Ways and methods of introducing antibiotics into the body. Ways of removing the antibiotic from the body

14.03.2020

Generally preferred oral route of administration... Parenteral therapy is needed when the patient is not functioning well digestive tract, low blood pressure, it is required to immediately create a therapeutic concentration of the antibiotic in the body (for example, with life-threatening infections) or oral administration the antibiotic is not absorbed in quantities sufficient to create a therapeutic concentration at the site of infection. Topical antibiotics are indicated for some local infections (eg, bacterial conjunctivitis).

There are a number of important factors to consider before choosing. These factors include the following:
activity against the pathogen (s), but this information may not be available at the time when it is necessary to start treatment;
the ability to reach the focus of infection in therapeutic concentration. To do this, one should know whether the antibiotic should have bacteriostatic or bactericidal properties against a known or suspected pathogen, because with certain infections, an exclusively bactericidal action is required;
available routes of administration for a particular patient;
profile side effects, their effect on the existing disease and possible drug interactions;
the frequency of drug use, which is of particular importance for outpatients, for whom the administration of the drug more than 1-2 times a day can create difficulties;
when using an antibiotic in liquid form (mainly for small children), you should find out if it tastes good and to what extent it is stable at different temperatures. Suspensions of some antibiotics should be kept in the refrigerator for safekeeping;
cost of treatment; it is about the true cost of treatment, which includes the price of the drug, administration fees, monitoring and complications, including the lack of treatment effect and the cost of retreatment.

The following classes are distinguished:
inhibitors of bacterial cell wall synthesis;
membrane function inhibitors bacterial cell;
synthesis inhibitors;
inhibitors of bacterial RNA synthesis;
difficult to classify antibiotics (mixed class);
topical antibiotics;
antibiotics for the treatment of mycobacterial infections.

Each class is described below and some of its constituent antibiotics. After discussion chemical nature each class provides information on pharmacology in terms of mechanisms of antibacterial action, spectrum of activity, and other pharmacological effects... The therapeutic use of antibiotics, pharmacokinetic characteristics, side effects and toxicity have been analyzed.

The effectiveness of antibacterial treatment with their timely appointment, due to the following factors:

- Etiological diagnosis of the disease, clinical diagnosis nosological forms of the infectious process, isolating the pathogen with the subsequent determination of its sensitivity to the antibacterial drug;

- The choice of the most active and at the same time the least toxic drug for a particular patient;

- Determination of the optimal dose of an antibiotic or other antibacterial agent, the route of its administration to create a maximum concentration in the focus of infection, which exceeds the minimum inhibitory concentration (MIC) by 2-3 times or more for a given microorganism.

Microorganisms are considered sensitive to antibiotics, the growth and reproduction of which in the blood and in the focus of inflammation stops when medium therapeutic doses of the drug are prescribed. The degree and sensitivity of the pathogen to the antibiotic is characterized by its minimum concentration in a nutrient medium in which there are no signs of reproduction of the isolated strain. This is the minimum inhibitory concentration (MIC). The lower the MIC, the higher the sensitivity of the pathogen to the antibacterial drug. To achieve a therapeutic effect, the concentration of the antibiotic in the blood and in the focus of inflammation should be 2-3 times higher than the MIC. This is the average therapeutic concentration (MCT).

The effectiveness of antibacterial treatment also depends on:

Knowledge and consideration of possible adverse reactions for an antibacterial agent;
Application (according to indications) combination antibacterial drugs in order to expand the spectrum of their action and / or enhance the antimicrobial effect.

Indications for combined antibacterial therapy:

Severe course of the disease, which requires intensive etiotropic therapy before establishing a bacteriological diagnosis.
Mixed infections with the isolation of microbial associations of different sensitivity.
Infections caused by pathogens with low sensitivity to antibiotics, which are in the arsenal of the doctor.

Routes of administration of antibiotics in children.

The main route of administration of modern antibiotics in children should be oral - as the least traumatic and more physiological.

Its advantages:

Pharmacoeconomic effect, including the possibility of home treatment;
Prevention of iatrogenism, including infectious complications;
To avoid psychological trauma to the child.

Of the parenteral routes of administration of antibiotics, the most reasonable is the intravenous route, as the least traumatic in the presence of a central or peripheral venous catheter.

The intramuscular route of administration should be used only for a short time, and upon reaching positive effect immediately switch to the oral route of administration a similar drug - step-down therapy.

