What are the main classes of antibiotics. How do different types of antibiotics work. Which antibiotics are commonly prescribed for various infections. What are the potential side effects and precautions for antibiotic use. How has antibiotic development progressed over time.

The Evolution of Antibiotic Development

Antibiotics have revolutionized modern medicine, saving countless lives since their discovery. The field of antibiotic development has seen significant progress over the years, with new classes and generations emerging to combat evolving bacterial threats.

Recent Additions to the Antibiotic Arsenal

In recent years, several new antibiotics have been introduced to address specific medical needs:

• Daptomycin (Cubicin®) – A lipopeptide antibiotic approved in 2003
• Telavancin (Vibativ®) – A lipoglycopeptide introduced in 2009
• Ceftaroline (Teflaro®) – A 5th generation cephalosporin approved in 2010
• Fidaxomicin (Dificid®) – A macrocyclic antibiotic launched in 2011
• Delafloxacin (Baxdela®) – A fluoroquinolone antibiotic approved in 2017

These new antibiotics demonstrate the ongoing efforts to develop more effective treatments against resistant bacteria and address gaps in current therapeutic options.

Beta-Lactam Antibiotics: The Cornerstone of Antimicrobial Therapy

Beta-lactam antibiotics form a crucial class of antimicrobial agents, characterized by their beta-lactam ring structure. This class encompasses several important antibiotic groups:

• Penicillins
• Cephalosporins
• Monobactams
• Carbapenems

These antibiotics work by inhibiting bacterial cell wall synthesis, leading to cell death. Their broad spectrum of activity and generally favorable safety profile make them a cornerstone of modern antibiotic therapy.

Penicillins: The First Line of Defense

Penicillins are among the oldest and most widely used antibiotics. They are bactericidal, meaning they kill bacteria rather than just inhibiting their growth. How do penicillins work? They interfere with the synthesis of peptidoglycan, a crucial component of bacterial cell walls, causing the cells to burst.

Some commonly prescribed penicillins include:

• Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
• Ampicillin (Omnipen, Polycillin, Principen)
• Penicillin G (Bicillin L-A, Pentids, Permapen)
• Penicillin V (Beepen-VK, V-Cillin K)

While penicillins are generally considered safe, the primary health concern associated with their use is the potential for hypersensitivity reactions, including allergic responses.

Cephalosporins: Generations of Progress

Cephalosporins represent a large and diverse group of antibiotics that have evolved over time. They are classified into generations, with each subsequent generation typically offering a broader spectrum of activity or improved pharmacokinetic properties.

First Generation Cephalosporins

First-generation cephalosporins are primarily effective against gram-positive bacteria and some gram-negative organisms. Examples include:

• Cefadroxil (Duricef, Ultracef)
• Cefalexin (Keflex, Keftab)
• Cefazolin (Ancef, Kefzol)

Second Generation Cephalosporins

Second-generation cephalosporins offer improved gram-negative coverage while maintaining good gram-positive activity. Some common second-generation cephalosporins are:

• Cefaclor (Ceclor, Distaclor)
• Cefuroxime (Ceftin, Zinacef)
• Cefoxitin (Mefoxin)

Third Generation Cephalosporins

Third-generation cephalosporins have enhanced gram-negative activity and some can cross the blood-brain barrier, making them useful for treating central nervous system infections. Notable examples include:

• Ceftriaxone (Rocephin)
• Cefotaxime (Claforan)
• Ceftazidime (Fortum, Ceptaz)

How do cephalosporins differ from penicillins in terms of their mechanism of action? While both classes inhibit cell wall synthesis, cephalosporins are generally more resistant to beta-lactamase enzymes produced by some bacteria, giving them a broader spectrum of activity in many cases.

Fluoroquinolones: Broad-Spectrum Synthetic Antibiotics

Fluoroquinolones are a class of synthetic broad-spectrum antibiotics that work by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes crucial for bacterial DNA replication. This unique mechanism of action sets them apart from beta-lactam antibiotics.

Some commonly prescribed fluoroquinolones include:

• Ciprofloxacin
• Levofloxacin
• Moxifloxacin
• Delafloxacin (a newer addition to this class)

Fluoroquinolones are effective against a wide range of bacterial infections, including respiratory, urinary tract, and skin infections. However, their use has become more restricted in recent years due to potential side effects, including tendon damage and peripheral neuropathy.

Macrolides: Protein Synthesis Inhibitors

Macrolide antibiotics work by binding to the 50S subunit of the bacterial ribosome, inhibiting protein synthesis. This mechanism makes them bacteriostatic (growth-inhibiting) rather than bactericidal in most cases.

Common macrolide antibiotics include:

• Erythromycin
• Azithromycin
• Clarithromycin

Macrolides are often used to treat respiratory tract infections, skin infections, and some sexually transmitted diseases. They are particularly useful for patients with penicillin allergies.

Tetracyclines: Broad-Spectrum Antibiotics with a Long History

Tetracyclines are a class of broad-spectrum antibiotics that have been in use since the 1940s. Like macrolides, they inhibit protein synthesis by binding to the 30S subunit of the bacterial ribosome.

Some commonly used tetracyclines include:

• Doxycycline
• Minocycline
• Tetracycline

Tetracyclines are effective against a wide range of bacteria, including some atypical organisms like Chlamydia and Mycoplasma. They are also used in the treatment of acne and certain parasitic infections.

Antibiotic Resistance: A Growing Concern

As the use of antibiotics has become widespread, bacterial resistance has emerged as a significant global health threat. How does antibiotic resistance develop? Bacteria can evolve mechanisms to survive antibiotic exposure, such as producing enzymes that break down antibiotics, modifying their cellular targets, or developing efflux pumps to expel antibiotics.

To combat antibiotic resistance, several strategies are being employed:

• Development of new antibiotic classes
• Combination therapies
• More judicious use of existing antibiotics
• Research into alternative antimicrobial strategies

The development of new antibiotics like daptomycin, telavancin, and fidaxomicin represents ongoing efforts to stay ahead of evolving bacterial resistance.

Proper Use and Precautions for Antibiotic Therapy

While antibiotics are powerful tools in fighting bacterial infections, their proper use is crucial to maintain their effectiveness and minimize side effects. What are some key considerations for antibiotic use?

• Use antibiotics only when prescribed by a healthcare professional
• Complete the full course of antibiotics as directed
• Do not use leftover antibiotics or share antibiotics with others
• Be aware of potential side effects and allergic reactions
• Inform your healthcare provider of any other medications you’re taking to avoid interactions

Healthcare providers must carefully consider the choice of antibiotic based on the suspected pathogen, the site of infection, and patient factors such as allergies and kidney function.

Potential Side Effects of Antibiotics

While generally safe, antibiotics can cause side effects in some patients. Common side effects may include:

• Gastrointestinal disturbances (nausea, diarrhea)
• Allergic reactions (ranging from mild rashes to severe anaphylaxis)
• Photosensitivity (increased sensitivity to sunlight)
• Disruption of normal gut flora, potentially leading to secondary infections

More serious but rare side effects can occur with certain antibiotics, such as tendon damage with fluoroquinolones or kidney damage with some aminoglycosides.

The ongoing development of new antibiotics, coupled with responsible use of existing ones, is crucial in the fight against infectious diseases. As our understanding of bacterial pathogens and antibiotic mechanisms grows, so too does our ability to develop more targeted and effective treatments. The field of antibiotic research remains dynamic, with promising new approaches on the horizon to address the challenges of antibiotic resistance and provide better outcomes for patients worldwide.

List of Antibiotics – eMedExpert.com

Based on “Antibiotic and Chemotherapy”

written by Roger G. Finch

Up-to-date comprehensive list of antibiotics by classes with generic and most common trade names.

New Antibiotics

-Lactam Antibiotics

Beta-lactam class of antibiotics includes penicillins, cephalosporins, monobactams, and carbapenems, all of which contain a β-lactam ring.

Penicillins

Antibiotics of the penicillin class are bactericidal and work by inhibiting the synthesis of bacterial cell walls. Penicillins are among the safest antibiotics.

Major health concerns: hypersensitivity reactions.

Generic	Brand Name
Amoxicillin	Amoxil, Polymox, Trimox, Wymox
Ampicillin	Omnipen, Polycillin, Polycillin-N, Principen, Totacillin
Bacampicillin	Spectrobid
Carbenicillin	Geocillin, Geopen
Cloxacillin	Cloxapen
Dicloxacillin	Dynapen, Dycill, Pathocil
Flucloxacillin	Flopen, Floxapen, Staphcillin
Mezlocillin	Mezlin
Nafcillin	Nafcil, Nallpen, Unipen
Oxacillin	Bactocill, Prostaphlin
Penicillin G	Bicillin L-A, Crysticillin 300 A. S., Pentids, Permapen, Pfizerpen, Pfizerpen-AS, Wycillin
Penicillin V	Beepen-VK, Betapen-VK, Ledercillin VK, V-Cillin K
Piperacillin	Pipracil
Pivampicillin
Pivmecillinam
Ticarcillin	Ticar

Cephalosporins

Cephalosporins are mainly bactericidal and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. Besides true cephalosporins (which are derived from cephalosporin C) this class includes oxacephems and carbacephems.

