List of effective new generation antibiotics. Modern classification of antibiotics

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. Besides, this type Medicines can be classified according to their origin, the nature of their effect on bacterial cells and some other characteristics.

general description

Antibiotics belong to the group of antiseptics 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 oldest group with which, in fact, the development of this direction of drug treatment began.
• Cephalosporins. This group is used very widely and differs high degree 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.

At the moment, there are only three main groups of penicillin antibiotics:

• biosynthetic;
• semi-synthetic;
• semi-synthetic wide range actions.

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 skin lesions, gonorrhea, syphilis, gas gangrene, etc. .

Semi-synthetic antibiotics of the penicillin group 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.

Semi-synthetic broad-spectrum 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 medical In practice today, four types of antibiotics from the penicillin group are used:

• First generation - medicines 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 antibiotics of the penicillin group.

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 of this group belong to low-toxic drugs, they, along with beneficial influence 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. Amoxicillin-based antibiotics are most often prescribed for infections. respiratory tract And various kinds gastrointestinal diseases. They are also taken for diseases of the genitourinary system.

The amoxicillin group of antibiotics is also used for various infections soft tissues 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 amount of induced side effects. Most often in medical practice the drugs Cefalotin and Cefazolin are used.

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 an effect on the patient's body toxic effect. 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 the human immune system to one degree or another. 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 influencing the pathogens of a huge number of 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 paranephritis, abscesses abdominal cavity 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 a negative effect on the human body as the first ones. There are antibiotics from the fluoroquinolone group:

• First generation. This type is used mainly for inpatient treatment of patients. 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.

Antibiotics are a broad group of drugs whose action is aimed at combating infectious diseases. Behind last 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 suppress the synthesis of external cell membrane bacteria that are not found in human body. These include cephalosporins, antibiotics penicillin series 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 a specific group of bacteria. Why is this happening? The fact is that viruses and bacteria are characterized by different structures 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 occurs after surgical interventions;
• 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 laboratory research 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 Cefuroxime and Ceftriaxone are considered.

Sinusitis

Angina

Antibiotic tablets are substances that inhibit the growth of microorganisms and, as a result, kill them. Used to treat infectious pathologies. Can be 100% natural or semi-synthetic. So, what drugs are antibiotics?

Prescription of universal antibiotics

Prescribing the described medications is justified in the following cases:

1. Therapy is selected based on clinical symptoms, i.e. without identifying the pathogen. This is relevant for active illnesses, for example, meningitis - a person can die in just a couple of hours, so there is no time for complex measures.
2. The infection has not one, but several sources.
3. The microorganism that causes the disease is resistant to narrow-spectrum antibiotics.
4. The complex is being carried out preventive measures after operation.

Classification of universal antibiotics

We are considering medicines can be divided into several groups (with names):

• penicillins – Ampicillin, Amoxicillin, Ticarcillin;
• tetracyclines - these include the drug of the same name;
• fluoroquinolones – Ciprofloxacin, Levofloxatin, Moxifloxacin; Gatifloxacin;
• aminoglycosides – Streptomycin;
• amphenicols – Levomycetin;
• carbapenems - Imipenem, Meropenem, Ertapenem.

This is the main list.

Penicillins

With the discovery of benzylpenicillin, scientists came to the conclusion that microorganisms could be killed. Despite the fact that, as they say, “a lot of water has already flown under the bridge,” this Soviet antibiotic has not been discounted. However, other penicillins were created:

• those that lose their qualities when passing through the acid-base environment of the gastrointestinal tract;
• those that do not lose their qualities when passing through the acid-base environment of the gastrointestinal tract.

Ampicillin and Amoxicillin

Special attention should be paid to antibiotics such as Ampicillin and Amoxicillin. In terms of action they are practically no different from each other. Able to cope with:

• gram-positive infections, in particular staphylococci, streptococci, enterococci, listeria;
• gram-negative infections, in particular, Escherichia coli and Haemophilus influenzae, salmonella, shigella, pathogens of whooping cough and gonorrhea.

And here pharmacological properties they have different ones.

Ampicillin is characterized by:

• bioavailability – no more than half;
• the period of elimination from the body is several hours.

