What are the main uses of ampicillin. How is ampicillin dosage determined. What are the common side effects of ampicillin. Are there any serious warnings associated with ampicillin use. How does ampicillin interact with other medications.

Understanding Ampicillin: An Overview of the Antibiotic

Ampicillin is a widely prescribed antibiotic belonging to the penicillin class of drugs. It’s primarily used to combat various bacterial infections by inhibiting bacterial cell wall synthesis. Available as a generic medication, ampicillin comes in multiple forms, including oral capsules, oral suspension, and intravenous formulations.

Why is ampicillin so frequently prescribed? The drug’s broad-spectrum activity against many types of bacteria makes it a versatile choice for treating a range of infections. However, its use requires careful consideration of potential side effects and drug interactions.

Key Features of Ampicillin

• Available as a generic drug
• Belongs to the penicillin class of antibiotics
• Comes in oral and intravenous forms
• Used to treat various bacterial infections
• May be part of combination therapy

The Mechanism of Action: How Ampicillin Fights Infections

How does ampicillin work to combat bacterial infections? Ampicillin’s mechanism of action involves interfering with bacterial cell wall synthesis. By binding to specific proteins called penicillin-binding proteins (PBPs), ampicillin prevents the formation of peptidoglycan cross-links in the bacterial cell wall. This weakens the cell wall, ultimately leading to bacterial cell lysis and death.

Is ampicillin effective against all types of bacteria? While ampicillin has a broad spectrum of activity, it’s particularly effective against many gram-positive and some gram-negative bacteria. However, its efficacy can be limited by bacterial resistance mechanisms, such as the production of beta-lactamase enzymes that can inactivate the drug.

Bacteria Commonly Targeted by Ampicillin

• Streptococcus pneumoniae
• Haemophilus influenzae
• Escherichia coli
• Proteus mirabilis
• Neisseria meningitidis

Indications and Uses: When Is Ampicillin Prescribed?

Ampicillin is prescribed for a variety of bacterial infections affecting different parts of the body. Its broad-spectrum activity makes it suitable for treating infections of the respiratory tract, urinary tract, gastrointestinal system, and more. In some cases, ampicillin may be used as part of a combination therapy to enhance its effectiveness or broaden its coverage.

Can ampicillin be used for viral infections? It’s crucial to understand that ampicillin, like all antibiotics, is ineffective against viral infections such as the common cold or flu. Misuse of antibiotics for viral infections can contribute to antibiotic resistance, a growing global health concern.

Common Infections Treated with Ampicillin

1. Respiratory tract infections (e.g., pneumonia, bronchitis)
2. Urinary tract infections
3. Meningitis
4. Gastrointestinal infections
5. Skin and soft tissue infections
6. Endocarditis

Dosage and Administration: Ensuring Proper Use of Ampicillin

The dosage of ampicillin can vary significantly depending on several factors, including the type and severity of infection, the patient’s age and weight, and their kidney function. It’s crucial to follow the prescribed dosage regimen carefully to ensure effective treatment and minimize the risk of side effects or antibiotic resistance.

How often should ampicillin be taken? Typically, ampicillin is administered every 6 hours (four times a day) for most infections. However, the frequency may be adjusted based on the specific condition being treated and individual patient factors.

General Dosage Guidelines for Adults

• Mild to moderate infections: 250-500 mg every 6 hours
• Severe infections: 1-2 g every 4-6 hours
• Maximum daily dose: 14 g

For children, dosages are typically calculated based on body weight. It’s essential to consult with a healthcare provider for precise dosing instructions, as they may vary depending on the specific circumstances.

Side Effects: Recognizing and Managing Adverse Reactions

While ampicillin is generally well-tolerated, it can cause a range of side effects, from mild to severe. Understanding these potential adverse reactions is crucial for patients and healthcare providers to monitor treatment progress and ensure patient safety.

What are the most common side effects of ampicillin? The most frequently reported side effects include gastrointestinal disturbances such as nausea, vomiting, and diarrhea. Skin rashes are also relatively common, particularly in patients with mononucleosis or certain viral infections.

Common Side Effects of Ampicillin

• Nausea and vomiting
• Diarrhea
• Skin rash
• Oral thrush (candidiasis)
• Headache

While these side effects are usually mild and resolve on their own, it’s important to report persistent or severe symptoms to a healthcare provider. In some cases, adjusting the dosage or switching to an alternative antibiotic may be necessary.

