Indicate semi-synthetic drugs of the penicillin group. Penicillin drugs name

Familiar today antibacterial drugs less than a century ago made a real revolution in medicine. Mankind has received powerful weapon to fight infections that were previously considered fatal.

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

The information provided is for informational purposes and is not a guide to action. All appointments are made exclusively by a doctor, and therapy is under his control.

Despite the low toxicity of penicillins, their uncontrolled use leads to serious consequences: the formation of resistance in the pathogen and the transition of the disease to chronic form difficult to cure. It is for this reason that most strains of pathogenic bacteria are resistant to first-generation ABP today.

Use for antibiotic therapy should be exactly the medication that was prescribed by a specialist. Independent attempts to find cheap analogue and savings can lead to deterioration.

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

When you have to replace the medicine due to an acute lack of finances, you need to ask the doctor about it, since only a specialist can choose the best option.

Penicillins: definition and properties

Preparations of the penicillin group belong to the so-called beta-lactams - chemical compounds that have a beta-lactam ring in their formula.

This structural component is of decisive importance in the treatment of bacterial infectious diseases: it prevents the production of a special peptidoglycan biopolymer by bacteria, which is necessary for the construction of the cell membrane. As a result, the membrane cannot form and the microorganism dies. There is no destructive effect on human and animal cells for the reason that they do not contain peptidoglycan.

Medications based on the waste products of mold fungi are widely used in all areas of medicine due to the following properties:

• High bioavailability - drugs are quickly absorbed and distributed through the tissues. The weakening of the blood-brain barrier during inflammation of the meninges also contributes to the penetration into the cerebrospinal fluid.
• Broad spectrum of antimicrobial action. Unlike first-generation chemicals, modern penicillins are effective against the vast majority of gram-negative and positive bacteria. They are also resistant to penicillinase and the acidic environment of the stomach.
• The lowest toxicity among all ABPs. They are allowed for use even during pregnancy, and the correct intake (as prescribed by the doctor and according to the instructions) almost completely eliminates the development of side effects.

In the process of research and experiments, many medications with different properties were obtained. For example, when belonging to the general series, penicillin and ampicillin are not the same thing. All penicillin antibiotics are well compatible with most other drugs. Concerning complex therapy with other types antibacterial drugs, then the joint use with bacteriostatics weakens the effectiveness of penicillins.

Classification

Careful study of the properties of the first antibiotic showed its imperfection. Despite a fairly wide range of antimicrobial activity and low toxicity, natural penicillin turned out to be sensitive to a special destructive enzyme (penicillinase) produced by some bacteria. In addition, it completely lost its qualities in an acidic gastric environment, therefore it was used exclusively in the form of injections. In search of more effective and stable compounds, various semi-synthetic compounds have been created. medicines.

To date, penicillin antibiotics, a complete list of which is given below, are divided into 4 main groups.

Biosynthetic

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

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

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

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

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

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

See also: Instructions for the use of penicillin in injections and tablets

Semi-synthetic antistaphylococcal

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

For a long time, penicillin was not used to treat staph infection until oxacillin was synthesized from it in 1957. It inhibits the activity of beta-lactamases of the pathogen, but is ineffective against diseases caused by benzylpenicillin-sensitive strains. This group also includes cloxacillin, dicloxacillin, methicillin and others, almost not used in modern medical practice due to increased toxicity.

Antibiotics of the penicillin group in broad spectrum tablets

This includes two subgroups of antimicrobials intended for oral use and having a bactericidal effect against most pathogens (both gram+ and gram-).

Aminopenicillins

Compared with the previous group, these compounds have two significant advantages. Firstly, they are active against a wider range of pathogens, and secondly, they are available in tablet form, which greatly facilitates the use. The disadvantages include sensitivity to beta-lactamase, that is, aminopenicillins (ampicillin and amoxicillin) are unsuitable for the treatment of staphylococcal infections.

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

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

Antipseudomonal

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

According to the degree of efficiency are divided into:

• Carboxypenicillins, the clinical significance of which has recently been declining. Carbenicillin, the first of this subgroup, is also effective against ampicillin-resistant Proteus. Currently, almost all strains are resistant to carboxypenicillins.
• Ureidopenicillins are more effective against Pseudomonas aeruginosa, and can also be prescribed for inflammation caused by Klebsiella. The most effective are Piperacillin and Azlocillin, of which only the latter remains relevant in medical practice.

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

Inhibitor-protected combined

The ampicillin group of antibiotics, highly active against most pathogens, is destroyed by penicillinase-forming bacteria. Since the bactericidal action of oxacillin resistant to them is much weaker than that of ampicillin and amoxicillin, combined drugs were synthesized.

In combination with sulbactam, clavulanate and tazobactam, antibiotics receive a second beta-lactam ring and, accordingly, immunity to beta-lactamases. In addition, inhibitors have their own antibacterial effect, enhancing the main active ingredient.

Inhibitor-protected drugs successfully treat severe nosocomial infections, strains of which are resistant to most drugs.

Read also: About modern classification antibiotics by parameter group

Penicillins in medical practice

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

Pulmonology and otolaryngology

Another discoverer noted the special effectiveness of penicillin against pathogens of respiratory diseases, so the drug is most widely used in this area. Almost all of them have a detrimental effect on bacteria that cause sinusitis, meningitis, bronchitis, pneumonia and other diseases of the lower and upper respiratory tract.

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

Venereology

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

Gastroenterology

Inflammation of the intestines caused by pathogenic microflora responds well to therapy with acid-resistant drugs.

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

Gynecology

In obstetric and gynecological practice, many penicillin preparations from the list are used both to treat bacterial infections of the female reproductive system and to prevent infection in newborns.

Ophthalmology

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

Urology

Diseases of the urinary system, which are of bacterial origin, respond well to therapy only with inhibitor-protected drugs. The remaining subgroups are ineffective, since the strains of pathogens are highly resistant to them.

Penicillins are used in almost all areas of medicine for inflammation caused by pathogenic microorganisms, and not only for treatment. For example, in surgical practice, they are prescribed to prevent postoperative complications.

Features of therapy

Treatment with antibacterial medications in general and penicillins in particular should be carried out only on prescription. Despite the minimal toxicity of the drug itself, its improper use seriously harms the body. In order for antibiotic therapy to lead to recovery, you should follow medical recommendations and know the characteristics of the drug.

Indications

The scope of application of penicillin and various preparations based on it in medicine is due to the activity of the substance with respect to specific pathogens. Bacteriostatic and bactericidal effects are manifested in relation to:

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

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

Contraindications

Strict contraindications include only individual intolerance to benzylpenicillin and other drugs in this group. Also, endolumbar (injection into spinal cord) administration of drugs to patients diagnosed with epilepsy.

