Penicillin is an antibiotic that changed the world
Penicillin tablets refers to antibiotics that are actively used to combat a number of bacterial diseases that arise as a result of the pathological activity of pathogens that are sensitive to penicillin. Let us consider in more detail the principle of action and features of the use of the presented drug.
Penicillin is an antibacterial agent resulting from the use of waste products of a particular mold fungus called Penicillium. The presented antibiotic drug is characterized by a wide spectrum of action, contributing to the destruction of such pathogens as spirochete, gonococcus, staphylococcus and others. Identical properties have modern counterparts of this drug (for example, phenoxymethylpenicillin). The drug is available in the form of a solution for injection, as well as tablets intended for resorption and for oral administration.
Indications for use
These medications are widely used in the field of modern medicine to combat a number of different diseases that are bacterial in nature. Experts identify the following indications for the use of penicillin tablets:
- Brain abscess.
- Infectious lesions of the upper respiratory tract.
- Otitis in acute or chronic form.
- Burn lesions in the third and fourth degree.
- Extensive wound surfaces localized in the skin.
- Gangrene gas.
- Scarlet fever.
- Purulent and inflammatory diseases of gynecological nature.
- Septic endocarditis in acute form.
- Infectious lesions of the urinary tract.
- Acute or chronic osteomyelitis.
- Purulent infectious diseases affecting mucous membranes and soft tissues.
- Empyema pleura.
- Laryngitis and tonsillitis.
- Inflammation of the lymph nodes.
Penicillin preparations are well tolerated by pediatric patients. In the field of pediatrics, the presented medicines are used in cases when there is:
- Pneumonia in newborns.
- Pleurisy of purulent nature.
- A septic process localized in the umbilical region.
With a high degree of effectiveness in the fight against infectious diseases of a bacterial nature, the use of penicillin tablets in some cases is not highly recommended and can be dangerous for the patient. There are the following contraindications to the use of drugs of this pharmacological group, as well as their analogues:
- Tendency to allergic reactions.
- Bronchial asthma.
- Ulcerous colitis.
- Increased individual sensitivity to the drug.
- Infectious mononucleosis.
- Enteritis is regional.
- Serious disorders in the functioning of the digestive system.
- Severe diseases of the gastrointestinal tract.
- Stomatitis aphthous.
- Renal pathology.
- Heart failure in acute form.
In some cases, the use of penicillin preparations may cause the development of undesirable reactions, such as:
- Attacks of vomiting.
- Allergic reactions.
- Increased body temperature.
- Candidiasis of the vagina and oral cavity.
However, in medical practice, only a few such incidents were recorded. In addition, it is necessary to emphasize that in most cases the development of side effects is observed with prolonged and uncontrolled intake of drugs.
In order to avoid possible complications and reduce the risks to a minimum, it is recommended to take medications only on prescription, strictly following his instructions and following the instructions for use. The choice of a specific drug, its dosage and the duration of the therapeutic course are determined by a specialist taking into account the disease, its severity, age and the individual characteristics of the patient.
Principles of application
Instructions for the use of penicillin group drugs states that the optimal dosage of the drug depends on the therapeutic regimen prescribed by the attending physician. Dosage for children is calculated individually, depending on the age and body weight of the child.
It is necessary to take pills every 8 hours. This rule is recommended to strictly observe, in order to achieve an optimal concentration of the active substance. The medicine is taken either half an hour before a meal, or 2 hours after a meal.
The average duration of treatment is from 5 to 14 days. The first results become noticeable after 3-4 days. If no visible effect is observed, you should contact your doctor to prescribe another antibiotic drug.
The advantages of the tablet form of the drug
Recently, the use of a tablet form of penicillin preparations has become particularly widespread, due to its undoubted advantages. First, the patient can save on the purchase of syringes and special solutions needed for injection. Secondly, the therapeutic course can be taken on an outpatient basis, without the help of medical personnel. In addition, the tablets include so-called antacid substances that help reduce the effect of gastric juice on the main active ingredient, ensuring the maximum therapeutic effect.
Doctors recommend the following list of modern tablets preparations related to penicillins:
Penicillin preparations are an extremely effective and effective remedy that helps to cure numerous infectious diseases. Compliance with medical recommendations and basic rules of application allows to achieve extremely fast and favorable results, while avoiding the occurrence of undesirable reactions and side effects.
The discovery of the antibacterial properties of penicillin occurred in 1928. Alexander Fleming, a well-known scientist, as a result of conducting an ordinary experiment with staphylococcal colonies, found spots of ordinary mold in some culture dishes.
As it turned out on further study, there were no harmful bacteria in the cups with mold spots. Subsequently, it was from the usual green mold that the molecule was removed that was capable of killing bacteria. This is how the first modern antibiotic, Penicillin, appeared.
Today, penicillins are a whole group of antibiotics produced by certain types of mold (genus Penicillium).
They can be active against whole groups of gram-positive microorganisms, as well as some gram-negative microorganisms: gonococci, streptococci, staphylococci, spirochetes, meningococci.