Serious Side Effects Requiring Immediate Medical Attention

1. Severe allergic reactions (anaphylaxis)
2. Severe skin reactions (e.g., Stevens-Johnson syndrome)
3. Clostridium difficile-associated diarrhea
4. Liver problems
5. Blood disorders

These serious side effects are rare but can be life-threatening. Patients should be educated about the signs and symptoms of these reactions and instructed to seek immediate medical attention if they occur.

Drug Interactions: Navigating Potential Complications

Ampicillin can interact with various medications, altering its effectiveness or increasing the risk of side effects. Understanding these interactions is crucial for healthcare providers when prescribing ampicillin and for patients to avoid potential complications.

Which drugs are known to interact with ampicillin? Several types of medications can interact with ampicillin, including other antibiotics, anticoagulants, and certain oral contraceptives. Some interactions may require dose adjustments, while others may necessitate using alternative medications.

Notable Drug Interactions with Ampicillin

• Probenecid: May increase ampicillin levels in the blood
• Allopurinol: Increased risk of skin rash
• Oral contraceptives: Reduced effectiveness of birth control
• Certain antibiotics (e.g., chloramphenicol, macrolides): May reduce ampicillin’s effectiveness
• Methotrexate: Increased risk of methotrexate toxicity

It’s essential for patients to inform their healthcare providers about all medications, supplements, and herbal products they are taking to avoid potential drug interactions. In some cases, alternative treatments or dose adjustments may be necessary to manage these interactions effectively.

Special Considerations and Warnings: Ensuring Safe Use of Ampicillin

While ampicillin is generally safe and effective when used appropriately, there are several important considerations and warnings that patients and healthcare providers should be aware of to ensure safe use of the medication.

Can ampicillin be used during pregnancy? Ampicillin is generally considered safe for use during pregnancy and is classified as FDA pregnancy category B. However, as with all medications during pregnancy, it should be used only when clearly needed and under the guidance of a healthcare provider.

Important Warnings and Precautions

1. Allergic reactions: Patients with a history of penicillin allergy should not use ampicillin without careful evaluation by a healthcare provider.
2. Antibiotic resistance: Complete the full course of treatment as prescribed to reduce the risk of developing antibiotic-resistant bacteria.
3. Superinfections: Prolonged use of ampicillin may lead to overgrowth of non-susceptible organisms, including fungi.
4. Renal impairment: Dosage adjustments may be necessary for patients with kidney problems.
5. Mononucleosis: Ampicillin can cause a rash in patients with mononucleosis and should be avoided in these cases.

Healthcare providers should carefully consider these factors when prescribing ampicillin and monitor patients closely for any signs of adverse reactions or treatment failure.

Antibiotic Stewardship: Promoting Responsible Use of Ampicillin

Antibiotic resistance is a growing global health concern, and responsible use of antibiotics like ampicillin is crucial to preserve their effectiveness for future generations. Antibiotic stewardship programs aim to promote the appropriate use of antibiotics, minimize the development of resistance, and improve patient outcomes.

How can patients contribute to antibiotic stewardship? Patients play a vital role in antibiotic stewardship by following prescribed treatment regimens, not sharing antibiotics with others, and not saving leftover antibiotics for future use.

Key Principles of Antibiotic Stewardship

• Use antibiotics only when necessary and prescribed by a healthcare provider
• Complete the full course of antibiotics as prescribed
• Do not use antibiotics for viral infections
• Practice good hygiene to prevent the spread of infections
• Stay up to date with vaccinations to prevent bacterial infections

By adhering to these principles, patients can help ensure that ampicillin and other antibiotics remain effective tools in the fight against bacterial infections. Healthcare providers also play a crucial role by prescribing antibiotics judiciously and educating patients about their proper use.

In conclusion, ampicillin is a valuable antibiotic with a wide range of applications in treating bacterial infections. However, its use requires careful consideration of potential side effects, drug interactions, and the principles of antibiotic stewardship. By understanding these aspects, patients and healthcare providers can work together to maximize the benefits of ampicillin while minimizing risks and contributing to the global effort to combat antibiotic resistance.

Side Effects, Dosage, Uses, and More

Highlights for ampicillin

1. Ampicillin oral capsule is available as a generic drug only.
2. Ampicillin also comes as an oral suspension as well as in an intravenous form, which is only given by a healthcare provider.
3. Ampicillin oral capsule is used to treat infections that are caused by certain types of bacteria.

