With erysipelas, 4th generation drugs. Treatment of erysipelas with antibiotics - what drugs treat inflammation

Antibiotics for erysipelas are the main treatment, because, as you know, the disease has an infectious nature. However, what specific drugs are used in the treatment? Where does erysipelas come from and how to deal with it or even prevent this disease even before it appears? You can learn this and other information about the treatment of erysipelas from this article.

General idea of ​​the disease

Erysipelas (erysipelas) is an infectious-allergic disease that affects the skin, mucous membranes and lymphatic system. The cause of the disease is beta-hemolytic streptococcus group A. The name of the disease comes from the French word "rouge", meaning "red", because with erysipelas, a characteristic feature is the formation of red spots on the patient's skin.

Erysipelas is one of the most common diseases caused by infections, immediately after respiratory and intestinal diseases. In addition, the patient, having recovered from erysipelas, runs the risk of encountering the manifestation of this disease again in the coming years.

In addition, medical scientists note with concern that today most cases of erysipelas are severe, while the percentage mild form decreased significantly. Up to a third of all cases of the disease are associated with impaired blood and lymph circulation. Antibiotics for erysipelas of the leg must be combined with drugs that normalize the circulation of fluids. There is also the possibility of developing severe complications of the disease, leading to death.

Erysipelas can affect a patient of any gender and age category, but most cases of the disease are observed among women over 50 years of age. There are also frequent cases of infection with streptococcus in infants, which subsequently also causes erysipelas. There are also statistics that suggest a predisposition to erysipelas in people with group III blood.

Most often, the disease is transmitted through direct contact with an infected person through skin lesions - wounds, abrasions, etc. Also, when the pathogen is carried, the transition of the disease to the active phase is possible after a pathological decrease in immunity.

The most common "targets" of the disease are the arms and legs, less often - the face and head. The disease has several stages of development, which have their own features, the main of which is the appearance of an area of ​​redness, protruding above the surface of healthy skin with a dense convex roller.

Risk groups for erysipelas

Erysipelas most often occurs with a decrease in either general or local skin immunity. It can occur in people who have undergone chemotherapy, are immunocompromised, or have undergone immunosuppressive treatment.

In addition, thrombosis, foot fungus, bedsores, sunburn and weathering, abrasions and other damage - in a word, any violation of the integrity skin, which opens the way for infection to the blood and lymph.

It is for this reason that it is important to treat any skin lesions with an antiseptic in time and properly care for them throughout the entire healing time. It is also necessary to be attentive to care products: it is important that they do not dry out the skin and do not leave dryness and cracks, which can also become a factor in infection.

Symptoms and signs of the disease

Erysipelatous inflammation develops very acutely, and often the patient can indicate a specific time, up to an hour, when the first symptoms appeared. The first symptoms are fever and severe chills. The fever lasts from 5 to 10 days.

10-20 hours after infection, the skin on the affected area turns red. Later, in the area of ​​redness, a dense roller is formed, which clearly rises above the skin. Usually in this place the skin has elevated temperature, swelling, can hurt. The roller lasts 7-10 days, and then peeling occurs in its place.

During the illness (especially in the first 5-7 days), the patient may experience nausea (sometimes ending in vomiting), muscle and joint pain, convulsions, delirium, and a strong rise in temperature. Severe swelling, a feeling of fullness, burning, as well as an increase in lymph nodes and the affected area may appear on the affected area.

There are 3 forms of complicated course of the disease:

• Erythematous - hemorrhagic - accompanied by hemorrhages;
• Erythematous - bullous - accompanied by the appearance of bubbles with transparent contents;
• Bullous - hemorrhagic - with blisters filled with purulent or bloody contents.

With complicated forms of the course of the disease, the risk of relapse is much higher than with the usual one.

General principles of treatment

A dermatologist can determine the symptoms and treatment of the disease, so if the first symptoms occur, you should go to him for the initial appointment. In addition, specialists of other profiles can be involved in the treatment - an infectious disease specialist, a surgeon, an immunologist, etc.

During the examination, the doctor asks and assesses the current condition of the patient, and also prescribes a number of laboratory research. The main indicators are general analysis blood and bacteriological examination, tk. the nature of the disease is infectious.

Treatment of erysipelas of the leg, arm or face is not much different from each other. The patient is usually prescribed to take drugs of two groups: antibiotics and antihistamines. Antibiotic treatment is necessary to eliminate the main cause of the disease - the causative agent of infection, while antihistamines are needed in order to reduce swelling and eliminate the consequences of intoxication of the body with bacterial waste products.

Antibiotics for the treatment of erysipelas

The drugs of choice in the treatment of erysipelas are antibiotics of the penicillin series. They can be changed to drugs of other groups if, as a result of a bacteriological study, it was revealed that the streptococcal strain has resistance to penicillins. They have a bactericidal effect, destroying the outer shell of the bacterium and thereby causing its death. The main drugs used in the group are:

• Phenoxymethylpenicillin. Produced under such trade names like Ospen, Kliacil, Megacillin Oral, Velikombin, etc. Preferably used in the form of tablets or syrup (children). Well therapeutic effect is 5-7 days for primary erysipelas, and 9-10 days for recurrent.
• Benzylpenicillin. Produced under the trade name of the same name in the form of a powder for preparation injection solution. The drug is injected directly into the affected area subcutaneously, the course of treatment is from a week to a month.
• Bicillin-5. It is a combined antibiotic, which is preferable to treat patients who are prone to relapse - with immunodeficiency, hereditary predisposition, who have had a severe form of erysipelas, etc. The injection of the drug is done once a month for several years.

Another group of antibiotics used for erysipelas of a limb or face is tetracycline. These drugs have a bacteriostatic effect, preventing the synthesis of new bacterial cells. Most often, drugs based on Doxycillin are used - they are produced under the trade names Doksibene, Vidoccin, Doxal, etc. The drugs are available in the form of tablets.

Levomycetin (Chloramphenicol) is another alternative to the penicillin series. It also has a bacteriostatic effect. The drug is produced under the same trade names. It is released in various forms which increases the breadth of its application.

are the most modern and least toxic of antibiotics. They are bacteriostatic at low concentrations and bactericidal at high concentrations. The main drug from this group used for erysipelas is Erythromycin. It is available in tablets.

The choice of a specific antibiotic depends not only on the results of a bacteriological study, but also on the patient's condition and individual response to drugs.

Other drugs in the treatment of erysipelas

As already noted, in addition to antibiotics, in the treatment of erysipelas, drugs such as antiallergic drugs (Tavegil, Diazolin, Suprastin) are used. They not only contribute to the speedy elimination of edema, but also the resorption of the infiltrate at the site of the lesion.

Nitrofurans and sulfonamides are a group of drugs that improve the effectiveness of penicillin, prevent the growth of bacteria and destroy them. In addition, immunomodulatory drugs are used to increase the patient's immune response: thymus preparations, biostimulants. Glucocorticoids are also used to treat erysipelas - hormonal preparations with a strong anti-inflammatory effect.

In addition to the mentioned remedies, a diet of natural ingredients (honey, walnuts, aloe, etc.) is used to increase immunity, and the site of inflammation itself is regularly treated with antimicrobials.

To prevent erysipelas, it is necessary, first of all, to observe personal hygiene. Without the reproduction of bacteria, the occurrence of this disease is impossible - therefore, by observing cleanliness and caution when in contact with an infected person, you can largely protect yourself.

Erysipelatous inflammation of the leg often occurs due to varicose veins or thrombophlebitis, so it is necessary to treat these diseases in a timely manner. In addition, erysipelas on the leg can occur due to excessively tight clothing or shoes, so natural, well-ventilated fabrics and proportionate clothing should be preferred.

Thus, adherence to hygiene measures and a healthy lifestyle can not only significantly prevent the development of the disease, but also prevent its reappearance.

Patients with erysipelas are not contagious. Women get sick more often than men. More than 60% of cases of erysipelas are carried by people aged 40 and older. The disease is characterized by a distinct summer-autumn seasonality.

Symptoms of erysipelas

The incubation period of erysipelas is from several hours to 3-5 days. In patients with a recurrent course, the development of the next attack of the disease is often preceded by hypothermia, stress. In the vast majority of cases, the onset is acute.

The initial period of erysipelas is characterized by the rapid development of general toxic phenomena, which in more than half of the patients for a period of several hours to 1-2 days ahead of the occurrence of local manifestations of the disease. Are celebrated

• headache, general weakness, chills, muscle pain
• 25-30% of patients develop nausea and vomiting
• already in the first hours of the disease, the temperature rises to 38-40 ° C.
• on areas of the skin in the area of ​​future manifestations, a number of patients develop a feeling of fullness or burning, mild pain.

The height of the disease occurs within a period of several hours to 1-2 days after the first manifestations of the disease. General toxic manifestations and fever reach their maximum. There are characteristic local manifestations.

Most often, erysipelas are localized on lower limbs, less often on the face and upper limbs, very rarely only on the trunk, in the area of ​​​​the mammary gland, perineum, in the area of ​​​​the external genitalia.

Skin manifestations

First, a slight red or pink spot, which within a few hours turns into a characteristic erysipelatous redness. Redness is a clearly delimited area of ​​the skin with uneven boundaries in the form of teeth, "tongues". The skin in the area of ​​redness is tense, hot to the touch, moderately painful to the touch. In some cases, you can find a "marginal roller" in the form of raised edges of redness. Along with reddening of the skin, its edema develops, spreading beyond the redness.

The development of blisters is associated with increased effusion at the site of inflammation. If the blisters are damaged or spontaneously rupture, fluid flows out, superficial wounds appear in place of the blisters. While maintaining the integrity of the blisters, they gradually shrink with the formation of yellow or brown crusts.

The residual effects of erysipelas, which persist for several weeks and months, include swelling and pigmentation of the skin, dense dry crusts in place of the blisters.

Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute

Diagnosis of erysipelas

Diagnosis of erysipelas is carried out by a general practitioner or infectious disease specialist.

• Increased titers of antistreptolysin-O and other antistreptococcal antibodies, detection of streptococcus in the blood of patients (using PCR) have a certain diagnostic value
• Inflammatory changes in the general blood test
• Violations of hemostasis and fibrinolysis (increased blood levels of fibrinogen, PDF, RKMF, an increase or decrease in the amount of plasminogen, plasmin, antithrombin III, an increase in the level of platelet factor 4, a decrease in their number)

Diagnostic criteria for erysipelas in typical cases are:

• acute onset of the disease with severe symptoms of intoxication, fever up to 38-39°C and above;
• predominant localization of the local inflammatory process on the lower extremities and face;
• development of typical local manifestations with characteristic redness;
• swollen lymph nodes in the area of ​​inflammation;
• absence of severe pain in the focus of inflammation at rest

Erysipelas treatment

Treatment of erysipelas should be carried out taking into account the form of the disease, the nature of the lesions, the presence of complications and consequences. Currently, most patients with mild erysipelas and many patients with moderate forms are treated in a polyclinic. Indications for mandatory hospitalization in infectious diseases hospitals (departments) are:

• severe course;
• frequent relapses of erysipelas;
• the presence of severe common comorbidities;
• old age or childhood.

