The first antimicrobial drug was discovered at the beginning of the 20th century. In 1929, a professor at the University of London, Alexander Fleming, took up a detailed study of the properties of green mold and noted its special antibacterial properties. And in 1940, a pure culture of this substance was bred, which became the basis of the first antibiotic. So appeared to everyone famous penicillin saving the lives of many people for almost 80 years.
Thus, only a fraction of the total probiotics was delivered to the intestines, which, in addition, has limited ability create a natural layer beneficial bacteria. However, researchers have managed to create a probiotic culture that will not harm digestive tract. Biofilm Probiotics provide natural probiotic care for the entire body. Immunity, in simple words, starts already in the mouth, where the biofilm effect is huge, says Ryshavka.
Hope for cancer patients
The use of a new generation of biofilm probiotics is also a hope for cancer patients. Their gut bacteria are especially damaged due to chemotherapy. In addition, some cancer drugs, such as cyclophosphamide, work in intestinal microflora. Therefore, peroxide microflora is very important during the treatment, adds Ryshawka.
Further development of the science of antimicrobials went on increasing. More and more appeared effective antibiotics, which had a detrimental effect on microbes, inhibiting their growth and reproduction.
Working in this direction, microbiologists have found that some of the isolated antimicrobial substances behave in a special way. They discover antibacterial action against several types of bacteria.
In addition to the Czech Republic, unique technologies are now spreading to countries such as Belgium, Denmark and Poland. And as we see below, this moment is just happening. Over time, the problem of curing today's banal infectious disease caused by bacteria may arise, because bacteria become more resistant to active substance contained in antibiotics. With the frequency of antibiotic use on a global scale, bacteria cause resistance or resistance to active substances.
Superbugs enter the scene
But this situation may, unfortunately, be real in a few decades if we do not play a leading role in the fight against pathogenic bacteria. The head of the Center for Antibiotics in the General Hospital of the Faculty of Prague, Vaclav Adamkova for Lidove Novini, says that it is hardly possible to invent something revolutionary in the fight against bacteria. In the Czech Republic, we belong to the European leader in terms of bacterial resistance, causing infections urination or blood poisoning. Fortunately, there are no perennial bacteria.
Preparations based on such substances of natural or synthetic origin, so beloved by doctors of various specializations, were called antibiotics. a wide range actions (ASHSD) and are no less widespread in clinical practice.
And yet, despite all the benefits of the above drugs, they have one significant drawback. Their activity against many bacteria extends not only to pathogenic microorganisms, but also to those that are vital for the human body, forming its microflora. So the active use of oral antibiotics can ruin beneficial microflora intestines, causing disturbances in its work, and the use of vaginal antibiotics - to disrupt acid balance vagina, provoking the development of fungal infections. Besides toxic effect antibiotics of the first generations did not allow their use for the treatment of patients with pathologies of the liver and kidneys, for the treatment of infectious diseases in childhood, during pregnancy and in some other situations, and a large number of side effects led to the fact that the treatment of one problem provoked the development of another.
Unfortunately, bacteria are resistant to the drug, and it's only a matter of time before we start fighting a "superbug" that our strongest antibiotics won't pay for. There was another case in the United States where a patient from Nevada died from a bacterial infection. From the very beginning of her hospitalization, it was clear that this was a kind of superbug that gradually refused treatment with 26 types of antibiotics, and the patient, after a two-week struggle for life, suffered from septic shock.
In this regard, the question arose of finding solutions to the problem of how to make antibiotic treatment not only effective, but also safe. Developments began to be carried out in this direction, which contributed to the entry into the pharmaceutical market of a new product - effective broad-spectrum antibiotics of a new generation with fewer contraindications and side effects.
A huge problem that speeds up the process when bacteria become resistant is the overuse of antibiotics. So we should only take antibiotics when really needed and don't go to the doctor with the first sneeze and ask for antibiotic treatment. The second pole is the use of antibiotics in animal husbandry, which also interferes very much in the game and enters our food chain.
Time will tell what happens after Flemming, but it is certain that we will see more super-symbols that are slowly losing the effectiveness of the antibiotic "atom" in the form of our most effective drugs. However, everyone can participate in the collective postponement of these cases by not taking antibiotics for minor health problems that only need hot tea and a few days in bed.
