the following indications:

The indisputable advantage of penicillin is its low range of side effects, which allows it to be used for almost all categories of patients. Sometimes various allergic reactions are observed - urticaria, rash, anaphylactic shock and others. With long-term use, cases of candida infection have been described.

However, the active use of penicillin in clinical practice has led to the development of resistance. For example, staphylococci began to produce a special enzyme, penicillinase, which is capable of breaking down this antibiotic. Therefore, a pressing question arose regarding what to replace penicillin with.

Amoxicillin is a newer drug from the penicillin group.

The drug also has a bactericidal effect and easily passes through the blood-brain barrier. Partially metabolized in the liver and excreted from the patient's body through the kidneys.

Among the disadvantages of amoxicillin is the need for multiple doses. Today, this drug is widely used for the treatment of respiratory tract infections (pharyngitis, tonsillitis, sinusitis, tracheitis, bronchitis), genitourinary system (cystitis, urethritis, pyelonephritis), as well as salmonellosis, leptospirosis, listeriosis, borreliosis and gastric ulcer caused by Helicobacter pylori infection .

Amoxicillin should not be prescribed in case of hypersensitivity to penicillin drugs, infectious mononucleosis (specific rash or liver damage occurs). Side effects include various allergic reactions, Stevens-Johnson syndrome, dyspeptic disorders, transient anemia and headache.

The drug is presented in pharmacies under the names “Amoxicillin”, “Amofast”, “V-Mox”, “Flemoxin Solutab”. The price varies greatly depending on the manufacturer.

Adults are usually prescribed amoxicillin 500 mg 3 times a day, and children weighing less than 40 kg are prescribed at a rate of 25-45 mg per 1 kg. Treatment for diseases with mild or moderate severity is carried out for a week; for more serious pathologies, the course is extended to 10 or more days.

Ampicillin, as an analogue of penicillin, has been used to treat bacterial pathologies since 1961. It also belongs to the group of penicillins and has a bactericidal effect.

But unlike previous drugs, its spectrum of action includes not only gram-positive microorganisms, but also gram-negative ones (Escherichia coli, Proteus, Haemophilus influenzae and others). However, many bacteria can break it down using penicillinase.

Today ampicillin is used for:

Ampicillin should not be prescribed if there is a history of allergic reactions to penicillins, liver dysfunction, infectious mononucleosis, leukemia and VIL infection. Cases of neurological symptoms occurring after taking the drug have been described. Dyspeptic symptoms, candidiasis, toxic hepatitis and pseudomembranous colitis are also sometimes observed.

The drug is available in the form of tablets for oral use of 0.25 g or powder for internal administration. The following trade names exist: “Ampicillin”, “Ampicillin-Norton”.

You can also replace penicillin with Augmentin, a combination drug of the antibiotic amoxicillin and clavulanic acid. The latter is a specific inhibitor of penicillinase, which is produced by streptococci, staphylococci, enterococci and neisseria. This avoids the destruction of the antibacterial drug, which significantly increases its effectiveness in situations of increased resistance of microorganisms. Augmentin was first synthesized and produced by the British pharmaceutical company Beecham Pharmaceuticals.

Most often the drug is prescribed for bacterial inflammatory processes of the respiratory system - bronchitis, tracheitis, laryngitis, otitis, sinusitis and community-acquired pneumonia. Augmentin is also used for cystitis, urethritis, pyelonephritis, osteomyelitis, gynecological pathologies, and the prevention of complications after surgical operations and manipulations.

Contraindications include various liver dysfunctions, increased sensitivity of the patient's body to penicillin antibiotics, and lactation in women. Most often, taking the drug is accompanied by the following side effects:

• allergic reactions;
• dyspeptic disorders;
• pseudomembranous colitis;
• headache;
• dizziness;
• drowsiness or sleep disturbance;
• Quincke's edema;
• toxic transient hepatitis.

Augmentin is available in powder form for syrup or tablets for oral administration. The suspension is used for children weighing more than 5 kilograms at the rate of 0.5 or 1 ml of the drug per 1 kg. For adolescents and adults, tablet form is used. Typically take one tablet (875 mg amoxicillin/125 mg clavulanic acid) 2 times a day. The minimum duration of therapy is 3 days.

Cefazolin belongs to the group of first generation cephalosporins. Like penicillins, it contains a beta-lactam base, which gives it a bactericidal effect against a significant number of gram-positive bacteria.

This antibiotic is used only for intravenous or intramuscular administration. Therapeutic concentration in the blood remains for 10 hours after administration.

Cefazolin also does not penetrate the blood-brain barrier and is almost completely excreted from the body by the patient’s kidneys. Today, the drug is used primarily to treat mild forms of respiratory system infections, as well as bacterial inflammation of the urinary tract (especially in children, pregnant women and the elderly).

Cefazolin should not be prescribed if the patient is hypersensitive to cephalosporins or penicillins, or combined with bacteriostatic drugs. When using it, allergic reactions sometimes develop, the filtration function of the kidneys is temporarily impaired, dyspeptic disorders appear, and a fungal infection occurs.

Cefazolin is produced in vials with 0.5 or 1.0 g of active ingredient for the preparation of injections. The dose of the drug depends on the type and severity of the infection, but usually 1.0 g of antibiotic is prescribed 2 or 3 times a day.

Today, ceftriaxone is one of the most used antibiotics in hospitals. It belongs to the third generation of cephalosporins. Among the serious advantages of the drug is the presence of activity against gram-negative flora and anaerobic infections. Also, ceftriaxone, unlike cefazolin, penetrates well through the blood-brain barrier, which allows it to be actively used for the treatment of bacterial meningitis in situations where there are no results of bacteriological testing yet. In addition, resistance to it is observed much less frequently than to drugs of the penicillin group.

Ceftriaxone is used to treat inflammatory processes of bacterial etiology of the respiratory, genitourinary and digestive systems. The antibiotic is also prescribed for meningitis, sepsis, infective endocarditis, Lyme disease, sepsis, osteomyelitis and for the prevention of complications during surgical procedures and operations.

Of particular importance is the use of ciftriaxone for neutropenia and other conditions with impaired hematopoiesis. This is due to the fact that the drug, unlike many other groups of antibiotics, does not inhibit the proliferation of blood cells.

Ceftriaxone should not be prescribed together with drugs containing calcium (Hartmann and Ringer solutions). When used in newborns, an increase in bilirubin levels in the blood plasma was noted. Also, before the first dose, it is necessary to test for the presence of hypersensitivity to the drug. Side effects include digestive disorders, allergic reactions and headaches.

The drug is produced in powder form in bottles of 0.5, 1.0 and 2.0 g under the names: “Altsison”, “Blitsef”, “Lendatsin”, “Norakson”, “Rotacef”, “Cefogram”, “Ceftriaxone” . The dosage and amount of administration depends on the age, pathology of the patient and the severity of his condition.

Everyone knows about penicillin. This antibiotic has saved many lives. But today it is no longer so popular, as more modern medicines have appeared. However, despite this, it can still be found in the pharmacy. Why is this so? The fact is that penicillin helps much better with purulent infections and some inflammations than other antibiotics. In addition, it is safer for the human body. We will tell you more about penicillin and the history of its discovery in this article.

Penicillin is the first antibiotic that was discovered at the beginning of the 20th century. It was discovered by one famous bacteriologist - Alexander Fleming. During the war he worked as a military doctor. And at that time there were no antibiotics, so many people died due to blood poisoning, inflammation and complications. Fleming was very upset by this and he began to work on creating a medicine that could save people from various infections.