The most important place in the complex treatment of patients with erysipelas is occupied by antimicrobial therapy. When treating patients in a polyclinic and at home, it is advisable to prescribe antibiotics in tablets:

• erythromycin,
• oletethrin,
• doxycycline,
• spiramycin (course of treatment 7-10 days),
• azithromycin,
• ciprofloxacin (5-7 days),
• rifampicin (7-10 days).

In case of intolerance to antibiotics, furazolidone (10 days) is indicated; delagil (10 days).

It is advisable to treat erysipelas in a hospital with benzylpenicillin, a course of 7-10 days. In severe cases of the disease, the development of complications (abscess, phlegmon, etc.), a combination of benzylpenicillin and gentamicin, the appointment of cephalosporins are possible.

With severe inflammation of the skin, anti-inflammatory drugs are indicated: chlotazol or butadione for 10-15 days.

Patients with erysipelas need to prescribe a complex of vitamins for 2-4 weeks. In severe erysipelas, intravenous detoxification therapy is performed (hemodez, reopoliglyukin, 5% glucose solution, saline) with the addition of 5-10 ml of a 5% solution of ascorbic acid, prednisolone. Cardiovascular, diuretic, antipyretic drugs are prescribed.

Treatment of patients with recurrent erysipelas

Treatment of recurrent erysipelas should be carried out in a hospital setting. It is mandatory to prescribe reserve antibiotics that were not used in the treatment of previous relapses. Cephalosporins are prescribed intramuscularly or lincomycin intramuscularly, rifampicin intramuscularly. The course of antibiotic therapy - 8-10 days. With especially persistent relapses, a two-course treatment is advisable. Consistently prescribe antibiotics that optimally act on streptococcus. The first course of antibiotic therapy is carried out with cephalosporins (7-8 days). After a 5-7-day break, a second course of treatment with lincomycin is performed (6-7 days). With recurrent erysipelas, immunity correction is indicated (methyluracil, sodium nucleinate, prodigiosan, T-activin).

Local therapy for erysipelas

Treatment of local manifestations of erysipelas is carried out only with its cystic forms with localization of the process on the limbs. The erythematous form of erysipelas does not require the use of topical treatments, and many of them ( ichthyol ointment, Vishnevsky balm, antibiotic ointments) are generally contraindicated. In the acute period, in the presence of intact blisters, they are carefully incised at one of the edges, and after the release of fluid, bandages are applied to the inflammation site with a 0.1% solution of rivanol or a 0.02% solution of furatsilin, changing them several times during the day. Tight bandaging is unacceptable.

In the presence of extensive weeping wound surfaces at the site of the opened blisters, local treatment begins with manganese baths for the extremities, followed by the application of the bandages listed above. For the treatment of bleeding, 5-10% dibunol liniment is used in the form of applications in the area of ​​​​the inflammation focus 2 times a day for 5-7 days.

Traditionally, in the acute period of erysipelas, ultraviolet irradiation is prescribed to the area of ​​​​the focus of inflammation, to the area of ​​\u200b\u200blymph nodes. Assign applications of ozocerite or dressings with heated naftalan ointment (on the lower limbs), paraffin applications (on the face), electrophoresis of lidase, calcium chloride, radon baths. The high efficiency of low-intensity laser therapy of a local focus of inflammation has been shown. The applied dose of laser radiation varies depending on the state of the focus, the presence of concomitant diseases.

Complications

Complications of erysipelas, mainly of a local nature, are observed in a small number of patients. Local complications include abscesses, cellulitis, skin necrosis, suppuration of blisters, inflammation of the veins, thrombophlebitis, inflammation of the lymphatic vessels. Common complications that develop in patients with erysipelas quite rarely include sepsis, toxic-infectious shock, acute cardiovascular failure, thromboembolism. pulmonary artery etc. The consequences of erysipelas include persistent stagnation of lymph. By modern ideas, lymph stagnation in most cases develops in patients with erysipelas against the background of already existing functional insufficiency of the lymphatic circulation of the skin (congenital, post-traumatic, etc.).

Prevention of recurrence of erysipelas

Prevention of recurrence of erysipelas is an integral part of a comprehensive dispensary treatment patients suffering from a relapsing form of the disease. Preventive intramuscular injection bicillin (5-1.5 million units) or retarpen (2.4 million units) prevents relapse of the disease associated with reinfection with streptococcus.

At frequent relapses(at least 3 in the last year), continuous (year-round) bicillin prophylaxis is advisable for 2-3 years with an interval of 3-4 weeks for bicillin administration (in the first months, the interval can be reduced to 2 weeks). In case of seasonal relapses, the drug is started to be administered a month before the start of the morbidity season in this patient with an interval of 4 weeks for 3-4 months annually. In the presence of significant residual effects after the transferred erysipelas, bicillin is administered at intervals of 4 weeks for 4-6 months.

Forecast and course

• With adequate treatment of mild and moderate forms - a complete recovery.
• Chronic lymphedema (elephantiasis) or scarring in a chronic relapsing course.
• In the elderly and debilitated, there is a high incidence of complications and a tendency to frequent recurrence.

erysipelas - acute illness infectious genesis, affecting the skin with moderate frequency. The causative agent of recurrence is B-hemolytic streptococcus group A. Streptococci enter the body with injuries of the skin, with non-sterile instruments in operating rooms. Erysipelatous inflammation is localized on the skin of the face and in the region of the lower extremities (shins).

Clinically, the disease is manifested by hyperemia (redness) of the skin area, itching, severe intoxication of the body, and an increase in body temperature up to 38 ° C and above. A rash and redness of a bright pink color appear on the legs.

Often there is a headache provoked by a decrease blood pressure. There is also a seal and swelling of the lymph nodes, painful on palpation.

Treatment

Treatment of erysipelas is to eliminate the pathogen, that is, in antibiotic therapy. In relation to staphylococcus, antibiotics of the penicillin group, cephalosporins, macrolides, sulfonamides and fluoroquinolones are the most active.

Penicillins

Preparations of the penicillin group are effective in infections caused by gram-positive microorganisms (streptococcal, staphylococcal flora), most anaerobes. Penicillins affect their progression and reproduction. The antibacterial effect is based on the ability of drugs to suppress the biosynthesis of elements of the cell wall of microorganisms. The difference between penicillins lies in the speed of onset of the pharmacological effect, its duration and ability to accumulate in the body.

1. Benzylpenicillin sodium salt. Powdered substance for injection solutions in the amount of 250 tons, -1 000000, 5 000000, 10 0000000 Action Units (ED). Indications for use are: erysipelas, pneumonia, meningitis, purulent processes skin. The drug can cause itching, headache, rashes on the skin, joint pain, angioedema. The reason for the development side effects is drug hypersensitivity. The drug is injected into the muscles, more often in the upper left quadrant, previously diluted in NaCl 0.9%, lidocaine, sterile liquid. In severe cases, the solution is administered intravenously. The dosage depends on the age and severity of the disease. For a child's body, from 50,000 to 100,000 IU / kg per day are prescribed. Adults from 2 million to 12 million units during the day. The frequency of receptions varies from 4 to 6 per day. Course of therapy: 7-10 days.
2. Bicillin-5. Produced in powder form for injection solutions in vials of 1.5 million units. Indications for use and spectrum of action are the same as benzylpenicillin sodium salt. The drug is injected only into the muscle. Once every 4 weeks, adults are administered 1500,000 IU. If the child is under 7 years old, then he is given 600,000 IU three times a week. If the child is older than 7 years, then he is given an injection of 1200,000 IU once every 4 weeks.
3. Ampicillin. Available in tablet form, suspensions, syrups and solution in the form of drops. It is an active antibiotic against streptococcal, staphylococcal flora, enterobacteriaceae, salmonella. It is indicated for infectious and inflammatory diseases of the skin, bronchitis, pneumonia, sepsis, whooping cough and so on. Contraindicated in hypersensitivity and mononucleosis. Should be taken with caution when bronchial asthma and pathologies of the liver. When taking the drug, a rash and other types of allergic reactions may appear. For adults, it is recommended to take 0.5 g. The number of doses can be from 2 to 4 times a day. The dosage for children is 100 mg/kg. The frequency of receptions increases up to 6 times a day. The duration of treatment is 5-10 days. For the treatment of erysipelas, it is also recommended to use the protected combined penicillins augmentin.
4. Augmentin. Augmentin consists of amoxicillin and clavulonic acid and is available in tablet form, suspension and powder for injection. It is prescribed in the form of tablets. Adults and adolescents: 1 tablet 3 times a day. As a suspension is used for young children. The dosage is ½-2 teaspoon 2-3 times a day.

Cephalosporins

Cephalosporins have a high activity against various microflora. They have good antibacterial activity against streptococci.

The following generations of cephalosporins are distinguished:

• 1st generation - cefazolin, cephalexin;
• 2nd generation - cefuroxime, ceflusodin;
• 3rd generation - cefotaxime, ceftriaxone;
• 4th generation - cefpir, cefepime.

The most effective for the treatment of erysipelas are 3rd and 4th generation cephalosporins.

The drugs are available in powder form for intramuscular injections of 0.25; 0.5; 1 and 2 years

Contraindications: pregnancy, children under 2.5 years of age, bleeding, colitis.

Method of application and dosage. Cephalosporins are administered parenterally (into the muscle and into the veins). The drug is diluted in an anesthetic solution (lidocaine) and injected into the muscle. When injected into a vein, the drug is dissolved in 100 ml of isotonic sodium chloride solution 0.9% or in 100 ml of 5% glucose. The dose for adults and adolescents is 1.0 every 8 hours. Toddlers and older children are administered 50-200 mg / kg 3 to 6 times a day.

macrolides and azalides

The main feature of this group of drugs are improved pharmacological properties against gram-positive (streptococci and staphylococci) bacteria. The drugs are well absorbed and create a high concentration for a long time. Also, when taking macrolides, the duration of the course of treatment is reduced.

1. Erythromycin. Available in tablets, suspensions, solutions for external use and in the form of an ointment. Undesirable effects (nausea, diarrhea, vomiting) are rare. When combined with erythromycin and streptomycin, it pharmacological effect intensifies. The drug is better tolerated than penicillins, and is prescribed for contraindications to penicillins. The drug is taken orally one hour before meals four times a day. For adults, 250 or 500 mg is recommended, up to 3 years - 400 mg, up to 6 years - 500-700 mg, from 6 to 8 years - 750 mg, adolescents 1 g each. In severe forms of infectious and inflammatory diseases, parenteral (intravenous) is used administration of drugs. You can also lubricate the area of ​​\u200b\u200baffected skin with an ointment or suspension of erythromycin.
2. Azithromycin. It is a derivative of erythromycin. It has a bactericidal effect. Available in the form of tablets, capsules, suspensions and solutions for injection. Used to treat erysipelas, acne, scarlet fever, otitis, bronchitis and so on. Contraindications are diseases of the liver and biliary tract, as well as the urinary system, pregnancy and children under 12 months of age. Side effects rarely develop. When they occur, jaundice, vomiting, nausea, stagnation of bile appear. With erysipelas inflammation of the lung Forms used are tablets and capsules. It is recommended to drink tablets 60 minutes before meals or 2 hours after meals.

For adults, there are several options for taking azithromycin.

• Method 1 - 500 mg 1 time per day. The number of receptions - 3.
• Method 2 - 500 mg 1 time on the first day, on days 2-5, 250 mg 1 time per day.

For children at a dosage of 10 mg / kg on the first day, and 5 mg / kg from 2 to 5 days for injection into the muscles.

