The main antibiotics are penicillins (list). The entire list of penicillin antibiotics, indications for use Which drugs are classified as penicillins

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

History of discovery

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

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

Penicillium group

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

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

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

Indications

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

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

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

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

Use of penicillin in medicine:

Contraindications

Application penicillin series for the treatment of infections is not always possible. People who are highly sensitive to the drug are strictly prohibited from taking the drug.

The use of this antibiotic is also contraindicated in patients suffering from asthma of various origins, hay fever, or a history of other active substances.

Release form

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

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

Mechanism of action

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

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

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

Instructions for use

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

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

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

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

Side effects

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

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

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

Rules for the use of antibiotics:

Drug interactions

When prescribing penicillin, attention should be paid to its interaction with other drugs used. Cannot be combined this antibiotic with the following medicines:

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

Penicillin price

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

Cheap

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

Drug synonyms

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

Natural analogues

Natural medicinal penicillins include:

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

Conditions for dispensing from pharmacies

According to the recipe.

Storage conditions and shelf life

Today no one can do without an antibiotic. medical institution. Successful treatment various diseases is possible only thanks to the appointment of an effective antibacterial therapy. Antibiotic introduced today wide range various drugs aimed at the destruction of the pathogenic environment of a bacterial nature.

The first antibiotic created was penicillin, which defeated some epidemics and fatal diseases in the 20th century. Today, antibiotics of the penicillin group are rarely used in medical practice due to the high sensitivity of patients and the risk of developing allergies.

Groups of antibiotics without penicillin

Antibacterial therapy without the use of penicillin components involves the appointment of alternative medicines other pharmacological groups. Antibiotics without penicillin are available in a wide range for the treatment of various diseases in hospital and outpatient practice in children or adults.

Group of cephalosporins

Cephalosporins are broad-spectrum antibiotics due to their detrimental effects on many groups of microorganisms, strains and other pathogenic environments. Drugs of the cephalosporin group are available as intramuscular or intravenous injections. Antibiotics of this group are prescribed for the following conditions:

Well-known cephalosporins include Ceforal, Suprax, Pancef. All antibiotics in this series have similar side effects, for example, dyspeptic disorders (stool upset, skin rashes, nausea). The main advantage of antibiotics is not only the detrimental effect on many strains, but also the possibility of treating children (including the neonatal period). Cephalosporin antibiotics are classified into the following groups:

I generation

Cephalosporin antibiotics include Cefadroxil and Cephalexin, Cefazolin, Cefuroxime.

They are used for inflammatory diseases caused by many anaerobic bacteria, staphylococcal infections, streptococci and others.

The drug comes in a variety of forms: from tablets to solutions for parenteral administration.

II generation

Well-known drugs in this group: Cefuroxime (injections), Cefaclor, Cefuroxime axetil. The drugs are especially active against many gram-positive and gram-negative bacteria. The drugs are available both in the form of solutions and in tablet form.

III generation

Antibiotics of this series are broad-spectrum. The drugs affect almost all microorganisms and are known under the following names:

• Ceftriaxone;
• Ceftazidime;
• Cefoperazone;
• Cefixime and Ceftibuten.

Release forms: injections for intravenous or intramuscular administration. When the drug is administered, it is often mixed with saline or lidocaine solution to reduce pain. The drug and additional components are mixed in one syringe.

IV generation

The group is represented by only one drug - Cefepime. The pharmacological industry produces the drug in powder form, which is diluted just before administration through the parenteral or intramuscular route.

The destructive effect of the antibiotic is to disrupt the synthesis of the body wall of the microbial unit at the cellular level. The main advantages include the possibility of treatment on an outpatient basis, ease of use, use in young children, minimal risks of side effects and complications.

Macrolide group

Antibiotics from the macrolide group are a new generation of drugs, the structure of which is a full-fledged macrocyclic lactone ring. Based on the type of molecular-atomic structure, this group received its name. Depending on the number of carbon atoms in the molecular composition, several types of macrolides are distinguished:

• 14, 15-membered;
• 15-membered.

Macrolides are especially active against many gram-positive coccal bacteria, as well as pathogens acting at the cellular level (for example, mycoplasma, legionella, campylobacter). Macrolides have the least toxicity and are suitable for treatment inflammatory diseases ENT organs (sinusitis, whooping cough, otitis of various classifications). The list of macrolide drugs is as follows:

Numerous medical research confirmed the low likelihood of side effects. The main disadvantage can be considered the rapid development of resistance of various groups of microorganisms, which explains the lack of therapeutic results in some patients.

Fluoroquinolone group

Antibiotics from the fluoroquinol group do not contain penicillin or its components, but are used to treat the most acute and severe inflammatory diseases.

These include purulent bilateral otitis media, severe bilateral pneumonia, pyelonephritis (including chronic forms), salmonellosis, cystitis, dysentery and others.

Fluoroquinols include the following drugs:

• Ofloxacin;
• Levofloxacin;
• Ciprofloxacin.

The very first developments of this group of antibiotics date back to the 20th century. The most famous fluoroquinols can belong to different generations and solve separate clinical problems.

I generation

Well-known drugs from this group are Negram and Nevigramon. The basis of antibiotics is nalidixic acid. The drugs have a detrimental effect on the following types of bacteria:

• Protea and Klebsiella;
• shigella and salmonella.

Antibiotics of this group are characterized by strong permeability, a sufficient amount negative consequences reception. According to the results of clinical and laboratory research, the antibiotic confirmed its absolute uselessness in the treatment of gram-positive cocci, some anaerobic microorganisms, and Pseudomonas aeruginosa (including the nosocomial type).

II generation

Second generation antibiotics are obtained through a combination of chlorine atoms and quinoline molecules. Hence the name - a group of fluoroquinolones. The list of antibiotics in this group is represented by the following drugs:

Second generation antibiotics are prescribed for serious surgical situations and are used in patients of any age group. The main factor here is the risk of death, not the occurrence of any side effects.

III, IV generation

To the main pharmacological drugs 3 generations include Levofloxacin (otherwise known as Tavanic), used for bronchitis of a chronic nature, severe bronchial obstruction in other pathologies, anthrax, and diseases of the ENT organs.

Moxifloxacin (pharmacol. Avelox), known for its inhibitory effect on staphylococcal microorganisms, is rightfully considered to be the 4th generation. Avelox is the only drug that is effective against non-spore-forming anaerobic microorganisms.

Antibiotics of various groups have special instructions, indications, and also contraindications for use. Due to the uncontrolled use of antibiotics without penicillin and others, a law was passed on prescription dispensing from pharmacy chains.

Such introductions are very necessary for medicine due to the resistance of many pathogenic environments to modern antibiotics. Penicillins have not been widely used in medical practice for more than 25 years, so it can be assumed that this group of drugs will effectively affect new types of bacterial microflora.

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- penicillins, cephalosporins, carbopenems - form the basis of modern chemotherapy. They have a bactericidal effect due to the destruction of peptidoglycan, a mucopeptide of the bacterial cell wall. The drugs have synergism against gram-negative flora with aminoglycosides and fluoroquinolones, but they cannot be mixed in the same syringe or infusion system due to physicochemical incompatibility. To overcome resistance, they are combined with beta-lactamase inhibitors.

