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Penicillin instructions for use, analogues, contraindications, composition and prices in pharmacies

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Shelf life of penicillin: The shelf life of penicillin is 5 years.

Storage conditions of the drug: Store at a temperature not exceeding 25 degrees, in a dry place.

Terms of dispensing from pharmacies: By prescription

Composition, form of release, Pharmacological action of penicillin

Ingredients of Penicillin

The composition of drugs that are related to antibiotics groups penicillins depends on which drug is being discussed.

Currently, four groups are used:

• natural penicillins;
• semi-synthetic penicillins;
• aminopenicillins, which have an extended spectrum of action;
• penicillins with a wide antibacterial spectrum of influence.

Release form of penicillin

Injectable preparations are produced, as well as penicillin tablets.

Means for injections are produced in glass bottles, which are closed with rubber stoppers and metal caps. The vials contain different doses of penicillin. It is dissolved before administration.

Penicillin-ecmolin tablets are also produced, intended for resorption and for oral administration. Sucking tablets contain 5000 units of penicillin. In tablets for oral administration - 50,000 units.

Tablets of penicillin with sodium citrate may contain 50,000 and 100,000 units.

Pharmacological action of penicillin

Penicillin is the first antimicrobial agent, which was obtained using the products of vital activity of microorganisms as a basis. The history of this drug begins in 1928, when Alexander Fleming, the inventor of the antibiotic, isolated it from a strain of the fungus Penicillium notatum. In the chapter describing the history of the discovery of penicillin, Wikipedia indicates that the antibiotic was discovered by accident, after it entered the culture of bacteria from external environment mold fungus, its bactericidal effect was noted. Later, the formula of penicillin was determined, and other specialists began to study how to get penicillin. However, the answer to the questions, in what year this remedy was invented, and who invented the antibiotic, is unequivocal.

The further description of penicillin on Wikipedia testifies to who created and improved the drugs. In the forties of the twentieth century, scientists in the USA and Great Britain worked on the process of producing penicillin in industry. For the first time the use of this antibacterial drug for the purpose of therapy bacterial infections happened in 1941. And in 1945, for the invention of penicillin, the Nobel Prize was awarded to its creator Fleming (the one who invented penicillin), as well as scientists who worked on its further improvement - Flory and Chain.

Speaking about who discovered penicillin in Russia, it should be noted that the first samples of the antibiotic were obtained in the Soviet Union in 1942 by microbiologists Balezina and Yermolyeva. Next in the country began industrial production antibiotic. In the late fifties, synthetic penicillins appeared.

When this medicine was invented, for a long time it remained the main antibiotic used clinically throughout the world. And even after other antibiotics without penicillin were invented, this antibiotic remained important drug for the treatment of infectious diseases. There is a claim that the medicine is obtained using cap mushrooms, but today there are different methods for its production. Currently, the so-called protected penicillins are widely used.

The chemical composition of penicillin indicates that the agent is an acid, from which various salts are subsequently obtained. Penicillin antibiotics include Phenoxymethylpenicillin (penicillin V), Benzylpenicillin (penicillin G), etc. The classification of penicillins involves their division into natural and semi-synthetic.

Biosynthetic penicillins provide a bactericidal and bacteriostatic effect by inhibiting the synthesis of the cell wall of microorganisms. They act on some gram-positive bacteria (Streptococcus spp., Staphylococcus spp., Bacillus anthracis, Corynebacterium diphtheria), some gram-negative bacteria (Neisseria meningitidis, Neisseria gonorrhoeae), anaerobic spore-forming rods (Spirochaetaceae Actinomyces spp.), etc.

The most active of penicillin preparations is Benzylpenicillin. Resistance to the influence of benzylpenicillin is demonstrated by strains of Staphylococcus spp., which produce penicillinase.

Penicillin is not effective tool in relation to bacteria of the enteric-typhoid-dysenteric group, pathogens of tularemia, brucellosis, plague, cholera, as well as pertussis, tuberculosis, Friedlander, Pseudomonas aeruginosa and viruses, rickettsiae, fungi, protozoa.