During pregnancy, antibiotic therapy with penicillin preparations should be treated with extreme caution. Despite the fact that they have a minimal teratogenic effect, it is worth prescribing tablets and injections only in case of urgent need, assessing the degree of risk to the fetus and the pregnant woman herself.

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

Side effect

Among other antibacterial agents, penicillins are favorably distinguished by their low toxicity.

Undesirable effects of use include:

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

To prevent the development of dysbacteriosis and avoid allergies, timely medical support of the body will help. It is desirable to combine antibiotic therapy with the intake of pre- and probiotics, as well as desensitizers (if sensitivity is increased).

Penicillin antibiotics for children: application features

For children, tablets and injections should be prescribed carefully, given the possible negative reaction, and the choice of a particular drug should be approached thoughtfully.

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

The body of a child is much more sensitive to drugs than that of an adult. Therefore, you should carefully monitor the condition of the baby (penicillin is excreted slowly and, accumulating, can cause convulsions), as well as take preventive measures. The latter include the use of pre- and probiotics for protection intestinal microflora, adherence to a diet and a comprehensive strengthening of immunity.

A little theory:

Historical information

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

Alexander Fleming - discoverer of penicillin

The Egyptians, for example, even 2500 years ago treated inflamed wounds with compresses from moldy bread, but scientists took up the theoretical side of the issue only in the 19th century. European and Russian researchers and doctors, studying antibiosis (the property of some microorganisms to destroy others), made attempts to derive practical benefits from it.

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

In 1941, Ernst Chain and Howard Flory were able to purify penicillin from impurities and conducted clinical trials with Fleming. The results were so successful that by the year 1943, the United States organized mass production of the drug, which saved many hundreds of thousands of lives during the war. The merits of Fleming, Cheyne and Flory before mankind were appreciated in 1945: the discoverer and developers became Nobel Prize winners.

Subsequently, the initial chemical preparation was constantly improved. This is how modern penicillins appeared, resistant to the acidic environment of the stomach, resistant to penicillinase and more effective in general.

Read a fascinating article: The Inventor of Antibiotics or the History of Mankind's Salvation!

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Mushrooms are the kingdom of living organisms. Mushrooms are different: some of them get into our diet, some cause skin diseases, some are so poisonous that they can cause death. But mushrooms of the genus Penicillium save millions of human lives from pathogenic bacteria.

Antibiotics of the penicillin series based on this mold (mold is also a fungus) are still used in medicine.

The discovery of penicillin and its properties

In the 30s of the last century, Alexander Fleming conducted experiments with staphylococci. He studied bacterial infections. After growing a group of these pathogens in a nutrient medium, the scientist noticed that there were areas in the cup that were not surrounded by live bacteria. The investigation showed that the usual green mold, which likes to settle on stale bread, is to blame for these spots. The mold was called Penicillium and, as it turned out, produced a substance that kills staphylococci.

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

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

The next 10 years there was an invisible war between pathogens that destroy penicillin, and scientists that modify this penicillin. So many modifications of penicillin were born, which now form the entire penicillin series of antibiotics.

Pharmacokinetics and principle of action

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

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

The drug is quickly excreted from the body, after 1-3 hours most of it is excreted through the kidneys.

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Classification of antibiotics

All drugs are divided into: natural (short and prolonged action) and semi-synthetic (anti-staphylococcal, broad-spectrum drugs, antipseudomonal).

Natural

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

Benzylpenicillin in the form of sodium and potassium salt refers to natural antibiotics of short action. Its action stops after 3-4 hours, so frequent repeated injections are necessary.

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

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

Semi-synthetic antibiotics of the penicillin group

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

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

Aminopenicillins are broad-spectrum drugs. They are inferior to benzylpenicillins in terms of strength in the fight against gram-positive bacteria, but they capture a larger range of infections. Compared to other drugs, they stay in the body longer and better penetrate some of the body's barriers. Examples of drugs: Ampicillin, Amoxicillin. You can often find Ampiox - Ampicillin + Oxacillin.

Carboxypenicillins and ureidopenicillins antibiotics effective against Pseudomonas aeruginosa. At the moment, they are practically not used, since infections quickly acquire resistance to them. You can occasionally see them as part of complex treatment.

Examples of drugs: Ticarcillin, Piperacillin

List of drugs

Tablets

Sumamed

Active ingredient: azithromycin.

Indications: Respiratory infections.

Contraindications: intolerance, severe kidney failure, childhood up to 6 months.

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: infections sensitive to the drug.

Price: 30-60 rubles.

Amoxicillin Sandoz

Indications: respiratory tract infections (including tonsillitis, bronchitis), urinary tract infections, skin infections, other infections.

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

Indications: streptococcal diseases, infections of mild and moderate severity.

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

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

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

injections

Bicillin-1

Active ingredient: benzathine benzylpenicillin.

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

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

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

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

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

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

Contraindications: hypersensitivity, renal dysfunction, childhood, pregnancy.

Price: 163 rubles.

Benzylpenicillin

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

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: Similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

For the treatment of children, Amoxiclav, Ospamox, Oxacillin are suitable. But Before using the medicine, you must always consult with your doctor to adjust the dose.

Indications for use

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

Most often, antibiotics treat infections of the respiratory tract and genitourinary system.

Application features

In the case of treating children, you need to follow the instructions of the doctor, who will prescribe the desired antibiotic and adjust the dose.

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

Not for the elderly special instructions, although the doctor should take into account the condition of the patient's kidneys and liver when prescribing treatment.

Contraindications and side effects

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

List of side effects

• The development of allergies, from itching and fever to anaphylactic shock and coma.
• Instantaneous development of an allergic reaction in response to the introduction of the drug into a vein.
• Dysbacteriosis, candidiasis.

In case of side effects, you should immediately contact for medical care, stop the drug and carry out symptomatic treatment.

Frequently asked Questions

Where does penicillin mold grow?

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

How to replace penicillin antibiotics?

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

Antibiotics from the penicillin series - strong remedy against infections caused by various bacteria. There are quite a few of them, and treatment must be selected in accordance with the type of pathogen.

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

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Antibiotics of the penicillin group are the first drugs created from the waste products of certain types of bacteria. AT general classification Penicillin antibiotics belong to the beta-lactam class of drugs. In addition to them, non-penicillin antibiotics are also included here: monobactams, cephalosporins and carbapenems.

The similarity is due to the fact that these drugs contain four-membered ring. All antibiotics of this group are used in chemotherapy and play an important role in the treatment of infectious diseases.

