Groups of antibiotics and side effects of antibiotics

What is an antibiotic?

Antibiotics are substances of either biological or semi-synthetic origin that can have a negative effect (inhibit the vital activity or cause complete death) of various pathogenic microorganisms (usually bacteria, less often protozoa, etc.).

The main natural producers of antibiotics are molds - penicillium, cephalosporium and others (penicillin, cephalosporin); actinomycetes (tetracycline, streptomycin), some bacteria (gramicidin), higher plants (phytoncides).

There are two main mechanisms of action of antibiotics:

1) Bactericidal mechanism - complete suppression of bacterial growth through action on the vital cellular structures of microorganisms, therefore causing their irreversible death. They are called bactericidal, they destroy microbes. For example, penicillin, cephalexin, and gentamicin can act in this way. The effect of the bactericidal drug will come faster.

2) The bacteriostatic mechanism is an obstacle to the proliferation of bacteria, the growth of microbial colonies is inhibited, and the body itself, more precisely, the cells of the immune system - leukocytes, have a destructive effect on them. This is how erythromycin, tetracycline, and chloramphenicol act. If you do not complete the full course of treatment and stop taking the bacteriostatic antibiotic early, the symptoms of the disease will return.

Viruses instead of antibiotics. How to deal with superinfections

MOSCOW, April 11 - RIA Novosti, Alfiya Enikeeva. For some time now, pathogenic bacteria have begun to develop resistance to the last reserve antibiotic - colistin.

It is used in cases where other drugs are powerless against infectious agents.

Indestructible microorganisms have appeared even in the Arctic, and the World Health Organization has compiled a list of the 12 most dangerous superbugs, a remedy for which must be found now.

Global threat

According to British researchers, by 2050 the number of deaths from antibiotic-resistant superbugs will increase from today's seven hundred thousand to ten million per year.

Most often, according to WHO experts, people will die from carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii.

All these pathogens are associated with so-called nosocomial infections, which patients contract in hospitals and clinics where they are treated for other diseases.

Also among the most dangerous superbugs, according to WHO, were enterococci (Enterococcus faecium), Staphylococcus aureus (MRSA), gonococcus and clarithromycin-resistant Helicobacter - pathogens that cause meningitis, blood poisoning, pneumonia, gonorrhea and urinary tract infections.

Judging by the experiment of Harvard scientists, resistance to drugs is developing rapidly in these microorganisms. In just 11 days, the ordinary E. coli Escherichia coli adapted to a thousand-fold dose of antibiotics and actually turned into a supermicrobe, practically invulnerable to any existing drugs.

Find a new antibiotic

Theoretically, scientists can create a drug against bacteria that are insensitive to current antibiotics, but its development and testing may take many years. And this, in turn, may be financially unprofitable for pharmaceutical companies.

A way out of this situation was proposed by researchers from MIPT, Moscow State University and the Institute of Biochemistry and Genetics of the Russian Academy of Sciences, who came up with a semi-automatic method for searching for a new class of antibiotics. It is based on the analysis of how certain substances act on pathogenic microorganisms and destroy them.

Scientists tested the effect of almost 125 thousand compounds on a strain of Escherichia coli and identified 688 substances with pronounced antibacterial activity. Some of them had the same substructural 2-pyrazol-1-yl-thiazole group.

This means that compounds belonging to this class may be effective in the fight against drug-resistant bacteria.

The researchers then analyzed eight molecules belonging to this group that destroyed microorganisms by blocking their protein synthesis. Among the substances studied, only one did not exhibit a cytotoxic effect and hypothetically did not pose a danger to humans. However, it still needs to be carefully studied and tested in model animals, the authors of the work note.

Viruses vs bacteria

American scientists propose to fight microorganisms resistant to antibiotics using bacteriophages - viruses that selectively infect bacterial cells. True, such therapy should use particles created specifically for a specific strain of the pathogen.

Experts have already helped a patient suffering from cystic fibrosis and chronically infected with an antibiotic-resistant strain of Mycobacterium abscessus in a similar way. At the beginning of 2020, the girl underwent a bilateral lung transplantation, and then a dangerous mycobacterium was discovered in the tests, which caused the postoperative wound to fester.