Thanks to his talent and perseverance, Fleming was already famous in scientific circles by the age of 20. At the same time, he was a terrible slob, but oddly enough, this was precisely what played a decisive role in his discovery. At that time, all experiments with bacteria were carried out in the simplest bioreactor (Petri dish). This is a wide glass cylinder with low walls and a lid. After each experiment, this bioreactor had to be well sterilized. And then one day Fleming got sick and during the experiment he sneezed, right into this Petri dish, into which he had already placed a bacterial culture. A normal doctor would immediately throw everything away and sterilize everything again. But Fleming did not do this.

A couple of days later, he checked the cup and saw that in some places all the bacteria had died, namely where he had sneezed. Fleming was surprised by this and began to work on it in more detail. A little later, he discovered lysozyme - a natural enzyme in the saliva of humans, animals and some plants, which destroys the walls of bacteria and dissolves them. But lysozyme acts too slowly, and not on all bacteria.

As mentioned above, Fleming was a slob and very rarely threw away the contents of Petri dishes. He did this only when the clean ones had already run out. And then one day he went on vacation, and left all the cups unwashed. During this time, the weather changed many times: it got colder, warmer, and the humidity level increased. Because of this, fungus and mold appeared. When the scientist returned home, he started cleaning and noticed that in one cup with staphylococci there was mold that killed these bacteria. By the way, this mold was also introduced completely by accident.

Until the 40s, Fleming actively studied his new discovery and tried to understand production technology. And he had to fail many times. Penicillin was very difficult to isolate, and its production was not only expensive but also slow. Therefore, he almost abandoned his discovery. But doctors from Oxford University saw the drug's future potential and continued Fleming's work. They disassembled the technology for producing penicillin, and already in 1941, thanks to this antibiotic, the life of a 15-year-old teenager who had blood poisoning was saved.

As it turned out later, similar studies were also carried out in the USSR. In 1942, penicillin was obtained by Zinaida Ermolyeva, a Soviet microbiologist.

By 1952, the technology had been improved, and this antibiotic could be purchased at any pharmacy. It has become widely used to treat various inflammations: pneumonia, gonorrhea, and so on.

We all know that antibiotics destroy not only pathogenic microbes, but also our microflora, that is, beneficial microbes. Penicillin works completely differently. It does not cause any harm to the human body and only acts on bacteria. This antibiotic blocks the synthesis of peptidoglycan, which takes part in the construction of new bacterial cell walls. As a result, the proliferation of bacteria stops. Our cell membranes have a different structure, so they do not react in any way to the administration of the drug.

A lot of time has passed since the creation of penicillin. Scientists have already discovered the fourth generation of antibiotics. Therefore, most doctors began to make complaints about penicillin - they say it is no longer effective, since the bacteria are accustomed to it. In addition, it disrupts the intestinal microflora. But is this really so?

Doctors are right about the fact that antibiotics disrupt the intestinal microflora. But we should not forget that today there are special preparations that help restore this microflora. In addition, antibiotics are no more harmful than smoking, alcohol, and so on.

Allergy to penicillin

A person can have an allergic reaction to any medicine. Therefore, taking any medication, especially antibiotics, should be prescribed and monitored by a doctor.

An allergic reaction to penicillin manifests itself as follows:

• signs of hives may appear;
• anaphylaxis;
• attacks of suffocation;
• angioedema;
• fever.

To avoid such symptoms, it is recommended to conduct an allergy test before prescribing treatment with penicillin. To do this, you need to inject a small amount of antibiotic into the patient and see what the body’s reaction will be. In small quantities, the drug will not cause any harm, so there is no need to worry that the sample may cause one of the above symptoms.

It is also worth noting that an allergy to penicillin may disappear over time. This is evidenced by some studies conducted by specialists.

As you can see, penicillin is a very useful antibiotic. During the time that it existed, this medicine was able to save many lives. It is prescribed for inflammatory processes. Since its discovery, it has been improved several times. Due to this, the microbes have not yet adapted to it. This is the reason for the highly effective action of this antibiotic.

Penicillin is the world's first antibiotic, which became a real salvation for millions of people. With its help, doctors were able to declare war on diseases that were considered fatal at that time: pneumonia, tuberculosis, sepsis. However, treatment of pathologies with antibiotics should be carried out only after an accurate diagnosis has been established and strictly as prescribed by the doctor.

The discovery of the antibacterial properties of penicillin occurred in 1928. The famous scientist Alexander Fleming, as a result of conducting a routine experiment with colonies of staphylococci, discovered stains of ordinary mold in some culture dishes.

As it turned out upon further study, there were no harmful bacteria in the cups with mold stains. Subsequently, it was from ordinary green mold that a molecule was derived that was capable of killing bacteria. This is how the first modern antibiotic, Penicillin, appeared.

Nowadays, penicillins are a whole group of antibiotics produced by certain types of mold (genus Penicillium).

They can be active against entire groups of gram-positive microorganisms, as well as some gram-negative ones: gonococci, streptococci, staphylococci, spirochetes, meningococci.

Penicillins belong to a large group of beta-lactam antibiotics, which contain a special beta-lactam ring molecule.

This is the largest family of antibacterial drugs, occupying a central place in the treatment of most infectious diseases. The antibacterial effect of beta-lactams lies in their ability to disrupt the synthesis of bacterial cell walls.

Antibiotics of the penicillin group are used in the treatment of a huge number of infectious diseases. They are prescribed when pathogenic microorganisms are sensitive to the drug for the treatment of the following pathologies:

• many types of pneumonia;
• sepsis;
• septic endocarditis;
• osteomyelitis;
• angina;
• bacterial pharyngitis;
• meningitis;
• infections of the genitourinary system, most of the gastrointestinal tract;
• scarlet fever;
• diphtheria;
• anthrax;
• gynecological diseases;
• diseases of the ENT organs;
• syphilis, gonorrhea and many others.

This type of antibiotic is also used in the treatment of wounds infected with bacteria. As a prevention of purulent complications, the drug is prescribed in the postoperative period.

The drug can be used in childhood for umbilical sepsis, pneumonia, otitis in newborns and infants, as well as young children. Penicillin is also effective for purulent pleurisy and meningitis.

Use of penicillin in medicine:

The use of penicillins to treat infections is not always possible. People who are highly sensitive to the drug are strictly prohibited from taking the drug.

The use of this antibiotic is also contraindicated in patients suffering from asthma of various origins, hay fever, and a history of

hives

or others

allergic reactions

on the active substance.

Modern pharmacological companies produce penicillin preparations for injections or in tablet form. Products for intramuscular administration are produced in bottles (made of glass), sealed with rubber stoppers and metal caps on top. Before administration, the substrate is diluted with sodium chloride or water for injection.

Tablets are produced in cell packaging in dosages from 50 to 100 thousand units. It is also possible to produce ecmoline lozenges. The dosage in this case does not exceed 5 thousand units.

The mechanism of action of penicillin is the inhibition of enzymes involved in the formation of the cell membrane of microorganisms. The cell membrane protects bacteria from environmental influences; disruption of its synthesis leads to the death of pathogenic agents.

This is the bactericidal effect of the drug. It acts on some types of gram-positive bacteria (streptococci and staphylococci), as well as several types of gram-negative ones.

It is worth noting that penicillins can only act on multiplying bacteria. In inactive cells, membranes are not built, so they do not die due to enzyme inhibition.

The antibacterial effect of penicillin is achieved by intramuscular administration, oral administration, and local action. More often, the injection form is used for treatment. When administered intramuscularly, the drug is quickly absorbed into the blood.

However, after 3-4 hours it completely disappears from the blood. Therefore, regular administration of the drugs at equal intervals from 4 times a day is recommended.

The drug can be administered intravenously, subcutaneously, or into the spinal canal. For the treatment of complex pneumonia, meningitis or syphilis, a special regimen is prescribed, which can only be prescribed by a doctor.

