New generation broad-spectrum antibiotics - list of names. Broad-spectrum antibiotics: bacteria don’t stand a chance! List and description of drugs

Today even young children know what antibiotics are school age. However, the term "antibiotics" wide range actions” sometimes baffles even adults and raises many questions. How wide is the spectrum? What antibiotics are these? And, yes, it seems that there are also narrow-spectrum drugs that may not help?

The most surprising thing is that even the all-knowing Internet often cannot help and dispel the fog of doubt. In this article we will try to slowly and methodically figure out what kind of broad-spectrum antibiotics they are, what bacteria they act on, as well as when, how and how many times a day they are used.

The diverse world of bacteria

And we will start from the very beginning - with microbes. Bacteria make up the majority of prokaryotes - single-celled living organisms without a clearly defined nucleus. It was bacteria that first populated the lonely Earth millions of years ago. They live everywhere: in soil, water, acidic hot springs and radioactive waste. Descriptions of about 10 thousand species of bacteria are known, but it is estimated that their number reaches a million.

And of course, bacteria live in the bodies of plants, animals and humans. Relationships between lower unicellular organisms and higher multicellular organisms can be different - both friendly, mutually beneficial for partners, and openly hostile.

A person cannot exist without “good”, correct bacteria that form the microflora. However, along with valuable bifidobacteria and lactobacilli, microbes that cause a wide variety of diseases enter our bodies.

The microflora also includes so-called opportunistic microorganisms. At favorable conditions they do no harm, but as soon as our immunity decreases, these yesterday’s friends turn into vicious enemies. In order to somehow understand the host of bacteria, doctors proposed classifying them.

Gram- and Gram+: deciphering the puzzle

The most famous division of microbes is very often mentioned in pharmacies, clinics, and in drug annotations. And just as often, the living average patient does not understand what we are actually talking about. Let's figure out together what these mysterious expressions gram+ and gram- mean, without which not a single description of the action of antibiotics is complete?

Back in 1885, the Dane Hans Gram decided to color the sections lung tissue to make bacteria more visible. The scientist found that the causative agent of typhus, Salmonella typhi, did not change color, while other microorganisms were exposed to the chemical.

The most famous classification today is based on the ability of bacteria to stain according to Gram. A group of bacteria that do not change color are called gram-negative. The second category is called gram-positive, that is, Gram-staining microorganisms.

Gram-positive and gram-negative pathogens: who is who?

Another, no less important classification of antibiotics breaks down drugs according to their spectrum of action and structure. Again, to understand the complex paragraphs of instructions explaining the spectrum of activity and belonging to a specific group, you need to get to know the microbes better.

Gram-positive bacteria include cocci, that is, spherical microorganisms, including numerous families of staphylococci and streptococci. In addition, clostridia, corynebacteria, listeria, and enterococci belong to this group. Gram-positive pathogens most often cause infectious diseases of the nasopharynx, respiratory tract, ear, as well as inflammatory processes of the eye.

Gram-negative bacteria are a not so numerous group of microorganisms that mainly cause intestinal infections, as well as diseases of the genitourinary tract. Much less commonly, gram-negative pathogens are responsible for respiratory tract pathologies. These include Escherichia coli, Salmonella, Shigella (the causative agent of diphtheria), Pseudomonas, Moraxella, Legionella, Klebsiella, Proteus.

Among gram-negative microorganisms there are also causative agents of severe hospital infections. These microbes are difficult to treat - in hospital conditions they develop special resistance to most antibiotics. Therefore, to treat such infectious diseases, special, often intramuscular or intravenous antibiotics wide spectrum of action.

Empirical therapy is based on this “separation” of gram-negative and gram-positive bacteria, which involves selecting an antibiotic without prior culture, that is, practically “by eye.” As practice shows, in the case of “standard” diseases, this approach to choosing a drug is completely justified. If the doctor has doubts about whether the pathogen belongs to one group or another, prescribing broad-spectrum antibiotics will help “get the ball in the air.”

Broad spectrum antibiotics: the whole army is at gunpoint

So, we come to the most interesting part. Broad-spectrum antibiotics are a universal antibacterial medicine. Whatever pathogen is the source of the disease, antibacterial agents a wide spectrum will have a bactericidal effect and defeat the microbe.

As a rule, broad-spectrum drugs are used when:

treatment is prescribed empirically, that is, based on clinical symptoms. When selecting an antibiotic empirically, time and money are not wasted on identifying the pathogen. The microbe that caused the disease will forever remain unknown. This approach is appropriate in the case of common infections, as well as fast-acting dangerous diseases. For example, with meningitis, death can be a foregone conclusion literally within a few hours if antibiotic therapy is not started immediately after the first signs of the disease;
pathogens are resistant to narrow-spectrum antibiotics;
a superinfection has been diagnosed, in which several types of bacteria are the culprits of the disease;
infection is prevented after surgical interventions.

List of broad-spectrum antibiotics

Let's try to name those antibacterial drugs, which have a wide spectrum of activity:

antibiotics of the penicillin group: , Ampicillin, Ticarcycline;
antibiotics of the tetracycline group: Tetracycline;
fluoroquinolones: Levofloxacin, Gatifloxacin, Moxifloxacin, Ciprofloxacin;
Aminoglycosides: Streptomycin;
Amphenicols: Chloramphenicol (Levomycetin);
Carbapenems: Imipenem, Meropenem, Ertapenem.

As you can see, the list of broad-spectrum antibiotics is not very large. And we will start a detailed description of drugs with, probably, the most popular group - penicillin antibiotics.

Penicillins - drugs that people know and love

With the discovery of an antibiotic of this particular group - Benzylpenicillin - doctors realized that microbes could be defeated. Despite its venerable age, benzylpenicillin is still used today, and in some cases it is a first-line drug. However, broad-spectrum agents include other, newer penicillin antibiotics, which can be divided into two groups:

drugs for parenteral (injection) and enteral administration, which withstand the acidic environment of the stomach;
injection antibiotics that do not withstand the action of hydrochloric acid - Carbenicillin, Ticarcillin.