Penicillins belong to a large group of beta-lactam antibiotics, which have in their composition a particular molecule of beta-lactam ring.
Penicillin antibiotics are used in the treatment of a huge number of infectious diseases. They are prescribed for the sensitivity of pathogenic microorganisms to the drug for the treatment of the following pathologies:
- many types of pneumonia,
- septic endocarditis,
- bacterial pharyngitis,
- infections of the urogenital system, most of the digestive tract,
- scarlet fever,
- gynecological diseases
- diseases of ENT organs,
- syphilis, gonorrhea and many others.
Also, this type of antibiotic is used in the treatment of wounds infected with bacteria. As prevention of suppurative complications, the drug is prescribed in the postoperative period.
The drug can be used in children with umbilical sepsis, pneumonia, otitis media in newborns and infants, and young children. Penicillin is also effective in purulent pleurisy and meningitis.
The use of penicillin in medicine:
Modern pharmacological companies produce penicillin preparations for injections or in the form of tablets. Means for intramuscular injection are produced in bottles (made of glass), sealed with rubber stoppers, and on top with metal caps. Before the introduction of the substrate is diluted with sodium chloride or water for injection.
Tablets are available in cellular packaging dosage from 50 to 100 thousand IU. It is also possible to produce ecmoline tablets for sucking. The dosage in this case does not exceed 5 thousand units.
Mechanism of action
The mechanism of action of penicillin is the inhibition of enzymes involved in the formation of the cell wall of microorganisms. The cell wall protects the bacteria from environmental exposure, disruption of its synthesis leads to the death of pathogenic agents.
This is the bactericidal effect of the drug. It acts on certain varieties of gram-positive bacteria (streptococci and staphylococci), as well as on several varieties of gram-negative bacteria.
It is worth noting that penicillins can only affect breeding bacteria. Shells are not built up in inactive cells, so they do not die due to enzyme inhibition.
Instructions for use
The antibacterial effect of penicillin is achieved by intramuscular injection, by ingestion, as well as by local action. More often for treatment use the injection form. When administered intramuscularly, the drug is rapidly absorbed into the blood.
However, after 3-4 hours it completely disappears from the blood. Therefore, it is recommended that regular administration of drugs with equal intervals of 4 times per day.
The drug is allowed to be administered intravenously, subcutaneously, as well as into the spinal canal. For the treatment of complex pneumonia, meningitis or syphilis, a special scheme is prescribed, which can only be prescribed by a doctor.
When taking penicillin in tablet form, the physician must also determine the dosage. As a rule, 250-500 mg every 6-8 hours are prescribed for bacterial infections. If necessary, a single dose may be increased to 750 mg. Take the pill should be half an hour before meals or 2 hours after. The duration of the course will tell the doctor.
Since penicillins are a natural drug, they have minimal toxicity among other groups of antibiotics, artificially derived. However, the occurrence of allergic reactions is still possible.
They manifest as redness, a rash on the skin, sometimes anaphylactic shock can occur. The occurrence of such pathologies is possible due to individual sensitivity to the drug or in violation of instructions.
Against the background of the use of penicillins, other side effects may occur:
Why an antibiotic allergy may appear, says Dr. Komarovsky:
When taking doses of penicillin, much higher than prescribed by a doctor, an overdose may occur. The first signs: nausea, vomiting, diarrhea. Such conditions are not dangerous for the life of the patient. Patients with insufficient kidney function may develop hyperkalemia.
Large doses of the drug, administered intravenously or intraventricularly, can trigger epileptic seizures. Such symptoms can occur only with the introduction of a single dose of more than 50 million units. To facilitate the patient's condition, benzodiazepines and barbiturates are prescribed.
Before using penicillin, tests are mandatory to determine sensitivity to the antibacterial drug. It is advisable to prescribe this drug to patients with disorders of renal function, as well as patients who have heart failure.
It is necessary to wash down the tablet form of penicillin with a large amount of liquid. In the process of treatment with antibiotics of penicillin, it is important not to miss the recommended doses, since the effect of the drug may be weakened. If this happens, you should take the missed dose as soon as possible.
Rules for the use of antibiotics:
In the appointment of penicillin should pay attention to its interaction with other means used. You can not combine this antibiotic with the following drugs:
- Tetracycline reduces the effectiveness of penicillin antibiotics.
- Aminoglycosides are able to conflict with penicillin in a chemical aspect.
- Sulfonamides also reduce the bactericidal effect.
Penicillin is considered one of the most inexpensive antibacterial drugs. The price of 50 bottles of powder to create a solution varies from 280 to 300 rubles. The cost of tablets 250 mg number 30 is a little more than 50 rubles.
As a replacement for conventional penicillin, doctors may recommend the following drugs from the list: Cefazolin, Bicillin-1, 3 or 5, as well as Ampicillin, Amoxicillin, Azithromycin, Amoxiclav.
All these drugs have a broad bactericidal action and are quite effective. However, to avoid allergic reactions, skin tests should be carried out before use.
Ampicillin and Bicillin can be attributed to cheap penicillin analogues. Their cost in tablet form also does not exceed 50 rubles.
