Chapter 7. Antimicrobials
Containing or stopping the growth of microbes is achieved by various methods (sets of measures): antiseptics, sterilization, disinfection, chemotherapy. Accordingly, the chemicals that are used to implement these measures are called sterilizing agents, disinfectants, antiseptics and antimicrobial chemotherapy. Antimicrobial chemicals are divided into two groups: 1) non-selective- destructive to most microbes (antiseptics and disinfectants), but at the same time toxic to the cells of the macroorganism, and (2) I haveselective actions(chemotherapeutic agents)..
7.1. Chemotherapy drugs
Chemotherapeutic antimicrobialsmedicines- This chemicals that are used to treat infectious diseases etiotropic
treatment (i.e., directed at the microbe as the cause of the disease), as well as (rarely and sharplyhorny!) to prevent infections.
Chemotherapy drugs are administered inside the body, so they must have a detrimental effect on infectious agents, but at the same time be non-toxic to humans and animals, i.e. have selectivity of action.
Currently, thousands of chemical compounds with antimicrobial activity are known, but only a few dozen of them are used as chemotherapeutic agents.
Based on which microbes chemotherapy drugs act on, they determine spectrum their activities:
acting on cellular forms of microorganisms (antibacterial, antifungalhigh, antiprotozoal).Antibacterial, in turn, are usually divided into drugs narrow And wide action spectrum: narrow- when the drug is active against only a small number of varieties of either gram-positive or gram-negative bacteria, and wide - if the drug acts on a sufficiently large number of species of representatives of both groups.
antiviral chemotherapy drugs.
In addition, there are some antimicrobial chemotherapeutic drugs that also have againsttumoral activity.
By type of action chemotherapy drugs are distinguished:
"Microbicidal"(bactericidal, fungicidal, etc.), i.e., having a detrimental effect on microbes due to irreversible damage;
"Microbostatic" i.e., inhibiting the growth and reproduction of microbes.
Antimicrobial chemotherapeutic agents include the following groups of drugs:
Antibiotics(act only on cellular forms of microorganisms; antitumor antibiotics are also known).
Synthetic chemotherapy drugs of different chemical structures (among them there are drugs that act either on cellular microorganisms or on non-cellular forms of microbes).
7.1.1. Antibiotics
The fact that some microbes can somehow inhibit the growth of others has been well known for a long time. Back in 1871-1872. Russian scientists V. A Manassein and A. G. Polotebnov observed the effect when treating infected wounds by applying mold. Observations by L. Pasteur (1887) confirmed that antagonism in the microbial world is a common phenomenon, but its nature was unclear. In 1928-1929 Fleming discovered a strain of the mold fungus penicillium (Penicillium notatum), releasing a chemical that inhibits the growth of staphylococcus. The substance was named "penicillin", but only in 1940 H. Flory and E. Chain were able to obtain a stable preparation of purified penicillin - the first antibiotic to be found wide application at the clinic. In 1945, A. Fleming, H. Florey and E. Chain were awarded Nobel Prize. In our country, a great contribution to the doctrine of antibiotics was made by Z. V. Ermolyeva and G. F. Gause.
The term “antibiotic” itself (from the Greek. anti, bios- against life) was proposed by S. Waksman in 1942 to designate natural substances, produced microorganisms and in low concentrations antagonistic to the growth of other bacteria.
Antibiotics- these are chemotherapeutic drugs made from chemical compounds of biological origin (natural), as well as their semi-synthetic derivatives and synthetic analogues, which in low concentrations have a selective damaging or destructive effect on microorganisms and tumors.
7.1.1.1. Sources and methods of obtaining antibiotics
The main producers of natural antibiotics are microorganisms that, being in their natural environment (mainly in the soil), synthesize antibiotics as a means of survival in the struggle for existence. Animal and plant cells can also produce some substances with a selective antimicrobial effect (for example, phytoncides), but they have not received widespread use in medicine as antibiotic producers
Thus, the main sources for obtaining natural and semi-synthetic antibiotics were:
Actinomycetes(especially streptomycetes) are branching bacteria. They synthesize the majority of natural antibiotics (80%).
Molds- synthesize natural beta-lactams (fungi of the genus Cephalosporiurr, And Penicillium) n fusidic acid.
Typical bacteria- for example, eubacteria, bacilli, pseudomonads - produce bacitracin, polymyxins and other substances that have an antibacterial effect.
There are three main ways to obtain antibiotics:
biological synthesis (this is how natural antibiotics are obtained - natural fermentation products, when producing microbes that secrete antibiotics during their life processes are cultivated under optimal conditions);
biosynthesis with subsequent chemical modifications(this is how semi-synthetic antibiotics are created). First, a natural antibiotic is obtained through biosynthesis, and then its original molecule is modified by chemical modifications, for example, certain radicals are added, as a result of which the antimicrobial and pharmacological characteristics of the drug are improved;
chemical synthesis (this is how synthetic products are obtained analogues natural antibiotics, for example chloramphenicol/chloramphenicol). These are substances that have the same structure.
like a natural antibiotic, but their molecules are chemically synthesized.
7.1.1.2. Classification of antibiotics by chemical structure
Based on their chemical structure, antibiotics are grouped into families (classes):
beta-lactams(penicillins, cephalosporins, carbapenems, monobactams)
glycopeptides
* aminoglycosides
tetracyclines
macrolides (and azalides)
lincosamides
chloramphenicol (chloramphenicol)
rifamycins
polypeptides
polyenes
different antibiotics(fusidic acid, ruzafungin, etc.)
Beta-lactams. The basis of the molecule is a beta-lactam ring, when destroyed, drugs lose their activity; type of action - bactericidal. Antibiotics in this group are divided into penicillins, cephalosporins, carbapenems and monobactams.
Penicillins. Natural drug - benzylpene-nicillin(penicillin G) - is active against gram-positive bacteria, but has many disadvantages: it is quickly eliminated from the body, destroyed in acidic environment stomach, is inactivated by penicillinases - bacterial enzymes that destroy the beta-lactam ring. Semi-synthetic penicillins, obtained by adding various radicals to the base of natural penicillin - 6-aminopenicillanic acid - have advantages over the natural drug, including a wide spectrum of action:
depot preparations(bicillin), lasts about 4 weeks (creates a depot in the muscles), is used to treat syphilis, prevent relapses of rheumatism;
acid-resistant(phenoxymethylpenicillin), oral administration;
penicillinase-resistant(methicillin, oxacyl-pl), but they have a rather narrow spectrum;
wide range (ampicillin, amoxicillin);
antipseudomonas(carboxypenicillins- carbe-nicillin, ureidopenicillins- piperacillin, azlo-cillin);
combined(amoxicillin + clavulanic acid, ampicillin + sulbactam). These drugs contain inhibitors enzymes - beta-lactamases(clavulanic acid, etc.), which also contain a beta-lactam ring in their molecule; their antimicrobial activity is very low, but they easily bind to these enzymes, inhibit them and thus protect the antibiotic molecule from destruction.
V Cephalosporins. The spectrum of action is wide, but they are more active against gram-negative bacteria. According to the sequence of introduction, there are 4 generations (generations) of drugs, which differ in activity spectra, resistance to beta-lactamases and some pharmacological properties, so drugs of the same generation Not replace drugs of another generation, but complement them.