Major health concerns: platelet function abnormalities (rare).

Monobactams

Carbapenems

Carbapenems have incredibly broad spectrum of antimicrobial activity. Today these agents are among the most powerful antibiotics.

Macrolide Antibiotics

Macrolides are bacteriostatic drugs that inhibit protein synthesis by targeting the 50S subunit.

Major health concerns: erythromycin estolate is hepatotoxic.

Lincosamides

Streptogramins

Aminoglycoside Antibiotics

Aminoglycosides are rapidly bactericidal antibiotics which inhibit protein synthesis. These agents mainly interfere with proofreading process. Aminoglycosides are the only bactericidal class among protein synthesis inhibitors.

Major health concerns: ototoxicity, nephrotoxicity.

Quinolone Antibiotics

Fluoroquinolones directly inhibit the bacterial nucleic acid synthesis.

Major health concerns: QTc prolongation and/or torsade de pointes, tendonitis, tendon rupture, joint arthropathies.

Sulfonamides

Sulfonamides act by inhibiting the pathway that bacteria use to synthesize folic acid. Sulfonamides with trimethoprim produce synergistic antibacterial activity.

Major health concerns: hypersensitivity reactions, renal damage, crystal nephropathy.

Tetracycline Antibiotics

Tetracyclines are protein synthesis inhibitors primary targeting the 30S ribosome. They are essentially bacteriostatic.

Major health concerns: photosensitivity, deposition in developing bones and teeth.

Other Antibiotics

Resources

Last updated: August, 2018

Everything You Need to Know

If you or your child has ever had an ear infection, strep throat, or bronchitis, you’re probably familiar with antibiotics. They are a commonly prescribed — and highly useful — form of medicine that has taken us out of an age where minor bacterial infections could be fatal. In fact, 4 out of 5 adults in the U.S. have taken antibiotics at some point in their life, while prescriptions given to children occur at an even higher rate. Unfortunately, nearly 30% of all antibiotic prescriptions are unnecessary. The medical community has long been in debate about whether the pros of antibiotics outweigh the cons but one thing is certain: antibiotics, while helpful, need to be taken with caution.

Read on to learn more about what antibiotics are, the pros and cons of taking antibiotics, and which illnesses and infections can be treated with antibiotics.

What are antibiotics?

Essentially, antibiotics are medications that help stop infections caused by bacteria. They work in two ways: they kill the bad bacteria causing the infection and keep the bacteria from reproducing more harmful bacteria. While there are over 100 types of antibiotics, there are 10 antibiotics that are most commonly used:

1. Amoxicillin
2. Azithromycin
3. Amoxicillin/Clavulanate
4. Clindamycin
5. Cephalexin
6. Ciprofloxacin
7. Sulfamethoxazole/Trimethoprim
8. Metronidazole
9. Levofloxacin
10. Doxycycline

Each type of antibiotic is only effective for certain types of bacterial infections (like strep throat or a urinary tract infection). When an antibiotic is prescribed, it’s meant to treat the specific spectrum of germs that are causing the infection. They are not, however, effective at treating viral infections (like a cold or the flu).

What do I need to know about antibiotic resistance?

The first antibiotics were discovered in the 1920s and couldn’t have come at a better time. Back then, even minor bacterial infections like strep throat were known to be fatal because there wasn’t an effective way to treat them. When the use of antibiotics became more widespread in the 1940s, people started living longer because of the ability to stop bad bacteria in its tracks. Since then, antibiotics have become a staple of modern medicine, used to treat everything from urinary tract infections to pneumonia.

However, the overuse and misuse of antibiotics has created a worldwide problem. Doctor’s have been prescribing them to patients who don’t really need them, a lot of whom have viral infections that can’t be treated with antibiotics. According to the World Health Organization (WHO), “Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. A growing list of infections – such as pneumonia, tuberculosis, blood poisoning, gonorrhea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.”

That doesn’t mean that antibiotics shouldn’t be used. They can be extremely helpful in treating bacterial infections. But, as bacteria become more resistant to antibiotics, it’s important to make sure that they are only used when absolutely necessary, prescribed in the right doses, and taken only as advised by a healthcare professional. If you are prescribed antibiotics, it’s important that you take all of your prescribed doses — stopping it too soon can lead to resistance.

What’s the difference between antibiotics and probiotics?

Think of your body like an ecosystem — it’s teeming with all kinds of bacteria, most of which are good bacteria that help your body digest food, absorb nutrients from your food, and develop a strong immune system. These bacteria are known as probiotics.

Antibiotics are meant to fight off any bad bacteria that causes an infection in your body. They’re generally highly effective at this when the right type of antibiotic is prescribed. However, antibiotics can sometimes kill off the probiotics that live inside of you. When this happens, you’re at more of a risk for developing side effects from the antibiotics, especially diarrhea. But there’s good news: you can safely take a probiotic supplement while you’re taking antibiotics. Just make sure you take them about 2 hours apart, to reduce the risk of the antibiotics fighting the probiotics you take.

Are antibiotics safe?

If prescribed and taken correctly, antibiotics are generally safe and can kill off the bacteria causing an infection. Still, it’s important to be aware of the potential side effects of antibiotics, as well as how they may interact with other medications you take.

What are the side effects of antibiotics?

While certain side effects are more common in some antibiotics than others, all antibiotics pose the risk of:

• Nausea
• Vomiting
• Cramps
• Diarrhea
• Photosensitivity (sensitivity to light and/or being more prone to sunburn while you’re on the antibiotic)
• Fever
• Tooth discoloration (this is most prevalent in children whose teeth are still developing)

Are there serious side effects to antibiotics?

While these antibiotic side effects are rare, they are also serious. If you’re taking antibiotics and are concerned about side effects you’re experiencing, you should call your doctor or head to urgent care right away (you can use Solv to find an urgent care near you and book an appointment online).

• Allergic reaction — Some people are allergic to certain types of antibiotics. If you are, you’ll likely develop an allergic reaction soon after starting your antibiotics. Some of the symptoms you may experience if you’re having an allergic reaction include:
  • Trouble breathing
  • Hives
  • Swelling of the tongue
• Stevens-Johnson Syndrome — This is a disorder of the skin and mucous membranes that starts off with flu-like symptoms (such as a sore throat and a fever) and can be followed by a painful rash that spreads and blisters. Stevens-Johnson Syndrome, or SJS, most commonly affects people with a weakened immune system or a family history of SJS. Other symptoms of SJS may include:
  • hives
  • skin pain
  • fever
  • cough
  • swelling of your face or tongue
  • pain in your mouth and throat
• Blood reactions — Again, people with weakened immune systems are more prone to developing blood reactions when taking antibiotics. The main symptom of a blood reaction is a new infection, especially if it appears suddenly after starting an antibiotic.
• Tendonitis — Certain types of antibiotics, specifically ciprofloxacin, have been linked to tendonitis (or when a tendon that connects bone to muscle rips or tears).
• Seizures — It’s very rare to have a seizure due to taking an antibiotic but it can happen. People who have epilepsy or have a history of seizures should let their doctor know before taking an antibiotic.

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Can antibiotics interfere with other medications that I take?

One common concern people have about antibiotics is whether they can negatively interact with other medications. This concern is not without cause; antibiotics can both reduce the effectiveness of other medications and cause adverse health issues when used at the same time as other medication. These medications range from Vitamin A supplements to birth control to antidepressants. For a full list of antibiotic interactions, this article by National Health Services is helpful. Be sure to let your doctor know if you’re taking any other prescriptions or supplements, or if you’re on birth control, if they decide you need to take an antibiotic.

Is it safe for kids to take antibiotics?

Just as antibiotics are safe for most adults, kids can also take antibiotics to treat bacterial infections. It’s worth pointing out, though, that children are often mis-prescribed antibiotics for illnesses that are viral, not bacterial. When this happens, there’s an increased risk of antibiotic resistance happening, which could prevent children from being effectively treated by antibiotics when they do have a bacterial infection.

Who should not take antibiotics?

While most everyone can take antibiotics, people who are pregnant, breastfeeding, have liver or kidney diseases, or have weakened immune systems should be extra cautious about when and if they take them.

When do you need antibiotics?