Properties of penicillin and its discovery

Before the discovery of antibiotics, many diseases seemed simply incurable, scientists and doctors around the world wanted to find a substance that could help defeat pathogenic microorganisms, while not causing damage to human health. People died from sepsis, wounds infected with bacteria, gonorrhea, tuberculosis, pneumonia and other dangerous and serious diseases.

The key point in medical history is 1928 It was in this year that penicillin was discovered. Millions of human lives for this discovery are due to Sir Alexander Fleming. The accidental appearance of mold on the nutrient medium of the Penicillium notatum group in Fleming's laboratory and the observation of the scientist himself gave a chance to fight against infectious diseases.

After the discovery of penicillin, scientists faced only one task - to isolate this substance in its pure form. This case turned out to be quite complicated, but in the late 30s of the 20th century, two scientists Ernst Cheyne and Howard Flory managed to create a drug with an antibacterial effect.

Properties of antibiotics of the penicillin group

antibiotic penicillin inhibits the emergence and development pathogenic organisms such as:

• meningococci;
• gonococci;
• streptococci;
• staphylococci;
• tetanus stick;
• pneumococci;
• anthrax;
• botulism stick;
• diphtheria bacillus, etc.

This is only a small list of those pathogenic bacteria in which penicillin and all drugs of the penicillin series suppress vital activity.

The antibiotic effect of penicillin is bactericidal or bacteriostatic. In the latter case, we are talking about the complete destruction of pathogenic organisms that caused the disease, most often acute and extremely severe. For diseases of moderate severity, antibiotics with a bacteriostatic effect are used - they do not allow bacteria to divide.

Penicillin is an antibiotic with a bactericidal effect. Microbes in their structure have a cell wall in which the main substance is peptidoglycan. This substance gives the bacterial cell stability, preventing it from dying even in very unsuitable conditions for life. By acting on the cell wall, penicillin destroys its integrity and disables its work.

In the human body, cell membranes do not contain peptidoglycan and therefore antibiotics of the penicillin group do not have a negative effect on our body. Also, we can talk about a small toxicity of these funds.

Penicillins have a wide range of dosages used, this is for human body safer, because it makes it possible for a particular patient to choose a therapeutic dosage with minimal side effects.

The main part of penicillin is excreted from the body by the kidneys with urine (more than 70%). Some antibiotics of the penicillin group are excreted using the biliary system, that is, they are excreted with bile.

List of drugs and classification of penicillins

The basis of the chemical compound of the penicillin group is beta-lactam ring, therefore they belong to beta-lactama drugs.

Since penicillin has been used in medical practice for more than 80 years, some microorganisms have developed resistance to this antibiotic in the form of the beta-lactamase enzyme. The mechanism of the enzyme's work consists in the connection of the hydrolytic enzyme of a pathogenic bacterium with the beta-lactam ring, which in turn facilitates their binding, and as a result, the inactivation of the drug.

To date, semi-synthetic antibiotics are most often used: it is taken as a basis chemical composition natural antibiotic and undergoes useful modifications. Due to this, humanity can still resist various bacteria that constantly produce different antibiotic resistance mechanisms.

To date, the Federal Application Guidelines medicines such a classification of penicillins is given.

Short acting natural antibiotics

Natural antibiotics do not contain beta-lactamase inhibitors, so they are never used against diseases caused by staphylococcus aureus.

Benzylpenicillin is active during treatment:

• lobar pneumonia;
• anthrax;
• bronchitis;
• pleurisy;
• peritonitis;
• sepsis;
• diseases of the genitourinary system;
• meningitis (in adults and in children from 2 years old);
• skin infections;
• wound infections;
• ENT diseases.

Side effects: for all antibiotics of the penicillin series, the main side effect is an allergic response of the body in the form of urticaria, anaphylactic shock, hyperthermia, Quincke's edema, skin rashes, nephritis. Possible failures in the work of the heart. During the introduction of significant dosages - convulsions (in children).

Restrictions on use and contraindications: hay fever, allergy to penicillin, impaired kidney function, arrhythmia, bronchial asthma.

Natural antibiotics with prolonged action

Benzylpenicillin benzathine is used in cases of:

• inflammation of the tonsils;
• syphilis;
• wound infections;
• scarlet fever.

It is also used to prevent complications after surgery.

Side effects: anemia, allergic response, abscess at the injection site of the antibiotic, headache, thrombocytopenia and leukopenia.

Contraindications: hay fever, bronchial asthma, propensity to allergies to penicillin.

Benzylpenicillin procaine is used in the treatment of:

• septic endocarditis,
• acute inflammatory diseases of the respiratory organs;
• osteomyelitis;
• meningitis;
• processes of inflammation of the biliary and urinary tract;
• peritonitis;
• eye diseases;
• dermatoses;
• wound infections.

It is used for relapses of erysipelas and rheumatism.

Side effect: convulsions, nausea, allergic reaction.

Contraindications: hypersensitivity to procaine and penicillin.

Antistaphylococcal agents

Oxacillin is the main representative of this group of antibiotics. The result of treatment is similar to benzylpenicillin, but unlike the second, this drug can destroy staphylococcal infections.

Side effects: skin rashes, urticaria. Rarely - anaphylactic shock, edema, fever, digestive disorders, vomiting, nausea, hematuria (in children), jaundice.

Contraindications: allergic reactions to penicillin.

Broad spectrum drugs

As an active substance, ampicillin is used in many antibiotics. Used to treat acute infections urinary and respiratory tract, infectious diseases of the digestive system, chlamydial infections, endocarditis, meningitis.

List of antibiotics that contain ampicillin: Ampicillin sodium salt, Ampicillin trihydrate, Ampicillin-Inotec, Ampicillin AMP-Forte, Ampicillin-AKOS, etc.

Amoxicillin is modified derivative of ampicillin. It is considered the main antibiotic, which is taken orally only. Used for meningococcal infections, acute respiratory diseases, Lyme disease, processes of inflammation of the gastrointestinal tract. It is used to prevent anthrax in women during pregnancy and children.

List of antibiotics that contain amoxicillin: Amoxicillin Sandoz, Amoxicar, Amoxicillin DS, Amoxicillin-ratiopharm, etc.

Side effects: dysbacteriosis, dyspeptic disorders, allergies, candidiasis, superinfection, CNS disorders.

Contraindications for this group of penicillins: hypersensitivity, mononucleosis, impaired liver function. Ampicillin is prohibited for newborns up to one month.

Antipseudomonal antibiotics

Carboxypenicillins contain active ingredient– carbenicillin. In this case, the name of the antibiotic is the same as the active ingredient. It is used in the treatment of diseases that are caused by Pseudomonas aeruginosa. Today, they are almost never used in medicine due to the availability of more powerful drugs.