When taking penicillin in tablet form, the dosage must also be determined by your doctor. As a rule, for bacterial infections, 250-500 mg is prescribed every 6-8 hours. If necessary, a single dose can be increased to 750 mg. The tablets should be taken half an hour before meals or 2 hours after. The duration of the course will be determined by the doctor.

Since penicillins are a natural drug, they have minimal toxicity among other groups of artificially bred antibiotics. However, allergic reactions are still possible.

They manifest themselves in the form of redness, rashes on the skin, and sometimes anaphylactic shock can occur. The occurrence of such pathologies is possible due to individual sensitivity to the drug or if the instructions are violated.

Other side effects may occur with the use of penicillins:

• stomatitis;
• rhinitis;
• glossitis;
• pharyngitis;
• nausea;
• diarrhea;
• vomit;
• pain in the injection area;
• tissue necrosis at the injection site;
• exacerbation of bronchial asthma;
• fungal infections (candidiasis);
• dysbacteriosis;
• dermatitis.

Why an allergy to an antibiotic may occur, says Dr. Komarovsky:

When taking doses of penicillin that significantly exceed those prescribed by your doctor, an overdose may occur. First signs: nausea, vomiting, diarrhea. Such conditions are not dangerous for the patient’s life. Hyperkalemia may develop in patients with insufficient renal function.

Large doses of the drug administered intravenously or intraventricularly can provoke epileptic seizures. Such symptoms can only occur when a single dose of more than 50 million units is administered. To alleviate the patient's condition, benzodiazepines and barbiturates are prescribed.

Before using penicillin, tests are required to determine sensitivity to the antibacterial drug. This drug should be prescribed with caution to patients with impaired renal function, as well as to patients diagnosed with heart failure.

The tablet form of penicillin should be taken with plenty of liquid. During treatment with penicillin antibiotics, it is important not to skip the recommended doses, since the effect of the drug may be weakened. If this happens, the missed dose should be taken as quickly as possible.

It happens that after 3-5 days after regular use or administration of the drug, improvement does not occur, then you should consult a doctor to adjust the course of treatment or dose of the drug. It is not recommended to interrupt the course of treatment without consulting a doctor.

Rules for the use of antibiotics:

When prescribing penicillin, attention should be paid to its interaction with other drugs used. This antibiotic should not be combined with the following medications:

1. Tetracycline reduces the effectiveness of penicillin antibiotics.
2. Aminoglycosides can conflict with penicillin in a chemical aspect.
3. Sulfonamides also reduce the bactericidal effect.
4. Thrombolytics.

Combining medications on your own is dangerous to health, so a course of antibiotics, taking into account all the details, should be prescribed by a doctor. If any drugs conflict with each other, an analogue may be prescribed.

Penicillin is considered one of the most inexpensive antibacterial drugs. The price of 50 bottles of powder to create a solution varies from 280 to 300 rubles. The cost of 250 mg tablets numbered 30 is just over 50 rubles.

As a replacement for regular penicillin, doctors can recommend the following drugs from the list: Cefazolin, Bicillin-1, 3 or 5, as well as Ampicillin, Amoxicillin, Azithromycin, Amoxiclav.

All these drugs have a broad bactericidal effect and are quite effective. However, to exclude allergic reactions, skin tests should be performed before use.

Penicillin analogues

Cheap analogues of penicillin include Ampicillin and Bicillin. Their cost in tablet form also does not exceed 50 rubles.

Synonyms for the drug are Procaine-benzylpenicillin, Benzylpenicillin sodium, potassium, novocaine salt.

Natural medicinal penicillins include:

• Phenkoxymethylpenicillin;
• Benzathine benzylpenicillin;
• Benzylpenicillin salts (sodium, potassium, novocaine).

Before purchasing the antibiotic Penicillin, you must carefully read the instructions for use, methods of use and dosage, as well as other useful information on the drug Penicillin. On the website “Encyclopedia of Diseases” you will find all the necessary information: instructions for proper use, recommended dosage, contraindications, as well as reviews from patients who have already used this drug.

Penicillin (Penicillium) is a waste product of various types of mold Penicillium notatum, Penicilium chrysogenum, etc.

Several types of penicillin compounds, which are obtained in crystalline form, pass into the culture liquid of these fungi.

Penicillin is an antibiotic whose chemical structure is based on a dipeptide formed from dimethylcysteine ​​and acetylserine.

The mechanism of action of penicillin is associated with the suppression of amino acid and vitamin metabolism of microorganisms and disruption of the development of their cell wall.

Penicillin is excreted by the kidneys (about 50%); its significant concentrations are created in the urine, exceeding the concentrations in the blood by 5–10 times. Some penicillin is also excreted in the bile.

Penicillin is one of the main representatives of the group of antibiotics; the drug has a wide range of bacteriostatic and bactericidal effects (of the penicillin preparations, benzylpenicillin is the most active).

Streptococci, pneumococci, gonococci, meningococci, causative agents of tetanus, gas gangrene, anthrax, diphtheria, certain strains of pathogenic staphylococci and Proteus are especially sensitive to penicillin.

Penicillin is ineffective against bacteria of the enteric-typhoid-dysenteric group, tuberculosis, whooping cough, Pseudomonas aeruginosa and Friedlander's bacilli, pathogens of brucellosis, tularemia, cholera, plague, as well as rickettsia, viruses, fungi and protozoa.

The most effective is intramuscular administration of penicillin preparations. With the intramuscular method of administration, penicillin is quickly absorbed into the blood (its maximum concentration in the blood is created after 30–60 minutes) and quickly passes into the muscles, lungs, wound exudate, and joint cavities.

The penetration of penicillin from the blood into the cerebrospinal fluid is insignificant, therefore, for meningitis and encephalitis, the combined use of penicillin is recommended - intramuscular and endolumbar.

Intramuscularly administered penicillin penetrates little into the abdominal and pleural cavities, which requires direct local exposure to penicillin.

Penicillin penetrates well through the placenta to the fetus.

The use of penicillin is indicated:

For sepsis (especially streptococcal);

In all sulfonamide-resistant cases of corresponding infections (pneumococcal, gonococcal, meningococcal infections, etc.);

With extensive and deeply localized infectious processes (osteomyelitis, severe phlegmon, gas gangrene);

After injuries involving and infection of large musculoskeletal masses;

In the postoperative period to prevent purulent complications;

For infected third and fourth degree burns;

For soft tissue injuries, chest injuries;

Purulent meningitis, brain abscesses, erysipelas, gonorrhea and its sulfonamide-resistant forms, syphilis, severe furunculosis, sycosis, and various inflammations of the eye and ear.

In the clinic of internal medicine, Penicillin is used to treat lobar pneumonia (together with sulfonamide drugs), focal pneumonia, acute sepsis, cholecystitis and cholangitis, prolonged septic endocarditis, as well as for the prevention and treatment of rheumatism.

Penicillin is used in children: for umbilical sepsis, septicopyemia and septic-toxic diseases of newborns, pneumonia in newborns and infants and young children, otitis in infants and young children, septic form of scarlet fever, septic-toxic form of diphtheria (necessarily in combination with special serum), pleuropulmonary processes , not amenable to the action of sulfonamide drugs, purulent pleurisy and purulent meningitis, with gonorrhea.

The antimicrobial effect of Penicillin is achieved both through resorptive and local action.

Penicillin preparations can be administered intramuscularly, subcutaneously and intravenously, inside cavities, into the spinal canal, by inhalation, sublingually (under the tongue), orally; locally - in the form of eye and nasal drops, rinses, rinses.