Lincosamides

Lincomycin hydrochloride. It has antibacterial activity against streptococcus, pathogens of gas gangrene, diphtheria bacillus. It has a bacteriostatic effect. Available in the form of capsules, ointments and solutions for injection.

Side effects: nausea, abdominal pain, vomiting, diarrhea.

Contraindicated in pregnancy, hepatic and kidney failure and with diarrhea.

Method of application and dosage. It is used orally, intravenously and intramuscularly. In adulthood, take 1500 mg or 2000 mg in tablet form, divided into 2 doses. For parenteral administration, a solution is used at a dosage of 600 mg, twice or thrice a day.

For a child's body, the dosage is calculated based on body weight. It is recommended in tablets from 30 to 60 mg / kg, divided into 3 doses, and for injection 10-20 mg / kg. Tablets are taken 1-2 hours before meals. The duration of treatment is 1-2 weeks.

Sulfonamides

They are used for infectious pathologies caused by bacteria. Sulfonamides exhibit chemotherapeutic activity against streptococci and staphylococci. They destroy the factors that provoke the growth and reproduction of bacterial cells.

Important! With insufficient intake of sulfonamides or early termination of treatment, strains of microorganisms develop resistance to drugs.

Sulfonamides can be combined with other drugs to enhance them; pharmacological effects.

1. Streptocid. Available in the form of a powder for external use, tablets, ointment and liniment. When using streptocide, dyspeptic disorders (nausea, vomiting), dizziness, blanching of the skin may occur. The drug should not be taken with diseases of the blood system and hematopoietic organs, with hyperthyroidism, kidney diseases. With superficial infectious and inflammatory pathologies of the skin, an ointment or liniment is used for treatment. With erysipelas of moderate and severe severity, it is prescribed in the form of tablets.
2. Biseptol. Is combination drug. It is used for erysipelas, intestinal infections. Available in the form of tablets, suspensions and solutions for injection. Contraindicated in pregnancy, diseases of the blood system, liver and kidneys. Newborns and premature babies are not recommended to take the drug. Use with caution in childhood. The drug is used inside. Adults need to take in the amount of 960 mg, divided into 2 doses. In childhood, the amount of the drug is selected according to age. The course of admission is divided into 3 times. The course of therapy is 5-14 days.

Important! After treatment with sulfonamides, it is necessary to do a general blood test once every 2 months.

Choice antibacterial drug should be carried out by a doctor, based on the severity of the disease. The course of treatment, dosage selection is carried out individually. When the first symptoms appear, you should immediately consult a specialist.

Erysipelas (erysipelas) is a common infectious disease characterized by streptococcal lesions of soft tissues and a tendency to relapse. The causative agent is group A beta-hemolytic streptococcus. Streptococci are very volatile, so the antibodies that are produced by the body to protect against infection cannot “remember” them and develop immunity.

This explains the frequent relapses of streptococcal infections. In addition, pathogens are dangerous because they release toxins that weaken the immune system and destroy the walls of blood vessels. The inflammatory process on the skin is accompanied by fever and symptoms of intoxication of the body.

The concept of "Erysipelas" comes from the French word, in literal translation meaning "red". This definition most accurately reflects appearance a patient in the acute phase of the disease, when the skin becomes swollen and reddened. AT last years doctors notice an alarming trend towards an increase in the incidence of severe forms of erysipelas associated with impaired lymph flow in the lower extremities and thrombophlebitis.

The prevalence of the disease reaches 20-25 cases per 10,000 population. Women and the elderly are more likely to be affected by this infection. The disease is characterized by a seasonal nature of the course, and most often occurs in summer or autumn.

A favorite place for localization of erysipelas is the legs (shins, calves) and hands, less often the face, trunk or inguinal region. Effective treatment of erysipelas is possible with timely seeking medical help. In this case, you can achieve a complete recovery and restoration of working capacity.

Streptococcus can live on the skin and mucous membranes without causing disease if a person has good immunity. But if it enters a weakened body, erysipelas occurs. Healthy man may be a carrier of infection, the presence of streptococcus in the body was detected in 15% of the population.

You can become infected through contact with a sick person or a carrier of infection, since the pathogen is transmitted by airborne droplets or through household items, a handshake.

The main causes contributing to the development of the disease are damage to the skin and the presence of concomitant diseases.

In addition, the occurrence of erysipelas can contribute to colds, hypothermia of the body and intake medicines that suppress the immune system. The disease often occurs against the background of fungal skin lesions, obesity, varicose veins veins.

Thus, there are a lot of predisposing factors contributing to the development of streptococcal infection, and the treatment of erysipelas should begin with identifying the causes of the disease.

From infection to the appearance of the first symptoms, only a few hours pass, much less often - 2-3 days. The disease begins acutely, with a sharp rise in temperature to 38-40 ° C and is accompanied by severe weakness, chills, dizziness, headache, muscle and joint pain. In severe cases, convulsions, clouding of consciousness, nausea and vomiting may occur.

There is an increase in lymph nodes, primarily those that are closest to the affected area. Symptoms of general intoxication occur in response to the first wave of toxins secreted by streptococci.

Within a day after the onset of the first symptoms, the skin at the site of the lesion turns red, there is a feeling of heat and itching. The bright red color of the skin is explained by the expansion of blood capillaries under the influence of streptococcal toxin. The affected area has clear boundaries and rises somewhat above the surface of healthy skin, resembling flames with its jagged edges.

In a few hours, the lesion can significantly increase in size, this area becomes swollen and painful, the pain increases with palpation. Patients note a burning sensation and skin tension in the periphery. Painful sensations are the result of compression of nerve endings as a result of edema. Toxins secreted by bacteria increase the permeability of the walls of blood vessels, as a result of which the liquid component of blood seeps through them, causing severe swelling.

When feeling the affected areas, it is noted that the skin becomes hot and painful. Heat and symptoms of intoxication may persist against the background of therapeutic measures for up to 10 days. Skin symptoms last longer - up to two weeks, then the redness disappears and the skin begins to peel off in its place. The pathological process is more often localized on the hands and lower extremities. Erysipelatous inflammation of the face manifests itself in the area of ​​the nose and cheeks in the form of a butterfly, can descend to the corners of the mouth and capture the area of ​​​​the ear canal.

In the erythematous-hemorrhagic form of the disease, subcutaneous hemorrhages occur against the background of lesions, from small to extensive, prone to merging with each other. The fever lasts longer than in other forms of the disease, and the disappearance skin manifestations happens much more slowly.

The bullous-hemorrhagic form is accompanied by the appearance of blisters filled with purulent or bloody contents. After opening them, ulcerations and erosions remain on the skin, leading to the appearance of scars.

The erythematous-bullous form is characterized by the presence in the lesion of small vesicles filled with transparent serous contents. After a short time, they open on their own and do not leave scars behind.

Erysipelas of the leg most often occurs in women and often in the initial stages does not cause much concern, as patients perceive swelling and redness of the skin as an allergic reaction. If treatment is not started on time, severe complications may develop on the lower leg and calves (purulent abscesses, elephantiasis).

can be recognized by severe itching, extensive swelling and rapid spread of painful redness. Lesions localized on the lower extremities are characterized by frequent relapses and a more severe course of the inflammatory process, which in some cases can lead to such a severe complication as gangrene.

The severity of erysipelas depends largely on the age of the patient. Yes, in old age acute form diseases and repeated relapses are especially severe and are accompanied by prolonged fever, symptoms of intoxication and exacerbation of concomitant diseases.

The course of streptococcal infection is often accompanied by severe complications. It can be suppuration (phlegmon, abscesses), tissue necrosis, thrombophlebitis. Violations of the lymph flow and stagnation of the lymph provoke the development of lymphedema and elephantiasis. With a significant weakening of the immune system, the development of toxic-infectious shock, cardiovascular insufficiency and sepsis is possible.

Diagnosis of erysipelas

Diagnosis of erysipelas is carried out by a therapist or infectious disease specialist. The doctor makes a diagnosis based on clinical picture and laboratory blood tests indicating signs of a bacterial infection.

In order to pick effective treatment, from the surface of the lesion, material can be taken for bacteriological examination. This will clarify the type of pathogen and find out its sensitivity to antibiotics.

The basis of the treatment of this infectious disease is antibiotic therapy, designed to destroy the pathogen. Beyond antibiotics complex treatment includes application antihistamines, which help to eliminate itching and allow you to cope with intoxication of the body.

Medical treatment

For the treatment of erysipelas, the doctor will prescribe individual therapy with the selection of antibiotics in tablets. The course of antibiotic therapy averages from 5 to 10 days. The following drugs are prescribed:

• Azithromycin
• Erythromycin
• Ciprofloxacin
• Spiramycin

In case of intolerance to antibiotics, treatment with furazolidone or delagil is carried out. In severe cases of the disease, treatment is carried out in a hospital, where a course of benzylpenicillin is prescribed. When complications are attached, cephalosporins and gentamicin are additionally used. For the treatment of extensive lesions, the use of anti-inflammatory drugs is indicated. If erysipelas of the leg is complicated by a fungal infection, antimycotic drugs are prescribed.

In addition, patients with erysipelas are prescribed a maintenance course of vitamin therapy, antipyretics and diuretics. To eliminate the symptoms of intoxication, intravenous infusion of solutions is carried out.

In case of recurrence of the disease, intramuscular injections of antibiotics are consistently used, which have the most optimal effect on streptococcus, and drugs are prescribed to maintain immunity.

Local treatment

Treatment with topical drugs is carried out only with cystic forms of the disease. The erythematous variety of Erysipelas does not need the use of such drugs, and some of them (ichthyol ointment, ointments with antibacterial components, Vishnevsky's liniment) can cause unwanted complications.

In the acute period, unopened blisters are carefully incised and, after the release of the serous fluid, dressings with a solution of furacilin or rivanol are applied to the lesion, changing them several times a day. If an extensive weeping wound surface appears at the site of the opened blisters, the appointment of baths with a solution of potassium permanganate and subsequent bandaging with the above components is indicated. With bleeding, applications of dibunol liniment are applied to the focus of inflammation.

Applications with a solution of dimexide are effective, which anesthetize well, improve blood circulation, and have antimicrobial and anti-inflammatory effects. For the treatment of weeping surfaces, powders with enteroseptol are used; for extensive lesions, oxycyclosol is used in the form of an aerosol, which allows treating areas of inflammation up to 20 square meters. cm.

Physiotherapy treatment

Physiotherapy procedures are used taking into account the stages of the disease and the severity of its symptoms:

At the stage of recovery, applications with naftalan ointment and the use of ozokerite therapy give a good effect.

Treatment of erysipelas folk remedies at home

Treatment of Erysipelas with folk remedies with a developed lesion of the skin will not give a result. That's why folk recipes based on homemade ointments, decoctions and infusions medicinal herbs can only be used in the initial stages as an aid and after consultation with your doctor. Here are a few recipes that are often used in the treatment of erysipelas at home. The most popular are compresses, which can quickly relieve inflammation and have an antiseptic and regenerating effect.