Indications for the use of penicillin

Indications for the use of penicillin are:

Antibiotics of the penicillin group, the names of which will be prompted directly by the attending physician, are used to treat diseases provoked by microorganisms sensitive to penicillin:

• pneumonia (croupous and focal);
• pleural empyema;
• septic endocarditis in acute and subacute form;
• sepsis;
• pyemia;
• septicemia;
• osteomyelitis in acute and chronic form;
• meningitis;
• infectious diseases bile and urinary tract;
• purulent infectious diseases of the skin, mucous membranes, soft tissues;
• angina;
• scarlet fever;
• erysipelas;
• anthrax;
• actinomycosis;
• diphtheria;
• gynecological purulent-inflammatory diseases;
• ENT diseases;
• eye diseases;
• gonorrhea, syphilis, blennorrhea.

Contraindications to the use of penicillin

Contraindications to the use of the drug penicillin are:

Tablets and injections are not used in such cases:

• with high sensitivity to this antibiotic;
• with urticaria, hay fever, bronchial asthma and other allergic manifestations;
• with the manifestation in patients of high sensitivity to sulfonamides, antibiotics, as well as to other drugs.

penicillin - instructions for use

Antimicrobial action is observed with local and resorptive action of penicillin.

Instructions for the use of penicillin in injections

The drug can be administered subcutaneously, intramuscularly, intravenously. The drug is also administered in spinal canal. In order for the therapy to be as effective as possible, it is necessary to calculate the dose so that 0.1–0.3 IU of penicillin is in 1 ml of blood. Therefore, the drug is administered every 3-4 hours.

For the treatment of pneumonia, syphilis, cerebrospinal meningitis, etc., a doctor prescribes a special scheme.

Instructions for use of penicillin tablets

The dosage of penicillin tablets depends on the disease and on the treatment regimen prescribed by the attending physician. As a rule, patients are prescribed 250-500 mg, the drug should be taken every 8 hours. If necessary, the dose is increased to 750 mg. It is recommended to take the tablets half an hour before a meal or two hours after a meal. The duration of treatment depends on the disease.

Side effects

In the process of application, the patient must understand what penicillin is, and what side effects he can provoke. In the course of treatment, allergy symptoms sometimes appear. As a rule, such manifestations are associated with sensitization of the body due to more early application these drugs. Also, allergies can occur due to prolonged use of the drug. At the first use of the drug, allergies are less common. There is a possibility of fetal sensitization during pregnancy if a woman takes penicillin.

Also during the course of treatment, the following side effects may develop:

• Digestive system: nausea, diarrhea, vomiting.
• Central nervous system: neurotoxic reactions, signs of meningism, coma, convulsions.
• Allergy: urticaria, fever, rash on the mucous membranes and on the skin, eosinophilia, edema. Cases of anaphylactic shock and fatal outcome. With such manifestations, adrenaline should be administered intravenously immediately.
• Manifestations associated with chemotherapeutic influence: oral candidiasis, vaginal candidiasis.

penicillin - analogues of the drug

Analogues of the drug penicillin are:

penicillin with alcohol

penicillin during pregnancy and lactation

There is no data

penicillin for children

It is used to treat children only after a doctor's prescription and under his supervision.

special instructions

Before using penicillin, it is important to conduct tests and determine the sensitivity to the antibiotic.

Carefully prescribe medicine to people who have impaired kidney function, as well as patients with acute heart failure, people who have a tendency to allergic manifestations or marked sensitivity to cephalosporins.

If after 3-5 days after the start of treatment there is no improvement in the patient's condition, it is important to consult a doctor who will prescribe other antibiotics or combined treatment.

Since in the process of taking antibiotics there is high probability manifestations of fungal superinfection, it is important to take antifungal agents during treatment. It is also important to consider that with the use of subtherapeutic doses of the drug or with an incomplete course of therapy, resistant strains of pathogens may appear.

When taking the drug inside, you need to drink it large quantity liquids. It is important to strictly follow the instructions on how to dilute the product.

In the process of treatment with penicillins, it is necessary to follow the prescribed treatment regimen very precisely and not to skip doses. If a dose is missed, the dose should be taken as soon as possible. You can not interrupt the course of treatment.

Since an expired medicine can be toxic, it should not be taken.

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

For a long time this antibiotic was the drug of choice for many 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 the low spectrum side effects, which allows it to be used for almost all categories of patients. Sometimes there are various allergic reactions - urticaria, rash, anaphylactic shock other. With prolonged use, cases of candidal infection are described.

However, the active use of penicillin in clinical practice led to the development of resistance. For example, staphylococci began to produce a special enzyme penicillinase, which is able to break down this antibiotic. Therefore appeared actual question about how to replace penicillin.

