Sumamed for mycoplasma treatment course. Study of the effectiveness of complex therapy for patients with urogenital chlamydia, mycoplasmosis and ureaplasmosis using the drug sumamed. Antibiotics for mycoplasma pneumonia

To treat this disease, doctors resort to the use of antibacterial drugs with a wide spectrum of action. Drugs of this type are very toxic, but very effective.

Pharmacokinetics and price of Azithromycin

Many people prefer to use Azithromycin because it is relatively inexpensive. The price for this medication in Moscow and large regional centers is within 150 rubles. In the regions, you can buy Azithromycin for 100-120 rubles.

Azithromycin has a pronounced bactericidal effect. The medication is able to resist gram-positive and gram-negative bacteria. The drug is also active against some anaerobic microorganisms and streptococci. Azithromycin is quickly adsorbed from the gastrointestinal tract. This is due to the fact that the medication has high resistance to acidic environments.

The maximum concentration of Azithromycin in the blood occurs 2.5-3 hours after administration. Metabolites of the drug are evenly distributed throughout the gastrointestinal tract and tissues of the urogenital tract. Also, the active components of the drug penetrate eukaryotic cells. Azithromycin metabolites are excreted by the kidneys.

The half-life of the drug is 14-20 hours.

Instructions for use of the drug

Before starting treatment for ureaplasma with Azithromycin, a person should undergo a comprehensive examination. In some cases, before the course of treatment, the patient is prescribed immunomodulatory drugs. Drugs of this type are administered intramuscularly. The duration of treatment with immunomodulatory therapy is 7-14 days.

The dosage of Azithromycin is determined individually. Usually it is 1-1.5 grams. Everything will depend on the age of the patient and the severity of the disease. Children under 14 years of age are recommended to take no more than 700 mg of the drug. The frequency of Azithromycin administration is 1 time per day. The duration of the course of treatment is 5 days. Treatment of ureaplasma with Azithromycin is carried out in several courses (usually 2-3).

Reviews from doctors indicate that Azithromycin is a very toxic medicine. This drug has a number of contraindications. Azithromycin cannot be used to treat ureaplasmosis in pregnant women, since drug metabolites can penetrate the placental barrier. In addition, the active components of the drug have a toxic effect on the liver.

You should not take the medication during lactation, since the breakdown products of Azithromycin are passed through breast milk. Hypersensitivity to the active or auxiliary components of the product may also be a contraindication for use.

Azithromycin metabolites have been found to cause serious damage to the liver and kidneys. That is why the medication is not recommended for long-term use. Doctors say that if acute liver or kidney failure develops, taking Azithromycin is strictly prohibited.

Side effects of the drug:

• From the gastrointestinal tract: vomiting, nausea, diarrhea, flatulence. Also, with long-term use of the drug, reversible cholestatic jaundice, anorexia or pseudomembranous colitis may appear.
• Allergic reactions: itching, skin rash, Stevens-Johnson syndrome. If the patient has hypersensitivity to macrolide antibiotics, anaphylactic shock may develop.
• From the central and peripheral nervous system: headaches, convulsions, disturbance of taste. Rarely - drowsiness, nervous agitation, anxiety.
• Leukopenia, neutropenia, thrombocytopenia.
• From the cardiovascular system: tachycardia, increased blood pressure, severe pain in the chest.
• From the genitourinary system: vaginitis, candidiasis.
• Decreased hearing acuity.
• Arthralgia.
• Hyperkalemia.

Azithromycin analogs

Sometimes, instead of Azithromycin, doctors resort to using Sumamed. This drug belongs to the antibiotic group of macrolides. Sumamed is available in the form of tablets and suspensions. The price for this drug ranges from 450 to 600 rubles.

The medication has a pronounced bactericidal effect. Sumamed is active against gram-positive and gram-negative bacteria. The drug is also able to effectively resist streptococci and anaerobic microorganisms.

The active components of the drug are evenly distributed throughout the body. The drug is well adsorbed, as it has pronounced resistance to the acidic environment of the stomach. The drug is excreted by the kidneys

How to take Sumamed for ureaplasma? The dosage of the drug is determined by the attending physician. Children under 14 years of age are recommended to take no more than 700-800 mg of the drug per day. When treating ureaplasmosis in adults, the dosage is increased to 1-1.5 grams. The frequency of taking Sumamed is 1 time per day. The duration of treatment with Sumamed is 3-5 days. If necessary, a second course of drug therapy is given after 5 days.

Contraindications to the use of Sumamed:

1. Intolerance to the active or auxiliary components of the product. If a person has previously experienced allergic reactions when consuming macrolides, then using Sumamed is strictly prohibited.
2. Pregnancy period. Metabolites of the drug are able to penetrate the placental barrier, so taking Sumamed during pregnancy is strictly prohibited.
3. Liver disorders. The active components of the drug accumulate in the liver tissue, so taking the medication is strictly prohibited in case of acute liver failure, cirrhosis, biliary dyskinesia or fatty hepatosis.
4. Acute renal failure.
5. Childhood. The medication is not recommended for children weighing up to 45 kg.
6. Lactation period.

Despite the fact that Sumamed is a very toxic drug, it is usually well tolerated by patients. However, if the wrong dosage is selected or the medication is used for a long time, the following side effects may occur:

• Disturbances in the functioning of the digestive tract. They manifest themselves as nausea, vomiting or diarrhea. Also, the medication can cause heartburn, anorexia and flatulence.
• Headaches, dizziness, drowsiness. In severe cases, hearing acuity decreases.
• Leukopenia.
• Short-term increase in liver enzyme levels.
• Arthralgia.
• Hyperkalemia.
• Disturbances in the functioning of the cardiovascular system. While taking Sumamed, a person may develop arterial hypertension or tachycardia.
• Pain in the sternum.

If the above side effects occur, symptomatic therapy is performed using antihistamines, laxatives, sedatives and sorbents. To relieve pain, you can resort to the use of antispasmodics, which include drotaverine.

Vilprafen is also used in the treatment of ureaplasmosis. This drug also belongs to the antibiotic group of macrolides. The cost of this drug ranges from 500 to 700 rubles. The medicine is available in tablet form.

Vilprafen is used in the treatment of ureaplasmosis and other diseases caused by gram-positive or gram-negative microorganisms. The medication is also active against streptococci and triponema.

The active component of Vilprafen inhibits protein synthesis in the body of the bacterium. As a result, the pathogenic microorganism dies. The medication is well adsorbed and distributed evenly throughout the body. Vilprafen metabolites accumulate in the liver and are excreted from the organ along with bile.

The daily dosage of the product is usually 1-2 grams per day. The frequency of taking the medicine is 2-3 times a day. You need to take the medication for 7-10 days. If necessary, a second course of treatment is carried out after 10-12 days. If it does not help, then instead of Vilprafen, use another antibiotic from the macrolide group.

The medication is contraindicated in children under 14 years of age, as the drug's metabolites have a toxic effect on the liver. In addition, acute liver failure and hypersensitivity to the active or auxiliary components of the drug are contraindications for use.

You can take Vilprafen during pregnancy or lactation. However, in this case, the attending physician must adjust the dosage. The duration of the course of treatment and the frequency of medication administration remain the same.

Side effects of Vilprafen:

1. From the digestive system: loss of appetite, diarrhea, heartburn, vomiting. With long-term use of the medication, the activity of liver enzymes may increase. Also, while using Vilprafen, the risk of reversible jaundice increases.
2. Impaired flow of bile from the liver. Chronic diseases (cirrhosis, biliary dyskinesia, fatty hepatosis) may also worsen.
3. Allergic reactions, manifested in the form of urticaria, suffocation and Quincke's edema. Reviews from doctors indicate that hypersensitivity reactions occur extremely rarely.
4. Dysbacteriosis.
5. Leukopenia.
6. Decreased hearing acuity.
7. Candidiasis.