Step therapy is a two-stage application of an anti-infectious drug with a transition from parenteral to non-parenteral (usually oral) route of administration in a short period of time, taking into account clinical condition the patient.

The basic principles of antibiotic therapy:

Reasonable indications for the appointment of an antibacterial drug.
The choice of a drug or a combination of drugs, taking into account the sensitivity to the causative agent of the infectious process.
Selection of the most active and least toxic drug.
The drug is administered in a regimen that ensures constant maintenance of its therapeutic concentration in the focus of infection throughout the entire course of treatment.
The optimal way to administer antibacterial drugs, depending on the patient's condition.
Selection of criteria for evaluating the effectiveness of antibiotic therapy (clinical, laboratory and instrumental data).
Timely resolution of the issue of the need for combined antibiotic therapy.
Taking into account the child's age, its anatomical and physiological characteristics and concomitant therapy.
Knowledge of the features of the pharmacodynamics and pharmacokinetics of the antibacterial drug.
Mandatory monitoring of side effects and complications of antibiotic therapy and their correction.

Antibiotics are a huge group of bactericidal drugs, each of which is characterized by its own spectrum of action, indications for use and the presence of certain consequences

Antibiotics are substances that can inhibit the growth of microorganisms or destroy them. According to the GOST definition, antibiotics include substances of plant, animal, or microbial origin. Currently, this definition is somewhat outdated, since a huge number of synthetic drugs have been created, however, it was natural antibiotics that served as the prototype for their creation.

The history of antimicrobial drugs begins in 1928, when A. Fleming was first discovered penicillin... This substance was just discovered, and not created, since it has always existed in nature. In living nature, it is produced by microscopic fungi of the genus Penicillium, protecting themselves from other microorganisms.

In less than 100 years, more than a hundred different antibacterial drugs have been created. Some of them are already outdated and not used in treatment, and some are only being introduced into clinical practice.

How antibiotics work

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All antibacterial drugs can be divided into two large groups according to their effect on microorganisms:

bactericidal - directly cause the death of microbes;
bacteriostatic - prevent the growth of microorganisms. Unable to grow and multiply, bacteria are destroyed immune system sick person.

Antibiotics realize their effects in many ways: some of them interfere with the synthesis of nucleic acids of microbes; others interfere with the synthesis of the bacterial cell wall, others disrupt protein synthesis, and the fourth block the functions of respiratory enzymes.

Antibiotic groups

Despite the diversity of this group of drugs, all of them can be attributed to several main types. This classification is based on the chemical structure - drugs from one group have a similar chemical formula, differing from each other in the presence or absence of certain fragments of molecules.

The classification of antibiotics implies the presence of groups:

Penicillin derivatives... This includes all drugs based on the very first antibiotic. In this group, the following subgroups or generations of penicillin drugs are distinguished:

Natural benzylpenicillin, which is synthesized by fungi, and semi-synthetic drugs: methicillin, nafcillin.
Synthetic drugs: carbpenicillin and ticarcillin, which have a wider range of effects.
Mecillam and azlocillin, which have an even broader spectrum of action.

Cephalosporins - the closest relatives of penicillins. The very first antibiotic in this group, cefazolin C, is produced by fungi of the genus Cephalosporium. Most of the drugs in this group have a bactericidal effect, that is, they kill microorganisms. There are several generations of cephalosporins:

1st generation: cefazolin, cephalexin, cefradine, etc.
II generation: cefsulodin, cefamandol, cefuroxime.
III generation: cefotaxime, ceftazidime, cefodizime.
IV generation: cefpirome.
V generation: ceftolosan, ceftopibrol.

The differences between different groups are mainly in their effectiveness - later generations have a wider spectrum of action and are more effective. Cephalosporins of the 1st and 2nd generations in clinical practice are now used extremely rarely, most of them are not even produced.

- drugs with a complex chemical structure that have a bacteriostatic effect on a wide range of microbes. Representatives: azithromycin, rovamycin, josamycin, leukomycin and a number of others. Macrolides are considered one of the safest antibacterial drugs - they can even be used by pregnant women. Azalides and ketolides are varieties of macorlides that differ in the structure of active molecules.

Another advantage of this group of drugs is that they are able to penetrate cells. human body, which makes them effective in the treatment of intracellular infections:,.