Ureidopenicillins include: Azlocillin, Piperacillin, Mezlocillin.

Side effect: nausea, eating disorders, urticaria, vomiting. Possible headache, drug-induced fever, superinfection, impaired renal function.

Contraindications: pregnancy, high sensitivity to penicillin.

Features of the use of antibiotics of the penicillin group in children

The use of antibiotics in pediatric treatment much attention is constantly paid, since the child's body has not yet fully formed and most of the organs and systems still not fully functional. Therefore, the choice of antibiotics for infants and growing children, doctors must be treated with great responsibility.

Penicillin in newborns is used for toxic diseases and sepsis. In the first years of life in children, it is used to treat otitis, pneumonia, meningitis, pleurisy.

With angina, SARS, cystitis, bronchitis, sinusitis, as a rule, children are prescribed Flemoxin, Amoxicillin, Augmentin, Amoxiclav. These antibiotics in relation to the child's body are the least toxic and the most effective.

Dysbacteriosis is one of the complications of antibiotic therapy, since beneficial microflora in children dies simultaneously with pathogenic microorganisms. Therefore, antibiotic treatment must be combined with the intake of probiotics. A rare side effect is an allergy to penicillin. in the form of a skin rash.

In infants, the excretory work of the kidneys is not sufficiently developed and the accumulation of penicillin is likely in the body. The result of this is the appearance of seizures.

Treatment with any antibiotics, even latest generation always has a significant effect on health. Naturally, from the main infectious disease they relieve, however, overall immunity is also significantly reduced. Since not only pathogenic bacteria die, but also healthy microflora. Therefore, it will take some time to restore the protective forces. If pronounced side effects, especially those associated with the gastrointestinal tract, then a sparing diet is needed.

Be sure to use probiotics and prebiotics (Bifidumbacterin, Linex, Bifiform, Acipol, etc.). The beginning of the reception must occur simultaneously with the start of the use of an antibacterial agent. At the same time, after a course of antibiotics, prebiotics and probiotics must be used for about 14 more days to populate the stomach with beneficial bacteria.

When antibiotics have a toxic effect on the liver, the use of hepatoprotectors can be recommended. These drugs will protect healthy liver cells and restore damaged ones.

Since immunity is reduced, the body is particularly susceptible to colds. Therefore, you need to take care of yourself and not overcool. Use immunomodulators, while it is desirable that they be plant origin(Purple Echinacea, Immunal).

If the disease is of viral etiology, then in this case antibiotics are powerless, even the latest generation and a wide spectrum of action. They can only serve as a preventive measure in joining viral infection bacterial. Antivirals are used to treat viruses.

In order to reduce the use of antibiotics and get sick less often, it is necessary to healthy lifestyle life. The most important thing is not to overdo it with the use of antibacterial agents in order to prevent the development of bacterial resistance to them. Otherwise, it will not be possible to cure any infection. Therefore, always consult your doctor before using any antibiotic.

Antibiotics of the penicillin series are several types of drugs that are divided into groups. In medicine, funds are used to treat various diseases of infectious and bacterial origin. The drugs have a minimum number of contraindications and are still used to treat various patients.

Discovery history

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

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

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

The discovery helped save many lives. Saved humanity from those diseases that previously caused panic among the population. Naturally, modern medicines have a relative similarity with those drugs that were used at the end of the 19th century. But the essence of medicines, their action has not changed so dramatically.

Penicillin antibiotics were able to revolutionize medicine. But the joy of discovery did not last long. It turned out that pathogenic microorganisms, bacteria can mutate. They mutate and become insensitive to drugs. As a result, penicillin-type antibiotics have undergone significant changes.

Scientists for almost the entire 20th century waged a “struggle” with microorganisms and bacteria, trying to create ideal drug. Efforts were not in vain, but such improvements have led to the fact that antibiotics have changed significantly.

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

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

Important: There are practically no contraindications for such medicines. It is not recommended to take them in the presence of individual intolerance to antibiotics, as well as in the event of an allergic reaction.

Modern antibacterial agents are significantly different from penicillin, which is familiar to many. In addition to the fact that today you can easily buy medicines of this class in tablets, there are a great many varieties of them. Classification, the generally accepted division into groups, will help to understand the preparations.

Antibiotics: classification

Antibiotics of the penicillin group are conditionally divided into:

1. Natural.
2. Semi-synthetic.

All medicines based on mold are antibiotics of natural origin. Today, such medicines are practically not used in medicine. The reason is that pathogenic microorganisms have become immune to them. That is, the antibiotic does not act on bacteria in the proper way, to achieve the desired result in the treatment is obtained only with the introduction of a high dose of the drug. The means of this group include: Benzylpenicillin and Bicillin.

The drugs are available in the form of a powder for injection. They effectively affect: anaerobic microorganisms, gram-positive bacteria, cocci, etc. since the medicines are of natural origin, they cannot boast of a long-term effect, injections are often done every 3-4 hours. This allows not to reduce the concentration of the antibacterial agent in the blood.

Penicillin antibiotics of semi-synthetic origin are the result of modification of preparations made from a mold fungus. Medicines belonging to this group managed to give some properties, first of all, they became insensitive to the acid-base environment. That allowed to produce antibiotics in tablets.

And also there were medicines that acted on staphylococci. This class of drugs is different from natural antibiotics. But the improvements have had a significant impact on the quality of drugs. They are poorly absorbed, have a not so wide sector of action, and have contraindications.

Semi-synthetic drugs can be divided into:

• Isoxazolpenicillins are a group of drugs that act on staphylococci, as an example, the names of the following drugs can be given: Oxacillin, Nafcillin.
• Aminopenicillins - several drugs belong to this group. They differ in a wide sector of action, but are significantly inferior in strength to antibiotics of natural origin. But they can fight a large number of infections. Means from this group remain in the blood longer. Such antibiotics are often used to treat various diseases, for example, 2 very well-known drugs can be given: Ampicillin and Amoxicillin.

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

Indications and contraindications for taking drugs

Antibiotics belonging to the penicillin group are prescribed by a doctor. Drugs are recommended to be taken in the presence of:

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

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

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

What are the contraindications for drugs:

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

Direct contraindications for the use of antibiotics:

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

Attention! The main side effect of taking medications is considered prolonged diarrhea and candidiasis. They are due to the fact that drugs affect not only pathogens, but also beneficial microflora.

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

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

List of drugs that doctors prescribe to patients

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

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

List or list of antibiotics of the penicillin series, which is available in powder form:

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

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

Prices for medicines

Sumamed - the cost varies from 300 to 500 rubles.

Amoxicillin tablets - the price is about 159 rubles. for packing.