In light of the World Health Organization’s fight against the overuse and misuse of antibiotics, many people are questioning whether they really need the antibiotics they’re being prescribed. While this is a legitimate concern, there’s good news.

According to the Centers for Disease Control (CDC), antibiotic prescriptions written in doctor’s offices and urgent care clinics dropped by 5% between 2011 and 2014 and are still improving today. On the flip side, an article written by Consumer Reports for The Washington Post says “still, in 2015, one-third of antibiotic prescriptions dispensed from pharmacies outside hospitals were unnecessary. Most were given to people with upper-respiratory conditions, which are often viral; antibiotics are effective only against bacterial infections.”

When you go to urgent care with your health concern, not only are you spending less money than you would at the emergency room, you’re also increasing your odds of being prescribed antibiotics only when you really need them.

Which bacterial infections and illnesses are treated for at urgent care?

Urgent care clinics treat for a broad range of infections and illnesses. They are generally equipped to handle most non-life-threatening health concerns. When it comes to bacterial infections that you may need antibiotics for, urgent care is a good place to go for:

If you have or think you might have any of these bacterial infections, you can use Solv to book a same-day urgent care appointment.

What are the pros and cons of antibiotics in 2019?

Over the last 70 years, antibiotics have been used to treat all kinds of bacterial infections. Without a doubt, they save lives. Still, there are downsides to taking antibiotics. Here, let’s take a look at some pros and cons of antibiotics in 2019.

What are the benefits of antibiotics?

• Antibiotics, when prescribed and taken properly, are highly effective at treating bacterial infections
• Most antibiotics have few side effects
• Antibiotics, especially those with generic alternatives, are affordable even if you don’t have health insurance

What are the disadvantages of taking antibiotics?

• Compromised gut health
• Risk of common and severe side effects
• Potential for becoming resistant to antibiotics in the future
• Antibiotics are the most frequent cause of adverse drug events (ADEs) that lead to emergency room visits in children and adults

Think you need antibiotics? Here are some questions you should ask your doctor.

If your doctor is prescribing you an antibiotic, chances are you need it. However, because of the uptick in antibiotic resistance, as well as the potential side effects of taking antibiotics, it can never hurt to ask questions. Here are some questions you may want to ask before taking antibiotics:

• Is my infection bacterial or viral? Can you test for that?
• Are there vaccinations that can protect me from bacterial infections?
• If myself or my child has an allergic reaction to an antibiotic, does that mean there’s an antibiotic resistance?
• What are the side effects of the antibiotic you’re prescribing?
• Are there are any over-the-counter medications we can try before using an antibiotic?

Antibiotics are practically a miracle drug. When they were first invented, they saved countless lives and, to this day, continue to do so. If you or your child develops a bacterial infection, one of the keys to returning to health could be an antibiotic. Still, go in with your eyes wide open and make sure that, if you are prescribed an antibiotic, you’re getting the correct prescription at the correct dosage and taking it as recommended.

List of Antibiotics  | Download Table

Purpose:
To compare the estimated effectiveness of seven frequently prescribed antibiotic classes as initial and secondary treatments of upper respiratory tract infections (URTI) and lower respiratory tract infections (LRTI) 1991-2012. The main outcome measure was a surrogate for estimated antibiotic effectiveness.

Methods:
Routine, primary care data from the UK Clinical Practice Research Datalink were used. Having established standardized criteria representing antibiotic treatment failure, estimated treatment effectiveness rates were calculated as one minus the treatment failure rate. For each year from 1991 to 2012, estimated effectiveness rates by treatment line, indication, and sub-indication were calculated. These were presented by antibiotic class, with a sub-analysis for the macrolide clarithromycin.

Findings:
From approximately 58 million antibiotic prescriptions in CPRD, we analyzed 8,654,734 courses of antibiotic monotherapy: 4,825,422 courses (56%) were associated with URTI; 3,829,312 (44%) were associated with LRTI. Aminopenicillins (4,148,729 [56%]), penicillins (1,304,561 [18%]), and macrolides (944,622 [13%]) predominated as initial treatments; macrolides (375,903 [32%]), aminopenicillins (275,866 [23%]), and cephalosporins (159,954 [14%]) as secondary treatments. Macrolides and aminopenicillins had estimated effectiveness rates ≥ 80% across the study period as initial treatments of URTI and LRTI. In secondary use, only macrolides maintained these rates: 80.7% vs. 79.8% in LRTI, 85.1% vs. 84.5% in throat infections, 80.7% vs. 82.3% in nasal infections, 83.5% vs. 83.8% in unspecified URTI in 1991 and 2012, respectively.

Implications:
After more than two decades, macrolides remained amongst the most effective antibiotic classes for both URTI and LRTI in initial and secondary antibiotic treatment when a further antibiotic course was prescribed.

Limitations:
Antibiotic treatments were classified as intention to treat. It is unknown whether the prescription was redeemed or taken correctly. We do not know the aetiology of these infections, therefore evidence of antibiotic non-response may relate to sub-optimal diagnosis and inappropriate treatment rather than antibiotic effectiveness for true bacterial infections.

Antibiotic Classification & Mechanism – Basic Science

Inhibits Cell Wall Synthesis
Penicillins (bactericidal: blocks cross linking via competitive inhibition of the transpeptidase enzyme)
Class/Mechanism	Drugs	Indications (**Drug of Choice)	Toxicity
Penicillin	Penicillin G Aqueous penicillin G Procaine penicillin G Benzathine penicillin G Penicillin V	Strep. pyogenes (Grp.A)** Step. agalactiae (Grp.B)** C. perfringens(Bacilli)**	Hypersensitivity reaction Hemolytic anemia
Aminopenicillins	Ampicillin Amoxicillin	Above +  ↑ Gram-negative: E. faecalis** E. Coli**	Above
Penicillinase-resistant-penicillins	Methicillin Nafcillin Oxacillin Cloxacillin Dicloxacillin	Above + PCNase-producingStaph. aureus	Above +  Interstitial nephritis
Antipseudomonal penicillins	Carbenicillin Ticarcillin Piperacillin	Above + Pseudomonas aeruginosa**	Above
Cephalosporins (bactericidal: inhibits bacterial cell wall synthesis via competitive inhibition of the transpeptidase enzyme)
1st generation	Cefazolin Cephalexin	Staph. aureus** Staph. epidermidis** Some Gram-negatives: E. Coli Klebsiella	Allergic reaction Coombs-positive anemia (3%)
2nd generation	Cefoxitin Cefaclor Cefuroxime	Above + ↑ Gram-negative	Allergic Reaction ETOH Disulfiram reaction
3rd generation	Ceftriaxone Cefotaxime Ceftazidime Cefepime (4th generation)	Above + ↑ Gram-negative Pseudomonas	Allergic Reaction ETOH Disulfiram reaction
Other Cell Wall Inhibitors
Vancomycin  (bactericidal: disrupts peptioglycan cross-linkage)	Vancomycin	MRSA** PCN/Ceph allegies** S. aureus S. epidermidis	Red man syndrome Nephrotoxicity Ototoxicity
Beta-lactamase Inhibitors  (bactericidal: blocking cross linking)	Clavulanic Acid Sulbactam Tazobactam	S aureus** S epidermis** E.Coli** Klebsiella**	Hypersensitivity Reaction Hemolytic anemia
Carbapenems	Imipenem (+ cilastatin) Meropenem Doripenem Ertapenem	Broadest activity of any antibiotic (except MRSA, Mycoplasma)
Aztreonam	Aztreonam	Gram-negative rods Aerobes Hospital-acquired infections
Polymyxins	Polymyxin B Polymyxin E	Topical Gram-negative infections
Bacitracin	Bacitracin	Topical Gram-positive infections
Protein Synthesis Inhibition
Anti-30S ribosomal subunit
Aminoglycosides (bactericidal: irreversible binding to 30S)	Gentamicin Neomycin Amikacin Tobramycin Streptomycin	Aerobic Gram-negatives Enterobacteriaceae  Pseudomonas	Nephrotoxicity Ototoxicity
Tetracyclines (bacteriostatic: blocks tRNA)	Tetracycline Doxycycline Minocycline Demeclocycline	Rickettsia Mycoplasma Spirochetes (Lyme’s disease)	Hepatotoxicity Tooth discoloration Impaired growth Avoid in children < 12 years of age
Anti-50S ribosomal subunit
Macrolides (bacteriostatic: reversibly binds 50S)	Erythromycin Azithromycin Clarithromycin	Streptococcus H. influenzae Mycoplamsa pneumonia	Coumadin Interaction (cytochrome P450)
Chloramphenicol (bacteriostatic)	Chloramphenicol	H influenzae Bacterial Meningitis Brain absces	Aplastic Anemia Gray Baby Syndrome
Lincosamide (bacteriostatic: inhibits peptidyl transferase by interfering with amino acyl-tRNA complex)	Clindamycin	Bacteroides fragilis S aureus Coagulase-negative Staph & Strep Excellent Bone Penetration	Pseudomembranous colitis Hypersensitivity Reaction
Linezolid (variable)	Linezolid	Resistant Gram-positives
Streptogramins	Quinupristin Dalfopristin	VRE GAS and S. aureus skin infections
DNA Synthesis Inhibitors
Fluoroquinolones (bactericidal: inhibit DNA gyrase enzyme, inhibiting DNA synthesis)
1st generation	Nalidixic acid	Steptococcus Mycoplasma Aerobic Gram +	Phototoxicity Achilles tendon rupture Impaired fracture healing
2nd generation	Ciprofloxacin Norfloxacin Enoxacin Ofloxacin Levofloxacin	As Above +Pseudomonas	as above
3rd generation	Gatifloxacin	As above + Gram-positives	as above
4th generation	Moxifloxacin Gemifloxacin	As above + Gram-positives + anaerobes	as above
Other DNA Inhibitors
Metronidazole (bacteridical: metabolic biproducts disrupt DNA)	Metronidazole (Flagyl)	Anaerobics	Seizures Crebelar dysfunction ETOH disulfram reaction
RNA Synthesis Inhibitors
Rifampin (bactericidal: inhibits RNA transcription by inhibiting RNA polymerase)	Rifampin	Staphylococcus Mycobacterium (TB)	Body fluid discoloration Hepatoxicity (with INH)
Mycolic Acids Synthesis Inhibitors
Isoniazid	Isoniazidz	TB Latent TB
Folic acid Synthesis Inhibitors
Trimethoprim/Sulfonamides (bacteriostatic: inhibition with PABA)	Trimethoprim/Sulfamethoxazole (SMX) Sulfisoxazole Sulfadiazine	UTI organisms Proteus Enterobacter	Thrombocytopenia Avoid in third trimester of pregnancy
Pyrimethamine	Pyrimethamine	Malaria T. gondii