When administered intramuscularly, penicillin is quickly absorbed into the blood, but after 3-4 hours penicillin almost completely disappears from it. For therapy to be effective, 1 ml of blood must contain 0.1–0.3 units of penicillin, therefore, to maintain a therapeutic concentration of the drug in the blood, it should be administered every 3–4 hours.

The use of Penicillin for the treatment of gonorrhea, syphilis, pneumonia, and cerebrospinal meningitis is carried out according to special instructions.

Treatment with benzylpenicillins, bicillins and other penicillin-containing drugs may be accompanied by side effects, most often of an allergic nature.

The occurrence of allergic reactions to penicillin drugs is usually associated with sensitization of the body to them as a result of previous use of these drugs, as well as as a result of prolonged exposure to them: professional sensitization of nurses and people working in the production of antibiotics.

Allergic reactions are less common upon first contact with penicillin. They occur mainly in people suffering from allergic diseases (urticaria, bronchial asthma).

Allergic reactions to penicillin on the skin are expressed in erythema, limited or widespread rashes, urticaria and urticarial rashes, macular, vesicular, pustular rashes, and sometimes life-threatening exfoliative dermatitis.

Numerous cases of contact dermatitis have been registered (medical personnel of medical institutions). Contact dermatitis and reactions from the skin and mucous membranes are observed both with general exposure and with local use of Penicillin in the form of ointments, lotions, drops for the nose and eyes.

From the respiratory system, rhinitis, pharyngitis, laryngopharyngitis, asthmatic bronchitis, bronchial asthma are noted.

From the gastrointestinal tract, allergic reactions are expressed in stomatitis, nausea, vomiting, and diarrhea.

In some cases, distinguishing between toxic and allergic genesis of side effects is difficult. The allergic origin of these phenomena is indicated by their combination with skin rashes; under the influence of penicillin, the development of agranulocytosis is also possible.

If allergic reactions occur from the skin, respiratory tract, or gastrointestinal tract, treatment with penicillin should be stopped or its dose reduced, and the patient should be prescribed Diphenhydramine, Pipolfen, Suprastin, calcium chloride, vitamin B1.

It should be remembered about the possibility of sensitization of the body even in the prenatal period when treating pregnant women with penicillin preparations.

The occurrence of anaphylactic shock when using Penicillin is a very serious complication that can develop regardless of the dose and route of administration of penicillin and, in severe cases, result in death within a short time (5–30–60 minutes), therefore, before injecting penicillin and its preparations, anamnestic records should be collected data on the use of penicillin drugs in the past and reactions to it.

If anaphylactic shock occurs, 0.2–0.3 ml of 0.1% Adrenaline should be immediately (!) administered intravenously (mixed with the patient’s blood). Injections are repeated until the patient recovers from a serious condition.

At the same time, 0.2–0.3 ml of a 0.1% adrenaline solution is injected into the penicillin injection site. Effective drip administration of norepinephrine (1.0 ml of 0.1% solution in 500 ml of 5% glucose solution) for 3 hours.

Prednisolone - 0.02 g intramuscularly or intravenously, atropine sulfate 0.1% solution - 0.5–0.8 ml subcutaneously, lobeline hydrochloride 1% solution - 0.5–1.0 ml intravenously or subcutaneously.

Instead of adrenaline, you can administer 1 ml of 5% Ephedrine, as well as Eufillin - 5-10 ml of a 2.4% solution with 20-40 ml of a 40% glucose solution intravenously, Diphenhydramine - 5% solution intramuscularly, 1 ml (or Pipolfen), chloride calcium - 10% solution, 10 ml intravenously.

Oxygen is under pressure.

Hydrocortisone - during shock and mainly to prevent late complications in a single dose of 0.05–0.07 g.

Intramuscular administration of a neurolytic mixture is also used: 2 ml of a 2.5% solution of Aminazin, 2 ml of 2% solutions of Promedol and Diphenhydramine and a 5% solution of vitamin B1 (using an anti-shock solution and vasopressor substances).

When recovering from a state of shock, patients require hospitalization and clinical observation, as late complications are possible.

When treated with Penicillin, as with other antibiotics, the occurrence of pathological conditions may be associated with the development of dysbiosis.

The basis of dysbiosis is that penicillin, like other antibiotics, has an antimicrobial effect in the body not only on pathogenic microorganisms, but also on opportunistic and non-pathogenic microbes, as a result of which the natural antagonism of microbial associations for the body is disrupted, non-pathogenic microorganisms can acquire a pathogenic character - so-called superinfections occur.

The body is affected by penicillin-resistant microbes (Proteus, Enterococcus, Pseudomonas aeruginosa, penicillin-resistant strains of staphylococci).

There are complications associated with the activation and proliferation of yeast-like (especially in weakened patients) saprophytic fungi present in the microbial flora of the mucous membranes of the oral cavity and genitals, trachea, and intestines.

Penicillin, by suppressing fungal antagonist bacteria, can create favorable conditions for the development of yeast-like flora. Clinically, candidiasis can occur in acute and chronic forms with pathological manifestations of the skin and mucous membranes (thrush of the mouth, genitals, etc.); from the internal organs (visceral candidiasis) in the form of damage to the lungs and upper respiratory tract; in the form of septic syndrome.

The appearance of candidiasis can be prevented by a rational choice of antibiotic, its correct dosage, regimen of use, the use of appropriate vaccines and serums, and establishing the sensitivity of the patient’s body to the antibiotic (by conducting special tests).

For the treatment of candidiasis in such cases, iodine preparations (1-3-5% solutions of potassium iodide) are prescribed in combination with intravenous administration of a 40% solution of hexamethylenetetramine, gentian violet 0.05-0.10 g 2-3 times a day, nicotinamide and others preparations of B vitamins.

For the prevention and treatment of candidiasis, special antifungal antibiotics are used, taken orally - Nystatin in tablets of 500,000 units, 6-10 tablets per day and Levorin 500,000 units 2-3 times a day in tablets or capsules, as well as ointments with nystatin sodium and levorin.

The use of penicillin is contraindicated in the presence of hypersensitivity to penicillin, bronchial asthma, urticaria, hay fever and other allergic diseases, or in patients with hypersensitivity to antibiotics, sulfonamides and other drugs.

It is possible for the body to become sensitized to penicillin during fetal development when pregnant women are treated with penicillin antibiotics.

Drinking alcohol during treatment with penicillin is strictly contraindicated.

Before using penicillin and its preparations, it is necessary to conduct sensitivity tests to them.

V-Penicillin Slovakofarm

Amoxisar

Amoxicillin

Amoxicillin capsules 0.25 g

Amoxicillin DS

Amoxicillin sodium sterile

Amoxicillin Sandoz

Amoxicillin-ratiopharm

Amoxicillin-ratiopharm 250 TC)

Amoxicillin trihydrate

Amoxicillin trihydrate (Purimox)

Ampicillin

Ampicillin AMP-KID

Ampicillin AMP-Forte

Ampicillin Innotec

Ampicillin sodium

Ampicillin sodium sterile

Ampicillin-AKOS

Ampicillin-Ferein

Ampicillin sodium salt

Ampicillin sodium salt, sterile

Ampicillin sodium salt-Vial

Ampicillin trihydrate

Ampicillin trihydrate capsules 0.25 g

Ampicillin trihydrate tablets 0.25 g

Benzathine benzylpenicillin sterile

Benzathinebenzylpenicillin sterile

Benzylpenicillin

Benzylpenicillin sodium salt

Benzylpenicillin sodium salt crystalline

Benzylpenicillin sodium salt, sterile

Benzylpenicillin sodium salt-Vial

Benzylpenicillin novocaine salt

Bicillin

Vepicombin

Gonoform

Grunamox

Danemox

Carbenicillin disodium salt 1 g

Cloxacillin

Cloxacillin sodium

Megacillin yelled

Oxacillin

Oxacillin sodium salt

Oxacillin sodium salt, sterile

Oxacillin sodium salt tablets

Ospamox

Penicillin G sodium salt

Penicillin G sodium salt, sterile

Pentrexil

Pipracil

Picillin

Procaine penicillin G 3 mega

Procaine-Benzylpenicillin

Procainebenzylpenicillin sterile

Prostaflin

Puricillin

Retarpen 1.2

Retarpen 2.4

Standacillin

Phenoxymethylpenicillin

Phenoxymethylpenicillin (for suspension)

Phenoxymethylpenicillin tablets

Flemoxin Solutab

Flucloxacillin

Hiconcil

Extensillin

I. Penicillin preparations obtained by biological synthesis (biosynthetic penicillins):

I.1. For parenteral administration (destroyed in the acidic environment of the stomach):

Short acting:

benzylpenicillin (sodium salt),

benzylpenicillin (potassium salt);

Long-lasting:

benzylpenicillin (novocaine salt),

Bicillin-1,

Bicillin-5.