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

Ampicillin in the form of a powder intended for injection - 170 rubles.

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

Amoxiclav - cost-120 rubles.

Ospamox - the price varies from 65 to 100 rubles.

Benzylpenicillin novocaine salt - 50 rubles.

Benzylpenicillin - 30 rubles.

Antibiotics for a child

Preparations based on penicillin (mold fungus) for the treatment of children are used only if indicated.

Most often, doctors prescribe to small patients:

• Amoxiclav can be prescribed to a newborn child, as well as an infant under the age of 3 months. The dosage is calculated according to the scheme, based on the condition of the child, his weight and the severity of the symptoms.
• Oxacillin - the drug is taken under the supervision of a doctor, it can be prescribed to a newborn if indicated. Antibacterial therapy is carried out under the supervision of a physician.
• Ospamox - the doctor calculates the dosage for children. It is determined according to the scheme (30-60 mg is divided per kg of weight and the number of doses per day).

Carefully! Conducting antibiotic therapy in children has its own nuances. For this reason, you should not independently prescribe such medicines to a child. There is a risk of making a mistake with the dosage and causing serious harm to the health of the baby.

Antibiotics related to penicillins are quite effective. They were discovered at the end of the 19th century and have found wide application in medicine. Despite the fact that pathogenic microorganisms often mutate, drugs of this class are still in demand.

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Antibiotics of the penicillin series are still used in medicine.

The discovery of penicillin and its properties

In the 30s of the last century, Alexander Fleming conducted experiments with staphylococci. He studied bacterial infections. After growing a group of these pathogens in a nutrient medium, the scientist noticed that there were areas in the cup that were not surrounded by live bacteria. The investigation showed that the usual green mold, which likes to settle on stale bread, is “guilty” of these spots. The mold was called Penicillium and, as it turned out, produced a substance that kills staphylococci.

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

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

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

Expert opinion

Astafiev Igor Valentinovich

Neurologist - City Pokrovskaya Hospital. Education: Volgograd State Medical University, Volgograd. Kabardino-Balkarian State University them. HM. Berbekova, Nalchik.

The next 10 years there was an invisible war between pathogens that destroy penicillin, and scientists that modify this penicillin. So many modifications of penicillin were born, which now form the entire penicillin series of antibiotics.

Pharmacokinetics and principle of action

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

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

The drug is quickly excreted from the body, after 1-3 hours most of it is excreted through the kidneys.

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Classification of antibiotics

All drugs are divided into: natural (short and prolonged action) and semi-synthetic (anti-staphylococcal, broad-spectrum drugs, antipseudomonal).

Natural

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

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

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

Expert opinion

Mitrukhanov Eduard Petrovich

Doctor - neurologist, City Polyclinic, Moscow. Education: Russian State Medical University, GBOU DPO Russian medical Academy postgraduate education Ministry of Health of the Russian Federation, Volgograd State Medical University, Volgograd.

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

Semi-synthetic antibiotics of the penicillin group

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

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

Aminopenicillins are broad-spectrum drugs. Inferior to benzylpenicillins in strength in the fight against gram-positive bacteria, but cover a larger range of infections. Compared to other drugs, they stay in the body longer and better penetrate some of the body's barriers. Examples of drugs: Ampicillin, Amoxicillin. You can often find Ampiox - Ampicillin + Oxacillin.

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

Examples of drugs: Ticarcillin, Piperacillin

List of drugs

Tablets

Sumamed

Active ingredient: azithromycin.

Indications: Respiratory infections.

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

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: infections sensitive to the drug.

Price: 30-60 rubles.

Amoxicillin Sandoz

Indications: respiratory tract infections (including tonsillitis, bronchitis), infections of the genitourinary system, skin infections, other infections.

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

Indications: streptococcal diseases, infections of mild and moderate severity.

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

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

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

injections

Bicillin-1

Active ingredient: benzathine benzylpenicillin.

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

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

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

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

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

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

Contraindications: hypersensitivity, impaired renal function, childhood, pregnancy.

Price: 163 rubles.

Benzylpenicillin

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

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: Similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

For the treatment of children, Amoxiclav, Ospamox, Oxacillin are suitable. But Before using the medicine, you must always consult with your doctor to adjust the dose.

Indications for use

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

Most often, antibiotics treat infections of the respiratory tract and genitourinary system.

Application features

In the case of treating children, you need to follow the instructions of the doctor, who will prescribe the desired antibiotic and adjust the dose.

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

For the elderly, there are no special instructions, although the doctor should take into account the condition of the patient's kidneys and liver when prescribing treatment.

Contraindications and side effects

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

List of side effects

• The development of allergies - from itching and fever to anaphylactic shock and coma.
• Instantaneous development of an allergic reaction in response to the introduction of the drug into a vein.
• Dysbacteriosis, candidiasis.

In case of side effects, you should immediately seek medical help, stop the drug and carry out symptomatic treatment.

Content

Penicillins were discovered at the beginning of the 20th century, but medical science has continuously improved their properties. So, modern drugs received resistance to penicillinase, which deactivated them earlier, and became immune to the acidic gastric environment.

Classification of penicillins

A group of antibiotics produced by molds of the genus Penicillium are called penicillins. They are active against most gram-positive, some gram-negative microbes, gonococci, spirochetes, meningococci. Penicillins are part of a large group of beta-lactam antibiotics. They are divided into natural and semi-synthetic, have common properties low toxicity, wide dosage range.

Classification of antibiotics:

1. Natural (benzylpenicillins, bicillins, phenoxymethylpenicillin).
2. Isoxazolpenicillins (oxacillin, flucloxacillin).
3. Amidinopenicillins (amdinocillin, acidocillin).
4. Aminopenicillins (ampicillin, amoxicillin, pivampicillin).
5. Carboxypenicillins (carbenicillin, carindacillin, ticarcillin).
6. Ureidopenicillins (azlocillin, piperacillin, mezlocillin).

According to the source of receipt, spectrum of action and combination with beta-lactamases, antibiotics are divided into:

1. Natural: benzylpenicillin, phenoxymethylpenicillin.
2. Antistaphylococcal: oxacillin.
3. Extended spectrum (aminopenicillins): ampicillin, amoxicillin.
4. Active against Pseudomonas aeruginosa (Pseudomonas aeruginosa): carboxypenicillins (ticarcillin), ureidopenicillins (azlocillin, piperacillin).
5. Combined with beta-lactamase inhibitors (inhibitor-protected): in combination with clavunate amoxicillin, ticarcillin, ampicillin / sulbactam.

Preparations of the penicillin group

Antibiotics of a number of penicillins are available in the form of tablets and injections, sold by prescription from a doctor, but over-the-counter drugs are also found.