Description:

Erysipelas or erysipelas is a serious infectious disease, the external manifestations of which are damage (inflammation) of the skin of a hemorrhagic nature, fever and endotoxicosis.
The name of the disease comes from the French word rouge, which translates as "red".
Erysipelas is a very common infectious disease, statistically ranked 4th, second only to intestinal infections and infectious hepatitis. Erysipelas is most often diagnosed in patients of older age groups. Between the ages of 20 and 30, erysipelas affects mainly men, whose professional activity associated with frequent microtraumatization and contamination of the skin, as well as with sudden changes in temperature. These are drivers, loaders, builders, military men, etc. In the older age group, most of the patients are women. Localization of erysipelas is quite typical - in most cases, inflammation develops on the skin of the upper and lower extremities, less often on the face, even less often on the trunk, in the perineum and on the genitals. All these inflammations are clearly visible to others and cause the patient a feeling of acute psychological discomfort.
The erysipelas are ubiquitous. The incidence of it in various climatic zones of our country is 12-20 cases per 10 thousand people per year. At present, the percentage of erysipelas in newborns has significantly decreased, although earlier this disease had a very high mortality rate.

Causes of occurrence:

The causative agent of erysipelas is group A beta-hemolytic streptococcus, which can be in the human body in active and inactive, the so-called L-form. This type of streptococcus is very resistant to the environment, but it dies when heated to 56 C for half an hour, which is of great importance in antiseptics. Beta-hemolytic streptococcus is a facultative anaerobe, i.e. can exist both in oxygen conditions and in an oxygen-free environment.
If a person suffers from any disease of streptococcal etiology, or simply is a carrier of this microorganism in any form, it can become a source of infection. According to statistics, about 15% of people are carriers of streptococcus of this type, while they do not have any clinical signs diseases. The main route of transmission of the pathogen is contact-household. Infection occurs through damaged skin - if present, abrasions, abrasions, etc. The airborne route of transmission has a less significant role in the transmission of infection (especially when erysipelas occurs on the face). Patients are slightly contagious.

Predisposing factors contribute to the occurrence of erysipelas infection, for example, persistent violations of lymph circulation, prolonged exposure to the sun, chronic venous insufficiency, fungal skin diseases, and a stress factor. Erysipelas is characterized by summer-autumn seasonality.
Very often, erysipelas occurs against the background of concomitant diseases: foot fungus, alcoholism, lymphostasis (problems with lymphatic vessels), foci of chronic streptococcal infection (with erysipelas of the face,; with erysipelas of the extremities,), chronic somatic diseases that reduce overall immunity (more often in old age).

Pathogenesis:

Primary, repeated (with a different localization of the process) and recurrent erysipelas are classified. According to its pathogenesis, primary and repeated erysipelas are acute streptococcal infections. The exogenous nature of infection and the cyclical course of the infectious process are characteristic. These pathogens are located in the lymphatic capillaries of the papillary and reticular layers of the dermis, where there is a focus of infectious-allergic inflammation of a serous or serous-hemorrhagic nature. In the implementation of inflammation, an important role is played by immunopathological processes with the formation of immune complexes in the dermis, incl. and perivascular. Recurrent erysipelas is a chronic streptococcal infection, with the formation of characteristic endogenous foci in the skin and regional lymph nodes. At the same time, mixed infection of the body of patients with bacterial and L-form streptococcus is observed. The L-form persists for a long time in the interrecurrent period of the disease in skin macrophages and organs of the macrophage system. With recurrent erysipelas, there is a severe violation of the immune status of patients, their sensitization and autosensitization.
It was also noticed that erysipelas most often occurs in people with III (B) blood group. Obviously, a genetic predisposition to erysipelas reveals itself only in old age (more often in women), against the background of repeated sensitization to group A beta-hemolytic streptococcus and its cellular and extracellular products (virulence factors) with certain pathological conditions, including those associated with involutional processes.

Symptoms:

The nature clinical manifestations erysipelas is divided into several forms:  
- erythematous
- erythematous bullous
- erythematous hemorrhagic
- bullous-hemorrhagic form.

The incubation period is from several hours to 3-5 days.
According to the severity of the disease, mild, moderate, severe form. Most often, the inflammatory process manifests itself in the lower extremities, less often - on the face, upper extremities, very rarely - in the trunk, genitals. The onset of the development of the disease is acute, there is a feeling of heat, general weakness, muscle pain. There is a critical increase in the patient's body temperature to fibril figures - 38-39.5 °. Often, the onset of the disease is accompanied by and. Very often, the described phenomena develop a day before skin manifestations.
The main sign of erysipelas is skin manifestations in the form of erythema with jagged edges clearly delimited from unaffected skin in the form of a tortuous line, arcs and tongues, which are often compared to "tongues of flame".

For erythematous erysipelas, the presence of a peripheral roller in the form of a raised edge of erythema is characteristic. The skin in the area of ​​erythema has a bright red color, with palpation of pain is usually insignificant, mainly along the periphery of the erythema. The skin is tense, hot to the touch. At the same time, swelling of the skin is characteristic, which extends beyond the limits of erythema. Marked as regional.

With erythematous bullous erysipelas against the background of erythema, blisters (bulls) appear. Contents bull -   transparent yellowish liquid.
With erythematous-hemorrhagic erysipelas, hemorrhages of various sizes occur - from small punctures to extensive and confluent, extending to the entire erythema. There is hemorrhagic and fibrinous exudate in the blisters, but they can also contain predominantly fibrinous exudate, have a flattened character and have a dense texture on palpation.

The mild course of erysipelas is characterized by mild symptoms, the temperature rarely rises above 38.5 °, and a moderate headache may be observed. In a severe course of the disease, the temperature reaches 40 ° and above, there are stunning chills, vomiting, mental disorders, meningeal syndrome (the so-called meningism). There is an increase in heart rate, hemodynamic parameters are falling.  
The fever in patients lasts up to 5 days. Acute inflammatory changes in the focus disappear within 5-7 days with erythematous erysipelas, up to 10-12 days or more with bullous-hemorrhagic erysipelas. Continuing during recovery, increased regional The lymph nodes, infiltration of the skin at the site of inflammation, subfebrile temperature are prognostically unfavorable for the development of early relapses.
Repeated erysipelas occurs 2 years or more after the previous disease and has a different localization.

Recurrent erysipelas is most often observed when the focus of inflammation is localized on the lower extremities. There are predisposing factors for the transition of primary erysipelas to recurrent, in particular with concomitant chronic skin diseases, especially fungal (epidermophytosis, rubrophytosis), previous, lymphostasis, the presence of foci of chronic streptococcal infection. Relapses develop in terms from several days and weeks to 1-2 years, their number can reach several tens. Frequent relapses lead to severe disorders in the lymphatic system.
Complications are usually local in nature: skin necrosis, abscesses, thrombophlebitis, lymphangitis, periadenitis. With concomitant serious illnesses and late treatment may develop, toxic shock. With frequent relapses, lymphedema (lymphedema) and secondary are possible.

Treatment:

For treatment appoint:

Therapeutic measures for erysipelas are in most cases carried out at home or on an outpatient basis. Patients are shown to drink plenty of water, rational nutrition. Indications for hospitalization are a severe course of the disease, a common local process, its bullous-hemorrhagic nature and recurrent erysipelas.

The main pathogenetic therapy of erysipelas is the appointment of antibiotics. Most often, one of the following antibacterial agents is used: oletethrin 0.25 g 4-6 times a day, metacycline hydrochloride 0.3 g 2-3 times a day, erythromycin or oleandomycin phosphate in daily doses up to 2 g, combined chemotherapy drug Bactrim (biseptol), sulfaton - 2 tablets 2 times a day in the morning and evening after meals. In a hospital setting and in severe cases of the disease, intramuscular administration of benzylpenicillin is indicated, with recurrent erysipelas - cephalosporins (cefazolin, klaforan, etc.), lincomycin hypochloride. The duration of taking antibiotics is 8-10 days. Pathogenetic treatment also includes non-steroidal anti-inflammatory drugs, ascorutin to strengthen vascular wall, a complex of vitamins. With frequent relapses of the disease, nonspecific stimulating and immunocorrective therapy (pentoxyl, methyluracil, sodium nucleinate), as well as prodigiosan, levamisole, is indicated. Two latest drug prescribed only in the hospital. With the recurrent nature of the course of the disease, autohemotherapy is used in some cases.
Local treatment of erysipelas is carried out only with its bullous forms and localization of the process on the limbs. The blisters are incised at one of the edges and dressings are applied to the focus of inflammation with a solution of ethacridine lactate (1:1000) or furacilin (1:5000), changing them several times a day. Subsequently, dressings with ectericide, vinylin are applied. In the acute period of the disease, physiotherapy can be used: UV irradiation and UHF therapy, and after the acute inflammatory process subsides, dressings with naftalan ointment, applications with paraffin and ozocerite, radon baths, electrophoresis of lidase or calcium chloride to prevent persistent lymphostasis. Patients are discharged no earlier than the 7th day after the normalization of body temperature. Those who have had erysipelas are registered in the office of infectious diseases for 3 months, and those suffering from recurrent erysipelas for at least 2 years.
Surgical treatment of complications in erysipelas. With development, the patient undergoes necrectomy after stabilization of the general condition. The wound is covered with dalcex-trypsin with an antiseptic, teralgin, algipor, hydrophilic ointment (levomekol) or chemotherapeutic agents (dimexide, iodopyrone, etc.). With large defects, after the appearance of dense granular granulations and the elimination of acute phenomena, a second operation is performed - autodermoplasty, the meaning of which is to close the skin defect, while the patient himself becomes the donor and recipient. With phlegmon and abscesses, the incision is made along the shortest way, dissect the skin, subcutaneous tissue and open the cavity of the abscess. After the evacuation of the detritus, the cavity is washed with antiseptics, dried, the edges of the wound are bred with hooks and an audit is performed. All non-viable tissues are excised. The wound, as a rule, is not sutured, sterile dressing. With purulent lymphadenitis, abscessed phlebitis and paraphlebitis and other foci of a purulent-inflammatory nature, surgical treatment is indicated - opening accumulations of pus, removing necrotic tissues, draining the wound.

Prevention:

Preventive measures to prevent the development of erysipelas include careful personal hygiene, prevention of injuries and abrasions of the legs. If such an injury has occurred, their treatment with antiseptics is indicated (for example, 5% alcohol solution of iodine, brilliant green solution). Timely rehabilitation of foci of chronic streptococcal infection is necessary. Prevention of recurrent erysipelas involves the treatment of diseases predisposing to relapse (fungal skin lesions, lymphovenous insufficiency). In some cases, medical prophylaxis of erysipelas is justified. With frequent, persistent relapses, bicillin-5 is administered for prophylactic purposes at 1,500,000 IU intramuscularly every 3-5 weeks. over the course of two to three years. In cases of pronounced seasonality of relapses and with significant residual effects, it is recommended to prescribe bicillin-5 with preventive courses lasting 3-4 months.

is an infectious disease caused by group A streptococcus, mainly affecting the skin and mucous membranes, characterized by the occurrence of limited serous or serous-hemorrhagic inflammation, accompanied by fever and general intoxication. Clinically, erysipelas is characterized by a typical bright red edematous skin lesion with clear boundaries and signs of lymphostasis. Complications of erysipelas include: the formation of necrotic foci, abscesses and phlegmon, thrombophlebitis, secondary pneumonia, lymphedema, hyperkeratosis, etc.