Side effects: allergic rashes, eosinophilia, less often other immediate hypersensitivity reactions (angioedema, urticaria), anaphylactic shock in children is extremely rare, as is neutro- and thrombocytopenia, hemolytic anemia, interstitial nephritis, phlebitis at the injection site. Ampicillin and cephalosporins rarely cause. Only benzylpenicillin sodium salt is administered endolumbarally - extremely carefully for health reasons. When prescribed to patients with renal failure take into account the content of potassium and sodium in the preparations.

Contraindications. Persons with a history of anaphylaxis, urticaria, or severe rash immediately after penicillin administration are at risk of developing an immediate reaction to other drugs in this group and should not be administered them. Patients allergic to a penicillin drug will react allergically to all penicillins, but only 10% of them will react allergically to cephalosporins and other beta-lactams. Individuals with a history of minimal rash (not a confluent rash on a small surface area of ​​the body) or a rash that occurred 72 hours or more after penicillin administration may not be allergic to penicillins; they should not refuse its use for serious infections, providing everything for the treatment of anaphylaxis.

Penicillins

Penicillins penetrate well into body tissues and fluids, incl. in the CSF during inflammation of the meninges and the administration of high doses. They are excreted mainly in the urine. Carbenicillin has lost its importance; ticarcillin and ureidopenicillins are used only in combination with lactamase inhibitors.

Drug interactions. They increase the risk of bleeding when used with direct and indirect anticoagulants, NSAIDs, and salicylates. When taken together with potassium supplements, potassium-sparing diuretics, ACE inhibitors hyperkalemia is possible. Increases the toxicity of methotrexate.

Natural penicillins

Benzylpenicillin(in Russia more often called penicillin) is a low-toxic drug that creates high concentrations (at a dose of 50 mg/kg IM - 15-25 mcg/ml in the blood and 60-70% of it in the tissues). Pneumococci in Russia retain 90-95% sensitivity to penicillin; sensitivity is lower in children in kindergartens and, especially, in boarding schools. Benzylpenicillin derivatives have the same antibacterial spectrum; Due to its lower effectiveness, phenoxymethylpenicillin should not be used to treat serious infections. In children with otitis and uncomplicated otitis, phenoxymethylpenicillin-benzathine (Ospen-syrup) has proven its worth; its concentration in the blood at a dose of 50 mg/kg is 4-6 mcg/ml.

Benzathine benzylpenicillin provides a prolonged effect when administered intramuscularly; it is used for infections caused by highly sensitive pathogens (GABHS, pallidum spirochete) to maintain a low therapeutic concentration for a long time.

Side effects. Jarisch-Herzheimer reaction (treatment of syphilis and other infections caused by spirochetes) - associated with the release of endotoxins.

Benzylpenicillin

Indications. Spicy otitis media, pneumococcal infection (, meningitis), streptococcal infections (acute, erysipelas, scarlet fever, endocarditis, necrotizing fasciitis), meningococcal infection, tick-borne borreliosis, leptospirosis, anthrax; actinomycosis, gas gangrene, syphilis.

Dosing: IM or IV slowly or by infusion: children from 1 month to 12 years, 100-200 thousand units/kg per day in 2-3 doses, for severe diseases - up to 500,000 units/kg/day vital indications (see below). Syphilis - see Section 6.3.

Side effects. At doses >20 million units/day - DNS disorders, increased creatinine levels.

Release form: powder for the preparation of solution for intravenous and intramuscular injections of 250,000, 500,000 and 1 million units (1 mg = 1610 units) (Benzylpenicillin - Russia)

Phenoxymethylpenicillin - Penicillin V (phenoxymethylpenicillin)

Indications: Streptococcal pharyngitis, secondary prevention of rheumatism; prevention of relapses of pneumococcal meningitis after traumatic brain injury, pneumococcal infection in children after splenectomy or with hypogammaglobulinemia; for the treatment of acute otitis media; erysipelas.

Dosage: orally, children over 12 years old - 500 mg every 6 hours, children under 1 year old - 50 mg/kg/day, from 1 to 6 years old - 30 mg/kg/day, 6-12 years old - 20-30 mg/day kg/day in 3-4 doses. Secondary prevention of rheumatism: orally, children - 500 mg 1-2 times a day.

Side effects: See above, also nausea and diarrhea.

Release form: Phenoxymethylpenicillin-benzathine syrup 750 mg/5 ml (Ospen-750 - Sandoz, Austria), tablet. 100 mg, 250 mg, dragee 100,000 units, powder for suspension: 250 mg/5 ml, 60 mg/ml (Phenoxymethylpenicillin - Russia).

Benzathine benzylpenicillin

Indications: acute streptococcal group A, erysipelas, prevention of rheumatism, treatment of diphtheria carriers; syphilis.

Contraindications: neurosyphilis. Do not administer intravenously or intra-arterially.

With caution: renal failure.

Dosing. In the treatment of acute tonsillitis, scarlet fever, erysipelas, wound infections in the acute phase, therapy begins with penicillin, benzathine continues with benzyl-penicillin: 1-2 injections of 1.2 million units once a week. For rheumatism, 2.4 million units intramuscularly every 15 days. For the prevention of scarlet fever in children under 7 years of age (or weighing up to 25 kg) 600,000 units, over 7 years of age (or weighing more than 25 kg) - 1,200,000 units. For the treatment of tonsillitis and the treatment of diphtheria carriers, these doses are once, for the prevention of rheumatism - same doses every 2 weeks, Syphilis: see Section 6.3.

Side effects: Rarely embolism; pain and inflammation at the injection site.

Release form: Por. d/prig. solution for intramuscular injection, benzathine benzylpenicillin in bottles: 300, 600 thousand, 1.2 and 2.4 million units. (Bicillin-1 (Russia); 1.2 and 2.4 million units (Retarpen, Extencillin - Sandoz, Austria).

Antistaphylococcal penicillins

Oxacillin

Oxacillin is used to treat infections caused by staphylococci, incl. producing beta-lactamase, but not MRSA. The rest of the spectrum of action is the same as that of natural penicillins, but the sensitivity of pneumococci and streptococci to it is lower than to penicillin. Bioavailability when taken orally is low.

Indications: Infectious diseases caused by staphylococci, incl. producing beta-lactamase: acute sinusitis, septicemia, abscesses, phlegmon, cholecystitis, infected burns, bacterial endocarditis.

With caution: bronchial asthma, chronic renal failure; liver failure.

Dosage: IM or IV for newborns - 20-40 mg/kg/day for 2 injections, for children 100-150 (up to 200) mg/kg/day - max, up to 12 g/day for 2-4 injections.

Side effects. Rarely - liver dysfunction, jaundice at high doses (in adults >12 g/day). Fever, nausea, vomiting, eosinophilia, anemia, neutropenia, transient hematuria in children.

Release form: Lyophilisate d/prig. solution for intravenous and intramuscular administration 250 mg, 500 mg (Oxacillin - Russia).