Ampicillin and Amoxicillin are popular broad-spectrum penicillins

Ampicillin and Amoxicillin occupy a special place of honor among penicillin antibiotics. The spectrum and effect on the human body of these two antibiotics are almost the same. Among the microorganisms sensitive to Ampicillin and Amoxicillin, the most well-known infectious agents are:

gram-positive bacteria: staphylococci and streptococci, enterococci, listeria;
gram-negative bacteria: gonorrhea pathogen Neisseria gonorrhoeae, E. coli, Shigella, salmonella, Haemophilus influenzae, whooping cough pathogen Bordetella pertussis.

With an identical spectrum, Ampicillin and Amoxicillin differ significantly in pharmacokinetic properties.

Ampicillin

Ampicillin was synthesized in the early 60s of the last century. The drug immediately won the hearts of doctors: its spectrum of action compared favorably with the antibiotics of the 50s, to which persistence, that is, addiction, had already developed.

However, Ampicillin has significant disadvantages - low bioavailability and short half-life. The antibiotic is absorbed by only 35–50%, and the half-life is several hours. In this regard, the course of treatment with Ampicillin is quite intensive: tablets should be taken at a dose of 250–500 mg four times a day.

A feature of Ampicillin, which is considered an advantage over Amoxicillin, is the possibility of parenteral administration of the drug. The antibiotic is produced in the form of a lyophilized powder, from which a solution is prepared before administration. Ampicillin is prescribed 250–1000 mg every 4–6 hours intramuscularly or intravenously.

Amoxicillin is slightly younger than its predecessor - it went on sale in the 70s of the 20th century. Nevertheless, this antibiotic is still one of the most popular and effective broad-spectrum drugs, including for children. And this became possible thanks to the undoubted advantages of the drug.

These include the high bioavailability of Amoxicillin tablets, which reaches 75–90%, against the background of quite long period half-life. Moreover, the degree of absorption does not depend on food intake. The drug has a high degree of affinity for the tissues of the respiratory tract: the concentration of Amoxicillin in the lungs and bronchi is almost twice as high as in other tissues and blood. It is not surprising that Amoxicillin is considered the drug of choice for uncomplicated forms of bacterial bronchitis and pneumonia.

In addition, the medicine is indicated for sore throat, infections of the urinary and reproductive tract, and infectious skin diseases. Amoxicillin is a component of eradication therapy for gastric and duodenal ulcers.

The drug is taken orally at a dosage of 250–1000 mg twice a day for 5–10 days.

Broad-spectrum parenteral penicillins

Penicillins, which are used for parenteral administration, differ from the known Ampicillin and Amoxicillin in their additional activity against Pseudomonas aeruginosa. This microorganism causes soft tissue infections - abscesses, purulent wounds. Pseudomonas also act as causative agents of cystitis - inflammation Bladder, as well as inflammation of the intestines - enteritis.

In addition, broad-spectrum parenteral penicillin antibiotics have bactericidal and bacteriostatic effects against:

gram-positive microorganisms: staphylococci, streptococci (except for strains that form penicillinase), as well as enterobacteria;
gram-negative microorganisms: Proteus, Salmonella, Shigella, Escherichia coli, Haemophilus influenzae and others.

Broad-spectrum parenteral penicillins include Carbenicillin, Ticarcillin, Carfecillin, Piperacillin and others.

Let's look at the most well-known antibiotics - Carbenicillin, Ticarcillin and Piperacillin.

Carbenicillin

In medicine, carbenicillin disodium salt is used, which is a white powder that is dissolved before use.

Carbenicillin is indicated for infections abdominal cavity, including peritonitis, genitourinary system, respiratory tract, as well as meningitis, sepsis, infections bone tissue, skin.

The drug is administered intramuscularly, and severe cases intravenous drip.

Ticarcillin

Unprotected Ticarcillin is prescribed for severe infections caused by strains of bacteria that do not produce penicillinase: sepsis, septicemia, peritonitis, postoperative infections. The antibiotic is also used for gynecological infections, including endometritis, as well as infections of the respiratory tract, ENT organs, and skin. In addition, Ticarcillin is used for infectious diseases in patients with a reduced immune response.

Piperacillin

Piperacillin is mainly used together with the beta-lactamase inhibitor tazobactam. However, if it is determined that the causative agent of the disease does not produce penicillinase, an unprotected antibiotic may be prescribed.

Indications for the use of Piperacillin include severe purulent-inflammatory infections of the genitourinary system, abdominal cavity, respiratory and ENT organs, skin, bones and joints, as well as sepsis, meningitis, postoperative infections and other diseases.

Protected broad-spectrum penicillins: antibiotics to fight resistance!

Amoxicillin and Ampicillin are far from omnipotent. Both drugs are destroyed by beta-lactamases, which are produced by some strains of bacteria. Such “harmful” pathogens include many types of staphylococcus, including Staphylococcus aureus, Haemophilus influenzae, Moraxella, Escherichia coli, Klebsiella and other bacteria.

If the infection is caused by beta-lactamase-producing pathogens, Amoxicillin, Ampicillin and some other antibiotics are simply destroyed without causing any harm to the bacteria. Scientists found a way out of the situation by creating complexes of penicillin antibiotics with substances that inhibit beta-lactamases. In addition to the most famous clavulanic acid, inhibitors of destructive enzymes include sulbactam and tazobactam.

Protected antibiotics can effectively fight infection that the fragile and lonely penicillin cannot. Therefore, combination drugs are often the drugs of choice in the most various diseases caused by bacterial infection, including hospital infections. The leading places in this list of broad-spectrum antibiotics are occupied by two or three drugs, and some injectable drugs used in hospitals remain behind the scenes. Paying tribute to the spectrum of each combined penicillin, we will open the veil of secrecy and list these, of course, worthy drugs.