The composition of the drug penicillin
The composition of drugs that belong toantibioticsgroups penicillinsIt depends on what kind of medicine it is.
Currently practiced the use of four groups:
- natural penicillins,
- semi-synthetic penicillins,
- aminopenicillins, which have an extended spectrum of action,
- penicillins with a wide antibacterial spectrum of influence.
Pharmacological action of penicillin
Penicillin is the first antimicrobial agent that was obtained using the products of microorganisms as a basis. The history of this drug begins in 1928, when the inventor of the antibiotic Alexander Fleming isolated it from a strain of the fungus of the species Penicillium notatum. In the chapter, which describes the history of the discovery of penicillin, Wikipedia shows that the antibiotic was discovered by chance, after the bacteria from the external environment of the mold fungus entered the culture, its bactericidal effect was noted. Later, the formula of penicillin was determined, and how to get penicillin, began to explore other specialists. However, the answer to the questions in which year this tool was invented, and who invented the antibiotic, is unequivocal.
A further description of penicillin on Wikipedia shows who created and improved the preparations. In the forties of the twentieth century, scientists in the United States and Great Britain worked on the process of producing penicillin in industry. For the first time the use of this antibacterial drug for the treatment of bacterial infections occurred in 1941. And in 1945 for the invention of penicillin, the Nobel Prize was received by its creator Fleming (the one who invented penicillin), as well as the scientists who worked on its further improvement, Flory and Chain.
Speaking about who discovered penicillin in Russia, it should be noted that the first samples of the antibiotic were obtained in the Soviet Union in 1942 by microbiologists Balezina and Yermolyeva. Further, the country began industrial production of antibiotics. In the late fifties, synthetic penicillins appeared.
When this medicine was invented, for a long time it remained the main antibiotic used clinically throughout the world. And even after other antibiotics without penicillin were invented, this antibiotic remained an important drug for the treatment of infectious diseases. There is a statement that the medicine is obtained using cap mushrooms, but today there are different methods of its production. Currently, the so-called protected penicillins are widely used.
The chemical composition of penicillin suggests that the agent is an acid from which various salts are subsequently obtained. Penicillin antibiotics include phenoxymethylpenicillin (penicillin V), benzylpenicillin (penicillin G), and others. The classification of penicillins suggests their separation into natural and semi-synthetic.
Biosynthetic penicillins provide a bactericidal and bacteriostatic effect, inhibiting the synthesis of the cell wall of microorganisms. They act on some Gram-positive bacteria (Streptococcus spp., Staphylococcus spp., Bacillus anthracis, Corynebacterium diphtheria), some Gram-negative bacteria (Neisseria meningitidis, Neisseria gonorrhoeae), anaerobic spore-forming bacillus (Spirochaetaceae Actinomyces spp.) And others.
The most active of the penicillin preparations is benzylpenicillin.Resistance to Benzylpenicillin is demonstrated by Staphylococcus spp. Strains that produce penicillinase.
Penicillin is not effective in relation to the bacteria of the typhoid-dysenteric group, the causative agents of tularemia, brucellosis, plague, cholera, as well as whooping cough, tuberculosis, friedlender, pyocyanic sticks and viruses, rickettsia, fungi, protozoa.
Penicillins are the oldest known antibiotics. They have many species, but some of them have lost their relevance due to resistance. The bacteria were able to adapt and became insensitive to the action of these drugs. This forces scientists to create new types of mold, analogs of penicillin, with new properties.
Penicillins have low toxicity for the body, a fairly widespread use and a good indicator of bactericidal action, but allergic reactions to them are much more common than doctors would like. This is due to the organic nature of antibiotics. It is also possible to attribute difficulties in combining them with other drugs, especially those with similar class, to negative qualities.
The first mention of penicillins in the literature took place in 1963, in a book about Indian sorcerers. They used mixtures of fungi for medicinal purposes. Alexander Fleming managed to get them for the first time in the enlightened world, but this did not happen purposefully, but accidentally, like all the great discoveries.
Before World War II, English microbiologists worked on the issue of industrial production of medicines in the required amounts. The same problem was simultaneously solved in the USA. Since then, penicillin has become the most common medicine. But over time, other groups of antibiotics were isolated and synthesized, which gradually forced it out of the podium. In addition, microorganisms began to show resistance to this drug, which complicated the treatment of severe infections.
Principle of antibacterial action
The bacterial cell wall contains a substance called peptidoglycan. The penicillin group of antibiotics affects the synthesis of this protein, inhibiting the formation of the necessary enzymes. The microorganism dies due to the inability to update the cell wall.
However, some bacteria have learned to resist such a rough invasion. They produce beta-lactamase, which breaks down enzymes that affect peptidoglycans. In order to cope with this obstacle, scientists had to create analogs of penicillin that can destroy beta-lactamase, too.
Danger to humans
At the very beginning of the era of antibiotics, scientists thought about how toxic they would be for the human body, because almost all of the living metry consists of proteins. But after conducting a sufficient amount of research, we found out that there is practically no peptidoglycan in our organisms, which means that the drug cannot do any serious harm.