Amoxicillin is a newer drug from the penicillin group.

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

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

Amoxicillin should not be prescribed for drug hypersensitivity penicillin series, infectious mononucleosis(there is a specific rash or liver damage). Among the side effects, it is necessary to highlight 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 - based on 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 (E. coli, Proteus, Haemophilus influenzae and others). However, many bacteria can break it down with the help of penicillinase.

Today, ampicillin is used for:

Ampicillin should not be prescribed if there is a history of allergic reactions to penicillins, abnormal liver function, infectious mononucleosis, leukemia and HIV infection. Cases have been described neurological symptoms after taking the drug. Also, dyspeptic phenomena, the addition of candidiasis, toxic hepatitis and pseudomembranous colitis are sometimes observed.

The drug is available in the form of tablets for oral administration 0.25 g or powder for internal administration. There are the following trade names: "Ampicillin", "Ampicillin-Norton".

You can also replace penicillin with Augmentin, a combined antibiotic preparation of 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 a situation of increasing resistance of microorganisms. For the first time, Augmentin synthesized and began to produce the British pharmaceutical company Beecham Pharmaceuticals.

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

Among the contraindications are various violations liver function, increased sensitivity of the patient's body to penicillin antibiotics, 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;
• angioedema;
• toxic transient hepatitis.

Augmentin is available as a powder 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 teenagers and adults use the tablet form. Standardly take one tablet (875 mg amoxicillin / 125 mg clavulanic acid) 2 times a day. The minimum duration of the course 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 is maintained for 10 hours after ingestion.

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

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

Cefazolin is produced in vials with 0.5 or 1.0 g of the active substance 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 the antibiotic is prescribed 2 or 3 times a day.

Today, ceftriaxone is one of the most commonly 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 infection. Also, ceftriaxone, unlike cefazolin, penetrates well through the blood-brain barrier, which allows it to be actively used to treat bacterial meningitis in a situation where there are no results yet. bacteriological research. In addition, resistance to it is much less common than to drugs. penicillin group.

Ceftriaxone is used to treat inflammatory processes of bacterial etiology of the respiratory, genitourinary and digestive systems. An 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 in 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 shaped elements blood.

Ceftriaxone should not be administered together with calcium-containing drugs (Hartmann's and Ringer's solutions). When used in newborns, an increase in plasma bilirubin levels was noted. Also, before the first dose, it is necessary to conduct a test for the presence of hypersensitivity to the drug. Among the side effects are digestive disorders, allergic reactions and headache.

The drug is produced in the form of a powder in vials of 0.5, 1.0 and 2.0 g under the names: Alcyson, Blitzef, Lendacin, Noraxon, Rotacef, Cefogram, Ceftriaxone . The dosage and amount of administration depends on the age, pathology of the patient and the severity of his condition.

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Penicillin is one of famous antibiotics in the history of mankind. The discovery of penicillin is the second most important discovery in the rankings, according to a survey by the London Science Museum. greatest discoveries humanity. Its discovery took place at the beginning of the 20th century, and the active use of penicillin as a medicine began during the Second World War.

Penicillin is a waste product of the fungus Penicillium. His therapeutic effect extends to almost all gram-positive and some gram-negative bacteria (staphylococci, gonococci, spirochetes, etc.).

The use of penicillin

The good tolerability of penicillin makes it possible to use it in in large numbers diseases:

• sepsis;
• gas gangrene;
• extensive lesions skin as a result of injuries;
• erysipelas;
• brain abscess;
• sexually transmitted diseases (gonorrhea, syphilis);
• high degree burns (3 and 4);
• cholecystitis;
• croupous and focal pneumonia;
• furunculosis;
• ophthalmic inflammation;
• ear diseases;
• upper respiratory infections.

In pediatric pediatrics, penicillin treatment may be prescribed for:

• septicopyemia (a type of sepsis with the formation of interconnected abscesses in different organs);
• sepsis umbilical region in newborns;
• otitis, pneumonia in newborns and children early age;
• purulent pleurisy and meningitis.

Release forms of penicillin

Penicillin is released as a powder, which is diluted before injection. special solution. Injections can be made intramuscularly, subcutaneously, intravenously. Also, a solution of penicillin can be used as an inhalation and drops (for the ears and eyes).