They are used in dentistry, otorhinolaryngology, surgery, urology, gynecology, ophthalmology, venereology.

Tablets

The penicillin series of antibiotics is represented by popular tablets:

Injections

Antibiotics of the penicillin group in the form of injections:

Penicillin antibiotics for children

Doctors prescribe penicillin antibiotics to children with caution because they have an increased risk of adverse effects. In the first years of life, the child is given benzylpenicillins to treat sepsis, meningitis, pneumonia. Contraindications are: intolerance to the components of the composition, insufficiency of the kidneys, liver.

Children's organism is more sensitive to antibiotics. Penicillins can accumulate, causing seizures. List of oral remedies used to treat bacterial diseases for children:

• Amoxicillin;
• Augmentin;
• Amoxiclav.

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Familiar today antibacterial drugs less than a century ago made a real revolution in medicine. Mankind has received a powerful weapon to fight infections that were previously considered fatal.

The first were the antibiotics penicillins, which saved many thousands of lives during the Second World War, and are relevant in modern medical practice. It was with them that the era of antibiotic therapy began.

Antibiotics of the penicillin series: a list of drugs, a brief description and analogues

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

The information provided is for informational purposes and is not a guide to action. All appointments are made exclusively by a doctor, and therapy is under his control.

Despite the low toxicity of penicillins, their uncontrolled use leads to serious consequences: the formation of resistance in the pathogen and the transition of the disease to a chronic form that is difficult to treat. It is for this reason that most strains of pathogenic bacteria are resistant to first-generation ABP today.

Use for antibiotic therapy should be exactly the medication that was prescribed by a specialist. Independent attempts to find a cheap analogue and save money can lead to a deterioration in the condition.

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

If you need to replace the prescribed drug with another drug, you should consult your doctor.

Penicillins: definition and properties

Preparations of the penicillin group belong to the so-called beta-lactams - chemical compounds that have a beta-lactam ring in their formula.

This structural component is of decisive importance in the treatment of bacterial infectious diseases: it prevents the production of a special peptidoglycan biopolymer by bacteria, which is necessary for the construction of the cell membrane. As a result, the membrane cannot form and the microorganism dies. There is no destructive effect on human and animal cells for the reason that they do not contain peptidoglycan.

Medications based on the waste products of mold fungi are widely used in all areas of medicine due to the following properties:

• High bioavailability - drugs are quickly absorbed and distributed through the tissues. The weakening of the blood-brain barrier during inflammation of the meninges also contributes to the penetration into the cerebrospinal fluid.
• Broad spectrum of antimicrobial action. Unlike first-generation chemicals, modern penicillins are effective against the vast majority of gram-negative and gram-positive bacteria. They are also resistant to the acidic environment of the stomach.
• Low toxicity. They are allowed for use even during pregnancy, and the correct intake (as prescribed by the doctor and according to the instructions) almost completely eliminates the development of side effects.

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

Classification of penicillins

Careful study of the properties of the first antibiotic showed its imperfection. Despite a fairly wide range of antimicrobial activity and low toxicity, natural penicillin turned out to be sensitive to a special destructive enzyme (penicillinase) produced by some bacteria. In addition, it completely lost its qualities in an acidic gastric environment, therefore it was used exclusively in the form of injections. In search of more effective and stable compounds, various semi-synthetic drugs have been created.

To date, penicillin antibiotics, a complete list of which is given below, are divided into 4 main groups.

Biosynthetic

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

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

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

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

These drugs are used for long-term antibiotic therapy of chronic rheumatism, syphilis, focal streptococcal infection.

Phenoxymethylpenicillin ® is another form of benzylpenicillin intended for the treatment of moderate infectious diseases. It differs from those described above in resistance to hydrochloric acid of gastric juice.

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

Semi-synthetic antistaphylococcal

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

For a long time, penicillin was not used to treat staphylococcal infections, until it was synthesized on its basis in 1957. It inhibits the activity of beta-lactamases of the pathogen, but is ineffective against diseases caused by benzylpenicillin-sensitive strains. This group also includes cloxacillin, dicloxacillin and others, almost not used in modern medical practice due to increased toxicity.

Antibiotics of the penicillin group in broad spectrum tablets

This includes two subgroups of antimicrobials intended for oral use and having a bactericidal effect against most pathogens (both gram+ and gram-).

Aminopenicillins

Compared with the previous group, these compounds have two significant advantages. Firstly, they are active against a wider range of pathogens, and secondly, they are available in tablet form, which greatly facilitates the use. The disadvantages include sensitivity to beta-lactamase, that is, aminopenicillins (ampicillin ® and amoxicillin ®) are unsuitable for the treatment of staphylococcal infections.

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

The preparations are well absorbed and act for a long time, which reduces the frequency of use to 2-3 times per 24 hours.

The main indications for use are:

• tonsillitis;
• bronchitis;
• pneumonia;
• infectious diseases ,
• enterocolitis and eradication (causative agent of stomach ulcers).

A common side effect of aminopenicillins is a characteristic non-allergic rash that disappears immediately after withdrawal. The appearance of a rash is most often observed in patients with infectious mononucleosis.

Antipseudomonal

They are a separate penicillin series of antibiotics used to treat Pseudomonas aeruginosa. Antibacterial activity is similar to aminopenicillins (with the exception of Pseudomonas) and is pronounced in relation to.

According to the degree of efficiency are divided into:

• Carboxypenicillins, the clinical significance of which has recently been declining. Carbenicillin ® , the first of this subgroup, is also effective against ampicillin-resistant Proteus. Currently, almost all strains are resistant to carboxypenicillins.
• Ureidopenicillins are more effective against Pseudomonas aeruginosa, and can also be prescribed for inflammation caused by Klebsiella. The most effective are Piperacillin ® and Azlocillin ® , of which only the latter remains relevant in medical practice.

To date, the vast majority of strains of Pseudomonas aeruginosa are resistant to carboxypenicillins and ureidopenicillins. For this reason, they are used only after receiving the results of crops on the sensitivity of bacteria to antibiotics.

Inhibitor-protected combined

The ampicillin group of antibiotics, highly active against most pathogenic bacteria, is destroyed by penicillinase-forming bacteria. Combined drugs have been synthesized to overcome bacterial resistance.

In combination with sulbactam, clavulanate and tazobactam, antibiotics receive a second beta-lactam ring and, accordingly, immunity to beta-lactamases. In addition, inhibitors have their own antibacterial effect, enhancing the main active ingredient.

Inhibitor-protected drugs successfully treat severe nosocomial infections, strains of which are resistant to most drugs.