Aminopenicillins

Ampicillin and amoxicillin, unlike natural pencillins, act on some gram-negative microorganisms, in particular, H. influenzae, which in Russia remains sensitive to aminopenicillins due to the low frequency of production of beta-lactamases. Ampicillin acts on E. fecalis, which in Russia is 90% sensitive to it. Activity against Salmonella and Shigella varies geographically. The value of empirical therapy with IMG1 is limited due to the high frequency of secondary resistance of E. coli. The drugs are inactivated by beta-lactamase produced by S. aureus, M. catarrhalis, N. gonorrhoeae, and enterobacteria.

Amoxicillin acts better than ampicillin and penicillin on; when taken orally, it has 2-2.5 times greater bioavailability than ampicillin (especially in the form of Solutab dispersible tablets), gives higher concentrations in plasma and tissues and is less likely to cause diarrhea. Ampicillin is used only parenterally.

Contraindications. Leukemoid reactions of the lymphatic type, lymphocytic leukemia.

With caution. Acute (possible mononucleosis), erythematous rashes characteristic of infectious mononucleosis, breastfeeding. Increased diaper rash - does not prevent repeated use.

Side effects. A feature of aminopenicillins is the development (about 7% of courses) of a maculopapular (“ampicillin”) rash (especially against the background of infection with the Ensteia-Barra virus - most recognize its non-allergic nature) on days 3-5 of treatment; the rash disappears without stopping the drug. Rarely vomiting, diarrhea, very rarely -.

Interaction. Reduce the contraceptive effect of estrogen-containing drugs. Allopurinol increases the risk of ampicillin rash.

Ampicillin

Indications. Acute otitis media, acute sinusitis, community-acquired, UTI, IZhP, shigellosis, salmonellosis, meningitis, bacterial endocarditis, septic infection of newborns (in combination with gentamicin), erysipelas.

Dosing: IM, slow IV or IV infusion. 100-200 mg/kg/day, meningitis, endocarditis - 200-300 mg/kg/day. (up to 8-12 g/day).

Release form: Powder for the preparation of solution for injection 250 mg, 500 mg, 1 and 2 g (Ampicillin - Russia).

Amoxicillin

Indications: infections of the upper respiratory tract(sinusitis, acute otitis media), : UTI. systemic tick-borne borreliosis (Lyme disease); prevention of endocarditis: eradication of H. pylori, dysentery, salmonellosis, salmonellosis carriage in the presence of sensitivity.

Dosage: orally, children 45 mg/kg/day, dose if there is a possibility of pneumococcal resistance (antibiotic treatment, visiting a child care facility) - 80-100 mg/kg/day. The course of treatment is 5-12 days.

Release form: dispersible tablets. 0.125, 025, 0.5 and 1 g. caps., tab. 0.25 and 0.5 g; table, p/obol. 0.5 and 1.0 g; por. and gran, d/prig. susp. 125 mg/5 ml and 250 mg/5 ml: por. d/prig. drops, 0.1 g/ml (Flemoxin Solutab - Astellas Pharma Europe B.B.. Netherlands. Amoxicillin - Russia Ospamox - Sanoz, Austria. Hiconcil - KRKA, Slovenia).

Inhibitor-protected penicillins

They are a combination penicillin drug and an inhibitor (beta-lactamase. The most widely used is amoxicillin/clavulanate, active against resistant H. influenzae, E. coli, M. catarrhalis, S. aureus, (but not MRSA); more active against pneumococci with reduced sensitivity than Ceftriaxone. Ticarcillin/clavulanate is effective against Serratia, Citrobacter, as well as some strains of P. aeruginosa. The addition of beta-lactamase inhibitors does not overcome the resistance of Pseudomonas aeruginosa. Only 20-30% of P. aeruginosa strains are sensitive to ticarcillin. bactericidal against anaerobes, including B. fragilis, Prevotella melaninogenicus. Sulbactam has its own clinically significant antibacterial activity against neisseria and acinetobacter.

Side effects. Nausea and vomiting, diarrhea, rarely - hepatitis, cholestatic jaundice. There have been cases of vasculitis, serum sickness, erythema multiforme (including Stevens-Johnson syndrome), exfoliative; Surface plaque on the teeth is possible when using the suspension.

Interaction. Antacids, laxatives, and glucosamine reduce the absorption of protected penicillins.

Amoxicillin/clavulanic acid

Indications. Infections of the respiratory tract, skin and soft tissues, bones, genitourinary and abdominal, caused by beta-lactamase-producing microorganisms. As a drug of first choice, it is used in children recently discharged from hospital or treated with antibiotics for a period of 3 months before the present illness, as well as in groups at increased risk for the resistance of pneumotropic flora (boarding schools, preschool children). The drug of choice for anaerobic infections (Vincenta, lung abscess, deep wounds), abscesses, fasciitis and phlegmon, animal bites, dental infections, as well as for antibacterial prophylaxis during operations on the abdominal and pelvic organs.

Contraindications. History of jaundice or hepatic dysfunction associated with the use of clavulanic acid. Increased diaper rash - does not prevent repeated use.

With caution. Kidney, liver failure; erythematous rashes characteristic of infectious mononucleosis, chronic lymphocytic leukemia.

Dosage (for amoxicillin): Orally for children under 12 years of age - 45 mg/kg/day in 2 divided doses (up to 750 mg/day), over 12 years of age and adults - 1750 mg per day in 2 divided doses (875×2). If necessary, the dose is increased to 80-100 mg/kg/day, preferably using drugs with a ratio of amoxicillin to clavulanate of 7:1 or higher. IV for newborns - 60 mg/kg/day for 2 injections, for children from 1 month. up to 12 years - 40-60 (up to 90-120) mg/kg/day, over 12 years and adults - 3-4 (up to 6) g/day for 3-4 administrations.

Release form. Amoxicillin to clavulanate ratio:

• 2:1 - table. 0.25/0.125 g (Augmentin - original amoxicillin/clavulanate produced by GlaxoSmithKline, UK, Medoklav - Medohsmi, Cyprus, Amoxiclav - Lek, Slovenia);
• 4:1 - table. 500/125 mg, por. d/prig. susp. 125 mg/31.25 mg/5 ml, 250 mg/62.5 mg/5 ml (Amoxiclav, Augmentin, Medoclav);
• 4:1 - table. dispersible 125 mg/31.25 mg; 250 mg/62.5 mg and 500 mg/125 mg (Flemoklav Solutab - Astellas Pharma Europe B.V., the Netherlands). 5:1 - time. for IV solution 500/100 mg, 1000/200 mg (Augmentin, Amoxiclav, Medoclav) 7:1 - table. 0.875/0.125 g (Amoxiclav)
• 7:1 - table. 0.875/0.125 g, por. d/prig. susp. 200/28.5 mg/5 ml and 400/57 mg/5 ml (Augmentin - dosing forms 2 times a day with the best ratio of amoxicillin and clavulanate).

Ampicillin/sulbactam

Indications and contraindications. Same as amoxicillin/clavulanate, hypersensitivity to sulbactam.