1st generation(cefazolin, cephalothin, etc.)- more active against gram-positive bacteria, destroyed by beta-lactamases;
2nd generation(cefuroxime, cefaclor, etc.)- more active against gram-negative bacteria, more resistant to beta-lactamases;
3rd generation(cefotaxime, ceftazidime, etc.) - more active against gram-negative bacteria, highly resistant to beta-lactamases;
4th generation(cefepime, etc.)- act mainly on gram-positive, some gram-negative bacteria and Pseudomonas aeruginosa, resistant to the action of beta-lactamases.
Carbapenems(imipenem, etc.)- of all beta-lactams they have the widest spectrum of action and are resistant to beta-lactamases.
Monobactams(aztreonam, etc.) - resistant to beta-lactamases. The spectrum of action is narrow (very active against gram-negative bacteria, including Pseudomonas aeruginosa).
GLYCOPEPTIDES(vancomycin and teicoplanin) - These are large molecules that have difficulty passing through the pores of gram-negative bacteria. As a result, the spectrum of action is limited to gram-positive bacteria. They are used for resistance or allergy to beta-lactams, for pseudomembranous colitis caused by Clostridium difficile.
AMINOGLICOSIDES- compounds whose molecules include amino sugars. The first drug, streptomycin, was obtained in 1943 by Vaksman as a treatment for tuberculosis.
Now there are several generations of drugs: (1) streptomycin, kanamycin, etc., (2) gentamicin,(3) sisomycin, tobramycin, etc. The drugs are bactericidal, the spectrum of action is wide (especially active against gram-negative bacteria, and affects some protozoa).
TETRACYCLINES is a family of large molecular drugs containing four cyclic compounds. Currently, semi-synthetics are mainly used, for example doxycycline. Action type - static. The spectrum of action is wide (especially often used to treat infections caused by intracellular microbes: rickettsia, chlamydia, mycoplasma, brucella, legionella).
MACROLIDES(and azalides) are a family of large macrocyclic molecules. Erythromycin- the most famous and widely used antibiotic. Newer drugs: azithromycin, clarithromycinmycin(they can be used only 1-2 times a day). The spectrum of action is wide, including intracellular microorganisms, legionella, hemophilus influenzae. The type of action is static (although, depending on the type of microbe, it can also be cidal).
LINCOSAMIDES(lincomycin and its chlorinated derivative - clindamycin). Bacteriostatics. Their spectrum of action is similar to macrolides; clindamycin is especially active against anaerobes.
POLYPEPTIDES(polymyxins). The spectrum of antimicrobial action is narrow (Gram-negative bacteria), the type of action is bactericidal. Very toxic. Application - external; currently not in use.
POLYENES(amphotericin B, nystatin etc.). Antifungal drugs, the toxicity of which is quite high, are therefore often used topically (nystatin), and for systemic mycoses, the drug of choice is amphotericin B.
7.1.2. Synthetic antimicrobial chemotherapy drugs
Using chemical synthesis methods, many substances have been created that are not found in living nature, but are similar to antibiotics in mechanism, type and spectrum of action. In 1908, P. Ehrlich synthesized salvarsan, a drug for the treatment of syphilis, based on organic arsenic compounds. However, the scientist’s further attempts to create similar drugs - “magic bullets” - against other bacteria were unsuccessful. In 1935, Gerhardt Domagk proposed pron-tosil (“red streptocide”) for the treatment of bacterial infections. The active principle of Prontosil was sulfonamide, which was released when Prontosil decomposed in the body.
To date, many varieties of antibacterial, antifungal, antiprotozoal synthetic chemotherapeutic drugs of various types have been created. chemical structure. The most significant groups include: sulfonamides, nitroimidazoles, quinolones and fluoroquinolones, imidazoles, nitrofurans, etc.
A special group consists of antiviral drugs (see section 7.6).
SULPHANAMIDES. The basis of the molecule of these drugs is the para-amino group, therefore they act as analogues and competitive antagonists of para-aminobenzoic acid, which is necessary for bacteria to synthesize vital folic (tetrahydrofolic) acid - a precursor of purine and pyrimidine bases. Bacteriostatics, the spectrum of action is wide. The role of sulfonamides in the treatment of infections has recently declined, as there are many resistant strains that cause serious side effects and the activity of sulfonamides is generally lower than that of antibiotics. The only drug in this group that continues to be widely used in clinical practice is its co-trimoxazole analogues. Co-trimoxazole (bactrim, 6ucenmol)- a combination drug that consists of sulfamethoxazole and trimethoprim. Both components act synergistically, potentiating each other's action. Acts bactericidal. Trimethoprim blocks-
Table 7.1. Classification of antimicrobial chemotherapy drugs by mechanism of action
Cell wall synthesis inhibitors
Beta-lactams (penicillins, cephalosporins, carbapenems, monobactams)
Glycopeptides
Synthesis inhibitors
Aminodicosides
Tetracyclines
Chloramphenicol
Lincosamides
Macrolides
Fusidic acid
Nucleic acid synthesis inhibitors
Inhibitors of nucleic acid precursor synthesis
Sulfonamides
Trimethoprim DNA replication inhibitors
Quinolones
Nitroimidazoles
Nitrofurans RNA polymerase inhibitors
Rifamycins
Function inhibitors
cell membranes
Imidazoles
Polymyxins
synthesizes folic acid, but at the level of another enzyme. Used for urinary tract infections caused by gram-negative bacteria.
QUINOLONES. The first drug of this class is nalidixic acid (1962). She has limited
The spectrum of action, resistance to it quickly develops, is used in the treatment of urinary tract infections caused by gram-negative bacteria. Nowadays, so-called fluoroquinolones are used, i.e., fundamentally new fluorinated compounds. Advantages of fluoroquinolones - different ways administration, bactericidal
action, good tolerability, high activity at the injection site, good permeability through the histohematic barrier, sufficient low risk development of resistance. In fluoroquinolones (qi-profloxacin, norfloxacin etc.) the spectrum is wide, the type of action is cidial. Used for infections caused by gram-negative bacteria (including Pseudomonas aeruginosa), intracellular
Particularly active against anaerobic bacteria, since only these microbes are able to activate metronidazole through reduction. Action type -
cidal, spectrum - anaerobic bacteria and protozoa (Trichomonas, Giardia, dysenteric amoeba). IMIDAZOLES (clotrimazole etc.). Antifungal drugs act at the level of the cytoplasmic membrane. NITROFURANS (furazolidone etc.). Action type
twiya - cidal, spectrum - wide. Are accumulating
in urine in high concentrations. They are used as uroseptics for the treatment of urinary tract infections.
Contains almost all anti-inflammatory medical supplies that have an antimicrobial effect include antibacterial substances. Exceptions are Akriderm SK, Lorinden S, Sofradex, Dermosolon and a few others. Below is detailed list and characteristics of antimicrobial external preparations that have a wide spectrum of action and are characterized by the highest therapeutic effect.
Synthetic antimicrobial agents of modern pharmacology
Betaderm-Betaderm.
Dosage forms. Cream and ointment for external use.
Compound. 1 g of antimicrobial drug contains betamethasone dipropionate - 0.5 mg, gentamicin sulfate - 1.0 mg. Pharmacological action. Betamethasone is a synthetic fluorinated glucocorticosteroid for external use, classified as moderately strong (group 3). It has anti-inflammatory, antiallergic, vasoconstrictor, antipruritic effects. Gentamicin is an antibiotic from the aminoglycoside group, active against streptococci.
Indications. Dermatoses complicated by secondary bacterial infection: allergic and atopic dermatitis, chronic lichen simplex, psoriasis, chronic lupus erythematosus, multimorphic exudative erythema.