Penicillins in medical practice

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

Pulmonology and otolaryngology

Another discoverer noted the special effectiveness of penicillin against pathogens of respiratory diseases, so the drug is most widely used in this area. Almost all of them have a detrimental effect on bacteria that cause pneumonia and other diseases of the lower and upper respiratory tract.

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

Venereology

Spirochetes are one of the few microorganisms that have retained susceptibility to benzylpenicillin and its derivatives. Benzylpenicillins are also effective against gonococci, which allows for successful treatment with minimal negative effects on the patient's body.

Gastroenterology

Inflammation of the intestines caused by pathogenic microflora responds well to therapy with acid-resistant drugs.

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

Gynecology

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

Urology

Diseases of the urinary system, which are of bacterial origin, respond well to therapy only with inhibitor-protected drugs. The remaining subgroups are ineffective, since the strains of pathogens are highly resistant to them.

Penicillins are used in almost all areas of medicine for inflammation caused by pathogenic microorganisms, and not only for treatment. For example, in surgical practice, they are prescribed to prevent postoperative complications.

Features of therapy

Treatment with antibacterial medications in general and penicillins in particular should be carried out only on prescription.

Despite the minimal toxicity of the drug itself, its improper use seriously harms the body. In order for antibiotic therapy to lead to recovery, you should follow medical recommendations and know the characteristics of the drug.

Indications

The scope of application of penicillin and various preparations based on it in medicine is due to the activity of the substance with respect to specific pathogens. Bacteriostatic and bactericidal effects are manifested in relation to:

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

Contraindications

Strict contraindications include only individual intolerance to benzylpenicillin and other drugs in this group. Also, endolumbar (injection into the spinal cord) administration of drugs to patients with diagnosed epilepsy is not allowed.

During pregnancy, antibiotic therapy with penicillin preparations should be treated with extreme caution. Despite the fact that they have a minimal teratogenic effect, it is worth prescribing tablets and injections only in case of urgent need, assessing the degree of risk to the fetus and the pregnant woman herself.

Since penicillin and its derivatives freely penetrate from the bloodstream into breast milk, it is advisable to refuse breastfeeding for the duration of therapy. The medicine can provoke an allergic reaction in the baby even at the first use. To prevent lactation, milk must be expressed regularly.

Side effect

Among other antibacterial agents, penicillins are favorably distinguished by their low toxicity.

Undesirable effects of use include:

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

Timely medical support of the body will help prevent the development of dysbacteriosis. It is desirable to combine antibiotic therapy with the intake of pre- and probiotics.

Penicillin antibiotics for children: application features

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

The body of a child is much more sensitive to drugs than that of an adult. Therefore, you should carefully monitor the condition of the baby, as well as take preventive measures. The latter include the use of pre- and probiotics to protect the intestinal microflora, diet and comprehensive strengthening of immunity.

A little theory:

Historical information

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

The Egyptians, for example, even 2500 years ago treated inflamed wounds with compresses from moldy bread, but scientists took up the theoretical side of the issue only in the 19th century. European and Russian researchers and doctors, studying antibiosis (the property of some microorganisms to destroy others), made attempts to derive practical benefits from it.

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

In 1941, Ernst Chain and Howard Flory were able to purify penicillin from impurities and conducted clinical trials with Fleming. The results were so successful that by the year 1943, the United States organized mass production of the drug, which saved many hundreds of thousands of lives during the war. The merits of Fleming, Cheyne and Flory before mankind were appreciated in 1945: the discoverer and developers became Nobel Prize winners.

Subsequently, the initial chemical preparation was constantly improved. This is how modern penicillins appeared, resistant to the acidic environment of the stomach, resistant to penicillinase and more effective in general.

On our site you can get acquainted with most groups of antibiotics, complete lists of their drugs, classifications, history and other important information. For this, a section "" has been created in the top menu of the site.

Antibiotics are substances that are produced by microorganisms or synthesized using medical technology from natural raw materials. These drugs are used to suppress the growth and development of colonies of pathogenic agents that have entered the human body.

Antibiotics of the penicillin group are the first drugs from this area that were used in clinical practice. And, despite the fact that almost 100 years have passed since their discovery, and the list of antimicrobial agents has been replenished with cephalosporin, fluoroquinol and other drugs, penicillin-type compounds still remain the main antibacterial drugs for stopping a huge list of infectious diseases.

A bit of history

The discovery of penicillin happened quite by accident: in 1928, a scientist working in one of the London hospitals, Alexander Fleming, discovered a mold that had grown on a nutrient medium, which was capable of destroying staphylococcus colonies.

The active substance of the microscopic mold filamentous fungus Penicillium notatum, the researcher called penicillin. Already 12 years later, the first antibiotic was isolated in its pure form, and in 1942, the Soviet microbiologist Zinaida Ermolyeva obtained a preparation from another type of fungus - Penicillium crustosum.

Since the second half of the 20th century, an unlimited amount of penicillin G (or benzylpenicillin) has become available to combat a wide variety of diseases.

Operating principle

The described active substance acts bactericidal and bacteriostatically on pathogens. The mechanism of the bactericidal scheme of the work of drugs included in the penicillin type (series) is associated with damage to the cell walls (violation of the integrity of the structure) of infectious agents, which leads to the death of microorganisms.

The bacteriostatic principle of action on pathogens is characterized by a temporary suppression of the ability of pathogens to reproduce.

The type of drug exposure is selected taking into account the severity of the development of the disease.

Most penicillins in small doses affect microbes bacteriostatically. With an increase in the amount of the drug involved, the effect changes to bactericidal. Only a doctor can choose a specific dosage of a drug of the penicillin group; it is impossible to use antibiotics for treatment on your own.

Systematization of drugs

Among the natural penicillins, in addition to benzylpenicillin (and its various salts - sodium, potassium) also include:

• Phenoxymethylpenicillin;
• Benzathine benzylpenicillin.

The basic principles for the classification of semi-synthetic types of penicillin are listed below.

• isoxazolyl-penicillins (Oxacillin, Nafcillin);
• amino-penicillins (Amoxicillin, Ampicillin);
• aminodi-penicillins (there are no medicines registered in the Russian Federation.);
• carboxy-penicillins (Carbenicillin);
• ureido-penicillins (Piperacillin, Azlocillin);
• inhibitor-protected penicillins (Piperacillin in combination with tazobactam, Ticarcillin in combination with clavulanate, Ampicillin in combination with sulbactam).

Brief description of natural medicines

Natural (natural) penicillins are drugs that have a narrow spectrum of effects on microorganisms. Due to their long (and often uncontrolled) use for medical purposes, most pathogens have managed to acquire immunity to these types of antibiotics.

