List and brief instructions for antibiotics related to penicillin drugs. List of antibiotics of the penicillin series, indications for taking drugs Tablets based on penicillin names

Antipyretics for children are prescribed by a pediatrician. But there are emergency situations for fever when the child needs to be given medicine immediately. Then the parents take responsibility and use antipyretic drugs. What is allowed to give to infants? How can you bring down the temperature in older children? What medicines are the safest?

The penicillin group of drugs has been known to physicians for almost 90 years. These antibacterial agents were the first antibiotics to be discovered and have been used for treatment since the 1940s. Although at that time all penicillins were only natural, while now the number of their varieties and names has increased significantly.

Operating principle

Applying antibiotics penicillin series, you can stop the bacterial cell from producing a substance called peptidoglycan, of which it mainly consists. This stops the growth and renewal of the pathogen, which subsequently dies. At the same time, drugs, destroying bacterial cells, have practically no effect on the human body, which contains almost no peptidoglycan.

Over time, the bacteria became resistant to penicillin antibiotics and began to produce beta-lactamase. To combat the changed microorganisms, new drugs called protected penicillins were invented.

Types of drugs and spectrum of activity

The main classification divides penicillin antibiotics into the following groups:

natural;
semi-synthetic;
aminopenicillins with an extended spectrum of action;
potentiated penicillins, which have the maximum effect on bacteria.

Antibiotics such as benzylpenicillin, commonly referred to simply as penicillin, phenoxymethylpenicillin, and benzathine benzylpenicillin are among the naturally occurring drugs. Such penicillins affect many Gram-positive and only a small proportion of Gram-negative bacteria.

The semi-synthetic or ampicillin series of antibiotics, whose names are known to many (among them, for example, amoxicillin, which is often treated for bronchitis, oxacillin and carbecillin), is more effective against all types of bacteria. And these drugs are obtained by combining the amino group of 6-aminopenic cillanic acid with various radicals necessary for binding beta-lactamase. Moreover, the first generation of semi-synthetic penicillins is more effective against b-lactamases, but is directed against a limited number of gram-positive bacteria. While penicillins of the II and III generation are characterized by a wider range, although less effective.

The capabilities of aminopenicillins include counteracting gram-positive cocci and a number of gram-negative bacteria. Particularly active against even the most dangerous microorganisms are drugs such as ampicillin, ticarcillin and piperacillin.

For potentiated or combined penicillins, developed due to the increasing number of bacteria resistant to them, the presence of a beta-lactam ring is characteristic. It is necessary to bind beta-lactamase and protect the antibiotic itself from being destroyed by these enzymes. Such drugs include, for example, ampicillin/sulbactam or piperacillin/tazobactam.

Application features

Penicillin antibiotics are available in various forms, from syrups to tablets and injections. Moreover, in the latter case, it is a powder that is placed in glass bottles and closed with rubber stoppers with metal caps. It is dissolved and used either for injection intramuscularly or, much less commonly, subcutaneously. There are also powders and granules from which a suspension for oral administration is prepared.

A fairly common form of oral administration of penicillins are tablets. They must be dissolved or washed down (the correct method is indicated in the instructions for the antibiotic). Moreover, as a liquid, it is best to use ordinary water at room temperature, and not, for example, juices or, especially, milk. As a rule, penicillin lozenges contain 5000 IU (action units) of penicillins. And in preparations for oral administration, ED is already 10 times more. Penicillin tablets containing sodium citrate may contain 50 or 100 thousand units.

What is the meaning of different ways of taking medicines? It turns out that some antibiotics of the penicillin series, the names of which indicate their belonging to ureidopenicillins (for example, azlocillin, mezlocillin and piperocillin), and the primary penicillin itself are destroyed by gastric juice. And they should be administered only in the form of injections.

Contraindications

Penicillins should not be used in the following cases:

in the presence of intolerance to specific drugs or groups known before taking medications;
with the manifestation of an allergic reaction after the use of penicillin antibiotics.

Side effects

Taking antibiotics related to penicillin group, you should be aware of the main side effects they can lead to. First of all, these are, of course, various forms of allergies associated with increased sensitivity of the body after the previous intake of drugs. After all, as a rule, the first use of any antibiotic causes side effects much less frequently than repeated use.

In addition, after the start of the course of treatment with penicillins, the appearance of:

vomiting and nausea;
neurotoxic reactions;
convulsions;
coma;
urticaria;
eosinophilia;
edema.

Sometimes this causes a fever and a rash. And in very rare cases, even anaphylactic shock can be recorded, leading to death (mainly in the elderly). In order to avoid this risk, at the first signs of anaphylaxis, intravenous adrenaline should be administered immediately.

Penicillins can also cause toxic effects. For example, fungal infections such as candidiasis oral cavity, vaginal candidiasis.

Penicillin antibiotics are β-lactam antibiotics. β-lactam antibiotics β-lactams, which are united by the presence of a β-lactam ring in their structure, include penicillins, cephalosporins, carbapen

ema and monobactams, which have a bactericidal effect. The similarity of the chemical structure determines, firstly, the same mechanism of action of all β-lactams - inhibition of penicillin-binding proteins (PBP), enzymes involved in the process of synthesis of the bacterial cell wall (under conditions of PBP inhibition, this process is disrupted, which entails lysis of the bacterial cell) , and, secondly, cross-allergy to them in some patients.

It is important that the cellular structures of bacteria that are the target of β-lactams are absent in mammals; therefore, specific toxicity to the macroorganism is not typical for these antibiotics.

