Penicillin analogues. Antibiotics of the penicillin group: indications, instructions for use

Penicillin antibiotics are considered the first AMPs that were developed from waste products of certain bacteria. IN general classification they are in the beta-lactam class. In addition to penicillins, this also includes carbapenems, cephalosporins and monobactams. The similarity is due to the fact that there is a four-membered ring. All drugs from this group are used in chemotherapy. They play an important role in treatment infectious diseases.

Initially all drugs penicillin group came from ordinary penicillin. It has been used in medicine since the 1940s. Nowadays many subgroups of both natural and synthetic origin have been created:

1. Natural penicillins.
2. Oxacillin.
3. Aminopenicillin.

Natural penicillin medicines are used in a number of cases. For example, medications that belong to the natural group of penicillins are recommended only for the treatment of those infections whose etiology is already known. For example, this can be confirmed during diagnostic measures or by characteristic symptoms. Depending on the form and how severely the disease develops, medications are prescribed for internal or parenteral use. Penicillins from the natural group help in the treatment of rheumatism, scarlet fever, tonsillopharyngitis, erysipelas, sepsis, and pneumonia.

In addition, such drugs are prescribed for the treatment of other diseases that are caused by streptococcus. For example, this applies to infectious endocarditis. For this disease, not only antibiotics from this group are used, but also drugs that have the following names: streptomycin, gentamicin, etc. Diseases that are caused by meningococcal type infections can also be cured with natural penicillins. Indications for their use are leptospirosis, gangrene, Lyme disease, syphilis, actinomycosis.

By the way, it is necessary to take into account the fact that medications with a prolonged effect do not have a high concentration in the blood, so they are not prescribed for the treatment of severe forms of the disease. The only exceptions are syphilis, tonsillopharyngitis, rheumatism and scarlet fever. If previously medications from this group were used to treat gonorrhea, now the causative agents of the disease quickly adapted and became resistant to these drugs.

As for oxacillin, it is prescribed only when the disease is caused by a staphylococcal infection, and this does not depend on its location. The infection may already be confirmed in laboratory conditions or be only inferred.

However, in any case, before prescribing such drugs to a patient, it is necessary to check whether bacteria are susceptible to their action. Medicines from the oxacillin group are prescribed in cases of sepsis, pneumonia, meningitis, endocarditis caused by bacterial infection, as well as various lesions bones, skin, joints, soft tissues caused by infections.

Aminopenicillins are prescribed in cases where the disease proceeds in sufficiently mild form, and without any complications in the form of other infections. Inhibitor-protective forms of aminopenicillins are used in cases of relapses in severe diseases. There are many medications, including antibiotic tablets. Substances are administered either orally or parenterally. Such drugs are prescribed when acute form cystitis, pyelonephritis, pneumonia, sinusitis, exacerbation chronic form bronchitis.

In addition, indications for use are intestinal diseases that are caused by infections, endocarditis, meningitis. Sometimes inhibitor-protective derivatives are prescribed by doctors for a preoperative form of prevention and in the treatment of infectious diseases of the skin and soft tissues.

What else applies?

The following drugs are also used:

1. Carboxypenicillin. Drugs from the carboxypenicillin group are now used less and less in medicine. They can be prescribed only in cases of nosocomial infections. Such medications should be used only in complex therapy, along with medications that can affect Pseudomonas aeruginosa. As for indications for use, carboxypenicillins are prescribed for infections on the skin, bones, soft tissues, joints. These medications will also be needed for abscess, pneumonia, sepsis, and infections in the pelvic organs.
2. Ureidopenicillin. Drugs from the ureidopenicillin group are often prescribed only together with aminoglycosides. This combination helps to cope with Pseudomonas aeruginosa. Indications for use are infectious diseases pelvic organs, soft tissues, skin (diabetic foot is also included). In addition, such funds will be needed for peritonitis, liver abscess, pneumonia, and lung abscess.

Mechanism of action

Drugs from the penicillin group have a bactericidal effect. They specifically affect penicillin-binding proteins, which are found in all bacteria. These compounds act as enzymes that participate already in the final stage of synthesis of the walls of the microorganism. As a result, the production of the substance is blocked and the bacterium dies. In addition, clavulonic acid, tazobactam and sulbactam have been developed to inhibit certain enzymatic substances. They are part of the drugs that belong to complex penicillins.

As for the effect on the human body, carboxypenicillins, benzylpenicillins and ureidopenicillins are destroyed in the human body due to hydrochloric acid, which is part of the gastric juice. In this regard, they can only be used parenterally. Drugs that contain oxacillin, phenoxymethylpenicillin and aminopenicillin, on the contrary, are resistant to acidic conditions and can be used orally. By the way, amoxicillin is best absorbed through the organs gastrointestinal tract. As for the worst indicators of digestibility, oxacillin and ampicillin have parameters of only 30%.