Long-term stagnation of the lymph, especially in the relapsing form, contributes to the occurrence of lymphedema and elephantiasis. Complications of lymphostasis also include hyperkeratosis, papillomas, eczema, lymphorrhea. Persistent pigmentation may remain on the skin after clinical recovery.

Diagnosis of erysipelas

Diagnosis of erysipelas is usually based on clinical symptoms. To differentiate erysipelas from others skin diseases you may need to consult a dermatologist. Laboratory tests show signs of bacterial infection. Specific diagnosis and isolation of the pathogen, as a rule, are not performed.

Treatment of erysipelas

Erysipelas is usually treated on an outpatient basis. In severe cases, with the development of purulent-necrotic complications, frequent relapses, in senile and early childhood, the patient is placed in a hospital. Etiotropic therapy consists in prescribing a course of antibiotics of the cephalosporin series of the first and second generations, penicillins, some macrolides, fluoroquinolones lasting 7-10 days in medium therapeutic dosages. Erythromycin, oleandomycin, nitrofurans and sulfonamides are less effective.

With frequent relapses, the sequential appointment of two types of antibiotics of different groups is recommended: after beta-lactams, lincomycin is used. Pathogenetic treatment includes detoxification and vitamin therapy, antihistamines. With bullous forms of erysipelas, the blisters are opened and frequently replaced gauze wipes with antiseptic agents are applied. Ointments are not prescribed so as not to once again irritate the skin and not slow down healing. Medications may be recommended local application: dexpanthenol, silver sulfadiazine. As a means of accelerating the regression of skin manifestations, physiotherapy is recommended (UHF, UVI, paraffin, ozocerite, etc.).

In some cases of recurrent forms, patients are prescribed courses of anti-relapse treatment with benzylpenicillin intramuscularly every three weeks. Persistently recurrent erysipelas is often treated with courses of injections for two years. With the presence of residual effects after discharge, patients may be prescribed a course of antibiotic therapy for up to six months.

Forecast and prevention of erysipelas

Erysipelas of a typical course usually has a favorable prognosis and, with adequate therapy, ends in recovery. A less favorable prognosis occurs in the case of complications, elephantiasis and frequent relapses. The prognosis worsens in debilitated patients, elderly people, people suffering from beriberi, chronic diseases with intoxication, digestive disorders and lymphovenous apparatus, immunodeficiency.

The general prevention of erysipelas includes measures for the sanitary and hygienic regime of medical institutions, compliance with the rules of asepsis and antiseptics when treating wounds and abrasions, prevention and treatment of pustular diseases, caries, streptococcal infections. Individual prevention consists in maintaining personal hygiene and timely treatment of skin lesions with disinfectants.

Erysipelas (erysipelas) is an infectious-allergic disease that affects the mucous membranes, subcutaneous fat and skin. The causative agent is Streptococcus pyogenes, or β-hemolytic streptococcus. To destroy it, use the system and local preparations that have bactericidal activity. Antibiotics destroy the pathogenic flora, prevent complications and stimulate tissue healing. The choice of drugs depends on the severity of the infection, the prevalence of lesions.

Basic principles of erysipelas treatment

Antibiotic treatment is carried out in outpatient or stationary conditions. With purulent-necrotic lesions of the skin and tissue, systemic preparations are used, which are administered parenterally (by injection) or orally. The antibiotics of the following groups show the greatest activity against Streptococcus pyogenes:

• penicillins;
• tetracyclines;
• macrolides;
• fluoroquinolones;
• cephalosporins.

For the treatment of lesions, local preparations of bacteriostatic action are used - tetracyclines, sulfonamides, macrolides.

Antibiotics in tablets

Tableted antibiotics are first-line drugs that are prescribed for the treatment of erysipelas. It is recommended to take them in courses of 5 to 10 days.

With severe inflammation of the skin and subcutaneous fat, systemic drugs are combined with local therapy.

Phenoxymethylpenicillin

Before treating erysipelas, it is necessary to determine the optimal drug to destroy the infection. Phenoxymethylpenicillin is a penicillin antibiotic that has bactericidal activity. When taken orally, it is rapidly absorbed into the blood, disrupting the synthesis of the protein components of streptococci.

A low-toxic drug is prescribed for:

• erysipelas;
• phlegmon;
• abscesses;
• lymphadenitis.

The dosage is determined by the severity and extent of the lesions. With a moderate course of streptococcal infection, adults and children from 10 years of age are prescribed up to 1 g of the drug per day. The daily dose is divided into at least 4 doses.

Doxycycline

A semi-synthetic drug from the tetracycline group has activity against pyogenic streptococci and other pyogenic bacteria. It is prescribed to reduce inflammation in case of skin lesions with erysipelas. It is also used to eliminate complications, which include:

• abscesses;
• fiber inflammation;
• ulcerative skin lesions.

Doxycycline destroys the cell walls of Streptococcus pyogenes. Due to this, the number of bacteria in the body decreases. The antibiotic is taken after meals every 12 hours. The maximum daily dose is 200 mg. The course of therapy varies from 7 to 10 days.

Levomycetin

Some antibiotics for erysipelas of the leg are not used, since streptococci neutralize their effect. In this case, drugs are prescribed that are active against bacteria that are resistant to sulfonamides or penicillins. Levomycetin is a drug based on chlormarfenicol, resistance to which develops very rarely.

To eliminate bacterial inflammation in the tissues, 250-500 mg are prescribed up to 4 times a day. With bullous erysipelas, the dose is increased to 1000 mg per day. Levomycetin is a highly toxic antibiotic. Overdose leads to serious side effects - glossitis (inflammation of the tongue), vomiting, stomatitis, enterocolitis, etc.

Erythromycin

The macrolide drug has a bacteriostatic effect on streptococcal infection. In high concentrations, it destroys pathogenic flora. Erythromycin binds to the DNA apparatus of streptococci, preventing the synthesis of daughter cells.

An antibiotic is taken for purulent-inflammatory pathologies of the skin, appendages and fiber. The dosage is determined by the age of the patient:

• children under 14 years old - up to 40 mg per 1 kg of body weight up to 4 times a day;
• adolescents and adults - 250-500 mg 4 times a day.

Tablets are taken one and a half hours before meals for 7-10 days.

Ceftriaxone

A 3rd generation cephalosporin drug is recommended for erysipelas of the lower leg, face and other parts of the body. Suppresses the biosynthesis of cell membranes of streptococci, which prevents their reproduction. It is effective for bacterial inflammation of not only soft tissues, but also bones. It is prescribed for patients with weakened immune defenses.

Dosage Features:

• newborns - up to 50 mg per 1 kg of weight 1 time per day;
• children under 12 years old - up to 80 mg per 1 kg of weight 1 time per day;
• adolescents and adults - 1000-2000 mg every 24 hours.

With bullous necrotic erysipelas, the dose for adults is increased to 4000 mg per day.

Clarithromycin

Before treating erysipelas on the leg, it is necessary to decide on the tactics of antibiotic therapy. Most antibiotics are toxic and cause severe pain in children. adverse reactions. To combat erysipelas in a child, it is recommended to use antibiotics from the macrolide group, since they are less toxic.

Reception features:

• adults and children over 12 years old - 250 mg twice a day;
• with complicated erysipelas - 500 mg twice a day;
• course of therapy - 10-14 days.

Clarithromycin destroys both local and disseminated (generalized) infections. Take the tablets inside, regardless of the meal.

Ampicillin

Beta-lactam antibiotic belongs to the group of penicillins. Shows bactericidal activity against many bacteria:

• streptococci;
• corynebacteria;
• staphylococci;
• anthrax bacilli, etc.

It is used for bacterial inflammation complicated by abscesses, sepsis, necrosis. With a mild course of erysipelas, 250-500 mg of Ampicillin are prescribed three times a day. In severe streptococcal infections, the dose is increased to 10 g divided into 4 doses. The duration of treatment varies from 7 to 14 days.

Ciprofloxacin

A systemic antibiotic from the group of fluoroquinolones interferes with the biosynthesis of DNA of pyogenic streptococci. It destroys pathogens that are dormant or actively multiplying. Appointed for:

• soft tissue infections;
• streptococcal inflammation of the skin;
• blood poisoning;
• non-healing wounds.

Amoxiclav

A penicillin antibiotic is used for uncomplicated bacterial inflammation of the skin. Amoxiclav is not active against bacteria that secrete beta-lactamase. Therefore, it is not included in the treatment of erysipelas complicated by other infections.

Treatment of erysipelas with antibiotics continues for 5-10 days. The dose is determined by the age of the patient:

• children 6-12 years old - 30-40 mg per 1 kg 3 times a day;
• children from 40 kg and adults - 250-500 mg 2-3 times a day.

To prevent irritation of the esophagus and gastric mucosa, Amoxiclav is taken at the beginning of a meal. Wash down the tablets with non-carbonated water - 200-250 ml.

Antibiotic ointments for erysipelas on the leg

Systemic therapy is aimed at destroying the infection throughout the body. And to remove puffiness in inflamed tissues, ointments with antimicrobial action are used. When using local remedies, there is a decrease in pain, itching, burning. Ointment with erysipelas on the leg prevents the spread of infection, damage to healthy tissues around the foci.

Synthomycin

The local drug is active against bacteria that are not sensitive to penicillins, sulfonamides. Synthomycin ointment for erysipelas on the leg eliminates:

• purulent wounds;
• trophic ulcers;
• skin ulceration;
• deep cracks in the foot.

An antibiotic is applied under an occlusive dressing 1 time in 1-3 days. To enhance the antimicrobial effect of the ointment, dressings are made with compressor paper.

Tetracycline

Antibacterial ointment from erysipelas quickly relieves inflammation by destroying pathogens in the lesions. Removes infectious allergic manifestations disease within 3-5 days. But dermatologists warn that beta-hemolytic streptococcus quickly develops resistance to the drug.

Applications with ointment are made 1-2 times a day. The average course of therapy is 3 weeks. It is not recommended to use tetracyclines for pregnant women with erysipelas of the legs or face. Their components have a toxic effect on the fetus.

Erythromycin

A local antibiotic is designed to destroy the infection on the skin, mucous membranes. It is applied to the affected area of ​​the leg with a thin layer 3-4 times a day. The duration of therapy depends on the severity of inflammation and is 4-6 weeks. Erythromycin ointment rarely provokes complications, therefore it is used to treat erysipelas in children.

Streptocid

An antimicrobial agent from the group of sulfonamides disrupts the synthesis of microbial cells. Due to this, the number of streptococci in the lesion is reduced. Streptocid ointment for erysipelas of the leg eliminates local manifestations of the disease:

• puffiness;
• redness;
• bubble rashes;
• purulent accumulations.

It is used for complicated purulent-necrotic forms of erysipelas. The antibiotic is applied openly or under a sterile dressing with a thin layer. The frequency of use is determined by the severity of the infection and ranges from 3 to 8 weeks. It is undesirable to use the ointment for kidney failure.

Preparations for injection

Severe forms of erysipelas are treated only with injections of solution antibiotics. The medicine quickly penetrates into the systemic circulation and destroys pathogenic bacteria.

Injectable drugs are indicated for severe intoxication, which is caused by the accumulation of streptococcal poisons in the body.

Benzylpenicillin

The penicillin antibiotic has a bactericidal effect on pyogenic bacteria. In high doses, it destroys enterococci, staphylococci, peptococci, etc.