Contraindications. Increased sensitivity to the components of the drug, common to the external action of glucocorticosteroids, phlebitis and trophic ulcers.
Side effect. Very rarely, erythema, exudation, burning and itching, and pigmentation disorders are observed.
Application and doses. Apply antimicrobial ointment externally to adults - 1-2 times a day. Continuous use for a week should not exceed 45 g. Do not prescribe during pregnancy and children under 2 years of age.
Special notes. Avoid prolonged use.
Flucinar N.
Combined drug.
Release form. Ointment in tubes of 15 g. Light yellow, translucent, fatty soft mass with a weak specific odor.
Compound. Active substances - fluocinolone acetonide, neomycin sulfate.
Pharmacological action. Fluocinolone acetonide is a synthetic fluorinated glucocorticoid for external action with anti-inflammatory, antiallergic, vasoconstrictor and antipruritic effects (40 times more active than hydrocortisone); neomycin sulfate is an antibiotic from the group of aminoglycosides of the 1st generation, active against a number of Gr+ and Gr- microorganisms (in low concentrations it has a bacteriostatic effect, in high concentrations it has a bactericidal effect).
Indications. Allergic dermatoses complicated by bacterial infection - dermatitis, eczema, urticaria, psoriasis, erythema multiforme, erythroderma, pruritus, lichen planus, secondary infections due to insect bites, bacterial skin infections complicated by the development of local allergic reactions, impetigo, infected diaper rash, 1st degree burns.
Contraindications. Hypersensitivity to the components of the drug. Viral, fungal infections skin infected with bacteria not sensitive to neomycin, conditions after immunization, rosacea, syphilitic and tuberculous skin lesions, perioral dermatitis, chronic facial dermatoses. Children under 2 years of age. Pregnancy, lactation.
Side effect. Irritation and itching are rarely observed. With prolonged use of this synthetic antimicrobial agent on the face, steroid acne, telangiectasia, striae, skin atrophy, perioral dermatitis, depigmentation, alopecia or hirsutism are possible. Urticaria or maculopapular rash may occur. At long-term use or applied to large surfaces, systemic side effects of glucocorticosteroids are possible, as well as oto- and nephrotoxic effects of neomycin.
Application and doses. Apply a small amount thin layer on the affected areas 2-3 times a day, after subsiding inflammatory process- 1-2 times a day. If a dressing is necessary, use a breathable version. Change occlusive dressings every 24-48 hours. The course of treatment is no longer than 2 weeks; Use no more than 2 g of ointment per day.
Special notes. If necessary, application to the skin of the face and skin folds treatment should be short-term. Use with caution when available atrophic changes skin, especially in the elderly.
Celestoderm-B with garamicin - Celestoderm-V.
Combined drug.
INN (international generic name) - Betamethasone + Gentamicin.
Release forms. Cream and ointment 0.1% betamethasone and 0.1% gentamicin.
Compound. Synthetic fluorine-containing external corticosteroid betamethasone, classified as strong (group 2), with a local anti-inflammatory, vasoconstrictor and antipruritic effect, as well as gentamicin - a bactericidal main antibiotic-amino-glycoside of the 2nd generation with a wide spectrum of action with high local antibacterial activity . Streptococci, staphylococci, and Gr bacteria are sensitive to the action of gentamicin.
Indications. Local treatment skin diseases that respond to corticosteroid therapy, the course of which is complicated by a bacterial infection: contact dermatitis, seborrheic, intertriginous, solar, exfoliative, atopic eczema, childhood, coinoid, neurodermatitis, psoriasis.
Contraindications. Hypersensitivity to the components of the drug.
Side effect. Burning, itching, irritation, dryness, folliculitis, hypertrichosis, acne, hypopigmentation, perioral dermatitis, allergic contact dermatitis.
Application and doses. Apply synthetic antimicrobial agent pharmacology apply a thin layer to the affected areas 2 times a day (in mild cases - 1 time a day). Children - with caution.
Anti-inflammatory antimicrobial ointments for external use
Akriderm SK - Akriderm SK.
Combined drug.
INN (international nonproprietary name) - Betamethasone dipropionate + salicylic acid.
Release form. Ointment in tubes of 15 and 30 g.
Compound. 1 g of combined antimicrobial drug contains betamethasone dipropionate 0.64 mg, 30 mg of salicylic acid and excipients.
Pharmacological action. A combination of a glucocorticosteroid with a drug with antiseptic and keratolytic effect. According to the classification of external glucocorticoids - strong (group 2).
Indications. Subacute and subacute dermatoses sensitive to external corticosteroid therapy chronic course with manifestations of hyperkeratosis: psoriasis, atopic dermatitis, neurodermatitis, lichen planus, dermatitis, ichthyosis.
Contraindications. Hypersensitivity to any of the components of the drug, as well as tuberculosis and viral infections skin, vaccinations, perioral dermatitis, rosacea.
Side effect. Locally, burning, itching, folliculitis, acne, stretch marks, skin atrophy, depigmentation, hyperkeratosis are possible. Very rarely, with prolonged use on large surfaces, occlusive-systemic manifestations occur with symptoms of an overdose of glucocorticosteroids or salicylic acid.
Application and doses. Apply a thin layer of anti-inflammatory antimicrobial ointment to the affected areas 1-2 times a day, lightly rubbing in, for no more than 3 weeks. If you want to prolong the course, use every other day. After the symptoms of the disease cease, treatment should be continued for some time to avoid relapse. Treatment of children under 12 years of age is under the supervision of a physician. During pregnancy and lactation, the duration and area of application of the drug are reduced.
Special notes. Do not apply antimicrobial ointment for external use to the skin of the breast before feeding.
Belogent - Belogent.
INN (international nonproprietary name) - Betamethasone + Gentamicin. Combined drug.
Release forms. Cream and ointment in tubes 0.05%, 30 g each.
Compound. 1 g of the drug contains 500 mcg of betamethasone dipropionate, the effect is strong (group 2), and 1 mg of gentamicin sulfate.
Pharmacological action. The combination of a fluorinated glucocorticosteroid and an aminoglycoside antibiotic gives a broad spectrum bactericidal effect: anti-inflammatory, antiallergic, antibacterial, antiproliferative and antipruritic.
Indications. Inflammatory and allergic dermatoses, complicated by bacterial infections or with the danger of its addition - dermatitis, eczema, neurodermatitis, psoriasis, lichen planus, anogenital itching - in children from 1 year of life and adults.
Application and doses. It is easy to rub a broad-spectrum antimicrobial agent into the affected areas 2 times a day (or 1 time). It is possible to use occlusive dressings.
Special notes. Avoid contact with eyes.
Effective antimicrobial agents: composition and side effects
Hyoxysone ointment - Ung. Hyoxysonum.
Combined drug.
Other trade names: Geocorton, Oxyzon.
Release form. Ointment in tubes of 10 g, in jars of 50 g.
Compound. 1 g of this effective antimicrobial agent contains 30 mg of oxytetracycline hydrochloride and 10 mg of hydrocortisone acetate. Contained in: aerosol preparation Oxycort.
Pharmacological action. A broad-spectrum antibiotic in combination with a halogen-free local glucocorticosteroid, weak in strength (group 4). Antibacterial, anti-inflammatory, antiallergic, antiexudative, antipruritic.
Indications. This antimicrobial skin ointment is used for dermatitis, eczema, and allergic dermatoses complicated by pyoderma.
Contraindications. Skin manifestations viral, fungal, tuberculosis nature. Hypersensitivity to the components of the drug.