Groups of new generation antibiotics and the development of antibiotic therapy
Among a large number antimicrobials(AMP) there are several groups of drugs that differ in their chemical structure:
- Beta-lactams, which are divided into the following classes:
- Penicillins
- Cephalosporins
- Carbapenems with increased resistance to beta-lactamase produced by some bacteria
- Macrolides (the least toxic drugs that have natural origin)
- Tetracycline antibiotics
- Aminoglycosides, especially active against gram-negative anaerobes, causing respiratory diseases
- Lincosamides resistant to gastric juice
- Antibiotics of the chloramphenicol series
- Glycopeptide preparations
- Polymyxins with a narrow spectrum of bacterial activity
- Sudfanilamides
- Quinolones, and in particular fluoroquinolones, have a wide spectrum of action.
In addition to the above groups, there are several more classes of narrowly targeted drugs, as well as antibiotics that cannot be attributed to a specific group. also in Lately Several new groups of drugs have appeared, however, they have a predominantly narrow spectrum of action.
Key facts about the World Health Organization
This process also means that the same treatment for the same disease will not work in a few years. Once bacteria become resistant to antibiotics, the usual infectious diseases will no longer be so easy to cure. This puts the population of the world, including everyone, at risk. Unfortunately, in a few years and decades, we may see hospitalizations with commonplace infections, higher medical costs to treat them, and higher deaths. Therefore, antibiotics should only be used where absolutely necessary.
Some groups and drugs have been familiar to us for a long time, others appeared later, and some are still unknown to the general consumer.
Antibiotics 1 and 2 generations cannot be called ineffective. They are still in use today. However, not only a person develops, but also the microbes inside him, acquiring resistance to commonly used drugs. 3rd generation antibiotic in addition to acquiring a wide spectrum of action, it was called upon to defeat such a phenomenon as antibiotic resistance, which has become especially relevant recently, and some antibiotics of the 2nd generation did not always successfully cope with it.
The infection will die in the future just as it did before the antibiotic era. The fight against antibiotics: a nightmare scenario. Update on the antibiotic resistance crisis. Why, if we are careless about antibiotics, do we ourselves put a noose around our neck and can ordinary bacteria turn into killers, says prof. Andrzej Gladysh, specialist in infectious diseases.
We grow deadly bacteria ourselves - without having to reach for antibiotics, treat them against doctor's recommendations, and stuff them with slaughter animals, fruits and vegetables. Bacteria resistant to all antibiotics have recently become one of the media heroes. The press, radio, television, the internet are all threatening with deadly germs that will soon kill us. Did something special happen, or is it perhaps an element of some great propaganda action? This is not a temporary action - this problem has been noticed for several years.
4th generation antibiotics in addition to a wide spectrum of action, they also have other advantages. Thus, penicillins of the 4th generation are not only highly active against gram-positive and gram-negative microflora, but, having a combined composition, they become active against Pseudomonas aeruginosa, which is the causative agent of a large number bacterial infections that hit various bodies and human systems.
It started with the first bacteria that were resistant to any antibiotics. They have become the cause of generalized infections or sepsis, ending in death. We now have a much larger group of microorganisms that have become resistant to antibiotics due to iatrogenic action, that is, as a result of prophylactic antibiotic abuse, especially in connection with minimally invasive plastic surgery procedures.
Do you think that by helping our beauty, we breed a mortal enemy? Yes, because, for example, it has been possible for some time to produce commercially effective next-generation antibiotics. Such a group was even carbapenems, which coped with most bacteria, even resistant to standard antibiotics. Meanwhile, plastic surgery has grown rapidly over the past 10 years. To make matters worse, in some countries these surgeries were carried out in facilities that did not care about the appropriate hygienic standard, but instead used protective antibiotics.
4th generation macrolides are also combination drugs, where as one of active substances acts as an antibiotic of the tetracycline series, which expands the field of activity of drugs.
Particular attention should be paid to 4th generation cephalosporins, the spectrum of action of which is rightly called ultra-wide. These drugs are considered the most powerful and widely used in clinical practice, since they are effective against bacterial strains that are resistant to previous generations of AMPs.
Instead of having a sterile room, prophylactically give the patient an antibiotic? This reminds me of the times 20 years ago when we talked about why some gynecological obstetric departments who have high level caesarean section, do not have many infections in patients. This was because before C-section was cut, the woman was already on an antibiotic and of course she was continued, giving the next one - just in case.
Did they have serious doubts about the cleanliness of their own room? Before today, in many cases doctors are not sure. He needs to get vaccinated because he has the treatment prostate. Therefore, both doctors and we - patients - are to blame for ourselves, because we are growing a stronger enemy. Doctors give antibiotics just in case, we make them save this medicine when we come with a cold. They do this either because they want to have peace of mind and are not going to take the time to convince the patient or to do so, because patients are known to be more and more demanding, so the doctor thinks: "I will not give antibiotics, and what- if it goes wrong, they will challenge me.”