The daily dose varies from 1000 to 2000 mg. Ampicillin, unlike Amoxicillin, can be administered parenterally. In this case, injections can be done both intramuscularly and intravenously.

In turn, Amoxicillin is characterized by:

• bioavailability – from 75 to 90%; does not depend on food intake;
• The half-life is several days.

The daily dose varies from 500 to 1000 mg. Duration of treatment is five to ten days.

Parenteral penicillins

Parenteral penicillins have one important advantage over Ampicillin and Amoxicillin - the ability to cope with Pseudomonas aeruginosa. It leads to the formation purulent wounds and abscesses, and is also a cause of cystitis and enteritis - infection Bladder and intestines, respectively.

The list of the most common parenteral penicillins includes Ticarcillin, Carbenicillin, Piperacillin.

The first is prescribed for peritonitis, sepsis, septicemia. Effective in the treatment of gynecological, respiratory and skin infections. Prescribed to patients who have the immune system is in unsatisfactory condition.

The second is prescribed in the presence of microorganisms in the abdominal cavity of the genitourinary system, bone tissue. Administered intramuscularly and, in difficult cases, intravenously through a dropper

The third is prescribed for pus in the abdominal cavity, genitourinary system, bone tissue, joints and skin.

Improved penicillins

Ampicillin and Amoxicillin become useless in the presence of beta-lactamases. But the great minds of mankind found a way out of this situation - they synthesized improved penicillins. In addition to the main active substance they contain beta-lactamase inhibitors, these are:

1. Amoxicillin with added clavulanic acid. Generics – Amoxiclav, Flemoclav, Augmentin. Sold in injections and in oral form.
2. Amoxicillin with the addition of sulbactam. In pharmacies it is called Trifamox. Sold in tablets and in oral form.
3. Ampicillin with the addition of sulbactam. In pharmacies it is called Ampisid. Sold by injection. It is used in hospitals for diseases that are difficult for the average person to recognize.
4. Ticarcillin with added clavulanic acid. In pharmacies it is called Timentin. Sold in a form for oral administration.
5. Piperacillin with tazobactam added. In pharmacies it is called Tacillin. Delivered by infusion drip.

Tetracyclines

Tetracyclines are not susceptible to beta-lactamases. And in this they are one step higher than penicillins. Tetracyclines destroy:

• gram-positive microorganisms, in particular staphylococci, streptococci, listeria, clostridia, actinomycetes;
• gram-negative microorganisms, in particular Escherichia coli and Hemophilus influenzae, salmonella, shigella, pathogens of whooping cough, gonorrhea and syphilis.

Their peculiarity is that they pass through the cell membrane, which allows them to kill chlamydia, mycoplasma and ureaplasma. However, they do not have access to Pseudomonas aeruginosa and Proteus.

Tetracycline is commonly found. Also on the list is Doxycycline.

Tetracycline

Undoubtedly, tetracycline is one of the most effective antibiotics. But he has weak sides. First of all, insufficient activity with a high probability of changes in the intestinal microflora. For this reason, you should choose tetracycline not in tablet form, but in ointment form.

Doxycycline

Doxycycline, compared to tetracycline, is quite active with a low probability of changes in intestinal microflora.

Fluoroquinolones

The first fluoroquinolones, such as Ciprofloxacin, Ofloxacin, Norfloxacin, could not be called universal antibiotics. They were only able to cope with gram-negative bacteria.

Modern fluoroquinolones, Levofloxacin, Moxifloxacin, Gatifloxacin, are universal antibiotics.

The disadvantage of fluoroquinolones is that they interfere with the synthesis of peptidoglycan - a kind of building material tendons. As a result, they are not permitted to persons under 18 years of age.

Levofloxacin

Levofloxacin is prescribed for the presence of microorganisms in the respiratory tract, bronchitis and pneumonia, infections in the ENT organs, otitis media and sinusitis, for infections in the skin, as well as for diseases gastrointestinal tract and urinary tract.

The duration of treatment is seven, sometimes ten, days. Dose – 500 mg at a time.

In pharmacies it is sold as Tavanik. Generics are Levolet, Glevo, Flexil.