The substances that make up penicillin drugs spread well throughout the body, affecting tissues, biological fluids, and organs. High concentrations will occur in the kidneys, mucous membranes, intestines, lungs, genitals, and fluids. A small dose may pass through breast milk and the placenta. They practically do not enter the prostate gland. Significant transformation in the liver is characteristic of ureidopenicillins and oxacillins. Other substances from this group are excreted from the body practically unchanged. In most cases, excretion is carried out by the kidneys. The time it takes to remove the substance is approximately an hour. If the patient is diagnosed with kidney failure, the time will increase. Almost all types of penicillins are eliminated from the body through hemodialysis.

Contraindications and side effects

Like all drugs, medications containing penicillin have their contraindications. Basically, this only applies to allergies to penicillin. People who are at risk of an allergic reaction due to intolerance to certain components should not use these medications. The same applies to an allergic reaction to novocaine.

As for side effects, if the drugs are overdosed or used incorrectly, there is a risk of an allergic reaction. This could be dermatitis, rash, urticaria. In rare cases, Quincke's edema, anaphylactic shock, bronchospasms, and fever appear. If a person experiences anaphylactic shock, then glucocorticoids, adrenaline, and oxygen therapy will be required. It is also urgent to ensure the functioning of the respiratory tubular organs.

Regarding problems with the work of the central nervous system, then in rare cases tremor and mental disorders appear.

Sometimes the patient has a headache and seizures.

Basically, this happens in those people who suffer from kidney failure.

Problems with the functioning of the digestive tract appear more often. A person may feel sick, have vomiting attacks, abdominal pain, and colitis. In this case, it is necessary to abandon such medications. Additionally, if colitis is suspected, sigmoidoscopy is prescribed. To restore your health, you need to return your water and electrolyte balance to normal. Sometimes taking drugs from the penicillin group also leads to disruption of these processes.

This leads to hyperkalemia, hypernatremia. As a result, blood pressure changes and swelling appears. In some cases, problems may arise in the functioning of the liver, kidneys, various hematological reactions, complications of the condition blood vessels. In rare cases, oral or vaginal candidiasis develops.

Penicillin antibiotics are characterized by low toxicity and an extended spectrum of action. Penicillin antibiotics have a bactericidal effect on most strains of gram-positive and gram-negative bacteria, Pseudomonas aeruginosa.

The effect of drugs from the list of penicillin antibiotics is determined by their ability to cause the death of pathogenic microflora. Penicillins act bactericidal by interacting with bacterial enzymes, disrupting the synthesis of the bacterial wall.

The targets for penicillins are reproducing bacterial cells. Antibiotics of the penicillin group are safe for humans, since the membranes of human cells do not contain bacterial peptidoglycan.

Classification

Based on the production method and properties, there are two main groups of penicillin antibiotics:

• natural - discovered in 1928 by Flemming;
• semisynthetic - created for the first time in 1957, when the active core of the antibiotic 6-APA was isolated.

A number of natural penicillins obtained from the Penicillum microfungus are not resistant to bacterial penicillinase enzymes. Because of this, the spectrum of activity of the natural penicillin series is narrowed compared to the group of semisynthetic drugs.

Classification of the penicillin series:

• natural;
  • phenoxymethylpenicillin – Ospen and analogues;
  • benzathine benzylpenicillin - Retarpen;
  • benzylpenicillin – Procaine penicillin;
• semi-synthetic;
  • aminopenicillins – amoxicillins, ampicillins;
  • antistaphylococcal;
  • antipseudomonas;
    • carboxypenicillins;
    • ureidopenicillins;
  • inhibitor-protected;
  • combined.

Under the influence of the widespread use of antibiotics, bacteria have learned to produce beta-lactamase enzymes, which destroy penicillins in the stomach.

To overcome the ability of bacteria that produce beta-lactamases to destroy antibiotics, combined inhibitor-protected agents were created.

Spectrum of action

Natural penicillins are active against bacteria:

• gram-positive - staphylococci, streptococci, pneumococci, listeria, bacilli;
• gram-negative - meningococci, gonococci, Haemophilus ducreyi - causing chancroid, Pasteurella multocida - causing pasteurellosis;
• anaerobes – clostridia, fusobacteria, actinomycetes;
• spirochetes - Leptospira, Borrelia, spirochete pallidum.

Semi action spectrum synthetic penicillins wider than natural ones.

Semi-synthetic groups of antibiotics from the penicillin series are classified according to their spectrum of action as:

• not active against Pseudomonas aeruginosa;
• antipseudomonas drugs.