I.2. For enteral administration (acid-resistant):

phenoxymethylpenicillin (penicillin V).

II. Semi-synthetic penicillins

II.1. For parenteral and enteral administration (acid-resistant):

Penicillinase-resistant:

oxacillin (sodium salt),

nafcillin;

Broad spectrum of action:

ampicillin,

amoxicillin.

II.2. For parenteral administration (destroyed in the acidic environment of the stomach)

Broad spectrum of action, including Pseudomonas aeruginosa:

carbenicillin (disodium salt),

ticarcillin,

azlocillin.

II.3. For enteral administration (acid-resistant):

carbenicillin (indanyl sodium),

carfecillin.

According to the classification of penicillins given by I.B. Mikhailov (2001), penicillins can be divided into 6 groups:

1. Natural penicillins (benzylpenicillins, bicillins, phenoxymethylpenicillin).

2. Isoxazolepenicillins (oxacillin, cloxacillin, flucloxacillin).

3. Amidinopenicillins (amdinocillin, pivamdinocillin, bacamdinocillin, acidocillin).

4. Aminopenicillins (ampicillin, amoxicillin, talampicillin, bacampicillin, pivampicillin).

5. Carboxypenicillins (carbenicillin, carfecillin, carindacillin, ticarcillin).

6. Ureidopenicillins (azlocillin, mezlocillin, piperacillin).

The source of production, spectrum of action, as well as combination with beta-lactamases were taken into account when creating the classification given in the Federal Guide (formulary system), issue VIII.

1. Natural:

benzylpenicillin (penicillin G),

phenoxymethylpenicillin (penicillin V),

benzathine benzylpenicillin,

benzylpenicillin procaine,

benzathine phenoxymethylpenicillin.

2. Antistaphylococcal:

oxacillin.

3. Extended spectrum (aminopenicillins):

ampicillin,

amoxicillin.

4. Active against Pseudomonas aeruginosa:

Carboxypenicillins:

ticarcillin.

Ureidopenicillins:

azlocillin,

piperacillin.

5. Combined with beta-lactamase inhibitors (inhibitor-protected):

amoxicillin/clavulanate,

ampicillin/sulbactam,

ticarcillin/clavulanate.

Natural (natural) penicillins are narrow-spectrum antibiotics that affect gram-positive bacteria and cocci. Biosynthetic penicillins are obtained from the culture medium on which certain strains of molds (Penicillium) are grown. There are several varieties of natural penicillins, one of the most active and persistent of them is benzylpenicillin. In medical practice, benzylpenicillin is used in the form of various salts - sodium, potassium and novocaine.

All natural penicillins have similar antimicrobial activity. Natural penicillins are destroyed by beta-lactamases, and therefore are ineffective for the treatment of staphylococcal infections, because in most cases, staphylococci produce beta-lactamases. They are effective primarily against gram-positive microorganisms (including Streptococcus spp., including Streptococcus pneumoniae, Enterococcus spp.), Bacillus spp., Listeria monocytogenes, Erysipelothrix rhusiopathiae, gram-negative cocci (Neisseria meningitidis, Neisseria gonorrhoeae), some anaerobes (Peptostreptococcus spp., Fusobacterium spp.), spirochetes (Treponema spp., Borrelia spp., Leptospira spp.). Gram-negative organisms are usually resistant, with the exception of Haemophilus ducreyi and Pasteurella multocida. Penicillins are ineffective against viruses (causative agents of influenza, polio, smallpox, etc.), mycobacterium tuberculosis, the causative agent of amebiasis, rickettsia, and fungi.

Benzylpenicillin is active mainly against gram-positive cocci. The antibacterial action spectra of benzylpenicillin and phenoxymethylpenicillin are almost identical. However, benzylpenicillin is 5–10 times more active than phenoxymethylpenicillin against susceptible Neisseria spp. and some anaerobes. Phenoxymethylpenicillin is prescribed for moderate infections. The activity of penicillin preparations is determined biologically by their antibacterial effect on a specific strain of Staphylococcus aureus. The activity of 0.5988 mcg of chemically pure crystalline sodium salt of benzylpenicillin is taken as a unit of action (1 unit).

Significant disadvantages of benzylpenicillin are its instability to beta-lactamases (with enzymatic cleavage of the beta-lactam ring by beta-lactamases (penicillinases) to form penicillanic acid, the antibiotic loses its antimicrobial activity), insignificant absorption in the stomach (requiring injection routes of administration) and relatively low activity against most gram-negative microorganisms.

Under normal conditions, benzylpenicillin preparations penetrate poorly into the cerebrospinal fluid, but with inflammation of the meninges, permeability through the BBB increases.

Benzylpenicillin, used in the form of highly soluble sodium and potassium salts, acts for a short time - 3–4 hours, because is quickly eliminated from the body and requires frequent injections. In this regard, poorly soluble salts of benzylpenicillin (including novocaine salt) and benzathine benzylpenicillin were proposed for use in medical practice.

Prolonged forms of benzylpenicillin, or depot penicillins: Bicillin-1 (benzathine benzylpenicillin), as well as combined drugs based on them - Bicillin-3 (benzathine benzylpenicillin + benzylpenicillin sodium + benzylpenicillin novocaine salt), Bicillin-5 (benzathine benzylpenicillin + benzylpenicillin novocaine salt ), are suspensions that can only be administered intramuscularly. They are slowly absorbed from the injection site, creating a depot in muscle tissue. This allows you to maintain the concentration of the antibiotic in the blood for a significant time and thus reduce the frequency of drug administration.

All benzylpenicillin salts are used parenterally, because they are destroyed in the acidic environment of the stomach. Of the natural penicillins, only phenoxymethylpenicillin (penicillin V) has acid-stable properties, although to a weak extent. Phenoxymethylpenicillin differs in chemical structure from benzylpenicillin in the presence of a phenoxymethyl group in the molecule instead of a benzyl group.

Benzylpenicillin is used for infections caused by streptococci, including Streptococcus pneumoniae (community-acquired pneumonia, meningitis), Streptococcus pyogenes (streptococcal tonsillitis, impetigo, erysipelas, scarlet fever, endocarditis), and meningococcal infections. Benzylpenicillin is the antibiotic of choice in the treatment of diphtheria, gas gangrene, leptospirosis, and Lyme disease.

Bicillins are indicated primarily when it is necessary to maintain effective concentrations in the body for a long time. They are used for syphilis and other diseases caused by Treponema pallidum (yaws), streptococcal infections (excluding infections caused by group B streptococci) - acute tonsillitis, scarlet fever, wound infections, erysipelas, rheumatism, leishmaniasis.