If the above side effects occur, gastric lavage is performed. Antihistamines are used to relieve hypersensitivity reactions. It is also recommended to use sorbents. To normalize the flow of bile from the liver, doctors resort to the use of choleretic agents. After a course of treatment of ureaplasmosis with Vilprafen, it is recommended to use immunomodulatory medications. The video in this article will tell you about Azithromycin.

Found ureaplasma parvum (ureaplasma parvum), what does this mean and what are the norms?

What is it, if ureaplasma parvum is detected in tests and how does the disease progress? These and other questions worry many patients who have the first signs of the disease.

Ureaplasma parvum is the causative agent of many sexually transmitted infections occurring in adults and children. Such pathogenic microorganisms are small in size and cause illness, which often occurs hidden.

Causes and symptoms

Ureaplasma parvum refers to infections transmitted sexually or from mother to fetus. This disease occurs much less frequently in men than in women. In addition, self-healing is even possible in men, but when ureaplasma DNA is determined in tests on one of the sexual partners, it is necessary to treat the second one as well.

Important! The main cause of ureaplasmosis is considered to be a decrease in immunity against the background of an ongoing infectious lesion of the genitourinary system.

In women, ureaplasma parvum often has no symptoms, however, the disease is accompanied by such symptoms as:

• itching and burning;
• painful symptoms when urinating;
• discharge.

In men, the symptoms of ureaplasma parvum are somewhat similar to those that occur in women, namely:

• itching and burning;
• discharge;
• change in urine;
• pain when urinating.

Since the symptoms of the disease are not strongly expressed and are not observed in all cases, to detect the disease in the body, it is necessary to conduct a number of studies.

Diagnostic methods

Ureaplasma parvum, what is it if it is detected in tests - this question worries many who are faced with a similar problem. To determine ureaplasma parvum in women, several examination methods are used. In particular, the PCR method is used, which allows one to detect the presence of pathogens. A culture method for ureaplasma is also carried out.

The first method is mainly suitable for qualitative and quantitative detection of the presence of infection, and the second method is most suitable for determining the sensitivity of the virus to antibiotics. The main disadvantage of the ureaplasma culture method is that it is much slower than the PCR method. However, this will allow you to select the required antibiotics.

Indications for testing for ureaplasma parvum are:

• frequent inflammation of the pelvic organs;
• vaginosis;
• pregnancy planning;
• cervical erosion.

During the examination, you can determine the presence of ureaplasma bacteria in the body.

Features of the study

To conduct an examination and detect ureaplasma parvum, a number of diagnostic measures are used, namely:

• serodiagnosis;
• polymer chain reaction;
• bacteriological research.

It is important to know if ureaplasma is detected in tests, what this means and what indicators are there when an infection is detected. Serodiagnosis is an enzyme-linked immunosorbent assay. To conduct the study, fasting blood is taken from a vein from the patient. Antibodies of various classes are detected in the blood for sensitivity to bacteria. A normal and negative result indicates the absence of bacteria in the body, and if the result is positive, this means that the patient is infected.

The polymer chain reaction makes it possible to identify even one bacterium in a biological material. This technique makes it possible to detect DNA and RNA characteristic of the course of ureaplasma parvum. If normal is indicated, then additional examination is necessary. If bacterial DNA is detected in the tests, this means that a sexually transmitted infection is present in the body.

One of the effective methods of conducting an examination is considered to be bacteriological examination of the obtained clinical material. Initially, biological material is collected. Typically, the examination involves collecting vaginal secretions, urethral secretions, urine and blood. During the examination, you can not only determine the presence of pathogens, but also their sensitivity to antibiotics.

It is especially important to carry out diagnostics in pregnant women, since if infection occurs during conception, there is a very high risk of infection of the fetus. Ureaplasma parvum can be the main cause of abortion, as it causes damage to the fallopian tubes and complicates the passage of the egg.

Treatment

The presence of ureaplasma bacteria in tests often does not indicate the need for therapy, since a small number of pathogenic microorganisms does not indicate the presence of the disease. Typically therapy is carried out for:

• pregnancy planning;
• genitourinary system infections;
• performing surgical intervention on the pelvic organs.

When the concentration of pathogenic microorganisms in the test material is no more than 10 to 4 CFU per ml and obvious signs of disease occur, then therapy should be started immediately.

Treatment of ureaplasmosis involves taking antibiotics, anti-inflammatory drugs, immunostimulants and vitamins. Patients are prescribed antibacterial drugs, in particular macrolides, fluoroquinolones, and tetracyclines. In particular, taking the drugs Sumamed, Ofloxacin, Azithromycin is indicated. Systemic antibacterial therapy is often complemented by local one. To strengthen the immune system, the use of immunomodulators is indicated, in particular Lysozyme, Timalin, Taquitin.

Vitamin therapy is indicated for additional strengthening and rapid recovery of the body after a complex illness. To restore the natural microflora of the vagina, the use of Gynoflor, Acilact suppositories, as well as Acipol, Linex, Bifiform capsules is indicated.

Patients with ureaplasmosis are prescribed Ortofen, Ibuprofen and Diclofenac. Physiotherapy is also used for therapy. Complex therapy of the disease with strict compliance with all instructions and the use of all prescribed medications, as this will get rid of the main signs of the disease and guarantee a quick recovery. With a subsequent exacerbation, the patient is prescribed completely different antibiotics. Ureaplasma bacteria quickly adapt to the use of antimicrobial agents, however, the treatment regimen must be regularly adjusted each time there is an exacerbation, using increasingly stronger drugs.

In order not to carry out long-term therapy, it is necessary to carry out competent and timely prevention of the disease. To carry out prevention, it is necessary to observe the basic rules of personal hygiene, use a condom, and also douche after sexual intercourse with special antiseptic agents.

Complications

The presence of the ureaplasma pathogen in tests is dangerous due to its complications in the form of inflammation. Ureaplasmosis is considered a complex infectious disease. The disease can manifest itself with deterioration of immunity, as well as with inflammatory processes occurring in the pelvic organs. In the absence of the required competent treatment, complications such as:

• inflammation in the pelvic area;
• ectopic pregnancy;
• premature birth.

When planning a pregnancy, it is very important to conduct a competent, timely examination and pass all tests.

Treatment of mycoplasma with drugs and folk remedies

Mycoplasmosis is a chronic disease of infectious etiology caused by the pathogenic bacterium mycoplasma. There are countless discussions surrounding this pathology regarding the diagnostic and treatment process. Due to ignorance and reluctance to consult with a specialist, many patients often make wrong decisions. Their consequences may not be the most pleasant. Mycoplasma - treatment, drugs, folk remedies, interpretation of tests with the determination of antibodies - this will be discussed further.

Immune system response

In response to the invasion, the immune system produces antibodies to mycoplasma. They circulate in the blood, and their determination is an indirect method for diagnosing mycoplasma. Immunoglobulins M are produced 2 weeks after penetration of the pathogen, and indicate that the body has encountered infection for the first time. Immunoglobulin G begins to be produced somewhat later and circulates in the blood for several years, and in some cases throughout life. Its presence means the chronic course of the disease or the presence of immunity.

The test result is considered negative when neither one nor the second type of antibody is detected. If only M antibodies are detected, this indicates that the mycoplasma entered the body very recently, the course of the disease is acute and appropriate treatment is necessary. Antibodies G indicate that the body has formed a strong immunity to the pathogen and treatment of mycoplasma is not indicated. If both types of antibodies are detected in the patient's blood, he has become infected again.