Penicillins, cephalosporins and monobactams are sensitive to the hydrolyzing action of special enzymes - β-lactamases produced by many bacteria. Carbapenems are characterized by a significantly higher resistance to β-lactamases.
Given the high clinical efficacy and low toxicity, β-lactam antibiotics have been the basis of antimicrobial chemotherapy for many years, occupying a leading position in the treatment of most bacterial infections.

Antibiotics of the penicillin group

Penicillins- the first antimicrobial preparations developed on the basis of biologically active substances produced by microorganisms. The ancestor of all penicillins, benzylpenicillin, was obtained in the early 40s. XX century. Its discovery marked a kind of revolutionary revolution in medicine, because, firstly, it transferred many bacterial infections from the category of inevitably lethal to potentially curable, and secondly, it determined the fundamental direction on the basis of which the development of many other antibacterial drugs.

Currently, the group of penicillins includes more than ten antibiotics, which, depending on the sources of production, structural features and antimicrobial activity, are divided into several subgroups. At the same time, some antibiotics, primarily carboxypenicillins and ureidopenicillins, have lost their original significance and are not used as monopreparations.

General properties of penicillins

Antibacterial drugs from the penicillin group have the following properties:

They have bactericidal action.
They are well distributed in the body, penetrate into many organs, tissues and environments, with the exception of non-inflamed meninges, eyes, prostate, organs and tissues. Creates high concentrations in the lungs, kidneys, intestinal mucosa, reproductive organs, bones, pleural and peritoneal fluid.
Small amounts pass through the placenta and pass into breast milk.
Poorly penetrate the BBB (with meningitis, the permeability increases, and the concentration of penicillin in the cerebrospinal fluid is 5% of the serum level), the blood-ophthalmic barrier (HOB), into the prostate gland.
Excreted by the kidneys, mainly by active excretion by the renal tubules.
The half-life is 0.5 hours.
The therapeutic level in the blood is maintained within 4-6 hours.

Side effects of penicillin ov

allergic reactions(according to various sources, in 1-10% of cases): urticaria; rash; Quincke's edema; fever; eosinophilia; bronchospasm.

The most dangerous is anaphylactic shock, which gives up to 10% mortality (in the US, about 75% of deaths from anaphylactic shock are due to the introduction of penicillin).

Local irritant action with the / m introduction (soreness, infiltrates).

Neurotoxicity: convulsions, which are more common in children, with the use of very high doses of penicillin, in patients with renal insufficiency, with the introduction of more than 10 thousand units endolumbally.

Violations electrolyte balance - in patients with heart failure, with the introduction of large doses of sodium salt, edema may increase, and with hypertension - an increase blood pressure(AD) (1 million units contains 2.0 mmol sodium).

Sensitization. It should be borne in mind that in some people the degree of sensitization to penicillin may vary over time. In 78% of them, skin tests become negative after 10 years. Therefore, the claim of penicillin allergy as a lifelong clinical diagnosis is incorrect.

Prevention measures

Careful history taking, use of freshly prepared solutions of penicillin, observation of the patient for 30 minutes after the first injection of penicillin, detection of hypersensitivity by skin testing.

Measures to help with the development of anaphylactic shock: ensuring patency respiratory tract(if necessary, intubation), oxygen therapy, adrenaline, glucocorticoids.

It should be noted that in bronchial asthma and other allergic diseases, the risk of developing allergic reactions to penicillins (as well as to other antibiotics) is slightly increased, and if they occur, they can be more severe. However, the prevailing point of view that penicillins should not be prescribed to people with allergic diseases at all is erroneous.

Indications for the use of penicillins

GABHS infections: tonsillopharyngitis, erysipelas, scarlet fever, acute rheumatic fever.
Meningitis in children older than 2 years and in adults.
Infective endocarditis (mandatory in combination with gentamicin or streptomycin).
Syphilis.
Leptospirosis.
Anthrax.
Anaerobic infections: gas gangrene, tetanus.
Actinomycosis.

Preparations of natural penicillins

Preparations of natural penicillins include the following:

Benzylpenicillin;
Benzylpenicillin sodium salt;
Benzylpenicillin novocaine salt;
Phenoxymethylpecillin;
Ospen 750;
Bicillin-1;
Retarpen.

Phenoxymethylpenicillin

A preparation of natural penicillin intended for oral administration.
According to the spectrum of activity, it practically does not differ from penicillin. Compared to penicillin, it is more acid-resistant. Bioavailability is 40-60% (slightly higher when taken on an empty stomach).

The drug does not create high concentrations in the blood: taking 0.5 g of phenoxymethylpenicillin inside approximately corresponds to the introduction of 300 thousand units of penicillin / m. The half-life is about 1 hour.

Side effects

Allergic reactions.
Gastrointestinal tract (GIT) - pain or discomfort in the abdomen, nausea; rarely vomiting, diarrhea.

Indications for use

Prevention of pneumococcal infections in individuals after splenectomy.

Benzathine phenoxymethylpenicillin

A derivative of phenoxymethylpenicillin. Compared with it, it is more stable in the gastrointestinal tract, absorbed faster, better tolerated. Bioavailability is independent of food.

Indications for use

Streptococcal (GAB) infections of mild to moderate severity: tonsillopharyngitis, infections of the skin and soft tissues.

Prolonged penicillin preparations

Prolonged penicillin preparations, or the so-called depot penicillins, include b enzylpenicillin novocaine salt And benzathine benzyl penicillin, and combined preparations created on their basis.

Side effects long-acting penicillin preparations

Allergic reactions.
Soreness, infiltrates at the injection site.
She syndrome (Hoigne) - ischemia and gangrene of the extremities with accidental injection into the artery.
Nicolau's syndrome (Nicholau) - embolism of the vessels of the lungs and brain when injected into a vein.