Indications

Penicillin antibiotics are used as first-line drugs for the treatment of bacterial infections in the treatment of:

• diseases of the respiratory system - pneumonia, bronchitis;
• ENT diseases - otitis media, tonsillitis, tonsillopharyngitis, scarlet fever;
• diseases of the urinary system – cystitis, pyelonephoritis
• gonorrhea, syphilis;
• skin infections;
• osteomyelitis;
• blenorrhea of ​​newborns;
• bacterial lesions of mucous membranes, connective tissue;
• leptospirosis, actinomycosis;
• meningitis.

Natural penicillins

Natural benzylpenicillins are destroyed by both beta-lactamases and gastric juice. Drugs of this group are produced as injection drugs:

• prolonged action - analogues with the names Bicillins numbered 1 and 5, novocaine salt of benzylpennicillin;
• short-acting - sodium, potassium salts of benzylpenicillin.

Depot forms of penicillins are released into the blood for a long time when administered intramuscularly, and are slowly released from the muscle into the blood after an injection:

• Bicellins 1 and 5 are prescribed once a day;
• Benzylpenicillin novocaine salt – 2 – 3 times a day.

Aminopenicillins

Antibiotics from the list of aminopenicillins are effective against most infections caused by bacteria Enterobacteriaceae, Helicobacter pylori, Haemophilus influenzae and other names of predominantly gram-negative bacteria.

The list of aminopenicillin antibiotics of the penicillin series includes the following drugs:

• ampicillin series;
  • Ampicillin trihydrate;
  • Ampicillin;
• amoxicillin;
  • Flemoxin Solutab;
  • Ospamox;
  • Amosin;
  • Ecobol.

The activity of antibiotics from the list of ampicillins and amoxicillins, the action spectra of drugs from these groups of penicillins are similar.

Antibiotics of the ampicillin series have a weaker effect on pneumococci, however, the activity of Ampicillin and its analogues with the names Ampicillin Akos, Ampicillin trihydrate is higher in relation to Shigella.

Antibiotics of the following groups are prescribed:

• ampicillins - orally in tablets and injections IM, IV;
• amoxicillin - for oral administration.

The amoxicillin series is effective against Pseudomonas aeruginosa, but some members of the group are destroyed by bacterial penicillinases. Penicillins from the group of ampicillin antibiotics are resistant to penicillinase enzymes.

Antistaphylococcal penicillins

The group of antistaphylococcal penicillins includes antibiotics with the following names:

• oxacillin;
• dicloxacillin;
• nafcillin;
• methicillin.

The drugs are resistant to staphylococcal penicillinases, which destroy other penicillin antibiotics. The most famous of this group is the antistaphylococcal drug Oxacillin.

Antipseudomonas penicillins

Antibiotics of this group have a wider spectrum of action than aminopenicillins and are effective against Pseudomonas aeruginosa, which causes severe cystitis, purulent tonsillitis, and skin infections.

The list of the group of antipseudomonas penicillins includes:

• carboxypenicillins – drugs;
  • Carbecin;
  • Piopen;
  • Carbenicillin disodium;
  • Timentin;
• ureidopenicillin group;
  • Securopen;
  • Azlin;
  • Baypen;
  • piperacillin Picillin.

Carbenicillin is available only in powder form for intramuscular and intravenous injections. Antibiotics of this group are prescribed to adults.

Timentin is prescribed for severe infections of the genitourinary and respiratory systems. Azlocillin and analogs are prescribed by injection for purulent-septic conditions:

• peritonitis;
• septic endocarditis;
• sepsis;
• lung abscess;
• severe infections of the genitourinary system.

Piperacillin is prescribed primarily for infections caused by Klebsiella spp.

Inhibitor-protected, combined agents

Inhibitor-protected penicillins include combination drugs that include an antibiotic and a substance that blocks the activity of bacterial beta-lactamases.

The following are beta-lactamase inhibitors, of which there are about 500 varieties:

• clavulanic acid;
• tazobactam;
• sulbactam.

For the treatment of respiratory and genitourinary infections, mainly protected penicillin antibiotics are used with the names:

• amoxicillin + clavunate;
  • Augmentin;
  • Amoxiclav;
  • Amoxil;
• ampicillin + sulbactam - Unazine.

For infections occurring against a background of weakened immunity, the following is prescribed:

• ticarcillin + clavunate - Timentin;
• piperacillin + tazobactam - Tazocin.

Combined-action drugs include the antibacterial agent Ampiox and its analogue Ampiox-sodium, including ampicillin + oxacillin.

Ampiox is available in tablets and powder form for injection. Ampiox is used in the treatment of children and adults from severe sepsis, septic endocarditis, and postpartum infection.

Penicillins for adults

The list of semi-synthetic penicillins, which are widely used for sore throats, otitis, pharyngitis, sinusitis, pneumonia, includes medications in tablets and injections:

• Hiconcil;
• Ospamox;
• Amoxiclav;
• Amoxicar;
• Ampicillin;
• Augmentin;
• Flemoxin Solutab;
• Amoxiclav;
• Piperacillin;
• Ticarcillin;

Against purulent chronic pyelonephritis, bacterial cystitis, urethritis, endometritis, salpingitis in women, penicillins are prescribed:

• Augmentin;
• Amoxiclav;
• Ampicillin + sulbactam;
• Honeyclave;
• Piperacillin + tazobactam;
• Ticarcillin with clavulanate.