Preparations of the penicillin group

Due to its effect on bacterial cells (suppression of chemical reactions necessary for life and reproduction bacterial cells) preparations based on penicillin are allocated to a separate classification group. To drugs natural group penicillin include:

• Procaine;
• Bicillin;
• Retarpen;
• smallpox;
• benzylpenicillin sodium salt;
• benzylpenicillin potassium salt.

Natural penicillins have the most gentle effect on the body. Over time, bacteria became resistant to natural penicillins and the pharmaceutical industry began to develop semi-synthetic penicillins:

• Ampicillin;
• Oxycellin;
• Ampiox.

Side effects of semi-synthetic drugs are more pronounced:

• gastrointestinal disorders;
• dysbacteriosis;
• skin allergic reactions;
• anaphylactic shock.

Currently, the fourth generation of drugs containing penicillin has been developed.

Familiar today antibacterial drugs less than a century ago made a real revolution in medicine. Mankind has received a powerful weapon to fight infections that were previously considered fatal.

The first were the antibiotics penicillins, which saved many thousands of lives during the Second World War, and are relevant in modern times. medical practice. It was with them that the era of antibiotic therapy began and thanks to them all other antimicrobial drugs were obtained.

Antibiotics of the penicillin series: a list of drugs, a brief description and analogues

This section presents complete list current antimicrobial agents medicines. In addition to the characteristics of the main compounds, all trade names and analogues are given.

Main title	Antimicrobial activity	Analogues
Benzylpenicillin potassium and sodium salts	Influence mainly on gram-positive microorganisms. Currently, most strains have developed resistance, but spirochetes are still sensitive to the substance.	Gramox-D ® , Ospen ® , Star-Pen ® , Ospamox ®
Benzylpenicillin procaine ®	Indicated for the treatment of streptococcal and pneumococcal infections. Compared to potassium and sodium salts, it acts longer, as it dissolves and is absorbed more slowly from the intramuscular depot.	Benzylpenicillin-KMP ® (-G, -Teva, -G 3 mega)
Bicillins (1, 3 and 5) ®	Used in chronic rheumatism with preventive purpose as well as for therapy infectious diseases moderate and mild severity of leakage caused by streptococci.	Benzicillin-1 ® , Moldamine ® , Extincillin ® , Retarpin ®
Phenoxymethylpenicillin ®	It has a therapeutic effect similar to the previous groups, but is not destroyed in an acidic gastric environment. Produced in the form of tablets.	V-Penicillin ® , Kliacil ® , Ospen ® , Penicillin-Fau ® , Vepicombin ® , Megacillin Oral ® , Pen-os ® , Star-Pen ®
	Active against staphylococci that produce penicillinase. It is characterized by low antimicrobial activity, it is completely ineffective against penicillin-resistant bacteria.	, Oxamp-Sodium ® , Oxamsar ®
	Extended spectrum of antimicrobial activity. In addition to the main spectrum inflammatory diseases Gastrointestinal tract, treats and caused by Escherichia, Shigella, Salmonella.	Ampicillin AMP-KID (-AMP-Forte ® , -Ferein, -AKOS, -trihydrate, -Innotek), Zetsil ® , Pentrixil ® , Penodil ® , Standacillin ®
	It is used to treat inflammation of the respiratory and urinary tract. After clarifying the bacterial origin of gastric ulcers, Helicobacter pylori is used for eradication.	, Ospamox,
Carbenicillin ®	Into the spectrum antimicrobial action Pseudomonas aeruginosa and enterobacteria are included. Digestibility and bactericidal effect are higher than those of Carbenicillin ® .	Securopen ®
Piperacillin ®	Similar to the previous one, but the level of toxicity is increased.	Isipen ® , Pipracil ® , Picillin ® , Piprax ®
Amoxicillin/clavulanate ®	Due to the inhibitor, the spectrum of antimicrobial activity is expanded compared to the unprotected agent.	, Amclave ® , Amovikomb ® , Verclave ® , Ranklav ® , Arlet ® , Klamosar ® , Rapiclav ®
Ampicillin/sulbactam ®		Sulacillin ® , Liboksil ® , Unazine ® , Sultasin ®
Ticarcillin/clavulanate ®	The main indication for use is nosocomial infections.	Gimentin ®
Piperacillin/tazobactam ®		Tazocin ®

The information provided is for informational purposes and is not a guide to action. All appointments are made exclusively by a doctor, and therapy is under his control.