Moxifloxacin

Moxifloxacin is prescribed for the presence of microorganisms in the respiratory tract, ENT organs, skin, and also as a prophylaxis after surgery.

Duration of treatment is from seven to ten days. Dose – 400 mg at a time.

It is sold in pharmacies as Avelox. There are few generics. Basics active substance is part of Vigamox - eye drops.

Gatifloxacin

Gatifloxacin is prescribed in the presence of microorganisms in the respiratory tract, ENT organs, urogenital tract, as well as serious illnesses eye.

Dose – 200 or 400 mg once.

In pharmacies it is sold as Tabris, Gaflox, Gatispan.

Aminoglycosides

A prominent representative of Aminoglycosides is Streptomycin, a drug that every person has heard of at least once in their life. It is indispensable in the treatment of tuberculosis.

Aminoglycosides are able to cope with most gram-positive and gram-negative bacteria.

Streptomycin

It is efficient. With its help, you can cure not only tuberculosis, but also diseases such as plague, brucellosis and tularemia. As for tuberculosis, localization is not important when using streptomycin. Sold in injections.

Gentamicin

It is gradually becoming a thing of the past, as it is very, very controversial. The fact is that there was hearing damage, up to complete deafness, which the doctors did not expect at all. In this case, the toxic effect is irreversible, i.e. nothing is returned after you stop taking it.

Amikacin

Amikacin is prescribed for peritonitis, meningitis, endocarditis, and pneumonia. Sold in ampoules.

Amphenicols

This group includes Levomycetin. It is prescribed when typhoid fever and paratyphoid fever, typhus, dysentery, brucellosis, whooping cough, intestinal infections. Sold in the form of injections and ointments.

Carbapenems

Carbapenems are intended to treat severe infections. They are able to cope with many bacteria, including those resistant to all the antibiotics listed above.

Carbapenem is:

• Meropenem;
• Ertapenem;
• Imipenem.

Carbapenems are administered using a special dispenser.

Now you know the names of antibiotics, which drugs are antibiotic tablets and which are not. Despite this, under no circumstances should you self-medicate, but seek help from a specialist. Remember that taking these medications incorrectly can seriously harm your health. Be healthy!

Random fact:

The performance of people performing any physical exercise during the day, increases by 15%. —

Article added by user Maria
20.12.2016

Generation of antibiotics

Antibiotics (antimicrobial drugs) are a group of medications used to treat infectious diseases caused by bacteria. Viral diseases, contrary to popular belief, are not treated with antibiotics.

Antibiotics either lead to the death of microbes and bacteria or prevent their reproduction. Antibiotics are divided into main groups, each of which is most effective against certain types bacteria. The choice of one or another antibiotic is determined by the doctor based on the suspected causative agent of the disease. The first antibiotic was penicillin, a substance isolated from a mold colony.

There are two main types of action of antibiotics on bacteria: bactericidal and bacteriostatic. Antibiotics with a bactericidal effect lead to the death of bacteria. Antibiotics with a bacteriostatic effect prevent bacteria from multiplying. Any group of antibiotics is effective against various types bacteria, which is associated with certain mechanisms of action of these drugs. There are the most common groups of antibiotics and diseases for which they need to be used.

Penicillins

Penicillins are a group of antibiotics, which includes the following drugs: Carbenicillin, Azlocillin, Augmentin, Penicillin, Ampicillin, Amoxicillin, Oxacillin and others. They act bactericidal. Penicillins lead to the death of bacteria and destroy their shell. This group belongs to broad-spectrum antibiotics because they are effective against bacteria: meningitis, syphilis pathogens, staphylococci, gonorrhea, streptococci and others. Penicillins are used to treat diseases of the inflammatory respiratory tract (pneumonia, bronchitis), and ENT organs (tonsillitis, sinusitis).