• Prescription completion warning:Finish all of your medication as prescribed by your doctor. Don’t stop taking your drug or skip doses if you start to feel better. Doing so could make your infection last longer. You could also become resistant to the drug. That means if you get another bacterial infection, ampicillin may not work to treat it.
• Diarrhea warning:This drug may cause diarrhea. Call your doctor if you have bloody or watery diarrhea with or without stomach cramps and fever after you stop taking this drug.

Ampicillin oral capsule is a prescription drug that’s only available in a generic form. Ampicillin also comes as an oral suspension and in an intravenous (IV) form, which is only given by a healthcare provider.

Why it’s used

Ampicillin is used to treat infections that are caused by certain types of bacteria. Ampicillin may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

Ampicillin belongs to the drug class penicillins. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Ampicillin works by killing bacteria to stop the infection from growing in your body.

Ampicillin oral capsule doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects of ampicillin oral capsule can include:

• nausea
• vomiting
• diarrhea
• rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Allergic reactions. Symptoms can include:
  • flu-like symptoms, such as fever and body aches
  • painful red or purple rash that spreads
  • blisters that could lead to skin breakdown
• Diarrhea that lasts after you stop taking the drug. Symptoms can include:
  • diarrhea with or without stomach cramps
  • diarrhea with a fever

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Ampicillin oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with ampicillin oral capsule are listed below.

Interactions that increase your risk of side effects

Increased side effects from ampicillin: Taking ampicillin with certain medications raises your risk of side effects from ampicillin. This is because the amount of ampicillin in your body may be increased. Examples of these drugs include:

• Probenecid
  • Taking this drug with ampicillin can cause more side effects. These can include severe nausea, vomiting, and diarrhea.
• Allopurinol
  • This drug increases the risk of skin rash when you take it with ampicillin.

Interactions that can make your drugs less effective

When ampicillin is less effective: When you take ampicillin with certain antibiotics, it may not work as well to treat your condition. This is because these antibiotics stop the growth of bacteria, and ampicillin needs bacteria to grow in order to kill them. Examples of these drugs include:

• Chloramphenicol, macrolides, sulfonamides, and tetracyclines

When other drugs are less effective: When certain drugs are used with ampicillin, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples include:

• Oral contraceptives (birth control pills)
  • Your doctor may prescribe a different form of birth control for you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergies

Ampicillin can cause a severe allergic reaction. Symptoms can include:

• rash
• trouble breathing
• swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Do not take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

Warnings for people with certain health conditions

For people with gonorrhea and syphilis: This drug alone won’t treat syphilis. You must receive an injectable dose of penicillin if you have gonorrhea and syphilis.

For people with diabetes: This drug may cause a false positive when your doctor tests you for glucose (sugar) in your urine. That means the test may say you have glucose in your urine when you really don’t. Ask your doctor if this drug is safe for you.

For people with kidney problems: If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of drug in your body and cause more side effects.

Warnings for other groups

For pregnant women: Ampicillin is a category B pregnancy drug. That means two things:

1. Research in animals has not shown a risk to the fetus when the mother takes the drug.
2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies do not always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

Call your doctor right away if you become pregnant while taking this drug.

For women who are breastfeeding: Ampicillin may pass into breast milk and cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: Newborns and infants should take the lowest dosage of this drug possible. This is because their kidneys aren’t fully developed. It may take longer for this drug to be removed from their bodies. This means it can cause more side effects.

This dosage information is for ampicillin oral capsule. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

The dosage information below is for the conditions that this drug is most often prescribed to treat. This list may not contain all conditions that your doctor can prescribe this drug for. If you have questions about your prescription, talk with your doctor.

Forms and strengths

Generic: Ampicillin

• Form: oral capsule
• Strengths: 250 mg, 500 mg

Dosage for genitourinary tract infections or gonorrhea

Adult dosage (ages 18–64 years)

For genitourinary tract infections other than gonorrhea:

• Typical dosage is 500 mg four times per day.
• Severe or chronic infections may require larger doses.

For gonorrhea:

• Typical dosage is 3.5 grams once, with 1 gram of probenecid.

Child dosage (children who weigh more than 20 kg)

For genitourinary tract infections other than gonorrhea:

• Typical dosage is 500 mg four times per day.