In 1957, 6-aminopenicillanic acid was isolated from natural penicillins and the development of semisynthetic drugs began on its basis.

6-Aminopenicillanic acid is the basis of the molecule of all penicillins (“penicillin core”) - a complex heterocyclic compound consisting of two rings: thiazolidine and beta-lactam. A side radical is associated with the beta-lactam ring, which determines the essential pharmacological properties of the resulting drug molecule. In natural penicillins, the structure of the radical depends on the composition of the medium in which Penicillium spp grow.

Semi-synthetic penicillins are obtained by chemical modification by adding various radicals to the 6-aminopenicillanic acid molecule. In this way, penicillins were obtained with certain properties:

Penicillinase (beta-lactamase) resistant;

Acid-resistant, effective when administered orally;

Having a wide spectrum of action.

Isoxazolepenicillins (isoxazolyl penicillins, penicillinase-stable, antistaphylococcal penicillins). Most staphylococci produce a specific enzyme beta-lactamase (penicillinase) and are resistant to benzylpenicillin (80–90% of Staphylococcus aureus strains are penicillinase-forming).

The main antistaphylococcal drug is oxacillin. The group of penicillinase-resistant drugs also includes cloxacillin, flucloxacillin, methicillin, nafcillin and dicloxacillin, which due to high toxicity and/or low effectiveness have not found clinical use.

The spectrum of antibacterial action of oxacillin is similar to that of benzylpenicillin, but due to the resistance of oxacillin to penicillinase, it is active against penicillinase-forming staphylococci that are resistant to benzylpenicillin and phenoxymethylpenicillin, as well as resistant to other antibiotics.

In terms of activity against gram-positive cocci (including staphylococci that do not produce beta-lactamase), isoxazolepenicillins, incl. oxacillin are significantly inferior to natural penicillins, therefore, for diseases caused by microorganisms sensitive to benzylpenicillin, they are less effective compared to the latter. Oxacillin does not show activity against gram-negative bacteria (except Neisseria spp.) and anaerobes. In this regard, drugs of this group are indicated only in cases where it is known that the infection is caused by penicillinase-forming strains of staphylococci.

The main pharmacokinetic differences between isoxazolepenicillins and benzylpenicillin:

Rapid, but not complete (30–50%) absorption from the gastrointestinal tract. These antibiotics can be used both parenterally (i.m., i.v.) and orally, but 1–1.5 hours before meals, because they have low resistance to hydrochloric acid;

High degree of binding to plasma albumin (90–95%) and the inability to remove isoxazolepenicillins from the body during hemodialysis;

Not only renal, but also hepatic excretion, no need to adjust the dosage regimen for mild renal failure.

The main clinical value of oxacillin is the treatment of staphylococcal infections caused by penicillin-resistant strains of Staphylococcus aureus (except infections caused by methicillin-resistant Staphylococcus aureus, MRSA). It should be taken into account that strains of Staphylococcus aureus resistant to oxacillin and methicillin are common in hospitals (methicillin, the first penicillinase-resistant penicillin, has been discontinued). Nosocomial and community-acquired strains of Staphylococcus aureus resistant to oxacillin/methicillin are usually multidrug-resistant - they are resistant to all other beta-lactams, and often also to macrolides, aminoglycosides, and fluoroquinolones. The drugs of choice for MRSA infections are vancomycin or linezolid.

Nafcillin is slightly more active than oxacillin and other penicillinase-resistant penicillins (but less active than benzylpenicillin). Nafcillin penetrates the BBB (its concentration in the cerebrospinal fluid is sufficient for the treatment of staphylococcal meningitis), is excreted primarily in bile (the maximum concentration in bile is much higher than the serum concentration), and to a lesser extent by the kidneys. Can be used orally and parenterally.

Amidinopenicillins are penicillins with a narrow spectrum of action, but with predominant activity against gram-negative enterobacteria. Amidinopenicillin preparations (amdinocillin, pivamdinocillin, bacamdinocillin, acidocillin) are not registered in Russia.

In accordance with the classification presented by D.A. Kharkevich, semi-synthetic broad-spectrum antibiotics are divided into the following groups:

I. Drugs that do not affect Pseudomonas aeruginosa:

Aminopenicillins: ampicillin, amoxicillin.

II. Drugs active against Pseudomonas aeruginosa:

Carboxypenicillins: carbenicillin, ticarcillin, carfecillin;

Ureidopenicillins: piperacillin, azlocillin, mezlocillin.

Aminopenicillins are broad-spectrum antibiotics. All of them are destroyed by beta-lactamases of both gram-positive and gram-negative bacteria.

Amoxicillin and ampicillin are widely used in medical practice. Ampicillin is the founder of the aminopenicillin group. In relation to gram-positive bacteria, ampicillin, like all semisynthetic penicillins, is inferior in activity to benzylpenicillin, but superior to oxacillin.

Ampicillin and amoxicillin have similar action spectra. Compared to natural penicillins, the antimicrobial spectrum of ampicillin and amoxicillin extends to sensitive strains of enterobacteria, Escherichia coli, Proteus mirabilis, Salmonella spp., Shigella spp., Haemophilus influenzae; They act better than natural penicillins on Listeria monocytogenes and sensitive enterococci.

Of all oral beta-lactams, amoxicillin has the greatest activity against Streptococcus pneumoniae, which is resistant to natural penicillins.

Ampicillin is not effective against penicillinase-forming strains of Staphylococcus spp., all strains of Pseudomonas aeruginosa, most strains of Enterobacter spp., Proteus vulgaris (indole-positive).

Combination drugs are available, for example Ampiox (ampicillin + oxacillin). The combination of ampicillin or benzylpenicillin with oxacillin is rational, because the spectrum of action with this combination becomes wider.

The difference between amoxicillin (which is one of the leading oral antibiotics) and ampicillin is its pharmacokinetic profile: when taken orally, amoxicillin is absorbed more quickly and well in the intestine (75–90%) than ampicillin (35–50%), bioavailability does not depend on food intake . Amoxicillin penetrates better into some tissues, incl. into the bronchopulmonary system, where its concentrations are 2 times higher than those in the blood.

The most significant differences in the pharmacokinetic parameters of aminopenicillins from benzylpenicillin:

Possibility of administration internally;

Insignificant binding to plasma proteins - 80% of aminopenicillins remain in the blood in free form - and good penetration into tissues and body fluids (with meningitis, concentrations in the cerebrospinal fluid can be 70–95% of concentrations in the blood);

The frequency of administration of combined drugs is 2–3 times a day.

The main indications for prescribing aminopenicillins are infections of the upper respiratory tract and ENT organs, kidney and urinary tract infections, gastrointestinal infections, eradication of Helicobacter pylori (amoxicillin), meningitis.

A feature of the undesirable effect of aminopenicillins is the development of an “ampicillin” rash, which is a maculopapular rash of a non-allergic nature, which quickly disappears when the drug is discontinued.

One of the contraindications to the administration of aminopenicillins is infectious mononucleosis.

Store in a cool, dry place, protected from light. The expiration date is individual and is indicated in the instructions for each drug of the penicillin group.

We would like to draw special attention to the fact that the description of the antibiotic Penicillin is presented for informational purposes only! To obtain more accurate and detailed information about the drug Penicillin, we ask you to refer exclusively to the manufacturer’s annotation! Do not self-medicate under any circumstances! You should definitely consult a doctor before starting to use the drug!

Penicillin is a narrow-spectrum antibiotic obtained from the mold fungus penicillium. Throughout the entire period of its life, this type of fungus is capable of synthesizing various varieties of penicillin, differing from each other in chemical composition, as well as the effect they have on the human body.