Uses, common brands, and safety information

Penicillin was discovered in 1928 by Alexander Fleming, a Scottish microbiologist and physician. It was named after Penicillium mold when Fleming noticed that the mold exhibited antibacterial properties. The discovery of penicillin would later change the world of medicine as the first true modern antibiotic. Today, there are several different types of penicillins produced to treat bacterial infections. 

Read on to learn more about the antibiotic class of penicillins, how they are used, and what side effects they can cause. 

Other penicillins include:

• Pipracil (piperacillin)
• Zosyn (piperacillin and tazobactam)
• Timentin (ticarcillin and clavulanate)
• Ticar (ticarcillin)
• Geocillin (carbenicillin)
• Permapen (penicillin G benzathine)
• Nallpen (nafcillin)
• Floxapen (flucloxacillin)
• Natacillin (hetacillin)
• Mezlin (mezlocillin)

What is penicillin?

Penicillin belongs to a group of antibiotics that are commonly prescribed to treat bacterial infections. Penicillins are part of a broader class of antibiotics known as beta-lactam antibiotics. These antibiotics contain a beta-lactam ring as part of their chemical structure. Penicillins have strong antimicrobial activity against many different strains of bacteria. They can be administered as oral tablets, oral capsules, liquid suspensions, and intravenous (IV) injections. 

How does penicillin work?

Penicillin works by blocking the ability of bacteria to maintain their cell wall. The bacterial cell wall is an important structure made up of a molecule called peptidoglycan that helps the cells keep their shape. Without their cell wall, bacteria cannot survive, which leads to bursting (lysis) and cell death. Because they directly kill bacteria, penicillins are considered bactericidal antibiotics. Penicillins are generally effective against gram-positive bacteria, but different penicillins can target other types of bacteria. 

What is penicillin used for?

Penicillin is used to treat bacterial infections of the ear, nose, and throat. It is also used to treat bacterial infections of the sinuses, skin, lower respiratory tract, stomach, intestines, kidneys, and bladder. Penicillin should only be used to treat infections caused by bacteria that are susceptible to penicillins. 

Penicillin can also treat the following:

Penicillin can be effective against several types of bacteria including:

• Listeria 
• Neisseria
• Shigella
• Salmonella
• Klebsiella
• E. coli
• H. influenzae
• Pseudomonas aeruginosa
• Bacteroides fragilis

Types of penicillin

Natural penicillins

The natural penicillins comprise the penicillin G-like antibiotics, including penicillin V potassium. These penicillins were among the first antibiotics ever used to treat bacterial infections. They work by inhibiting cell wall synthesis to kill bacteria, and they are primarily effective against gram-positive bacteria and some gram-negative bacteria. The natural penicillins include penicillin G and penicillin V. 

Aminopenicillins

Like natural penicillins, aminopenicillins work by blocking bacterial cell wall synthesis. However, they can target a broader spectrum of bacteria; aminopenicillins are effective against most gram-positive bacteria, enterococci, and some gram-negative bacilli, such as H. influenzae and E. coli. Aminopenicillins are generally combined with a beta-lactamase inhibitor like clavulanate or sulbactam to make them more effective. Examples include ampicillin, amoxicillin, and hetacillin. 

Broad-spectrum (antipseudomonal) penicillins

Broad-spectrum, or antipseudomonal, penicillins are a group of penicillin antibiotics that have the same antibacterial activity as aminopenicillins plus additional activity against Pseudomonas and certain strains of Enterobacter and Serratia species. Like other penicillins, antipseudomonal penicillins are typically taken with beta-lactamase inhibitors. Antipseudomonal penicillins are usually given with another antibiotic class called aminoglycosides to treat infections caused by Pseudomonas aeruginosa. Examples of antipseudomonal penicillins include piperacillin, carbenicillin, ticarcillin, and mezlocillin. 

Beta-lactamase inhibitors 

Some bacteria produce beta-lactamase, an enzyme that inactivates beta-lactam antibiotics. Beta-lactamase inhibitors are a type of medicine that fights bacterial resistance to beta-lactam antibiotics. They are generally combined with a penicillin antibiotic to prevent penicillin from breaking down, which helps increase its effectiveness. Beta-lactamase inhibitors do not have any antibacterial activity when used alone. Examples include clavulanate (or clavulanic acid), sulbactam, and tazobactam.  

Penicillinase resistant penicillins

Penicillinase resistant penicillins are a group of penicillins that are primarily used to treat penicillinase-producing methicillin-sensitive Staphylococcus aureus. They can also be used to treat Streptococcus pneumoniae and group A streptococcal infections, as well as certain types of methicillin-sensitive staphylococcal infections. Resistant types of these bacteria produce an enzyme called penicillinase, which can inactivate penicillin antibiotics. Examples of penicillinase-resistant penicillins include oxacillin, dicloxacillin, nafcillin, flucloxacillin, and cloxacillin. 

Who can take penicillin?

Adults

Penicillin can be used to treat bacterial infections in adults. Dosage varies depending on the type of penicillin and formulation used. In adults, penicillin doses are typically measured in milligrams. 

Children

Penicillin is one of the most commonly prescribed antibiotics in children. Many common childhood infections that affect the ears, nose, and throat are usually treated with a penicillin antibiotic. Around 10% of children have been diagnosed with a penicillin allergy, although most children who have been diagnosed do not have a true allergy to the antibiotic. For example, gastrointestinal side effects are not considered a true allergy. In children, penicillin doses are typically calculated using milligrams per kilogram of body weight.  

Is penicillin safe?

Penicillin is generally safe for treating infectious diseases when given in appropriate doses. High doses of penicillin may lead to central nervous system toxicity, which can manifest as seizures. The risk of central nervous system toxicity may be higher in people with renal, or kidney, problems.

In rare cases, penicillin may cause anaphylactic reactions. Penicillin should be avoided in individuals with a history of hypersensitivity reactions to penicillin. Symptoms of anaphylaxis include rash, itchiness, swelling, and trouble breathing. Anaphylactic reactions require immediate medical attention. Those with a history of allergic reactions to penicillin should also avoid taking penicillin derivatives, cephalosporins, carbapenems, and monobactam antibiotics. 

In cases where an alternative to a penicillin-type antibiotic will not be appropriate, a patient can undergo skin testing to assess the presence of an allergic reaction to penicillin. If the skin test is positive, a desensitization process can be started to slowly administer the antibiotic until it is tolerable and effective. 

Penicillin recalls

There are no current penicillin recalls as of February 2021.

Penicillin restrictions

Penicillin is not used to treat infections caused by viruses or fungi. In order to prevent antibiotic resistance, penicillin should only be used to treat bacterial infections that are susceptible to penicillin. Penicillin should only be used with a valid prescription from a doctor. Penicillin doses may need to be adjusted or reduced in patients with severe renal problems.  