Determining antibodies is not a direct method for diagnosing mycoplasmosis, so only a specialist should interpret the results.

More information about tests for mycoplasma.

Medications

To eliminate mycoplasma, treatment uses general and local drugs. First of all, broad-spectrum antibiotics are prescribed. It is optimal to select the drug according to culture and sensitivity testing. In this case, the chances of success are highest. The need for such an approach is also evidenced by the fact that the pathogen’s resistance to drugs is constantly growing, and repeated treatment is prescribed not because of a new infection, but because of the ineffectiveness of the initial course.

The most commonly used drugs are macrolides and fluoroquinolones. Representatives of the first group include:

• clarithromycin;
• azithromycin;
• roxithromycin;
• josamycin.

Clarithromycin - Klacid, Fromilid, Klabax - is prescribed in a dose of 500 mg twice a day. The duration of the course is up to two weeks.

Azithromycin - Sumamed - take one tablet per day, which contains 500 mg of the active substance. The course of treatment is five days. In addition, there is a treatment regimen in which azithromycin is prescribed once, in a dose of 1 g.

Roxithromycin - Rulid, Roxide - is prescribed for two weeks. The daily dose is 300 mg, divided into two doses.

Josamycin - Vilprafen - taken 500 mg, three times a day, for 10 days.

Of the fluoroquinolones, levofloxacin is used to treat mycoplasmosis. Tablets are taken once a day. The usual dose is 500-750 mg. To obtain a positive result, the drug is consumed within a week.

In addition to the sensitivity of bacteria, when selecting therapeutic agents, they are guided by the following indicators:

• patient's age;
• presence of pregnancy or lactation;
• the condition of all organs and systems, in particular the kidneys and liver;
• patient sensitivity to drugs;
• presence of allergies.

Unconventional means

Folk remedies can play a supporting role in the treatment of mycoplasma. With their help, you can quickly relieve symptoms that cause discomfort. Itching, burning, and unpleasant odor disappear very quickly under the influence of medicinal decoctions. Some herbs have a pronounced anti-inflammatory effect and can enhance the effect of medications.

But you need to clearly understand that today not a single folk remedy is known that would really be effective against mycoplasma.

With this approach, the disease often becomes chronic, when any signs of the disease are absent, and the patient remains a carrier of the disease. Subjectively, this may be assessed as recovery, but in reality it is not.

Medicinal herbs and homeopathic drugs can only be used as an aid to an integrated approach to the healing process. Their selection should be carried out by a qualified specialist, coordinating his actions with the prescriptions of the attending physician.

Herbal infusions

Goldenrod very quickly relieves inflammatory processes. It can be used not only for mycoplasma, but also for other genitourinary diseases. Following in terms of efficiency are the hogweed, wintergreen and wintergreen. These herbs can be used even when the exact etiological factor of inflammation has not been established.

To prepare decoctions, plant components are poured with boiling water and infused in a warm place or thermos for an hour. After the specified time, the resulting product is filtered and used for its intended purpose. To get a glass of decoction, take 10 g of herbs for the specified amount of water. You can use both single-component products and mixtures. In the latter case, the herbs are taken in equal parts.

To quickly relieve itching and burning, use a decoction of oak bark and bergenia root, with which they take local baths. To enhance the effect, you can add a few drops of tea tree or sage essential oil to the decoction. The only condition is the absence of allergies to these substances.

Finally

Only a specialist can know exactly how to treat mycoplasma. By making decisions on your own, you can greatly harm yourself. Despite the fact that the prognosis for life will remain favorable, chronicity of the pathological process and health problems in the future are possible.

• Mycoplasma is the causative agent of bronchitis;
• General information and treatment of mycoplasma hominis.

Mycoplasmosis is an insidious disease, since it can be asymptomatic for a long time. Signs of the disease appear only when it begins to progress. In this case, treatment may be difficult and lengthy. The most effective therapeutic method in such a situation is the use of antibacterial drugs. With their help, it is possible to cleanse the body of pathogenic microorganisms. The main thing is to choose the appropriate antibiotics for mycoplasmosis and follow the rules for their use.

In what cases is treatment for mycoplasmosis necessary?

Mycoplasma belongs to the category of opportunistic microorganisms. Normally, they can be present in the human body. Therefore, their detection during tests is not a direct indication for the use of antibacterial therapy. It is necessary to start treatment as soon as possible in the following cases:

• If signs of inflammatory processes appear.
• When the concentration of mycoplasma exceeds established standards.
• If microorganisms are detected during pregnancy planning.
• In case of detection of mycoplasma genitalium. This species is considered the most pathogenic.
• When mycoplasma is detected in the body of a woman who has consulted a doctor about infertility.

A specialist can prescribe antibacterial therapy only after a thorough examination. It is necessary to identify the specific type of pathogen during laboratory tests. This is the only way the treatment will be effective.

Basic principles of treatment

The use of antibiotics should only be carried out under the supervision of the attending physician. Self-medication in such a situation can have serious health consequences. It is necessary to follow the basic rules of therapy:

• During the research, it was revealed that mycoplasma is most sensitive to antibiotics of the tetracycline, macrolide and fluoroquinolone group. The use of such drugs will bring the fastest results.
• The use of antibiotics for mycoplasma is indicated for both sexual partners. This is the only way to deal with microorganisms.
• During the treatment period, it is necessary to completely stop all sexual intercourse, including using a condom.
• When taking medications, you must strictly follow the dosage prescribed by your doctor. It is prohibited to correct it without permission.
• Antibiotics kill not only pathogenic, but also beneficial microflora. Therefore, measures will have to be taken to restore normal microflora. Probiotics are used for this. The specific product should also be recommended by a specialist.

After the course of treatment is completed, you will need to undergo a re-examination. Only laboratory tests will help ensure that the disease is defeated.

Treatment with tetracycline antibiotics

Drugs in this group are prescribed if the disease proceeds without complications. Most often, doctors prescribe:

• Doxycycline. It is used to treat adults and children over 9 years of age from mycoplasmosis. During such therapy, prolonged exposure to the sun is not recommended, since during this period the skin may react negatively to exposure to ultraviolet radiation. When using doxycycline, you must have regular blood and urine tests. If elevated nitrogen or urea levels are detected in the samples, discontinue use immediately. Therapy will also have to be noted if side effects occur: stomach colic, attacks of nausea and vomiting, swelling, skin rashes. Doxycycline is taken twice a day for two weeks. After this, it is necessary to undergo tests to monitor the effectiveness of treatment.
• Tetracycline. Can be used in tablet or ointment form. External use of the product is allowed only in the early stages. Sometimes ointments are recommended for use during pregnancy. Most often used in tablet form. Tetracycline should not be used if the cause of mycoplasmosis is the development of a fungal infection. In exceptional cases, side effects from taking it may occur. These include: intestinal and stomach pain, inflammation of the oral mucosa, diarrhea, decreased appetite, exacerbation of gastritis and some others. Today, tetracycline is classified as an older generation of antibiotics and is therefore used quite rarely.

The specific dosage and duration of therapy is determined by the doctor. You cannot shorten or extend the course of treatment on your own. This can provoke an exacerbation of the disease.

Therapy using a group of macrolides

This group includes a large number of modern drugs. They have a wide spectrum of action, making them quite effective.