Benzylpenicillin is often used in medicine to treat diseases of the upper and lower respiratory tract.

In addition, this drug is of great historical significance, since the first medical studies done after its discovery proved that with the help of this medicine it is possible to completely cure people suffering from syphilis, staphylococcal and streptococcal infections.

Penicillin: active substance, release form and effect of treatment with the drug

The antibiotic penicillin is a drug whose chemical structure is based on a dipeptide formed from substances such as dimethylcysteine ​​and acetylserine.

The mechanism of action of penicillins is to block the vitamin and amino acid metabolism of pathogenic microorganisms, as a result of which their reproduction completely stops and the cell wall is destroyed, which leads to their death.

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Penicillin is excreted from the human body by the kidneys, as well as along with bile. Its content in urine is much higher than the concentration in the blood (almost 10 times).

In pharmacies, this drug is sold in powder form for the preparation of suspensions for injection. There are also penicillin tablets used to treat gonorrhea and other sexually transmitted diseases.

The classification of penicillins involves their division into natural and semi-synthetic. The second group is widely used in medicine and has a bactericidal as well as bacteriostatic effect, destroying the cell walls of pathogenic bacteria, preventing them from regenerating.

Antibiotics of the penicillin group do not have any effect on bacteria of the enteric-typhoid-dysenteric group, therefore it is not used for the treatment of diseases caused by these microorganisms. Also, Benzylpericillin, which is the most common drug belonging to the penicillin group, is ineffective in the treatment of pulmonary tuberculosis, whooping cough, plague, and cholera.

To achieve maximum effect from the drug, it is administered intramuscularly. This is explained by the fact that, in this way, the active substances of the drug are absorbed into the blood faster. Their highest concentration is observed within half an hour, maximum 1 hour after the administration of penicillin to the patient.

It is worth noting that Penicillin tablets are used extremely rarely, which is explained by its poor absorption into the blood. Under the influence of gastric juice, the structure of the active components of the drug is destroyed, and this, in turn, leads to the fact that the results from such therapy have to wait a very long time.

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The use of Penicillin must be justified. Otherwise, it may lead to adverse consequences.

Like any other antibiotic, this drug can cause severe allergic reactions, so using it for therapeutic purposes without being sure of its safety for the patient is strictly prohibited.

First of all, you need to undergo special allergy tests. They are performed in two ways.

The first method of performing allergy tests involves the direct participation of the patient. Several shallow scratches are made on the back of the hand using a special stylus (as when taking a blood test). The laboratory assistant drops a small amount of the drug into the resulting wounds.

The result of such a test can be seen in about half an hour, although sometimes you have to wait a little longer. If redness or swelling appears on the treated surface, the patient feels a burning sensation and severe itching, then this is evidence of an allergy to penicillin. In this case, the doctor will have to look for a replacement drug with which it will be possible to cure this or that disease without risk or danger to the patient’s health.

1. Option two involves conducting a special analysis of venous blood. This does not require the patient’s personal presence, since the results of such an allergy test are prepared within 5-7 days and involve the use of certain reagents.

Penicillin-based drugs are indicated for patients with various pathologies of the respiratory system. They are often used:

• for pneumonia (focal or lobar);
• for the treatment of pleural empyema;
• for the purpose of relieving septic endocarditis occurring in catarrhal and subacute forms;
• to combat sepsis (blood poisoning);
• with pyaemia and septicemia;
• for therapeutic purposes for osteomyelitis, occurring in acute or chronic form;
• for the treatment of meningitis of varying severity;
• for the purpose of relieving infectious diseases of the gallbladder and urinary tract;
• for the treatment of pustules on the skin, mucous membranes or soft tissues;
• with sore throat (especially purulent);
• to relieve symptoms of scarlet fever;
• for medicinal purposes in erysipelas;
• with anthrax;
• for the treatment of ENT diseases of varying nature and severity;
• with actinomycosis;
• for the purpose of treating diphtheria;
• for gynecological diseases of a purulent or inflammatory nature;
• for therapeutic purposes for eye diseases;
• for the treatment of sexually transmitted diseases, in particular gonorrhea, syphilis;
• with blenorrhea;
• for the treatment of bronchitis;
• for the treatment of pneumonia.

Treatment with penicillin for the above diseases is highly effective, however, it is worth noting that you should not expect immediate results. As a rule, the course of therapy is 5-7 days, although if we are talking about sexually transmitted diseases, this process may take longer.

Along with antibiotics, doctors always prescribe medications against dysbiosis. Be sure to follow all instructions and follow the instructions of your doctor, otherwise this may lead to the development of serious complications.

Features of the use of penicillin for the treatment of children and pregnant women

Penicillin group drugs are used with caution for the treatment of various diseases in women during pregnancy, as well as for the treatment of young children.

It is allowed to use such a medicine only if the child has reached one year of age.

At an earlier age, this medication can have an otogenic effect, which can lead to hearing problems in the baby.

It is important to know that the use of penicillin in the form of injections in small patients is permitted only in a hospital setting. A parent's decision to self-medicate can have serious consequences for a sick child, so the entire therapy process should be closely monitored by a qualified physician. At home, only oral use of the drug is allowed.

As for the use of Benzylpenicillin or Bicillin for women during pregnancy, its administration should be either intramuscular or intravenous. It is also allowed to use the medicine in the form of an ointment for external use. Taking pills for the treatment of diseases of the respiratory or genital tract is absolutely prohibited in order to avoid pathologies of intrauterine development of the fetus or adverse reactions in an infant.

Contraindications to the use of the drug

Penicillin is a very serious drug that has its own contraindications for use for therapeutic purposes. If precautions are neglected, this may lead to the development of serious side effects.

The use of this medicine is absolutely excluded:

1. During pregnancy.
2. In case of individual intolerance to the components of the drug.
3. In case of allergic reactions (urticaria, bronchial asthma, etc.).
4. In case of sudden reactions of the body to antibiotics of various nature.

Despite the fact that the use of this drug is undesirable during pregnancy and breastfeeding, it can still be used. However, this only happens if the benefit to the woman significantly outweighs the risk to the fetus.

Side effects of taking penicillin

When taking penicillin-based drugs, the patient must be aware of what this substance is and how the body may react to it.

In the first days of therapy, allergic reactions may occur, especially in women during pregnancy.

This is due to increased sensitivity of the body, which often develops as a result of earlier use of this drug or its analogues. Side effects from improper use of the drug can be as follows.

• From the digestive system:

  • diarrhea;
  • vomit;
  • nausea.

• From the side of the central nervous system:

  • neurotoxic reactions;
  • the appearance of symptoms of meningism;
  • coma;
  • convulsions.

• Allergic reactions to the drug:

  • development of urticaria;
  • increased body temperature;
  • the appearance of rashes on the surface of the skin, as well as on the mucous membranes of the mouth, nose, etc.;
  • eosinophilia;
  • swelling of the limbs or face.

In addition to the above side effects, candidiasis of the oral cavity or vagina in women is often observed. In extremely rare cases, patients treated with Penicillin developed anaphylactic shock with a fatal outcome. If signs of such a condition appear in a patient, he must be given adrenaline intravenously.

Often, when treated with this drug, patients experience the development of dysbiosis. This anomaly is due to the fact that the active components of the drug affect not only pathogenic microorganisms, but also beneficial intestinal bacteria.

For this reason, when carrying out penicillin-based therapy, it is important to take drops or capsules that help restore and maintain normal intestinal microflora.

In addition to dysbiosis, patients may develop a fungal infection caused by Candida fungi. To prevent this from happening, the choice of antibiotic must be approached especially carefully. The patient is obliged to follow absolutely all the doctor’s recommendations without changing the dosage or number of uses of the drug.