Amoxicillin + clavulanic acid. The most famous combined broad-spectrum antibiotic, which has dozens of generics: Augmentin, Amoxiclav, Flemoclav. There are both oral and injectable forms of this antibiotic.

Amoxicillin and sulbactam. Trade name - Trifamox, available in tablet form. A parenteral form of Trifamox is also available.

Ampicillin and sulbactam. Trade name - Ampisid, used for injections, more often in hospitals.

Ticarcillin + clavulanic acid. Trade name Timentin, available only in parenteral form. Indicated for treatment severe infections caused by resistant, hospital-acquired strains.

Piperacillin + tazobactam. Trade names Piperacillin-tazobactam-Teva, Tazacin, Santaz, Tazrobida, Tacillin J, etc. The antibiotic is used as an infusion drip, that is, in the form of intravenous infusions for moderate and severe polyinfections.

Broad spectrum tetracyclines: time-tested

Well-known broad-spectrum drugs include tetracycline antibiotics. This group of drugs is united general structure, which is based on the four-cyclic system (“tetra” translated from Greek - four).

Tetracycline antibiotics do not have a beta-lactam ring in their structure, and therefore are not subject to destructive action beta-lactamases. The group of tetracyclines has a general spectrum of action, which includes:

gram-positive microorganisms: staphylococci, streptococci, clostridia, listeria, actinomycetes;
gram-negative microorganisms: the causative agent of gonorrhea Neisseria gonorrhoeae, Haemophilus influenzae, Klebsiella, Escherichia coli, Shigella (the causative agent of dysentery), salmonella, the causative agent of whooping cough Bordetella pertussis, as well as bacteria of the genus Treponema, including the causative agent of syphilis - spirochete pallidum.

A distinctive feature of tetracyclines is their ability to penetrate into the bacterial cell. Therefore, these products cope well with intracellular pathogens - chlamydia, mycoplasma, ureaplasma. Pseudomonas aeruginosa and Proteus are not susceptible to the bactericidal action of tetracyclines.

The two most commonly used tetracyclines today are Tetracycline and Doxycycline.

Tetracycline

One of the founders of the tetracycline group, discovered back in 1952, is still used today, despite its advanced age and side effects. However, the prescription of tetracycline tablets can be criticized, given the existence of more modern and effective antibiotics wide spectrum of action.

TO negative aspects oral tetracycline undoubtedly has rather limited therapeutic activity, as well as the ability to change the composition of the intestinal flora. In this regard, when prescribing tetracycline tablets, one should take into account increased risk the occurrence of antibiotic-associated diarrhea.

It is much more effective and safe to prescribe external and local forms of tetracycline. Yes, tetracycline eye ointment included in the Russian list of vitally important medicines and is an excellent example of a topical broad-spectrum antibacterial drug.

Doxycycline

Doxycycline is distinguished by its therapeutic activity (almost 10 times higher than Tetracycline) and impressive bioavailability. In addition, Doxycycline has a much lesser effect on the intestinal microflora than other drugs in the tetracycline group.

Fluoroquinolones are essential broad-spectrum antibiotics

Probably, no doctor can imagine his medical practice without fluoroquinolone antibiotics. The first synthesized representatives of this group were distinguished by a narrow spectrum of action. With the development of pharmaceuticals, new generations of fluoroquinolone antibacterial agents were discovered and the spectrum of their activity expanded.

Thus, first generation antibiotics - Norfloxacin, Ofloxacin, Ciprofloxacin - work primarily against gram-negative flora.

Modern fluoroquinolones of the II, III and IV generations, unlike their predecessors, are antibiotics of the broadest, so to speak, spectrum of action. These include Levofloxacin, Moxifloxacin, Gatifloxacin, and other drugs active against:

Note that all fluoroquinolones, without exception, are contraindicated for use in children under 18 years of age. This is due to the ability of antibiotics of this group to disrupt the synthesis of peptidoglycan, a substance included in the structure of the tendon. Therefore, taking fluoroquinolones in children is associated with the risk of changes in cartilage tissue.

Second generation fluoroquinolone, Levofloxacin is prescribed for respiratory tract infections - pneumonia, bronchitis, ENT - sinusitis, otitis media, as well as diseases urinary tract, reproductive tract, including urogenital chlamydia, infections of the skin (furunculosis) and soft tissues (atheromas, abscesses).

Levofloxacin is prescribed 500 mg per day at a time for seven, less often - 10 days. In severe cases, the antibiotic is administered intravenously.

In Russian pharmaceutical market Many drugs containing lomefloxacin are registered. An original remedy- the brand is the German Tavanik. Its generics include Levofloxacin Teva, Levolet, Glevo, Flexil, Ecolevid, Hyleflox and other drugs.

Moxifloxacin

Moxifloxacin is a highly active fluoroquinolone antibiotic III generation wide spectrum, indicated for infections of the ENT organs, respiratory tract, skin, soft tissues, postoperative infections. The drug is prescribed in tablets of 400 mg once a day. The course of treatment ranges from 7 to 10 days.

The original drug of moxifloxacin, which is most often used, is Avelox manufactured by Bayer. There are very few generics of Avelox, and it is quite difficult to find them in pharmacies. Moxifloxacin is included in eye drops Vigamox indicated for infectious diseases inflammatory processes conjunctiva of the eye and other diseases.

Gatifloxacin

The drug of the latest, IV generation of fluoroquinolones is prescribed for severe, including hospital-acquired respiratory tract diseases, ophthalmological pathologies, infections of the ENT organs, and urogenital tract. The antibacterial effect of Gatifloxacin also applies to pathogens that are sexually transmitted.

Gatifloxacin is prescribed 200 or 400 mg per day once.