Aminoglycosides... Representatives: gentamicin, amikacin, kanamycin. Effective against a large number of aerobic gram-negative microorganisms. These drugs are considered the most toxic and can lead to quite serious complications. They are used to treat infections of the genitourinary tract.
Tetracyclines... Basically, these are semi-synthetic and synthetic drugs, which include: tetracycline, doxycycline, minocycline. Effective against many bacteria. The disadvantage of these drugs is cross-resistance, that is, microorganisms that have developed resistance to one drug will be insensitive to others from this group.
Fluoroquinolones... These are completely synthetic drugs that do not have their natural counterpart. All drugs in this group are divided into the first generation (pefloxacin, ciprofloxacin, norfloxacin) and the second (levofloxacin, moxifloxacin). They are most often used to treat infections of the ENT organs (,) and respiratory tract ( , ).
Lincosamides. This group includes the natural antibiotic lincomycin and its derivative clindamycin. They have both bacteriostatic and bactericidal effects, the effect depends on the concentration.
Carbapenems... These are one of the most modern antibiotics that act on a large number of microorganisms. Drugs in this group belong to reserve antibiotics, that is, they are used in the most difficult cases when other drugs are ineffective. Representatives: imipenem, meropenem, ertapenem.
Polymyxins... These are highly specialized drugs used to treat infections caused by. Polymyxins include polymyxin M and B. The disadvantage of these drugs is the toxic effect on nervous system and kidneys.
Anti-tuberculosis drugs... This is a separate group of drugs that have a pronounced effect on. These include rifampicin, isoniazid, and PASK. Other antibiotics are also used to treat tuberculosis, but only if resistance to these drugs has developed.
Antifungal agents... This group includes drugs used to treat mycoses - fungal infections: amphotirecin B, nystatin, fluconazole.

Ways of using antibiotics

Antibacterial drugs are available in different forms: tablets, powder, from which the solution for injection is prepared, ointments, drops, spray, syrup, suppositories. The main uses for antibiotics are:

Oral - oral administration. The medicine can be taken as a tablet, capsule, syrup, or powder. The frequency of administration depends on the type of antibiotics, for example, azithromycin is taken once a day, and tetracycline - 4 times a day. There are guidelines for each type of antibiotic that tell you when to take it - before, during, or after. The effectiveness of treatment and the severity of side effects depend on this. For small children, antibiotics are sometimes prescribed in the form of a syrup - it is easier for children to drink a liquid than to swallow a pill or capsule. In addition, the syrup can be sweetened to remove the unpleasant or bitter taste of the medicine itself.
Injectable- in the form of intramuscular or intravenous injections. With this method, the drug enters the site of infection faster and acts more actively. The disadvantage of this route of administration is painfulness during the injection. Injections are used for moderate and severe diseases.

Important:should give injections exclusively nurse in a polyclinic or hospital! Injecting antibiotics at home is strictly not recommended.

Local- applying ointments or creams directly to the site of infection. This method of drug delivery is mainly used for skin infections - erysipelas, as well as in ophthalmology - with an infectious lesion of the eye, for example, tetracycline ointment for conjunctivitis.

The route of administration is determined only by the doctor. This takes into account many factors: the absorption of the drug in the gastrointestinal tract, the state digestive system in general (in some diseases, the rate of absorption decreases, and the effectiveness of treatment decreases). Some drugs can only be administered one way.

When injected, you need to know how the powder can be dissolved. For example, Abaktal can only be diluted with glucose, since it is destroyed when sodium chloride is used, which means that the treatment will be ineffective.

Antibiotic sensitivity

Any organism sooner or later gets used to the most severe conditions. This statement is also true with respect to microorganisms - in response to prolonged exposure to antibiotics, microbes develop resistance to them. The concept of sensitivity to antibiotics was introduced into medical practice - with what effectiveness a particular drug affects the pathogen.

Any prescription of antibiotics should be based on knowledge of the sensitivity of the pathogen. Ideally, before prescribing the drug, the doctor should conduct a sensitivity test and prescribe the most effective drug. But the time for carrying out such an analysis is at best a few days, and during this time the infection can lead to the most sad result.

Therefore, in case of infection with an unexplained pathogen, doctors prescribe drugs empirically - taking into account the most likely pathogen, with knowledge of the epidemiological situation in a particular region and a medical institution. For this, antibiotics of a wide spectrum of action are used.