Dosing. Children of all ages, including newborns - 150 mg/kg/day, (100 mg/kg/day ampicillin and 50 mg/kg/day sulbactam) for 3-4 (for newborns - for 2) administrations, adults - 1.5-12 g per day for 2-4 administrations IM or IV.

Release forms: por. d/prig. solutions 0.5/0.25 g, 1/0.5 g, 2/1 g (Unasin-Pfizer, USA).

Ticarcillin + clavulanic acid (ticarcilliri/clavulanic acid)

Indications. Severe (lungs, abdominal cavity, bones, soft tissues, urinary tract), caused by multiresistant gram-negative flora, including anaerobic.

Dosage (for ticarcillin): children over 3 months. with a weight of up to 60 kg - 200-300 mg/kg/day for 4-6 injections, for children weighing 60 kg or more, as well as adults - 12-18 g for 4-6 injections intravenously (in 30 minutes) .

Side effects: dizziness, neutropenia, hypokalemia.

Release form: liof. por. d/prig. 1500/100 mg and 3000/200 mg (15:1) (Timentin-GlaxoSmith-Klein, UK).

Mushrooms are a kingdom of living organisms. Mushrooms come in many varieties: some of them end up in our diet, some cause skin diseases, and some are so poisonous that they can cause death. But fungi of the genus Penicillium save millions of human lives from pathogenic bacteria.

Penicillin antibiotics based on this mold (mold is also a fungus) are still used in medicine.

In the 30s of the last century, Alexander Fleming conducted experiments with staphylococci. He studied bacterial infections. Having grown a group of these pathogens in a nutrient medium, the scientist noticed that there were areas in the dish around which there were no living bacteria. The investigation showed that the culprit for these stains was ordinary green mold, which likes to settle on stale bread. The mold was called Penicillium and, as it turned out, produced a substance that kills staphylococci.

Fleming studied the issue further and soon isolated pure penicillin, which became the world's first antibiotic. The principle of action of the medicine is as follows: when a bacterial cell divides, each half restores its cell membrane with the help of a special chemical element, peptidoglycan. Penicillin blocks the formation of this element, and the bacterial cell simply “resolves” in the environment.

But difficulties soon arose. Bacterial cells learned to resist the drug - they began to produce an enzyme called “beta-lactamase,” which destroys beta-lactams (the basis of penicillin).

For the next 10 years, an invisible war took place between pathogens that destroy penicillin, and scientists who modify this penicillin. This is how many modifications of penicillin were born, which now form the entire penicillin series of antibiotics.

The drug for any type of use spreads quickly throughout the body, penetrating almost all its parts. Exceptions: cerebrospinal fluid, prostate and visual system. In these places the concentration is very low; under normal conditions it does not exceed 1 percent. With inflammation, a rise of up to 5% is possible.

Antibiotics do not affect cells human body, since the latter do not contain peptidoglycan.

The medicine is quickly eliminated from the body; after 1-3 hours, most of it exits through the kidneys.

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All drugs are divided into: natural (short and long-acting) and semi-synthetic (antistaphylococcal, broad-spectrum drugs, antipseudomonas).

These drugs obtained directly from mold. At the moment, most of them are obsolete, as pathogens have become immune to them. In medicine, benzylpenicillin and Bicillin are most often used, which are effective against gram-positive bacteria and cocci, some anaerobes and spirochetes. All these antibiotics are used only as injections into the muscles, since the acidic environment of the stomach quickly destroys them.

Benzylpenicillin in the form of sodium and potassium salts is a natural short-acting antibiotic. Its effect wears off after 3-4 hours, so frequent repeated injections are necessary.

Trying to eliminate this deficiency, pharmacists created natural long-acting antibiotics: Bicillin and benzylpenicillin novocaine salt. These drugs are called “depot forms” because after injection into the muscle they form a “depot” in it, from which the medicine is slowly absorbed into the body.

Examples of drugs: benzylpenicillin salt (sodium, potassium or novocaine), Bicillin-1, Bicillin-3, Bicillin-5.

Several decades after penicillin was obtained pharmacists were able to isolate its main active ingredient, and the process of modification began. Most drugs, after improvement, became resistant to the acidic environment of the stomach, and semi-synthetic penicillins began to be produced in tablets.

Isoxazolepenicillins are drugs that are effective against staphylococci. The latter have learned to produce an enzyme that destroys benzylpenicillin, and drugs from this group interfere with the production of the enzyme. But you have to pay for the improvement - drugs of this type are less absorbed into the body and have a smaller spectrum of action compared to natural penicillins. Examples of drugs: Oxacillin, Nafcillin.

Aminopenicillins are broad-spectrum drugs. They are inferior to benzylpenicillins in the fight against gram-positive bacteria, but cover a wider range of infections. Compared to other drugs, they remain in the body longer and penetrate certain body barriers better. Examples of drugs: Ampicillin, Amoxicillin. You can often find Ampiox - Ampicillin + Oxacillin.

Carboxypenicillins and ureidopenicillins – antibiotics effective against Pseudomonas aeruginosa. At the moment, they are practically not used, since infections quickly become resistant to them. Occasionally you can find them as part of a comprehensive treatment.

Examples of drugs: Ticarcillin, Piperacillin

Sumamed

Active ingredient: azithromycin.

Indications: respiratory tract infections.

Contraindications: intolerance, severe renal failure, children under 6 months of age.

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: infections sensitive to the drug.

Price: 30-60 rubles.

Amoxicillin Sandoz

Indications: respiratory tract infections (including sore throat, bronchitis), genitourinary system infections, skin infections, other infections.

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

Indications: streptococcal diseases, mild to moderate infections.

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

Indications: infections of the respiratory tract, urinary system, gynecological infections, other infections sensitive to amoxicillin.

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

Injections

Bicillin-1

Active ingredient: benzathine benzylpenicillin.

Indications: acute tonsillitis, scarlet fever, wound infections, erysipelas, syphilis, leishmaniasis.

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

Indications: infections of the lower and upper respiratory tract, gastrointestinal tract, genitourinary system, gynecological and surgical infections.

Contraindications: hypersensitivity, severe gastrointestinal infections, lymphocytic leukemia, mononucleosis.

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

Indications: respiratory and urinary tract, gastrointestinal tract, meningitis, endocarditis, sepsis, whooping cough.

Contraindications: increased sensitivity, renal dysfunction, childhood, pregnancy.

Price: 163 rubles.

Benzylpenicillin

Indications: severe infections, congenital syphilis, abscesses, pneumonia, erysipelas, anthrax, tetanus.

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

Amoxiclav, Ospamox, Oxacillin are suitable for treating children. But Before using the medicine, you must consult your doctor to adjust the dose.

Indications for use

Antibiotics of the penicillin group are prescribed for infections; the type of antibiotics is selected based on the type of infection. These can be various cocci, rods, anaerobic bacteria, and so on.

Most often, infections of the respiratory tract and genitourinary system are treated with antibiotics.

In the case of treating children, you must follow the instructions of the doctor, who will prescribe the right antibiotic and adjust the dose.