With purulent inflammation, sepsis, skin infections, the antibiotic is administered intramuscularly or drip. A single dose is 250-500 thousand units. In the case of gangrenous changes in the tissues, the dosage is increased 3-4 times.

Rifampicin

A semi-synthetic antibiotic used to treat tuberculosis. But it exhibits bactericidal activity against streptococci, so it is also prescribed to eliminate inflammation of a non-tuberculous nature.

Application Features:

• single dose - 900-1200 mg;
• maximum daily dose - 1200 mg;
• frequency of reception - up to 3 times a day.

Rifampicin is not prescribed for children under 6 years of age.

Bicillin-5

The beta-lactam antibiotic has a prolonged bactericidal effect against most pyogenic bacteria. The antimicrobial concentration of Bicillin-5 remains in the bloodstream for more than a day. This provides fast elimination bacterial inflammation in the skin.

The antibiotic is administered exclusively intramuscularly. Adults are prescribed 1,500,000 IU no more than 1 time per month. The course of therapy is 3-12 months.

Gentamicin

In complicated forms of the disease, aminoglycoside antibiotics are prescribed. Gentamicin removes not only bacterial inflammation, but also complications of erysipelas:

• phlegmon;
• lymphadenitis;
• sepsis.

The solution is injected into a vein or muscle. The dosage depends on body weight - up to 3 mg of the drug per 1 kg of body weight intramuscularly. The daily dose is divided into 2-3 injections. The course of therapy is 8-10 days.

Erysipelas is an infectious-allergic disease that requires complex therapy. To quickly remove inflammation, they combine drugs for local, parenteral and oral administration. Uncomplicated erysipelas are treated with antibacterial tablets of the cephalosporin, penicillin and macrolide series.

Probably, the reader more than once had to meet people on the street with inflamed edematous purple spots on the skin of the face, arms or legs. This disease is called erysipelas due to the rich pink hue taken on by the skin. The appearance of a bright spot indicates that the affected tissues are highly inflamed, and the cause of this condition is an infection that has penetrated into the tissues through a small wound. And since any bacterial infection is treated only with the help of antimicrobial agents, antibiotics for erysipelas form the basis of therapy.

What is erysipelas?

Cephradine

The antibiotic "Cefradin" is also considered a drug of the cephalosporin group with a bactericidal effect. It is effective at infectious diseases skin and underlying tissues, including erysipelas. Shows resistance to most beta-lactamases.

It is one of the few cephalosporins that can be taken orally. However, it has release forms that can be used for injections and infusion.

An antibiotic in the form of tablets is prescribed in a daily dose of 1-2 g, divided into 2-4 doses. The maximum allowable daily dosage is 4 g. The dose for the treatment of small patients is calculated based on the ratio: 25-50 mg of the drug per kilogram of weight. The daily dose is recommended to be divided into 2 times.

In / m and / in the infusion of an antibacterial solution is carried out four times during the day. A single dosage can range from 500 mg to 1 g (no more than 8 g per day).

A contraindication to the use of an antibiotic is primarily considered a negative reaction of the body to cephalosporin and penicillin drugs. It is forbidden to use the drug during pregnancy and lactation.

Caution must be observed when prescribing the drug to newborn children, patients with severe disorders of the liver and kidneys, with enterocolitis.

Possible side effects: allergic manifestations (both superficial and severe), headache and dizziness, disruption of the renal system, indigestion, signs of dysbacteriosis and candidiasis, liver problems, stomatitis, changes in blood characteristics. When injected, irritation reactions and swelling at the injection site are possible.

Prescription and use of antibiotics should be carried out taking into account drug interaction with other drugs. It is possible to co-administer with bactericidal antibiotics, but not with bacteriostatic ones due to a decrease in the effectiveness of antibiotic therapy.

Combined use with diuretics, vincomycin and clindomycin preparations increases the toxic effect on the kidneys of Cephradine. We have an identical situation with the simultaneous use of the described antibiotic and antibacterial agents from the group of aminoglycosides.

The drug is incompatible with ethanol.

, , , , , , ,

Imipenem

Let us also pay attention to the antimicrobial drug from the group of carbapenems, which are also considered beta-lactam antibiotics, but they are considered more resistant to specific enzymes produced by streptococcal bacteria. This is a drug called Imipenem.

This effective antimicrobial drug, which is credited with a bactericidal effect, is produced in the form of a powder for preparing a solution, which is immediately used for intravenous and intramuscular administration.

The drug acts quickly. The maximum concentration of the antibiotic in the blood is observed after 15-20 minutes. The drug retains its effect for 5 hours after ingestion.

Antibiotic use: The solution can be used both for intramuscular injections and for droppers. The latter is practiced only in severe cases complicated by sepsis.

Deep intramuscular injections are allowed to be given to adults and young patients from the age of 12. The daily dose ranges from 1000 to 1500 mg. It is recommended to inject twice a day.

The daily dosage for intravenous administration ranges from 1000 to 4000 mg maximum. Droppers should be placed every 6 hours. For children under 12 years of age and over 3 months, the dose is calculated. Based on the ratio: 60 mg per kilogram of the child's weight.

Contraindications for use. The drug is not prescribed to patients who have experienced hypersensitivity reactions to any type of beta-lactam antibiotics. It is dangerous to give infusions or injections to children who have been diagnosed with kidney failure.

It is not forbidden to use an antibiotic during pregnancy for acute indications in case of danger to the life of the mother. Breastfeeding during treatment with the drug is unacceptable.

The side effects of the drug are similar to those of Cephradine, only in some cases additional seizures similar to epileptic seizures and muscle cramps were noted.

Interaction with other drugs. An increase in seizure activity is observed if Imipenem is taken with drugs such as Cilastatin or Ganciclovir.

Oxacillin

Let's go back to penicillins known for a long time. The new generation of these effective antibiotics for erysipelas is characterized by increased resistance to bacterial beta-lactamase, which is an obstacle to the development of antibiotic resistance. One of these drugs is Oxacillin.

The antibiotic has a pronounced antimicrobial effect against most pathogens of streptococcal erysipelas and other groups.

The antimicrobial drug in the form of a lyophilizate is intended for the preparation of a solution, which is then used for intramuscular injections or intravenous droppers. The medicine for injections is diluted with water for injections (3 g per vial of antibiotic). V / m injections should be made in the area of ​​\u200b\u200bthe inner quadrant of the buttocks.

For intravenous injections, water for injection or saline (5 ml) is added to lyophysilate at a dose of 0.25-0.5 g. The injection is done slowly, for 10 minutes.

Infusion administration involves the dissolution of lyophysilate in saline or glucose solution. The dropper is placed for 1-2 hours.

A single dose of the drug for injection ranges from 0.25 mg to 1 g. Injections are recommended to be done every 6 hours.

The course of treatment is usually 1-3 weeks or more.

With prolonged administration of large doses of the drug, an overdose phenomenon is possible, which is accompanied by bleeding and the development of dangerous superinfections. Kidney function may also be disrupted due to the toxic effect of the antibiotic.

Restrictions on use: "Oxacillin" is not used to treat patients with hypersensitivity to beta-lactam antibiotics, as well as with a tendency to allergies.

Side effects of the drug can manifest as allergic reactions, including anaphylaxis and bronchospasm. In this case, therapy is supplemented with antihistamines.

While taking the medicine, nausea and vomiting, stool disorders, malfunctions of the liver and kidneys, the development of candidiasis of the skin and mucous membranes, pseudomembranous colitis, etc. can be observed.

Drug interactions: "Oxacillin" belongs to the category of bactericidal antibiotics, which means that bacteriostatic antimicrobial agents can reduce its effectiveness.

The use of "Probenecid" can provoke an increase in the serum concentration of the antibiotic, which has a negative effect on the kidneys.

To expand the spectrum of action of "Oxacillin", it is advisable to combine it with such AMPs of the penicillin series as "Ampicillin" and "Benzylpenicillin".

Storage conditions. The optimum temperature regime is 15-25 degrees. Dry darkened rooms are suitable for storing the medicine. Keep away from children.

Best before date. With proper storage, the drug remains effective and relatively safe for 2 years.

Clindomycin

According to the annotation to the drug from the group of lincosamides called "Clindomycin", this antibiotic can also be successfully used in the treatment of erysipelas.

Pharmacodynamics. This antimicrobial and antiprotozoal agent in small concentrations has a bacteriostatic effect, i.e. inhibits the growth and reproduction of bacteria, however, an increase in the concentration of the antibiotic leads to the rapid death of bacteria (bactericidal effect).

Pharmacokinetics. It quickly passes into the blood when taken orally, but eating food can somewhat slow down this process. Easily spreads through various fluids and tissues of the body, including exudate of wound surfaces. The kidneys and intestines are involved in the excretion of the drug from the body.

The drug can be found on pharmacy shelves in the form of tablets (capsules) for internal use, injection solution, vaginal tablets, gel for external use.

Application of the medicine: Antibiotic capsules are taken between meals with a glass of water, which will help protect the gastric mucosa from irritation. The daily dosage for adults ranges from 4 to 12 capsules, depending on the severity of the infection. The frequency of taking the drug - 3-4 times a day.

For children from 6 years old, the dose is calculated based on the ratio: 8-25 mg per kilogram of the child's weight. For young children, the drug is administered by injection.

To increase the effectiveness of antibiotic therapy, this antimicrobial drug is recommended to be combined with penicillin drugs. In this case, the dose will be less, which means that the toxic effect of the drug will also be less.

Contraindications for use. Systemic use of an antibiotic is prohibited in case of intolerance to the drug, hypersensitivity to lincomycin, infectious meningitis, regional enteritis, ulcerative colitis, inflammation of the intestine against the background of antibiotic therapy. myasthenia, severe violations liver and kidneys. In pediatrics, it is used from 1 month.

Possibilities of use during pregnancy: Despite the fact that Clindamycin is able to cross the placenta and accumulate in the liver of the fetus, it has not been found to have a negative effect on the developing organism or the course of pregnancy. For this reason, an antibiotic, according to the doctor's indications, can be used during pregnancy. But from breastfeeding better to be.

Side effects. Taking the drug can provoke changes in the composition of the blood. Rapid intravenous administration of the drug is undesirable because it can cause symptoms of heart failure, the development of collapse and arterial hypotension.

Oral medication may be accompanied by pain in the epigastrium, the development of colitis, nausea, and stool disorders. Sometimes there are violations of the liver and kidneys. There is a taste of metal in the mouth.

Allergic reactions, usually. Easy and moderate. Anaphylaxis can develop only in case of hypersensitivity to the drug.

Interaction with other drugs. The incompatibility of "Clindamycin" is noted with groups of drugs such as aminoglycosides and barbiturates. You can not mix the antibiotic with solutions containing B vitamins. This antibiotic is also incompatible with preparations based on ampicillin, phenytoin, aminophylline, calcium gluconate and magnesium sulfate.

When used together with erythromycin and chloramphenicol, drug antagonism is suspected, which negates therapy.

Caution must be observed when taking an antibiotic simultaneously with muscle relaxants, because of the danger of impaired neuromuscular conduction.

Opioid analgesics, taken against the background of antibiotic therapy with clindamycin, can greatly reduce respiratory function and cause apnea.

The combined use of an antibiotic and drugs for diarrhea can provoke the development of pseudomembranous colitis.

Storage conditions. You can store the antibiotic at room temperature, protected from direct sunlight and children.