Spectrum of action
Virtually all types of penicillins affect gram-positive bacteria of the genus Staphylococcus, Streptococcus, Corynebacterium diphtheria and the causative agent of plague. Also in their spectrum of action includes all gram-negative microorganisms, gonococci and meningococci, anaerobic sticks and even some mushrooms (for example, actinomycetes).
Scientists invent new and new types of penicillins, trying to prevent bacteria from getting used to their bactericidal properties, but this group of drugs is no longer suitable for the treatment of nosocomial infections. One of the negative properties of this type of antibiotics is dysbacteriosis, since the human intestine is colonized by bacteria that are sensitive to the effects of penicillin. This is worth remembering when taking medication.
Main types (classification)
Modern scientists propose the modern division of penicillins into four groups:
- Natural, which are synthesized by mushrooms. These include benzylpenicillins and phenoxymethylpenicillin. These drugs have a narrow spectrum of activity, mainly against gram-negative bacteria.
- Semisynthetic drugs that are resistant to penicillinases. Used to treat a wide range of pathogens. Representatives: methicillin, oxacillin, nafcillin.
- Carboxypenicillins (carbpenicillin).
- Group of drugs with a wide spectrum of action:
For example, it is worth quoting a few of the most common currently available drugs that correspond to this group. Perhaps the most famous of the pennicillins can be considered "Bicillin-3" and "Bicillin-5". They discovered a group of natural antibiotics and were flagships in their category until more advanced forms of antimicrobial drugs appeared.
- "Extensillin". Instructions for use states that it is a long-acting beta-lactam antibiotic. The indications for its use are exacerbations of rheumatic disease and diseases caused by treponema (syphilis, yaws and pint). Available in powders. "Extentsillin" instructions for use does not recommend combining with non-steroidal anti-inflammatory drugs (NVPS), as possible competitive interaction. This may adversely affect the effectiveness of treatment.
- "Penicillin-Fau" refers to the group of phenoxymethylpenicillins. It is used to treat infectious diseases of upper respiratory tract, skin and mucous membranes, gonorrhea, syphilis, tetanus. It is used as a preventive measure after surgical interventions, to maintain remission in case of rheumatism, small chorea, bacterial endocarditis.
- The antibiotic "Ospen" is an analogue of the previous drug. It is available in the form of tablets or granules. It is not recommended to combine with NSAIDs and oral contraceptives. Often used in the treatment of childhood diseases.
This group of drugs includes chemically modified antibiotics derived from mold fungi.
- The first on this list is "Amoxicillin". Instructions for use (price - about a hundred rubles) indicates that the drug has a wide spectrum of action and is used for bacterial infections of almost any location. Its advantage is that it is stable in the acidic environment of the stomach, and after absorption the concentration in the blood is higher than that of other members of this group. But do not idealize Amoxicillin. Instructions for use (price may vary in different regions) warns that the drug should not be prescribed to patients with mononucleosis, allergies and pregnant women. Long reception is impossible because of a significant amount of side reactions.
- Oxacillin sodium salt is prescribed when bacteria produce penicillinase. The drug is acid-proof, it can be taken orally, it is well absorbed in the intestine. It is rapidly excreted by the kidneys, so you need to constantly maintain the desired concentration in the blood. The only contraindication is an allergic reaction. Available in pill form or in vials, as a liquid for injection.
- The last representative of semi-synthetic penicillins is ampicillin trihydrate. Instructions for use (tablets) indicates that it has a wide spectrum of action, affecting both gram-negative and gram-positive bacteria. Patients are well tolerated, but caution should be given to those who take anticoagulants (for example, people with pathology of the cardiovascular system), because the drug potentiates their action.
Penicillins are sold in pharmacies in the form of powder for injection. Therefore, for intravenous or intramuscular administration, they must be dissolved in a liquid. At home, you can use distilled water for injection, isotonic sodium chloride solution or a solution of two percent novocaine. It must be remembered that the solvent should not be too warm.
Indications, contraindications and side effects
Indications for treatment with antibiotics are diagnoses: lobar and focal pneumonia, pleural empyema, sepsis and septicemia, septic endocarditis, meningitis, osteomyelitis. In the field of action fall bacterial angina, diphtheria, scarlet fever, anthrax, gonorrhea, syphilis, purulent skin infections.
There are few contraindications to treatment by the penicillin group. First, the presence of hypersensitivity to the drug and its derivatives. Secondly, the established diagnosis of epilepsy, which makes it impossible to introduce the drug into the spinal column. As for pregnancy and lactation, in this case, the expected benefit should significantly exceed the possible risks, because the placental barrier is permeable to penicillins. While taking the medicine, the child must be temporarily transferred to another feeding method, as the drug penetrates the milk.
Side effects can be observed on several levels at once.
CNS may cause nausea, vomiting, irritability, meningism, seizures, and even coma. Allergic reactions are manifested in the form of skin rashes, fever, pain in the joints and edema. There are cases of anaphylactic shock and death. Due to the bactericidal action, candida of the vagina and oral cavity is possible, as well as dysbacteriosis.