To combat mycoplasmosis, the following substances of this group are used:

• Azithromycin. The most popular based on it is Summed. The active substance has the ability to accumulate in affected tissues, which prolongs the duration of action of the drug and increases its effectiveness. Available in the form of capsules or tablets. Azithromycin is rapidly absorbed. The maximum concentration in the blood is observed after 3 hours. It is allowed to take the drug no more than once every three days. Summed is prohibited for use by pregnant women, as well as those who suffer from kidney damage, arrhythmia or liver failure. In some cases, men and women may experience side effects of the drug, for example, attacks of nausea and diarrhea, flatulence, abdominal pain; in such situations, stop taking the drug.
• Clarithromycin. This substance is part of the drug Klacid. Available in the form of capsules, tablets or powder for suspension. It is prohibited to use this remedy during pregnancy or with renal or liver failure. It has a wide list of side effects, for example, headaches, hallucinations, dyspeptic disorders, hearing loss, skin rashes, thrombocytopenia and some others. The maximum duration of treatment is 14 days.
• Roxithromycin. It is a component of the drug Rulid. This is a modern antibiotic of semi-synthetic origin. The medicine is of a new generation, so mycoplasma has not yet developed immunity to it. It is forbidden to take during pregnancy, with kidney and liver damage, as well as for children under two months. Available in tablet form. There have been no cases of overdose with Rulid. Sometimes therapy can provoke attacks of nausea, itchy skin, pain in the abdomen, and dizziness. This remedy is often used to treat mycoplasmosis in both women and men.
• Josamycin is the main component of the drug Vilprafen. Quickly and effectively copes with all types of mycoplasma. The substance is of natural origin. Quickly penetrates the cells of the body and accumulates in the affected tissues. Vilprafen is available in tablet form or as a suspension. Contraindications include: kidney and liver failure, weight less than 10 kg. The course of treatment is from 10 to 14 days.
• Midecamycin. This substance is part of the drug Macropen. Available in the form of tablets or granules for making a suspension. Take three times a day for a week. Midecamycin can provoke the development of side effects: diarrhea, loss of appetite, intestinal inflammation, allergic reactions. Contraindicated while breastfeeding a baby, as well as in cases of serious liver damage.

The use of the above antibiotics against mycoplasma demonstrates good results. The main thing is not to exceed or underestimate the dosage recommended by a specialist.

Use of fluoroquinol antibiotics

When using drugs of this group, accumulation of the active substance in the kidneys and genitals is observed. Therefore, it is necessary to strictly adhere to the prescribed dosages.

Most often, specialists use the following substances in the treatment of mycoplasmosis:

• Ciprofloxacin. This substance becomes the main components of the drug Tsiprobay, Tsiprolet and Tsiprinol. They have a wide spectrum of action and quickly cope with the causative agent of the disease. Treatment of ureaplasma in men is especially successful with their help. These products are available in tablet form. It is recommended to take them on an empty stomach, since at this time absorption reaches its maximum. It is completely eliminated from the body after a day. The dosage is selected based on the type of pathogen. The drug rarely causes side effects. In extreme cases, skin itching, allergic rashes, and insomnia may occur. The drug is not approved for use during pregnancy, adolescence and childhood, as well as in cases of serious damage to the kidneys and liver. Experts do not recommend taking ciprofloxacin simultaneously with medications intended to reduce stomach acidity.
• Pefloxacin. Completely absorbed 20 minutes after administration. Its maximum concentration is observed every two hours. Has a therapeutic effect for 12 hours. Excreted naturally. This remedy is contraindicated in case of individual intolerance, epilepsy, anemia, pregnancy. It is not allowed to be used to treat children under 18 years of age.
• Ofloxacin. Allows you to achieve the effect within an hour after administration. It is recommended if treatment with other antibiotics has not helped cope with mycoplasmosis. Ofloxacin is taken twice a day for 10 days. In special cases, the course is increased to 28 days. Every day it is necessary to maintain the same amount of time between doses. Side effects from both male and female bodies are extremely rare. If, after using the drug, sleep disturbances, an allergic reaction or headaches appear, then the therapy is stopped.
• Levofloxacin. Under its action, the synthesis of enzymes that are necessary for the life of pathogenic microorganisms is blocked. As a result, they not only lose their ability to reproduce, but die completely. It is necessary to carefully monitor the dosage of the drug. In case of an overdose, convulsions, nausea, dizziness, and erosive changes in mucous surfaces appear. The use of levofloxacin in combination with non-steroidal anti-inflammatory drugs and antacids is not recommended. This drug is contraindicated in case of individual intolerance, renal or liver failure, epilepsy, pregnancy. For the treatment of mycoplasmosis, it is used once a day for a week.
• Norfloxacin. It is quickly absorbed and effectively fights the pathogen of mycoplasmosis. Contraindicated in case of renal and liver failure, individual intolerance. Since studies have shown that the drug is more likely to negatively affect the development of fetal joints, it is prohibited to take during pregnancy. May cause side effects: dyspeptic disorders, headaches, hallucinations, swelling, allergic manifestations, increased photosensitivity of the skin and others. For the treatment of mycoplasmosis, the drug is prescribed twice a day. The duration of the course is 10 days.

If the drug is chosen correctly and all dosages are followed, then the likelihood of a quick cure is high. The specialist must focus not only on the type of pathogen and the severity of the disease, but also on the individual characteristics of the patient’s body.

Restoration of microflora after antibiotics

After the use of antibiotics, not only pathogenic but also beneficial microorganisms die in the body. This leads to indigestion and other health problems. Therefore, it is necessary to take special medications that will fill the digestive tract with beneficial bacteria. They are divided into three main classes:

• Probiotics. They contain one or more strains of beneficial bacteria. Preparations with lactobacilli can be taken simultaneously with antibiotics. In pediatrics, products containing bifidobacteria are more often used. The most effective probiotics are Lactobacterin, Sporbacterin, Enterol, Bifidumbacterin.
• Prebiotics. These are drugs, after taking which, a favorable environment is created in the intestines for the active reproduction of beneficial microflora. They contain inulin, lactose or oligofructosaccharides. This group includes: Hilak forte, Duphalac and others.
• Symbiotics. Combines the properties of probiotics and prebiotics. This group includes: Bifiform, Polybacterin and others.

There are various tablets for mycoplasma. Mycoplasmosis is a dangerous disease for both women, as it leads to inflammation of the genitourinary system, female infertility, changes in sperm quality, miscarriage, etc. If mycoplasmosis was sexually transmitted, then both partners should undergo treatment. The basis of treatment is antibiotics, immunomodulators, and probiotics.

Antibiotic therapy

The most effective antibiotic drugs for the treatment of mycoplasma:

• Terzhinan;
• Tetracycline;
• Ofloxacin;
• Vilprafen;
• Sumamed;
• Amoxiclav;
• Trichopolum;
• Unidox Solutab;
• Azithromycin;
• Doxycycline.

Sumamed

It is prescribed only in tablets, since this dosage form has the highest degree of absorption from the intestine and increased resistance to an acidic environment. The active ingredient is erythromycin, so the drug is not prescribed for gram-positive bacteria, as it will not be beneficial.

Sumamed has a certain peculiarity: it accumulates in cells and tissues, where its concentration is several times higher than the amount of drug in the blood, and this is important for eliminating pathogens located inside cells that cannot be affected by immune defense and other antibiotic drugs. The substances of the drug remain in the areas of inflammation for about 5 days, so the course of treatment, as a rule, does not exceed 5 days.

Sumamed, like all medications, has contraindications: liver and kidney diseases. If absolutely necessary, it is prescribed during pregnancy and lactation.