Penicillins are not used against prostatitis, since they do not penetrate the prostate tissue.

If you are allergic to penicillins, the patient may experience urticaria, anaphylactic shock, and in case of treatment with cephalosporins.

To avoid an allergic reaction, if you are allergic to beta-lactam antibiotics, which are penicillins and cephalosporins, macrolide antibiotics are prescribed.

Exacerbation of chronic pyelonephritis in pregnant women is treated:

• Ampicillin;
• Amoxicillin + clavulanate;
• Ticarcillin + clavulanate;
• Oxacillin - for staphylococcal infections.

The list of non-penicillin antibiotics that a doctor can prescribe during pregnancy for sore throat, bronchitis or pneumonia includes the following medications:

• cephalosporins;
  • Cefazolin;
  • Ceftriaxone;
• macrolides;
  • Azithromycin;
  • Clarithromycin.

Penicillins for the treatment of children

Penicillins are low-toxic antibiotics, which is why they are often prescribed to children for infectious diseases.

Preference when treating children is given to inhibitor-protected penicillins intended for oral administration.

The list of penicillin antibiotics intended for the treatment of children includes Amoxicillin and analogues, Augmentin, Amoxiclav, Flemoxin and Flemoclav Solutab.

Non-penicillin forms of the antibiotic Solutab are also used to treat children; the list includes analogues with the names:

• Vilprafen Solutab;
• Unidox Solutab.

Medicines in the form of Solutab dispersible tablets are no less effective than injections and cause less child grief and tears during the treatment process. Read about antibiotics in dispersible form effervescent tablets can be found on the “Antibiotic Solutab” page.

Since birth, the drug Ospamox and a number of its analogues, which are produced in soluble tablets, granules and powder for the preparation of suspension, have been used to treat children. The dosage is prescribed by the doctor based on the age and weight of the child.

In children, penicillin may accumulate in the body due to immaturity of the urinary system or kidney disease. An increased concentration of antibiotic in the blood has a toxic effect on nerve cells, which is manifested by seizures.

If such symptoms appear, treatment is stopped, and the penicillin antibiotic is replaced for the child with a drug from another group.

Contraindications, side effects of penicillins

Contraindications for the use of penicillins include allergies to penicillin analogues and cephalosporins. If a rash appears during treatment, itchy skin, you need to stop taking the medications and consult a doctor.

An allergy to penicillins can manifest as angioedema and anaphylaxis.

The list of side effects of penicillins is small. The main negative manifestation is the suppression of beneficial intestinal microflora.

Diarrhea, candidiasis, skin rash - these are the main side effects from the use of penicillins. Less often side effect drugs this series manifests itself:

• nausea, vomiting;
• headache;
• pseudomembranous colitis;
• swelling.

The use of certain groups of the penicillin series - benzylpenicillins, carbenicillins, can cause a violation electrolyte balance with the occurrence of hyperkalemia or hypernatremia, which increases the risk of a heart attack and increased blood pressure.

A wider list of adverse reactions for oxacillin and analogues:

• violation of the leukocyte formula - low hemoglobin, low neutrophils;
• from the kidneys in children - the appearance of blood in the urine;
• fever, vomiting, nausea.

To prevent the development of undesirable effects, you must follow the instructions for use and take the medicine in the dosage prescribed by your doctor.

Read more complete information about each group of penicillin antibiotics in the “Drugs” section.

Penicillin antibiotics are universal drugs that allow a person to get rid of bacterial pathologies in a timely and effective manner. These medicines are based on mushrooms, living organisms that save millions of people around the world every year.

The history of the discovery of penicillin antibacterial agents dates back to the 30s of the 20th century, when scientist Alexander Fleming, who was studying bacterial infections, accidentally identified an area in which bacteria did not grow. As additional research showed, such a place in the bowl was the mold that usually covers stale bread.

As it turned out, this substance easily killed staphylococci. After additional research, the scientist was able to isolate penicillin in its pure form, which became the first antibacterial agent.

The principle of action of this substance is as follows: during bacterial cell division, to restore its own damaged membrane, these substances use elements called peptidoglycans. Penicillin does not allow this substance to form, which is why bacteria lose the ability not only to reproduce, but also to develop further, and are destroyed.

However, not everything went smoothly; after some time, bacterial cells began to actively produce an enzyme called beta-lactamase, which began to destroy beta-lactams, which form the basis of penicillins. To solve this problem, additional components were added to the composition of antibacterial agents, for example, clavulonic acid.