Despite the low toxicity of penicillins, their uncontrolled use leads to serious consequences: the formation of resistance in the pathogen and the transition of the disease to chronic form difficult to cure. It is for this reason that most strains of pathogenic bacteria are resistant to first-generation ABP today.

Use for antibiotic therapy follows exactly the medication that was prescribed by a specialist. Independent attempts to find a cheap analogue and save money can lead to a deterioration in the condition.

For example, the dosage of the active substance in a generic may differ up or down, which will negatively affect the course of treatment.

When you have to replace the medicine due to an acute lack of finances, you need to ask the doctor about it, since only a specialist can choose the best option.

Penicillins: definition and properties

Preparations of the penicillin group belong to the so-called beta-lactams - chemical compounds having a beta-lactam ring in its formula.

This structural component is of decisive importance in the treatment of bacterial infectious diseases: it prevents the production of a special peptidoglycan biopolymer by bacteria, which is necessary for the construction of the cell membrane. As a result, the membrane cannot form and the microorganism dies. There is no destructive effect on human and animal cells for the reason that they do not contain peptidoglycan.

Medications based on the waste products of mold fungi are widely used in all areas of medicine due to the following properties:

• High bioavailability - drugs are quickly absorbed and distributed through the tissues. The weakening of the blood-brain barrier during inflammation of the meninges also contributes to the penetration into the cerebrospinal fluid.
• Wide spectrum antimicrobial action. Unlike first-generation chemicals, modern penicillins are effective against the vast majority of gram-negative and positive bacteria. They are also resistant to penicillinase and the acidic environment of the stomach.
• The lowest toxicity among all ABPs. They are approved for use even during pregnancy, and correct reception(as prescribed by the doctor and according to the instructions) almost completely eliminates the development of side effects.

In the process of research and experiments, many medications have been obtained with various properties. For example, when belonging to the general series, penicillin and ampicillin are not the same thing. All penicillin antibiotics are well compatible with most other drugs. Concerning complex therapy with other types of antibacterial drugs, then the combined use with bacteriostatics weakens the effectiveness of penicillins.

Classification of penicillins

Careful study of the properties of the first antibiotic showed its imperfection. Despite a fairly wide range of antimicrobial activity and low toxicity, natural penicillin turned out to be sensitive to a special destructive enzyme (penicillinase) produced by some bacteria. In addition, it completely lost its qualities in an acidic gastric environment, therefore it was used exclusively in the form of injections. In search of more effective and stable compounds, various semi-synthetic drugs have been created.

To date penicillin antibiotics, the full list of which is given below, are divided into 4 main groups.

Biosynthetic

Produced by the fungi Penicillium notatum and Penicillium chrysogenum, benzylpenicillin is an acid molecular structure. For medical purposes, it combines chemically with sodium or potassium to form salts. The resulting compounds are used to prepare injection solutions which are rapidly absorbed.

The therapeutic effect is noted within 10-15 minutes after injection, but lasts no more than 4 hours, which requires frequent repeated injections into muscle tissue(v special occasions sodium salt can be administered intravenously).

These drugs penetrate well into the lungs and mucous membranes, and into the cerebrospinal and synovial fluid, myocardium and bones - to a lesser extent. However, with inflammation meninges(meningitis) the permeability of the blood-brain barrier increases, which allows for successful treatment.

To prolong the effect of the drug, natural benzylpenicillin combines with novocaine and other substances. The resulting salts (novocaine, Bicillin-1, 3 and 5) after intramuscular injection form a drug depot at the injection site, from where active substance enters the bloodstream constantly and at a low rate. This property allows you to reduce the number of injections up to 2 times a day while maintaining therapeutic effect potassium and sodium salts.

These drugs are used for long-term antibiotic therapy of chronic rheumatism, syphilis, focal streptococcal infection.

Phenoxymethylpenicillin ® is another form of benzylpenicillin designed to treat infectious diseases. moderate. Differs from those described above in resistance to hydrochloric acid gastric juice.

This quality allows the drug to be produced in the form of tablets for oral administration (from 4 to 6 times a day). Most pathogenic bacteria are currently resistant to biosynthetic penicillins, except for spirochetes.

Semi-synthetic antistaphylococcal

Natural benzylpenicillin is inactive against strains of staphylococcus that produce penicillinase (this enzyme destroys the beta-lactam ring of the active substance).