Side effect. When using this broad-spectrum antimicrobial drug, allergic reactions and the development of secondary infections are rarely observed.
Application and doses. 0.5-1 g in a thin layer on the affected area 2 times a day. The use of bandages is possible.
Diprogenta.
Combined preparation for external use.
Release forms. Cream, ointment in tubes of 15 and 30 g.
Compound. 1 g of cream and ointment contains betamethasone dipropionate - 500 mcg and gentamicin sulfate - 1 mg. Includes corticosteroids for external use, betamethasone dipropionate, classified as strong (group 2), a broad-spectrum antibiotic from the aminoglycoside group - gentamicin.
Pharmacological action. Anti-inflammatory, antiallergic, antipruritic, antimicrobial.
Indications. Allergic and inflammatory dermatoses complicated by secondary infection: contact, intertriginous dermatitis, atopic dermatitis, solar, seborrheic, radiation dermatitis, psoriasis, erythroderma.
Contraindications. Primary bacterial, viral, fungal infections skin, skin tuberculosis, skin manifestations of syphilis, skin reactions after vaccination, chicken pox, hypersensitivity to the drug.
Side effect. This antimicrobial drug broad spectrum can cause itching, burning, steroid acne, irritation and dry skin.
Application and doses. Apply, lightly rubbing into the affected areas of the skin, 2 times a day. If necessary, apply occlusive dressings.
Special notes. The use of this antimicrobial agent requires caution in the 1st trimester of pregnancy.
Anti-inflammatory antimicrobial drugs: composition and indications
Cortomycetin ointment - Ung. Cortomycetinum.
Combined drug.
Release form. Ointment white with a yellowish tint. Compound. Active ingredients: hydrocortisone acetate, chloramphenicol.
Pharmacological action. Non-halogenated glucocorticoid, according to classification - weak (group 4); broad spectrum antibiotic.
Pharmacological action. Antiallergic, anti-inflammatory, antipruritic, antimicrobial.
Indications. Inflammatory and allergic diseases skin, including those complicated by microbial flora - infected microbial eczema. Also, this broad-spectrum antimicrobial drug is effective for neurodermatitis and pyoderma.
Contraindications. Tuberculosis, viral, fungal diseases skin, ulcerative lesions, pregnancy.
Side effect. Itching, hyperemia, pain, exacerbation of acute inflammatory reactions.
Application and doses. Apply antimicrobial combination remedy apply a thin layer to the affected areas 2-3 times a day daily dose from 2 to 30 g. For occlusive dressings, the drug is prescribed in a reduced dose once a day. The duration of the course is from 7 days to a month.
Levovinisol - Laevovinisolum.
INN (international nonproprietary name) - Chloramphenicol. Combined drug.
Release form. Aerosol cans of 80 mg, equipped with a spray valve.
Compound. Contains chloramphenicol, vinylin, linetol, citral, propylene (freon), ethyl alcohol.
Pharmacological action. Antimicrobial and anti-inflammatory. The antibiotic chloramphenicol has a wide spectrum of activity and acts bactericidal or bacteriostatic.
Indications. Bedsores, trophic ulcers, infected wounds and erosions, superficial and limited deep burns.
Contraindications. Individual hypersensitivity to chloramphenicol, microflora resistance to it.
Side effect. When applied to wounds, a burning sensation may occur. This side effect of this antimicrobial agent goes away very quickly.
Application and doses. Spray the drug from 20-30 cm onto the lesion 2-3 times a week, and when severe lesions- daily 2 times a day.
Anti-inflammatory antimicrobial agents and methods of their use
Lorinden S. - Lorinden S.
Combined drug.
Release forms. Cream and ointment in tubes of 15 g.
Compound. 1 g of this antimicrobial drug contains 200 mcg of flumethasone pivalate and 30 mg of iodochlorhydroxyquinoline.
Pharmacological action. The first component is a local fluorinated glucocorticoid, classified as moderately strong (group 3) with antiallergic, antipruritic and antiexudative effects, and the second component has antibacterial and antifungal effects.
Indications. Allergic dermatoses complicated by bacterial infection, dermatitis, eczema, psoriasis, including old cases on the scalp, atopic dermatitis, lichen planus, discoid lupus erythematosus, bacterial and, complicated by local allergic reactions, impetigo. In the acute phase of the disease, a cream is used, and then an antimicrobial ointment is used.
Contraindications. Viral lesions skin, manifestations of tuberculosis and syphilis on the skin, neoplasms and precancerous skin diseases, vulgar and rosacea, perioral dermatitis, trophic ulcers of the leg associated with varicose veins veins, conditions after vaccination. For occlusive dressing - skin infections.
Application and doses. Apply to affected areas of skin 3 times a day until improvement. During pregnancy, do not use in the 1st trimester, later - only on small surfaces.
Special notes. This antimicrobial agent of modern pharmacology requires caution when administered to nursing mothers.
Oxycort - Oxycort.
INN (international nonproprietary name) - Oxytetracycline + Hydrocortisone. Complex drug.
Release forms. Ointment in a tube of 20 g, aerosol for external use in a bottle of 75 g.
Compound. The ointment contains oxytetracycline hydrochloride 3% and hydrocortisone acetate 1%; aerosol - 0.4 and 0.13%, respectively. Pharmacological action. A broad-spectrum antibiotic provides an antibacterial effect, and a glucocorticoid is anti-inflammatory, antiallergic and antipruritic, with a weak effect (group 4). The aerosol has a pronounced drying effect.
Indications. Dermatitis, eczema, atopic dermatitis, complicated by pyogenic infection, as well as trophic ulcers, sunburn, strepto- and staphyloderma, erysipelas, infected diaper rash. This broad-spectrum antimicrobial drug is also used for other dermatoses complicated by secondary bacterial infection.
Contraindications. Skin manifestations of skin tuberculosis, viral and mycotic infections, pregnancy (if there are large areas of damage), individual intolerance to the components of the drug.
Side effect. Rarely, when using this antimicrobial drug, allergic rash, and with prolonged use, steroid acne, skin atrophy, telangiectasia, and hypertrichosis are possible.
Application and doses. Apply a thin layer to the affected areas 2 times a day. Spray the aerosol from a distance of 15-20 cm 2 times a day.
Special notes. Avoid contact of the drug with mucous membranes; Do not inhale the aerosol.
Antimicrobials: broad-spectrum skin ointments
Pimafucort - Pimafucort.
Combined drug.
Release forms. Cream and ointment for external use contain natamycin (1%), neomycin (0.35%) and hydrocortisone (1%).
Pharmacological action. Antimicrobial, antifungal and anti-inflammatory. The effect of hydrocortisone is anti-inflammatory, antipruritic. Neomycin is a broad-spectrum antibiotic that is active against a number of Gr+ and Gr- bacteria. Natamycin is a polyene antibiotic of the macrolide group, effective against yeast, yeast-like fungi, dermatophytes and trichomonas.
Indications. Superficial dermatoses infected with bacteria or fungi sensitive to neomyin and natamycin, as well as pustular dermatoses, mycoses, otomycosis.
During pregnancy, treat with caution.
Contraindications. Hypersensitivity to components. Side effect. At the beginning of treatment - a slight exacerbation of the disease, with prolonged use - stretch marks in the areas of application.
Application and doses. This external antimicrobial agent is applied to affected areas of the skin for children and adults 2-4 times a day for up to 4 weeks.