Prevention vascular complications: strict adherence to the technique of introduction - in / m into the upper outer quadrant of the buttocks using a wide needle, with the obligatory horizontal position patient. Before insertion, it is necessary to pull the plunger of the syringe towards you to make sure that the needle is not in the vessel.

Indications for use

Infections caused by micro-organisms highly sensitive to penicillin: streptococcal (GABHS) tonsillopharyngitis; syphilis (except neurosyphilis).
Prevention of anthrax after contact with spores (benzylpenicillin novocaine salt).
Year-round prevention of rheumatic fever.
Prevention of diphtheria, streptococcal cellulitis.

Benzylpenicillin novocaine salt

With the / m administration, the therapeutic concentration in the blood is maintained for 12-24 hours, however, it is lower than with the introduction of an equivalent dose of benzylpenicillin sodium salt. The half-life is 6 hours.

It has a local anesthetic effect, it is contraindicated in case of allergy to procaine (novocaine). In case of an overdose, mental disorders are possible.

Benzathine Benzylpenicillin

It acts longer than benzylpenicillin novocaine salt, up to 3-4 weeks. After intramuscular injection peak concentration is observed after 24 hours in children and after 48 hours in adults. The half-life is several days.

Pharmacokinetic studies of domestic preparations of benzathine benzylpenicillin, conducted in the State scientific center antibiotics have shown that when they are used, the therapeutic concentration in the blood serum lasts no more than 14 days, which requires their more frequent administration than the foreign analogue - Retarpen.

Combined drugs penicillins

Bicillin-3, Bicillin-5.

Isoxazolylpenicillins (anti-staphylococcal penicillins)

The drug isoxazolylpenicillins - Oxacillin.

The first isoxazolylpenicillin with antistaphylococcal activity was methicillin, which was later discontinued due to lack of advantages over newer analogues and nephrotoxicity.

Currently, the main drug of this group in Russia is oxacillin. Nafcillin, cloxacillin, dicloxacillin and flucloxacillin are also used abroad.

Oxacillin

Activity spectrum
Oxacillin is resistant to penicillinase, which is produced by more than 90% of S. aureus strains. Therefore, they are active against penicillin-resistant S. aureus (PRSA) and a number of strains of S. epidermidis resistant to the action of natural penicillins, amino-, carboxy- and ureidopenicillins. This is the main clinical significance of this drug.

At the same time, oxacillin is much less active against streptococci (including S. pneumoniae). It has practically no effect on most other microorganisms sensitive to penicillin, including gonococci and enterococci.

One of serious problems is the spread of strains (especially nosocomial) S. aureus resistant to isoxazolylpenicillins and received, based on the name of the first of them, the abbreviation MRSA (raeticillin-resistant S. aureus). In fact, they are multi-resistant, as they are resistant not only to all penicillins, but also to cephalosporins, macrolides, tetracyclines, lincosamides, carbapenems, fluoroquinolones and other antibiotics.

Side effects

Allergic reactions.
Gastrointestinal tract - abdominal pain, nausea, vomiting, diarrhea.
Moderate hepatotoxicity - increased activity of liver transaminases, especially with the introduction of high doses (more than 6 g / day); as a rule, it is asymptomatic, but sometimes it can be accompanied by fever, nausea, vomiting, eosinophilia (a liver biopsy shows signs of nonspecific hepatitis).
Decreased hemoglobin level, neutropenia.
Transient hematuria in children.

Indications for use

Confirmed or suspected staphylococcal infections of various localization (with sensitivity to oxacillin or an insignificant risk of the spread of methicillin resistance):

bone and joint infections;
pneumonia;
infective endocarditis;
meningitis;
sepsis.

Aminopenicillins

The aminopencillins are ampicillin And amoxicillin. Compared to natural penicillins and isoxazolylpenicillins their antimicrobial spectrum is extended by some Gram-negative bacteria of the Enterobacteriaceae family and H. influenzae.

Ampicillin

Differences from penicillin in the spectrum of antibacterial activity

It acts on a number of gram (-) bacteria: E. coli, P. mirabilis, salmonella, shigella (the latter are resistant in many cases), H. influenzae (strains that do not produce β-lactamase).
More active against enterococci (E. faecalis) and listeria.
Somewhat less active against streptococci (GABHS, S. pneumoniae), spirochetes, anaerobes.

Ampicillin has no effect on Gram-negative pathogens of nosocomial infections, such as Pseudomonas aeruginosa (P. aeruginosa), Klebsiella, Serratia, Enterobacter, Acinetobacter, etc.

It is destroyed by staphylococcal penicillinase, therefore it is inactive against most staphylococci.

Side effects

Allergic reactions.
Gastrointestinal disorders - abdominal pain, nausea, vomiting, most often diarrhea.
"Ampicillin" rash (in 5-10% of patients), according to most experts, is not associated with an allergy to penicillins.

The rash is maculopapular in nature, is not accompanied by itching, and may resolve without discontinuation of the drug. Risk factors: Infectious mononucleosis(rash is noted in 75-100% of cases), cytomegaly, chronic lymphocytic leukemia.

Indications for use

Acute bacterial infections of the upper respiratory tract ( otitis media, rhinosinusitis - if necessary, parenteral administration).
Community-acquired pneumonia (if necessary, parenteral administration).
Urinary tract infections (UTIs) - cystitis, pyelonephritis (not recommended for empirical therapy due to high level pathogen resistance).
Intestinal infections (salmonellosis, shigellosis).
Meningitis.
Infective endocarditis.
Leptospirosis.

