How do antibiotics lead to yeast infections. What are the common symptoms of a yeast infection. Which antibiotics are most likely to cause vaginal candidiasis. How can you treat a yeast infection effectively.

Understanding the Link Between Antibiotics and Yeast Infections

Yeast infections, also known as vaginal candidiasis, are a common consequence of antibiotic use. These infections occur when the delicate balance of bacteria and yeast in the vagina is disrupted. While antibiotics are essential for treating bacterial infections, they can inadvertently kill beneficial bacteria that keep Candida fungus in check. This allows the yeast to multiply unchecked, leading to infection symptoms.

According to recent statistics, approximately 70% of females experience at least one yeast infection in their lifetime, with 8% suffering from recurring Candida infections. These infections can develop at any age but are more prevalent during reproductive years.

Recognizing the Symptoms of a Yeast Infection

Identifying a yeast infection early is crucial for prompt treatment. Common symptoms include:

• Itching and burning sensations around the vulva
• White, lumpy, odorless vaginal discharge
• Pain during sexual intercourse
• Discomfort while urinating
• Increased vaginal discharge

In severe cases, redness, swelling, or cracks may form in the vaginal walls. It’s important to note that these symptoms can be more pronounced just before menstruation.

Can yeast infection symptoms be confused with other conditions?

Yes, yeast infection symptoms can sometimes be mistaken for other conditions, such as urinary tract infections (UTIs). While both conditions can cause discomfort during urination, yeast infections typically present with itching and a characteristic discharge, which are not common in UTIs. If you’re unsure about your symptoms, it’s best to consult a healthcare professional for an accurate diagnosis.

Antibiotics Most Likely to Cause Yeast Infections

Not all antibiotics increase the risk of yeast infections. Broad-spectrum antibiotics, which target a wide range of bacteria, are the most likely culprits. The following types of antibiotics are particularly associated with an increased risk of yeast infections:

1. Tetracyclines (e.g., doxycycline, minocycline)
2. Quinolones (e.g., ciprofloxacin, levofloxacin)
3. Broad-spectrum penicillins (e.g., ampicillin, amoxicillin)

These antibiotics are commonly prescribed for various conditions, including acne, urinary tract infections, respiratory infections, and sexually transmitted infections.

Risk Factors for Developing Antibiotic-Induced Yeast Infections

While anyone taking antibiotics can develop a yeast infection, certain factors can increase the risk:

• Pregnancy
• Use of hormonal contraceptives
• Diabetes
• Weakened immune system (e.g., due to chemotherapy or HIV infection)

If you have any of these risk factors, it’s important to discuss them with your healthcare provider when being prescribed antibiotics. They may recommend preventive measures or alternative treatments to reduce the risk of developing a yeast infection.

Are yeast infections sexually transmitted?

No, yeast infections are not considered sexually transmitted infections (STIs). While they are more common among sexually active individuals, there is no evidence to suggest that they are transmitted through sexual contact. However, sexual activity can sometimes contribute to the disruption of the vaginal microbiome, potentially increasing the risk of yeast overgrowth.

Effective Treatments for Antibiotic-Induced Yeast Infections

Treating a yeast infection is typically a straightforward process. The most common treatments include:

• Antifungal creams or ointments applied directly to the vagina
• Oral antifungal medications, such as fluconazole or miconazole

These treatments are available both over-the-counter and by prescription, depending on the severity of the infection and local regulations. For recurring or chronic infections, stronger treatments may be necessary, such as higher doses of fluconazole or creams containing boric acid, nystatin, or flucytosine.

How long does it take for a yeast infection to clear up with treatment?

The duration of treatment can vary depending on the severity of the infection and the chosen treatment method. In most cases, symptoms begin to improve within 2-3 days of starting treatment. However, it’s important to complete the full course of treatment as prescribed, even if symptoms subside earlier. This typically ranges from 1-7 days for topical treatments and a single dose for oral medications. For recurring infections, longer treatment courses may be necessary.

Preventing Yeast Infections While Taking Antibiotics

While it’s not always possible to prevent a yeast infection when taking antibiotics, there are several steps you can take to reduce your risk:

1. Maintain good hygiene practices
2. Wear breathable, cotton underwear
3. Avoid douching or using scented feminine products
4. Consider taking probiotics during your antibiotic course
5. Consume a balanced diet low in sugar and refined carbohydrates

If you have a history of yeast infections or are at higher risk, your healthcare provider may recommend preventive antifungal treatment while you’re taking antibiotics.

Can dietary changes help prevent yeast infections?

While there’s no definitive evidence that diet alone can prevent yeast infections, some studies suggest that certain dietary changes may help support vaginal health. Reducing sugar and refined carbohydrate intake, consuming probiotic-rich foods like yogurt, and increasing intake of garlic and coconut oil (which have natural antifungal properties) may be beneficial. However, these dietary changes should be seen as complementary to medical treatments, not as replacements.

When to Seek Medical Attention for a Yeast Infection

The Centers for Disease Control and Prevention (CDC) recommends that anyone suspecting they have a yeast infection should consult a healthcare professional. This is particularly important because the symptoms of yeast infections can be similar to those of other vaginal infections, which may require different treatments.

You should seek medical attention if:

• It’s your first suspected yeast infection
• Your symptoms are severe or don’t improve with over-the-counter treatment
• You experience recurring infections (4 or more in a year)
• You’re pregnant
• You have additional symptoms like fever, abdominal pain, or foul-smelling discharge

Can untreated yeast infections lead to complications?

While yeast infections are generally not serious, leaving them untreated can lead to discomfort and potential complications. In rare cases, the infection can spread to other parts of the body, particularly in individuals with weakened immune systems. Chronic, untreated yeast infections may also increase the risk of HIV transmission. Additionally, recurring infections can impact quality of life and sexual health. Therefore, it’s important to address yeast infections promptly and thoroughly.