In case of pregnancy, antibiotics must be used with extreme caution, as they penetrate into the fetus. During lactation, it is better to switch to mixtures, since the medicine also penetrates into the milk.

No for older people special instructions, although the doctor should take into account the condition of the patient’s kidneys and liver when prescribing treatment.

The main and, often, the only contraindication is individual intolerance. It occurs frequently - in approximately 10% of patients. Additional contraindications depend on the specific antibiotic and are prescribed in the instructions for use.

If side effects need to apply immediately medical care, discontinue the drug and carry out symptomatic treatment.

Where does penicillin mold grow?

Almost everywhere. This mold includes dozens of subspecies, and each of them has its own habitat. The most notable representatives are penicillin mold, which grows on bread (it also attacks apples, causing them to quickly rot) and the mold used in the production of some cheeses.

What can replace penicillin antibiotics?

If the patient is allergic to penicillin, non-penicillin antibiotics can be used. Names of drugs: Cefadroxil, Cephalexin, Azithromycin. The most popular option is Erythromycin. But you need to know that Erythromycin often causes dysbiosis and stomach upset.

Penicillin antibiotics are a powerful remedy against infections caused by various bacteria. There are quite a few types of them, and treatment must be selected according to the type of pathogen.

They seem harmless to the body due to the fact that the only contraindication is a hypersensitivity reaction, but improper treatment or self-medication can provoke resistance of the pathogen to the antibiotic, and you will have to select another treatment, more dangerous and less effective.

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Antibacterial drugs that are common today made a real revolution in medicine less than a century ago. Humanity has received powerful weapons to fight infections that were previously considered fatal.

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

This section provides a complete list of currently relevant antimicrobial drugs. In addition to the characteristics of the main compounds, all trade names and analogues are given.

Main title	Antimicrobial activity	Analogs
Benzylpenicillin potassium and sodium salts	Affects mainly 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 has a longer effect, since it dissolves more slowly and is absorbed from the intramuscular depot.	Benzylpenicillin-KMP (-G, -Teva, -G 3 mega)
Bicillins (1, 3 and 5)	It is used for chronic rheumatism for prophylactic purposes, as well as for the treatment of infectious diseases of moderate and mild severity caused by streptococci.	Benzicillin-1, Moldamine, Extincillin, Retarpin
Phenoxymethylpenicillin	It has a therapeutic effect similar to the previous groups, but is not destroyed in the acidic gastric environment. Available in tablet form.	V-Penicillin, Kliatsil, Ospen, Penicillin-Fau, Vepicombin, Megacillin Oral, Pen-os, Star-Pen
Oxacillin	Active against staphylococci that produce penicillinase. It is characterized by low antimicrobial activity and is completely ineffective against penicillin-resistant bacteria.	Oksamp, Ampioks, Oksamp-Sodium, Oksamsar
Ampicillin	Extended spectrum of antimicrobial activity. In addition to the main range of inflammatory diseases of the gastrointestinal tract, it also treats those caused by Escherichia, Shigella, and Salmonella.	Ampicillin AMP-KID (-AMP-Forte, -Ferein, -AKOS, -trihydrate, -Innotek), Zetsil, Pentrixil, Penodil, Standacillin
Amoxicillin	Used to treat inflammation of the respiratory and urinary tract. After identifying the bacterial origin of the stomach ulcer, Helicobacter pylori is used to eradicate.	Flemoxin solutab, Hiconcil, Amosin, Ospamox, Ecobol
Carbenicillin	The spectrum of antimicrobial action includes Pseudomonas aeruginosa and Enterobacteriaceae. 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 an unprotected agent.	Augmentin, Flemoklav solutab, Amoxiclav, Amklav, Amovicombe, Verklav, Ranklav, Arlet, Klamosar, Rapiklav
Ampicillin/sulbactam		Sulacillin, Liboccil, Unazin, Sultasin
Ticarcillin/clavulanate	The main indication for use is nosocomial infections.	Hymentin
Piperacillin/tazobactam		Tazocin

The information provided is for informational purposes only and is not a guide to action. All prescriptions are made exclusively by a doctor, and therapy is carried out under his supervision.

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 a chronic form that is difficult to cure. It is for this reason that most strains of pathogenic bacteria today are resistant to first-generation ALD.

The medication prescribed by the specialist should be used for antibacterial therapy. Independent attempts to find cheap analogue and saving can lead to a worsening of the condition.

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

When you have to change a medicine due to an acute lack of finances, you need to ask your doctor about it, since only a specialist will be able to choose the best option.

Drugs of the penicillin group belong to the so-called beta-lactams - chemical compounds, which has a beta-lactam ring in its formula.

This structural component is crucial in the treatment of bacterial infectious diseases: it prevents bacteria from producing a special biopolymer of peptidoglycan, 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 due to the fact that they do not contain peptidoglycan.

Medicines based on waste products of mold fungi have been obtained widespread in all areas of medicine due to the following properties:

• High bioavailability - drugs are quickly absorbed and distributed throughout the tissues. The weakening of the blood-brain barrier during inflammation of the meninges also contributes to penetration into the cerebrospinal fluid.
• Extensive spectrum of 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.
• Lowest toxicity among all antibiotics. They are approved for use even during pregnancy, and proper use (as prescribed by a doctor and according to the instructions) almost completely eliminates the development of side effects.

In the process of research and experiments, many medications with different properties were obtained. For example, if they belong to the general series, penicillin and ampicillin are not the same thing. All penicillin antibiotics are well compatible with most other drugs. As for complex therapy with other types of antibacterial drugs, combined use with bacteriostatics weakens the effectiveness of penicillins.

A thorough study of the properties of the first antibiotic showed its imperfection. Despite a fairly wide spectrum of antimicrobial action 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, so it was used exclusively in the form of injections. In search of more effective and stable compounds, various semi-synthetic drugs have been created.

Today, penicillin antibiotics, a full list of which is given below, are divided into 4 main groups.

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

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

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

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

These drugs are used for long-term antibiotic therapy of chronic rheumatism, syphilis, and focal streptococcal infection.
Phenoxymethylpenicillin is another form of benzylpenicillin intended for the treatment of moderate infectious diseases. Differs from those described above in its resistance to hydrochloric acid of gastric juice.

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

Read also: Instructions for using penicillin in injections and tablets

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

For a long time, penicillin was not used to treat staphylococcal infections, until oxacillin was synthesized on its basis in 1957. It inhibits the activity of beta-lactamases of the pathogen, but is ineffective against diseases caused by strains sensitive to benzylpenicillin. This group also includes cloxacillin, dicloxacillin, methicillin and others, which are almost never used in modern medical practice due to increased toxicity.

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

Compared to the previous groups, these compounds have two significant advantages. Firstly, they are active against a wider range of pathogens, and secondly, they are available in tablet form, which makes them much easier to use. Disadvantages include sensitivity to beta-lactamase, that is, aminopenicillins (ampicillin and amoxicillin) are unsuitable for the treatment of staphylococcal infections.