After performing a sensitivity analysis, the doctor has the opportunity to change the drug to a more effective one. Replacement of the drug can be made even if there is no effect of treatment for 3-5 days.

Etiotropic (targeted) prescription of antibiotics is more effective. In this case, it turns out what caused the disease - with the help of bacteriological research, the type of pathogen is established. Then the doctor selects a specific drug to which the microbe has no resistance (resistance).

Are antibiotics always effective?

Antibiotics work only on bacteria and fungi! Unicellular microorganisms are considered bacteria. There are several thousand species of bacteria, some of which coexist quite normally with humans - more than 20 species of bacteria live in the large intestine. Some bacteria are conditionally pathogenic - they become the cause of the disease only under certain conditions, for example, when they enter an atypical habitat for them. For example, very often prostatitis is caused by E. coli, which enters the ascending route from the rectum.

Note: antibiotics are absolutely ineffective for viral diseases. Viruses are many times smaller than bacteria, and antibiotics simply do not have a point of application of their ability. Therefore, antibiotics for colds do not have an effect, since colds in 99% of cases are caused by viruses.

Antibiotics for coughs and bronchitis can be effective if bacteria are causing the symptoms. Only a doctor can figure out what caused the disease - for this he prescribes blood tests, if necessary, a sputum test if it leaves.

Important:prescribing antibiotics to oneself is unacceptable! This will only lead to the fact that some of the pathogens develop resistance, and the next time the disease will be much more difficult to cure.

Of course, antibiotics are effective when - this disease is exclusively bacterial in nature, caused by streptococci or staphylococci. For the treatment of angina, the simplest antibiotics are used - penicillin, erythromycin. The most important thing in the treatment of angina is compliance with the frequency of administration of drugs and the duration of treatment - at least 7 days. You can not stop taking the medication immediately after the onset of the condition, which is usually noted on the 3-4th day. True angina should not be confused with tonsillitis, which may be of viral origin.

Note: untreated sore throat can cause acute rheumatic fever or!

Inflammation of the lungs () can be of both bacterial and viral origin. Bacteria cause pneumonia in 80% of cases, therefore, even with empirical administration, antibiotics for pneumonia have good effect... In viral pneumonia, antibiotics do not have a therapeutic effect, although they prevent the bacterial flora from joining the inflammatory process.

Antibiotics and alcohol

The simultaneous intake of alcohol and antibiotics in a short period of time does not lead to anything good. Some drugs are broken down in the liver, just like alcohol. The presence of an antibiotic and alcohol in the blood puts a heavy load on the liver - it simply does not have time to neutralize ethanol... As a result, the likelihood of developing unpleasant symptoms increases: nausea, vomiting, intestinal disorders.

Important: a number of drugs interact with alcohol at a chemical level, as a result of which it directly reduces curative action... These drugs include metronidazole, chloramphenicol, cefoperazone and a number of others. The simultaneous intake of alcohol and these drugs can not only reduce healing effectbut also lead to shortness of breath, seizures and death.

Of course, some antibiotics can be taken while drinking alcohol, but why risk your health? It is better to abstain from alcohol for a short time - the course of antibiotic therapy rarely exceeds 1.5-2 weeks.

Antibiotics during pregnancy

Pregnant women get sick infectious diseases no less often than everyone else. But the treatment of pregnant women with antibiotics is very difficult. In the body of a pregnant woman, a fetus grows and develops - an unborn child, very sensitive to many chemicals... The ingress of antibiotics into the developing organism can provoke the development of fetal malformations, toxic damage to the central nervous system of the fetus.

In the first trimester, it is advisable to avoid the use of antibiotics altogether. In the second and third trimesters, their appointment is safer, but also, if possible, should be limited.

It is impossible to refuse to prescribe antibiotics to a pregnant woman with the following diseases:

Pneumonia;
angina;
infected wounds;
specific infections: brucellosis, borrelliasis;
genital infections:,.

What antibiotics can be prescribed to a pregnant woman?

Penicillin, cephalosporin drugs, erythromycin, josamycin have almost no effect on the fetus. Penicillin, although it crosses the placenta, does not adversely affect the fetus. Cephalosporin and other named drugs cross the placenta in extremely low concentrations and are not able to harm the unborn child.

Conditionally safe drugs include metronidazole, gentamicin and azithromycin. They are prescribed only for health reasons, when the benefit to the woman outweighs the risk to the child. Such situations include severe pneumonia, sepsis, and other serious infections, in which a woman can simply die without antibiotics.