The Role of Probiotics in Managing Antibiotic-Induced Yeast Infections

Probiotics have gained attention as a potential way to prevent and manage yeast infections, especially those induced by antibiotics. These beneficial bacteria can help restore the natural balance of the vaginal microbiome.

Several studies have shown promising results for the use of probiotics in preventing and treating yeast infections:

• Oral probiotic supplements containing Lactobacillus species may help reduce the risk of developing a yeast infection while taking antibiotics
• Vaginal probiotic suppositories can help restore the balance of good bacteria in the vagina
• Consuming probiotic-rich foods like yogurt may provide some protective benefits

While more research is needed to fully understand the effectiveness of probiotics for this purpose, many healthcare providers recommend them as a complementary approach to traditional antifungal treatments.

How do you choose an effective probiotic for yeast infection prevention?

When selecting a probiotic for yeast infection prevention, look for products that contain strains specifically shown to support vaginal health, such as Lactobacillus rhamnosus and Lactobacillus reuteri. The probiotic should have a high colony-forming unit (CFU) count, typically in the billions, to ensure an adequate amount of beneficial bacteria. It’s also important to choose a reputable brand that guarantees the potency of their product through the expiration date. Always consult with your healthcare provider before starting any new supplement regimen, especially if you’re taking other medications.

Long-Term Management of Recurrent Yeast Infections

For individuals who experience frequent yeast infections, especially after antibiotic use, long-term management strategies may be necessary. These can include:

1. Maintenance therapy with regular, low-dose antifungal medications
2. Lifestyle modifications to reduce risk factors
3. Regular probiotic supplementation
4. Identifying and addressing underlying health conditions that may contribute to recurrent infections

A healthcare provider can help develop a personalized plan based on individual needs and medical history. This may involve a combination of preventive treatments, lifestyle changes, and ongoing monitoring.

Can stress contribute to recurrent yeast infections?

Yes, stress can potentially contribute to recurrent yeast infections. Chronic stress can weaken the immune system, making it harder for the body to maintain the balance of microorganisms in the vagina. Additionally, stress can lead to behaviors that may increase the risk of yeast infections, such as poor diet choices or disrupted sleep patterns. Managing stress through techniques like meditation, regular exercise, and adequate sleep may help reduce the frequency of yeast infections. However, stress management should be seen as part of a comprehensive approach to preventing recurrent infections, not as a standalone solution.

Understanding the relationship between antibiotics and yeast infections is crucial for anyone taking these medications. By recognizing the symptoms, knowing which antibiotics pose the highest risk, and implementing preventive strategies, you can reduce your chances of developing an uncomfortable yeast infection. Remember, while yeast infections are common and generally not serious, it’s always best to consult with a healthcare professional for proper diagnosis and treatment, especially if you experience recurring infections or have other risk factors.

Yeast infection from antibiotics: Causes, symptoms, and treatment

Taking certain antibiotics may lead to a yeast infection in the vagina, also known as a fungal infection or vaginal candidiasis.

A yeast infection is a form of vaginitis, which means inflammation in the vagina. Vaginitis is the most common vaginal condition in people aged 15–44.

Vaginal candidiasis, caused by Candida fungus, is the second most common type of vaginal infection in the United States, after bacterial infections.

This article examines how taking antibiotics can sometimes lead to yeast infections. It also describes which antibiotics can cause these infections and how to treat them.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?

A yeast infection occurs when something upsets the delicate balance of bacteria and yeast in the vagina.

A small amount of Candida fungus is usually present in the vagina, and beneficial bacteria help keep this fungus under control.

Antibiotics work by killing bacteria that cause infection, but they can also kill beneficial bacteria in other parts of the body, including the vagina.

Without enough beneficial bacteria to keep the yeast at bay, Candida yeast can multiply, causing the symptoms of a yeast infection.

Some people are more prone to yeast infections than others. According to current estimates, 8% of females have recurring Candida infections, and around 70% of females report dealing with this condition at least once in their lifetime.

Yeast infections can develop at any age, but these infections are more common during reproductive years.

The common symptoms of a vaginal yeast infection tend to be more noticeable just before menstruation. A person may experience:

• an itchy sensation on and around the vulva, which is the area outside the vagina
• a burning sensation on or around the vulva
• white, lumpy, odorless vaginal discharge
• pain during sex
• pain or discomfort while urinating
• an increase in vaginal discharge

These symptoms are mild in most cases. In severe infections, redness, swelling, or cracks form in the walls of the vagina.

It can be difficult to distinguish between a yeast infection and a urinary tract infection (UTI). Learn to tell the difference here.

Not all antibiotics are likely to cause yeast infections — only broad-spectrum antibiotics tend to have this effect. These drugs can kill several different types of bacteria.

The following three types of broad-spectrum antibiotic, in particular, may increase the risk of a yeast infection:

Tetracyclines

Doctors prescribe tetracyclines for acne, UTIs, intestinal tract infections, eye infections, sexually transmitted infections, and gum disease.

Examples of tetracyclines and common brand names include:

• demeclocycline (Detravis)
• doxycycline (Adoxa)
• eravacycline (Xerava)
• minocycline (Minocin)
• omadacycline (Nuzyra)
• tetracycline (Sumycin)

Quinolones

Doctors prescribe quinolones for difficult-to-treat UTIs, hospital-acquired pneumonia, and bacterial prostatitis. Common examples include:

• ciprofloxacin (Cipro)
• levofloxacin (Levaquin)
• moxifloxacin (Avelox)

Broad-spectrum penicillins

Broad-spectrum penicillins, such as ampicillin and amoxicillin, may also lead to yeast infections.