Cephalosporins

Cephalosporins, like penicillins, have a bactericidal effect and destroy the bacterial membrane. Cephalosporins are large group antibiotics, which includes 5 generations of drugs:

• 1st generation: Cephalexin (Lexin), Cefazolin. As is customary, these antibiotics are used in the treatment of diseases of soft tissues and skin (subcutaneous fat, muscles) caused by streptococci and staphylococci: erysipelas, carbuncle, boil and the rest.
• 2 generations: Cefoxitin, Cefuroxime (Zinacef), Cefachlor, and others. According to the rules, they are used to treat diseases of the ENT organs (tonsillitis, sinusitis, tonsillitis), respiratory diseases (pneumonia, bronchitis) and more.
• 3 generations: Ceftazidime (Orzid), Cefotaxime, Ceftriaxone, Cefexime, etc. Most used for the treatment of ENT organs (otitis media, sinusitis, pharyngitis, tonsillitis), various diseases respiratory system(pneumonia, bronchitis). In addition, they are effective in gynecological diseases(cervicitis, endometritis), pyelonephritis, meningitis, cystitis, etc.
• 4 generations: Cefepime is used to treat severe infectious diseases for which other drugs are ineffective: meningitis, peritonitis (inflammation of the peritoneum), pyelonephritis, bronchitis, pneumonia and others.
• 5th generation: Ceftobiprole is used to treat severe infections with weakened immunity (for example diabetes) and is effective for diseases caused by staphylococcus, Pseudomonas aeruginosa, coli(e.coli).

Macrolides

• Macrolides are broad-spectrum antibiotics, including the following drugs: Rovamycin, Vilprafen, Clarithromycin (Klacid), Erythromycin, Azithromycin (Sumamed), etc.

Tetracyclines

• Tetracyclines include the following drugs: Minocycline, Unidox, Tetracycline, Doxycycline, etc.

Aminoglycosides

• Aminoglycosides include: Amikacin, Kanamycin, Neomycin, Gentamicin, etc.

Fluoroquinolones

• Fluoroquinolones are a group antibacterial agents, which includes: Norfloxacin, Ofloxacin, Moxifloxacin, Levofloxacin, Ciprofloxacin, etc.

Levomecithin

• Levomecitin is a broad-spectrum antibiotic that is used for meningitis, brucellosis, typhoid fever and other infectious diseases.

Sulfonamides

• Sulfonamides are antibacterial agents, which include Sulfalen, Trimethoprim, Sulfadiazine, Cotrimoxazole, Biseptol, Streptocide, etc.

Metronidazole

• Metronidazole is an antibacterial drug that is available under various names trade names: Flagyl, Trichopolum, Klion, Metrogil, etc.

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Antibiotics are a group of drugs that can inhibit the growth and development of living cells. They are most often used to treat infectious processes caused by various strains of bacteria. The first drug was discovered in 1928 by British bacteriologist Alexander Fleming. However, some antibiotics are also prescribed for oncological pathologies, as a component of combination chemotherapy. This group of drugs has practically no effect on viruses, with the exception of some tetracyclines. IN modern pharmacology the term “antibiotics” is increasingly being replaced by “antibacterial drugs”.

They were the first to synthesize drugs from the penicillin group. They have helped to significantly reduce the mortality rate of diseases such as pneumonia, sepsis, meningitis, gangrene and syphilis. Over time, due to the active use of antibiotics, many microorganisms began to develop resistance to them. Therefore, the search for new groups became an important task. antibacterial drugs.

Gradually pharmaceutical companies synthesized and began to produce cephalosporins, macrolides, fluoroquinolones, tetracyclines, chloramphenicol, nitrofurans, aminoglycosides, carbapenems and other antibiotics.

Antibiotics and their classification

Basic pharmacological classification Antibacterial drugs are divided according to their effect on microorganisms. Based on this characteristic, two groups of antibiotics are distinguished:

• bactericidal - drugs cause the death and lysis of microorganisms. This effect is due to the ability of antibiotics to inhibit membrane synthesis or suppress the production of DNA components. Penicillins, cephalosporins, fluoroquinolones, carbapenems, monobactams, glycopeptides and fosfomycin have this property.
• bacteriostatic - antibiotics can inhibit the synthesis of proteins by microbial cells, which makes their reproduction impossible. As a result, further development is limited pathological process. This action is typical for tetracyclines, macrolides, aminoglycosides, lincosamines and aminoglycosides.

Based on the spectrum of action, two groups of antibiotics are also distinguished:

• with broad - the drug can be used to treat pathologies caused by a large number of microorganisms;
• with a narrow one - the medicine affects individual strains and types of bacteria.