Which of the drugs should not be prescribed during pregnancy

The following drugs should not be used in pregnant women:

aminoglycosides - can lead to congenital deafness (the exception is gentamicin);
clarithromycin, roxithromycin - in the experiments they had a toxic effect on the embryos of animals;
fluoroquinolones;
tetracycline - disrupts the formation of the skeletal system and teeth;
chloramphenicol - dangerous in late pregnancy due to the suppression of bone marrow functions in the child.

For some antibacterial drugs, there is no evidence of negative effects on the fetus. The explanation is simple - no experiments are carried out on pregnant women to determine the toxicity of drugs. Experiments on animals do not allow 100% certainty to exclude all negative effects, since the metabolism of drugs in humans and animals can differ significantly.

It should be noted that before you should also stop taking antibiotics or change plans for conception. Some drugs have a cumulative effect - they can accumulate in a woman's body, and for some time after the end of the course of treatment, they are gradually metabolized and excreted. It is recommended to get pregnant no earlier than 2-3 weeks after the end of the antibiotic intake.

The consequences of taking antibiotics

The ingestion of antibiotics into the human body leads not only to the destruction of pathogenic bacteria. Like all foreign chemicals, antibiotics have a systemic effect - in one way or another, they affect all body systems.

There are several groups of side effects of antibiotics:

Allergic reactions

Almost any antibiotic can cause allergies. The severity of the reaction is different: a rash on the body, Quincke's edema (angioedema), anaphylactic shock. If an allergic rash is practically not dangerous, then anaphylactic shock can be fatal. The risk of shock is much higher with antibiotic injections, which is why injections should only be given in medical institutions - emergency assistance can be provided there.

Antibiotics and other antimicrobial drugs that cause cross-allergic reactions:

Toxic reactions

Antibiotics can damage many organs, but the liver is most affected by them - against the background of antibiotic therapy, toxic hepatitis. Individual drugs have a selective toxic effect on other organs: aminoglycosides - on hearing aid (cause deafness); tetracyclines inhibit growth bone tissue in children.

note: the toxicity of the drug usually depends on its dose, but with individual intolerance, sometimes even smaller doses are enough for the effect to appear.

Effects on the gastrointestinal tract

When taking some antibiotics, patients often complain of stomach pain, nausea, vomiting, and upset stools (diarrhea). These reactions are most often due to the local irritating effect of drugs. The specific effect of antibiotics on the intestinal flora leads to functional disorders of its activity, which is most often accompanied by diarrhea. This condition is called antibiotic-associated diarrhea, which is popularly known under the term dysbiosis after antibiotics.

Other side effects

Other side effects include:

suppression of immunity;
the appearance of antibiotic-resistant strains of microorganisms;
superinfection - a condition in which microbes resistant to a given antibiotic are activated, leading to the emergence of a new disease;
violation of the metabolism of vitamins - due to the suppression of the natural flora of the large intestine, which synthesizes some B vitamins;
jarisch-Herxheimer bacteriolysis is a reaction that occurs when using bactericidal drugs, when a large amount of toxins are released into the blood as a result of the simultaneous death of a large number of bacteria. The reaction is clinically similar to shock.

Can antibiotics be used for prophylactic purposes?

Self-education in the field of treatment has led to the fact that many patients, especially young mothers, try to prescribe an antibiotic for themselves (or their child) at the slightest sign of a cold. Antibiotics do not have a prophylactic effect - they treat the cause of the disease, that is, they eliminate microorganisms, and in the absence, only the side effects of the drugs appear.

There are a limited number of situations where antibiotics are given before clinical manifestations infections in order to prevent it:

surgery - in this case, the antibiotic in the blood and tissues prevents the development of infection. Usually enough single dose drug administered 30-40 minutes before the intervention. Sometimes even after appendectomy in postoperative period do not inject antibiotics. After "clean" surgical operations antibiotics are not prescribed at all.
major injuries or wounds (open fractures, contamination of the wound with earth). In this case, it is absolutely obvious that an infection has got into the wound and you should "crush" it before it manifests itself;
emergency prevention of syphilis it is carried out during unprotected sexual contact with a potentially sick person, as well as with health workers who get the blood of an infected person or other biological fluid on the mucous membrane;
penicillin can be prescribed for children for the prevention of rheumatic fever, which is a complication of angina.