Can you take penicillin while pregnant or breastfeeding?

Penicillin is generally safe to use during pregnancy and while breastfeeding. Studies in animals have not shown that penicillins carry a risk of causing harm to the fetus. Penicillin G is an effective antibiotic for preventing the transmission of syphilis from the mother to the fetus. A healthcare provider should be consulted for appropriate antibiotic treatment during pregnancy or breastfeeding. 

Are penicillins controlled substances?

No, penicillin is not a controlled substance.

Common penicillin side effects

The most common side effects of penicillins include:

• Diarrhea
• Nausea
• Vomiting
• Stomach upset
• Abdominal pain
• Skin rash
• Itching
• Hives
• White or black patches on the tongue or in the mouth
• Injection site reactions such as redness, itching, and swelling (when the antibiotic is administered via intravenous route)

Serious adverse effects of penicillins may include:

• Central nervous system toxicity
• Inflammation in the kidneys
• Low white blood cell count
• Low platelet levels
• Clostridioides difficile-associated diarrhea

Low white blood cell counts, or leukopenia, is a common adverse effect of nafcillin. High doses of penicillin given intravenously may cause low platelet levels, which can increase the risk of bleeding. 

Penicillin can alter the growth of normal bacteria in the colon and cause an overgrowth of a bacteria called Clostridioides difficile (formerly known as Clostridium difficile). This type of bacteria can cause pseudomembranous colitis, or inflammation of the colon, and serious diarrhea. Although mild diarrhea is common with antibiotics, a healthcare provider should be contacted if severe diarrhea develops after using penicillin. 

Penicillins like ticarcillin and carbenicillin may need to be avoided or monitored in patients with heart or kidney problems. These types of penicillins may cause increased levels of sodium in the blood. 

How much does penicillin cost?

Many penicillin antibiotics are available in generic versions. The generic version of an antibiotic is generally cheaper than the brand name while being equally effective. Penicillin antibiotics are also covered by most Medicare and insurance plans. The average retail cost of penicillin V potassium can be around $40 depending on the dosage prescribed. 

Patients may be able to save on penicillin antibiotics through various savings programs from manufacturers and pharmacies. Discount savings cards are also available to help lower the cost of penicillin antibiotics. 

Antibiotics | Michigan Medicine

Information about this medicine

What are the most important things you need to know about your medicines?

Make sure you know about each of the medicines you take. This includes why you take it, how to take it, what you can expect while you’re taking it, and any warnings about the medicine.

The information provided here is general. So be sure to read the information that came with your medicine. If you have any questions or concerns, talk to your pharmacist or doctor.

Why are antibiotics used?

Antibiotics are drugs used to kill bacteria. Bacteria can cause infections such as strep throat, ear infections, and pneumonia.

These medicines can’t cure everything. They don’t kill viruses or help with allergies. And they don’t help illnesses such as the common cold, the flu, or a runny nose.

Antibiotics are generally safe and very effective at fighting bacterial infections.

What are some examples of antibiotics?

Here are some examples of antibiotics. For each item in the list, the generic name is first, followed by any brand names.

• amoxicillin
• azithromycin (Zithromax)
• cephalexin (Keflex)
• ciprofloxacin (Cipro)

This is not a complete list of antibiotics.

What about side effects?

Some people get diarrhea, nausea, or a yeast infection when they take antibiotics.

General information about side effects

All medicines can cause side effects. Many people don’t have side effects. And minor side effects sometimes go away after a while.

But sometimes side effects can be a problem or can be serious.

If you’re having problems with side effects, talk to your doctor. He or she may be able to lower your dose or change to a different medicine.

Always be sure you get specific information on the medicine you’re taking. For a full list of side effects, check the information that came with the medicine you’re using. If you have questions, talk to your pharmacist or doctor.

Cautions about antibiotics

Cautions for antibiotics include the following:

• Don’t take antibiotics if you don’t need them. If you take them when they’re not needed, any bacteria that don’t die can change and become harder for the antibiotics to kill in the future. This is called antibiotic resistance.
• Take your antibiotics as directed. This will help make sure your infection is cured. Do not stop taking them just because you feel better.

Cautions for all medicines

• Allergic reactions: All medicines can cause a reaction. This can sometimes be an emergency. Before you take any new medicine, tell the doctor or pharmacist about any past allergic reactions you’ve had.
• Drug interactions: Sometimes one medicine may keep another medicine from working well. Or you may get a side effect you didn’t expect. Medicines may also interact with certain foods or drinks, like grapefruit juice and alcohol. Some interactions can be dangerous.
• Harm to unborn babies and newborns: If you are pregnant, trying to get pregnant, or breastfeeding, ask your doctor or pharmacist if any of the medicines you take could harm your baby.
• Other health problems: Before taking a medicine, be sure your doctor or pharmacist knows about all your health problems. Other health problems may affect your medicine. Or the medicine for one health problem may affect another health problem.

Always tell your doctor or pharmacist about all the medicines you take. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. That information will help prevent serious problems.

Always be sure you get specific information on the medicine you’re taking. For a full list of warnings, check the information that came with the medicine you’re using. If you have questions, talk to your pharmacist or doctor.

Related topics

Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis

https://doi.org/10.1016/S1473-3099(17)30753-3Get rights and content

Summary

Background

The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs.

Methods

We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority ranking of the antibiotic-resistant bacteria was established after a preference-based survey was used to obtain expert weighting of criteria.

Findings

We selected 20 bacterial species with 25 patterns of acquired resistance and ten criteria to assess priority: mortality, health-care burden, community burden, prevalence of resistance, 10-year trend of resistance, transmissibility, preventability in the community setting, preventability in the health-care setting, treatability, and pipeline. We stratified the priority list into three tiers (critical, high, and medium priority), using the 33rd percentile of the bacterium’s total scores as the cutoff. Critical-priority bacteria included carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistant Enterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistant Campylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier.

Interpretation

Future development strategies should focus on antibiotics that are active against multidrug-resistant tuberculosis and Gram-negative bacteria. The global strategy should include antibiotic-resistant bacteria responsible for community-acquired infections such as Salmonella spp, Campylobacter spp, N gonorrhoeae, and H pylori.

Funding

World Health Organization.

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Cheap analogs to expensive antibiotics

Antibiotics are one of the most expensive groups of drugs that hit the wallet of the average Ukrainian the hardest. And if the cost of “old” antibiotics is even more or less acceptable, then new broad-spectrum antibiotics are incredibly expensive, which is not surprising, since about 1 billion US dollars are spent on the development of one new antibiotic.

And now, after looking a little, you can understand that there are not so many new antibiotics, because not only do development and clinical research take decades, but also the cost of the project is equal to the cost of a flight into space.In this regard, only very few pharmaceutical companies in the United States and Europe can conduct such expensive research.

So, the latest antibiotic on the market is Linezolid (trade name Zyvox), the owner of the patent for it is Pfizer (for reference, this is the same company that invented and released ViaGru). At the same time, it was synthesized back in 1990, and only in 2000 was it first used in practice.

And what are the rest of the pharmaceutical companies doing, including domestic ones, which cannot afford such expenses? The answer is simple – they produce generics, that is, analogues of long-known antibiotics under a different trade name.The cost of these drugs is often lower than the cost of the original drug, but there are also opposite cases.

Let us explain once again that analogs or generics are drugs with the same active ingredient as the original drug, but with a different trade name, for example ViaGra and Jenagra.

Doctors, prescribing antibiotic therapy, can prescribe both the original drug (which happens less often) and its analogue (in most cases). The reason for this is the work of medical representatives of pharmaceutical companies and distributor firms.

So if your doctor has prescribed you an expensive antibiotic, do not rush to purchase it to the detriment of your budget. Most likely, he has a cheaper alternative, which you can advise and the pharmacist at the pharmacy, if you ask him about it.

Important! When buying an analogue of a prescribed drug, pay attention to the dose and dosage form of the prescribed and purchased drug. They must match! The exceptions are cases when the dose of the analogue of the drug in tablets (capsules) is 2 times less than that prescribed, then you can take 2 tablets (capsules).For example, you need 500 mg Ciprinol tablets, but the pharmacy only has Ciprinol 250 mg.

We have provided a list of analogs of the most famous and widely used antibiotics, which, without exaggeration, have dozens of analogues in Ukraine and thousands around the world.

Penicillin antibiotics

Flemoxin Solutab , tablets. This antibiotic is used to treat lung and uncomplicated cases of bronchitis, sinusitis, pneumonia, peptic ulcer, cystitis, etc.Flemoxin Solutab contains 125, 250, 500 or 1000 mg of amoxicillin No. 20.