Features of use
Precautions should be prescribed to patients with impaired liver and kidney function, with established heart failure. It is not recommended to use them to people prone to allergic reactions, as well as those who have a hypersensitivity to cephalosporins.
If five days after the start of therapy no change in the patient's condition has occurred, then it is necessary to use penicillin analogs or replace the antibiotic group. Simultaneously with the appointment, for example, of the substance "Bitsillin-3", it is necessary to take care of the prevention of fungal superinfection. For this, antifungal drugs are prescribed.
It is necessary to explain to the patient in an accessible way that interruption of the medication without good reason causes the resistance of microorganisms. And to overcome it will require more powerful drugs that cause severe side effects.
Penicillin analogues have become indispensable in modern medicine. Although it is the earliest open group of antibiotics, it still remains relevant for the treatment of meningitis, gonorrhea and syphilis, has a fairly wide spectrum of action and mild side effects so that it can be prescribed to children. Of course, like any medicine, penicillins have contraindications and side effects, but they are more than offset by the possibilities for use.
Amoxicillin is a newer drug from the penicillin group.
The drug also has a bactericidal effect, easily passes through the blood-brain barrier. Partially metabolized in the liver and excreted from the patient through the kidneys.
Among the disadvantages of amoxicillin - the need for multiple doses. Today, this drug is widely used to treat infections of the respiratory tract (pharyngitis, sore throats, sinusitis, tracheitis, bronchitis), urinary system (cystitis, urethritis, pyelonephritis), as well as with salmonellosis, leptospirosis, listeriosis, borreliosis, and gastric ulcer, caused by a heli-co-closure. .
Amoxicillin should not be prescribed for hypersensitivity to penicillin-type drugs, infectious mononucleosis (specific rash or liver damage occurs). Among the side effects are various allergic reactions, Stevens-Johnson syndrome, dyspeptic disorders, transient anemia and headache.
The drug is presented in pharmacies under the names "Amoxicillin", "Amofast", "V-Moks", "Flemoksin Solyutab." The price varies greatly depending on the manufacturer.
Adults are routinely prescribed amoxicillin 500 mg 3 times a day, and for children weighing less than 40 kg, the rate is 25–45 mg per 1 kg. Treatment for diseases with mild or moderate severity spend a week, with more serious pathologies, the course is extended to 10 or more days.
Ampicillin, as an analogue of penicillin, began to be used for the treatment of bacterial pathologies since 1961. He also belongs to the penicillin group and has a bactericidal effect.
But unlike previous drugs, its spectrum of action includes not only gram-positive microorganisms, but also gram-negative (E. coli, Proteus, hemophilic wand and others). However, many bacteria are able to cleave it with penicillinase.
Today, ampicillin is used for:
- bacterial cholecystitis,
- bronchitis, sinusitis,
- pneumonia without complications
- wound infection in surgery.
Ampicillin should not be prescribed if there is a history of allergic reactions to penicillins, abnormal liver function, infectious mononucleosis, leukemia and HIV infection. Cases of neurological symptoms after taking the drug are described. Also sometimes observed dyspeptic symptoms, the addition of candidiasis, toxic hepatitis and pseudomembranous colitis.
Available drug in the form of tablets for oral administration of 0.25 g or powder for internal administration. The following trade names exist: Ampicillin, Ampicillin-Norton.
The drug is recommended to take half an hour before a meal or 120 minutes after it. The dose for adults ranges from 250 to 1000 mg every 6 hours. The duration of therapy should not be less than 5 days.
Penicillin can also be replaced with Augmentin, a combination drug of the amoxicillin antibiotic and clavulanic acid. The latter is a specific inhibitor of penicillinase, which is produced by streptococci, staphylococci, enterococci and neisseria. This avoids the destruction of the antibacterial drug, which significantly increases its effectiveness in a situation of increasing the resistance of microorganisms. For the first time Augmentin synthesized and began to produce the British pharmaceutical company Beecham Pharmaceuticals.
Most often, the drug is prescribed for bacterial inflammatory processes of the respiratory system - bronchitis, tracheitis, laryngitis, otitis, sinusitis and non-hospital pneumonia. Augmentin is also used in cystitis, urethritis, pyelonephritis, osteomyelitis, gynecological pathologies, prevention of complications after surgical operations and manipulations.
Among contraindications distinguish various dysfunctions of the liver, increased sensitivity of the patient to the penicillin antibiotics, lactation in women. Most often, the drug is accompanied by the following side effects:
- allergic reactions
- dyspeptic disorders
- pseudomembranous colitis,
- drowsiness or sleep disturbance,
- Quincke's edema,
- toxic transient hepatitis.
Augmentin is available in powder form for the preparation of syrup or tablets for oral administration. Suspension is used for children with a body weight of more than 5 kilograms per 0.5 or 1 ml of the drug per 1 kg. For teens and adults use the tablet form. As a standard, take one tablet (875 mg of amoxicillin / 125 mg clavulanic acid) 2 times a day. The minimum duration of the course of therapy is 3 days.