Spectrum of action

After penetration into the human body, the drug easily spreads throughout all tissues and biological fluids. The only areas where it penetrates in very small quantities (up to 1%) are the cerebrospinal fluid, organs of the visual system and the prostate gland.

The drug is eliminated outside the body through the kidneys, after about 3 hours.

The antibiotic effect of the natural variety of the drug is achieved by combating the following bacteria:

• gram-positive (staphylococci, pneumococci, streptococci, bacilli, listeria);
• gram-negative (gonococci, meningococci);
• anaerobic (clostridia, actiminocetes, fusobacteria);
• spirochetes (pallid, leptospira, borrelia);
• effective against Pseudomonas aeruginosa.

Penicillin antibiotics are used to treat various pathologies:

• infectious diseases of moderate severity;
• diseases of ENT organs (scarlet fever, tonsillitis, otitis media, pharyngitis);
• infections respiratory organs(bronchitis, pneumonia);
• diseases of the genitourinary system (cystitis, pyelonephritis);
• gonorrhea;
• syphilis;
• skin infections;
• osteomyelitis;
• blenorrhea occurring in newborns;
• leptospirosis;
• meningitis;
• actinomycosis;
• bacterial lesions of mucous and connective tissues.

Antibiotics classification

Penicillin antibiotics have different ways production, as well as properties, which allows us to divide them into 2 large groups.

1. Natural ones that were discovered by Fleming.
2. Semi-synthetic, were created a little later in 1957.

Experts have developed a classification of antibiotics from the penicillin group.

Natural ones include:

• phenoxylmethylpenicillin (Ospen, as well as its analogues);
• benzathine benzylpenicillin (Retarpen);
• benzylpenicillin sodium salt (Procaine penicillin).

The group of semi-synthetic products usually includes:

• aminopenicillins (amoxicillins, ampicillins);
• antistaphylococcal;
• antipeseudomonas (ureidopenicillins, carboxypenicillins);
• inhibitor-protected;
• combined.

Natural penicillins

Natural antibiotics have one weakness: they can be destroyed by beta-lactamase, as well as gastric juice.

Medicines classified in this group are in the form of solutions for injection:

• with extended action: this includes a penicillin substitute - bicillin, as well as novocaine salt of benzylpenicillins;
• with little effect: sodium and potassium salts of benzylpenicillins.

Long-acting penicillins are administered intramuscularly once a day, and novocaine salt is administered 2 to 3 times a day.

Biosynthetic

The penicillin series of antibiotics consists of acids, which, through the necessary manipulations, are combined with sodium and potassium salts. Such compounds are characterized by rapid absorption, which allows them to be used for injection.

Usually, therapeutic effect is noticeable already a quarter of an hour after administration of the drug, and it lasts for 4 hours (therefore, the drug requires repeated administration).

To prolong the effect of natural benzylpenicillin, it was combined with novocaine and some other components. The addition of novocaine salts to the main substance made it possible to lengthen the achieved therapeutic effect. Now it has become possible to reduce the number of injections to two or three per day.

Biosynthetic penicillins are used to treat the following diseases:

• chronic rheumatism;
• syphilis;
• streptococcus.

For the treatment of moderately severe infections, phenoxylmethylpenicillin is used. This variety is resistant to the destructive effects of hydrochloric acid, which is contained in gastric juice.

This substance is available in tablets, which can be taken orally (4-6 times a day). Biosynthetic penicillins work against most bacteria, with the exception of spirochetes.

Semi-synthetic antibiotics belonging to the penicillin series

This type of medication includes several subgroups of medications.

Aminopenicillins actively work against: enterobacteria, Haemophilus influenzae, Helicobacter pylori. These include the following drugs: ampicillin series (Ampicillin), amoxicillin (Flemoxin Solutab).

The activity of both subgroups of antibacterial agents extends to similar types of bacteria. However, ampicillins are not very effective against pneumococci, but some of their varieties (for example, Ampicillin trihydrate) easily cope with Shigella.

Drugs in this group are used as follows:

1. Ampicillin by intravenous and intramuscular infections.
2. Amoxicillin by oral administration.

Amoxicillins actively fight Pseudomonas aeruginosa, but, unfortunately, some of the representatives of this group can be destroyed under the influence of bacterial penicillinases.

The antistaphylococcal subgroup includes: Methicillin, Naficillin, Oxacillin, Fluxocillin, Dicloxacillin. These drugs are resistant to staphylococci.

The antipseudomonas subgroup, as the name implies, actively fights Pseudomonas aeruginosa, which provokes the appearance of severe forms of tonsillitis and cystitis.

This list includes two types of drugs:

1. Carboxypenicillins: Carbecin, Timentin (for the treatment of severe lesions of the urinary tract and respiratory organs), Pyopen, disodium Carbinicillin (used only in adult patients by intramuscular, intravenous administration).
2. Ureidopenicillins: Picillin piperacillin (used more often for pathologies caused by Klebsiella), Securopen, Azlin.