Average cost of Flemoxin Solutaba tab. 250 mg No. 20 – 90-100 UAH, 500 mg No. 20 – 120-160 UAH, tab. 1000 mg – 150-190 UAH.

Cheap analogues: Ospamox tab. 500 mg No. 12 and 1000 mg. No. 12. The average cost is 60-80 UAH. and 80-110 UAH. respectively.

Amoxil tab. 250 mg # 20 and 500 mg # 20. The average cost is 25-35 UAH. and UAH 45-55. respectively.

Antibiotics of the group of inhibitor-protected aminopenicillins

Flemoklav Solutab , tablets.This antibiotic is used to treat lung and uncomplicated cases of bronchitis, sinusitis, pneumonia, peptic ulcer, cystitis, etc., caused by bacteria producing b-lactamase. Flemoklav Solutab contains 500 mg of amoxicillin / 125 mg of clavulanic acid or 875 mg of amoxicillin / 125 mg of clavulanic acid.

Average cost of Flemoklav Solutab tab. 500/125 mg No. 20 – 110-150 UAH, 875/125 mg No. 14 – 120-150 UAH.

Amoxil K-625 tab. 500/125 mg No. 14. The average cost is 55-70 UAH.

Antibiotics of the cephalosporin group

Emssef , powder for solution for intramuscular injection. Widely used injectable broad-spectrum antibiotic. One bottle of Emsef contains 1000 mg of ceftriaxone.

Average cost of Emsef so far. d / inv. solution for inf. 1 fl. 1000 mg – 65-85 UAH

Cheap analogues: Oframax pore. d / inv. solution for inf. 1 fl. 1000 mg. The average cost is 30-50 UAH.

Ceftriaxone por.d / inv. solution for inf. 1 fl. 1000 mg. The average cost is 6-10 UAH.

Antibiotics of the macrolide group

Sumamed , tablets, powder for preparation of suspension for oral administration. One of the safest antibiotics approved for use by children from 6 months of age. As part of Sumamed caps. contains 250 mg of azmitromycin, Sumamed tab. contains 500 mg of azithromycin, Sumamed powder d / prig. suspension d / peror. approx. contains 100mg / 5ml of azithromycin.

Average cost of Sumamed caps. 250 mg No. 6 – 160-190 UAH, Sumamed tab. 500 mg No. 3 – 180-210 UAH, Sumamed powder for prig. suspension d / peror. approx. 100mg / 5ml – 120-140 UAH

Cheap analogs: Ormaks powder d / prig. suspension d / peror. approx. 100mg / 5ml. The average cost is 60-80 UAH.

Azithromycin tab. 250 mg # 6 and 500 mg # 3. The average cost is 30-50 UAH. and 35-50 UAH. respectively.

Fromilid , tablets. An antibiotic used to treat respiratory infections, otitis media, skin infections.As part of Fromilid tab. contains 250 or 500 mg of clarithromycin.

Average cost of Fromilid tab. 250 mg No. 14 – 170-200 UAH, Fromilida tab. 500 mg No. 14 – 280-330 UAH.

Cheap analogues: Clarithromycin-Health tab. 250 mg No. 10 and 500 mg No. 10. The average cost is 50-60 UAH. and 90-110 UAH. respectively.

Antibiotics of the tetracyclines group

Doxibene capsules. Most often, this antibiotic is used to treat genital infections caused by chlamydia, mycoplasma and ureaplasma.As part of Doxibene caps. contains 100 mg of doxycycline.

Average cost of Doxibene caps. 100 mg No. 10 – 40-50 UAH.

Cheap analogues: Doxycycline (Borschagovsky) 100 mg No. 10. The average cost is 7-10 UAH.

Antibacterial drugs of the fluoroquinolone group

Tsiprinol , tablets. Synthetic broad-spectrum antibacterial drug. The composition of Tsiprinol contains 250 or 500 mg of ciprofloxacin.

Average cost of Ciprinol tab.250 mg No. 10 – 85-110 UAH, Tsiprinol tab. 500 mg No. 10 – 90-110 UAH.

Cheap analogues: Tsiprolet tab. 250 mg No. 10 and 500 mg No. 10. The average cost is 40-50 UAH. and UAH 75-90. respectively.

Ciprofloxacin tab. 250 mg No. 10 and 500 mg No. 10. The average cost is 9-15 UAH. and 20-25 UAH. respectively.

Antibacterial drugs of the nitroimidazole group

Trichopol , tablets. Antibacterial synthetic drug used in the treatment of bacterial infections of the genital organs.As part of Trichopolum tab. contains 250 mg of metronidazole.

Average cost of Trichopolum tab. 250 mg No. 20 – 70-90 UAH

Cheap analogues: Metronidazole-Health tab. 250 mg No. 20. The average cost is 20-30 UAH.

This small list of analogs will help you save money if you are prescribed the above antibiotics and antibacterial drugs. We would like to draw your attention to the fact that any antibiotics are prescribed exclusively by a doctor. Taking antibiotics without a doctor’s prescription is strictly prohibited!

This list deliberately does not include antibiotics for the treatment of severe infectious processes, since they have almost no analogues, and only the attending physician can replace them.

Source: https://doc.ua/news/articles/deshevye-analogi-dorogim-lekarstvam-antibiotiki

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90,000 The Ministry of Health has updated the list of drugs for the treatment of COVID-19 – RBC

Five drugs remain on the list of recommended for the treatment of COVID-19.Another drug, which was previously on this list, was approved by the Ministry of Health for the treatment of severe community-acquired pneumonia.

Photo: Evgeny Odinokov / RIA Novosti

The Ministry of Health has released the tenth version of the guidelines on coronavirus.The document was published on the website of the department.

Six drugs were listed in the previous version. In the new document, azithromycin, a broad-spectrum antibiotic from the group of semisynthetic macrolides, was excluded from the list.

“For some drugs, the information available today on the results of therapy does not allow us to make an unambiguous conclusion about their effectiveness or ineffectiveness, and therefore their use is permissible by the decision of the medical commission in the prescribed manner, if the potential benefit to the patient outweighs the risk of their use.” , – explained in Mizdrava.

Now azithromycin is recommended for use only in antibiotic therapy of severe community-acquired pneumonia in those infected who are in intensive care, follows from the guidelines.

Scientists have found a cure for COVID 30 times stronger than remdesivir

Five drugs remain on the list of drugs recommended by the Ministry of Health for the treatment of coronavirus – favipiravir, remdesivir, umifenovir, hydroxychloroquine and interferon-alpha.90,000 Can natural antibiotics replace medicines?

Natural antibiotics are substances created by nature itself and possess a wide spectrum of antimicrobial activity. They can be used in the treatment of the initial stages of many inflammatory infectious diseases, relieve the condition and remove unpleasant symptoms. Of course, there is no food that can completely replace drugs. In addition, any fruits, herbs, spices, and different types of teas can cause allergies.It is also impossible to calculate the exact dosage of a natural medicine.

Is it possible to do with natural antibiotics for colds and sore throats? They are best used in combination with proven products. The main thing is to approach this thoughtfully, be sure to take into account your condition and possible allergic reactions.

If you develop intolerance to any natural antibiotics, you must stop using them and consult a doctor.

Juicy pomegranate

Even children know for sure that onions, garlic and tea with raspberries help with colds and flu.Pomegranate fruits can also be added to the list of “tasty medicines”. Pomegranate is a unique southern fruit in which everything is useful: grains, partitions and even a peel. This is a real storehouse of vitamins C, E, B1, B2, as well as minerals – iron, potassium, calcium, silicon and iodine, which are necessary for every person.

A few years ago, scientists at Kingston University discovered that pomegranate skin contains substances that can fight antibiotic-resistant staphylococci and other common infections.The antimicrobial activity of fresh pomegranate juice was also revealed, which is due to the high content of polyphenols – chemical compounds that protect our cells from negative influences. ¹

In order to nourish your body with useful substances and accelerate recovery from acute respiratory viral infections, you can use pomegranate fruits and its juice. Remember that concentrated pomegranate juice is not recommended for people with gastrointestinal diseases. Plus, like most other juices, it can harm your tooth enamel, so it’s best to drink it through a straw.

Hot ginger

Ginger root is a spice whose popularity in Russia has been growing at an unheard of pace lately. This plant contains vitamins, fatty acids, minerals, healthy oils and amino acids. The amount of vitamin C in ginger is twice that in apples and practically the same as in citrus fruits.

Ginger is also a natural antibiotic and, due to its composition and warming effect, has anti-inflammatory, expectorant, antipyretic and diaphoretic effects.Therefore, it can be used in the treatment and prevention of diseases of the throat, cough and runny nose. ²

Ginger is good not only in pickled form, when it is used with Japanese cuisine, but also as an additive in tea and salads, as well as in many other dishes, both raw and thermally processed.