Special notes. Do not apply to the eye area. With prolonged treatment with this drug and application of antimicrobial ointment to large areas with bandages, the production of corticosteroid hormones is suppressed, and in the presence of wounds - riskotoxic and nephrotoxic effects.
Polcortolon TS - Polcortolon TS.
INN (international nonproprietary name) - Triamcinolone + Tetracycline. Combined drug.
Release form. Aerosol for external use in 40 ml bottles.
Compound. The active ingredients are triamcinolone and tetracycline hydrochloride.
Pharmacological action. Triamcinolone is a glucocorticoid with anti-inflammatory, antiallergic, antiexudative and antipruritic effects, and tetracycline hydrochloride is a broad-spectrum antibiotic.
Indications. Inflammatory skin diseases are acute and subacute, complicated by bacterial infection, when the lesion is localized in the folds - dermatitis, eczema, intertrigo.
Contraindications. Children's age, as well as hypersensitivity to Tetracycline, perioral dermatitis.
Side effect. Irritation is rarely observed at the sites where the aerosol is applied.
Application and doses. Apply antimicrobial anti-inflammatory drugs to the affected areas 1 - 3 times a day. Occlusive dressings are not practical. Special notes. Do not apply to mucous membranes.
Antimicrobial drugs and their characteristics
Sofradex - Sofradex.
INN (international nonproprietary name) - Dexamethasone + Framycetin + Gramicidin.
Release forms. Ointment, eye (ear) drops. Translucent ointment of yellowish-white color, sterile; transparent colorless sterile drops.
Compound. Framycein sulfate BP (soframycin), gramicidin and dexamethasone.
Pharmacological action. This effective drug has antimicrobial and anti-inflammatory effects.
Indications.; otitis externa.
Contraindications. Viral or fungal infection purulent inflammation eye, glaucoma, herpetic keratitis. For otitis externa, do not use in case of perforation of the eardrum due to the risk of ototoxicity.
Application and doses. Drops - adults (including the elderly) and children, 2 or 3 drops; introduce gradually one drop 3-4 times a day. Ointment - 1-2 times a day.
Supirocin-B - Supirocin-B.
Combined drug.
INN (international nonproprietary name) - Betamethasone + Mupirocin.
Release form. Ointment for external use in tubes of 15 g.
Compound. Betamethasone dipropionate 0.05% and mupirocin 2%, etc.
Pharmacological action. Betamethasone is a glucocorticosteroid for external action, according to the classification - strong (group 2) with anti-inflammatory, antiallergic, anti-edematous, antipruritic effects. Mupirocin is an antibiotic of natural origin, depending on the concentration, bactericidal or bacteriostatic: Gr + cocci and Gr - rods.
Indications. Non-allergic and allergic contact dermatitis, as well as seborrheic, atopic, exfoliative dermatitis, dermatitis herpetiformis, eczema, neurodermatitis. Also this antimicrobial drug broad spectrum of action is used for urticaria and psoriasis complicated by secondary bacterial infections.
Contraindications. Bacterial, viral, fungal skin lesions, trophic leg ulcers associated with varicose veins, rosacea and acne vulgaris, skin cancer, Kaposi's sarcoma, melanoma, nevus, atheroma, hemangioma, xanthoma, post-vaccination skin reactions, as well as pregnancy, lactation, childhood up to 12 years old.
Side effect. Non-allergic and allergic contact dermatitis, folliculitis, hypertrichosis, hypopigmentation, skin atrophy, acne-like rashes, perioral dermatitis, secondary infection, maceration, prickly heat.
Application and doses. Apply a thin layer to the affected areas 2-3 times a day for 5-14 days. Only for treating affected areas no more than 10 cm long and up to 100 square centimeters in area. If there is no improvement within 3-5 days, the patient should be re-examined.
Special notes. Avoid contact with eyes, mucous membranes, and open wound surfaces. Due to its potent characteristics, it is preferable to use this antimicrobial agent only in the acute period of the disease, and for a short time, on minor surfaces of the skin.
External antimicrobial agents: indications and contraindications
Triderm - Triderm.
INN (international nonproprietary name) - Betamethasone + Gentamicin + Clotrimazole. Combined drug.
Release forms. Ointment and cream 15 g each.
Compound. Betamethasone dipropionate, clotrimazole, gentamicin. For external use.
Pharmacological action. Betamethasone dipropionate is a fluorinated external glucocorticoid, classified as moderately strong (group 3) with anti-inflammatory, antiallergic, antiexudative and antipruritic effects. Clotrimazole - with an antifungal effect against dermatophytes and yeast-like fungi. Gentamicin is an antibiotic of the aminoglycoside group, has a bactericidal effect on Gr+ and Gr- bacteria.
Indications. Dermatoses complicated by secondary infection; mycoses of the hands and feet, smooth skin, inguinal mycosis.
Contraindications. Hypersensitivity to the components of the drug, lactation.
Side effect. Exudation, erythema, pigmentation disorder, burning sensation, itching. Betamethasone-induced folliculitis, hypertrichosis, acne, hypopigmentation, perioral dermatitis, skin maceration, development of secondary resistant flora, skin atrophy, stretch marks, prickly heat, burning, itching, dryness. Caused by clotrimazole - erythema, peeling, swelling, maceration of the skin, urticaria, paresthesia, itching. Caused by gentamicin - hyperemia, itching.
Application and doses. Apply a thin layer to the affected and surrounding skin in the morning and at night for 3-4 weeks. Use with caution during pregnancy; lactation is incompatible with the use of the drug.
Special notes. When applying this broad-spectrum antimicrobial ointment to large surfaces, as well as when using occlusive dressings, suppression of the production of corticosteroid hormones is possible. Avoid application to damaged skin and open wounds. If resistant bacterial or fungal microflora appears, use of the drug should be discontinued and the necessary therapy should be prescribed.
Fucidin G - Fucidin N.
INN (international nonproprietary name) - Hydrocortisone + Fusidic acid. Combined drug.
Release form. Cream for external use in tubes of 15 g. Homogeneous white cream. Keep out of the reach of children.
Compound. Active ingredients: fusidic acid hemihydrate (an antibiotic of a polycyclic structure) and hydrocortisone acetate. Pharmacological action. Unites antibacterial effect fusidic acid - against staphylococci, streptococci, as well as the causative agent of lichen versicolor, etc. and the anti-inflammatory effect of hydrocortisone.
Indications. Complicated by bacterial infection, non-allergic and allergic contact dermatitis, seborrheic dermatitis, atopic dermatitis, eczema, neurodermatitis, lichen planus, discoid lupus erythematosus.
Contraindications. Hypersensitivity to the components of the drug, as well as skin tuberculosis, manifestations of syphilis on the skin, chicken pox, viral and fungal skin infections, post-vaccination skin reactions, trophic ulcers, rosacea, acne vulgaris, open wounds.
Side effect. Itching, burning, tingling, erythema, dry skin, as well as irritation and rash. Rarely, when using this antimicrobial drug, acne-like rashes, hyperpigmentation, folliculitis, stretch marks, skin atrophy, hypertrichosis, and allergic contact dermatitis are possible.
Application and doses. Apply a thin layer to the affected areas of the skin 2 times a day for 2 weeks. During pregnancy and lactation, do not use for a long time and during large quantities, at breastfeeding Do not apply to the mammary glands.
Special notes. Use cautiously on the face, in skin folds and in children. Avoid contact with eyes.
Broad-spectrum antimicrobial drugs: composition and application
Dermosolon – Dermosolon.
Combined drug.
Release form. Yellowish ointment in tubes of 5 g.