Cefazolin belongs to the group of first-generation cephalosporins. Like penicillins, it has a beta-lactam base, which gives it a bactericidal effect against a significant number of gram-positive bacteria.
This antibiotic is used only for intravenous or intramuscular administration. Therapeutic blood concentration is maintained for 10 hours after administration.
Cefazolin also does not penetrate the blood-brain barrier and is almost completely eliminated from the body by the kidneys of the patient. Today, the drug is used primarily to treat mild forms of infections of the respiratory system, as well as with bacterial inflammation of the urinary tract (especially in children, pregnant women and the elderly).
Cefazolin should not be prescribed in the presence of hypersensitivity in the patient to cephalosporins or penicillins, as well as combined with bacteriostatic drugs. When it is used, allergic reactions sometimes develop, the filtration function of the kidneys is temporarily impaired, dyspeptic disorders appear, a fungal infection joins.
Cefazolin is released in vials with 0.5 or 1.0 g of the active ingredient for the preparation of injections. The dose of the drug depends on the type and severity of the infection, but it is usually prescribed 1.0 g of antibiotic 2 or 3 times a day.
To date, ceftriaxone is one of the most commonly used antibiotics in hospitals. It belongs to the third generation of cephalosporins. Among the major advantages of the drug is the presence of activity against gram-negative flora and anaerobic infection. Также цефтриаксон, в отличие от цефазолина, хорошо проникает через гематоэнцефалический барьер, что позволяет его активно использовать для лечения бактериальных менингитов в ситуации, когда еще нет результатов бактериологического исследования.In addition, resistance to it is observed much less frequently than to drugs of the penicillin group.
Ceftriaxone is used to treat the inflammatory processes of the bacterial etiology of the respiratory, urogenital and digestive systems. Also, an antibiotic is prescribed for meningitis, sepsis, infective endocarditis, Lyme disease, sepsis, osteomyelitis and for the prevention of complications during surgical manipulations and operations.
Of particular importance is the use of fithriaxone in neutropenia and other conditions with impaired blood formation. This is due to the fact that the drug, unlike many other groups of antibiotics, does not inhibit the proliferation of blood cells.
Ceftriaxone should not be administered with calcium-containing drugs (Hartmann and Ringer solutions). When used in newborns, an increase in plasma bilirubin values was observed. Also, before the first dose, it is necessary to test for the presence of hypersensitivity to the drug. Among the side effects are digestive disorders, allergic reactions and headaches.
The drug is released in the form of a powder in bottles of 0.5, 1.0 and 2.0 g under the names: "Alcizon", "Blitsef", "Lendatsin", "Norakson", "Rotazef", "Cefograf", "Ceftriaxone" . The dosage and amount of intake depends on the age, pathology of the patient and the severity of his condition.
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Indications and dosage:
Penicillin use is indicated:
- In sepsis (especially streptococcal)
- In all sulfonamide-resistant cases of relevant infections (pneumococcal, gonococcal, meningococcal infection, etc.)
- With extensive and deeply localized infectious processes (osteomyelitis, severe phlegmon, gas gangrene)
- After injuries with involvement in the process and infection of large musculoskeletal arrays
- In the postoperative period for the prevention of purulent complications
- When infected burns of the third and fourth degree
- When soft tissue injuries
- When wounds of the chest
- With purulent meningitis
- With brain abscesses
- With erysipelas
- With gonorrhea and its sulfonamide-resistant forms
- With severe furunculosis
- With sycosis
- With various eye and ear inflammations
In the clinic of internal diseases, Penicillin is used to treat lobar pneumonia (along with sulfa drugs), focal pneumonia, acute sepsis, cholecystitis and cholangitis, prolonged septic endocarditis, as well as for the prevention and treatment of rheumatism.
In children, Penicillin is used: for umbilical sepsis, septicopyemia and septic-toxic diseases of the newborn, pneumonia in the newborn and infants and young children, otitis of infants and young children, the septic form of scarlet fever, the septic-toxic form of diphtheria (always in combination with a special serum ), pleuropulmonary processes that are not susceptible to the action of sulfa drugs, purulent pleurisy and purulent meningitis, with gonorrhea.
The antimicrobial effect of Penicillin is achieved with both resorptive and local effects.
Penicillin preparations can be administered intramuscularly, subcutaneously and intravenously, inside the cavities, into the spinal canal, by inhalation, sublingually (under the tongue), inside, topically - in the form of eye and nasal drops, rinses, washes.
When administered intramuscularly, penicillin is rapidly absorbed into the blood, but after 3-4 hours penicillin almost completely disappears from it. For the effectiveness of therapy in 1 ml of blood should be 0.1-0.3 U of penicillin, therefore, to maintain the therapeutic concentration of the drug in the blood, it should be administered every 3-4 hours.
The use of Penicillin for the treatment of gonorrhea, syphilis, pneumonia, cerebrospinal meningitis is carried out according to a special instruction.