Overdose of penicillin and its interaction with other drugs

Throughout the course of treatment, it is important to remember the dosage of this medication. It, as well as the entire treatment regimen, can only be prescribed by the attending physician, based on the patient’s complaints and the results of his tests.

If you take the drug in too high a concentration, it can lead to an overdose, manifested by nausea, vomiting, and severe diarrhea. However, do not panic: this condition is not life-threatening for the patient.

When penicillin is administered intravenously, hyperkalemia may develop in patients suffering from renal failure.

In addition, if the permissible dosage is exceeded when using the drug intramuscularly or intravenously, the patient may experience epileptic seizures. However, it is worth noting that such anomalies occur only when more than 50 million units of the drug are administered in 1 approach. In this case, the patient is prescribed barbiturates or benzodiazepines.

This drug is not recommended for use together with Probenecid, since their incompatibility leads to a retention of the active substances of penicillin in the human body, which is why its elimination takes much longer than expected.

In addition, treatment with penicillin is contraindicated in the case of the use of medications such as:

1. Tetracycline. In this case, the bactericidal effect of using Benzylpenicillin or Bicillin is significantly reduced.
2. Aminoglycosides, since they conflict with each other in the physicochemical aspect.
3. Thrombolytics.
4. Sulfonamides, which also significantly reduce the bactericidal effect of penicillins.
5. Cholestyramine reduces the bioavailability of penicillin group drugs.
6. Birth control pills.

Based on the foregoing, the patient must make an unambiguous conclusion that it is impossible to independently prescribe a course of treatment during which various medications are combined: such actions can cause severe harm to health.

If a particular penicillin-based medicine is contraindicated for use, the doctor can prescribe its analogue, which will be absolutely safe for the patient’s health. Doctors often recommend medications such as:

1. Benzylpenicillin sodium salt has a bactericidal effect.
2. Benzylpenicillin potassium salt.
3. Phenoxymethylpenicillin.
4. Bicillin-1, 3 and 5.
5. Ampicillin.
6. Eficillin.
7. Methicillin sodium salt.

Before using any of the above drugs, allergy tests must be performed. This will help avoid the development of serious complications and allergic reactions from using the antibiotic for therapeutic purposes.

• nervousness, sleep and appetite disturbances...
• frequent colds, problems with the bronchi and lungs...
• headaches...
• bad breath, plaque on teeth and tongue...
• change in body weight...
• diarrhea, constipation and stomach pain...
• exacerbation of chronic diseases...

Bondarenko Tatyana

Expert of the OPnevmonii.ru project

Penicillin tablets are antibiotics that are actively used to combat a number of bacterial diseases that arise as a result of the pathological activity of pathogens characterized by sensitivity to penicillin. Let us consider in more detail the principle of action and features of the use of the presented drug.

Penicillin is an antibacterial agent obtained from the waste products of a special mold fungus called Penicillium. The presented antibiotic drug is characterized by a wide spectrum of action, helping to destroy pathogens such as spirochetes, gonococcus, staphylococcus and others. Modern analogues of this medication (for example, Phenoxymethylpenicillin) have identical properties. The drug is available in the form of a solution for injection, as well as in tablets intended for resorption and for oral administration.

Indications for use

These medications are actively used in the field of modern medicine to combat a number of different diseases that are bacterial in nature. Experts identify the following indications for the use of the tablet form of penicillins:

1. Sepsis.
2. Brain abscess.
3. Cholecystitis.
4. Infectious lesions of the upper respiratory tract.
5. Otitis in acute or chronic form.
6. Burn lesions in the third and fourth degrees.
7. Furunculosis.
8. Pneumonia.
9. Gonorrhea.
10. Extensive wound surfaces localized in the skin area.
11. Syphilis.
12. Gas gangrene.
13. Angina.
14. Anthrax.
15. Scarlet fever.
16. Diphtheria.
17. Septicemia.
18. Purulent and inflammatory diseases of a gynecological nature.
19. Actinomycosis.
20. Septic endocarditis in acute form.
21. Infectious lesions of the urinary tract.
22. Meningitis.
23. Acute or chronic form of osteomyelitis.
24. Purulent diseases of an infectious nature, affecting mucous membranes and soft tissues.
25. Empyema of the pleura.
26. Tetanus.
27. Laryngitis and tonsillitis.
28. Sinusitis.
29. Inflammatory lesions of the lymph nodes.

Penicillin preparations are well tolerated by pediatric patients. In the field of pediatrics, the medications presented are used in cases where there is:

1. Otitis.
2. Pneumonia in newborns.
3. Septicopyemia.
4. Meningitis.
5. Pleurisy of a purulent nature.
6. A septic process localized in the umbilical region.

Contraindications for use

Despite the high degree of effectiveness in combating infectious diseases of a bacterial nature, the use of penicillin tablets in some cases is highly discouraged and can be dangerous for the patient. The following contraindications to the use of drugs of this pharmacological group, as well as their analogues, are identified:

1. Tendency to allergic reactions.
2. Bronchial asthma.
3. Hay fever.
4. Hives.
5. Ulcerous colitis.
6. Increased individual sensitivity to the drug.
7. Infectious mononucleosis.
8. Regional enteritis.
9. Serious disturbances in the functioning of the digestive system.
10. Pharyngitis.
11. Diarrhea.
12. Severe diseases of the gastrointestinal tract.
13. Aphthous stomatitis.
14. Kidney pathologies.
15. Acute heart failure.

Side effects

In some cases, the use of penicillin drugs may cause the development of undesirable reactions, such as:

1. Nausea.
2. Attacks of vomiting.
3. Allergic reactions.
4. Diarrhea.
5. Increased body temperature.
6. Coma.
7. Cramps.
8. Swelling.
9. Hives.
10. Eosinophilia.
11. Candidiasis of the vagina and oral cavity.

In some particularly severe cases, taking these drugs can lead to the development of anaphylactic shock and death of the patient.

However, only a few such incidents have been recorded in medical practice. In addition, it must be emphasized that in most cases, the development of side effects is observed with prolonged and uncontrolled use of medications.

In order to avoid possible complications and minimize risks, it is recommended to take medications exclusively as prescribed by a doctor, strictly observing his instructions and following the instructions for use. The choice of a specific drug, its dosage and the duration of the therapeutic course are determined by a specialist, taking into account the disease, its severity, age and individual characteristics of the patient.

Principles of application

The instructions for the use of drugs of the penicillin group state that the optimal dosage of the drug depends on the therapeutic regimen prescribed by the attending physician. The dosage for children is calculated individually, depending on the age and body weight of the child.

The tablets must be taken every 8 hours. It is recommended to strictly follow this rule in order to achieve the optimal concentration of the active substance. The medicine is taken either half an hour before a meal, or 2 hours after a meal.

The average duration of treatment is from 5 to 14 days. The first results become noticeable after 3-4 days. If no visible effect is observed, you should contact your doctor to prescribe another antibiotic drug.

Advantages of the tablet form of the drug

Recently, the use of tablet form of penicillin preparations has become especially widespread, which is associated with its undoubted advantages. Firstly, the patient can save on the purchase of syringes and special solutions needed for injections. Secondly, the therapeutic course can be completed on an outpatient basis, without the help of medical personnel. In addition, the tablets include so-called antacid substances that help reduce the effect of gastric juice on the main active ingredient, providing maximum therapeutic effect.

1. Flemoxin.
2. Amoxicillin.
3. Ospamox.
4. Amoxil KMP.

Penicillin preparations are an extremely effective and efficient remedy that helps cure numerous infectious diseases. Compliance with medical recommendations and basic rules of use allows you to achieve extremely fast and favorable results, while avoiding the occurrence of unwanted reactions and side effects.