Most drugs containing gatifloxacin are produced by Indian companies. Most often in pharmacies you can find Tabris, Gaflox, Gatispan.

Aminoglycosides: essential antibiotics

Aminoglycosides comprise a group of antibacterial drugs that have similar properties in structure and, of course, spectrum of action. Aminoglycosides inhibit protein synthesis in microbes, exerting a pronounced bactericidal effect against sensitive microorganisms.

The first aminoglycoside is a natural antibiotic isolated during World War II. Surprisingly, modern phthisiology still cannot do without the same Streptomycin, which was discovered back in 1943 - the antibiotic is now widely used in phthisiology to treat tuberculosis.

All four generations of aminoglycosides, which were gradually isolated and synthesized over more than half a century, have an equally broad spectrum antibacterial action. Antibiotics of this group act on:

gram-positive cocci: streptococci and staphylococci;
gram-negative microorganisms: coli, Klebsiella, Salmonella, Shigella, Moraxella, Pseudomonas and others.

Aminoglycosides of different generations have some individual characteristics, which we will try to trace using examples of specific drugs.

The oldest broad-acting aminoglycoside of the first generation in injections, which is distinguished by its high antibacterial activity against mycobacterium tuberculosis. Indications for the use of Streptomycin are primary tuberculosis of any localization, plague, brucellosis and tularemia. The antibiotic is administered intramuscularly, intratracheally, and also intracavernosally.

A very controversial antibiotic of the second generation, which is gradually falling into oblivion, is Gentamicin. Like other aminoglycosides II and older generations, Gentamicin is active against Pseudomonas aeruginosa. The antibiotic exists in three forms: injection, external in the form of ointments and local ( eye drops).

Interestingly, unlike the vast majority of antibiotics, Gentamicin perfectly retains its properties in dissolved form. Therefore, the injection form of the drug is a ready-made solution in ampoules.

Gentamicin is used for infectious and inflammatory diseases of the biliary tract - cholecystitis, cholangitis, urinary tract - cystitis, pyelonephritis, as well as for infections of the skin and soft tissues. IN ophthalmological practice eye drops with Gentamicin are prescribed for blepharitis, conjunctivitis, keratitis and other infectious eye lesions.

The reason for a wary attitude towards Gentamicin is data on the side effects of the antibiotic, in particular ototoxicity. IN last years There is sufficient evidence of hearing impairment due to Gentamicin therapy. There are even cases of complete deafness that developed due to the administration of an antibiotic. The danger is that, as a rule, toxic effect Gentamicin is irreversible, that is, hearing does not recover after discontinuation of the antibiotic.

Based on this sad trend, most doctors prefer to opt for other, safer aminoglycosides.

Amikacin

An excellent alternative to Gentamicin is the third-generation broad-spectrum antibiotic Amikacin, which is produced in powder form for the preparation of an injection solution. Indications for the use of Amikacin are peritonitis, meningitis, endocarditis, sepsis, pneumonia and other severe infectious diseases.

Amphenicols: let's talk about good old Levomycetin

The main representative of the amphenicol group is the natural broad-spectrum antibiotic chloramphenicol, which is known to almost every one of our compatriots under the name Levomycetin. The drug is a structural levorotatory isomer of chloramphenicol (hence the prefix “left”).

The spectrum of action of Levomycetin covers:

gram-positive cocci: staphylococci and streptococci;
gram-negative bacteria: gonorrhea pathogens, Escherichia coli and Haemophilus influenzae, Salmonella, Shigella, Yersinia, Proteus, Rickettsia.

In addition, Levomycetin is active against spirochetes and even some large viruses.

Indications for the use of Levomycetin are: typhoid fever and paratyphoid fever, dysentery, brucellosis, whooping cough, typhus, various intestinal infections.

External forms of Levomycetin (ointment) are prescribed for purulent diseases skin, trophic ulcers. Thus, in Russia, an ointment containing Levomycetin, which is produced under the name Levomekol, is very popular.

In addition, Levomycetin is used in ophthalmology for inflammatory eye diseases.

A course of treatment with Levomycetin or How to harm your body?

Levomycetin is affordable, effective, and therefore loved by many intestinal antibiotic wide spectrum. So beloved that you can often meet a patient in a pharmacy buying those same anti-diarrhea pills and praising their effectiveness. Of course: I took two or three tablets - and the problems went away. It is in this approach to treatment with Levomycetin that the danger lurks.

We must not forget that Levomycetin is an antibiotic that must be taken in a course. We know that, for example, the antibiotic Amoxicillin should not be taken for less than five days, but by drinking two tablets of Levomycetin, we manage to completely forget about the antibacterial origin of the drug. What happens to the bacteria in this case?

It's simple: the weakest enterobacteria, of course, die after two or three doses of Levomycetin. The diarrhea stops, and we, giving glory to the power of bitter pills, forget about the troubles. Meanwhile, strong and persistent microorganisms survive and continue their vital functions. Often as opportunistic pathogens, which become more active at the slightest decrease in immunity and show us where the crayfish hibernate. Then Levomycetin may no longer cope with selected microbes.

To prevent this from happening, you should follow the recommended course of antibiotic therapy. For the treatment of acute intestinal infections the drug is taken at a dosage of 500 mg three to four times a day for at least a week. If you are not ready to follow a fairly intensive course, it is better to give preference to others antimicrobials, for example, nitrofuran derivatives.

Carbapenems: reserve antibiotics

As a rule, we encounter carbapenems extremely rarely or not at all. And this is wonderful - after all, these antibiotics are indicated for the treatment of severe hospital infections that threaten life. The spectrum of action of carabapenems includes most existing pathological strains, including resistant ones.

Antibiotics in this group include:

Meropenem. The most common carbapenem, which is produced under the trade names Meronem, Meropenem, Cyronem, Jenem, etc.;
Ertapenem, tradename Invanz;
Imipenem.