Doxycycline

Doxycycline is also an effective antibiotic. This drug is prescribed to patients over 9 years of age, pregnant and lactating women. Available in capsule form, taken before and after meals with plenty of liquid. This minimizes the negative impact on the gastrointestinal tract, since the medicine takes a long time to be eliminated from the body. You need to take the medicine in an individual dosage once a day. Treatment of mycoplasma takes 2 weeks.

Doxycycline needs to be replaced if the following appears while taking it:

• nausea and vomiting;
• stomach ache;
• skin rashes;
• swelling;
• diarrhea.

Azithromycin

The medicine accumulates in areas of inflammation and has a bactericidal effect, eliminating the causes of mycoplasmosis. The active component is erythromycin; if the pathogen is resistant to this substance, the antibiotic will be ineffective. In this regard, the sensitivity of the microflora to Azithromycin is preliminarily determined. You need to take the tablets 1 hour before or 2 hours after eating.

The dosage of the drug is determined individually depending on the age and weight of the patient.

Trichopolum

The medication is effective in the fight against many inflammatory diseases of the genitourinary system, since the substances of the drug penetrate well into the tissues of the urogenital tract and accumulate in the affected areas in high concentrations, this allows you to quickly eliminate the symptoms of mycoplasmosis.

The active component of Trichopolum is metronidazole. The drug is effective for treating:

• mycoplasmosis;
• chlamydia;
• ureaplasmosis.

Trichopolum suppresses the formation of nucleic acids and inhibits the growth of bacteria. When used together, Trichopolum enhances the effect of:

• Doxycycline;
• Azithromycin;
• Vilprafen.

Vilprafen

The drug belongs to the group of macrolides and is prescribed to prevent the production of protein in bacteria. The active substance is josamycin. The maximum concentration of drugs in the blood is observed within a few hours after administration.

In the dosage prescribed by the doctor, the medicine is taken 2 times a day every 12 hours, always after meals. This method of administration allows you to maintain the required concentration of the drug for the productive treatment of mycoplasma. The course of therapy is at least 10 days.

Vilprafen is not prescribed together with other antibiotics, as it reduces their effect. Also, the antibiotic in question reduces the effectiveness of hormonal contraceptives.

Vilprafen has side effects: vomiting, diarrhea, heartburn, nausea, lack of appetite, dysbacteriosis. An absolute contraindication is liver disease.

Unidox Solutab

The active component of Unidox Solutab is doxycycline, which inhibits protein synthesis and disrupts their metabolism in the cells of pathogenic pathogens. The maximum effectiveness of the drug is observed during the stage of growth and cell division. The medicine is absorbed regardless of food intake.

Amoxiclav

This is a combination drug consisting of penicillin and clavulanic acid, which is an inhibitor of mycoplasma beta-lactamases. The drug is well absorbed by the body and accumulates in maximum concentration within an hour.

Most often, Amoxiclav is used to treat mycoplasmosis in women. The reason is that drugs quickly penetrate and accumulate in the uterus and ovaries. However, this same property is a contraindication for use during pregnancy. In exceptional cases, the medicine is prescribed to pregnant women if there is a risk of transmitting the infection to the child. The dosage is prescribed by a doctor, it must be divided into several parts and taken at regular intervals.

Since many pathogenic microorganisms are resistant to Tetracycline, before prescribing this drug, it is necessary to test the sensitivity of the microflora to the drug. Otherwise, treatment may be ineffective. Tablets are not prescribed to children under 7 years of age and pregnant women. If vomiting, nausea, diarrhea, signs of gastritis, or lack of appetite are observed, another drug is prescribed for treatment.

When treating with antibiotics, certain rules must be followed:

• follow the timing and dosage of medications prescribed by your doctor;
• do not change medications yourself;
• do not drink alcohol;
• If side effects occur, stop taking and consult a doctor.

Preparations against fungal microflora

To treat mycoplasma, in addition to antibiotics, antifungal drugs can be prescribed, which may even be more effective when affected by fungal microflora.

Ofloxacin is an antifungal and antibacterial drug that is effective in the treatment of diseases of the genitourinary system of fungal etiology in men and women. For mycoplasmosis, tablets should be taken before or after meals with water. Therapy with Ofloxacin continues until all symptoms disappear, after which it continues for several more days. However, the course of treatment should not exceed 30 days. Contraindications to taking the drug are: pregnancy, lactation, age under 15 years.

Terzhinan is also an antibacterial and antifungal agent. Intended for the treatment of women only. Such tablets should not be taken, but inserted into the vagina. When administering the medicine, you need to be in a lying position, preferably before going to bed; first, the medicine needs to be soaked a little in water. The course of treatment is 10–20 days; the menstrual cycle is not a reason to stop therapy. During treatment, a burning sensation, an allergic reaction, and irritation may occur, but such signs most often appear at the beginning of therapy. It is forbidden to use Terzhinan in the 1st trimester of pregnancy, with limited treatment in the 2nd and 3rd trimesters, during breastfeeding.

Other means to combat mycoplasma

Since antibiotics are the basis for the treatment of mycoplasmosis, in addition to destroying pathogenic microorganisms, they also harm the beneficial microflora of the genitourinary system. Therefore, a doctor can prescribe urogenital suppositories for mycoplasma for a woman, and medications in tablets and capsules that are resistant to an acidic environment for a man.

Immunomodulatory drugs are also prescribed to correct immunodeficiency, protect the body from the side effects of other medications, and to enhance the effect of the main therapy. Such remedies include Wobenzym, Anaferon, Ginseng, and Echinacea purpurea.

Taking antibiotic drugs should be accompanied by the use of probiotics, which enrich the body with bifidobacteria and lactobacilli:

• Lacidophilus;
• Linux;
• Hilak Forte;
• Bifidumbacterin;
• Bifiform.

Since the microbe lacks a cell wall, widely available penicillin antibiotics are ineffective to destroy it. Drugs that affect the deep structures of mycoplasma are needed. These include drugs from the group of macrolides (Erythromycin, Vilprafen), azalides (Azithromycin, also known as Sumamed), tetracyclines (Doxycycline) and the antiprotozoal Trichopolum.

There is an opinion that it is not necessary to treat hominis,

The most popular, standard treatment regimens for mycoplasmosis are suitable for women and men:

More options, analogs, alternatives, new antibiotics, full list:

Minocycline. The first dose of the drug is 0.2 g, then take 0.1 g 2 times a day for the same period of time.

Ericicline is a combination drug consisting of erythromycin and oxytetracycline dihydrate in a ratio of 1:. One capsule contains 0.125 mg of each component. Prescribe 500 mg (2 capsules) 4 times a day after meals for 14 days.

There is evidence of high effectiveness sparfloxacin, however, this drug has not yet been registered in Russia.

• Vibramycin- 200 mg in the first dose, in subsequent doses 100 mg orally 2 times a day; the course of treatment ranges from 10 to 21 days;

• Sumamed- 1000 mg at the first dose, subsequent times 500 mg orally 1 time per day; the course of treatment usually lasts 4 days;
• Fromilid- 500 mg orally 2 times a day for 10-14 days.
• Norfloxacin- 400-800 mg orally 1 time per day for 7-10 days.

Let's take a closer look at the properties of the main list of drugs:

Erythromycin

This antibiotic is capable of blocking protein synthesis in mycoplasmas. In normal concentrations it inhibits the growth of microbes, and in higher concentrations it completely destroys them. The medicine is well absorbed in the intestines in tablet form, in addition, it has a tropism for the genitourinary organs, where it accumulates in the greatest quantities.

However, the use of Erythromycin during pregnancy is undesirable due to its penetration through the placental barrier. The drug is also excreted in milk, so it is not prescribed to women who are breastfeeding.