Compound. Prednisolone 0.5% and 5-chloro-7-iodo-8-hydroxyquinoline 3%.
Pharmacological action. Anti-inflammatory, antiallergic, antipruritic, antimicrobial.
Indications. Infected eczema, ulcers, pustular and fungal skin lesions.
Contraindications and side effects. Characteristic of external glucocorticosteroids and individual intolerance to the 2nd component of the ointment.
Application and doses. Apply a thin layer of a broad-spectrum antimicrobial agent to the skin 1-3 times a day.
Fucicort - Fucicort.
INN (international nonproprietary name) - Fusidic acid + Betamethasone valerate. Combined drug.
Release form. White cream for external use in 15 g tubes. Store out of the reach of children.
Compound. Active ingredients: fusidic acid (antibiotic with a polycyclic structure) and betamethasone valerate (glucocorticoid).
Pharmacological action. Highly active against staphylococci, streptococci, and the causative agent of lichen versicolor. Betamethasone valerate is a topical glucocorticoid according to the classification - strong (group 2) with anti-inflammatory and antipruritic effect.
Indications. Non-allergic and allergic contact dermatitis, seborrheic, atopic, neurodermatitis, discoid form of lupus erythematosus, complicated by bacterial infections.
Contraindications. Hypersensitivity to components, skin tuberculosis, manifestations of syphilis on the skin, chicken pox, viral and fungal skin infections, post-vaccination reactions on the skin, trophic ulcers, rosacea. Also, the use of this broad-spectrum antimicrobial drug is contraindicated in acne vulgaris and open wounds.
Side effect. Locally - itching, burning, tingling, dry skin, irritation, erythema, rash. Rarely - acne-like changes, hypopigmentation, folliculitis, stretch marks, atrophy.
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Antimicrobial drugs are produced not only in the form of the usual tablets, but also in powders, injection solutions, in the form of ointments, sprays, gels and creams. Their main purpose is to suppress the development and spread of pathogenic microbes. Modern pharmacology produces antimicrobial agents for both adults and children.
Antimicrobial drugs in powders
Borozin - Borozin.
Release form. Sachets in the amount of 5 pcs. 5 g of powder each.
Pharmacological action. This antimicrobial drug normalizes the sweating process and inhibits the microbial flora.
Indications. Increased sweating bad smell stop, prevention of fungal diseases.
Application and doses. Divide the bag into 2 parts, put it in the left and right shoes daily (for a long time).
Brilliant green -Viride nitens
Release forms. Powder, alcohol solution 1% and 2% in 10 ml bottles. Compound. Bis-(para-diethylamino) triphenyl-anhydrocarbinol oxalate.
Application and doses. Prescribed externally as an antiseptic in the form of a 1% or 2% alcohol or aqueous solution for lubrication in case of pyoderma.
Dermatol – Dermatolum.
International nonproprietary name - Bismuth subgallate.
Release forms. Powder and ointment 10% on Vaseline.
Compound. Bismuth subgallate - amorphous powder of lemon- yellow odorless and tasteless.
Pharmacological action. This antimicrobial medicine is used externally as an astringent and drying agent for inflammatory diseases skin and mucous membranes in the form of powder, ointment and suppositories.
Indications. Ulcers, eczema, dermatitis.
Special notes. Store in a well-packed container, protected from light.
Furacilin - Furacilin.
International nonproprietary name - Nitrofiral.
Release form. This product, included in the list of antimicrobial drugs, is a yellow or greenish-yellow powder with a bitter taste, poorly soluble in water. Used in the form of ointment 0.02%, tablets 0.2 for the preparation of solutions.
Compound. Furacilin is a 5-nitrofurfural semi-carbazone.
Pharmacological action. Antibacterial agent. Acts on Gr+ and Gr microorganisms - staphylococci, streptococci, Escherichia coli etc.
Indications. Externally for the treatment and prevention of purulent-inflammatory processes, bedsores, ulcerative lesions, 2nd and 3rd degree burns, purulent wounds.
Contraindications. Chronic allergic dermatoses.
Side effect. Development of dermatitis.
Application and doses. Use aqueous 0.02% and alcohol 0.066% (1:1500) solutions, as well as ointment. The alcohol solution is made with 70% ethyl alcohol.
Antimicrobial drugs in the form of ointments
Desitin ointment - Ung. Destiny.
International nonproprietary name - Zinc oxide.
Release form. Ointment in tubes of 57 and 113 g.
Compound. Zinc oxide, inactive components - cod liver oil, neutralizer LC-2, tenox B HA, methylparaben, white petrolatum, anhydrous lanolin.
Pharmacological action. Physical barrier of the skin, reduces the impact of irritants. Provides long-lasting moisture protection when baby for a long time is in wet diapers. Weak astringent, soothing, slight desquamating effect.
Indications. Prevention and treatment of diaper rash. Remedy for minor burns, cuts, scrapes and sunburn. Soothing and protective effect for eczema.
Contraindications. Hypersensitivity to components.
Side effect. When using this antimicrobial agent, erythema and itching are possible.
Application and doses. For diaper rash in children, use 3 or more times a day. When using this antimicrobial drug for the prevention of diaper dermatitis, apply to the skin covered by the diaper before bedtime, when the child may be in wet diapers for a long time. For minor burns, cuts, scratches, and sunburn, apply the ointment in a thin layer. During pregnancy and lactation, use is not contraindicated.
Special notes. Prescribe only for superficial and non-infected lesions.
Interferon (alpha-2-interferon and KIP).
International nonproprietary name - Interferon alpha-2b.
Release form. This antimicrobial drug is available in the form of an ointment in tubes and jars of 5 g, 10 g and 30 g.
Compound. 1 g of ointment contains 500,000 IU alpha interferon, KIP is a complex immunoglobulin preparation (contains IgG, M, A with control for viruses).
Pharmacological action. The CIP contains antibodies against herpes viruses, chlamydia, and staphylococci.
Indications. Herpes simplex and herpes zoster, genital warts, papillomas, long-term non-healing trophic ulcers.
Contraindications. Individual intolerance. The drug is not suitable if the oil smells rancid.
Application and doses. Apply the antimicrobial agent in a thin layer 2-3 times a day for herpes (5-7 days), for other diseases - 7-14 days, for trophic ulcers Apply the ointment around the periphery of the ulcer.
Boric acid - Acidum boricum.
International nonproprietary name - Boric acid.
Release forms. Boric ointment 5%; Boric petroleum jelly contains 5 boric acid and 95 parts of petroleum jelly. A solution of boric acid 0.5%, 1%, 2%, 3%, 5% in ethyl alcohol 70%. Aqueous solutions are prepared from the powder ex tempore. Boric-zinc liniment (boric acid 1 g, zinc oxide 10 g, sunflower oil 10 g). Boric-naphthalan paste (boric acid 5 g, zinc oxide and starch 25 g each, naphthalan ointment 45 g - in glass jars of 50 and 100 g). Teymurov's paste (boric acid and sodium tetraborate 7 g each, salicylic acid - 1.4 g, zinc oxide - 25 g, hexamethylene tetramine 3.5 g, formaldehyde solution 3.5 g, lead acetate 0.3 g, talc 25 d , glycerin 12 g, mint oil 0.3 g, distilled water - 12 g and emulsifier -3 g) as a disinfectant, drying, deodorizing agent for sweating and diaper rash.
Pharmacological action. This antimicrobial drug has antiseptic activity. In the form of an ointment, it has an anti-pediculosis effect. Boric acid is used in adults.