Child dosage (children who weigh 20 kg or less)

For genitourinary tract infections:

• Typical dosage is 100 mg/kg per day in four equally divided and spaced doses.

For gonorrhea:

• Typical dosage is 3.5 grams as a single dose.

Child dosage (children who weigh less than 20 kg)

For genitourinary tract infections:

• Typical dosage is 100 mg/kg per day in four equally divided and spaced doses.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for respiratory tract infections

Adult dosage (ages 18–64 years)

• Typical dosage is 250 mg four times per day.

Child dosage (children ages 0–17 years who weigh more than 20 kg)

• Typical dosage is 250 mg four times per day.

Child dosage (children ages 0–17 years who weigh 20 kg or less)

• Typical dosage is 50 mg/kg per day in equally divided and spaced doses three to four times per day.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for gastrointestinal tract infections

Adult dosage (ages 18–64 years)

• Typical dosage is 500 mg four times per day.

• Typical dosage is 500 mg four times per day.

Child dosage (children who weigh more than 20 kg)

• Typical dosage is 500 mg four times per day.

Child dosage (children who weigh 20 kg or less)

• Typical dosage is 100 mg/kg per day in four equally divided and spaced doses.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for meningitis

Adult dosage (ages 18–64 years)

Your doctor will decide the dosage that’s right for you.

Child dosage (ages 0–17 years)

Your child’s doctor will decide the dosage that’s right for your child.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Ampicillin oral capsule is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your bacterial infection may not get better. It may even get worse.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

Finish all of your medication that your doctor prescribes. Don’t stop taking your drug or skip doses if you start to feel better. Doing so could make your infection last longer. You could also become resistant to the drug. This means that if you get another bacterial infection, ampicillin may not work to treat it.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include upset stomach and diarrhea.

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of your infection will get better.

Keep these considerations in mind if your doctor prescribes ampicillin oral capsule for you.

General

• Don’t take this drug with food.
• Take this drug with 8 oz. of water 30 minutes before eating or two hours after eating.

Storage

• Store the capsules at room temperature between 68°F and 77°F (20°C and 25°C).
• Store them away from light.

Refills

A prescription for this medication is refillable. You should not need a new prescription to refill this medication. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will likely monitor certain health issues during your treatment. This can help make sure you stay safe while you take this drug. These issues include:

• Kidney function. Your doctor may do blood tests to check how well your kidneys are working. If your kidneys don’t work well, your doctor may reduce how often you take this drug.
• Liver function. Your doctor may do blood tests to check how well your liver is working. If your liver doesn’t work well, your doctor may lower your dosage of this drug.
• Blood cell counts. Your doctor may do blood tests to check if this drug is reducing your red blood cell and platelet levels. If it is, your doctor may lower your dosage or stop your treatment with the drug.
• Syphilis. If you have gonorrhea, your doctor will also test for you for syphilis. They’ll do this when you start the drug and then again three months later. This is because treatment for gonorrhea can mask symptoms of syphilis.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Alcohol and Amoxicillin: Find More Information

While it is less dangerous to drink alcohol while taking Amoxicillin than it is to drink with many other drugs, it is still highly recommended that potential drinkers abstain.

Understanding Amoxicillin

Amoxicillin, sometimes called Amoxil, is an antibiotic similar to penicillin that treats bacterial infections, including ones plaguing the ears, nose, skin, urinary tract, lungs, and throat.

Patients needing relief for bacterial infections can take Amoxicillin orally via extended-release tablets or immediate-release tablets. Both types of oral tablets can either be chewed or swallowed. The typical strength of Amoxicillin dosage is 500mg or 875mg, and doses are taken anywhere between 8 to 12 hours with food.

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Common And Short-Term Effects Of Amoxicillin

Amoxicillin has both short and long-term effects that varying in severity. The effects of Amoxicillin are generally mild to moderate depending on the individual’s sensitivity to the drug. If someone is hypersensitive to Amoxicillin, he or she may endure the following symptoms:

• Vomiting
• Diarrhea
• Discharge
• Rashes
• Black, swollen hairy tongue
• Stomach pain
• Dizziness
• Headache
• Yeast infections
• Nausea

The effects of Amoxicillin can vary based on whether or not the individuals have surpassed their recommended dosage. Side effects like diarrhea can lead to other symptoms like dehydration. Dehydration is a special concern when Amoxicillin is combined with alcohol, which also causes dehydration. Headaches can increase irritability and distract patients from completing every day activities, which can also be made worse with alcohol. Usually, short-term of non-life-threatening side effects disappear within days or weeks.