Antimicrobial therapy for seven months did not produce any results.

Then the scientists selected three phages that were the most aggressive towards the pathogenic microorganism, mixed them and tested the effect of the created drug on a culture of Mycobacterium abscessus strain GD01, which was isolated from the patient a month after the operation. The resulting mixture did not leave a single bacteria alive, even at high concentrations.

A combination of three bacteriophages was then administered intravenously to the patient every 12 hours for 32 weeks. As a result, her condition improved significantly: the postoperative wound began to heal, and the dangerous bacteria no longer appeared in the sputum and blood.

However, the authors of the article warn: it is too early to talk about the effectiveness of treatment with bacteriophages, because this is an isolated clinical case. However, the medical literature has already described successful treatment of infections caused by superbugs using antibiotics and bacteriophage.

Artificial and effective

Chinese, American and Singaporean scientists have synthesized a substance that can destroy several antibiotic-resistant bacteria at once, including Pseudomonas aeruginosa and Staphylococcus aureus (MRSA).

We are talking about a biodegradable polycarbonate polymer with guanidine functional groups, whose molecules can bind to the bacterial membrane and, without destroying it, penetrate into the cell. There, guanidine disrupts the structure of cytoplasmic proteins, and they precipitate, killing the bacterium.

The researchers tested the new drug on rat red blood cells and embryonic human kidney cells. The polymer turned out to be absolutely non-toxic for the former and less toxic for the latter than the antibiotic polymyxin B, used today in the treatment of bacterial infections.

In addition, the new compound completely decomposed within three days, and its decay products were harmless.

In addition, it turned out that the polymer created by scientists is not addictive to dangerous microorganisms. Experts treated a culture of Acinetobacter baumannii, the causative agent of pneumonia, with this compound in concentrations that allowed some bacteria to survive.

Then a new crop was grown from them and again treated with polycarbonate. And so thirty times in a row. However, even after this, the microbes did not develop resistance to the polymer.

For comparison, the bacteria developed resistance to the antibiotic, which is usually used against Acinetobacter baumannii, in eight cycles.

The authors of the work intend to test the polymer they created on humans in the future.

Source: https://ria.ru/20200411/1569880170.html

What types of antibiotics are there?

I. By mechanism of action: - Bactericidal antibiotics (penicillin group, streptomycin, cephalosporins, aminoglycosides, polymyxin, gramicidin, rifampicin, ristomycin) - Bacteriostatic antibiotics (macrolides, tetracycline group, chloramphenicol, lincomycin)

II. According to the spectrum of action: - Broad spectrum of action (prescribed for an unknown pathogen, they have a wide spectrum of antibacterial action on many pathogens, but there is a small probability of death of representatives of the normal microflora of various body systems). Examples: ampicillin, cephalosporins, aminoglycosides, tetracycline, chloramphenicol, macrolides, carbapenems. - Narrow spectrum of action: 1) With a predominant effect on gr+ bacteria and cocci - staphylococci, streptococci (penicillins, cephalosporins of the 1st-2nd generation, lincomycin, fusidine, vancomycin); 2) With a predominant effect on gr-bacteria, for example, E. coli and others (III generation cephalosporins, aminoglycosides, aztreonam, polymyxins). *- gram + or gram- differ from each other in Gram staining and microscopy (gram+ are stained purple, and gram- reddish). — Other narrow-spectrum antibiotics: 1) Antituberculosis (streptomycin, rifampicin, florimitsin) 2) Antifungal (nystatin, levorin, amphotericin B, batrafen) 3) Antiprotozoa (monomycin) 4) Antitumor (actinomycins)

III. By generation: There are antibiotics of 1st, 2nd, 3rd, 4th generations. For example, cephalosporins, which are divided into 1st, 2nd, 3rd, 4th generation drugs:

I generation: cefazolin (kefzol), cephalothin (keflin), cephaloridine (zeporin), cephalexin (kefexin), cefradine, cefapirin, cefadroxil. II generation: cefuroxime (ketocef), cefaclor (Vercef), cefotaxime (claforon), cefotiam, cefotetan. III generation: cefotriaxone (Longacef, Rocephin), cefonerazole (Cefobit), ceftazidime (Cefadim, Myrocef, Fortum), cefotaxime, cefixime, cefroxidine, ceftizoxime, cefrpyridoxime. IV generation: cefoxitin (mefoxin), cefmetazole, cefpirome.