The manufacturer guarantees that, subject to the requirements for storing the medicine, it retains its antibacterial properties for 3 years.

, , , ,

Olethetrin

Another antibiotic with a bacteriostatic effect, which has found application in the treatment of erysipelas, is called Oletetrin. This medicine does not belong to a specific group of antibiotics, as it is a combination of macrolide oleandomycin and tetracycline, which helps to reduce the rate of development of antibiotic resistance to the drug.

The drug is produced in the form of tablets of various dosages (125 and 250 mg).

Method of application and dose. It is recommended to take an antibiotic after meals to reduce the irritating effect of tablets on the gastrointestinal mucosa. For the same reason, it is recommended to drink the medicine with a sufficient amount of liquid.

A single dose for adults is 250 mg. Multiplicity of reception - 4 times a day. For children from 8 years old, an effective and safe single dosage is calculated based on the ratio: 5-7 mg per kilogram of the patient's weight with the same frequency of administration. The course of treatment is usually 1-1.5 weeks.

Contraindications for use. "Oletetrin" can not be prescribed to patients who have an increase in sensitivity to the components of the drug, those who suffer from leukopenia or mycoses. It is dangerous to prescribe this antibiotic to patients with severe liver and kidney dysfunction.

In pediatrics, the medicine is used from the age of 8.

Use during pregnancy and lactation is unacceptable.

Side effects. Taking pills in different patients may be accompanied by problems with the gastrointestinal tract in the form of a deterioration in appetite, nausea with vomiting, stool disorders, and epigastric pain. Cases of the development of an inflammatory process in the tissues of the tongue (glossitis) and allergic reactions have also been reported. There is a possibility uterine bleeding while taking oral contraceptives.

Can affect the color of teeth in children, which has irreversible consequences.

If the drug is taken long time possible violation of the internal microflora and the development of thrush. Prolonged antibiotic therapy can lead to a lack of B vitamins in the body or an increase in photosensitivity.

Interaction with other drugs. Acid-lowering agents, preparations that contain iron, and dairy products make it difficult for the absorption of this antimicrobial substance in the digestive tract.

An antibiotic that has a bacteriostatic effect cannot be used in conjunction with bactericidal ones, as this will reduce the effectiveness of antibiotic therapy.

"Oletetrin" should not be taken together with retinol. This can lead to a strong increase intracranial pressure. Parallel administration with methoxyflurane increases the toxic effect on the body of the latter, which affects the functioning of the kidneys.

Storage conditions. The optimal temperature regime for storing antibiotics is from 15 to 25 degrees. Under such conditions, it retains its properties for up to 2 years from the date of issue.

It's time to talk about the latest developments pharmaceutical industry, which, along with old drugs, doctors are beginning to actively include in the treatment of erysipelas. It must be understood that new generations and varieties of antibiotics effective for erysipelas and other infectious lesions of the skin and muscles were developed taking into account mutational changes in the environment of pathogenic microorganisms that caused the emergence of new bacterial strains resistant to many antimicrobial drugs. It is not in vain that doctors prefer innovative developments, because they are effective even where other antibiotics do not work due to the development of antibiotic resistance.

Linezolid

So, "Linezolid" is a synthetic drug from a new group of antibiotics (oxazolidones) with a unique mechanism of action (pharmacodynamics), which has not yet been fully studied. It is only known that linezolid is able to disrupt protein synthesis. It binds to the ribosomes of bacteria and disrupts the formation of the complex responsible for the translation of genetic material to future generations. Cross-resistance in the antibiotic, which is so far the only representative of oxazolidones, with other antibiotic options is not observed due to the fact that their mechanism of action is different from others.

The drug finds active use with a severe course of the infectious process on the skin and in soft tissues. The only drawback of the drug is its high cost.

Pharmacokinetics. The drug is characterized by almost 100% bioavailability even when taking tablets, which is quite rare. The drug is able to easily penetrate into various tissues of the body, with the exception of white adipose tissue and bones. Metabolized in the liver. It is excreted mainly by the kidneys.

Release form. The medicine can be found on sale in the form of a solution used for infusions and tablets weighing 600 mg.

Method of application and dose. Intravenous administration antibiotic is carried out by infusion twice a day, in adults with an interval of 12 hours, in children - 8 hours. The infusion should last from half an hour to 2 hours.

A single dose for patients over 12 years of age is 600 mg of linozolid (300 ml of solution), for children under 12 years of age it is calculated as 10 mg per kilogram of the child's weight.

The therapeutic course is from 10 to 14 days. But as soon as the patient becomes better, he is transferred to oral medication in the same dosage.

Contraindications for use. Solution for infusion is used in the treatment of children from 5 years of age, tablets - from 12 years of age. Do not prescribe droppers for intolerance to the components of the drug.

Tablets are restricted for uncontrolled hypertension, pheochromocytoma, carcinoid, thyrotoxicosis, bipolar disorder, schizophrenia, and affective disorders, acute attacks of dizziness.

Use during pregnancy. The drug is still little studied, but there is reason to consider it potentially dangerous to the fetus and newborns. This means that during periods of pregnancy and breastfeeding, drug therapy is not recommended.

Side effects. The most common of the unpleasant symptoms observed during antibiotic treatment are headaches, nausea with vomiting, diarrhea, the development of fungal infections, the appearance metallic taste in the mouth, liver dysfunction, changes in blood characteristics. Rarely, cases of development various kinds neuropathy.

Interaction with other drugs. This innovative antibiotic can be attributed to the group of weak reversible MAO inhibitors, so it is not advisable to use it in conjunction with drugs that have a similar effect.

"Linezolid" in the form of a solution for droppers can be mixed with the following formulations:

• glucose solution 5%,
• saline,
• Ringer's solution.

Do not mix in the same container for infusion "Linezolid" and any other medicines other than the above.

Antagonism may occur if Linezolid is taken at the same time as the following drugs:

• ceftriaxone,
• amphotericin,
• chlorpromazine,
• diazepam,
• trimethoprim-sulfamethoxazole.

The same applies to pentamidine, phenytoin, erythromycin.

Storage conditions. Store the antimicrobial agent in a dry place away from sunlight at room temperature.

The shelf life of the drug, regardless of the form of release, is 2 years.

Cubicin

Another completely new antimicrobial drug that can be successfully used in the treatment of severe erysipelas has active substance named daptomycin. On the market, an antibiotic from the group of cyclic lipopeptides of natural origin can be found with the name "Cubicin".

Release form. The drug is produced in the form of a lyophilisate, from which an infusion solution is prepared (vials of 350 or 500 mg).

Pharmacodynamics. This antibiotic is advisable to use to combat gram-positive microorganisms. It has a rapid bactericidal effect, which allows you to normalize the patient's condition in a short time.

Pharmacokinetics. It is fairly quickly and well distributed within tissues richly supplied with blood vessels. Able to cross the placenta. It is excreted mainly by the kidneys.

Method of application and dose. The drug is intended for use in droppers. You need to enter it for at least half an hour. The daily (single) dose of the drug for adult patients is calculated as 4 mg per kilogram of weight. The course of treatment is 1-2 weeks.

Overdose. With the introduction of large doses of the drug may increase side effects. Treatment is symptomatic. It is possible to remove the antibiotic from the body using hemodialysis or peritoneal dialysis.

Contraindications for use. The main contraindication to drug therapy is hypersensitivity to its components. Caution must be observed when prescribing an antibiotic to patients with severe impairment of the kidneys or liver, obesity, people over 65 years of age.

Side effects. Taking the drug can provoke the development of superinfections: fungal pathologies and UTIs. Also, sometimes there are changes in the composition of the blood, metabolic disorders, anxiety and deterioration of sleep, headaches and dizziness, deterioration in taste perception, numbness of the extremities, and an increase in heart rate. Some patients complain of redness of the face, disruption of the gastrointestinal tract, kidneys and liver, the appearance of itching and rashes on the skin, myalgia, hyperthermia, and weakness.

Interaction with other drugs. The drug should be used with extreme caution if the patient is being treated with drugs that can cause myopathies or potentially nephrotoxic drugs.

Perhaps the combined use of daptomycin with drugs such as aztreonam, ceftazidime, ceftriaxone, gentamicin, fluconazole, levofloxacin, dopamine, heparin, lidocaine.

Storage conditions. Store the solution for infusion in a cold place at a temperature of 2 to 8 degrees.

Best before date. Use within 3 years.

One of dangerous consequences Systemic antibiotic therapy is considered to be the development of dysbacteriosis, because antimicrobial drugs do not have a selective effect, which means that, together with pathogenic microflora, they destroy the beneficial one. It is possible to prevent the development of dysbacteriosis in the body, from the first days of antibiotic treatment, taking drugs in parallel with them that restore the beneficial microflora and the protective functions of the body.

Local antibiotic therapy for erysipelas

So far we've been talking about systemic drugs preventing the spread of infection within the body. However, erysipelas has specific external manifestations in the form of severe redness and swelling of the skin, which means that in this case, one cannot do without external agents with an antibacterial effect.

Antibiotics for local therapy in erysipelas are not unique. More often than others, erythromycin, synthomycin and tetracycline ointments are prescribed, which have a fairly wide range of applications for various skin pathologies.

Erythromycin ointment

Erythromycin ointment refers to local antibiotics with bacteriostatic action, which have long been used to treat acne and acne. However, it also shows good efficacy in the treatment of other inflammatory pathologies of the skin and soft tissues caused by a bacterial infection.

The medicine in the form of an ointment can only be used externally. It should be applied to inflamed tissues 2 to 3 times a day with a thin layer. The course of local antibiotic therapy will be at least 1.5 months.

Increasing the dose or frequency of application of the ointment may lead to greater severity of side effects.

Only hypersensitivity to its composition is considered a contraindication to the use of the ointment. Since the active substance of the ointment is able to penetrate deep into the tissues of the body, including the placenta, it should be used during pregnancy only under strict indications. Breastfeeding for the duration of treatment, doctors advise interrupting.

At the site of application of the ointment, redness, burning, peeling and itching may occur. A rash on the skin and mild manifestations of allergies are possible.

Drug interactions: Erythromycin is incompatible with antimicrobial agents such as lincomycin, clindamycin and chloramphenicol. May reduce the effectiveness of drugs that act bactericidal.

When treating with erythromycin ointment, abrasive agents should not be used on the skin.

Store the ointment at temperatures above zero, but not more than 20 degrees. It is allowed to use erythromycin ointment for 3 years from the date of production.

Ointment Tetracycline 3%

"Tetracycline" 3% - an antibiotic ointment used for erysipelas and other skin pathologies caused by an infectious factor. It is another drug with a wide spectrum of antibacterial activity with a bacteriostatic effect.

Unlike erythromycin ointment, tetracycline in the form of an external agent is practically not absorbed into intact skin and does not enter the systemic circulation, which makes it safe to use during pregnancy and lactation.

Restrictions on the use of antibiotic ointment are considered to be hypersensitivity to the components of the drug and the age of younger than 11 years.

It is used only for topical skin treatment. It should be applied to diseased tissues 1 or 2 times a day with a thin layer. It is allowed to apply a sterile bandage on top.

They appear mainly at the site of application of the ointment. Redness, burning, swelling or itching on the skin covered with ointment is quite possible.