Carbapenems are administered only intravenously, intravenously infusion and bolus, that is, using a special dispenser.

Antibiotic therapy: the golden rule of safety

At the end of our excursion into the world of broad-spectrum antibiotics, we cannot ignore most important aspect, on which the safety of drugs and, ultimately, our health is based. Every patient - current or potential - should know and remember that the right to prescribe antibiotics belongs exclusively to the doctor.

No matter how much knowledge you think you have in the field of medicine, you should not give in to the temptation to “treat yourself.” Moreover, you should not rely on the hypothetical pharmaceutical abilities of neighbors, friends and colleagues.

Only good doctor. Trust the knowledge and experience of a great specialist, and this will help you maintain your health for many years.

Introduction

Antibiotics are chemotherapeutic substances formed by microorganisms or obtained from other natural sources, as well as their derivatives and synthetic products that have the ability to selectively suppress pathogens in the patient’s body or delay the development malignant neoplasms. Antibiotics differ from other drugs in their heterogeneity, i.e. multicomponent composition. For every antibiotic there is an enzyme that inactivates it. The quality of natural and semi-synthetic antibiotics is assessed by toxicity, which is determined by biological methods in animals. A significant part of antibiotics are produced in the form of hermetically sealed dry powders due to their instability in aqueous solutions. Antibiotics occupy first place among the drugs that cause adverse reactions; these are direct toxicity, dysbiosis, nephro- and ototoxicity (streptomycin), allergic reactions (penicillin). Since antibiotics are in most cases mixtures of substances, their activity is determined in units of action (AU). The method is based on comparing the inhibition of growth of a test microorganism by certain concentrations of the test drug with the inhibition of growth by known concentrations of a standard antibiotic drug.

IN medical practice About 25 thousand medications are used. Moreover, almost 90% of drugs were developed in last decades, which allows us to talk about a “pharmaceutical explosion”. Not only the number of drugs is growing, but also the strength of their effect on the body. With the introduction of highly effective drugs such as antibiotics into clinical practice, the possibilities for treating various diseases are significantly expanding.

However, as the effectiveness of drugs increases, their range narrows. therapeutic action and the risk of complications from drug therapy increases. On average modern drug therapy is accompanied by complications in 19-33% of patients, up to 8% of people are hospitalized due to drug complications, in 2-3% with drug complications incorrect treatment may result in death.

That's why this topic very relevant nowadays.

The purpose of this course work- carry out analysis medicinal substances and dosage forms containing antibiotics.

1. Identify the meaning of medicinal substances and dosage forms containing antibiotics;

2. Identify storage rules;

3. Study the characteristics of physical, chemical and pharmacological properties;

4. Explore existing methods identification and quantification.

Use of antibiotics in medicine

The clinic uses about 40 antibiotics that do not provide harmful action on the human body. To achieve a therapeutic effect, it is necessary to maintain so-called therapeutic concentrations in the body, especially at the site of infection. Increasing the concentration of antibiotics in the body is more effective, but can be complicated side effects drugs. If necessary, to enhance the effect of the antibiotic, several antibiotics can be used (for example, streptomycin with penicillin), as well as eficillin (for pneumonia) and others medicines (hormonal drugs, anticoagulants, etc.). Combinations of some antibiotics have a toxic effect, and therefore their combinations cannot be used. Penicillins are used for sepsis, pneumonia, gonorrhea, syphilis, etc.

Benzylpenicillin, ecmonovocillin ( novocaine salt penicillin with ecmolin) are effective against staphylococci; Bicillins-1, -3 and -5 (dibenzylethylenediamine salt of penicillin) are used to prevent rheumatic attacks. A number of antibiotics - streptomycin sulfate, pascomycin, dihydrostreptomycin pascate, pantomycin, dihydrostreptomycin pantothenate, streptomycin saluzide, as well as cycloserine, viomycin (florimycin), kanamycin and rifamycin - are prescribed for the treatment of tuberculosis. Syntomycin drugs are used in the treatment of tularemia and plague; tetracyclines - for the treatment of cholera. To combat carriage pathogenic staphylococci use lysozyme with ecmoline.

Semi-synthetic penicillins with a broad spectrum of action - ampicillin and hetacillin - inhibit the growth of intestinal, typhoid and dysentery bacilli.

Long-term and widespread use of antibiotics has caused the emergence of a large number of antibiotic-resistant pathogenic microorganisms. The emergence of resistant microbes to several antibiotics simultaneously is practically important - cross-drug resistance. To prevent the formation of antibiotic-resistant forms, widely used antibiotics are periodically replaced and they are never used topically. wound surfaces. Diseases caused by antibiotic-resistant staphylococci are treated with semisynthetic penicillins (methicillin, oxacillin, cloxacillin and dicloxacillin), as well as erythromycin, oleandomycin, novobiocin, lincomycin, leukocin, kanamycin, rifamycin; shincomycin and josamycin are used against staphylococci resistant to many antibiotics. In addition to resistant forms, when antibiotics are used (most often streptomycin), so-called dependent forms (microorganisms that develop only in the presence of antibiotics) may appear. With the irrational use of antibiotics, the pathogenic fungi, located in the body, which leads to candidiasis. For the prevention and treatment of candidiasis, the antibiotics nystatin and levorin are used.

In some cases, during treatment with antibiotics, side effects. Penicillin for long-term use in large doses has a toxic effect on the central nervous system, streptomycin - on auditory nerve, etc. These phenomena are eliminated by reducing doses. Sensitization ( increased sensitivity) in the body can manifest itself regardless of the dose and method of administration of antibiotics and be expressed in an exacerbation of the infectious process (entry into the blood large quantities toxins due to the massive death of the pathogen), in relapses of the disease (as a result of suppression of the body’s immunobiological reactions), superinfection, as well as allergic reactions.