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

The drugs are well absorbed and act for a long time, which reduces the frequency of use to 2-3 times every 24 hours. The main indications for use are meningitis, sinusitis, otitis, infectious diseases of the urinary and upper respiratory tract, enterocolitis and eradication of Helicobacter (the causative agent of stomach ulcers). Common side effect aminopenicillin is a characteristic rash of non-allergic nature, which immediately disappears after discontinuation.

They are a separate penicillin series of antibiotics, the name of which makes their purpose clear. Antibacterial activity is similar to aminopenicillins (with the exception of pseudomonas) and is pronounced against Pseudomonas aeruginosa.

According to the degree of effectiveness they are divided into:

• Carboxypenicillins, the clinical significance of which has recently decreased. 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.

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

Ampicillin group of antibiotics, highly active against most pathogens, is destroyed by penicillinase-forming bacteria. Since the bactericidal effect of oxacillin, which is resistant to them, is significantly weaker than that of ampicillin and amoxicillin, combined medications were synthesized.

In combination with sulbactam, clavulanate and tazobactam, antibiotics obtain 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.

Read also: About modern classification antibiotics by group of parameters

Its broad spectrum of action and good tolerance by patients have made penicillin the optimal treatment for infectious diseases. At the dawn of the era of antimicrobial drugs, benzylpenicillin and its salts were the drugs of choice, but at the moment most pathogens are resistant to them. However, modern semi-synthetic penicillin antibiotics in tablets, injections and others dosage forms occupy one of the leading places in antibiotic therapy in various fields of medicine.

The discoverer also noted the particular 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 sinusitis, meningitis, bronchitis, pneumonia and other diseases of the lower and upper respiratory tract.

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

Spirochetes are one of the few microorganisms that remain susceptible to benzylpenicillin and its derivatives. Benzylpenicillins are also effective against gonococci, which makes it possible to successfully treat syphilis and gonorrhea with minimal negative effects on the patient’s body.

Intestinal inflammation caused by pathogenic microflora responds well to treatment with acid-resistant medications.

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

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

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

Diseases of the urinary system that are of bacterial origin respond well to treatment only with inhibitor-protected medications. The remaining subgroups are ineffective, since pathogen strains 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.

Treatment with antibacterial medications in general and penicillins in particular should be carried out only as prescribed by a doctor. Despite the minimal toxicity of the medicine 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.

The scope of application of penicillin and various drugs based on it in medicine is determined by the activity of the substance against specific pathogens. Bacteriostatic and bactericidal effects occur in relation to:

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

Low toxicity and a broad spectrum of action make antibiotics of the penicillin group the optimal treatment for tonsillitis, pneumonia (both focal and lobar), scarlet fever, diphtheria, meningitis, blood poisoning, septicemia, pleurisy, pyemia, osteomyelitis in acute and chronic forms, septic endocarditis, various purulent infections of the skin, mucous membranes and soft tissues, erysipelas, anthrax, gonorrhea, actinomycosis, syphilis, blenorrhea, as well as eye diseases and ENT diseases.

Strict contraindications include only individual intolerance to benzylpenicillin and other drugs in this group. Endolumbar (injection into the spinal cord) administering medications to patients diagnosed with epilepsy.

During pregnancy, antibiotic therapy with penicillin drugs should be treated with extreme caution. Despite the fact that they have minimal teratogenic effects, tablets and injections should be prescribed only in cases of urgent need, assessing the degree of risk to the fetus and the pregnant woman herself.

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

Among other antibacterial agents, penicillins stand out due to their low toxicity.

Undesirable consequences of use include:

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

Timely medicinal support of the body will help prevent the development of dysbiosis and avoid allergies. It is advisable to combine antibiotic therapy with the use of pre- and probiotics, as well as desensitizers (if sensitivity is increased).

Tablets and injections should be prescribed to children with caution, taking into account the possible negative reaction, and approach the choice of a specific drug thoughtfully.

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

A child's body is much more sensitive to drugs than an adult's. Therefore, you should carefully monitor the baby’s condition (penicillin is excreted slowly and, when accumulated, can cause convulsions), and also take preventive measures. The latter include the use of pre- and probiotics to protect the intestinal microflora, diet and comprehensive strengthening of the immune system.

A little theory:

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

Alexander Fleming - discoverer of penicillin

The Egyptians, for example, 2500 years ago treated inflamed wounds with compresses made 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), attempted to derive practical benefits from it.

This was achieved by Alexander Fleming, a British microbiologist, who in 1928, on September 28, discovered mold in Petri dishes with colonies of staphylococcus. Its spores, which got onto the crops due to the negligence of the laboratory staff, sprouted and destroyed pathogenic bacteria. Interested, Fleming carefully studied this phenomenon and isolated a bactericidal substance called penicillin. For many years The discoverer worked to obtain a chemically pure, stable compound suitable for treating people, but others invented it.

In 1941, Ernst Chain and Howard Florey were able to purify penicillin from impurities and carried out research together with Fleming clinical trials. The results were so successful that by 1943, mass production of the drug was organized in the United States, which saved many hundreds of thousands of lives during the war. The services of Fleming, Chain and Flory to humanity were recognized in 1945: the discoverer and developers became Nobel Prize laureates.

Subsequently, the original chemical 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.

Read a fascinating article: The inventor of antibiotics or the story of saving humanity!

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Penicillin antibiotics are several types of drugs that are divided into groups. In medicine, drugs are used to treat various diseases of infectious and bacterial origin. The drugs have a minimal number of contraindications and are still used to treat various patients.

Once Alexander Fleming was studying pathogens in his laboratory. He created a nutrient medium and grew staphylococcus. The scientist was not particularly clean; he simply put beakers and cones in the sink and forgot to wash them.

When Fleming needed the dishes again, he discovered that they were covered with fungus - mold. The scientist decided to test his guess and examined one of the containers under a microscope. He noticed that where there was mold, there was no staphylococcus.

Alexander Fleming continued his research, he began to study the effect of mold on pathogenic microorganisms and revealed that the fungus has a destructive effect on the membranes of bacteria and leads to their death. The public could not be skeptical about the research.

The discovery helped save many people's lives. It saved humanity from those diseases that previously caused panic among the population. Naturally, modern medicines are relatively similar to those drugs that were used at the end of the 19th century. But the essence of the medications and their action have not changed so dramatically.

Penicillin antibiotics were able to revolutionize medicine. But the joy of the discovery did not last long. It turned out that pathogenic microorganisms and bacteria can mutate. They change and become insensitive to drugs. This led to significant changes in antibiotics such as penicillin.

Scientists spent almost the entire 20th century “fighting” microorganisms and bacteria, trying to create the ideal drug. The efforts were not in vain, but such improvements have led to the fact that antibiotics have changed significantly.

New generation drugs are more expensive, act faster, and have a number of contraindications. If we talk about those drugs that were obtained from mold, they have a number of disadvantages:

• Poorly digestible. Gastric juice acts on the fungus in a special way, reducing its effectiveness, which undoubtedly affects the result of treatment.
• Penicillin antibiotics are drugs of natural origin, for this reason they do not have a wide spectrum of action.
• Medicines are quickly eliminated from the body, approximately 3-4 hours after injection.