The external agent in the form of an ointment is stored at room temperature for no more than 3 years from the date of issue.

Another effective topical remedy for erysipelas is a topical chloramphenicol-based liniment called Synthomycin. Most often, doctors prescribe a 10% antibiotic ointment.

The active substance of the ointment - chloramphenicol - is a bacteriostatic antibiotic that is active against strains that have developed resistance to penicillins and tetracyclines during evolution.

Liniment can be applied both directly on the wound and under the bandage 1 time in 1-3 days.

Contraindications to the use of the ointment are hypersensitivity to its components, porphyrin disease, which occurs with a violation of pigment metabolism, fungal skin lesions. Do not use on skin with signs of eczema and psoriasis. Care should be taken when prescribing an ointment to patients who have impaired kidney or liver function, diagnosed with a lack of glucose-6-phosphate dehydrogenase, newborns.

Therapy with synthomycin ointment may be accompanied by allergic reactions and changes in blood composition.

Drug interactions: Chloramphenicol can reduce the antibacterial effect of certain drugs (penicillins, cephalosporins).

The instruction does not recommend the simultaneous use of this antibiotic with macrolides and lincosamides (clindamycin, lincomycin, erythromycin).

According to doctors, antibiotics for erysipelas should be used only in the phase of active infection. Preference is usually given antimicrobials penicillin series. However, the main condition for effective antibiotic therapy was and remains the compliance of the antibiotic chosen by the doctor with the causative agent of the disease detected in the body. Otherwise, the treatment will not have a positive result, but will only contribute to the already urgent problem of antibiotic resistance.

Erysipelas is a problem that anyone can face. This disease has the status of recurrent and can manifest itself at any age.

World statistics show that the disease is very common and ranks fourth after hepatitis, intestinal, and respiratory problems. The trend observed by specialists is not at all encouraging: over the past 20 years, the incidence of erysipelas has increased by 25%. As for mortality, the problem under consideration causes the death of only 5% of all patients.

To combat the disease in question, specialists in the field of medicine most often use antibiotics. Let us further consider a list of the most popular and effective of them, as well as recommended dosages.

Main groups of antibiotics

With erysipelas, medical experts recommend antibiotics to their patients, classified into four main groups: penicillins, macrolides, tetracyclines and levomycetins. The drugs assigned to each of them perform certain actions with the protein contained in the body, which, in the process of inflammation, is directed to the formation of new bacterial cells.

As for the form of release of drugs, they can be presented in as well as solutions for injection.

Penicillins

The most common group of antibiotics that treat erysipelas are penicillins. Means of this type can be presented both in the form of dragees (tablets) and in the form of injection solutions in capsules.

Preparations containing penicillin, entering the body, begin their interaction with the enzymes that make up the cell membrane, resulting in not only cell destruction, but also the death of the microorganism itself that causes inflammation. Specialists in the field of medicine, as a rule, prescribe this remedy in cases where the cause of the disease is a bacterium that has the property of growth and reproduction. Empirically, it has been found that penicillin treatment becomes more effective when it is used in combination with Streptocid or Furazolidone.

The most commonly used antibiotics for erysipelas are Benzylpenicillin, Bicillin-5, and Phenoxymethylpenicillin. The first version of the drug is presented in the form of solutions for injection, which should be injected into the affected area twice a day, 250,000-500,000 IU. The duration of treatment in this way can be up to a month. Bitsillin-5 is presented in the same form. Injections with this composition are made very rarely - once a month, but for a couple of years. The use of this drug is carried out to prevent possible relapses. As for "Phenoxymethylpenicillin", this drug is offered to patients both in the form of syrup and in tablets. The process of treating erysipelas with an antibiotic of this type should be carried out within a week if the disease is at an early stage, and about 10 days if it has already begun to progress.

Tetracyclines

It should be noted that penicillin antibiotics with erysipelas are classic drug. All other drugs can be prescribed only if the patient's body has an individual intolerance to penicillin.

The peculiarity of the action of tetracyclines is that these components are aimed at inhibiting the process of protein synthesis, which is required to build new bacterial cells.

most famous and effective drug containing tetracyclines is "Doxycycline". This remedy is presented in the form of dragees, which must be consumed twice a day after meals with water.

Levomycetins

What antibiotics for erysipelas are used by medical specialists to treat the disease? Under the condition of individual intolerance to penicillin, these are levomycetins, which slow down the growth of the number of streptococci in the human body, acting in a manner similar to tetracyclines.

How to treat erysipelas? Levomycetin antibiotics are presented in tablets of the same name. They must be taken three times a day, 250 mg each. The total duration of treatment with this drug is 1-2 weeks, depending on the extent of inflammation.

Macrolides

As for the peculiarities of the action of the preparations of this series, it consists in the complete suppression of the activity of pathogenic bacteria in the human body, as a result of which it completely subsides, and the microorganisms begin to die. However, the second effect is possible only if the doctor prescribes a high dose of the drug.

What antibiotics to take for erysipelas? The most famous drug from the macrolide series is "Erythromycin", which is presented in the form of tablets intended for oral administration (1/4 g, 4-5 times a day, one hour before meals).

The most popular drugs

There is a certain list of drugs that are recognized as the most effective in combating skin inflammation, called erysipelas. These include Linezolid, Kubicin and Oletetrin. Let's consider each of them in more detail.

As for Linezolid, this agent belongs to a group of synthetic drugs that have a special mechanism of action, which consists not only in protein synthesis, but also in disrupting the formation of a separate complex, which can subsequently be passed on to future generations. This antibiotic is excellent for erysipelas on the leg, the effectiveness of its action is especially noticeable when the inflammation is quite large. With regard to dosing, this remedy must be taken in an amount of 600 mg at a time, twice a day.

"Cubicin" is another new generation remedy that, from the very moment of its appearance on the pharmacological market, has attracted the attention of medical specialists involved in the treatment of erysipelas and skin inflammations of a different type. This tool has gained its popularity due to the instant bactericidal effect, which is observed already in the first hours after application. The drug in question is produced exclusively in the form of solutions that must be injected into the muscle with a needle. The course of treatment with this medicine is no more than a couple of weeks. The daily dose of the drug for an adult individual should be calculated individually - 4 mg of the substance per kilogram of body weight.

With the help of which antibiotics is erysipelas on the leg eliminated the fastest? These include "Oletetrin" - a substance that has a bacteriostatic property. In its composition, it is a mixture of oleandomycin, tetracycline and macrolide - such components are excellent for those individuals who are characterized by individual intolerance to penicillin. The medicine is available in the form of tablets with different dosages. It is necessary to take the remedy 4 times a day, 250 mg each (for an adult).

Despite the wide variety medicines, which help to deal with the problem, the antibiotic with which the treatment of erysipelas will be most effective should be selected by a specialist in the field of medicine and only after a preliminary examination.

Indications for the use of antibiotics

Which antibiotics can be drunk with erysipelas, and which ones are not - this should be determined by the attending doctor. To do this, he conducts an examination and examines the personal medical card patient, as well as the condition of the inflammation itself.

There are certain situations that are direct indicators for the use of antibiotics for erysipelas in the treatment process. These cases include: the diagnosis of advanced erysipelas, as well as the absence positive results after treatment by other methods and means.

Combination with other drugs

In order to more effectively deal with the problem that has arisen, almost all medical specialists prescribe complex treatment to their patients, which is the use of antibiotics in combination with other drugs. As a rule, among those there are antiallergic drugs, of which Tavegil, Diazolin and Suprastin are considered the most popular. The course of treatment with antibiotics in combination with drugs of this type should last about 7-10 days, 1-2 tablets should be taken every day, depending on the common features human body. As a rule, during such treatment, the patient undergoes painful swelling, and the allergic reaction also disappears.

Often, a course of antibiotic treatment is combined with the use of sulfonamides and nitrofurans. As a result of this combination in the human body, the processes of formation of bacteria that develop puffiness will be disrupted.

Often, specialists in the field of medicine prescribe various biostimulants to their patients - substances that help strengthen immunity. In some cases, patients are prescribed glucocorticoids - these components, according to many doctors, on the contrary, have a detrimental effect on immune system the human body, although they have an excellent anti-allergic effect. The optimal solution problems, many experts in the field of medicine consider a course consisting of antibiotics and multivitamins, which replenish the vitamin reserve in a difficult period for the body.

Some treatments involve a combination of antibiotics and injections of thymus enzymes and proteolytic enzymes. Such treatment methods activate the nutrition of muscle tissues and improve the resorption of the infiltrate.

Leather processing

In the process of treating erysipelas, antibiotics have a positive effect. However, it should be understood that the internal treatment of the problem is not enough to get the desired effect as quickly as possible. For this, it is necessary to apply some external influences. The course of treatment of the disease involves the use of some compresses with various skin-friendly solutions. In particular, this is true in the treatment of erysipelas on the leg.

What antibiotics should be moistened with compress dressings? As a rule, for such purposes it is recommended to use the aerosol "Oxycyclozol", as well as "Furacilin" and "Microcid". Leave such compresses on the affected areas for 3-4 hours - during this time, all the bacteria that have settled in the upper layers of the skin and on its surface will be destroyed.

Some experts recommend using a 50% solution of Dimexide, as well as powder with Enteroseptol. The second agent can be applied by scattering a small layer on the inside of clean clothes. This technique is great for the case when the face is on the leg. Antibiotics in this case are also prescribed - this will speed up recovery.

Hygiene rules

In the event that a patient has erysipelas, a specialist in the field of medicine must necessarily recommend that he observe certain rules of personal hygiene, even though the disease is not dangerous to others and the patient can safely stay at home. However, the practice of observing elementary rules of hygiene allows you to speed up the process of final recovery.

First of all, pay attention to the regularity of taking a shower - it is advisable to do this every day. Experts do not recommend using a bath for such purposes, especially with hot water. The area affected by the infection does not need to be rubbed - it is enough just to wash it with soap. After performing water procedures, it is advisable to lie down on a bed with clean linen, which is also recommended to be changed every day. Separate requirements are put forward in relation to the material from which the bed linen is made - it must be natural and soft (preferably cotton).

In addition to taking antibiotics, with erysipelas, it is necessary to do daily washing of the inflamed area using herbal decoctions(it is recommended to take coltsfoot or medicinal chamomile). In the event that the erysipelas has formed in the genital area or on the face, it is best to use calendula or string to create decoctions, and if the inflammation is at the healing stage and is covered with roughness, then at this stage it is best to lubricate the affected area with rosehip oil or juice, squeezed out of Kalanchoe.

Disease prevention

In order not to get sick with erysipelas, you should carefully monitor not only your health, but also your lifestyle. Special attention should be paid to water procedures, which should be carried out as often as possible (maximum - once a day). This is necessary so that a person can avoid diaper rash in various places that cause the formation of a problem. In the event of such, after taking a shower, the body should be treated with powder.

Special attention should be paid to personal hygiene products. It should be noted that for bathing it is best to use a shower gel with a pH level of less than 7. The same rule applies to soap. Best Option It turns out that the agent, which includes lactic acid. This is necessary in order not to break the protective layer of the skin, the presence of which prevents the occurrence of various infections.

In order to avoid the manifestation of erysipelas and subsequent treatment of the disease, it is necessary to treat wounds and damage that form on the body in a timely manner. For this purpose, it is best to use camphor oil, Yoddicirin, and hydrogen peroxide.