The newer generation of antibiotics differs from the previous one in a wider spectrum of action on microorganisms, greater safety for the human body (that is, a lower frequency of adverse reactions), more convenient administration (if the first generation drug needs to be administered 4 times a day, then the 3rd and 4th generations - only 1-2 times a day), are considered more “reliable” (higher effectiveness in bacterial foci, and, accordingly, an earlier onset of therapeutic effect). Also, modern drugs of the latest generations have oral forms (tablets, syrups) with a single dose during the day, which is convenient for most people.

Do humans have worms: symptoms and main signs

The prevalence of diseases associated with the activity of parasites is quite high, especially when it comes to certain categories of the population. For example, pinworms are most common in young children, and fishermen are susceptible to opisthorchiasis and diphylbothriasis, and hunters are afraid of trichinosis and various tapeworms.

In addition, worms in humans, symptoms and a clear clinical picture can provoke the development of secondary infections and diseases. Therefore, it is important for any person to be able to recognize such an unpleasant “neighborhood” in himself in time and seek help from a specialist.

How does worm infection occur?

In order to understand whether there are risks of infection with parasites and to correctly interpret the symptoms of the presence of worms, you need to know the main routes of infection by them. Most often, pathogenic microorganisms enter the human body in the form of eggs, which hatch after a while.

Today, doctors suggest 4 main ways of infection with helminths according to sources:

1. Geohelminthiasis. In this case, we are talking about eggs entering through contaminated soil and water, which contain many immature larvae. They get into the ground and water along with the feces of sick animals, as well as through transmission by insects. Flies are frequent carriers of helminthiasis, transporting eggs onto human food.
2. Contact. To become an object of parasitism, it is enough to have contact with an already infected person; this method is most often characteristic of pinworms.
3. Biohelminthiasis. The transmission of pests occurs through the consumption of improperly prepared cow or pig meat, fish with insufficient heat treatment (sushi, kebabs, dried and smoked fish, lard with meat streaks, etc.).
4. There is a separate type of pest that enters the human body through the bite of infected insects.

The mechanism of entry of the pathogen into the human body is oral-fecal. According to statistics, the most typical sources of invasions are pets, soil, and dirty water. It is enough to work in the garden and not enough to clean your hands and nails of soil residues to become an object of parasitism by pathogenic microorganisms. The main enemies of such diseases are sanitation and personal hygiene.

What should you pay attention to first?

In situations where a person has worms, it is very important to be able to recognize what symptoms indicate such a disease and consult a doctor in time. Experts advise taking preventive measures to avoid infection for children who attend kindergartens, as well as families who keep pets in the house.

You need to pay special attention to the primary signs of worms in humans; symptoms appear a little later, and there are cases of long-term asymptomatic development of infestations. When infected, a person will experience intestinal disorders in the form of discomfort, bloating, flatulence, loose stools and constipation, nausea and general malaise. Do not underestimate the situation; these manifestations require an examination. Often, helminthic disease can be determined even visually by the feces, in which individuals will sooner or later be found.

The main symptoms of worms in an adult

Almost all types of diseases involve the manifestation of a number of characteristic signs, by which a person can independently recognize the disease before going to the doctor. The first symptoms of worms can also be determined in advance, after which the person is sent for diagnosis.

Symptoms characteristic of helminthiasis:

• allergies in the form of skin rashes - urticaria, eczematous spots, papillomas, boils, acne;
• a prolonged cough that cannot be cured with special medications or even antibiotics;
• inflammatory processes of the upper respiratory tract - pneumonia, runny nose (if strongyloidiasis or ascariasis);
• poor intestinal permeability, constipation (intensive infestation) or loose stools and bloating (when the tapeworms are long and large);
• reduced immunity, frequent ARVI;
• digestive problems, nervousness;
• due to the excitability of the nervous system, grinding of teeth is observed;
• the blood is poisoned by the waste products of parasites, which causes depression;
• When migrating individuals, pain is felt in the tissues and joints.