There is also a classification of antibacterial drugs according to their origin:

• natural - obtained from living organisms;
• semisynthetic antibiotics are modified molecules of natural analogues;
• synthetic - they are produced completely artificially in specialized laboratories.

Description various groups antibiotics

Beta-lactams

Penicillins

Historically, the first group of antibacterial drugs. Has a bactericidal effect on a wide range of microorganisms. Penicillins are divided into the following groups:

• natural penicillins (synthesized in normal conditions mushrooms) - benzylpenicillin, phenoxymethylpenicillin;
• semisynthetic penicillins, which are more resistant to penicillinases, which significantly expands their spectrum of action - oxacillin, methicillin medications;
• with extended action - preparations of amoxicillin, ampicillin;
• penicillins with broad action for microorganisms - medications mezlocillin, azlocillin.

To reduce bacterial resistance and increase the chance of success of antibiotic therapy, penicillinase inhibitors - clavulanic acid, tazobactam and sulbactam - are actively added to penicillins. This is how the drugs “Augmentin”, “Tazocim”, “Tazrobida” and others appeared.

These medications are used for infections of the respiratory (bronchitis, sinusitis, pneumonia, pharyngitis, laryngitis), genitourinary (cystitis, urethritis, prostatitis, gonorrhea), digestive (cholecystitis, dysentery) systems, syphilis and skin lesions. The most common side effects are allergic reactions (urticaria, anaphylactic shock, angioedema).

Penicillins are also the most by safe means for pregnant women and babies.

Cephalosporins

This group of antibiotics has a bactericidal effect on a large number of microorganisms. Today the following generations of cephalosporins are distinguished:

The vast majority of these medications exist only in injection form, therefore they are used mainly in clinics. Cephalosporins are the most popular antibacterial agents for use in hospitals.

These drugs are used to treat a huge number of diseases: pneumonia, meningitis, generalized infections, pyelonephritis, cystitis, inflammation of bones, soft tissues, lymphangitis and other pathologies. Hypersensitivity is common with the use of cephalosporins. Sometimes a transient decrease in creatinine clearance, muscle pain, cough, and increased bleeding (due to a decrease in vitamin K) are observed.

Carbapenems

Are pretty new group antibiotics. Like other beta-lactams, carbapenems have a bactericidal effect. Remain sensitive to this group of medications great amount various strains of bacteria. Carbapenems are also resistant to enzymes synthesized by microorganisms. Data properties have led to them being considered rescue drugs when other antibacterial agents remain ineffective. However, their use is strictly limited due to concerns about the development of bacterial resistance. This group of drugs includes meropenem, doripenem, ertapenem, imipenem.

Carbapenems are used to treat sepsis, pneumonia, peritonitis, acute surgical pathologies abdominal cavity, meningitis, endometritis. These drugs are also prescribed to patients with immunodeficiencies or due to neutropenia.

Side effects include dyspepsia, headache, thrombophlebitis, pseudomembranous colitis, convulsions and hypokalemia.

Monobactams

Monobactams act predominantly only on gram-negative flora. The clinic uses only one active substance from this group - aztreonam. Its advantages include resistance to most bacterial enzymes, which makes it the drug of choice when treatment with penicillins, cephalosporins and aminoglycosides is ineffective. IN clinical guidelines Aztreon is recommended for enterobacter infection. It is used only intravenously or intramuscularly.

Among the indications for use, sepsis should be highlighted, community-acquired pneumonia, peritonitis, infections of the pelvic organs, skin and musculoskeletal system. The use of aztreonam sometimes leads to the development of dyspeptic symptoms, jaundice, toxic hepatitis, headache, dizziness and allergic rash.

Macrolides

Medicines are also characterized by low toxicity, which allows them to be used during pregnancy and during pregnancy. early age child. They are divided into the following groups:

• natural ones, which were synthesized in the 50-60s of the last century - preparations of erythromycin, spiramycin, josamycin, midecamycin;
• prodrugs (converted to the active form after metabolism) - troleandomycin;
• semisynthetic - medications azithromycin, clarithromycin, dirithromycin, telithromycin.