Antibiotics are a broad group of drugs whose action is aimed at combating infectious diseases. In recent years, the list of these funds has undergone some changes. New generation broad-spectrum antibiotics have gained great popularity. Eat modern drugs, which are aimed at eliminating the causative agent of a specific disease. Narrow-acting drugs are more preferable because they do not affect normal microflora.

How do new generation antibiotics work?

Medical professionals successfully use antibacterial agents due to the fact that life-threatening important processes in the cells of the human body differ from similar processes in a bacterial cell. These new generation drugs act selectively, affecting only the cell of the pathogenic microorganism, without affecting human ones. Classification occurs depending on the way in which they influence the vital activity of microorganisms.

Some drugs inhibit the synthesis of the outer cell membrane of bacteria, which is absent in the human body. These include cephalosporins, penicillin antibiotics, etc. Another group almost completely suppresses protein synthesis in bacterial cells. The latter include macrolides and tetracycline antibiotics. The list of broad-spectrum drugs is divided according to the principle of antibacterial activity. The instructions must indicate the area of activity of the tablets.

Some drugs have a broad spectrum of action, being effective against many bacteria, while others may have a narrow focus, targeting certain group bacteria. Why is this happening? The fact is that viruses and bacteria are characterized by different structure and functioning, so what kills bacteria does not affect viruses. Broad-spectrum antibiotics are used when:

pathogens exhibit resistance to the influence of a highly targeted drug;
a superinfection has been identified, the culprits of which are several types of bacteria;
prevention of infections after surgical interventions is carried out;
treatment is prescribed based on clinical symptoms, that is, empirically. In this case, the specific pathogen is not identified. This is appropriate for common infections and dangerous fast-acting diseases.

Features of broad-spectrum antibiotics

New generation broad-spectrum drugs are universal means, which can include inflammation of the lymph nodes, a cold, accompanying cough, runny nose, etc. Whatever pathogen causes the disease, the remedies will defeat the microbe. Each newly developed medicine has a more advanced, improved effect against pathogenic microorganisms. The new generation of antibiotics is believed to cause minimal damage to the human body.

List of new generation antibiotics with a wide spectrum of action

The list of existing new generation broad-spectrum antibiotics includes many drugs, both cheap and more expensive. The most frequently used of all groups of drugs are penicillins, macrolides, fluoroquinolones, and cephalosporins. They are available in the form of injection solutions, tablets, etc. New generation drugs are characterized by improved pharmacological actions, when compared with older drugs. So the list is:

tetracycline group: “Tetracycline”;
penicillins: “Ampicillin”, “Amoxicillin”, “Ticarcyclin”, “Bilmitsin”;
fluoroquinolones: Gatifloxacin, Levofloxacin, Ciprofloxacin, Moxifloxacin;
carbapenems: “Meropenem”, “Imipenem”, “Ertapenem”;
amphenicols: "Chloramphenicol";
aminoglycosides: "Streptomycin".

Find out more about the drug and children, instructions for use and contraindications.

Names of highly targeted strong antibiotics

New generation highly targeted drugs are used when the causative agent of the infection is precisely identified. Each drug acts on a specific group of pathogenic microorganisms. Unlike broad-spectrum antibiotics, they do not contribute to disorders and do not suppress the immune system. Due to a deeper degree of purification of the active substance, the medicine has less toxicity.

Bronchitis

For bronchitis, in most cases, new generation broad-spectrum antibiotics are prescribed, but the choice of drug should be based on the results of laboratory testing of sputum. The best medicine is considered to be the one that has a detrimental effect directly on the bacterium that caused the disease. This approach is explained by the fact that the study takes from 3 to 5 days, and bronchitis must be treated as early as possible to avoid complications. The following antibacterial drugs are often prescribed:

Macrolides - prescribed for individual intolerance to penicillin. Clarithromycin and Erythromycin are widely used.
Penicillin has been used in medicine for a long time, and therefore some microorganisms have developed resistance to the active substance. Therefore, the drugs were enhanced with additives that block the action of enzymes produced by microorganisms in order to reduce the activity of penicillin. The most effective are Amoxiclav, Panklav, and Augmentin.
Fluoroquinolones – used to treat chronic bronchitis during the period of exacerbation. Levofloxacin, Moxifloxacin, and Ciprofloxacin are characterized by great effectiveness.
Cephalosporins are prescribed in case of obstructive forms of the disease. Modern antibiotics include Cefuroxime and Ceftriaxone.

Sinusitis

Angina

Antibiotics include a broad group of drugs that are active against bacteria, suppressing growth and development or destroying them. This is one of the most important groups drugs, which is very relevant today. Thanks to them, most infectious diseases caused by such pathogens respond well to treatment.

Types of antibiotics

The very first substance that destroys microorganisms was penicillin. It was discovered in 1922 by the English microbiologist A. Fleming. Today there are more than 100 different representatives of this pharmacological group medicines. Modern antibiotics divided into types according to several criteria - according to the nature of the effect on microorganisms and the antibacterial spectrum, direction of action, chemical structure and method of preparation.

Penicillin is a natural antibiotic that is a means of combating the existence of actinomycetes fungi. Thanks to the release of penicillin, they suppress the growth and reproduction of bacteria, thereby providing themselves with superiority in terms of the nutrient medium.

Types by nature of impact

Based on the nature of their effect on bacterial cells, there are 2 types of agents, which include:

Bacteriostatic drugs inhibit the growth, development and reproduction of microorganisms. Their use stops infectious process in the body, which allows the immune system to destroy bacterial cells (chloramphenicol).
Drugs bactericidal action- destroy bacterial cells, thereby reducing their number in the body (cephalosporins, amoxicillin).

Some bacteria, after their death and destruction cell wall, released into the blood a large number of toxic substances (endotoxins). In this case, the use of bacteriostatic agents is indicated.