Today, in the treatment of diseases, the drugs Bicillin and Benzylpenicillin are most often used, which are quite effective against some anaerobic agents, spirochetes, a number of cocci and gram-positive pathogens.

Gram-negative bacteria H.ducreyi, P.multocida, Neisseria spp., as well as Listeria, varieties of corynebacteria (in particular, C.diphtheriae) are still sensitive to natural antibiotics.

The method of using drugs to prevent the development of these pathogens is injection.

Natural penicillins, according to experts, have one major drawback: they are destroyed under the influence of beta-lactamases (enzymes that are produced by certain microorganisms). That is why natural antibiotics belonging to the penicillin group are not used to treat ailments caused by staphylococcal infections.

Description of synthesized types of drugs

A number of semi-synthetic drugs included in the penicillin antibiotic series, and united in the aminodipenicillin group, are not registered in our country. Acidocillin, Amdinocillin, Bakamdinocillin are medicines with a narrow spectrum of action and are effective against gram-negative enterobacteria.

The remaining synthesized groups of drugs are widely used in medical institutions in Russia and require more detailed consideration.

Antistaphylococcal (penicillinase-stable) drugs

Another name for this group of antibiotics is isoxazolylpenicillins. Most often, the drug Oxacillin is used in therapy. The subspecies includes several more drugs (in particular, Nafcillin, Dicloxacillin, Methicillin), which are used extremely rarely due to their high toxicity.

In terms of the spectrum of effects on pathogens, Oxacillin is similar to the drugs included in the penicillin natural series, but is slightly inferior to them in terms of activity (in particular, it is less effective against microbes that are sensitive to the effects of benzylpenicillin).

The main difference between the drug and other penicillins is resistance to beta-lactamases, which are produced by staphylococci. The practical use of Oxycillin was found in the fight against strains of this microorganism, which is the causative agent of community-acquired infections.

Aminopenicillins

This group of semi-synthetic penicillins is characterized by a wide range of effects on pathogens. The ancestor of aminopenicillins is the drug Ampicillin. In a number of parameters, it is superior to Oxycillin, but inferior to Benzylpenicillin.

Close in scope to this medication is the drug Amoxicillin.

Since these representatives of the group are susceptible to the destructive effect of beta-lactamases, medicines protected from the effects of enzymes of infectious agents by inhibitors (for example, Amoxicillin in combination with clavuanic acid, Ampicillin in combination with sulbactam) were introduced into medical practice.

The expansion of the antimicrobial spectrum of inhibitor-protected aminopenicillins occurred due to the manifestation of their activity against:

• Gram-negative bacteria (C.diversus, P.vulgaris, Klebsiella spp.);
• gonococci;
• staphylococci;
• anaerobes of the species B.fragilis.

The growth and development of microorganisms whose resistance to the penicillin type of antibiotics is not associated with the production of beta-lactamase, inhibitor-protected aminopenicillins do not affect.

Ureidopenicillins and carboxypenicillins

Representatives of these groups - semi-synthetic antibiotics of the penicillin series that stop Pseudomonas aeruginosa; the list of these drugs is quite wide, but in modern medicine they are rarely used (pathogens lose their sensitivity to them in a short time).

Medicines of the carboxypenicillin species Carbenicillin, Ticarcillin (the latter is not registered in the territory of the Russian Federation) prevent the development of colonies of gram-positive bacteria and microorganisms of the family P.aeruginosa, Enterobacteriaceae.

Most effective remedy from the group of ureidopenicillins - Piperacillin; it is used in the fight against diseases caused by Klebsiella spp.

The described antibiotics, as well as natural penicillins, are subject to the negative influence of beta-lactamases. The solution to the problem was found in the synthesis of fundamentally new antimicrobial agents, which, in addition to the already mentioned active substances inhibitors were introduced.

Inhibitor-protected ureidopenicillins, carboxypenicillins have a wide range of effects on most known pathogens.

Pharmacokinetics

When taken orally, the antibiotic, which is part of the penicillin series of drugs, is quickly absorbed and, penetrating into the liquid media and tissues of the body, begins to act on the colonies of pathogens.

Medicines are characterized by the ability to concentrate in the pleural, pericardial, synovial fluids and bile. Practically do not pass into the internal environment of the organs of vision and prostate, cerebrospinal fluid. In minimal proportions are in breast milk. In small quantities penetrate the placental barrier.

If necessary (for example, when meningitis is detected in a patient), therapeutic concentrations in the cerebrospinal fluid are achieved by administering significant doses of drugs.

Part of the penicillins in tablet form is destroyed under the influence of gastrointestinal enzymes, and therefore is used parenterally.

The main indicators of the process of transporting active substances from the digestive system into the blood of frequently used medicines (in tablets) are shown in the table.

Removal of penicillins mainly (more than 60%) occurs with the help of the kidneys; some drugs are excreted in the bile. Almost all drugs of the described group are removed during hemodialysis.

Contraindications

Despite the fact that most representatives of penicillins are characterized by high efficiency in the elimination of infectious agents, it is impossible to use these drugs to treat all patients without exception.

One of the disadvantages of this kind of medicines is the frequent occurrence of allergic reactions in patients (according to statistics, the percentage of manifestations skin rashes, swelling and itching reaches an indicator of 10 units).

In the presence of an individual intolerance to penicillin in the anamnesis, use in therapy medical goods this group is not allowed.

Warnings

Antibiotics of the penicillin group can cause toxic side effects non-allergic etiology, in particular:

• bouts of nausea and vomiting;
• pain in the abdomen;
• diarrhea
• pseudomembranous colitis.

When using high doses of drugs, seizures, headache, hallucinations and fever may occur.

In addition, the use of drugs of the described series is often accompanied by the development of candidiasis, intestinal dysbacteriosis, the appearance of edema, and a violation of the level of blood pressure.

It should be noted that penicillins are among the most low-toxic antibiotics, and the above side effect on the body manifests itself more often with independent uncontrolled use of medications (without prior consultation with a doctor).

Indications

Mostly antibiotics of the penicillin group are used to eliminate the symptoms of infections. upper paths, tonsillitis, otitis, as well as in order to stop the growth of colonies of infectious agents that cause inflammation of the urinary tract, the development of scarlet fever, syphilis and gonorrhea; for the prevention of rheumatism.

In addition, penicillin antibiotic therapy is involved in making such diagnoses as:

• erysipelas;
• sepsis;
• Lyme disease;
• meningitis;
• tonsillopharyngitis;
• leptospirosis;
• actinomycosis

It should be remembered that the use of drugs of the penicillin group is allowed only on prescription. Self-medication can provoke the development of superinfection or the occurrence of severe complications of the disease.