Indications. Weeping dermatitis and eczema - 3% solution in cold lotions. Alcohol solutions 0.5-3% for treating affected skin areas with pyoderma, eczema, diaper rash; 10% solution in glycerin - for lubricating the affected areas during diaper rash. For the treatment of pediculosis - 5% boric ointment.
Contraindications. This antimicrobial drug is not recommended for patients with impaired renal function, nursing mothers for treating the mammary glands, children, pregnant women, or those with individual intolerance. Boric acid preparations should not be applied to large areas of the body.
Side effect. With prolonged use of acid and overdose, as well as with impaired renal function, acute and chronic toxic reactions are possible: nausea, vomiting, diarrhea, skin rashes, desquamation of the epithelium, headaches, confusion, convulsions, oliguria, and rarely, shock.
Application and doses. Externally as a moderate antiseptic. In the form of an ointment for lice, apply to the scalp, and after 20-30 minutes, wash off with warm running water and soap, comb out thoroughly with a fine comb. Do not apply in case of acute inflammatory skin diseases, avoid getting the ointment in the eyes.
Xeroform ointment - Ung. Xeroformii.
Release form. Ointment 3-10% yellow in color, uniform consistency with a characteristic odor.
Compound. Basic bismuth tribromophenolate with bismuth oxide.
Pharmacological action. Antiseptic, drying, astringent.
Indications. This effective antimicrobial drug is prescribed for skin diseases, taking into account the pharmacological action of xeroform.
Special notes. Store the powder in a container protected from light and moisture.
Salicylic acid ointment - Ung. Acidi salicylici.
International nonproprietary name - Salicylic acid.
Release forms. Ointment 2 or 3%, 25 g each in glass jars, 2% alcohol solution for external use, 30 ml in a bottle. Store in a place protected from the sun.
Compound. The active substance is salicylic acid.
Pharmacological action. Antiseptic for external use with a distracting, irritating and keratolytic effect. Causes swelling and softening of the stratum corneum, which gradually becomes discolored and is easily scraped off from the surface of the skin or removed in layers. This one of the best antimicrobial drugs has an antipruritic effect.
Indications. Infected skin lesions, seborrhea, seborrheic dermatitis, psoriasis, keratoderma, hyperkeratosis, horny eczema, pityriasis versicolor, lichen planus, limited neurodermatitis. Contraindications. Individual intolerance to the drug.
Side effect. Burning, itchy skin, rashes.
Application and doses. Apply a thin layer to affected areas of the skin no more than 2 times a day; It is also possible to wipe with an alcohol solution.
Zinc ointment - Ung. Zinci.
Release forms. In a package of 30 g. Zinc paste, salicylic-zinc paste, zinc-ichthyol paste, zinc-naphthalan ointment with anesthesin. Baby powder.
Compound. The active ingredient is zinc oxide.
Pharmacological action. Antiseptic, astringent, drying.
Indications. This antimicrobial agent is prescribed for dermatitis, diaper rash, ulcers, etc.
Gentamicin sulfate - Gentamicin sulfate.
Release form. For external use - ointment 0.1% in a tube of 15 g.
Pharmacological action. Antimicrobial agent broad-spectrum action of the group of aminoglycosides. Active against Gr-bacteria: Escherichia coli, Shigella, Klebsiella, Pseudomonas aeruginosa; Gr+ bacteria: staphylococci (including those resistant to other antibiotics), certain strains of streptococci. Does not affect anaerobes.
Indications. Infections caused by microorganisms sensitive to the drug: furunculosis, folliculitis, burns, skin abscesses and ulcers, infected animal bites, wounds.
Application and doses. Apply the ointment in a thin layer to the damaged surface. You can use gauze soaked in ointment. Frequency - 1-2 times a day, and in severe cases - 3-4 times a day.
Antimicrobial drugs for injection
Benzylpenicillin / Benzylpenicillinum.
International nonproprietary name - Benzylpenicillin.
Release form. Injection bottles of 250,000, 500,000, 1,000,000 and 5,000,000 units. Compound. Benzylpenicillin sodium salt.
Pharmacological action. An antibiotic of the group of biosynthetic penicillins, destroyed by penicillinase. This antimicrobial drug has a bactericidal effect by inhibiting the synthesis cell wall microorganisms. Active against Gr+ bacteria: Streptococcus spp., Staphylococcus spp. (non-penicillinase-forming), Corynebacterium diphtheriae, Gr-bacteria, anaerobic bacteria, and spirochetes. Strains of Staphylococcus spp. that produce penicillinase are resistant to the action of benzylpenicillin. Destroys in an acidic environment. The novocaine salt of Benzylpenicillin, compared to the potassium and sodium salts, is characterized by a longer duration of action.
Indications. Syphilis, plaque scleroderma, infections of the skin and subcutaneous tissue (including erysipelas), Lymeborreliosis, gonorrhea, blenorrhea.
Contraindications. Hypersensitivity to drugs penicillin series, atopic dermatitis, bronchial asthma, urticaria, hay fever.
Side effects. Skin rash, rarely - headache, nausea, loss of appetite, intestinal dysbiosis, candidiasis.
Application and doses. 500,000-1,000,000 units are administered intramuscularly every 6 hours from 7-10 days to 1 month or more. When treating syphilis, use the drug according to accepted regimens.
Special notes. Severe allergic reactions may occur, including the development anaphylactic shock. Use in insufficient doses leads to the development resistant strains pathogens. Use with caution in patients with impaired renal function and heart failure. Due to the possibility of developing fungal superinfection, it is advisable to prescribe antifungal drugs against the background of penicillin therapy.
Extensillin – Extencilline.
International nonproprietary name - Benzathine benzylpenicillin. Trade name others: Bicillin 1.
Release form. Vials with lyophilized dry substance for injection, 50 pcs. in packaging.
Compound. 1 bottle contains benzathine benzylpenicillin 600,000, 1,200,000 or 2,400,000 units.
Pharmacological action. Long-acting antibiotic of the biosynthetic penicillin group. Active against Gr+ bacteria, Gr- cocci, actinomycetes and spirochetes. This antimicrobial medicine is used to treat infections caused by Treponema pallidum and Streptococcus. Not resistant to penicillinase.
Indications. Syphilis, erysipelas, wound infection, rheumatism.
Contraindications. Hypersensitivity to benzathine benzylpenicillin and other penicillin antibiotics.
Side effects. Anemia, thrombocytopenia, leukopenia, blood clotting disorders, allergic reactions - urticaria, rash on the skin and mucous membranes, joint pain, fever, anaphylactic shock.
Application and doses. Extensillin is administered deeply intramuscularly. For the treatment of syphilis - intramuscularly with an interval of 8 days in a single dose of 2,400,000 units 2-3 times a day. Dilute with water for injection for each dosage in 2.4 and 8 ml, respectively.
Other antimicrobial agents for children and adults
Drapolen - Drapolen.
International nonproprietary name - Bezalkonium chloride + Cetrimide.
Release form. Cream in tubes of 55 g.
Compound. The active ingredients are benzalkonium chloride and cetrimide.
Pharmacological action. An antimicrobial drug called Drapolene has an antiseptic, disinfectant effect - it damages the membranes of microorganisms.
Indications. Prevention and treatment of diaper rash in children early age, an antimicrobial drug for the treatment of contact dermatitis in adults; minor burns (including sunburn).
Contraindications. Hypersensitivity to components.
Side effect. Despite the fact that this antimicrobial agent is considered one of the best, allergic skin reactions are possible when using it.