Yeast infections are common, but a few circumstances may make it more likely a person will develop one. These circumstances include:

• pregnancy
• hormone contraceptive use, such as birth control pills
• diabetes
• a weakened immune system due to factors such as chemotherapy treatment or HIV infection

If a person is living with one of these risk factors, they should talk with their doctor if they have been prescribed antibiotics, as there can be an increased risk of yeast infection.

While yeast infections are more common among sexually active people, there is no evidence that they are sexually transmitted.

Treating a yeast infection is usually a straightforward process. In most cases, a person will either apply a cream or ointment to the inside of the vagina or take a pill containing an antifungal medicine, such as fluconazole or miconazole.

A doctor can prescribe antifungal creams or tablets. People can also find over-the-counter (OTC) antifungal vaginal creams at drugstores, or online.

Some infections, such as recurring chronic infections, may require stronger treatment. In this case, a doctor may recommend additional doses of fluconazole or creams that contain boric acid, nystatin, or flucytosine.

The Centers for Disease Control and Prevention (CDC) recommend that anyone who suspects they have vaginal candidiasis speak with a healthcare professional. This is because the symptoms are similar to those of other vaginal infections, which require different treatments.

A healthcare professional can ensure that a person gets the right medication for the infection. To identify vaginal candidiasis, they usually take a small sample of vaginal discharge for examination under a microscope.

Pregnancy and fluconazole

Pregnant people may want to avoid treating yeast infections with fluconazole due to the risk of birth abnormalities. According to an older safety announcement from the Food and Drug Administration (FDA), a single 150-microgram dose of fluconazole may not cause this effect, but taking it for longer periods or at a higher dosage carries this risk.

While a 2013 study did not find a significantly increased risk of birth abnormalities when pregnant people took fluconazole, a more recent cohort study from 2020 did find an association with fluconazole use during the first trimester and musculoskeletal malformations.

Pregnant individuals managing a yeast infection should discuss with their doctor about the risks of fluconazole, and other alternative treatments.

People can help prevent vaginal candidiasis by taking antibiotics only when they are necessary. It is worth remembering that antibiotics do not work on viral infections, such as a cold or the flu.

Antibiotics also do not work on some common bacterial infections, such as many types of bronchitis, sinus infections, and ear infections. A person should always speak with a healthcare professional before starting a course of antibiotics.

A few other ways to help prevent yeast infections include:

• wearing cotton undergarments
• avoiding feminine hygiene sprays
• avoiding scented tampons
• avoiding harsh soaps when cleaning the vagina
• using condoms during sex

In addition, there is some evidence that eating yogurt that contains live cultures every day or taking Lactobacillus acidophilus capsules may help prevent these infections.

While little high quality research has investigated this use of probiotics, many healthcare professionals recommend taking a probiotic supplement either during or immediately after completing a course of antibiotics to reduce the risk of a yeast infection.

Some types of antibiotics can lead to a vaginal yeast infection, which is a form of vaginitis known as vaginal candidiasis.

Antibiotics kill bacteria, which can upset the delicate balance of yeast and bacteria in the vagina. This allows the Candida fungus to multiply, leading to symptoms such as itching, burning, or pain during sex.

It is usually straightforward to treat yeast infections with OTC antifungal medications. However, anyone who suspects that they have this type of infection should consult a doctor to rule out other issues with similar symptoms.

Yeast infection from antibiotics: Causes, symptoms, and treatment

Taking certain antibiotics may lead to a yeast infection in the vagina, also known as a fungal infection or vaginal candidiasis.

A yeast infection is a form of vaginitis, which means inflammation in the vagina. Vaginitis is the most common vaginal condition in people aged 15–44.

Vaginal candidiasis, caused by Candida fungus, is the second most common type of vaginal infection in the United States, after bacterial infections.

This article examines how taking antibiotics can sometimes lead to yeast infections. It also describes which antibiotics can cause these infections and how to treat them.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?

A yeast infection occurs when something upsets the delicate balance of bacteria and yeast in the vagina.

A small amount of Candida fungus is usually present in the vagina, and beneficial bacteria help keep this fungus under control.

Antibiotics work by killing bacteria that cause infection, but they can also kill beneficial bacteria in other parts of the body, including the vagina.

Without enough beneficial bacteria to keep the yeast at bay, Candida yeast can multiply, causing the symptoms of a yeast infection.

Some people are more prone to yeast infections than others. According to current estimates, 8% of females have recurring Candida infections, and around 70% of females report dealing with this condition at least once in their lifetime.

Yeast infections can develop at any age, but these infections are more common during reproductive years.

The common symptoms of a vaginal yeast infection tend to be more noticeable just before menstruation. A person may experience:

• an itchy sensation on and around the vulva, which is the area outside the vagina
• a burning sensation on or around the vulva
• white, lumpy, odorless vaginal discharge
• pain during sex
• pain or discomfort while urinating
• an increase in vaginal discharge

These symptoms are mild in most cases. In severe infections, redness, swelling, or cracks form in the walls of the vagina.

It can be difficult to distinguish between a yeast infection and a urinary tract infection (UTI). Learn to tell the difference here.

Not all antibiotics are likely to cause yeast infections — only broad-spectrum antibiotics tend to have this effect. These drugs can kill several different types of bacteria.

The following three types of broad-spectrum antibiotic, in particular, may increase the risk of a yeast infection:

Tetracyclines

Doctors prescribe tetracyclines for acne, UTIs, intestinal tract infections, eye infections, sexually transmitted infections, and gum disease.

Examples of tetracyclines and common brand names include:

• demeclocycline (Detravis)
• doxycycline (Adoxa)
• eravacycline (Xerava)
• minocycline (Minocin)
• omadacycline (Nuzyra)
• tetracycline (Sumycin)

Quinolones

Doctors prescribe quinolones for difficult-to-treat UTIs, hospital-acquired pneumonia, and bacterial prostatitis. Common examples include:

• ciprofloxacin (Cipro)
• levofloxacin (Levaquin)
• moxifloxacin (Avelox)

Broad-spectrum penicillins

Broad-spectrum penicillins, such as ampicillin and amoxicillin, may also lead to yeast infections.