Types by spectrum of action

The spectrum of action determines the amount various types bacteria against which the drug is active. Based on this criterion, the following groups of antibiotics are distinguished:

Broad spectrum of action - active against most microorganisms, pathogens of human infectious diseases (cephalosporins, amoxicillin, protected with clavulanic acid).
Narrow spectrum of action - destroys or suppresses only a few types of microorganisms (anti-tuberculosis drugs).

For most diseases, broad-spectrum drugs are used. If necessary A laboratory determination of sensitivity to antibiotics is carried out - for this purpose, bacteriological isolation of bacteria from the patient is carried out, followed by their cultivation on a nutrient medium with the drug. The lack of colony growth indicates the bacteria are sensitive to it.

By direction of action

This classification divides into species, depending on their predominant activity in relation to various groups microorganisms:

Antibacterial agents are actually antibiotics that are used to treat most infectious diseases.
Antitumor agents - some substances obtained from mold fungi have the ability to influence the course of the oncological process by suppressing the proliferation of cancer cells.
Antifungal agents - destroy fungal cells.

In a relationship antifungal agents There is an ongoing debate whether they should be included in the same category as antibiotics.

By method of receipt

There are several variations in obtaining antibiotics today. Therefore, the following groups of funds are distinguished:

Natural - isolated directly from mold fungi.
Semi-synthetic - also isolated from mold fungi, but to enhance the activity and spectrum of action, a chemical modification of the molecule of a natural substance is carried out.
Synthetic - the molecule is produced only chemically.

Types by chemical structure

The chemical structure determines the nature, spectrum and direction of the effects of antibacterial agents. Based on their chemical structure, the following types are distinguished:

Today, these main groups of drugs are used to treat various infectious diseases. To prevent the development of chronicity of the process and resistance of bacteria, it is very important to use them according to the recommendations

Antibiotics are a group of medications that have a damaging or destructive effect on bacteria that cause infectious diseases. As antiviral agents This type of medicine is not used. Depending on the ability to destroy or inhibit certain microorganisms, there are different groups antibiotics. In addition, this type of medicine can be classified according to its origin, the nature of its effect on bacterial cells and some other characteristics.

general description

Antibiotics belong to the group of antiseptic biological drugs. They are waste products of moldy and radiant fungi, as well as some types of bacteria. There are currently more than 6,000 known natural antibiotics. In addition, there are tens of thousands of synthetic and semi-synthetic ones. But only about 50 such drugs are used in practice.

Main groups

All such drugs existing on this moment, are divided into three large groups:

antibacterial;
antifungal;
antitumor.

In addition, according to the direction of action, this type of medicine is divided into:

active against gram-positive bacteria;
anti-tuberculosis;
active against both gram-positive and gram-negative bacteria;
antifungal;
destroying helminths;
antitumor.

Classification by type of effect on microbial cells

In this regard, there are two main groups of antibiotics:

Bacteriostatic. Medicines of this type suppress the development and reproduction of bacteria.
Bactericidal. When using drugs from this group, existing microorganisms are destroyed.

Types by chemical composition

The classification of antibiotics into groups in this case is as follows:

Penicillins. This is the most old group, with which, in fact, the development of this direction of drug treatment began.
Cephalosporins. This group It is used very widely and is characterized by a high degree of resistance to the destructive action of β-lactamases. This is the name given to special enzymes secreted by pathogenic microorganisms.
Macrolides. These are the safest and quite effective antibiotics.
Tetracyclines. These drugs are used mainly to treat the respiratory system and urinary tract.
Aminoglycosides. They have a very wide spectrum of action.
Fluoroquinolones. Low-toxic bactericidal preparations.

These antibiotics are used in modern medicine more often. Besides them, there are some others: glycopeptides, polyenes, etc.

Antibiotics of the penicillin group

Medicines of this type are the fundamental basis of absolutely any antimicrobial treatment. At the beginning of the last century, no one knew about antibiotics. In 1929, the Englishman A. Fleming discovered the very first such drug - penicillin. The principle of action of drugs in this group is based on the suppression of protein synthesis in the cell walls of the pathogen.

On currently There are only three main groups of penicillin antibiotics:

biosynthetic;
semi-synthetic;
semi-synthetic broad spectrum.

The first type is used mainly for the treatment of diseases caused by staphylococci, streptococci, meningococci, etc. Such antibiotics can be prescribed, for example, for diseases such as pneumonia, infectious lesions skin, gonorrhea, syphilis, gas gangrene etc.

Antibiotics penicillin group semi-synthetic ones are most often used to treat severe staphylococcal infections. Such drugs are less active against certain types of bacteria (for example, gonococci and meningococci) than biosynthetic ones. Therefore, before their appointment, procedures such as isolation and precise identification of the pathogen are usually performed.

Broad-spectrum semi-synthetic penicillins are usually used if traditional antibiotics (chloramphenicol, tetracycline, etc.) do not help the patient. This variety includes, for example, the fairly frequently used amoxicillin group of antibiotics.

Four generations of penicillins

In honey In practice today, four types of antibiotics from the penicillin group are used:

The first generation is medicines of natural origin. This type of drug has a very narrow range of applications and is not very resistant to penicillinases (β-lactamases).
The second and third generations are antibiotics that are much less susceptible to the destructive enzymes of bacteria, and therefore more effective. Treatment with their use can take place in a fairly short time.
The fourth generation includes broad-spectrum penicillin antibiotics.

The most famous penicillins are the semisynthetic drugs Ampicillin, Carbenicillin, Azocillin, as well as the biosynthetic Benzylpenicillin and its durant forms (bicillins).

Side effects

Although antibiotics in this group are low-toxic drugs, they, along with their beneficial effects, can also have a negative effect on the human body. Side effects when using them are as follows:

itching and skin rash;
allergic reactions;
dysbacteriosis;
nausea and diarrhea;
stomatitis.