Penicillin use is contraindicated in:
- The presence of hypersensitivity to penicillin
- Bronchial asthma
- Hay fever and other allergic diseases
- Hypersensitivity of patients to antibiotics, sulfonamides and other drugs
It is possible to sensitize the body to penicillin during fetal development during the treatment of pregnant women with antibiotics-penicillin drugs.
Interaction with other drugs and alcohol:
Bactericidal antibiotics (including cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides) have a synergistic effect, bacteriostatic antibiotics (including macrolides, chloramphenicol, linkosamides, tetracyclines) are antagonistic. Care must be taken when combining penicillins that are active against Pseudomonas aeruginosa (Pseudomonas aeruginosa) with anticoagulants and antiplatelet agents (potential risk of increased bleeding). It is not recommended to combine penicillins with thrombolytics. When combined with sulfonamides may reduce the bactericidal effect. Oral penicillins can reduce the effectiveness of oral contraceptives due to impaired enterohepatic circulation of estrogens. Penicillins can slow down the elimination of methotrexate from the body (inhibit its tubular secretion). The combination of ampicillin with allopurinol increases the likelihood of a skin rash. The use of high doses of the potassium salt of benzylpenicillin in combination with potassium-saving diuretics, potassium preparations or ACE inhibitors increases the risk of hyperkalemia. Penicillins are pharmaceutically incompatible with aminoglycosides.
Drinking alcohol during treatment with penicillin is absolutely contraindicated.
Composition and properties:
Benzylpenicillin sodium salt 1000 000 IU
Powder for solution for injection of 1 million IU, bottle (bottle) box (box) 100,
Penicillinum (Penicillinum) is an antimicrobial drug based on the chemical structure of which is a dipeptide formed from dimethylcysteine and acetylserine.
The mechanism of action of penicillin is associated with the suppression of amino acid and vitamin metabolism of microorganisms and impaired development of the cell wall in them.
Penicillin is excreted by the kidneys (about 50%), in the urine its significant concentrations are created, exceeding the concentration in the blood by 5-10 times. Some penicillin is also excreted in the bile.
At a temperature not higher than 25 ° C.
The description of the drug "Penicillin" on this page is a simplified and supplemented version of the official instructions for use. Before acquiring and
using the drug, you should consult your doctor and familiarize yourself with the approved manufacturer's abstract.
Description and composition of the drug
Penicillin is the first bactericidal agent obtained from the waste products of microorganisms. Its inventor is called Alexander Fleming, who discovered the antibiotic by chance, having discovered its antimicrobial action.
The first samples of the drug were obtained in the USSR by scientists Balezina and Yermolyeva in the middle of the twentieth century. After that, the drug began to produce on an industrial scale. In the late 1950s, synthetic penicillins were also obtained.
Currently, four groups of penicillins are used in medicine:
- natural origin,
- semi-synthetic compounds
- wide spectrum aminopenicillins,
- penicillins wide bactericidal spectrum.
For injections, penicillin G sodium salt of 500 thousand U or 1 million U is used. In pharmacy chains, such powder can be purchased in glass, sealed with a rubber stopper, vials. Before direct administration, the powder is diluted with water. In the pharmacy, it is possible to get the medication by prescription.
In its chemical composition, penicillin is an acid to produce salts. Its biosynthetic products act on anaerobic spore-forming rods, gram-positive and gram-negative bacteria, inhibiting the synthesis of their walls. The most active and relevant today is considered to be the drug Benzylpenicillin.
Penicillin is injected intramuscularly and immediately after direct application enters the blood and quickly concentrates in the muscles and joints, tissue damage. The highest degree of concentration of the composition is observed after half an hour after the procedure.
The concentration of the drug in the cerebrospinal fluid and the abdominal cavity is minimal. The composition is excreted through the kidneys and bile. The half-life is up to one and a half hours.
Penicillin Treatment Methods
According to the instructions for use, the drug is allowed to be administered in four main ways, depending on the type and extent of the lesion:
- in the spinal canal,
Staging injections carried out every three to four hours, maintaining the content of the composition so that for every milliliter of patient's blood accounted for a concentration of 0.1-0.3 U. In most cases, the treatment scheme is selected for each patient individually. The same applies to the course of treatment.
Restrictions and main contraindications
Penicillin has relatively few contraindications. The main one is hypersensitivity to the antibiotic itself and other drugs of its group. In addition, the drug is not recommended for use with:
- manifestations of allergies in the form of urticaria, asthma and pollinosis,
- manifestations of intolerance to antibiotics and sulfonamides.
Apply the drug under the supervision of a physician is necessary for pathologies of the kidneys and the cardiovascular system.
Penicillin Interaction with Other Medicines
Joint treatment with the use of Probenecid increases the half-life of the components of the antibiotic. The use of tetracycline and sulfonamides significantly reduces the effectiveness of penicillin. Cholistyramine seriously reduces the bioavailability of the antibiotic.
Due to incompatibility it is impossible to simultaneously give a shot of Penicillin and any aminoglycoside. The combined use of thrombolytics is also prohibited.