Yeast infections are common, but a few circumstances may make it more likely a person will develop one. These circumstances include:

• pregnancy
• hormone contraceptive use, such as birth control pills
• diabetes
• a weakened immune system due to factors such as chemotherapy treatment or HIV infection

If a person is living with one of these risk factors, they should talk with their doctor if they have been prescribed antibiotics, as there can be an increased risk of yeast infection.

While yeast infections are more common among sexually active people, there is no evidence that they are sexually transmitted.

Treating a yeast infection is usually a straightforward process. In most cases, a person will either apply a cream or ointment to the inside of the vagina or take a pill containing an antifungal medicine, such as fluconazole or miconazole.

A doctor can prescribe antifungal creams or tablets. People can also find over-the-counter (OTC) antifungal vaginal creams at drugstores, or online.

Some infections, such as recurring chronic infections, may require stronger treatment. In this case, a doctor may recommend additional doses of fluconazole or creams that contain boric acid, nystatin, or flucytosine.

The Centers for Disease Control and Prevention (CDC) recommend that anyone who suspects they have vaginal candidiasis speak with a healthcare professional. This is because the symptoms are similar to those of other vaginal infections, which require different treatments.

A healthcare professional can ensure that a person gets the right medication for the infection. To identify vaginal candidiasis, they usually take a small sample of vaginal discharge for examination under a microscope.

Pregnancy and fluconazole

Pregnant people may want to avoid treating yeast infections with fluconazole due to the risk of birth abnormalities. According to an older safety announcement from the Food and Drug Administration (FDA), a single 150-microgram dose of fluconazole may not cause this effect, but taking it for longer periods or at a higher dosage carries this risk.

While a 2013 study did not find a significantly increased risk of birth abnormalities when pregnant people took fluconazole, a more recent cohort study from 2020 did find an association with fluconazole use during the first trimester and musculoskeletal malformations.

Pregnant individuals managing a yeast infection should discuss with their doctor about the risks of fluconazole, and other alternative treatments.

People can help prevent vaginal candidiasis by taking antibiotics only when they are necessary. It is worth remembering that antibiotics do not work on viral infections, such as a cold or the flu.

Antibiotics also do not work on some common bacterial infections, such as many types of bronchitis, sinus infections, and ear infections. A person should always speak with a healthcare professional before starting a course of antibiotics.

A few other ways to help prevent yeast infections include:

• wearing cotton undergarments
• avoiding feminine hygiene sprays
• avoiding scented tampons
• avoiding harsh soaps when cleaning the vagina
• using condoms during sex

In addition, there is some evidence that eating yogurt that contains live cultures every day or taking Lactobacillus acidophilus capsules may help prevent these infections.

While little high quality research has investigated this use of probiotics, many healthcare professionals recommend taking a probiotic supplement either during or immediately after completing a course of antibiotics to reduce the risk of a yeast infection.

Some types of antibiotics can lead to a vaginal yeast infection, which is a form of vaginitis known as vaginal candidiasis.

Antibiotics kill bacteria, which can upset the delicate balance of yeast and bacteria in the vagina. This allows the Candida fungus to multiply, leading to symptoms such as itching, burning, or pain during sex.

It is usually straightforward to treat yeast infections with OTC antifungal medications. However, anyone who suspects that they have this type of infection should consult a doctor to rule out other issues with similar symptoms.

ANTIBIOTICS: LIFE GOES ON | Science and life

Antibiotics entered the life of people more than half a century ago. Thanks to them, pneumonia, tuberculosis, gangrene and other infections have ceased to be deadly to humans. But even the most powerful antibiotics are not able to destroy all pathogenic bacteria. Nature does not tolerate emptiness. In the fight against drugs, bacteria “activated” the natural genetic mechanisms of resistance formation. As a result, new generations of microbes have appeared that are not affected by even the strongest drugs. Every year there are more and more “resistant” infections, so the efforts of physicians around the world are aimed at finding new methods to combat dangerous invulnerable bacteria. Scientists of the Moscow Research Institute for the discovery of new antibiotics (NIIINA) named after. G. F. Gause RAMS have achieved significant success in this.

English physician Alexander Fleming in 1928 suggested the existence of substances in fungal microorganisms that prevent the growth of bacteria.

In Fleming’s experiment, fungi produce substances that inhibit the growth of bacteria.

Staphylococcus aureus (Gram stain shown) is a bacterium that often becomes resistant to antibiotics.

G. F. Gause and M. G. Brazhnikova in the laboratory during the work on the creation of the first Soviet antibiotic gramicidin S. 1940s.

In the 19th century, the Moscow authorities allocated a territory on Devichye Pole for the construction of university clinics.

Table 1. *Tables compiled according to Professor Janos Berdi (Hungary), creator of the database on antibiotics and other biologically active substances.

Sulfur yellow tinder fungus forms a large amount of organic acids and at least three antibiotics effective against resistant forms of staphylococci. Photo by E. Ershova.

Table 2.

Lab-grown oak sponge tinder fungus is shaped like a coral. At least four antibiotics can be obtained from this tree fungus.

Omphalothus mushroom culture is grown in laboratory conditions on liquid media. Depending on the growing conditions and the composition of the nutrient medium, the fungus grows in different ways. Photo by O. Efremenkova.

Antibiotic illudin from omphalotus lamellar fungus is recognized as promising for antitumor therapy.

New domestic glycopeptide antibiotic eremomycin isolated from soil actinomycete.

Dung beetle fungus culture contains substances capable of destroying even resistant Staphylococcus aureus bacteria. Photo by O. Efremenkova.