Antibiotics for children

The use of antibiotics in children is generally no different from their use in other groups of people. For young children, pediatricians most often prescribe antibiotics in syrup. This dosage form more convenient to receive, unlike injections, it is completely painless. Older children may be given antibiotics in tablets and capsules. In severe cases of infection, they switch to the parenteral route of administration - injections.

Important: the main feature in the use of antibiotics in pediatrics lies in the dosages - children are prescribed smaller doses, since the drug is calculated in terms of a kilogram of body weight.

Antibiotics are very effective drugshaving at the same time a large number of side effects. In order to be cured with their help and not harm your body, they should be taken only as directed by a doctor.

What antibiotics are there? When is antibiotic use necessary and when is it dangerous? The main rules of antibiotic treatment are told by the pediatrician, Dr. Komarovsky:

Gudkov Roman, resuscitator

Introduction antibacterial agents intravenously or intramuscularly used for moderate and severe disease. Parenteral administration allows:

significantly increase the bioavailability of the used medium;
accelerate the achievement of maximum therapeutic concentrations in plasma and obtain a visible therapeutic effect much faster;
exclude the effect on the drug of enzymes of the digestive system;
provide first aid to patients without consciousness, with indomitable vomiting or dysphagia (violation of the act of swallowing);
use drugs that are poorly absorbed or destroyed in the digestive tract.

Antibiotic injections should be performed in a hospital setting. The attending physician should prescribe drugs, as well as calculate the dosage of the antibiotic required for the administration. Antibiotic dosages are selected individually and depend on the age, weight and severity of the patient's condition.

To prevent development allergic reactions (Quincke's edema, anaphylactic shock), all antibiotics are administered only after a sensitivity test.

Self-selection of the drug and the selection of dosages can lead to the development of severe side effects.

Before diluting the drug, the nurse must check the labels on the ampoule with the prescription sheet, and also check the expiration date of the ampoule. The package with the syringe must be checked for integrity and expiration date. Then a thorough hand hygiene is carried out. After wearing the gloves, they are treated with an alcohol ball.

The syringe package must be opened from the piston side. After opening the package, you should connect the needle to the syringe (the protective cap cannot be removed from the needle).

After opening the metal cap on the antibiotic bottle, you should also treat the rubber protective stopper with an alcohol ball.

Next, you need to remove the protective cap from the needle, draw the necessary solvent into the syringe (injection water, isotonic physiological solution). After piercing the rubber stopper with a needle, you need to carefully introduce the liquid into the bottle.

After disconnecting the syringe from the needle (the needle remains in the cap), the vial must be shaken thoroughly until the antibiotic is completely dissolved.

The dissolved preparation must be homogeneous, transparent and free of foreign matter. For some antibiotics, a yellowish tint of the solution is allowed.

After the antibiotic has completely dissolved, it is necessary to connect the syringe back to the needle, turn the bottle over and collect the required amount of medicine.

After dialing the solution, make sure that there are no air bubbles in it. If necessary, turn the syringe upside down, tap the cylinder lightly (so that the bubbles rise) and release the air bubbles.

How to calculate your antibiotic dose

Two dilution methods are used - 1: 1 and 2: 1.

In pediatric practice, one-to-one dilution is used, and for adults - two to one.

For the correct calculation of the dose, it must be remembered that 1,000,000 IU of the drug is equivalent to 1,000 milligrams (1 gram). Accordingly, 0.5 grams \u003d 500,000 units, 0.25 grams \u003d 250,000 units.

When an antibiotic is diluted one-to-one, 1 milliliter of solvent is used per 100,000 antibiotic units. Accordingly, to dilute 250 thousand units of the drug, add 2.5 milliliters, 500 thousand - five milliliters, 1 million units - 10 milliliters of solvent.

Dilution of antibiotics and calculation of the required dose in neonatology is also carried out on a one-to-one basis.

If the antibiotic is diluted at the rate of two to one, then 0.5 milliliters of solvent is used per one hundred thousand units of the drug.

Accordingly, for 250 thousand units, 1.25 of the solvent is taken, for 500 thousand - 2.5 and for 1 million units - 5 milliliters of solvent.

Antibiotic dilution rules

When using the one-to-one dilution method, it must be borne in mind that each milliliter of the resulting solution will contain 100 thousand units or 100 milligrams drug... Accordingly, every 0.1 milliliter of solution contains 1000 IU or ten milligrams of the drug.