Warnings and precautions

Ampicillin can only be dissolved in water for injection or in 0.9% sodium chloride solution. Freshly prepared solutions must be used. When stored for more than 1 hour, the activity of the drug decreases sharply.

Amoxicillin

It is a derivative of ampicillin with improved pharmacokinetics.

According to the antimicrobial spectrum, amoxicillin is close to ampicillin (the microflora has cross-resistance to both drugs).

amoxicillin - the most active among all oral penicillins and cephalosporins against S. pneumoniae, including pneumococci with an intermediate level of resistance to penicillin;
somewhat stronger than ampicillin, acts on E. faecalis;
clinically ineffective against Salmonella and Shigella, regardless of the results of in vitro susceptibility testing;
highly active in vitro and in vivo against H. pylori.

Similarly to ampicillin, amoxicillin is destroyed by β-lactamases.

Side effects

Allergic reactions.
"Ampicillin" rash.
Gastrointestinal tract - mostly moderate abdominal discomfort, nausea; diarrhea is much less common than with ampicillin.

Indications for use

Upper respiratory tract infections - acute otitis media, acute rhinosinusitis.
Lower respiratory tract infections - exacerbation of chronic obstructive pulmonary disease (COPD), community-acquired pneumonia.
Urinary tract infections - cystitis, pyelonephritis (not recommended for empirical therapy due to the high level of resistance of pathogens).
H. pylori eradication (in combination with antisecretory drugs and other antibiotics).
Tick-borne borreliosis (Lyme disease).
Prevention of infective endocarditis.
Prevention of anthrax (in pregnant women and children).

Warnings

Do not use in the treatment of shigellosis and salmonellosis.
Amoxicillin preparations - Ampicillin-AKOS, Ampicillin-Ferein, Ampicillin sodium salt, Amoxicillin, Amoxicillin Sandoz, Amosin, Ospamox, Flemoxin Solutab, Hikontsil.

Carboxypenicillins

Carboxypenicillins include carbenicillin (discontinued and no longer available) and ticarcillin (part of the ticarcillin/clavulanate combination).

Their main advantage for a long time was their activity against R. aeruginosa, as well as some Gram-negative bacteria resistant to aminopenicillins (Enterobacter, Proteus, Morganella, etc.). However, to date, carboxypenicillins have practically lost their "antipseudomonal" value due to the high level of resistance to them by Pseudomonas aeruginosa and many other microorganisms, as well as poor tolerance.

They have the greatest neurotoxicity among penicillins, can cause a violation of platelet aggregation, thrombocytopenia, electrolyte imbalance - hypernatremia, hypokalemia.

Ureidopenicillins

Ureidopenicillins include azlocillin (not currently used) and piperacillin (used as part of the combination drug piperacillin + tazobactam. Compared to carboxypenicillins, they have a broader antimicrobial spectrum and are somewhat better tolerated.

Initially, they were more active than carboxypenicillins against P. aeruginosa, but now most strains of Pseudomonas aeruginosa are resistant to ureidopenicillins.

Inhibitor-protected penicillins

The main mechanism for the development of bacterial resistance to β-lactam antibiotics is the production of special enzymes, β-lactamases, which destroy the β-lactam ring - the most important structural element of these drugs, providing their bactericidal effect. This protective mechanism is one of the leading ones for such clinically important pathogens as S. aureus, H. influenzae, M. catarrhalis, K. pneumoniae, B. fragilis, and many others.

Simplified approach to the systematization of β-lactamases produced by microorganisms, depending on the direction of action, they can be divided into several types:

1) penicillinases that destroy penicillins;

2) cephalosporinases that destroy cephalosporins of I-II generations;

3) extended-spectrum β-lactamases (ESBLs), which combine the properties of the first two types and, in addition, destroy cephalosporins of III and IV generations;

4) metallo-β-lactamases, which destroy almost all β-lactams (except for monobactams).

In order to overcome this resistance mechanism, β-lactamase inactivating compounds were obtained: clavulanic acid (clavulanate), sulbactam and tazobactam.

On this basis, combined preparations containing a penicillin antibiotic (ampicillin, amoxicillin, piperacillin, ticarcillin) and one of the β-lactamase inhibitors have been created.

Such drugs are called inhibitor-protected penicillins.

As a result of the combination of penicillins with β-lactamase inhibitors, the natural (primary) activity of penicillins against many staphylococci (except MRSA), gram-negative bacteria, non-spore-forming anaerobes is restored, and their antimicrobial spectrum is also expanded due to a number of gram-negative bacteria (Klebsiella, etc.) with natural resistance to penicillins.

It should be emphasized that β-lactamase inhibitors make it possible to overcome only one of the mechanisms of bacterial resistance. Therefore, for example, tazobactam cannot increase the sensitivity of P. aeruginosa to piperacillin, since resistance in this case is caused by a decrease in the permeability of the outer membrane of the microbial cell for β-lactams.

Amoxicillin + clavulanate

The drug consists of amoxicillin and potassium clavulanate. The ratio of components in preparations for oral administration is from 2:1, 4:1 and 8:1, and for parenteral administration - 5:1. Clavulanic acid, used as a potassium salt, is one of the most potent inhibitors of microbial β-lactamase. Therefore, amoxicillin in combination with clavulanate is not destroyed by β-lactamases, which significantly expands the spectrum of its activity.

Spectrum of antibacterial activity

Amoxicillin + clavulanate acts on all microorganisms sensitive to amoxicillin. In addition, unlike amoxicillin:

has a higher antistaphylococcal activity: acts on PRSA and some strains of S. epidermidis;
acts on enterococci producing (3-lactamase;
active against gram (-) flora producing (3-lactamase (H. influenzae, M. catarrhalis, N. gonorrhoeae, E. coli, Proteus spp., Klebsiella spp., etc.), except for ESBL producers;
has high antianaerobic activity (including B. fragilis).
Does not affect Gram (-) bacteria resistant to aminopenicillins: P. aeruginosa, Enterobacter, Citrobacter, Serration, Providence, Morganella.