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HISTORY OF THE DISCOVERY OF SUBSTANCES THAT DESTROY BACTERIA

In 1928, the English physician Alexander Fleming made a discovery that marked the beginning of a new era in medical science. He drew attention to the fact that many microbiologists had observed before him, but they did not attach any importance to the discovered phenomenon. On a dense nutrient medium in a Petri dish, the researcher grew colonies of bacteria. During the experiment, the so-called “flight” occurred: a spore of a fungus that accidentally got out of the air marked the beginning of the growth of a fungal colony among bacteria. But the most important thing was that around the fungal microorganisms, the bacteria suddenly stopped multiplying. Fleming suggested that the fungus colony releases a substance into the nutrient medium that prevents the growth of bacteria. His guess was completely confirmed. Later, Oxford University staff, Briton Howard Flory and Ernst Cheyne, a native of Germany, managed to isolate and determine the structure of the world’s first antibacterial substance, named penicillin after the fungus-producer belonging to the genus Penicillium. So humanity has acquired a tool to fight many deadly bacterial infections. Fleming, Flory and Chain at 1945 received the Nobel Prize for their discovery. Penicillin was followed by discoveries of other antibacterial substances.

The term “antibiotic” (translated from Greek – “against life”) was proposed in 1942 by an American microbiologist, a native of Russia, a specialist in soil microbiology Zelman Waksman. His name is also associated with the discovery of another well-known antibacterial substance – streptomycin, which is still used to treat tuberculosis. Both penicillin and streptomycin are produced by soil microorganisms (fungi and actinomycetes are the two main groups of antibiotic producers). But there are other organisms – producers of antibacterial substances . Currently, about 30,000 antibiotics of natural origin are known, synthesized by living beings of various taxonomic groups.

According to the most common definition in the scientific community, antibiotics are substances produced by various living organisms that are capable of destroying bacteria, fungi, viruses, ordinary and tumor cells or suppressing their growth. But this does not mean that all antibiotics that exist today are produced by living cells. Chemists have long learned to improve, enhance the antibacterial properties of natural substances, modifying them using chemical methods. The compounds thus obtained are classified as semi-synthetic antibiotics. Of the huge number of natural and semi-synthetic antibiotics, only about a hundred are used for medical purposes.

BACTERIA RESIST

After the discovery of antibiotics, doctors hoped that a little more and humanity would forever get rid of most infectious diseases. But everything turned out to be not so simple. The fact is that approximately two years after the start of the widespread use of an antibacterial drug in medical practice, pathogenic bacteria develop resistance to it. Such resistance, called resistance, is a hereditary response of microorganisms to antibiotics. From a biological point of view, according to Darwin’s theory, the development of resistance is nothing more than the result of an interspecies struggle for existence between a person and a pathogenic bacterium (or other target organism targeted by the use of an antibiotic). How does this happen? Populations of bacteria are constantly changing; during their reproduction, various mutations occur, including those due to which microorganisms acquire resistance to the drug used. Due to the high reproduction rate and large population size, the frequency of occurrence of mutations that provide antibiotic resistance is high enough for the surviving, that is, resistant forms, to compensate for the loss of the bacterial population. This is how new forms of resistant pathogens are born. If a person has become infected with a resistant strain of a pathogen, then it is useless to treat it with a previously used antibiotic.

Penicillin began to be used during World War II. Even then, doctors knew about new strains of bacteria, against which penicillin was powerless. Scientists have found that bacteria resistant to this antibiotic produce penicillinase enzymes that break down the penicillin molecule. Then doctors began to develop semi-synthetic antibiotics resistant to penicillinase. As a result, such derivatives of penicillin as methicillin, oxacillin, dicloxacillin, carbenicillin appeared in the arsenal of doctors.

The bacterium with the beautiful name “Staphylococcus aureus” ( Staphylococcus aureus ) is one of the most common pathogens in the human population. It causes various diseases: skin diseases (including pyoderma of newborns, pemphigus, dermatitis, abscesses, boils, panaritium, etc.), respiratory organs (tonsillitis, pleurisy, pneumonia are the most common), nervous system and sensory organs (meningitis, otitis, conjunctivitis, etc.), diseases of the digestive system (stomatitis, peritonitis, enteritis, enterocolitis, food poisoning), as well as arthritis, osteomyelitis, endocarditis, phlebitis, cystitis, urethritis, mastitis, orchitis and staphylococcal sepsis – primary or developing against the background of existing purulent foci. Staphylococcus is one of the main so-called hospital infections that occurs in clinics of various profiles, but the most dangerous in maternity hospitals.

Staphylococcus aureus strains resistant to penicillin and its semi-synthetic
analogues, appeared already at the stage of clinical trials of these drugs. Among
resistant bacterial populations – strains that are not affected by methicillin
(as well as oxacillin). These bacteria are called methicillin-resistant.
or MRSA (from English methicillin resistant Staphylococcus aureus ). Mechanism
the occurrence of this type of bacterial resistance to antibiotics is associated with a mutation
receptor protein on the cell surface: antibiotic molecules cannot attach
to the cell membrane of resistant bacteria. MRSA strains are not only resistant to
penicillins, but also to another large group of beta-lactam antibiotics – cephalosporins.
The term comes from the name of the fungus cephalosporium (Cephalosporium) ,
from which a compound of this class was first isolated. Later cephalosporins
were found in a number of fungi, as well as in actinomycetes and bacteria. But penicillins
and cephalosporins until recently were used in medical practice most
often. Moreover, some strains of Staphylococcus aureus in recent years
acquired resistance to many antibiotics. Such highly resistant populations
bacteria are designated by the English abbreviation MDR (multidrug resistant). Now
in the arsenal of physicians to combat MDR strains there is an antibiotic vancomycin.
But more and more often there are pathogenic bacteria that are immune to the effects of
almost all known drugs. The number of strains that “does not take”
no single drug, now reaches 2% of all cases of staph infections.