Vilprafen

The active ingredient of Vilprafen tablets is also an antibiotic of the macrolide group - josamycin. It is able to accumulate in the lung tissue, due to which it is successfully used to treat not only but also typical in children and adults. This is one of the few remedies that are prescribed. But it’s still worth weighing the possible risks and benefits of treatment.

“Vilprafen” for mycoplasmosis can reduce the effectiveness of other antibiotics, which is why it is not used in combination with antibacterial drugs. It may also reduce the effectiveness of hormonal contraceptives, which should be taken into account during treatment.

Another advantage of this drug for mycoplasmosis is that it accumulates in the largest quantities at the site of inflammation, which means it has less effect on healthy tissue. This allows you to avoid a lot of side effects. However, for patients with renal and liver failure, Azithromycin is contraindicated for mycoplasmosis, as it places an increased burden on these organs.

Doxycycline

Doxycycline is also often prescribed in the treatment of mycoplasmosis, as it is well distributed throughout the organs and is slowly eliminated, providing a long-lasting effect. It is usually prescribed after meals to avoid damage to the stomach lining.

Doxycycline is contraindicated in children under 9 years of age and in women during pregnancy. This is explained by the possibility of its negative impact on the child’s teeth with the formation of stains and defects (tetracycline teeth). In addition, the medicine causes increased sensitivity to ultraviolet radiation, which is why it is advisable to avoid prolonged exposure to the sun during treatment.

Trichopolum

Since mycoplasma extremely rarely causes disease on its own, it makes sense to treat it immediately in combination with other infections.

Most often, mycoplasmosis is accompanied by trichomoniasis, chlamydia and ureaplasmosis. "Trichopol", the active substance of which is metronidazole, is effective against all these microorganisms at once. It inhibits the formation of nucleic acids, significantly inhibiting the growth of bacteria.

Unlike other drugs, Trichopolum is compatible and even increases its effectiveness when prescribed simultaneously with other antibiotics, for example, Azithromycin, Doxycycline or Vilprafen. The drug may turn urine dark due to the presence of a dye in its composition.

For specialists only: Minimum inhibitory concentrations (MIC) of antibiotics (µg/ml) for various types of urogenital mycoplasmas:

Treatment mycoplasma pneumonia devoted to .

Suppositories for mycoplasma

Treatment with suppositories should always take place combined with oral antibiotics, otherwise it will only give temporary results.

The use of suppositories exclusively, without the use of tablets, is recommended only:

1. pregnant women in the 1st trimester;
2. lactating women, when for some reason it is not possible to switch the child to formula.

because in these two cases, general treatment is contraindicated. But even in these cases, one must remember that there is a risk to the health of the woman herself, due to an untreated disease.

• Betadine - vaginal suppositories containing 200 mg of polyvidone iodide, inserted into the vagina at night for 14 days;
• Hexicon - suppositories with chlorhexidine, have an antiseptic effect, are allowed at all stages of pregnancy, but they can only be considered as a temporary solution;
• Dalatsin is a vaginal cream administered by a dispenser in the amount of 5 g into the vagina at night; the course of treatment takes 7 days.

Adaptogens

In the absence of contraindications (hypertension, cardiovascular system disorders, hyperkinesis), the following is used:

• saparal 0.05 g (1 tablet) 2 - 3 times a day after meals;
• Eleutherococcus extract 20 - 30 drops 2 - 3 times a day 30 minutes before meals;
• Aralia tincture 30 - 40 drops 2 - 3 times a day 30 minutes before meals;
• pantocrine 30 - 40 drops or 1 - 2 tablets 2 - 3 times a day 30 minutes before meals;
• Leuzea extract 30 - 40 drops 2 - 3 times a day 30 minutes before meals;
• Schisandra tincture 20 - 30 drops 2 - 3 times a day;
• ginseng tincture 20 drops 2 - 3 times a day 30 minutes before meals.

The goal of immunotherapy is to correct the immunodeficiency state that has caused the chronic course of the disease.

To restore local immunity after treatment with antibiotics, Bifidumbacterin and Acylact are used in the form of suppositories.

The drug Mycoplasma-Immun is administered intramuscularly. Immediately after administration, it increases specific immunity. However, before prescribing it, you should check whether the patient has allergies, since the product contains human protein.

The drug is not prescribed to pregnant women unless absolutely necessary, since studies on the effect on the fetus have not been conducted. Basically, the experience of using this medicine indicates the absence of adverse reactions. Allergies were detected only in people prone to this.

Group of proteolytic enzymes

Proteolytic enzymes, dissolving areas of inflammation and adhesions, release the pathogen and make it accessible to medications; in addition, the effect of proteolytic enzymes may be associated with the destruction of proteins blocking the interferon system and restoration to some extent of the interferon-forming ability of the body's cells.

Along with antibiotics, a-chymotrypsin (5 ml intramuscularly every other day for 20 days) or Wobenzym (orally on average 5 capsules 3 times a day before meals) is prescribed.

In order to restore the vaginal microbiocenosis and correct local immunity after antibiotic treatment, eubiotics are recommended - bifidumbacterin or acylact in suppositories for rectal and vaginal use.

Traditional medicine against mycoplasmosis

Treatment of mycoplasmosis is a difficult process, since the infectious agents penetrate the cell membranes of the body. To rid a patient of an infectious disease, it is necessary to destroy the infected cells. There is no other way to get rid of mycoplasmosis.

Doctors have nothing against traditional recipes, but they believe that this is only maintenance therapy.

With their help, you can reduce or completely get rid of the unpleasant symptoms that occur when an infection enters the body.

No herb can destroy infected cells located in the mucous membrane of the urinary canal. Therefore, if patients completely refuse drug treatment and choose traditional medicine, then this will end with the disease being asymptomatic and developing into a chronic form.

1. Goldenrod. Pour 40 grams of dried herbs and pour half a liter of boiling water. After it sits for an hour, strain and drink half a glass four times a day for one month;
2. Garlic can relieve women from the symptoms of mycoplasmosis. Traditional healers recommend eating at least 2 cloves of garlic per day. You can also make garlic paste. To do this, take 100-130 grams of garlic and grind it using a blender. We take the same amount of vegetable oil, 30 grams of lemon juice and 10-15 grams of salt. Beat everything in a blender. The resulting paste can be added to all dishes;
3. When a patient experiences itching or burning in the genital area and suspects the development of mycoplasmosis, then baths can be taken with the addition of medicinal herbs. These can be bergenia root, oak bark, Kuril tea and boron uterus. Women often douche with such decoctions. For greater effect, repeat the procedure three to four times a day. If the symptoms do not go away, then you can do douching, but you can only do it once every two days. To achieve greater effect, you can add a few grams of tea tree oil or sea buckthorn oil. This is useful for female representatives.
4. combine the leaves of St. John's wort and the flowers of the grass in a ratio of 1:; 5 tbsp. pour a liter of water over the collection and bring to a boil in a water bath, after 10 minutes remove and leave to infuse under the lid for 2-3 hours, then strain; take 1 glass three times a day 15 minutes before meals;
5. combine chamomile, blue cornflower, knotweed, St. John's wort and corn silk in equal proportions; 1 tbsp. pour 300 ml of boiling water over the collection and leave to infuse under the lid for the next hour, then strain; take ½ glass three times a day, regardless of meals;
6. 2 tbsp. place tricolor violet flowers in a thermos and pour ½ liter of boiling water, leave for an hour, then strain; take 1 tbsp three times a day.

What can result from untimely treatment of an infectious disease?