Worms in humans symptoms photo:

Distinctive features of the manifestation of pests may be certain places of their localization.

1. If worms are in the liver:

• pale skin as a result of anemia;
• rapid weight loss;
• unhealthy appearance of a person;
• feverish condition;
• aches all over the body;
• rash in the form of hives;
• feeling of liver enlargement;
• frequent nausea and vomiting;
• loss of appetite;
• loose stool.

1. Symptoms of worms in humans in the intestines:

• allergic reactions;
• an increase in the number of eosinophils in the blood;
• muscle and joint pain;
• itching, swelling;
• feverish condition;
• weakened immunity and the development of other gastrointestinal diseases.

1. If there are worms in a person’s lungs:

• loss of strength, discomfort and weakness;
• a sharp increase in body temperature;
• shortness of breath and severe attacks of suffocation;
• coughing attacks, more often in the morning, with sputum production;
• tingling and pain in the sternum area;
• frequent nausea and vomiting;
• intense headache;
• visual impairment;
• signs of toxicosis and loss of appetite;
• allergic reactions.

1. If pests are in the eyes:

• swelling of the eyelids, similar to boils;
• sensation of movement in the eye area;
• conjunctivitis;
• long, sinuous lines on the skin;
• conjunctival larval granuloma.

1. If worms are in the brain:

• frequent pain in the back of the head and temples;
• persistent depression;
• headaches are accompanied by nausea and vomiting;
• insomnia;
• severe headaches while drinking alcohol;
• nervous breakdowns;
• sudden disruption of the visual organs.

Thanks to the clinical picture, the specialist will be able to accurately determine not only the type of parasites, but also their location, the presence of complications and consequences.

What tests need to be taken?

Today, each clinic offers various standard and new methods for diagnosing helminthiases, but the following tests are considered the most common:

• Analysis of feces for eggs, when feces are collected in a special container during the day; before carrying out the manipulations, the person must wash with soap.
• Scraping, a simple way to detect pests, is when in the morning a piece of tape is glued to the anus, then it is removed and placed in a container.
• Collection of material is carried out using a cotton swab. Usually, to detect the larvae, it is enough to hold a stick in the anus.
• A blood test that can detect non-standard types of infestations. The choice of tests is prescribed by the attending physician.

The newest method for detecting such a disease is ELISA, when antibody proteins that appear as a result of the presence of the causative agent of the disease are detected in a person’s blood. Using such proteins, a specialist can determine the duration and intensity of the invasion.

Which doctor should I contact for treatment?

In order to be able to timely recognize the presence of pathogenic microorganisms, determine their type, quantity and establish an accurate diagnosis, you need to know which specialist deals with these diseases. Typically, the clinic has an infectious disease doctor or parasitologist, whose competence includes the treatment of infestations and other parasitic diseases.

If the primary disease provokes serious consequences, pathologies and dysfunction of internal organs, the person may be referred to other specialized specialists - a gastroenterologist, ophthalmologist, ENT specialist, cardiologist, neurologist or surgeon.

How can antibiotics be introduced into the body?

1) By mouth or orally (tablets, capsules, drops, syrups). It is worth keeping in mind that a number of drugs are poorly absorbed in the stomach or are simply destroyed (penicillin, aminoglycosides, carbapinems). 2) Into the internal environment of the body or parenterally (intramuscularly, intravenously, into the spinal canal) 3) Directly into the rectum or rectally (in enemas) The onset of the effect when taking antibiotics by mouth (orally) is expected longer than with parenteral administration. Accordingly, in severe cases of disease, parenteral administration is given absolute preference.