For a long time, penicillin was not used to treat staph infection, until in 1957 it was synthesized on its basis. It inhibits the activity of beta-lactamases of the pathogen, but is ineffective against diseases caused by benzylpenicillin-sensitive strains. This group also includes cloxacillin, dicloxacillin, methicillin and others, almost not used in modern medical practice due to increased toxicity.

Antibiotics of the penicillin group in broad spectrum tablets

This includes two subgroups antimicrobial agents, intended for oral use and having a bactericidal effect on most pathogenic microorganisms(both gram+ and gram-).

Aminopenicillins

Compared with the previous group, these compounds have two significant advantages. First, they are active towards more a wide range pathogens, secondly, are available in tablet form, which greatly facilitates the use. The disadvantages include sensitivity to beta-lactamase, that is, aminopenicillins (ampicillin ® and amoxicillin ®) are not suitable for the treatment of staphylococcal infections.

However, in combination with oxacillin (Ampioks ®) they become resistant.

The preparations are well absorbed and act for a long time, which reduces the frequency of use to 2-3 times per 24 hours.

The main indications for use are:

A common side effect of aminopenicillins is a characteristic non-allergic rash that disappears immediately after withdrawal.

Antipseudomonal

They are a separate penicillin series of antibiotics, from the name of which the purpose becomes clear. Antibacterial activity is similar to aminopenicillins (with the exception of Pseudomonas) and is pronounced in relation to.

According to the degree of efficiency are divided into:

• Carboxypenicillins, whose clinical significance in Lately decreases. Carbenicillin ® , the first of this subgroup, is also effective against ampicillin-resistant Proteus. Currently, almost all strains are resistant to carboxypenicillins.
• Ureidopenicillins are more effective against Pseudomonas aeruginosa, and can also be prescribed for inflammation caused by Klebsiella. The most effective are Piperacillin ® and Azlocillin ® , of which only the latter remains relevant in medical practice.

To date, the vast majority of strains of Pseudomonas aeruginosa are resistant to carboxypenicillins and ureidopenicillins. For this reason, their clinical significance is reduced.

Inhibitor-protected combined

The ampicillin group of antibiotics, highly active against most pathogens, is destroyed by penicillinase-forming bacteria. Since the bactericidal action of oxacillin resistant to them is much weaker than that of ampicillin and amoxicillin, combined drugs were synthesized.

In combination with sulbactam, clavulanate and tazobactam, antibiotics receive a second beta-lactam ring and, accordingly, immunity to beta-lactamases. In addition, inhibitors have their own antibacterial effect, enhancing the main active ingredient.

Inhibitor-protected drugs successfully treat severe nosocomial infections, strains of which are resistant to most drugs.

Penicillins in medical practice

An extensive spectrum of action and good tolerance by patients made penicillin optimal remedy therapy for infectious diseases. At the dawn of the era of antimicrobial drugs, benzylpenicillin and its salts were the drugs of choice, but this moment most pathogens are resistant to them. Nevertheless, modern semi-synthetic penicillin antibiotics in tablets, injections and other dosage forms occupy one of the leading places in antibiotic therapy in the most different areas medicine.

Pulmonology and otolaryngology

Another discoverer noted the special effectiveness of penicillin against pathogens of respiratory diseases, so the drug is most widely used in this area. Almost all of them have a detrimental effect on bacteria that cause pneumonia and other diseases of the lower and upper respiratory tract.

Inhibitor-protected agents treat even particularly dangerous and persistent nosocomial infections.

Venereology

Spirochetes are one of the few microorganisms that have retained susceptibility to benzylpenicillin and its derivatives. Benzylpenicillins are also effective against gonococci, which allows for successful treatment with minimal negative effects on the patient's body.

Gastroenterology

Inflammation of the intestines caused by pathogenic microflora responds well to therapy with acid-resistant drugs.

Of particular importance are aminopenicillins, which are part of the complex eradication of Helicobacter.

Gynecology

In obstetric and gynecological practice, many penicillin preparations from the list are used both for the treatment of female bacterial infections and for the prevention of infection in newborns.

Ophthalmology

Here, penicillin antibiotics also occupy a worthy place: keratitis, abscesses, gonococcal conjunctivitis and other eye diseases are treated with ointments and injection solutions.