Bacteria of other species are also becoming resistant to drugs. For example, Pseudomonas aeruginosa (Pseudomonas aeruginosa ), a common causative agent of hospital infections, causes severe wound and burn infections, various inflammatory and hemorrhagic phenomena, mainly in young children and adults with weakened immune systems. According to the leading Russian specialist in the epidemiology of resistance, Professor S. V. Sidorenko, there are currently no effective antibiotics to treat approximately 20% of Pseudomonas aeruginosa strains, that is, there is simply nothing to treat every fifth patient.

PREREQUISITES FOR INVULNERABLE BACTERIA

Strains of resistant pathogenic bacteria appear in places where people with weakened immune systems gather. Therefore, super-resistant bacteria are most often found in hospitals, maternity hospitals, nursing homes, and prisons. Hence the term “hospital” or “nosocomial” infections. The longer the patient stays in the clinic, the higher the likelihood of contracting nosocomial infections.

The prevalence of such hospital-acquired infections varies by country, region, and over time. Thus, in the USA, the average incidence of hospital infections in pediatric intensive care units is 6.1%, and in France – 23.5%. In clinics in Moscow and St. Petersburg, the frequency of occurrence of a stable form of staphylococcus MRSA in 1998 ranged from 0 to 40%, and now in some metropolitan hospitals it reaches 80%.

In addition, pathogenic microorganisms resistant to most antibiotics have recently begun to spread among quite healthy people. The process is very difficult to control and even more difficult to prevent. For example, in the United States, scientists have found that resistant strains of Staphylococcus aureus MRSA spread among athletes who come into direct contact (for example, among wrestlers) or come into contact with some common object, such as a ball, as happens when playing handball or basketball. Cases of the spread of MRSA in school sports teams are described.

The more antibiotics are used, the more often bacteria that have lost their sensitivity to them appear and spread. Therefore, the uncontrolled use of antibacterial drugs without a doctor’s prescription is especially dangerous. Often, with a self-diagnosed cold, many begin to take antibiotics designed to treat bacterial infections. But we should not forget that the so-called cold can hide a variety of infectious diseases, including viral ones (for example, influenza), against which the use of antibacterial drugs is not only useless, but even harmful. There is no effect from such treatment, but the natural bacterial flora is disturbed in the body, as a result of which opportunistic infections can develop, such as candidiasis (uncontrolled growth of yeast fungi of the genus Candida ). In addition, there is an unjustified risk of the emergence of resistant bacterial strains in the body.

Another common mistake in treatment is that the patient, when feeling better, refuses the prescribed antibiotic ahead of time or takes it at a lower dose than the one prescribed by the doctor. This is dangerous in that it leads to an increase in the likelihood of developing drug resistance in a pathogenic bacterium; therefore, a subsequent attempt at treatment with the same antibiotic will be ineffective.

Sometimes, during treatment with antibacterial drugs, resistance to drugs is developed in bacteria that make up the human microflora. Such “self” resistant bacteria can transfer resistance genes to foreign bacteria that cause various diseases. As a result of interspecies exchange of genes, infectious agents also become resistant.

BACTERIA RESISTANCE CAN BE FIGHTED

The emergence and spread of resistant microorganism strains is controlled by regulating the use of antibiotics. In many developed countries, antibiotics are sold strictly by prescription. Other measures are being taken. Currently, the use of medical antibiotics for food preservation is prohibited worldwide. Cattle that have been treated with antibiotics or received them as growth stimulants should be slaughtered after the time of excretion of drugs from the body of the animal, that is, there should be no traces of the drug in the meat that goes on sale.

Another approach to the problem of resistance is the development of new drugs that can overcome bacteria that have become resistant to long-used drugs. It takes an average of 10 years to develop and introduce a new antibiotic. But despite this impressive period, scientific teams and pharmaceutical companies in many countries of the world continue to isolate and synthesize new antibacterial substances.

How feasible is the task of finding new natural antibiotics? It was mentioned above
that the main known producers of antibacterial compounds are soil
microorganisms – actinomycetes, bacteria and fungi. From 1950s to 1990s
For years, researchers have followed the beaten path, continuing to search for
new antibiotics in the same live microorganisms. This can be explained
not only by the inertia of thinking, but also by the fact that in those years the industrial base
made it possible to produce in fermenters on liquid nutrient media a huge amount of
microbial mass of soil microorganisms producing antibiotics.

But science does not stand still, and in the last fifteen to twenty years the spectrum of organisms that produce antibiotics has expanded (see Table 1). Among them now are not only soil microbes, but also many species of plants and animals. As potential manufacturers of antibiotics, higher fungi are very promising, especially those that can be cultivated under artificial conditions. The development of genetic engineering not only makes such objects interesting in theoretical terms, but also allows you to create cost-effective biotechnological production methods. To obtain large quantities of natural antibiotics, it is no longer necessary to grow and process tons of biomass (living organisms and higher plants). Antibacterial substances can be obtained by inserting the genes of the “desired” antibiotic into the bacterial genome. In the process of life, bacteria produce the desired medicinal substance, turning into a kind of pharmaceutical factory for the production of antibiotics.

An example of an antibiotic producing plant is the Pacific yew. Taxol, an anti-cancer antibiotic used to treat ovarian cancer, is isolated from its bark. The content of taxol in yew bark is only thousandths of a percent, so one therapeutic dose of the drug initially cost about a thousand dollars. Today, the price has fallen significantly due to the development of a method for obtaining taxol by biotechnological methods.