Less Common And Long-Term Effects Of Amoxicillin

Individuals can experience breathing problems, problems urinating, or have seizures as a result of Amoxicillin. Allergic reactions can produce rashes on the skin and discomfort to the individual. There are other symptoms that are problematic, including:

• Dark urine/problems urinating
• Bruising and abnormal bleeding
• Asthma
• Menstrual problems
• Jaundice
• Liver damage
• Flu-like symptoms
• Open sores from exposed blisters

The long-term effects from Amoxicillin can worsen depending on how often someone uses the medication. If someone combines Amoxicillin with another prescription medication or substance like alcohol, symptoms can become more complex due to both chemicals reacting.

Additionally, individuals suffering diabetes or kidney disease can increase their likelihood of effects such as dark urine (diabetes) or worsening kidney disease. Other long-term effects of Amoxicillin include brain fog, depression, hallucinations, and psychotic disorders. The latter effects are more common in Amoxicillin and Clarithromycin combinations.

Alcohol And Amoxicillin

Although it is comparatively less dangerous to drink while taking Amoxicillin, patients taking an antibiotic with alcohol should always be careful. Alcohol can weaken your immune system, leaving you vulnerable to bacteria. Doctors typically discourage patients to use alcohol while drinking, as individuals can increase the time it takes to recover and endure increased side effects. If someone binge drinks and takes Amoxicillin, he or she is exposing him or herself to challenging side effects ranging from blacking out, aggressive behavior, and alcohol dependence. At worse, alcohol dependences can encourage a tolerance, and possibly an alcohol use disorder.

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Fighting off a substance use disorder, or combining medications with other chemicals can be dangerous. If you or a loved one cannot taper use, or seek to mix medications, this can be harmful. You may risk having a substance use disorder and may not realize it. Contact a treatment provider who can discuss treatment options with you. Facilities offer a safe space for individuals to heal with counseling, peer groups, and medications.

On the medical front: how a Soviet antibiotic saved hundreds of thousands of soldiers | Articles

One of the first Soviet antibiotics, gramicidin C, played a huge role in saving many thousands of lives on the fronts of the Great Patriotic War. The medicine in the form of a paste for external use did not allow the wounded to die from purulent infections, gangrene and burns, and killed dangerous streptococcal and staphylococcal bacteria. The drug was handed over to the allies of the anti-Hitler coalition in 1944; Margaret Thatcher studied it while defending her dissertation in chemistry. Izvestia for the first time publishes archival documents related to the creation and production of this medicine.

Born in 1942

Despite the fact that the world’s first antibiotic, penicillin, was discovered back in 1928, by the beginning of the Great Patriotic War it was unavailable in the Soviet Union. In the USSR, the first samples of this substance were obtained in 1942. The drug was called crustosin, since its active substance was isolated by microbiologist Zinaida Yermolyeva from a strain of the fungus species Penicillium crustosum. But it was not the only antibiotic created at the beginning of the war. In the same 1942, microbiologists Georgy Gause and Maria Brazhnikova managed to obtain a domestic drug called gramicidin C.

Photo: from the archives of the Institute for the Research of New Antibiotics. G.F. Gause

Maria Brazhnikova

– The drug was created in Moscow, at the Institute of Malaria and Medical Parasitology, – Associate Professor of the Department of Pharmaceutical and Toxicological Chemistry named after Izvestiya told Izvestia. A.P. Arzamastseva of the Institute of Pharmacy of the Sechenov University Vera Kuzina. – The name of the drug reflected its action: the first part of the name means that it kills gram-positive bacteria. The second part – cidin – comes from the Latin caedo (to kill). The letter C in the name of the antibiotic meant “Soviet”, it was needed in order to distinguish the version of the drug from gramicidin, discovered earlier in the United States.

Researcher Maria Brazhnikova described the atmosphere of the search in her memoirs: “All the tables in the laboratory were filled with flat glass plates, the so-called Petri dishes. On other tables were placed racks with test tubes filled with earth. Samples were collected everywhere – in yards, gardens, landfills, in forests and fields of the Moscow region. The employees’ pockets were full of small parcels of earth. The earth was brought to the laboratory, poured into test tubes, and a little water was poured into each test tube to make an “earth porridge”.