Urology

Diseases of the urinary system, which are of bacterial origin, respond well to therapy only with inhibitor-protected drugs. The remaining subgroups are ineffective, since the strains of pathogens are highly resistant to them.

Penicillins are used in almost all areas of medicine for inflammation caused by pathogenic microorganisms, and not only for treatment. For example, in surgical practice, they are prescribed to prevent postoperative complications.

Features of therapy

Treatment with antibacterial medications in general and penicillins in particular should be carried out only on prescription.

Despite the minimal toxicity of the drug itself, its improper use seriously harms the body. In order for antibiotic therapy to lead to recovery, you should follow medical recommendations and know the characteristics of the drug.

Indications

Scope of application of penicillin and various drugs on its basis in medicine is due to the activity of the substance with respect to specific pathogens. Bacteriostatic and bactericidal effects are manifested in relation to:

• Gram-positive bacteria - gonococci and meningococci;
• Gram-negative - various staphylococci, streptococci and pneumococci, diphtheria, Pseudomonas aeruginosa and anthrax, Proteus;
• Actinomycetes and spirochetes.

Contraindications

To the number strict contraindications applies only individual intolerance benzylpenicillin and other drugs of this group. Also, endolumbar (injection into spinal cord) administration of drugs to patients diagnosed with epilepsy.

During pregnancy, antibiotic therapy with penicillin preparations should be treated with extreme caution. Although they have minimal teratogenic effects, it is worth prescribing pills and injections only in case of urgent need, assessing the degree of risk to the fetus and the pregnant woman herself.

Since penicillin and its derivatives freely penetrate from the bloodstream into breast milk, for the duration of therapy, it is advisable to refuse breastfeeding. The medicine can provoke a severe allergic reaction in the baby even at the first use. To prevent lactation, milk must be expressed regularly.

Side effect

Among other antibacterial agents, penicillins are favorably distinguished by their low toxicity.

TO undesirable consequences uses include:

• Allergic reactions. Most often appear skin rash, itching, urticaria, fever and swelling. Extremely rarely, in severe cases, anaphylactic shock is possible, requiring the immediate administration of an antidote (adrenaline).
• . Imbalance of the natural microflora leads to digestive disorders (flatulence, bloating, constipation, diarrhea, abdominal pain) and the development of candidiasis. In the latter case, the mucous membranes of the oral cavity (in children) or the vagina are affected.
• neurotoxic reactions. The negative effect of penicillin on the central nervous system manifested by increased reflex excitability, convulsions, and sometimes coma.

Prevent the development of dysbacteriosis and avoid allergies will help timely medical support organism. It is desirable to combine antibiotic therapy with the intake of pre- and probiotics, as well as desensitizers (if sensitivity is increased).

Penicillin antibiotics for children: application features

For children, tablets and injections should be prescribed carefully, taking into account the possible backlash, and the choice of a particular drug should be approached thoughtfully.

In the first years of life, benzylpenicillin is used in case of sepsis, pneumonia, meningitis, otitis media. For treatment respiratory infections, sore throats, bronchitis and sinusitis are selected the most safe antibiotics from the list: Amoxicillin ® , Augmentin ® , Amoxiclav ® .

The body of a child is much more sensitive to drugs than that of an adult. Therefore, you should carefully monitor the condition of the baby (penicillin is excreted slowly and, accumulating, can cause convulsions), and also take preventive measures. The latter include the use of pre- and probiotics for protection intestinal microflora, adherence to a diet and a comprehensive strengthening of immunity.

A little theory:

Historical information

The discovery that made a real revolution in medicine at the beginning of the 20th century was made by accident. I must say that the antibacterial properties of mold fungi were noticed by people in ancient times.

Alexander Fleming - discoverer of penicillin

The Egyptians, for example, even 2500 years ago treated inflamed wounds with compresses from moldy bread, but scientists took up the theoretical side of the issue only in the 19th century. European and Russian researchers and doctors, studying antibiosis (the property of some microorganisms to destroy others), made attempts to derive practical benefits from it.

Alexander Fleming, a British microbiologist, succeeded in this, who in 1928, on September 28, found mold in Petri dishes with staphylococcus colonies. Its spores, which fell on the crops due to the negligence of the laboratory staff, germinated and destroyed pathogenic bacteria. Interested Fleming carefully studied this phenomenon and singled out bactericide called penicillin. Long years the discoverer worked on obtaining a chemically pure stable compound suitable for treating people, but others invented it.