It is necessary to prepare an antibiotic solution immediately before administration.
Calculation example:

There are different ways to “direct” an antibiotic to the places where microbes accumulate. You can smear an abscess on the skin with an antibiotic ointment. Can be swallowed (tablets, drops, capsules, syrups). You can prick - into a muscle, into a vein, into a spinal canal.

The route of administration of the antibiotic is not of fundamental importance - it is only important that the antibiotic is in the right place and in the right amount on time . This is, so to speak, a strategic goal. But the tactical question - how to achieve this - is no less important.

Obviously, any pill is clearly more convenient than injections. But ... Some antibiotics in the stomach are destroyed, for example, penicillin. Others are not absorbed, or hardly absorbed from the intestine, such as gentamicin. The patient may vomit, he may be unconscious at all. The effect of a drug swallowed will come later than from the same drug administered intravenously - it is clear that the more severe the disease, the more grounds for unpleasant injections.

WAYS OF REMOVING ANTIBIOTICS FROM THE BODY.

Some antibiotics, such as penicillin or gentamicin, are excreted unchanged from the body in the urine. This allows, on the one hand, to successfully treat kidney disease and urinary tract, but, on the other hand, with a significant impairment of the kidneys, with a decrease in the amount of urine, it can lead to excessive accumulation of the antibiotic in the body (overdose).

Other drugs, such as tetracycline or rifampicin, are excreted not only in the urine, but also in the bile. Again, obvious effectiveness in diseases of the liver and biliary tract, but special care with liver failure.

SIDE EFFECTS.

Medicines without side effects does not exist. Antibiotics are no exception, to put it mildly.

Allergic reactions are possible. Some drugs cause allergies often, such as penicillin or cephalexin, others rarely, such as erythromycin or gentamicin.

Certain antibiotics have damaging (toxic) effects on some organs. Gentamicin - on the kidneys and auditory nerve, tetracycline - for the liver, polymyxin - for the nervous system, chloramphenicol - for the hematopoietic system, etc. After taking erythromycin, nausea and vomiting often occur, large doses of chloramphenicol cause hallucinations and decreased visual acuity, any broad-spectrum antibiotics contribute to the development of dysbiosis ...

Now let's think about it!

On the one hand, the following is obvious: taking any antimicrobial agent requires mandatory knowledge of everything that was listed above. That is, all the pros and cons should be well known, otherwise the consequences of treatment can be the most unpredictable.

But, on the other hand, while swallowing Biseptol on your own, or, on the advice of a neighbor, thrusting an ampicillin pill into the child, did you give an account of your actions? Did you all know that?

Of course they didn't. They did not know, did not think, did not suspect, wanted the best ...

It is better to know and think ...

What you need to know.

– Any antimicrobial agent should only be prescribed by a doctor!

– It is unacceptable to use antibacterial drugs with viral infections , ostensibly for the purpose of prevention - in order to forestall the development of complications. It never succeeds; on the contrary, it only gets worse. Firstly, because there is always a microbe that will survive. Secondly, because by destroying some bacteria, we create conditions for the reproduction of others, increasing, but not decreasing, the likelihood of all the same complications. In short, an antibiotic should be prescribed when bacterial infection is already there, and not in order to supposedly prevent it. The most correct attitude to prophylactic antibiotic therapy lies in the slogan put forward by the brilliant philosopher M.M. Zhvanetsky: "You have to experience troubles as they come!"

Prophylactic antibiotic therapy is not always evil. After many operations, especially on organs abdominal, it is vital. During a plague epidemic, the massive intake of tetracycline can protect against infection. It is only important not to confuse such concepts as prophylactic antibiotic therapy in general and the prophylactic use of antibiotics for viral infections in particular.

- If you are already giving (taking) antibiotics, in no case do not stop treatment immediately after it becomes a little easier. The required duration of treatment can only be determined by a doctor.

– Never beg for something stronger.

The concept of the strength and weakness of an antibiotic is largely arbitrary. For our average compatriot, the strength of an antibiotic has a lot to do with its ability to empty pockets and wallets. People really want to believe in the fact that if an antibiotic, for example, "thienam" is 1000 times more expensive than penicillin, then it is a thousand times more effective. Yes, it was not there ...