Fragrant cinnamon

Cinnamon is also able to fight viral diseases. Scientists spoke about this not so long ago at a conference of the American Society for Microbiology.It was found that cinnamon extract destroys the envelope of viruses, thereby destroying them. It was experimentally found that an aqueous solution containing only 5 mg of cinnamon in just 10 minutes is able to destroy almost 100% of viruses placed in the same medium. ³

The useful essential oil contained in cinnamon improves digestion, induces appetite and has a tonic effect. Cinnamon has not only antiviral, but also antibacterial, antifungal properties and can act as a diaphoretic, expectorant and antipyretic agent in ARVI. ⁴

Of course, this does not mean that you should immediately start consuming cinnamon in large quantities, but in the absence of contraindications, you can try to prepare meals and drinks with this spice. Any baked goods, jams, jellies and mousses can be tasted better with cinnamon. It also perfectly complements the taste of coffee, tea, chocolate, dairy products and any desserts.

Healing honey and lemon

Of course, some of the most popular natural antibiotics are honey and lemon.Who among us has not heard the most common advice at the beginning of a cold – drink tea with lemon and honey? The advisers are absolutely right. Surely many of us have come across a situation where a similar drink, when a cold begins, warmed, removed discomfort and helped to recover faster.

The combination of honey and lemon is a real storehouse of nutrients that we need every day. Both honey and lemon are on the list of the best natural antibiotics, and their use increases the body’s immune response and makes it resistant to infections. ⁵

The main thing is to remember that honey and lemon must be added not to boiling water, which has a detrimental effect on vitamins, but to moderately hot tea. In the absence of contraindications and allergies, for prevention purposes, you can chew fresh lemon zest, and add honey not only to drinks, but also to other dishes.

What if natural antibiotics don’t work for a sore throat?

Unfortunately, even the most healthy foods and natural antibiotics are not always able to replace drugs and relieve sore throat.In this case, you must consult a doctor.

Also, in the event of a sore throat, a drug comes to the rescue, which combines the natural benefits of honey, lemon, as well as the achievements of many years of work by pharmacists who have managed to create a symptomatic remedy for relieving sore throat.

We are talking about the drug Strepsils ^® Intensive (honey-lemon resorption tablets), which has a local analgesic and anti-inflammatory effect on the mucous membrane of the mouth and throat: reduces swelling, difficulty in swallowing, pain and irritation in the throat ⁷ .

The drug helps to eliminate sore throat, regardless of the cause of its occurrence (whether it be viruses, bacteria or fungi).

Method of application and dosage

⁷

Adults and children over 12 years of age: Slowly dissolve one tablet every 3-6 hours.

Maximum daily dose: 5 tablets.

The duration of the course of treatment is no more than 3 days. If, after taking the drug for 3 days, the symptoms persist or worsen, it is necessary to stop treatment and consult a doctor.

Read the instructions before using the drug.

90,000 WHO expanded the list of antibiotics and explained how to use them – Russian newspaper

WHO published new recommendations on the use of antibiotics and expanded the list of essential drugs used (EML) to include both drugs for common infections and drugs for severe pathologies – HIV / AIDS, tuberculosis, hepatitis C, leukemia.

WHO experts divided all antibiotics into three groups and gave clear recommendations in which cases the drugs of each category are used.This is done to combat the spread of antibiotic resistance. Three groups of antibiotics: Access (available), Watch (used with caution) and Reserve (reserve drugs) contain drugs for 21 types of infections. Moreover, the list of infections can be expanded if the new classification justifies itself and is convenient and useful for use.

Access Group 1 is used to treat a wide range of common infections. For example, it includes amoxicillin, which is widely used to treat infectious diseases, including pneumonia.

The Watch group includes antibiotics that are recommended for the treatment of certain infections and only if the first group does not work. An example is the antibiotic ciprofloxacin, which is used to treat urinary tract and upper respiratory tract infections. The use of this antibiotic, according to WHO experts, should be drastically reduced to avoid further development of resistance.

The third group of Reserve includes antibiotics that should be considered “last resort” and used in the most extreme cases when alternatives have failed – for example, for the treatment of life-threatening multidrug-resistant infections.To this group, WHO experts attributed, in particular, colistin and cephalosporin.

In total, the WHO list is now 433 most important antibiotics for public health, including for the first time included 30 new drugs for adults and 25 used in children.

Antibiotics for COVID-19: Frequently Asked Questions

09/24/2021

Do antibiotics help in the early stages of treating a new coronavirus infection?

No.Antibiotics do not cure viral infections. They are designed to treat bacterial diseases, with different antibiotics for different diseases and different types of bacteria.

Why did my doctor prescribe an antibiotic for me to take at home?

This is probably due to the fact that your diagnosis of COVID-19 has not been confirmed, and there is reason to suspect that your symptoms are caused by bacterial flora, or you suffer from a chronic disease in which pathogenic microorganisms are constantly present in your body.

What happens if I start taking antibiotics on my own, which were not prescribed by doctors for me, but, taking into account the personal experience of the past illness, were recommended by neighbors, relatives “who were helped”, bloggers on the Internet?

Most likely, nothing good or bad will happen to you right away. However, if you subsequently need antibiotic treatment for a specific, correct purpose, your doctor will most likely have to prescribe antibiotics in injectable forms (injections) rather than pill antibiotics.Due to the simplest surgical operation, for example, tooth extraction or opening a panaritium, hospitalization may be required, since an antibiotic will need to be selected for a long time to prevent purulent complications and it is not a fact that it will succeed. After all, the microflora of your body, with uncontrolled intake of antibiotics, becomes less susceptible to them in the future, and not only to the one you have specifically chosen, but also to other antibiotics from this group.

According to the WHO, diseases associated with antibiotic resistance (antibiotic resistance) will cause 10 million deaths per year by 2050.

You, too, can be among the patients with mild, severe and fatal complications, which lead to self-medication with antibiotics. These include: clostridial superinfection (life-threatening diarrhea), fungal complications that will require long and expensive treatment; allergic reactions, including, in extreme manifestations, Lyell’s syndrome with exfoliation of the skin; kidney damage, as a result of which you can become a regular patient of a hemodialysis center for the treatment of severe chronic renal failure; damage to the conducting system of the heart, which can lead to its sudden cardiac arrest; bone marrow damage and a number of other serious complications.

How can diarrhea be life threatening?

Taking antibiotics is one of the main factors that increases the likelihood of infection with the highly specific bacterium C. difficile. Antibiotics can kill naturally occurring, beneficial bacteria in the gastrointestinal tract, allowing Clostridia to multiply and release toxic substances. These toxins cause diarrhea and other symptoms of infection, reflecting the development of intestinal wall necrosis and secondary sepsis.

What is the “mold” that is often reported in the media about the coronavirus epidemic in India?

“Mold” is a secondary fungal infection of organs and systems of the body, associated, among other things, with inadequate use of antibiotics. Mucormycosis (black mold) is a severe fungal disease that usually occurs in Russia in oncohematological patients. It is called mucomycetes, which are ubiquitous and affect the eyes, nasopharynx, and respiratory tract.In India, where antibiotics are included in the official treatment regimens for COVID-19, this problem has already been reported in more than 4,000 patients. This fact is accompanied by a poor prognosis for survival. Aspergillosis (white mold) occurs very often in patients with COVID-19, affects mainly lung tissue, and requires long-term toxic treatment. Patients with invasive aspergillosis are also at risk of death.

Are there any delayed consequences of taking antibiotics?

Certainly.All groups of antibiotics are capable of triggering serious autoimmune diseases. There are even some studies that prove that antibiotics, by suppressing certain parts of the immune system, create favorable conditions for the multiplication of the virus and can lead to the death of patients with a new coronavirus infection, making it worse.

What is antibiotic flu-like syndrome?

A number of commonly used antibiotics, when used without indications, can by themselves provoke the appearance of flu-like symptoms: myalgia, chills, shortness of breath, joint pain, headache, asthenia.All this will complicate the diagnosis and treatment of the underlying disease.

I was told that the antibiotics I used, azithromycin, ceftriaxone, levofloxacin, are quite harmless. Is it so?

Azithromycin, which is widely used in self-therapy, is a very difficult antibiotic. It is capable of provoking the development of liver failure, up to liver necrosis, anaphylactic reactions (in rare cases fatal), convulsions, hearing impairment up to deafness, impaired perception of taste and smell, which often mimics the coronavirus clinic.

Levofloxacin has a huge list of possible side effects. May cause psychotic reactions such as hallucinations and depression, agitation, seizures and confusion; visual and hearing impairment, gustatory sensitivity and smell; capable of affecting tendons, up to and including rupture.