Side effects

Like amoxicillin. In addition, due to the presence of clavulanate, in rare cases (more often in the elderly), hepatotoxic reactions (increased transaminase activity, fever, nausea, vomiting) are possible.

Indications for use

Bacterial infections of the upper respiratory tract (acute and chronic rhinosinusitis, acute otitis media, epiglottitis).
Bacterial infections of the lower respiratory tract (exacerbation of COPD, community-acquired pneumonia).
Infections of the biliary tract (acute cholecystitis, cholangitis).
Urinary tract infections (acute pyelonephritis, cystitis).
intra-abdominal infections.
Infections of the pelvic organs.
Bone and joint infections.

Amoxicillin + sulbactam

The drug consists of amoxicillin and sulbactam in ratios of 1:1 and 5:1 for oral administration and 2:1 for parenteral administration.
The spectrum of activity is close to amoxicillin + clavulanate. Sulbactam, in addition to inhibiting β-lactamases, exhibits moderate activity against Neisseria spp., M. catarrhalis, Acinetobacter spp.
Side effects

Like amoxicillin.

Indications for use

Infections of the urinary tract (acute pyelonephritis, cystitis).
intra-abdominal infections.
Infections of the pelvic organs.
Infections of the skin and soft tissues (including wound infections after bites).
Bone and joint infections.
Perioperative antibiotic prophylaxis.

Ampicillin + sulbactam

The drug consists of ampicillin and sulbactam in a ratio of 2:1. For oral administration, the prodrug sultamicillin is intended, which is a combination of ampicillin and sulbactam. During absorption, hydrolysis of sultamicillin occurs, with the bioavailability of ampicillin and sulbactam exceeding that of an equivalent dose of conventional ampicillin.

Ampicillin + sulbactam is similar in most parameters to amoxicillin + clavulanate and amoxicillin + sulbactam.

Indications for use

Bacterial infections of the upper respiratory tract (acute and chronic rhinosinusitis, acute otitis media, epiglottitis).
Bacterial infections of the NDP (exacerbation of COPD, community-acquired pneumonia).
Infections of the gastrointestinal tract (acute cholecystitis, cholangitis).
MBP infections (acute pyelonephritis, cystitis).
intra-abdominal infections.
Infections of the pelvic organs.
Infections of the skin and soft tissues (including wound infections after bites).
Bone and joint infections.
Perioperative antibiotic prophylaxis.

It has an advantage over amoxicillin + clavulanate in infections caused by Acinetobacter.

Warning

When administered intramuscularly, the drug should be diluted with a 1% solution of lidocaine.

Ticarcillin + clavulanate

Combination of carboxypenicillin ticarcillin with clavulanate in a ratio of 30:1. Unlike inhibitor-protected aminopenicillins, it acts on P. aeruginosa (but many strains are resistant) and surpasses them in activity against nosocomial strains of enterobacteria.

Gram-positive cocci: staphylococci (including PRSA), streptococci, enterococci (but inferior in activity to inhibitor-protected aminopenicillins).
Gram-negative rods: representatives of the Enterobacteriaceae family (E. coli, Klebsiella spp., Proteus spp., Enterobacter spp., Serratia spp., C. diversus, etc.); P. aeruginosa (but not superior to ticarcillin); non-fermenting bacteria - S. maltophilia (surpasses other β-lactams in activity).
Anaerobes: spore-forming and non-spore-forming, including B. fragilis.

Side effects

Allergic reactions.
Neurotoxicity (tremor, convulsions).
Electrolyte disorders (hypernatremia, hypokalemia - especially in patients with heart failure).
Violation of platelet aggregation.

Indications for use

Severe, predominantly nosocomial infections of various localization:

intra-abdominal infections;
infections of the pelvic organs;
skin and soft tissue infections;
bone and joint infections;
sepsis.

Piperacillin + tazobactam

The combination of ureidopenicillin piperacillin with tazobactam in a ratio of 8:1. Tazobactam surpasses sulbactam in the degree of β-lactamase inhibition and is approximately equivalent to clavulanate. Piperacillin + tazobactam is regarded as the most potent inhibitor-protected penicillin.

Spectrum of antibacterial activity

Gram-positive cocci: staphylococci (including PRSA), streptococci, enterococci.
Gram-negative rods: representatives of the Enterobacteriaceae family (E. coli, Klebsiella spp., Proteus spp., Enterobacter spp., Serratia spp., C. diversus, etc.); P. aeruginosa (but not superior to piperacillin); non-fermenting bacteria - S. maltophilia.
Anaerobes: spore-forming and non-spore-forming, including B. frailis.

Side effects

Same as Ticarcillin + clavulanate.

Indications for use

Severe, predominantly nosocomial infections of various localization, caused by multiresistant and mixed (aerobic-anaerobic) microflora:

lower respiratory tract infections (pneumonia, lung abscess, pleural empyema);
complicated urinary tract infections;
intra-abdominal infections;
infections of the pelvic organs;
skin and soft tissue infections;
bone and joint infections;
sepsis.

Preparations of inhibitor-protected penicillins

(Amoxicillin + clavulanate) - Amovikomb, Amoxiclav, Amoxivan, Arlet, Augmentin, Bactoclav, Betaklav, Verklav, Klamosar, Medoklav, Panklav 2X, Rapiclav, Fibell, Flemoklav Solutab, Foraklav, Ecoklav.