Yet even these new cephalosporins are not without drawbacks, as they can cause multiple side effects. The fight against this moment is ongoing to this day, therefore, of all known cephalosporins, 4 generations (and there are about 10 varieties) in mass production only preparations based on cefpirome and cefipime are allowed.
Apparently, in cases such as antibiotics for influenza, they are completely ineffective. This indicates ignorance, or she wanted to ensure that the patient had the flu, but that pneumonia did not develop, to give an antibiotic. There is no worse therapeutic strategy. This, unfortunately, explains the situation that more and more often we are dealing with sepsis or sepsis that has nothing to cure.
Everything more of deaths due to sepsis or systemic infection, even the standard one, not associated with some particularly virulent hospital strain, is caused by bacteria that until recently were common but resistant to antibiotics. It may also hurt to stop treatment and take too small doses. Importance have a dose and time of administration. If the doctor recommends therapy for 14 days, it must last that long because each antibiotic has been previously tested in the laboratory.
The only 4th generation drug from the aminoglycoside group is able to deal with such pathogenic microorganisms, like cytobacter, aeromonas, nocardia, not subject to drugs of earlier generations. It is also effective against Pseudomonas aeruginosa.
5th generation broad spectrum antibiotics- it is mainly ureido- and piperazinopenicillins, as well as the only approved drug from the group of cephalosporins.
Thanks to this, it is known what dose is needed and how long it takes for the drug to be effective. If we give less, we will have a so-called non-therapeutic concentration, that is, ineffective. The bacterium was slightly chipped, but not killed. She has rebuilt her coat, learned the antibiotic and already knows how to protect against it in the future. What does it mean? That we won't heal ourselves effectively, and what's more, we won't kill bacteria in the future. Sometimes the procedure for administering the drug is also important - not enough orally, but, for example, intravenously to get to where it is needed.
5th generation penicillins are considered effective against gram-positive and gram-negative bacteria, including Pseudomonas aeruginosa. But their disadvantage is the lack of resistance to beta-lactamase.
The active component of the approved 5th generation cephalosporins is ceftobiprole, which is rapidly absorbed and good metabolism. It is used to combat strains of streptococci and staphylococci resistant to early generations of beta-lactams, as well as various anaerobic pathogens. A feature of the antibiotic is that under its action, bacteria are not able to mutate, which means that they do not develop antibiotic resistance.
You won't find understanding for those who keep a supply of antibiotics at home and reach for medicines when they think it's appropriate. The same thing happens when a doctor discharges a patient from the hospital three days after surgery, but he advises him to take an antibiotic for seven days.
And the patient claims that he feels good, the wound is dry, so he does not need to take an antibiotic. This is a mistake - if we start taking a medicine, we must follow it to the end of the recommended therapy in order to be effective. According to you, the bacteria have learned how to survive the antibiotic. This is normal - this is biology, this is nature. Just as we change, we develop, our immunity, our physiognomy changes, therefore all microorganisms, including bacteria, change and adapt to new conditions.
Ceftaroline-based antibiotics also have high efficiency, however, they lack a protective mechanism against beta-lactamases produced by enterobacteria.
Also developed new drug based on a combination of ceftobiprol and tazobactam, making it more resistant to various kinds beta lactamase.
There are times when the bacteria that we successfully fought with standard antibiotics until recently are now unstoppable. There is a well-known group of enterococci with which we long time lived. Now it turns out that more than 10 percent. these bacteria have become so resistant that even the most effective modern antibiotics does not work. Enterococci cause infections urinary tract, gastrointestinal tract. As long as its presence was associated with antibiotics, the matter was simple.
On the this moment we have situations where these bacteria develop infections in people who have not taken antibiotics at all. So they pass from person to person? Yes, and worse, they are resistant to antibiotics, which is why they can appear. The same applies to bacteria - with the use of antibiotics, we support those that can survive by learning to be resistant to antibiotics.
6th generation antibiotics penicillin series are also not devoid of a wide spectrum of action, but they show the greatest activity against gram-negative bacteria, including those that the frequently prescribed 3rd generation penicillins based on amoxicillin cannot cope with.
These antibiotics are resistant to most beta-lactamase-producing bacteria, but are not without the usual side effects of penicillins.
Carbapenems and fluoroquinolones are relatively new types of antimicrobial drugs. Carbapenems are highly effective, resistant to most beta-lactamase drugs, but they are not able to resist New Delhi metallo-beta-lactamase. Some carbapenems are not effective against fungi.