Combination antibiotics from the penicillin series

Combination drugs otherwise called inhibitor-protected, this means that they block bacterial beta-lactamases.

The list of beta-lactamase inhibitors is very large, the most common are:

• clavulonic acid;
• sulbactam;
• tazobactam.

For the purpose of treating pathologies of the respiratory and genitourinary systems, the following antibacterial compounds are used:

• amoxicillin and clavulonic acid (Augmentin, Amoxil, Amoxiclav);
• ampicillin and sulbactam (Unasin);
• ticarcillin and clavulonic acid (Timentin);
• piperacillin and tazobactam (Tazocin);
• ampicillin and oxacillin (Ampiox sodium).

Penicillins for adults

Semi-synthetic drugs are actively used to combat sinusitis, otitis, pneumonia, pharyngitis, and tonsillitis. For adults there is a list of the most effective drugs:

• Augmentin;
• Amoxicar;
• Ospamox;
• Amoxicillin;
• Amoxiclav;
• Ticarcillin;
• Flemoxin Solutab.

To get rid of pyelonephritis (purulent, chronic), cystitis (bacterial), urethritis, salpingitis, endometritis, use:

• Augmentin;
• Honeyclave;
• amoxiclav;
• Ticarcillin with clavulonic acid.

When a patient suffers from an allergy to penicillin drugs, he may have an allergic reaction in response to taking such drugs (this can be simple hives, or a severe reaction leading to anaphylactic shock). If such reactions occur, the patient is advised to use drugs from the macrolide group.

• Ampicillin;
• Oxacillin (if the pathogen is staphylococcus);
• Augmentin.

If you are intolerant to the penicillin group, the doctor may recommend the use of a group of reserve antibiotics in relation to penicillins: cephalosporins (Cefazolin) or macrolides (Clarithromycin).

Penicillins for the treatment of children

Many antibacterial agents have been created based on penicillins, some of them are approved for use in pediatric patients. These drugs are characterized by low toxicity and high efficiency, which allows their use in small patients.

For children, inhibitor-protected drugs are used orally.

The following antibiotics are prescribed to children:

• Flemoklav Solutab;
• Augmentin;
• Amoxiclav;
• Amoxicillin;
• Flemoxin.

Non-penicillin forms include Vilprafen Solutab, Unidox Solutab.

The word “solutab” means that the tablets dissolve under the influence of liquid. This fact makes it easier for young patients to take medications.

Many antibiotics of the penicillin group are produced in the form of suspensions that look like a sweet syrup. To determine the dosage for each patient, it is necessary to take into account his age and body weight.

Only a specialist can prescribe antibacterial agents for children. Self-medication with the use of such drugs is not allowed.

Contraindications side effects of penicillins

The use of penicillin drugs, despite all their effectiveness and benefits, is not possible for all categories of patients; the instructions for the drugs contain a list of conditions when the use of such drugs is prohibited.

Contraindications:

• hypersensitivity, personal intolerance or strong reactions to components medicine;
• previous reactions to cephalosporins, penicillins;
• dysfunction of the liver and kidneys.

Each drug has its own list of contraindications, indicated in the instructions; you should familiarize yourself with it before starting drug therapy.

Usually, penicillin antibiotics well tolerated by patients. But, in rare cases, more negative manifestations may occur.

Side effects:

• allergic reactions are manifested by skin rash, urticaria, tissue swelling, itching, other rashes, Quincke's edema, anaphylactic shock;
• from the gastrointestinal tract, nausea, epigastric pain, and digestive disorders may appear;
• circulatory system: increase in indicators blood pressure, heart rhythm disturbances;
• liver and kidneys: development of insufficiency in the functioning of these organs.

To prevent the development adverse reactions, it is very important to take antibiotics only as prescribed by the doctor, be sure to use auxiliary products (for example, probiotics) that he recommends.

Penicillin antibiotics are several types of drugs that are divided into groups. In medicine, drugs are used for treatment various diseases infectious and bacterial origin. The drugs have a minimal number of contraindications and are still used to treat various patients.

History of discovery

Once Alexander Fleming was studying pathogens in his laboratory. He created a nutrient medium and grew staphylococcus. 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 discovered that they were covered with fungus - mold. The scientist decided to test his guess and examined one of the containers under a microscope. He noticed that where there was mold, there was no staphylococcus.

Alexander Fleming continued his research; he began to study the effect of mold on pathogenic microorganisms and discovered 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 people's lives. It saved humanity from those diseases that previously caused panic among the population. Naturally, modern medicines are relatively similar to those drugs that were used in late XIX century. But the essence of the medications and their action have not changed so dramatically.