Important: These medications have virtually no contraindications. It is not recommended to take them if you have an individual intolerance to antibiotics, or if you develop an allergic reaction.

Modern antibacterial agents differ significantly from the familiar penicillin. In addition to the fact that today you can easily purchase medications of this class in tablets, there are a great variety of them. Classification and generally accepted division into groups will help you understand the drugs.

Antibiotics of the penicillin group are conventionally divided into:

1. Natural.
2. Semi-synthetic.

All medicines based on mold are antibiotics of natural origin. Today, such medications are practically not used in medicine. The reason is that pathogenic microorganisms have become immune to them. That is, the antibiotic does not act on bacteria properly; the desired result in treatment can only be achieved by administering high dose drug. The drugs in this group include: Benzylpenicillin and Bicillin.

The drugs are available in powder form for injection. They effectively affect: anaerobic microorganisms, gram-positive bacteria, cocci, etc. since the medications are of natural origin and cannot boast of a long-lasting effect, injections are often given every 3-4 hours. This allows you to maintain your concentration antibacterial agent in the blood.

Penicillin antibiotics of semi-synthetic origin are the result of modification of drugs produced from mold fungus. It was possible to impart some properties to medications belonging to this group; first of all, they became insensitive to acid-base environments. This made it possible to produce antibiotics in tablets.

Medicines also appeared that acted on staphylococci. This class of drugs is different from natural antibiotics. But the improvements have significantly affected the quality of the drugs. They are poorly absorbed, do not have such a wide sector of action, and have contraindications.

Semi-synthetic drugs can be divided into:

• Isoxazolepenicillins are a group of drugs that act on staphylococci; examples include the names of the following drugs: Oxacillin, Nafcillin.
• Aminopenicillins - several drugs belong to this group. They have a wide sector of action, but are significantly inferior in strength to antibiotics of natural origin. But they can fight a large number of infections. Drugs from this group remain in the blood longer. Such antibiotics are often used to treat various diseases, for example two very well-known drugs: Ampicillin and Amoxicillin.

Attention! The list of medications is quite large; they have a number of indications and contraindications. For this reason, you should consult your doctor before starting antibiotics.

Antibiotics belonging to the penicillin group are prescribed by a doctor. It is recommended to take the drugs if you have:

1. Diseases of an infectious or bacterial nature (pneumonia, meningitis, etc.).
2. Respiratory tract infections.
3. Diseases of an inflammatory and bacterial nature of the genitourinary system (pyelonephritis).
4. Skin diseases of various origins (erysipelas, caused by staphylococcus).
5. Intestinal infections and many other diseases of an infectious, bacterial or inflammatory nature.

Information: Antibiotics are prescribed for extensive burns and deep wounds, gunshot or stab wounds.

In some cases, taking medications helps save a person's life. But you should not prescribe such drugs yourself, as this can lead to addiction.

What contraindications do medications have:

• You should not take medications during pregnancy or lactation. The drugs may affect the growth and development of the child. They can change the quality of milk and its taste characteristics. There are a number of drugs that are conditionally approved for the treatment of pregnant women, but such an antibiotic must be prescribed by a doctor. Since only a doctor can determine the permissible dosage and duration of treatment.
• The use of antibiotics from the groups of natural and synthetic penicillins for treatment is not recommended for the treatment of children. Drugs in these classes may have toxic effects on the child's body. For this reason, medications are prescribed with caution, determining the optimal dosage.
• You should not use medications without obvious indications. Use medications for a long period of time.

Direct contraindications for the use of antibiotics:

1. Individual intolerance to drugs of this class.
2. Tendency to allergic reactions of various kinds.

Attention! The main side effects of taking medications are long-term diarrhea and candidiasis. They are due to the fact that the drugs affect not only pathogenic microorganisms, but also beneficial microflora.

The penicillin series of antibiotics is distinguished by the presence of a small number of contraindications. For this reason, drugs in this class are prescribed very often. They help to quickly cope with the disease and return to a normal rhythm of life.

Medicines latest generation have a wide spectrum of action. Such antibiotics do not have to be taken for a long time, they are well absorbed and, with adequate therapy, can “put a person back on his feet” in 3–5 days.

The question is which antibiotics are best? can be considered rhetorical. There are a number of drugs that doctors prescribe more often than others for one reason or another. In most cases, drug names are well known to the general public. But it’s still worth studying the list of medications:

1. Sumamed is a drug used to treat infectious diseases of the upper respiratory tract. The active ingredient is erythromycin. The medication is not used to treat patients with acute or chronic renal failure, and is not prescribed to children under 6 months of age. The main contraindication to the use of Sumamed should still be considered individual intolerance to the antibiotic.
2. Oxacillin is available in powder form. The powder is diluted, and then the solution is used for intramuscular injections. The main indication for the use of the drug is infections that are sensitive to this medicine. Hypersensitivity should be considered a contraindication to the use of Oxacillin.
3. Amoxicillin belongs to a number of synthetic antibiotics. The drug is quite well known; it is prescribed for sore throat, bronchitis and other respiratory tract infections. Amoxicillin can be taken for pyelonephritis (inflammation of the kidneys) and other diseases of the genitourinary system. The antibiotic is not prescribed to children under 3 years of age. Intolerance to the medication is also considered a direct contraindication.
4. Ampicillin - the full name of the medicine: Ampicillin trihydrate. Indications for the use of the drug should be considered infectious diseases of the respiratory tract (sore throat, bronchitis, pneumonia). The antibiotic is excreted from the body by the kidneys and liver; for this reason, Ampicillin is not prescribed to people with acute liver failure. Can be used to treat children.
5. Amoxiclav is a drug that has a combined composition. It is considered one of the latest generation antibiotics. Amoxiclav is used to treat infectious diseases of the respiratory system and genitourinary system. It is also used in gynecology. Contraindications to the use of the medication include hypersensitivity, jaundice, mononucleosis, etc.

List or list of penicillin antibiotics, which are available in powder form:

1. Benzylpenicillin novocaine salt is an antibiotic of natural origin. Indications for the use of the drug include severe infectious diseases, including congenital syphilis, abscesses of various etiologies, tetanus, anthrax and pneumonia. The medicine has practically no contraindications, but modern medicine it is used extremely rarely.
2. Ampicillin is used to treat the following infectious diseases: sepsis (blood poisoning), whooping cough, endocarditis, meningitis, pneumonia, bronchitis. Ampicillin is not used to treat children or people with severe renal failure. Pregnancy can also be considered a direct contraindication to the use of this antibiotic.
3. Ospamox is prescribed for the treatment of diseases of the genitourinary system, gynecological and other infections. Prescribed in the postoperative period if there is a high risk of developing inflammatory process. Antibiotics are not prescribed for severe infectious diseases Gastrointestinal tract, in the presence of individual intolerance to the drug.

Important: Called an antibiotic, the drug must have an antibacterial effect on the body. All those medications that affect viruses have nothing to do with antibiotics.

Sumamed - cost varies from 300 to 500 rubles.

Amoxicillin tablets - price is about 159 rubles. per package.