After administration, the antibiotic ends up in the blood and then in a specific organ. There is a favorite localization of certain drugs in certain organs and systems. Accordingly, for a particular disease, drugs are prescribed taking into account this property of the antibiotic. For example, for pathology in bone tissue, lincomycin is prescribed, for hearing organs - semi-synthetic penicillins, etc. Azithromycin has a unique ability to distribute: in case of pneumonia, it accumulates in the lung tissue, and in case of pyelonephritis - in the kidneys.

Antibiotics are eliminated from the body in several ways: with urine unchanged - all water-soluble antibiotics are eliminated (example: penicillins, cephalosporins); with urine in a modified form (example: tetracyclines, aminoglycosides); with urine and bile (example: tetracycline, rifampicin, chloramphenicol, erythromycin).

Classification

Superinfection after antibiotics is characterized by the accumulation of apathogenic and opportunistic bacteria. This condition of the body occurs due to the suppression of the body's microflora by sulfonamide drugs, antibiotics and tuberculostatic drugs.

An endogenous infection can be caused by:

• coli;
• Pseudomonas aeruginosa;
• anaerobic bacteria;
• enterobacteria;
• pathogenic fungi.

Exogenous superinfection can occur as a result of another infection with the same virus that provoked the primary disease, but more resistant to antibiotics.

Diseases of an exogenous nature occur due to the fact that the virus enters the body through the respiratory tract. As far as we know, a healthy person has a protective layer on the mucous membrane of the paranasal sinuses and lungs, however, in a patient who has suffered an infectious disease, this layer may be damaged, resulting in infection with sinusitis, sore throat or pneumonia.

One of the most well-known forms of superinfection is candidiasis (fungi of the genus candida). Specific is the appearance of white plaque on the mucous membrane. Depending on the location of the lesion, candida fungi can appear in various clinical manifestations, which quite often delays the diagnosis of candidiasis.

Reminder for the patient before taking an antibiotic

Before you are prescribed an antibiotic, tell your doctor: - If you have had any side effects from medications in the past. — About the development in the past of allergic reactions to medications. - About the current use of other treatment and the compatibility of already prescribed drugs with the required medications now. — About the presence of pregnancy or the need to breastfeed.

You need to know (ask your doctor or find it in the instructions for the drug): - What is the dose of the drug and the frequency of administration during the day? — Is special nutrition required during treatment? — Course of treatment (how long to take the antibiotic)? — Possible side effects of the drug. — For oral forms – connection of taking the medicine with food intake. — Is it necessary to prevent side effects (for example, intestinal dysbiosis, for the prevention of which probiotics are prescribed).

When to consult a doctor when treating with antibiotics: - If signs of an allergic reaction appear (skin rash, itching, shortness of breath, swelling of the throat, etc.). - If within 3 days of taking there is no improvement, but on the contrary, new symptoms have appeared.

Diagnostics

In order to correctly diagnose the disease, it is necessary to contact a highly qualified specialist who is obliged to:

• conduct an examination of the patient’s ENT organs;
• find out about the symptoms that bother the patient;
• examine the patient's history.

The clinician may prescribe additional examinations:

• general blood analysis;
• general urine analysis;
• immunogram;
• blood chemistry.

It is also possible to undergo additional examination by the following doctors:

• otolaryngologist;
• immunologist;
• dermatologist.

With syphilis, it is necessary to skillfully differentiate superinfection from relapse of syphilis. Timely consultation with a doctor contributes to a faster recovery from the disease.

Features of taking antibiotics:

When taken orally, the time of taking the drug is important (antibiotics can bind to food components in the digestive tract and the subsequent formation of insoluble and slightly soluble compounds that are poorly absorbed into the general bloodstream; accordingly, the effect of the drug will be poor).

An important condition is the creation of an average therapeutic concentration of the antibiotic in the blood, that is, a sufficient concentration to achieve the desired result. That is why it is important to follow all doses and frequency of administration per day prescribed by your doctor.

Currently, the problem of antibiotic resistance of microorganisms (resistance of microorganisms to the action of antibacterial drugs) is acute. The causes of antibiotic resistance may be self-medication without the participation of a doctor; interrupting the course of treatment (this certainly affects the lack of full effect and “trains” the microbe); prescribing antibiotics for viral infections (this group of drugs does not act on intracellular microorganisms, which are viruses, so improper antibiotic treatment of viral diseases only causes more pronounced immunodeficiency).