The scientists then poured a nutrient medium containing meat broth and sugar into Petri dishes. A drop of suspension containing thousands of dangerous microbes (separately prepared staphylococci) was placed on the surface of a solidified nutrient medium, and then a drop of “earth porridge” from a test tube was applied there. The cups inoculated in this way were kept in a thermostat at a certain temperature.

Photo: from the archive of the Institute for the Research of New Antibiotics. G.F. Gauze

George Gauze

After a certain time, dozens of differently colored dots grew on the surface of the jelly: yellow colonies of staphylococci mixed with red, blue and white colonies of soil microbes. Around some colonies of soil microbes, a “desert zone” could be clearly distinguished. They protected themselves by releasing into the environment a substance that suppressed all life. This was the same antibiotic that saved tens of thousands of lives during the war years.

Combat tests

Medicine based on the obtained substance immediately began to be used in military medicine. Scientists did not have any opportunity to conduct any preclinical or clinical trials that are mandatory today, thousands of wounded Soviet soldiers ended up in military hospitals every day, and they needed help immediately.

“During the difficult years of the war, our scientists established the antibacterial properties of gramicidin,” the head of the sector for the search for natural compounds that overcome the resistance of bacteria, the Research Institute for the Development of New Antibiotics named after Izvestia, told Izvestia. G.F. Gauze Olga Efremenkova. – An important difference between gramicidin C and other antibiotics was that resistance of pathogenic microorganisms practically does not develop to it. A significant drawback of the drug was its high toxicity, so it could only be used externally. It was applied to the body of the wounded in the form of a paste.

Photo: from the archives of the Institute for the Research of New Antibiotics. G.F. Gause

However, even in this form, the drug was so effective in the treatment of purulent infections that already in 1943 the People’s Commissariat of Health of the RSFSR issued an order on its mass production and delivery to the front (Fig. 1).

During the war years, this local antibiotic helped Soviet soldiers and civilians fight purulent-inflammatory infections of soft tissues and skin, including those that arose after wounds, ulcers, bedsores, and osteomyelitis. He has proven himself well in furunculosis and carbuncles – frequent companions of heavy military service and difficult living conditions of the civilian population during the war. It was also used to prevent and treat microbial contamination of burn wounds in our soldiers.

Letter from across the ocean

The fame of the effectiveness of Soviet gramicidin quickly spread beyond the USSR. In 1945, the Institute of Malaria and Tropical Diseases received a letter from the Rockefeller Institute for Medical Research (New York). René Dubos turned to George Gause for help, it was he who isolated the first gramicidin from soil bacteria in 1939.

“As you can imagine, I am extremely interested in your work with Brazhnikova concerning the Soviet gramicidin,” says the letter in the possession of Izvestia. “Of course, we are very eager to compare your culture and your substance with our own, and I would like to know if you could not find it possible to send us a culture of a microbe isolated from Russian soil.”

Dubos also told Russian microbiologists that a large number of gramicidin factories were being built in America, and if the Soviet strain proved to be more effective, it would make sense to produce it in order to save the lives of soldiers.

Photo: from the archive of the Institute for the Research of New Antibiotics. G.F. Gause

Studies of Soviet gramicidin led by biochemist Andrey Belozersky showed that the active substance is a protein. However, further scientific studies of the structure of this substance were required. To this end, within the framework of cooperation between the allies, the USSR Ministry of Health in 19In 1944, he donated a sample of a new antibiotic to the Lister Medical Institute (London). There he was engaged in the famous biochemist Richard Sing. Interestingly, the chemist Margaret Thatcher, who later became Prime Minister of Great Britain, took part in crystallographic studies on the structure of gramicidin C. She was involved in the study of gramicidin while writing her dissertation.

“Gramicidin C had significant advantages over the American namesake: it had a simpler amino acid composition, a wider spectrum of antibacterial action and higher resistance to external influences,” Vladimir Chubarev, professor at the Department of Pharmacology at the Institute of Pharmacy of Sechenov University, explained to Izvestia. – Thousands of soldiers of the Soviet army were saved and returned to duty thanks to gramicidin C. When treating the wounded during the war, they found that this medicine inhibits the growth of streptococci, staphylococci, pneumococci, anaerobic infection pathogens.