Penicillins cannot be used simultaneously with antibiotics of another group - macrolides.

Amoxicillin group of antibiotics

This variety antimicrobials refers to penicillins and is used to treat diseases caused by infection with both gram-positive and gram-negative bacteria. Such medications can be used to treat both children and adults. Most often, amoxicillin-based antibiotics are prescribed for respiratory tract infections and various kinds diseases of the gastrointestinal tract. They are also taken for diseases of the genitourinary system.

The amoxicillin group of antibiotics is also used for various soft tissue infections and skin. These drugs can cause the same side effects as other penicillins.

Group of cephalosporins

The action of drugs in this group is also bacteriostatic. Their advantage over penicillins is their good resistance to β-lactamases. Antibiotics of the cephalosporin group are classified into two main groups:

taken parenterally (bypassing the gastrointestinal tract);
taken orally.

In addition, cephalosporins are classified into:

First generation drugs. They have a narrow spectrum of action and have virtually no effect on gram-negative bacteria. Moreover, such drugs are successfully used in the treatment of diseases caused by streptococci.
Second generation cephalosporins. More effective against gram-negative bacteria. They are active against staphylococci and streptococci, but have virtually no effect on etherococci.
Third and fourth generation drugs. This group of drugs is very resistant to the action of β-lactamases.

The main disadvantage of drugs such as cephalosporin antibiotics is that when taken orally they are very irritating to the gastrointestinal mucosa (except for the drug Cephalexin). The advantage of drugs of this type is that the number of side effects caused is much smaller compared to penicillins. The drugs most often used in medical practice are Cefalotin and Cefazolin.

Negative effects of cephalosporins on the body

Side effects that sometimes occur when taking antibiotics of this series include:

negative effects on the kidneys;
violation of hematopoietic function;
various types of allergies;
negative impact on the gastrointestinal tract.

Antibiotics of the macrolide group

Among other things, antibiotics are classified according to the degree of selectivity of action. Some are capable of negatively affecting only the cells of the pathogen, without affecting human tissue in any way. Others may have a toxic effect on the patient's body. Macrolide group drugs are considered the safest in this regard.

There are two main groups of antibiotics of this variety:

natural;
semi-synthetic.

The main advantages of macrolides include the highest efficiency of bacteriostatic effects. They are especially active against staphylococci and streptococci. Among other things, macrolides do not negatively affect the gastrointestinal mucosa, and therefore are often available in tablets. All antibiotics affect to one degree or another immune system person. Some types are depressing, some are beneficial. Antibiotics of the macrolide group have a positive immunomodulatory effect on the patient's body.

Popular macrolides are Azithromycin, Sumamed, Erythromycin, Fuzidin, etc.

Antibiotics of the tetracycline group

Medicines of this type were first discovered in the 40s of the last century. The very first tetracycline drug was isolated by B. Duggar in 1945. It was called "Chlortetracycline" and was less toxic than other antibiotics existing at that time. In addition, it also turned out to be very effective in terms of its impact on pathogens huge amount very dangerous diseases (for example, typhoid).

Tetracyclines are considered somewhat less toxic than penicillins, but have more negative influence on the body than macrolide antibiotics. Therefore, at the moment they are actively being replaced by the latter.

Today, the drug “Chlortetracycline”, discovered in the last century, oddly enough, is very actively used not in medicine, but in agriculture. The fact is that this drug can accelerate the growth of animals taking it almost twice. The substance has such an effect because when it enters the animal’s intestines it begins to actively interact with the microflora present in it.

In addition to the drug “Tetracycline” itself, medications such as “Metacycline”, “Vibramycin”, “Doxycycline”, etc. are often used in medical practice.

Side effects caused by tetracycline antibiotics

Refusal wide application The use of drugs of this type in medicine is primarily due to the fact that they can have not only beneficial but also negative effects on the human body. For example, when long-term use, tetracycline antibiotics can interfere with the development of bones and teeth in children. In addition, by interacting with the microflora of the human intestine (if used incorrectly), such drugs often provoke the development of fungal diseases. Some researchers even argue that tetracyclines can have a depressing effect on the male reproductive system.

Antibiotics of the aminoglycoside group

Preparations of this type have a bactericidal effect on the pathogen. Aminoglycosides, like penicillins and tetracyclines, are one of the oldest groups of antibiotics. They were opened in 1943. In subsequent years, drugs of this type, in particular Streptomycin, were widely used to treat tuberculosis. In particular, aminoglycosides are effective against gram-negative aerobic bacteria and staphylococci. Among other things, some drugs in this series are also active against protozoa. Since aminoglycosides are much more toxic than other antibiotics, they are prescribed only for severe illnesses. They are effective, for example, in sepsis, tuberculosis, severe forms of paranephritis, abdominal abscesses, etc.

Very often, doctors prescribe aminoglycosides such as Neomycin, Kanamycin, Gentamicin, etc.

Fluoroquinolone group drugs

Most drugs of this type of antibiotic have a bactericidal effect on the pathogen. Their advantages include, first of all, the highest activity against a huge number of microbes. Like aminoglycosides, fluoroquinolones can be used to treat serious illnesses. However, they do not have such an effect on the human body. negative impact, like the first. There are antibiotics from the fluoroquinolone group:

First generation. This variety mainly used for inpatient treatment sick. First generation fluoroquinolones are used for infections of the liver, biliary tract, pneumonia, etc.
Second generation. These drugs, unlike the first ones, are very active against gram-positive bacteria. Therefore, they are also prescribed for treatment without hospitalization. Second generation fluoroquinolones are very widely used for sexually transmitted diseases.

Popular drugs in this group are Norfloxacin, Levofloxacin, Gemifloxacin, etc.

So, we found out which group antibiotics belong to, and figured out exactly how they are classified. Because most of these drugs can cause side effects, they should only be used as directed by your doctor.