(Amoxicillin + sulbactam) - Trifamox IBL, Trifamox IBL DUO.

(Ampicillin + sulbactam)— Ampiside, Libaktsil, Sultasin.

(Ticarcillin + clavulanate) - Timentin.

(Piperacillin + tazobactam) - Santaz, Tazocin, Tazrobida, Tacillin J.

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

Antibiotics of the penicillin series are still used in medicine.

The discovery of penicillin and its properties

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

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

Ask your question to a neurologist for free

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

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

Expert opinion

Astafiev Igor Valentinovich

Neurologist - City Pokrovskaya Hospital. Education: Volgograd State Medical University, Volgograd. Kabardino-Balkarian State University named after A.I. HM. Berbekova, Nalchik.

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

Pharmacokinetics and principle of action

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

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

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

Watch a video on this topic

Classification of antibiotics

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

Natural

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

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

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

Expert opinion

Mitrukhanov Eduard Petrovich

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

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

Semi-synthetic antibiotics of the penicillin group

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

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

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

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

Examples of drugs: Ticarcillin, Piperacillin

List of drugs

Pills

Sumamed

Active ingredient: azithromycin.

Indications: Respiratory infections.

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

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: infections sensitive to the drug.

Price: 30-60 rubles.

Amoxicillin Sandoz

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

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

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

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

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

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

injections

Bicillin-1

Active ingredient: benzathine benzylpenicillin.

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

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

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

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

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

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

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

Price: 163 rubles.

Benzylpenicillin

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

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: Similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

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

Indications for use

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

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

Application features

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

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

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

Contraindications and side effects

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

List of side effects

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

If side effects occur, seek immediate medical attention medical care, stop the drug and carry out symptomatic treatment.

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

This section presents complete list current antimicrobial agents medicines. In addition to the characteristics of the main compounds, all trade names and analogues.

Main title	Antimicrobial activity	Analogues
Benzylpenicillin potassium and sodium salts	Influence mainly gram-positive microorganisms. Currently, most strains have developed resistance, but spirochetes are still sensitive to the substance.	Gramox-D, Ospen, Star-Pen, Ospamox
benzylpenicillin procaine	Indicated for the treatment of streptococcal and pneumococcal infections. Compared to potassium and sodium salts, it acts longer, as it dissolves and is absorbed more slowly from the intramuscular depot.	Benzylpenicillin-KMP (-G, -Teva, -G 3 mega)
Bicillins (1, 3 and 5)	It is used for chronic rheumatism with a preventive purpose, as well as for therapy. infectious diseases moderate and mild severity of leakage caused by streptococci.	Benzicillin-1, Moldamine, Extincillin, Retarpin
Phenoxymethylpenicillin	It has a therapeutic effect similar to the previous groups, but is not destroyed in an acidic gastric environment. Produced in the form of tablets.	V-Penicillin, Kliacil, Ospen, Penicillin-Fau, Vepicombin, Megacillin Oral, Pen-os, Star-Pen
Oxacillin	Active against staphylococci that produce penicillinase. It is characterized by low antimicrobial activity, it is completely ineffective against penicillin-resistant bacteria.	Oxamp, Ampiox, Oxamp-Sodium, Oxamsar
Ampicillin	Extended spectrum of antimicrobial activity. In addition to the main spectrum inflammatory diseases Gastrointestinal tract, treats and caused by Escherichia, Shigella, Salmonella.	Ampicillin AMP-KID (-AMP-Forte, -Ferein, -AKOS, -trihydrate, -Innotek), Zetsil, Pentrixil, Penodil, Standacillin
Amoxicillin	It is used to treat inflammation of the respiratory and urinary tract. After clarifying the bacterial origin of gastric ulcers, Helicobacter pylori is used for eradication.	Flemoxin solutab, Hikoncil, Amosin, Ospamox, Ecobol
Carbenicillin	The spectrum of antimicrobial action includes Pseudomonas aeruginosa and enterobacteria. The digestibility and bactericidal effect is higher than that of Carbenicillin.	Securopen
Piperacillin	Similar to the previous one, but the level of toxicity is increased.	Isipen, Pipracil, Picillin, Piprax
Amoxicillin/clavulanate	Due to the inhibitor, the spectrum of antimicrobial activity is expanded compared to the unprotected agent.	Augmentin, Flemoklav solutab, Amoxiclav, Amklav, Amovikomb, Verklav, Ranklav, Arlet, Klamosar, Rapiclav
Ampicillin/sulbactam		Sulacillin, Liboksil, Unazine, Sultasin
Ticarcillin/clavulanate	The main indication for use is nosocomial infections.	Gimentin
Piperacillin/tazobactam	The main indication for use is nosocomial infections.	Tazocin

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

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

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

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

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

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

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

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

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

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

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

Currently, penicillin antibiotics full list which are listed below are divided into 4 main groups.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

According to the degree of efficiency are divided into:

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

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

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

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

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

See also: About the modern classification of antibiotics by group of parameters

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

TO undesirable consequences uses include:

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

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

For children, tablets and injections should be prescribed carefully, taking into account the possible backlash, and the choice of a particular drug should be approached thoughtfully.

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

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

A little theory:

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

Alexander Fleming - discoverer of penicillin

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

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

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

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

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

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

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

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

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

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

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

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

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

Watch a video on this topic

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

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

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

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

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

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

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

Examples of drugs: Ticarcillin, Piperacillin

Pills

Sumamed

Active ingredient: azithromycin.

Indications: Respiratory infections.

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

Price: 300-500 rubles.

Oxacillin

Active ingredient: oxacillin.

Indications: infections sensitive to the drug.