With the development of molecular biological methods for obtaining natural compounds, the search for new antibiotics even in the organisms of higher animals and plants has become quite economically justified. Moreover, the search range is practically unlimited. According to the Hungarian professor Janos Berdy, living organisms studied to some extent (and this does not mean that all of them have been thoroughly studied at the molecular level) make up only a small part of the biodiversity of our planet (see Table 2). The scientist believes that of the 8-10 million species of insects that exist in nature, only a tenth has been described, of one and a half million bacteria – six thousand.

In our time, it is even possible to discover new species of vertebrates, let alone
open microorganisms in general a great variety. For example, no more than 0.1-10% of the microorganisms present there are sown from the soil using traditional microbiological methods. The rest (the so-called “live, but not cultivated” microorganisms) have not yet been fully studied and represent an almost inexhaustible source of producers of new antibiotics.

FROM GRAMICIDIN TO EREMOMICIN

In our country, the development of antibacterial drugs began even before the Great Patriotic War. The first domestic original antibiotic gramicidin C (soviet gramicidin) isolated from soil bacterium Bacillus brevis var . G.-B., was discovered by Georgy Frantsevich Gause and Maria Georgievna Brazhnikova in 1942, and began to use it already during the war. This antibiotic is still used today, it is widely known under the trade name gramidin.

In 1953, in the Soviet Union, on the basis of the laboratory of antibiotics of the USSR Academy of Medical Sciences, the Research Institute for the Development of New Antibiotics of the Russian Academy of Medical Sciences was established, now named after G. F. Gause, who initiated research to search for new medicinal compounds. In total, during the first thirty years of the institute’s activity, scientists introduced 16 antibacterial and antitumor antibiotics into medical practice. In the difficult years of perestroika, the institute was headed by a student of G. F. Gauze, Corresponding Member of the Russian Academy of Medical Sciences Yuri Vasilyevich Dudnik. Thanks to his efforts, it was possible to almost completely preserve the scientific personnel and not interrupt research, and, unfortunately, not every scientific institution can boast of this. Now the institute is headed by Professor Maria Nikolaevna Preobrazhenskaya, a world-famous specialist in the chemical transformation of antibiotics.

For many years, soil bacteria actinomycetes have been the main objects of search for new antibacterial substances at the institute, and in recent years higher fungi have been added to them. Under the guidance of Professor Larisa Petrovna Terekhova, methods have been developed for the selective isolation of actinomycetes from the soil, which makes it possible to grow species that are not usually cultivated in the laboratory. For example, irradiation of soil with ultraviolet, microwave, and extremely high frequency (EHF) electromagnetic waves makes it possible to increase the probability of isolating representatives of rare genera of actinomycetes many times over. This is very important because, for example, the producer of the new antibiotic daptomycin occurs at a frequency of one bacterium in ten million.

With the help of new methods, 9280 organisms isolated from the natural environment have been studied at our institute over the past four years. Of these, 1,169 contained antibiotics effective against the resistant strain of Staphylococcus aureus MRSA. Scientists recognized 265 substances as the most promising from a pharmaceutical point of view and studied their chemical composition. Of these, 28 previously known antibiotics have been identified, and 36 have been recognized as new compounds. But only seven new antibiotics have shown a high therapeutic effect and low toxicity in animal experiments.

Higher fungi are also recognized as promising producers of antibiotics. For example,
In 1950, a broad-spectrum antibacterial antibiotic was described
illudin. This compound is formed by the agaric omphalotus Omphalotus
olearius growing on bark, on stumps or on the ground near olive trees,
and also near trees of some other deciduous species. However, due to the high
toxicity as a medicine, this antibiotic was not in demand then. In recent
years in the United States again began to conduct intensive research on the therapeutic effect
illudin and its synthetic derivatives. The drug has become one of the so-called
old new antibiotics, which have recently appeared quite a lot.
It turned out that illudin derivatives have a selective effect on
a number of tumor cells. NIIINA scientists are also working with a strain of omphalotus that produces
illudin, from the collection of cultures of cap mushrooms of the Institute of Botany. N. G. Kholodny
National Academy of Sciences of Ukraine.

Another example of an antibiotic producer is the well-known oyster mushroom ( Pleurotus ostreatus) . Like omphalotus, oyster mushroom grows on dead wood and on weakened trees. NIIINA employees found that this species produces at least eight antibiotics of various chemical nature and antimicrobial activity. The cascade of biosynthesis of medicinal substances begins on the fourth or fifth day of cultivation of the fungus in a liquid medium and continues for three weeks. Interestingly, the first to appear and then disappear in the process of cultivation is antifungal activity, which in nature helps oyster mushrooms compete with other fungi for a food source (wood).

Another fungus, sulfur-yellow tinder fungus, or “chicken on a tree” (Laetiporus sulphureus), also produces at least three antibiotics. They are effective against resistant forms of staphylococci. Another tree higher fungus, in which Russian researchers first discovered four antibiotics, is the oak sponge (Daedalea quercina) .

Antibacterial substances were found not only in wood-destroying fungi, but also in coprofils – dung beetles (genus Coprinus ). For the most part, these are small cap mushrooms with thin pulp, the fruiting bodies of which live from several hours to several days, and then blur into an inky liquid mass. A hundred years ago, ink was made from such blurry hats, which was a suspension of dark spores. The signature on documents made with such ink had an additional degree of reliability: it is difficult to fake it because the spores of a particular type of coprinus, visible under a magnifying glass, differ in shape and size from those of other coprinus, that is, it was ink “with a secret. ” Now in coprinus Coprinus congregatus , a new antibiotic belonging to the nemotin group was found, and in the dung beetle Coprinus lagopu – lagopodin B, non-toxic and effective against strains of resistant Staphylococcus aureus MRSA.