1. Infertility in women. Develops as a result of inflammation of the surface layer of the endometrium or uterine tubes. If a woman’s endometrium is damaged, then the fertilized egg does not have the opportunity to develop further, since the uterine tissues are inflamed. When the uterine tubes become inflamed, the lumen inside them may narrow. Because of this, the egg cannot reach the uterus, and the sperm cannot reach the egg. In this case, it is difficult for a woman to become pregnant;
2. Infertility in men. A man cannot fertilize a woman's egg due to damage to the prostate gland or testicles. These factors significantly affect the quantity and quality of sperm composition;
3. Impotence. This process also develops against the background of the affected prostate and testicles. A man cannot fully engage in sexual intercourse because he does not have an erection. Even if there is an erection, the pain does not allow the job to be completed;
4. Spontaneous miscarriage or premature birth. The endometrium plays the role of a nutrient medium for the fetus, and if it is damaged, it negatively affects intrauterine development;
5. Autoimmune diseases. They arise from a weakened immune system. The immune system is weakened due to infectious and inflammatory processes. At these moments, immune cells try to fight the tissues and cells of their own body, which negatively affects its functions.

Prevention

The rules for preventing this disease consist mainly of avoiding unprotected sexual intercourse with unfamiliar partners, as well as an annual full examination for infections that can be sexually transmitted.

Also, if any sexually transmitted infections occur, it is necessary to treat them in a timely manner, followed by a diagnosis of cure.

Since mycoplasmosis is activated when immunity is reduced, care should be taken to increase the body’s defenses by maintaining a healthy lifestyle, as well as taking a course of vitamin preparations.

Drug sensitivity tables

Summary table of antibiotic susceptibility of human mycoplasmas (Review of publications Antimicrob. Agents Chemother. 1992-2003* indicates the minimum inhibitory concentration MIC (µg/ml)

< 1 означает высокая чувствительность, эффективный препарат.

1-10 average sensitivity.

32 and above – low sensitivity, the drug is ineffective.

Another study - Journal of Antimicrobial Chemotherapy 2008 62(1): 122-125Incidence and antimicrobial susceptibilities of genital mycoplasmas in outpatient women with clinical vaginitis in Athens, GreeceNektaria Kechagia, Sotiris Bersimis and Stylianos Chatzipanagiotou

Here, the higher the value, the higher the efficiency.

The number of sexually transmitted infectious diseases is growing every year, and the structure of these infections is constantly changing. Today, microorganisms, the pathogenicity of which was previously underestimated, are playing an increasingly important role in the development of inflammation of the urogenital tract.

In particular, this applies to mycoplasma infection, due to its widespread prevalence and frequent resistance to antibiotic therapy.

According to modern epidemiological studies, in more than 40% of cases of chronic inflammation of the urogenital tract, mycoplasma infection is detected during diagnosis.

• Show all

  1. Features of the pathogen that influence the choice of treatment tactics

  Mycoplasmas belong to the family Mycoplasmataceae, which in turn is divided into, each of which includes more than one hundred species.

  Mycoplasmosis is prone to an asymptomatic chronic course and is often resistant to standard antibacterial therapy regimens, which requires constant correction and adherence to modern recommendations.

  2. Indications and requirements for therapy

  Treatment of infection must be carried out taking into account all clinical data and the results of a comprehensive study of the body for obligate pathogens and common opportunistic microorganisms.

  Thus, M. Hominis infection is treated only when bacteria are detected in a titer of more than 10x4 CFU/ml. There is no minimum titer for M. genitalium; this species is classified as an obligate pathogen.

  If clinical signs of an inflammatory reaction cannot be identified, and mycoplasmas are isolated in diagnostically significant quantities, then the absolute indications for starting therapy are a violation of a person’s reproductive health and a burdened gynecological history.

  1. 1 Treatment of genitourinary mycoplasmosis should be comprehensive, that is, include etiotropic drugs, correction of immunity and lifestyle.
  2. 2 The selection of medicines should be made taking into account the biological characteristics of the pathogen and the state of the macroorganism as a whole.
  3. 3 When selecting drugs, the severity of the clinical picture of inflammation and the form of the disease should be taken into account.
  4. 4 The number of courses and their total duration are selected individually; it is rarely possible to cure an infection with 1 course of antibiotics.
  5. 5 Treatment of the sexual partner is mandatory, regardless of the presence or absence of symptoms of infection.
  6. 6 After completing a course of therapy, an assessment of its effectiveness is required.

  3. Antibacterial sensitivity of mycoplasmas

  The issue of choosing antibacterial therapy for mycoplasmosis is currently being actively discussed. Analysis of etiotropic treatment should begin with groups of antimicrobial agents to which mycoplasmas are resistant.

  Due to the absence of a cell wall, mycoplasmas are completely insensitive to antibiotics, the main mechanism of action of which is to inhibit the biosynthetic processes of bacterial cell walls. These include penicillins, cephalosporins and sulfonamides.

  Mycoplasma M. Hominis are currently fully resistant to the following drugs:

  1. 1 Spiramycin;
  2. 2 According to Medscape, mycoplasma hominis (M. hominis) is resistant to many 14- and 15-membered macrolides, which were actively used several years ago (erythromycin, azithromycin, roxithromycin, clarithromycin).

  The very first antibacterial drug used to treat infection was tetracycline. Currently, about 45-50% of mycoplasmas are completely resistant to it.

  According to R. Hannan, the most effective drugs for the treatment of mycoplasmosis are antibacterial agents that affect the synthesis of ribosomal bacterial proteins.

  Thus, for mycoplasma infection, the following groups of antibiotics are of particular importance:

  1. 1 Tetracyclines (Unidox Solutab);
  2. 2 Fluoroquinolones (Ofloxacin, Levofloxacin);
  3. 3 Macrolides (Vilprafen, Sumamed, Zitrolide, Hemomycin).

  In vitro studies have shown that macrolides and new generations of fluoroquinolones have the most pronounced antimicrobial effect against mycoplasmas.

  Among commonly used drugs, josamycin demonstrates consistently high rates of therapy effectiveness (94-95%).

  Doxycycline is also gradually increasing its position - the number of strains sensitive to it is gradually increasing (from 93 to 97%).

  At the same time, the sensitivity of mycoplasmas to tetracycline has sharply decreased today and does not exceed 45-50%.

  3.1. Tetracyclines

  The tetracycline group includes a number of synthetic and semi-synthetic derivatives that suppress the synthesis of bacterial proteins by binding to the S70 and S30 ribosomal subunits. They have a pronounced bacteriostatic effect and a wide antimicrobial spectrum.

  For mycoplasmosis, the most effective and frequently used are doxycycline hydrochloride and doxycycline monohydrate, which differ from tetracycline in a greater level of safety and better pharmacological properties.

  In this case, it is preferable to use monohydrate (Unidox Solutab), which does not lead to the appearance of symptoms of esophagitis and has minimal effect on the intestinal microflora.

  Doxycycline is most conveniently prescribed in the form of dispersible tablets, which allows the antibiotic to be used in both tablet and suspension form.

  The advantage of the dispersible form is a stable and uniform increase in the concentration of the drug in the blood serum.

  Features of doxycycline:

  1. 1 High antimycoplasma activity;
  2. 2 High affinity for bone tissue, which ensures high efficiency in the treatment of arthrosis associated with mycoplasmosis;
  3. 3 Greater breadth of distribution throughout the body;
  4. 4 Low toxicity, which makes long-term use possible.

  Disadvantages include the frequent development of photosensitivity, a high incidence of complications from the digestive system with prolonged oral administration, and the impossibility of administration during pregnancy.

  For mycoplasma urethritis, doxycycline is used 100 mg 2 times a day, course duration is 7 days.