Price: 30-60 rubles.

Amoxicillin Sandoz

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

Contraindications: intolerance, children under 3 years of age.

Price: 150 rubles.

Ampicillin trihydrate

Indications: pneumonia, bronchitis, tonsillitis, other infections.

Contraindications: hypersensitivity, liver failure.

Price: 24 rubles.

Phenoxymethylpenicillin

Active ingredient: phenoxymethylpenicillin.

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

Price: 7 rubles.

Amoxiclav

Active ingredient: amoxicillin + clavulanic acid.

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

Contraindications: hypersensitivity, jaundice, mononucleosis and lymphocytic leukemia.

Price: 116 rubles.

Bicillin-1

Active ingredient: benzathine benzylpenicillin.

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

Contraindications: hypersensitivity.

Price: 15 rubles per injection.

Ospamox

Active ingredient: amoxicillin.

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

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

Price: 65 rubles.

Ampicillin

Active ingredient: ampicillin.

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

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

Price: 163 rubles.

Benzylpenicillin

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

Contraindications: intolerance.

Price: 2.8 rubles per injection.

Benzylpenicillin novocaine salt

Active ingredient: benzylpenicillin.

Indications: Similar to benzylpenicillin.

Contraindications: intolerance.

Price: 43 rubles for 10 injections.

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

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

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

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

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

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

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

Where does penicillin mold grow?

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

How to replace penicillin antibiotics?

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

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

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

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Antibiotics owe their appearance to the Scottish scientist Alexander Fleming. More precisely, his carelessness. In September 1928 he returned to his laboratory from a long trip. In the Petri dish forgotten on the table, a moldy area has grown during this time, and a ring of dead microbes has formed around it. It was this phenomenon that the microbiologist noticed and began to investigate.

The mold in the test tube contained a substance that Fleming called penicillin. However, as many as 13 years passed before penicillin was obtained in its pure form, and its action was first tested on humans. Mass production of the new drug began in 1943, at a distillery where whiskey used to be brewed.

To date, there are about several thousand natural and synthetic substances that have an antimicrobial effect. However, the most popular of them are still penicillin drugs.

Any pathogenic microorganism, getting into the blood or tissues, begins to divide and grow. The effectiveness of penicillins is based on their ability to disrupt the formation of bacterial cell walls.

Antibiotics of the penicillin group block special enzymes that are responsible for the synthesis of a protective, peptidoglycan layer in the bacterial shell. It is thanks to this layer that they remain insensitive to aggressive environmental influences.

The result of impaired synthesis is the inability of the shell to withstand the difference between external pressure and pressure inside the cell itself, due to which the microorganism swells and simply breaks.

Penicillins are antibiotics with a bacteriostatic effect, that is, they affect only active microorganisms that are in the stage of division and the formation of new cell membranes.

According to the chemical classification, penicillin antibiotics belong to β-lactam antibiotics. In their structure, they contain a special beta-lactam ring, which determines their main action. To date, the list of such drugs is quite large.

The first, natural penicillin, despite all its effectiveness, had one significant drawback. He did not have resistance to the enzyme penicillinase, which was produced by almost all microorganisms. Therefore, scientists have created semi-synthetic and synthetic analogues. Today, antibiotics of the penicillin group include three main types.

Like many years ago, they are obtained using the fungi Penicillium notatum and Penicillium chrysogenum. The main representatives of this group today are Benzylpenicillin sodium or potassium salt, as well as their analogues Bicillins -1, 3 and 5, which are the novocaine salt of penicillin. These drugs are unstable to the aggressive environment of the stomach and therefore are used only in the form of injections.

Benzylpenicillins are distinguished by the rapid onset of the therapeutic effect, which develops literally in 10–15 minutes. However, its duration is quite small, only 4 hours. Bicillin boasts greater stability, thanks to its combination with novocaine, its action lasts for 8 hours.

Another representative on the list of this group, phenoxymethylpenicillin, is resistant to an acidic environment, therefore it is available in tablets and suspensions that can be used by children. However, it also does not differ in the duration of action and can be administered from 4 to 6 times a day.

Natural penicillins are used very rarely today due to the fact that most pathological microorganisms have developed resistance to them.

This penicillin group of antibiotics was obtained using various chemical reactions, adding additional radicals to the main molecule. The slightly modified chemical structure endowed these substances with new properties, such as resistance to penicillinase and a wider spectrum of action.

Semi-synthetic penicillins include:

Antistaphylococcal, such as Oxacillin obtained in 1957 and still used today and cloxacillin, flucloxacillin, and dicloxacillin, which are not used due to high toxicity.
Antipseudomonal, a special group of penicillins that was created to fight infections caused by Pseudomonas aeruginosa. These include Carbenicillin, Piperacillin and Azlocillin. Unfortunately, today these antibiotics are used very rarely, and due to the resistance of microorganisms to them, new drugs are not added to their list.
Penicillin series of broad-spectrum antibiotics. This group acts on many microorganisms and is resistant to an acidic environment, which means that it is produced not only in injection solutions, but also in tablets and suspensions for children. This includes the most commonly used aminopenicillins, such as Ampicillin, Ampiox, and Amoxicillin. The drugs have a long-term effect and are usually applied 2-3 times a day.

Of the entire group of semi-synthetic drugs, it is the broad-spectrum penicillin antibiotics that are the most popular and are used both in inpatient and outpatient treatment.

In the past, injections of penicillin could cure blood poisoning. Today, most antibiotics are ineffective even for simple infections. The reason for this is resistance, that is, resistance to drugs that microorganisms have acquired. One of its mechanisms is the destruction of antibiotics by the enzyme beta-lactamase.