In 1941, Ernst Cheyne and Howard Flory were able to purify penicillin from impurities and carried out together with Fleming clinical trials. The results were so successful that by the year 43 in the United States organized mass production a drug that saved many hundreds of thousands of lives during the war. The merits of Fleming, Cheyne and Flory before mankind were appreciated in 1945: the discoverer and developers became laureates Nobel Prize.

Subsequently, the initial chemical preparation was constantly improved. This is how modern penicillins appeared, resistant to the acidic environment of the stomach, resistant to penicillinase and more effective in general.

On our site you can get acquainted with most groups of antibiotics, complete lists of the drugs included in them, classifications, history and other important information. For this, a section "" has been created in the top menu of the site.

Among the huge variety of medicines Penicillin occupies a special place in medicine. Instructions for use characterizes this medication as an antibiotic intended for the treatment of many infectious diseases. But several modern people they don’t even realize how great the event became when the Scottish microbiologist A. Fleming in 1928 was the first to discover this antibacterial agent obtained from a mold of the genus Penicillium. Thanks to the discovery of penicillin, it became possible to treat such previously fatal infectious diseases as syphilis and pneumonia (pneumonia). And during the Second World War, Penicillin was actively used to treat open wounds in order to prevent infection, which saved the lives of thousands of people. Currently, many drugs have been developed based on this antibiotic, but Penicillin was the first.

Action spectrum

This antibacterial agent is capable of destroying a number of pathogens. The bactericidal and bacteriostatic action of Penicillin extends to meningococci, pneumococci, gonococci, streptococci. The causative agents of diphtheria, gas gangrene, anthrax, tetanus, some types of staphylococci. The drug causes the death of bacteria, blocking on cellular level synthesis of the main substance of vital activity of pathogenic microorganisms - peptidoglycan. In fairness, it should be noted that Penicillin is ineffective against Pseudomonas aeruginosa, Friedlander's, tuberculosis, pertussis bacilli, as well as typhoid and dysentery intestinal bacteria.

Indications for use

Penicillin is used to treat wide range deeply localized infections. First of all, it is sepsis, syphilis, focal and lobar pneumonia, sycosis, gonorrhea, purulent meningitis, brain abscess. Also, this antibiotic is used to prevent complications after severe burns, abdominal operations, as well as in the presence of open stab wounds. The drug showed high efficiency in the treatment of rheumatism, purulent pleurisy, otitis, septic endocarditis, cholangitis, cholecystitis. Without the participation of this antibacterial agent, the treatment of childhood diseases, including in newborn babies, is not complete. These include septic-toxic diphtheria, septic scarlet fever, septicopyemia, umbilical sepsis.

Mode of application

Doctors believe that the most healing effect achieved with intramuscular or subcutaneous administration of Penicillin. Also, this antibacterial agent is often used in the form of solutions for rinsing, washing, drops for the nose and eyes. For example, when administered intramuscularly, after 30 minutes in the blood, highest concentration antibiotic, after which it quickly spreads into the cavity of the joints, lungs and other muscles. To support required level concentration, the drug is administered every 3 to 4 hours. The dosage and duration of treatment is determined by the attending physician.

Contraindications

Penicillin, like any antibiotic, has contraindications for use. Many people are hypersensitive to drugs of the penicillin group and sulfonamides. Therefore, it is better for such people to choose another antibacterial agent. It is not recommended to use this antibiotic for hay fever, bronchial asthma, urticaria, as well as for pregnant women and nursing mothers. During treatment with Penicillin, the use of alcoholic beverages is strictly prohibited.

Side effects

Of the side effects that Penicillin can cause, the instructions for use note that the most common negative manifestations are allergic reactions. Human skin is especially affected. Exfoliative dermatitis, urticaria-like rash, urticaria, erythema, pustular, vesicular, and macular lesions may appear. Respiratory organs can respond with asthmatic bronchitis, laryngopharyngitis, rhinitis. And most severe complication- anaphylactic shock. Therefore, the doctor always asks the patient about the tolerability of this antibiotic.

So penicillin is greatest invention last century in the field of medicine, for which A. Fleming was awarded the Nobel Prize. Interestingly, a discovery of this magnitude remained unpatented. A substance so valuable to mankind should not serve as a source of income - such was the conviction of A. Fleming and his colleagues.