Thanks to the work of NIIINA scientists in Russia, after a 20-year break, the industrial production of a new glycopeptide antibiotic eremomycin is finally being established. This is the seventeenth development in the half-century existence of the institute. The introduction was preceded by a long way: first, an actinomycete strain was isolated from the soil, then its taxonomic affiliation was identified ( Amycolatopsis orientalis subsp. eremomycini ), established the spectrum of microorganisms sensitive to it, worked out the isolation procedure, established the chemical structure of the antibiotic, carried out selection, which made it possible to increase the productivity of the original strain (“wild”) many times over and create an industrial producer strain on its basis, developed a biosynthesis technology new antibiotic, studied its effect in vivo on animals , conducted clinical trials. The new domestic antibiotic eremomycin is effective against many resistant forms of pathogenic bacteria, including Staphylococcus aureus MRSA.

The phenomenon of bacterial resistance does not allow scientists and manufacturers to rest for long.
on laurels”, but requires the development and implementation of new and new effective drugs.
Unfortunately, in Russia for the last 20 years the biotechnology industry and related
with it, the production of medicines was in decline. Domestic
manufacturers, at best, decided to release the so-called generics –
analogues of foreign medicines, the license term of which has already expired. Meanwhile and with
in terms of the development of advanced technologies, and in terms of national security
the development and introduction of new antibiotics in the coming decades should become
one of the priority areas of Russian science and technology.

What preventive measures are taken to prevent the child from getting an infection?

author: PD Dr. med. Gesche Tallen, Dipl.-Biol. Maria Yiallouros, Erstellt am 2023/02/15, editor: Dr. Natalie Kharina-Welke, Translator: Dr. Natalie Kharina-Welke, Last modified: 2023/02/15

https://kinderkrebsinfo.de/doi/e121680

General Precautions

If there is an increased risk that the child may become infected, or the child already has neutropenia‎, the attending physicians inform his family about all the risks in such a situation: what can become a potential source of danger, what potential complications can be encountered, what must be observed in preventive to prevent the child from getting an infection. But even if all precautions were taken, no one can give a 100% guarantee that the child will not catch some kind of infection.

There is a risk of contracting an infection, for example, if there is close physical contact with other people or animals, when children play outside/in a playground with dirt, if they are injured by some kind of plant, or if they have eaten fruits or raw vegetables. It is also important that severely immunocompromised children do not come into contact with people who have an infectious disease or who are about to be vaccinated (live vaccine‎).

Good to know: general rules to avoid catching an infection are to follow hygiene measures such as washing your hands, regularly rinsing your mouth with disinfectants, not brushing your teeth with hard bristled brushes and not trimming your nails. It is necessary to constantly care for the skin with moisturizers. There should be no potted plants/flowers in the room. It is necessary to refuse nuts, as there may be fungal microorganisms and fungal spores.

If a child has a central venous catheter, then it must be carefully treated with antiseptic agents. All potential risks of infectious complications are discussed with the patient and his family by the attending physicians individually. How great these risks are depends mainly on each specific situation with the disease (that is, what exactly the child is ill with and at what stage the disease is), as well as how intensive the treatment is. More often than not, maximum precautions are required only at certain critical stages of treatment [SIM2001b‎].

Drug prevention of bacterial, viral and fungal infections

Certain pathogens (besides those we have already mentioned) are the most dangerous for patients with severely weakened immunity. This includes, for example, the pathogen “Pneumocystis carinii” (the microorganism Carini’s pneumocystis). It causes such a chronic disease as pneumocystis pneumonia, that is, chronic inflammation of the lungs, which is very difficult to treat. Also, measles, chicken pox, herpes and mold fungi can cause severe infectious complications. Therefore, cancer patients receive certain drugs as a prophylaxis in order to avoid infection with these fairly common pathogens of infectious diseases, which, as a rule, are not dangerous for a healthy person.

During the entire treatment for the prevention of pneumocystis pneumonia, children receive the antibiotic co-trimoxazole (the active ingredient is trimethoprim / sulfamethoxazole TPM / SMK, in the CIS countries this active ingredient is contained, for example, in biseptol). It is usually given three times a week (three days in a row, for example, at the end of the week on weekends). Children receive the drug in liquid form. This liquid lubricates the mucous membranes of the oral cavity. If the child has an individual intolerance to this drug, there are other options for preventive treatment (eg pentamidine inhalation). Co-trimoxazole is often not tolerated only because of the carrier substance attached to the antibiotic, and not because of the antibiotic itself. Therefore, if you change the drug, the active substance of this antibiotic can continue to be given.

When a child is neutropenic, and during very intensive treatment phases (induction/induction and reinduction/reinduction), children are treated prophylactically against molds and yeasts (Candida or Aspergillus) that cause fungal infections (for example, children get suspension of amphotorecin B). In addition, a sick child should not play on the street / in a playground with earth. During treatment, do not make repairs at home, or any kind of reconstruction work, because they are associated with a high risk of contracting a fungal infection for people with a weakened immune system.

It is also necessary to take precautions against possible certain virus infections. Immunocompromised children should not come into contact with people who have chicken pox (varicella virus) or shingles (varicella-zoster virus). Because infection with these viruses can be fatal to a child. If, nevertheless, there was an accidental contact with someone infected with these viruses, then the child must be treated with antiviral drugs (for example, acyclovir) to avoid infectious complications.

Aciclovir [GRA2001‎] [GRA2001a‎] [GRO2001‎] [GRO2001a‎] [SIM2001‎].

If radiation therapy of the spleen was necessary in the treatment, then after the end of the treatment it is necessary to vaccinate against certain certain bacteria [bacteria] (pneumococci, menigococci). There are situations when during treatment and after treatment, the child should be given antibiotics (penicillin) as a prophylaxis.

sources of information

[SIM2001b]
Simon A, Fleischhack G: Non-pharmacologic strategies to prevent and control infectious complications in pediatric hematology/oncology patients.