Ceftriaxone – an antibiotic that is more often used intramuscularly at home, quite often becomes the culprit of clostridial infection, disorders in the hematopoietic system, and severe kidney damage.

Therefore, in view of the above, the appointment of antibiotics is indicated exactly when there is a specific goal of treatment. Indications for the appointment of antibiotics are determined by only by a doctor , taking into account the assessment of clinical manifestations, laboratory and instrumental research methods, and the patient’s anamnesis.

90,000 list of drugs – the best probiotics to restore intestinal microflora

A child is born with a sterile intestine, but by one year the composition of the microflora coincides with that of an adult.Throughout life, under the influence of nutrition, disease and other factors, the balance of microorganisms in the digestive tract changes, but gradually recovers to normal concentrations. Sometimes this process is delayed. Then the doctor may recommend prebiotics and probiotics for the intestines.

Types of probiotics

Two types of remedies are used to restore the intestines. Probiotics are preparations that contain beneficial bacteria in dried or dissolved form.Most often these are microorganisms from the genus Lactobacillus and Bifidobacterium, which normally dominate the human digestive tract.

Prebiotics are substances necessary for the growth of good microflora. In some cases, you can do without them, but after serious illness, antibiotic treatment or poisoning, they will speed up recovery by creating a favorable environment for bacteria.

Several dozen types of bacteria live in the digestive tract of a healthy adult, but two types of microbes predominate: bifidobacteria and lactobacilli.Others are in the minority. Therefore, the following types of probiotics are distinguished, depending on the composition:

• consist only of lactobacilli – recommended for intestinal viral infections;
• as part of only bifidobacteria – doctors prescribe them for candidal intestinal lesions and as recovery for women after vaginal candidiasis;
• combination preparations – contain bifidobacteria and lactobacilli, useful for bacterial intestinal infections.

It is possible to restore normal microflora with various forms of preparations.Probiotics are released in dry form, from which a suspension is independently prepared before use. There are ready-made liquid forms of the medicine that are convenient for giving to a small child. Some products are produced in capsules in a gelatinous shell. It is not damaged in the stomach and only dissolves in the intestines. This protects bacteria from the action of hydrochloric acid.

The creation of drugs for solving digestive problems took place in several stages. Therefore, pharmacists isolate several generations of probiotics:

• 1st generation – these are monopreparations that consist of one type of bacteria that live in the intestine, these include Bifidumbacterin, Lactobacterin.
• 2nd generation – contains good bacteria that are antagonists of harmful flora. They secrete substances that destroy dangerous microorganisms and prepare the environment for the colonization of beneficial microflora. This type of drug includes Enterol and Bactisubtil.
• 3rd generation – probiotics that contain from 2 to 30 strains of one live microorganism or a combination of several types of bacteria. This group of drugs includes Linex, Bifikol, Bifilong.
• 4th generation – contains not only good bacteria, but also substances from the prebiotic group.They serve as a breeding ground, help microflora grow, multiply and accelerate its recovery. This group of drugs includes Bifiliz, Kipatsid.
• 5th generation – synbiotics, these are several types of beneficial bacteria and substances necessary for colonization of the intestines. They are able to regulate the growth and metabolic activity of the microbiota. This group includes Floristin, Bifiform and other drugs.

Which drug is suitable in a particular case, the doctor should decide, taking into account the patient’s condition, his age.For adults, a high dosage and frequency of taking probiotics is required.

TOP-10 of the best probiotics

A large number of probiotics are sold in pharmacies, from which it is difficult to choose the right drug. The correct decision is to consult a gastroenterologist or therapist to prescribe a drug with a good effect.

To decide which one is better, you can focus on the TOP-10 list:

1. Linex is one of the most popular drugs that helps to restore the intestinal microflora.It contains live lyophilized bifidobacteria and lactobacilli, as well as enterococci. Linex is available in capsules and powder, it can be used in infants by mixing the contents of the shell with milk.
2. Hilak Forte – drops for the treatment of dysbiosis, contains lactobacilli, their effect is complemented by non-pathogenic E. coli and streptococci. It can be used for irritable bowel syndrome, gastroenteritis, colitis, diseases of the gallbladder and liver caused by the pathology of the digestive tract.
3. Florin Forte – restores microflora due to the presence of bifidobacteria and lactobacilli. The composition includes lactose, which is necessary for the fermentation process, shifting the pH in the intestine to the acidic side. It is produced in the form of a sachet with a powder, which must be dissolved before use.
4. Normobact L – helps to restore intestinal flora with the help of lactic acid bacteria and prebiotics necessary for their reproduction. The composition includes fructooligosaccharides, which are a nutrient medium, increase the survival of the microbiota and increase the effectiveness of treatment.
5. Acipol is a remedy for the treatment of dysbiosis in adults and children. It helps after long-term treatment with antibiotics for therapeutic diseases, it is used to treat acute intestinal infections, chronic colitis, in people prone to allergies and atopic dermatitis.
6. Bifiform is a probiotic containing enterobacteria and bifidobacteria. In the intestines, they form a natural symbiosis and support each other’s existence. Enterococcus colonizes the loops of the small intestine, and the type of bifidobacteria used has a high growth rate, therefore, it quickly restores the microbiota of the large intestine.
7. Normoflorin L is a liquid probiotic consisting of lactobacilli. It has a positive effect on the body due to the addition of the prebiotic lactitol to the solution, which improves the growth of bacteria. Before use, the required dose of the drug is mixed with any liquid.
8. Florok is a probiotic that consists of lactobacilli, bifidobacteria and lactose, which is necessary for normal colonization of the digestive tract. It can be used both to restore microflora and to prevent diarrhea while traveling.
9. Bak-set Forte are capsules containing 14 types of live beneficial bacteria. The drug is recommended for children over 3 years old and adults for the treatment of stool disorders and the prevention of dysbiosis.
10. Rioflora is a complex probiotic that includes several strains of bifidobateria and lactobacilli, as well as non-pathogenic streptococci. But the capsules may contain traces of lactose, milk and soy, so the manufacturer does not recommend using them in case of hypersensitivity to these substances.

Advice for selection

Which of the following probiotics will help cope with digestive problems depends on the disease. If the body needs help after a course of antibiotic treatment, it is better to use complex preparations where a prebiotic is added. It will accelerate the colonization of bacteria in the intestinal mucosa.

Regardless of the name, preparations in the form of powder, capsules or solution are suitable for adults. Drops are designed specifically for young children who need a small dose of the drug.They are good to mix with drinks or mother’s milk.

When using products with probiotic effects, the symptoms of bloating, rumbling, flatulence may worsen due to the fermentation process. But this goes away on its own and does not require the cancellation of therapy. If an allergic rash appears while taking probiotics, treatment is stopped.

90,000 The Ministry of Agriculture proposed to approve the list of antibiotics banned for animals

“Establishing a list of active substances for antimicrobial drugs, in respect of which restrictions are imposed on their use for medicinal purposes, including for the treatment of farm animals, will prevent the unreasonable use of antimicrobial drugs and the spread of antimicrobial resistance (resistance of pathogens to antimicrobial drugs.- “ViZh” ) “, – explained in the Ministry of Agriculture.

In the proposed list, antimicrobial drugs were divided into three groups:

– Group A: prohibited for all animals. These include, for example, mecillins and pivmecillins. In the same group, substances prohibited for productive animals. For example, amphenicols: chloramphenicol (chloramphenicol).

– Group B. This group is called Second Choice Drugs. These include, for example, beta-lactams / penicillins in combination.

– Group C: “Medicines of the first choice”. This group includes natural penicillins.

As Veterinary and Life previously reported, the classification of antimicrobial drugs was developed at the All-Russian State Center for the Quality and Standardization of Medicines for Animals and Feed of the Rosselkhoznadzor (FSBI VGNKI).

“Drugs from group B can be used to treat animals if drugs from group C are ineffective (drugs of the first choice) – according to the results of determining the sensitivity of pathogens to antibiotics or the therapy started with drugs of group C, it turned out to be ineffective,” Sergey explained to Vizh Lenev, Leading Researcher, Laboratory of Quality and Standardization of Bacterial Medicines, Federal State Budgetary Institution VGNKI.

Drugs of the first choice are used when symptoms of a disease in animals appear on the basis of a preliminary diagnosis, the scientist explained. He stressed that antimicrobials from groups B and C must be prescribed strictly by prescription.

The project developers cited international experience as an example. For example, in the EU countries, antibiotics are prescribed by a veterinarian who observes the animal. For this, a prescription must be drawn up. The protocol of treatment indicates the sensitivity of the causative agent to the drug, the period of its use and the period of elimination from the animal’s body are prescribed.

Earlier, the Ministry of Agriculture proposed to determine the cases when animals can be given antimicrobial drugs for the treatment of infectious and parasitic diseases.

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