Macrolides are used for many bacterial pathologies: peptic ulcer, bronchitis, pneumonia, ENT infections, dermatosis, Lyme disease, urethritis, cervicitis, erysipelas, impentigo. This group of medications should not be used for arrhythmias or renal failure.

Tetracyclines

Tetracyclines were first synthesized more than half a century ago. This group has a bacteriostatic effect against many strains of microbial flora. In high concentrations they also exhibit a bactericidal effect. A special feature of tetracyclines is their ability to accumulate in bone tissue and tooth enamel.

On the one hand, this allows clinicians to actively use them for chronic osteomyelitis, and on the other hand, it disrupts the development of the skeleton in children. Therefore, they should absolutely not be used during pregnancy, lactation and under the age of 12 years. Tetracyclines, in addition to the drug of the same name, include doxycycline, oxytetracycline, minocycline and tigecycline.

They are used for various intestinal pathologies, brucellosis, leptospirosis, tularemia, actinomycosis, trachoma, Lyme disease, gonococcal infection and rickettsioses. Contraindications also include porphyria, chronic diseases liver and individual intolerance.

Fluoroquinolones

Fluoroquinolones are large group antibacterial agents with a broad bactericidal effect on pathogenic microflora. All drugs are similar to nalidixic acid. The active use of fluoroquinolones began in the 70s of the last century. Today they are classified by generation:

• I - preparations of nalidixic and oxolinic acid;
• II - medications with ofloxacin, ciprofloxacin, norfloxacin, pefloxacin;
• III - levofloxacin preparations;
• IV - medications with gatifloxacin, moxifloxacin, gemifloxacin.

The latest generations of fluoroquinolones are called “respiratory”, due to their activity against microflora, which most often causes the development of pneumonia. They are also used to treat sinusitis, bronchitis, intestinal infections, prostatitis, gonorrhea, sepsis, tuberculosis and meningitis.

Among the disadvantages, it is necessary to highlight the fact that fluoroquinolones can influence the formation of the musculoskeletal system, therefore childhood, during pregnancy and lactation they can be prescribed only for health reasons. The first generation of drugs is also characterized by high hepato- and nephrotoxicity.

Aminoglycosides

Aminoglycosides found active use in treatment bacterial infection caused by gram-negative flora. They have a bactericidal effect. Their high efficiency, which does not depend on the functional activity of the patient’s immune system, has made them indispensable means with its disorders and neutropenia. The following generations of aminoglycosides are distinguished:

Aminoglycosides are prescribed for respiratory system infections, sepsis, infective endocarditis, peritonitis, meningitis, cystitis, pyelonephritis, osteomyelitis and other pathologies. Among the side effects great importance have toxic effects on the kidneys and hearing loss.

Therefore, during the course of therapy it is necessary to regularly biochemical analysis blood (creatinine, GFR, urea) and audiometry. Pregnant women, during lactation, patients with chronic disease kidney or hemodialysis patients, aminoglycosides are prescribed only for health reasons.

Glycopeptides

Glycopeptide antibiotics have a broad-spectrum bactericidal effect. The best known of them are bleomycin and vancomycin. IN clinical practice glycopeptides are reserve drugs that are prescribed when other antibacterial agents are ineffective or the infectious agent is specific to them.

They are often combined with aminoglycosides, which allows increasing the combined effect against Staphylococcus aureus, enterococcus and streptococcus. Glycopeptide antibiotics have no effect on mycobacteria and fungi.

Assign this group antibacterial agents for endocarditis, sepsis, osteomyelitis, phlegmon, pneumonia (including complicated), abscess and pseudomembranous colitis. Glycopeptide antibiotics should not be used for renal failure, hypersensitivity to drugs, lactation, neuritis auditory nerve, pregnancy and lactation.

Lincosamides

Lincosamides include lincomycin and clindamycin. These drugs exhibit a bacteriostatic effect on gram-positive bacteria. I use them mainly in combination with aminoglycosides as a second-line treatment for severe patients.

Lincosamides are prescribed for aspiration pneumonia, osteomyelitis, diabetic foot, necrotizing fasciitis and other pathologies.

Quite often, while taking them, it develops candida infection, headache, allergic reactions and inhibition of hematopoiesis.

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