In antibiotic therapy there is such a concept as “ antibiotic of choice ". Those. for each infection, for each specific bacterium, an antibiotic is recommended, which should be used first - it is called the antibiotic of choice. If this is not possible - for example, allergies, second line antibiotics are recommended, etc. Angina - penicillin, otitis media - amoxicillin, typhoid fever - chloramphenicol, whooping cough - erythromycin, plague - tetracycline, etc.

Everything is very expensive drugs are used only in very serious and, fortunately, not very frequent situations, when a particular disease is caused by a microbe that is resistant to the action of most antibiotics, when there is a pronounced decrease in immunity.

- Prescribing any antibiotic, the doctor cannot predict everything possible consequences... There are cases individual intolerance a specific person of a specific drug. If this happened and, after taking one pill of erythromycin, the child vomited all night and complained of abdominal pain, then the doctor was not to blame. There are hundreds of different drugs to treat pneumonia. And the less often the antibiotic is used, the wider the spectrum of its action and, accordingly, the higher the price, the more likely it will help. But, the greater the likelihood of toxic reactions, dysbacteriosis, suppression of immunity. The injections are more likely and faster to heal. But it hurts, but suppuration is possible in the place where it was injected. And if you are allergic - after the pill they washed the stomach, and after the injection - what to wash? The patient's relatives and the doctor must necessarily find a common language ... Using antibiotics, the doctor always has the opportunity to play it safe - injections instead of pills, 6 times a day instead of 4, cephalexin instead of penicillin, 10 days instead of 7 ... But the golden mean, the correspondence between the risk of failure and the likelihood of a quick recovery is largely determined by the behavior of the patient and his relatives ... Who's to blame if the antibiotic didn't work? Is it really just a doctor? What kind of organism is this, which even with the help of the strongest drugs cannot cope with the infection! Well, what kind of lifestyle had to be organized in order to bring immunity to the extreme ... And I do not want to say that all doctors are angels, and mistakes, unfortunately, are not uncommon. But it is necessary to shift the emphasis, because for a particular patient nothing gives the answer to the question "who is to blame?" The question "what to do?" - is always more relevant. But, all the time:

“It was necessary to appoint injections!”;

“Do you know any other medicine besides penicillin?”;

“What does it mean dear, we do not feel sorry for anything for Mashenka”;

"And you, doctor , guarantee what will this help? ";

“The third time you change the antibiotic, but you cannot cure an ordinary sore throat!”

- The boy Sasha has bronchitis. The doctor prescribed ampicillin, 5 days passed and it became much better. After 2 months, another illness, all the symptoms are exactly the same - again bronchitis. There is personal experience: ampicillin helps with this disease. Let's not bother the pediatrician. We will swallow the proven and effective ampicillin. The situation described is very typical. But its consequences are unpredictable. The fact is that any antibiotic is able to bind to blood serum proteins and, under certain circumstances, becomes an antigen - that is, to cause the production of antibodies. After taking ampicillin (or any other drug), antibodies to ampicillin may be in the blood. In this case, there is a high probability of developing allergic reactions, sometimes very (!) Severe. In this case, an allergy is possible not only to ampicillin, but also to any other antibiotic similar in its chemical structure (oxacillin, penicillin, cephalosporin). Any repeated use of an antibiotic multiplies the risk of allergic reactions ... There is another important aspect. If the same disease repeats after a short time, then it is quite logical to assume that when it reappears, it (the disease) is associated with those microbes that "survived" after the first course of antibiotic therapy, and, therefore, the antibiotic used will not be effective.

- Corollary to the previous point. The doctor cannot choose the right antibiotic if he does not have information about when, about what, what drugs and in what doses your child received. Parents must have this information! Write down! Pay special attention to any manifestations of allergies.

- Do not try to adjust the dose of the drug ... Low doses of antibiotics are very dangerous because there is a high likelihood of resistant bacteria developing. And if it seems to you that “2 tablets 4 times a day” is a lot, and “1 tablet 3 times a day” is just right, then it is quite possible that soon you will need 1 injection 4 times a day.

– Do not part with your doctor until you know exactly how to take a particular drug. Erythromycin, oxacillin, chloramphenicol - before meals, taking ampicillin and cephalexin - whenever you like, tetracycline is not allowed with milk ... Doxycycline - 1 time per day, biseptol - 2 times a day, tetracycline - 3 times a day, cephalexin - 4 times a day...

Once again about the most important thing.