Penicillin antibiotics were able to revolutionize medicine. But the joy of the discovery did not last long. It turned out that pathogenic microorganisms and bacteria can mutate. They change and become insensitive to drugs. This led to significant changes in antibiotics such as penicillin.

Scientists spent almost the entire 20th century “fighting” microorganisms and bacteria, trying to create the ideal drug. The 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, and have a number of contraindications. If we talk about those drugs that were obtained from mold, they have a number of disadvantages:

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

Important: These medications have virtually no contraindications. It is not recommended to take them if you have an individual intolerance to antibiotics, or if you develop an allergic reaction.

Modern antibacterial agents differ significantly from the familiar penicillin. In addition to the fact that today you can easily purchase medications of this class in tablets, there are a great variety of them. Classification and generally accepted division into groups will help you understand the drugs.

Antibiotics: classification

Antibiotics of the penicillin group are conventionally divided into:

1. Natural.
2. Semi-synthetic.

All medicines based on mold are antibiotics of natural origin. Today, such medications 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 properly; the desired result in treatment can only be achieved by administering a high dose of the drug. The drugs in this group include: Benzylpenicillin and Bicillin.

The drugs are available in powder form for injection. They effectively act on: anaerobic microorganisms, gram-positive bacteria, cocci, etc. Since the medications are of natural origin, they cannot boast of a long-term effect, injections are often given every 3-4 hours. This allows you to maintain your concentration antibacterial agent in blood.

Penicillin antibiotics of semi-synthetic origin are the result of modification of drugs produced from mold. It was possible to impart some properties to medications belonging to this group; first of all, they became insensitive to acid-base environments. Which made it possible to release .

Medicines also appeared that acted on staphylococci. This class of drugs is different from natural antibiotics. But the improvements have significantly affected the quality of the drugs. They are poorly absorbed, do not have such a wide sector of action, and have contraindications.

Semi-synthetic drugs can be divided into:

• Isoxazolepenicillins 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 have 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. Drugs from this group remain in the blood longer. Such antibiotics are often used to treat various diseases, for example two very well-known drugs: Ampicillin and Amoxicillin.

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

Indications and contraindications for taking medications

Antibiotics belonging to the penicillin group are prescribed by a doctor. It is recommended to take the drugs if you have:

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

Information: Antibiotics are prescribed for extensive burns and deep wounds, gunshot or knife wounds.

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

What contraindications do medications have:

• You should not take medications during pregnancy or lactation. The drugs may affect the growth and development of the child. They can 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 such an antibiotic must be prescribed by a doctor. Since only a doctor can determine the permissible dosage and duration of treatment.
• The use of antibiotics from the groups of natural and synthetic penicillins for treatment is not recommended for the treatment of children. Drugs of 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 obvious indications. Use medications for a long period of time.

Direct contraindications for the use of antibiotics:

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

Attention! Main side effect Long-term diarrhea and candidiasis are considered to be caused by taking medications. They are due to the fact that the drugs affect not only pathogenic microorganisms, but also beneficial microflora.

The penicillin series of antibiotics is distinguished 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.

The latest generation of medicines 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 back on his feet” in 3–5 days.

List of drugs that doctors prescribe to patients

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

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

List or list of penicillin antibiotics, which are available in powder form:

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

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

Prices for medicines

Sumamed - the cost varies from 300 to 500 rubles.

Amoxicillin tablets - the price is about 159 rubles. per package.

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

Ampicillin in powder form, intended for injection - 170 rubles.

Oxacillin - the average price for 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 rub.

Benzylpenicillin - 30 rubles.

Antibiotics for a child

Preparations based on penicillin (mold) are used to treat children only if indicated.

Most often, doctors prescribe to young patients:

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

Carefully! Carrying out antibacterial therapy Children have their own nuances. For this reason, you should not prescribe such medications to your child on your own. There is a risk of making a mistake with the dosage and causing serious harm to the baby’s health.

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

Penicillin is the very first in the world, which became a real salvation for millions of people. With its help, doctors were able to declare war on diseases that were considered fatal at that time: pneumonia, tuberculosis,. However, treatment of pathologies with antibiotics should be carried out only after an accurate diagnosis has been established and strictly as prescribed by the doctor.

History of discovery

The discovery of the antibacterial properties of penicillin occurred in 1928. The famous scientist Alexander Fleming, as a result of conducting a routine experiment with colonies, discovered stains of ordinary mold in some cups with cultures.

As it turned out upon further study, there were no harmful bacteria in the cups with mold stains. Subsequently, it was from ordinary green mold that a molecule was derived that was capable of killing bacteria. This is how the first one appeared modern antibiotic- Penicillin.

Penicillium group

Nowadays, penicillins are a whole group of antibiotics produced by certain types of mold (genus Penicillium).

They can be active against entire groups of gram-positive microorganisms, as well as some gram-negative ones: staphylococci, spirochetes, meningococci.