Ampicillin trihydrate - cost of tablets is 20–30 rubles.

Ampicillin in powder form, intended for injection - 170 rubles.

Oxacillin - average price per drug varies from 40 to 60 rubles.

Amoxiclav - cost - 120 rubles.

Ospamox - price varies from 65 to 100 rubles.

Benzylpenicillin novocaine salt - 50 rub.

Benzylpenicillin - 30 rub.

groups penicillins , depends on what kind of medicine we are talking about.

Currently, four groups are used:

• natural penicillins;
• semisynthetic penicillins;
• aminopenicillins, which have an extended spectrum of action;
• penicillins, which have a wide antibacterial spectrum of influence.

Release form

Injectable preparations are available, as well as penicillin tablets.

The injection product is 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-ecmoline tablets are also produced for resorption and oral administration. Sucking tablets contain 5000 units of penicillin. In tablets for oral administration - 50,000 units.

Penicillin tablets with sodium citrate may contain 50,000 and 100,000 units.

Pharmacological action

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

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 industrial production process of penicillin. The first use of this antibacterial drug for the treatment of bacterial infections occurred in 1941. And in 1945, for the invention of penicillin, the Nobel Prize was received by its creator Fleming (the one who invented penicillin), as well as by the 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 were obtained in the Soviet Union in 1942 by microbiologists Balezina And Ermolyeva. Then industrial production of the antibiotic began in the country. In the late fifties, synthetic penicillins appeared.

When this drug 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 an 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, so-called protected penicillins are widely used.

The chemical composition of penicillin indicates that the drug 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 bactericidal and bacteriostatic effects, 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), into anaerobic spore-forming rods ( Spirochaetaceae Actinomyces spp.), etc.

The most active of penicillin drugs is . Strains demonstrate resistance to the influence of benzylpenicillin Staphylococcus spp., which produce penicillinase.

Penicillin is not effective means in relation to bacteria of the enteric-typhoid-dysenteric group, causative agents of tularemia, brucellosis, plague, cholera, as well as whooping cough, tuberculosis, Friedlander's, Pseudomonas aeruginosa and viruses, rickettsia, fungi, protozoa.

Pharmacokinetics and pharmacodynamics

The most effective method is administered intramuscularly. After such use, the active component reaches the patient very quickly. The highest concentration of the product is observed 30-60 minutes after application. After a single administration, only trace concentrations are determined.

It is quickly detected in muscles, wound exudate, in joint cavities, and in muscles.

IN cerebrospinal fluid a small amount is observed. A small amount will also enter the pleural cavities and abdominal cavity, therefore, if necessary, direct local action of the drug is required.

Penetrates to the fetus through the placenta. It is excreted from the body through the kidneys, so about 50% of the drug is eliminated. Also, part of it is excreted in bile.

If a patient takes penicillin tablets, he needs to take into account that when taken orally, the antibiotic is poorly absorbed, and part of it is destroyed under the influence of gastric juice and beta-lactamase, which is produced by intestines .

Indications for use

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

• pneumonia (lobar and focal);
• pleural empyema;
• septic endocarditis in acute and subacute forms;
• sepsis ;
• pyemia;
• septicemia;
• in acute and chronic form;
• infectious diseases biliary and urinary tract;
• purulent infectious diseases of the skin, mucous membranes, soft tissues;
• erysipelas;
• anthrax;
• actinomycosis;
• gynecological purulent-inflammatory diseases;
• ENT diseases;
• eye diseases;
• gonorrhea, , blenorrhea.

Contraindications

Tablets and injections are not used in the following cases:

• with high sensitivity to this antibiotic;
• at , , and others;
• when patients exhibit high sensitivity to sulfonamides, antibiotics, as well as other drugs.

Side effects

During use, the patient must understand what penicillin is and what side effects it can cause. During treatment, allergy symptoms sometimes appear. As a rule, such manifestations are associated with sensitization of the body due to earlier use of these drugs. Also may occur due to prolonged use of the drug. When using the medicine for the first time, allergies are observed less frequently. There is a possibility of sensitization of the fetus during pregnancy if a woman takes penicillin.

The following side effects may also develop during the course of treatment:

• Digestive system: nausea, , vomit.
• Central nervous system : neurotoxic reactions, signs of meningism, convulsions .
• Allergy:, fever, rash on mucous membranes and skin, eosinophilia,. Cases recorded and death. If such manifestations occur, you should immediately administer intravenously.
• Manifestations associated with chemotherapeutic effects: oral cavity, vaginal candidiasis.

Instructions for use of penicillin (Method and dosage)

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, or intravenously. The drug is also injected into the spinal canal. For therapy to be as effective as possible, the dose must be calculated so that there is 0.1–0.3 units of penicillin in 1 ml of blood. Therefore, the drug is administered every 3-4 hours.

For treatment pneumonia , , cerebrospinal meningitis, etc. a special regimen is prescribed by the doctor.

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 tablets half an hour before meals or two hours after meals. The duration of treatment depends on the disease.

Overdose

It should be borne in mind that when taking large doses of penicillin, an overdose may occur, which may cause unpleasant symptoms in the form nausea, vomiting, diarrhea . But this condition is not life-threatening.

With intravenous administration of potassium salt in patients suffering from renal failure , can develop hyperkalemia .

When large doses of the drug are administered intraventricularly or intravenously, epileptic seizures may occur. But such a symptom appears in adult patients only after administration of at least 50 million units. medicines. In this case, the patient is prescribed barbiturates or benzodiazepines.

Interaction

When taking an antibiotic, the elimination process may slow down from the body due to inhibition of its tubular secretion.

Terms of sale

The drugs are sold by prescription; the doctor writes a prescription to the patient in Latin.

Storage conditions

It should be stored at a temperature of no more than 25 degrees, in a dry place.

Best before date

The shelf life of penicillin is 5 years.

Special instructions

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

Prescribe the medicine with caution to people who have impaired renal function, as well as to patients with acute heart failure , people who have a tendency to allergic manifestations or severe sensitivity to cephalosporins .

If 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 combination treatment.

Since in the process of taking antibiotics there is a high probability of manifestations fungal superinfection , it is important to take antifungal medications during treatment. It is also important to consider that when using subtherapeutic doses of the drug or with an incomplete course of therapy, the emergence of resistant strains of pathogens is possible.

When taking the drug orally, you should take it with plenty of liquid. It is important to strictly follow the instructions on how to dilute the product.

During treatment with penicillins, it is necessary to strictly follow the prescribed treatment regimen and not skip doses. If a dose is missed, the dose should be taken as soon as possible. You cannot interrupt the course of treatment.

Since expired medicine may be toxic, it should not be taken.

Analogs

Level 4 ATX code matches:

There are a number of penicillin drugs; the most optimal antibiotic is determined by the doctor individually.

With alcohol

For children

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

Penicillin during pregnancy and lactation

It is advisable to prescribe an antibiotic during pregnancy only if the expected benefit outweighs the likelihood of negative effects. Lactation should be stopped during the period of taking the drugs, since the substance passes into the milk and can provoke the development of severe allergic manifestations in the child.