The risk of bleeding increases with the simultaneous use of anticoagulants and Penicillins against Pseudomonas aeruginosa. Therefore, treatment in this case should be monitored by a specialist.
Antibiotic therapy slows the elimination of methotrexate, and also reduces the effectiveness of oral contraceptive pills.
Analogs of Penicillin
If the use of Penicillin is not possible, it is recommended to replace the funds with a similar one. Among the most famous and effective analogues:
- Cefazolin. The drug from the group of cephalosporins, which may be used in case of intolerance to penicillin drugs. It is used for intramuscular and intravenous administration and retains its therapeutic properties after the procedure for ten hours.
- Ceftriaxone. Cephalosporin medication is most often used in the hospital. It is intended for the treatment of inflammatory processes caused by a bacterial pathogen, is active against gram-negative bacteria and anaerodic infections.
- Extensillin. It refers to the number of beta-lactam antibiotics of prolonged exposure. The drug is available in powders and is not recommended for use simultaneously with nonsteroidal drugs against inflammatory processes.
Among the preparations for oral administration, having in the composition of the same active ingredient, emit:
- Ampicillin Trihydrate,
- Flemoxine Solutab,
Important: Replacement is made in case of impossibility of stabbing, intolerance of penicillins, as well as with the lack of effectiveness of the latter.
The good tolerability of penicillin makes it possible to use it with a large number of diseases:
- gas gangrene,
- meningococcal infection
- extensive skin lesions from injuries,
- brain abscess,
- sexually transmitted diseases (gonorrhea, syphilis),
- high burns (3 and 4),
- lobar and focal pneumonia,
- ophthalmic inflammation,
- ear diseases,
- upper respiratory tract infection.
In pediatric pediatrics, penicillin treatment can be prescribed for:
- septicopyemia (a type of sepsis with the formation of interconnected abscesses in different organs),
- sepsis of the umbilical region in newborns,
- otitis media, pneumonia in newborns and in young children,
- purulent pleurisy and meningitis.
Penicillin release forms
Penicillin produces in the form of a powder, which is diluted with a special solution before injection. Injections can be made intramuscularly, subcutaneously, intravenously. Also penicillin solution can be used as inhalation and drops (for ears and eyes).
Because of their effects on bacteria cells (the suppression of chemical reactions necessary for the life and reproduction of bacterial cells), penicillin-based preparations are divided into a separate classification group. The preparations of the natural group of penicillin include:
- benzylpenicillin sodium salt,
- benzylpenicillin potassium salt.
Natural penicillins have the most gentle effect on the body. Over time, the bacteria became resistant to natural penicillins and the pharmaceutical industry began to develop semi-synthetic penicillins:
Side effects of semisynthetic drugs are more pronounced:
- disorders of the gastrointestinal tract,
- skin allergies,
- anaphylactic shock.
Currently, the fourth generation of penicillin-containing preparations has been developed.
Penicillin preparations, almost all are destroyed by gastric acid and do not provide the proper therapeutic effect. But there are drugs containing penicillin, produced in tablets. The composition of these medicines added antacid substances that reduce the impact of gastric juices. Mostly these drugs are semi-synthetic substances:
- Amoxicillin tablets,
- Amoxyl - ILC,
As a rule, taking pills with penicillin tablets is carried out independently of meals for 5-10 days.
Composition and release form
Penicillin (Penicillin) is available in the form of tablets and injections. Their composition:
Powder to prepare the solution
White round pills
Amorphous white powder without taste and smell
Penicillin content, IU
5,000, 50,000, 10,000 per piece
5000 per ml ready solution
10, 20, 30 tablets in blisters or blister packs
Ampoules of 1, 2, 3 ml complete with solvent or without
Dosing and Administration
Instructions for use Penicillin differs depending on the form of release of funds. So, tablets are taken orally, injections are given intramuscularly. With an overdose of drugs can develop nausea, diarrhea, vomiting. In case of renal failure and intravenous administration of penicillin potassium salt, hyperkalemia can develop. When receiving doses of funds above 50 million units, epilepsy occurs. Barbiturates, benzodiazepines will help to eliminate it.
Depending on the disease and the severity of the penicillin pill regimen is different. The standard dose is 250–500 mg every 8 hours. If necessary, the instruction advises to increase the dosage to 750 mg once. Tablets are taken half an hour before meals or two hours after it. The course of treatment depends on the presence of complications.
Penicillin in ampoules
Penicillin solution can be administered intravenously, intramuscularly or subcutaneously. Also, the drug is used for direct injection into the spinal canal. For effective therapy, the dose is calculated so that 1–0 ml of blood has 0.1–0.3 units of the drug. Means is administered with an interval of 3-4 hours. Treatment regimens differ for pneumonia, cerebrospinal meningitis, syphilis. They are determined by the doctor.
Penicillin for children
Penicillin-based antibiotics are used in children only according to strict medical indications with great care. During treatment requires constant monitoring of the blood picture, liver and kidney work. The risk of medication is associated with insufficient study of the effectiveness and safety of work in patients of younger children and adolescents.