  Resistance to doxycycline in mycoplasmas is quite rare, and the increase in the number of sensitive strains is most likely due to the fact that recently macrolides have been used more often.

  3.2. Fluoroquinolones

  Antibacterial agents of the fluoroquinolone group have a unique mechanism of antimicrobial action, inhibiting the formation of enzymes responsible for the growth and development of bacterial cells.

  They have a wide spectrum of antimicrobial activity and affect most gram-positive and gram-negative microorganisms.

  Their advantages include minimal impact on the intestinal microflora and a high accumulation rate in body tissues and blood serum.

  Disadvantages include relatively high toxicity, which makes their long-term use impossible.

  Today, fluoroquinolones are classified as alternative, reserve drugs and are not recommended as first-line drugs.

  Among all fluoroquinolones in the Russian Federation, for the treatment of urogenital mycoplasmosis, preference is given to ofloxacin (tablets 300 mg 3 times a day, course 10 days) or levofloxacin (tablets 500 mg per day, course 7-10 days).

  3.3. Macrolides

  The most significant today are macrolides, antibiotics that disrupt the growth and development of bacterial cells at the level of ribosomal subunits.

  The action of macrolides is bacteriostatic, but in high concentrations they have a bactericidal effect. According to many researchers, macrolides should be used as the drugs of choice for the treatment of mycoplasmosis.

  The advantages of this group of antibiotics are:

  1. 1 High bioavailability, low minimum effective concentrations;
  2. 2 Rapid increase in intracellular concentration with achievement of maximum values ​​in a short time;
  3. 3 Better tolerability compared to fluoroquinolones and tetracyclines;
  4. 4 Possibility of long-term use;
  5. 5 High efficiency against mycoplasmas and ureaplasmas;
  6. 6 Moderate anti-inflammatory and immunomodulatory activity.

  For a long time, only azithromycin was used from the group of macrolides (trade names - Sumamed, Hemomycin, Zitrolide, etc.). It is still one of the drugs present in the recommended regimens.

  In the Russian Federation it acts as an alternative drug. According to the results of ongoing clinical studies, azithromycin and doxycycline have approximately the same activity.

  Clarithromycin is currently excluded from the standard therapy for mycoplasmosis. Josamycin (trade name Vilprafen, tablets) has the lowest minimum effective concentrations for mycoplasmas.

  Josamycin (Vilprafen) acts on all clinically significant strains of mycoplasmas, and often on concomitant infectious agents. Its advantage is the less frequent development of resistance. The standard treatment regimen is 500 mg tablets 3 times a day for 7-10 days.

  Despite its widespread use, most strains of mycoplasmas and ureaplasmas remain highly sensitive to josamycin. It is included in the first line of therapy, according to domestic recommendations of the Society of Obstetricians and Gynecologists, as well as the Russian Society of Dermatologists.

  Unlike other macrolides, Vilprafen does not have a negative effect on liver function and has pronounced immunomodulatory properties, which makes it an ideal drug for this infection.

  4. Treatment of mycoplasmosis during pregnancy

  However, when mycoplasmas are detected in a diagnostically significant titer, in the presence of symptoms of infection and a burdened obstetric history, treatment is mandatory, including in order to prevent intrauterine infection of the fetus.

  The choice of drug depends on the gestational age and the expected sensitivity of the bacteria to the therapy.

  Given the often mixed nature of inflammation, preference should be given to drugs with a broad spectrum of activity.

  In the second and third trimester, it is possible to use erythromycin at a dosage of 500 mg 3 times a day. within 10 days.

  Antibacterial therapy is also supplemented by the use of immunomodulators, and after completing the course of antibacterial treatment, restoration of the vaginal microflora is necessary.

  5. Addition to antibacterial therapy

  Since mycoplasmosis is often combined with a violation of the patient’s immune status, in our country treatment also includes other medications: immunomodulators, enzymes, adaptogens and vitamins, although all these groups of drugs do not have a wide evidence base.

  Adaptogens are specific medicinal substances or plants that can increase the body’s nonspecific resistance to the effects of harmful physical and biological environmental factors.

  This pharmacological group includes drugs of both natural and artificial origin. Natural adaptogens include extracts of eleutherococcus, ginseng, ginger and lemongrass.

  They can be used 20-30 drops 30 minutes before meals up to 3 times a day. The course of application is about one month, 2-3 courses are carried out per year. Of the synthetic adaptogens, the most famous in Russia is trekrezan, which stimulates the production of the body’s own interferons, designed to correct immune disorders. It is used at 0.2 - 0.6 mg per day for two weeks.

  In addition to antibacterial therapy for mycoplasmosis, proteolytic enzymes, or enzymes, are often prescribed. A group of proteolytic enzymes is used to resolve inflammatory adhesions in the urogenital tract, which helps release pathogens and make them accessible to the action of the antibiotic.

  They are believed to have anti-inflammatory and immunomodulatory effects.

  This makes it possible to reduce standard dosages of antibacterial agents and increases the effectiveness of therapy. The most common drugs in this group are alpha-chymotrypsin (5 ml IM every other day for 20 days) or Wobenzym (5 capsules orally 3 times a day before meals).

  Let us repeat once again that adequate studies of these medications have not been conducted, so the need for their prescription is assessed by the attending physician (gynecologist, venereologist, urologist).

  6. Restoration of vaginal microflora

  Restoring the physiological vaginal microflora is a mandatory step in the treatment of vaginal infections. Every woman normally has a strictly balanced vaginal biocenosis.

  The constant acidity of the vaginal secretion ensures inhibition of the growth of opportunistic microflora and prevents the penetration of pathogenic bacteria.

  The vagina simply cannot be sterile; it is home to about nine different types of microorganisms, most of which are lactobacilli.

  The main negative factors suppressing their growth are:

  1. 1 Antibiotic therapy, without subsequent correction of microbiocenosis;
  2. 2 Violations of estrogen concentration;
  3. 3 Menstrual irregularities;
  4. 4 Constant alkalization of the internal environment of the vagina (using regular soap for washing, frequent douching);
  5. 5 Disturbance of the normal anatomy of the genital organs.

  There is a widespread erroneous belief that after completing the first stage of treatment (antibacterial therapy), the second stage (restoration of microflora) is not required, and the number of lactobacilli will increase over time without outside intervention.

  However, research results show the opposite: in only 13% of women, the microflora is restored without the use of additional medications.

  As a second stage of therapy, you can use vaginal suppositories with lactobacilli - lactonorm, acylact, gynoflor.

  7. Criteria for recovery

  After completing the full cycle of treatment, it is necessary to conduct a follow-up examination of both sexual partners to assess its effectiveness. This is due to the fact that taking antibiotics does not guarantee a 100% recovery.

  Diagnostic tests are prescribed no earlier than 1 month after completion of the course. Control is carried out using the PCR method, and the material for research is smears from the urethra and vagina.

  It is recommended to collect material from women approximately 2-3 days after the end of the next menstruation. A negative PCR result within three reproductive cycles in women and one month in men indicates the absence of infection in the body.

  8. Prevention

  At the moment, measures to prevent mycoplasmosis are no different from measures to prevent other sexually transmitted infections.

  It is important to remember that asymptomatic carriage of mycoplasmas in apparently healthy people does not reduce their etiological role in the development of chronic infections of the urogenital tract.

  To prevent infection, as well as for timely detection of mycoplasma infection, it is necessary:

  1. 1 Use of barrier contraception from the moment of sexual activity;
  2. 2 A full examination of the sexual partner, in case of refusal of a barrier method of contraception;
  3. 3 Detection of infections of the urogenital tract before conception, when planning pregnancy;
  4. 4 Health education of the population.