Fluoroquinolones - synthetic drugs with pronounced antimicrobial activity, which are close in action to antibiotics. They are effective against most bacteria, including Mycobacterium tuberculosis, some types of pneumococci, Pseudomonas aeruginosa, etc. However, against anaerobic bacteria their efficiency is extremely low.
Most antibiotics work selectively, and broad-spectrum drugs are considered the most powerful - antibiotics that have a devastating effect on both gram-negative and gram-positive bacteria.
macrolides
These are a type of narrow-acting antibiotics that have a negative effect on gram-positive bacteria. Do not depress immunity, stop growth bacterial cell. The most powerful macrolide antibiotics are josamycin and clarithromycin. This group includes oleandomycin, erythromycin, spiramycin, azithromycin. Used to treat chlamydial infection, sinusitis, otitis, treatment of infections respiratory tract, in dentistry.
Have side effects: phlebitis with injections, allergies, dyspepsia, sensitivity quickly decreases.
Cephalosporins
In this group, broad-spectrum antibiotics are among the most powerful today. They are well tolerated by the body, have a bactericidal effect. The cephalosporin group includes four generations of antibiotics.
1st generation: cefadroxil, cephalexin, cefazolin. Works great in the fight against staphylococci.
2nd generation: cefuroxime, cefamandol, cefaclor. These antibiotics are active against Haemophilus influenzae, Proteus, Escherichia coli, Klebsiella.
3rd generation: ceftriaxone, ceftazidime, cefoperazone, ceftibuten, cefotaxime. Most often, these drugs are used for pyelonephritis, pneumonia, meningitis, osteomyelitis, pelvic and abdominal infections.
4th generation - antibiotics of the most powerful action. This group includes cefepime (maximim). have even more wide application than all previous generations, but are also characterized by a set of serious side effects: hemotoxicity, nephrotoxicity, dysbacteriosis, neurotoxicity.
Fluoroquinolones
Very powerful antibiotics with a wide spectrum of activity. They are divided into 2 generations - early and new. First-generation antibiotics are very active against gram-negative bacteria and Pseudomonas aeruginosa, while second-generation fluoroquinolones are also active against gram-negative bacteria, but are not effective against Pseudomonas aeruginosa. Fluoroquinolones perfectly penetrate into individual tissues and organs, circulate in the blood for a long time.
Norfloxacin is used to treat urinary tract infections.
Ciprofloxacin is effective for meningitis, sepsis, infections of the urinary tract and respiratory organs, infections of soft tissues and skin, suppuration of the joints and bones, STDs.
Ofloxacin is used for gardnerella, Helicobacter pylori, chlamydia.
Lomefloxacin is used to treat tuberculosis and chlamydia.
These are just some representatives of fluoroquinolones, the list of antibiotics of this group is much wider. May have side effects such as dyspepsia, phototoxicity, toxic liver damage, arthrotoxicity.
Penicillins
Among general antibiotics, penicillins are recognized as the most powerful. They are mainly excreted by the kidneys and have low toxicity.
Representatives of this group of antibiotics: oxacillin, ampicillin, ampiox, amoxicillin, phenoxymethylpenicillin.
Penicillins are used to treat infections genitourinary system, respiratory organs, skin, intestines and stomach, gonorrhea, syphilis, suppuration of soft tissues. Antibiotics of this group can be drunk in two last trimesters pregnancy, they are also prescribed from birth, in some cases they can be prescribed during lactation.
Side effects of antibiotics penicillin group: allergy, dyspeptic disorders, toxic effects on the blood.
Carbapenems
They have a wide spectrum of action, very strong. Antibiotics of this group are used as reserve drugs in the treatment of infections caused by resistant anaerobes and enterobacteria.
The group of carbapenems includes: meropenem, thienam. Possible side effects: candidiasis, dyspepsia, allergies, phlebitis.
Tetracyclines
Broad-spectrum antibiotics with antimicrobial effect. Tetracyclines are active against gram-negative and gram-positive bacteria, leptospira, spirochetes, rickettsiae. They suppress the biosynthesis of microbial cell protein at the level of ribosomes, are characterized by complete cross-resistance.
Representatives: doxycycline, oxytetracycline, tetracycline.
Tetracyclines are contraindicated in children under 8 years of age, pregnant and lactating women, people with hepatic and renal insufficiency (the exception is doxycycline). Possible side effects: dizziness, headaches, upset gastrointestinal tract, individual intolerance. In most cases, in the absence of violations of the regimen, tetracyclines are well tolerated by the body.