In order to avoid this, scientists have created a combination of penicillins with special substances - beta-lactamase inhibitors, namely clavulanic acid, sulbactam or tazobactam. Such antibiotics were called protected and today the list of this group is the most extensive.

In addition to protecting penicillins from the damaging effects of beta-lactamases, inhibitors also have their own antimicrobial activity. The most commonly used of this group of antibiotics is Amoxiclav, which is a combination of amoxicillin and clavulanic acid, and Ampisid, a combination of ampicillin and sulbactam. Doctors and their analogues are prescribed - drugs Augmentin or Flemoklav. Protected antibiotics are used to treat children and adults, and they are the drugs of first choice in the treatment of infections during pregnancy.

Antibiotics protected by beta-lactamase inhibitors have been successfully used even to treat severe infections resistant to most other drugs.

Statistics show that antibiotics are the second most commonly used drug after painkillers. According to the analytical company DSM Group, 55.46 million packages were sold in only one quarter of 2016. To date, pharmacies sell approximately 370 different brands of drugs, which are produced by 240 companies.

The entire list of antibiotics, including the penicillin series, refers to strict dispensing drugs. Therefore, you will need a prescription from a doctor to purchase them.

Indications for the use of penicillins can be any infectious diseases that are sensitive to them. Doctors usually prescribe penicillin antibiotics:

In diseases caused by gram-positive bacteria, such as meningococci, which can cause meningitis and gonococci, which provoke the development of gonorrhea.
With pathologies that are provoked by gram-negative bacteria, such as pneumococci, staphylococci or streptococci, which are often the causes of infections of the upper and lower respiratory tract, genitourinary system and many others.
With infections caused by actinomycetes and spirochetes.

The low toxicity that the penicillin group has compared to other antibiotics makes them the most prescribed drugs for the treatment of tonsillitis, pneumonia, various infections of the skin and bone tissue, diseases of the eyes and ENT organs.

This group of antibiotics is relatively safe. In some cases, when the benefits of their use outweigh the risks, they are prescribed even during pregnancy. Especially when non-penicillin antibiotics are ineffective.

They are also used during lactation. However, doctors still advise against breastfeeding while taking antibiotics, as they are able to penetrate into milk and can cause allergies in the baby.

The only absolute contraindication to use penicillin preparations is an individual intolerance to both the main substance and auxiliary components. For example, Benzylpenicillin novocaine salt is contraindicated in case of allergies to novocaine.

Antibiotics are quite aggressive drugs. Even though they do not have any effect on the cells of the human body, there can be unpleasant effects from their use.

Most often it is:

Allergic reactions, manifested mainly in the form skin itching, redness and rashes. Less commonly, swelling and fever may occur. In some cases, anaphylactic shock may develop.
Violation of the balance of the natural microflora, which provokes disorders, abdominal pain, bloating and nausea. In rare cases, candidiasis may develop.
A negative effect on the nervous system, the signs of which are irritability, excitability, convulsions can rarely occur.

To date, of the entire variety of open antibiotics, only 5% are used. The reason for this lies in the development of resistance in microorganisms, which often arises from the misuse of drugs. Antibiotic resistance is already killing 700,000 people every year.

In order for the antibiotic to be as effective as possible and not cause the development of resistance in the future, it must be drunk in the dosage prescribed by the doctor and always the full course!

If your doctor has prescribed you penicillins or any other antibiotics, be sure to follow these rules:

Strictly observe the time and frequency of taking the drug. Try to drink the medicine at the same time, so you will ensure a constant concentration of the active substance in the blood.
If the dosage of penicillin is small and the drug needs to be drunk three times a day, then the time between doses should be 8 hours. If the dose prescribed by the doctor is designed to be taken twice a day - up to 12 hours.
The course of taking the drug can vary from 5 to 14 days and is determined by your diagnosis. Always drink the entire course prescribed by your doctor, even if the symptoms of the disease no longer bother you.
If you don't feel better within 72 hours, be sure to let your doctor know. Perhaps the drug he chose was not effective enough.
Do not substitute one antibiotic for another on your own. Do not change the dosage or dosage form. If the doctor prescribed injections, then the pills in your case will not be effective enough.
Be sure to follow the instructions for admission. There are antibiotics that you need to drink with meals, there are those that you drink immediately after. Drink the drug only with plain, non-carbonated water.
Avoid alcohol, fatty, smoked and fried foods during antibiotic treatment. Antibiotics are mainly excreted by the liver, so you should not load it additionally during this period.

If penicillin antibiotics are prescribed to a child, then you should be especially careful about taking them. The children's body is much more sensitive to these drugs than an adult, so allergies in babies may occur more often. Penicillins for children are produced, as a rule, in a special dosage form, in the form of suspensions, so you should not give the child pills. Take antibiotics correctly and only as directed by your doctor, when you really need to.

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

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

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

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

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

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

For almost the entire 20th century, scientists have been "fighting" against microorganisms and bacteria, trying to create the perfect drug. Efforts were not in vain, but such improvements have led to the fact that antibiotics have changed significantly.

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

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

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

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

Antibiotics of the penicillin group are conditionally divided into:

Natural.
Semi-synthetic.

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

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

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

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

Semi-synthetic drugs can be divided into:

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

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

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

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

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

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

What are the contraindications for drugs:

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

Direct contraindications for the use of antibiotics:

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

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

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

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

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

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

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

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

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

Sumamed - the cost varies from 300 to 500 rubles.

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

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

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

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

Amoxiclav - cost-120 rubles.

Ospamox - the price varies from 65 to 100 rubles.

Benzylpenicillin novocaine salt - 50 rubles.

Benzylpenicillin - 30 rubles.