Penicillins belong to a large group of beta-lactam antibiotics, which contain a special beta-lactam ring molecule.

Indications

Antibiotics of the penicillin group are used in the treatment of a huge number of infectious diseases. They are prescribed when pathogenic microorganisms are sensitive to the drug for the treatment of the following pathologies:

• many types of pneumonia;
• osteomyelitis;
• infections of the genitourinary system, most of the gastrointestinal tract;
• scarlet fever;
• diphtheria;
• anthrax;
• gynecological diseases;
• diseases of the ENT organs;
• syphilis, gonorrhea and many others.

This type of antibiotic is also used in the treatment of wounds infected with bacteria. As a prevention of purulent complications, the drug is prescribed in the postoperative period.

The drug can be used in childhood for umbilical sepsis, pneumonia, otitis in newborns and infants, also early age. Penicillin is also effective for purulent pleurisy and meningitis.

Use of penicillin in medicine:

Contraindications

The use of penicillins to treat infections is not always possible. People who are highly sensitive to the drug are strictly prohibited from taking the drug.

The use of this antibiotic is also contraindicated in patients suffering from asthma of various origins, hay fever, or a history of other active substances.

Release form

Modern pharmacological companies produce penicillin preparations for injections or in tablet form. Products for intramuscular administration are produced in bottles (made of glass), sealed with rubber stoppers and metal caps on top. Before administration, the substrate is diluted with sodium chloride or water for injection.

Tablets are produced in cell packaging in dosages from 50 to 100 thousand units. It is also possible to produce ecmoline lozenges. The dosage in this case does not exceed 5 thousand units.

Mechanism of action

The mechanism of action of penicillin is the inhibition of enzymes involved in the formation of the cell membrane of microorganisms. The cell membrane protects bacteria from exposure environment, disruption of its synthesis leads to the death of pathogenic agents.

This is the bactericidal effect of the drug. It acts on some types of gram-positive bacteria (streptococci and staphylococci), as well as several types of gram-negative ones.

It is worth noting that penicillins can only act on multiplying bacteria. In inactive cells, membranes are not built, so they do not die due to enzyme inhibition.

Instructions for use

The antibacterial effect of penicillin is achieved when intramuscular injection, when taken orally, as well as with local action. More often, the injection form is used for treatment. When administered intramuscularly, the drug is quickly absorbed into the blood.

However, after 3-4 hours it completely disappears from the blood. Therefore, regular administration of the drugs at equal intervals from 4 times a day is recommended.

The drug can be administered intravenously, subcutaneously, or into the spinal canal. For the treatment of complex pneumonia, meningitis or syphilis, a special regimen is prescribed, which can only be prescribed by a doctor.

When taking penicillin in tablet form, the dosage must also be determined by your doctor. As a rule, for bacterial infections, 250-500 mg is prescribed every 6-8 hours. If necessary, a single dose can be increased to 750 mg. The tablets should be taken half an hour before meals or 2 hours after. The duration of the course will be determined by the doctor.

Side effects

Since penicillins are a natural drug, they have minimal toxicity among other groups of artificially bred antibiotics. However, the emergence allergic reactions it's still possible.

The tablet form of penicillin should be taken with plenty of liquid. During treatment with penicillin antibiotics, it is important not to skip the recommended doses, since the effect of the drug may be weakened. If this happens, the missed dose should be taken as quickly as possible.

It happens that after 3-5 days after regular use or administration of the drug, improvement does not occur, then you should consult a doctor to adjust the course of treatment or dose of the drug. It is not recommended to interrupt the course of treatment without consulting a doctor.

Rules for the use of antibiotics:

Drug interactions

When prescribing penicillin, attention should be paid to its interaction with other drugs used. This antibiotic should not be combined with the following medicines:

1. reduces the effectiveness of penicillin antibiotics.
2. Aminoglycosides can conflict with penicillin in a chemical aspect.
3. Sulfonamides also reduce the bactericidal effect.
4. Thrombolytics.

Penicillin price

Penicillin is considered one of the most inexpensive antibacterial drugs. The price of 50 bottles of powder to create a solution varies from 280 to 300 rubles. The cost of 250 mg tablets numbered 30 is just over 50 rubles.

Cheap

Cheap analogues of penicillin include Ampicillin and Bicillin. Their cost in tablet form also does not exceed 50 rubles.

Drug synonyms

Synonyms for the drug are Procaine-benzylpenicillin, Benzylpenicillin sodium, potassium, novocaine salt.

Natural analogues

Natural medicinal penicillins include:

• Phenkoxymethylpenicillin;
• Benzathine benzylpenicillin;
• Benzylpenicillin salts (sodium, potassium, novocaine).

Conditions for dispensing from pharmacies

On prescription.

Storage conditions and shelf life