Application and doses. Apply a thin layer to previously washed and dried skin; for children - at every diaper change.
Special notes. The effect weakens upon contact with soap or other anionic surfactant.
Cuprum-zinc cream (Uriage).
Medicinal cosmetic product.
Release form. Emulsion in tubes of 40 ml.
Compound. Copper and zinc gluconates, TLR2-Regul, Uriage thermal water.
Pharmacological action. This drug has antimicrobial activity, reduces adhesion Staphylococcus aureus with corneocytes, prevents secondary infection, soothes and heals the skin.
Indications. Hygiene and care of atopic skin during exacerbation in newborns, children and adults. Accompanying treatment with glucocorticoids to prevent secondary infections: contact dermatitis, cheilitis, gluteal erythema in newborns, eczema.
Contraindications, side effects. Not marked.
Application. Two applications with an antimicrobial agent for children and adults per day on skin previously cleansed with gel or soap.
Special notes. Can be used in parallel with external corticosteroid therapy or in between courses of treatment.
Cuprum-zinc spray with smectite (Uriage).
Medicinal cosmetic product.
Release form. Spray 100 ml.
Compound. Colloidal silicates of mineral and natural origin in micropowder (smectite), copper gluconate, zinc gluconate, Uriage thermal water.
Pharmacological action. Absorbent, aseptic, soothing.
Indications. This antimicrobial agent is intended for wet areas in newborns, children and adults.
Application. Apply as needed to wet areas.
Special notes. No drug interactions have been established.
Chlorhexidine - Chlorhexidine.
International nonproprietary name - Chlorhexidine. Other trade name: Plivasept (cream).
Release forms. Aqueous solution 20% in bottles of 0.5, 3 and 5 l; for individual prevention of sexually transmitted diseases 0.05% solution in polymer packaging of 100 ml. Cream - bigluconate (1%) and hydrocortisone (1%) in tubes of 20, 50 and 100 g.
Compound. The solution and cream contain chlorhexidine in the form of bigluconate.
Pharmacological action. This antimicrobial drug is one of the most active local antiseptics. Strong bactericidal effect on Gr+ and Gr- bacteria. Effective against pathogens of sexually transmitted diseases: treponemas, gonococci, trichomonas. Hydrocortisone contained in the cream has an anti-inflammatory effect.
Indications. An aqueous solution of 0.5% is used to disinfect wounds and burns. Prevention of sexually transmitted diseases - syphilis, gonorrhea, trichomoniasis, lavage of the urethra and bladder. The cream is used for acute and chronic eczema, dermatitis with concomitant bacterial infections, pyoderma, impetigo, panaritium, diaper rash, acne vulgaris, as well as for the healing of scratches, abrasions, and microtraumas.
Contraindications. The solution should not be prescribed if there is a tendency to allergic reactions, dermatitis. Regarding the cream - viral diseases skin, allergy to the drug.
Application and doses. Apply the cream to the affected area of skin in a thin layer 1-3 times a day. Long-term use of this antimicrobial drug is not recommended.
Special notes. Avoid getting the cream into your eyes.
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Antibiotics are a broad group of medicines, whose action is aimed at combating diseases infectious nature. In recent years, the list of these funds has undergone some changes. New generation broad-spectrum antibiotics have gained great popularity. There are modern drugs that are aimed at eliminating the pathogen certain disease. Narrow-acting drugs are more preferable because they do not affect normal microflora.
How do new generation antibiotics work?
Medical professionals successfully use antibacterial agents due to the fact that life-threatening important processes in the cells of the human body differ from similar processes bacterial cell. These new generation drugs act selectively, affecting only the cell of the pathogenic microorganism, without affecting human ones. Classification occurs depending on the way in which they influence the vital activity of microorganisms.
Some drugs suppress the synthesis of external cell membrane bacteria that are not found in human body. These include cephalosporins, penicillin antibiotics, etc. Another group almost completely suppresses protein synthesis in bacterial cells. The latter include macrolides and tetracycline antibiotics. The list of broad-spectrum drugs is divided according to the principle of antibacterial activity. The instructions must indicate the area of activity of the tablets.
Some drugs have a broad spectrum of action, being effective against many bacteria, while others may have a narrow focus, targeting a specific group of bacteria. Why is this happening? The fact is that viruses and bacteria are characterized by different structure and functioning, so what kills bacteria does not affect viruses. Broad-spectrum antibiotics are used when:
- pathogens exhibit resistance to the influence of a highly targeted drug;
- a superinfection has been identified, the culprits of which are several types of bacteria;
- prevention of infections occurs after surgical interventions;
- treatment is prescribed based on clinical symptoms, that is, empirically. In this case, the specific pathogen is not identified. This is appropriate for common infections and dangerous fast-acting diseases.
Features of broad-spectrum antibiotics
The new generation of broad-spectrum drugs are universal remedies that can treat inflammation of the lymph nodes, colds, accompanying coughs, runny nose, etc. Whatever pathogen causes the disease, the remedies will defeat the microbe. Each newly developed medicine has a more advanced, improved effect against pathogenic microorganisms. The new generation of antibiotics is believed to cause minimal damage to the human body.
List of new generation antibiotics with a wide spectrum of action
The list of existing new generation broad-spectrum antibiotics includes many drugs, both cheap and more expensive. The most frequently used of all groups of drugs are penicillins, macrolides, fluoroquinolones, and cephalosporins. They are available in the form of injection solutions, tablets, etc. New generation drugs are characterized by improved pharmacological actions, when compared with older drugs. So the list is:
- tetracycline group: “Tetracycline”;
- penicillins: “Ampicillin”, “Amoxicillin”, “Ticarcyclin”, “Bilmitsin”;
- fluoroquinolones: Gatifloxacin, Levofloxacin, Ciprofloxacin, Moxifloxacin;
- carbapenems: “Meropenem”, “Imipenem”, “Ertapenem”;
- amphenicols: "Chloramphenicol";
- aminoglycosides: "Streptomycin".
Find out more about the drug and children, instructions for use and contraindications.
Names of highly targeted strong antibiotics
New generation highly targeted drugs are used when the causative agent of the infection is precisely identified. Each drug acts on a specific group of pathogenic microorganisms. Unlike broad-spectrum antibiotics, they do not contribute to disorders and do not suppress the immune system. Due to a deeper degree of purification of the active substance, the medicine has less toxicity.
Bronchitis
For bronchitis, in most cases, new generation broad-spectrum antibiotics are prescribed, but the choice of drug should be based on the results laboratory research sputum. The best medicine is considered to be the one that has a detrimental effect directly on the bacterium that caused the disease. This approach is explained by the fact that the study takes from 3 to 5 days, and bronchitis must be treated as early as possible to avoid complications. The following antibacterial drugs are often prescribed:
- Macrolides - prescribed for individual intolerance to penicillin. Clarithromycin and Erythromycin are widely used.
- Penicillin has been used in medicine for a long time, and therefore some microorganisms have developed resistance to active substance. Therefore, the drugs were enhanced with additives that block the action of enzymes produced by microorganisms in order to reduce the activity of penicillin. The most effective are Amoxiclav, Panklav, and Augmentin.
- Fluoroquinolones – used to treat chronic bronchitis during the period of exacerbation. “Levofloxacin”, “Moxifloxacin”, “Ciprofloxacin” are characterized by great effectiveness.
- Cephalosporins are prescribed in case of obstructive forms of the disease. Modern antibiotics include Cefuroxime and Ceftriaxone.
Sinusitis