Another important problem is the development of adverse reactions during antibiotic therapy (digestion, dysbacteriosis, individual intolerance and others).

Solving these problems is possible through rational antibiotic therapy (competent prescription of a drug for a specific disease, taking into account its preferred concentration in a specific organ and system, as well as professional prescription of a therapeutic dose and a sufficient course of treatment). New antibacterial drugs are also being created.

Symptoms of intestinal dysbiosis after antibiotics

Intestinal dysbiosis after antibiotics has the same symptoms as dysbiosis caused by other factors:

• diarrhea or constipation (types of defecation disorders may alternate and diarrhea may be replaced by constipation);
• flatulence;
• intestinal colic;
• rumbling in the stomach;
• pain after eating;
• general weakness;
• decreased protective function of the body;
• loss of appetite;
• increase in body temperature to 37-38°C;
• nausea;
• vomit;
• allergic manifestations (skin rashes and itching, development of bronchospasm, angioedema).

To cure dysbiosis, it is necessary to eliminate the cause of the symptom complex. Normalize the quantitative and qualitative composition of microflora.

People whose gastric juice is highly acidic or have an individual intolerance to a component of the tablet form of drugs are prescribed rectal suppositories to restore flora. Children and adults can be treated this way. Suppositories have a local positive effect in the large intestine.

There are vaginal suppositories to eliminate problems in the vagina of women with disturbances in the microflora of the genital organs from taking antibiotics.

General rules for taking antibiotics:

1) Any antibiotic should be prescribed only by a doctor!

2) Self-medication with antibiotics for viral infections is strictly not recommended (usually motivated by the prevention of complications). You may make the viral infection worse. You should only think about taking it if the fever persists for more than 3 days or if there is an exacerbation of a chronic bacterial outbreak. Only a doctor can determine the obvious indications!

3) Carefully follow the prescribed course of antibiotic treatment prescribed by your doctor. Under no circumstances should you stop taking it after you feel better. The disease will definitely return.

4) Do not adjust the dosage of the drug during treatment. In small doses, antibiotics are dangerous and affect the development of bacterial resistance. For example, if it seems to you that 2 tablets 4 times a day is somehow too much, it’s better to take 1 tablet 3 times a day, then it is likely that you will soon need 1 injection 4 times a day, since the tablets will stop working.

5) Antibiotics should be taken with 0.5-1 glass of water. Don’t try to experiment and wash them down with tea, juice, and especially milk. You will drink them “in vain.” Milk and dairy products should be taken no earlier than 4 hours after taking the antibiotic or completely avoid them during the course of therapy.

6) Observe a certain frequency and order of taking the drug and food (different drugs are taken in different ways: before, during, after meals).

7) Strictly adhere to the specified time of taking the antibiotic. If 1 time a day, then at the same time, if 2 times a day, then strictly after 12 hours, if 3 times, then after 8 hours, if 4 times, then after 6 hours, and so on. This is important for creating a certain concentration of the drug in the body. If you suddenly missed the time for taking it, take the drug as soon as possible.

Taking an antibiotic requires a significant reduction in physical activity and a complete cessation of sports.

9) There are certain interactions of some drugs with each other. For example, the effect of hormonal contraceptives is reduced when taking antibiotics. Taking antacids (Maalox, Rennie, Almagel and others), as well as enterosorbents (activated carbon, white carbon, enterosgel, polyphepam and others) can affect the absorption of the antibiotic, so simultaneous use of these drugs is not recommended.

10) Do not drink alcohol (alcohol) during the course of antibiotic treatment.

Etiology

It has been proven that the disease develops as a result of two main reasons:

• antibiotic treatment;
• contact with a carrier of infection.

While a person takes antibiotics, in addition to the pathogenic flora, the beneficial flora in his body also dies, which stops the development of the pathogenic flora. In this state, opportunistic microorganisms become pathogenic, which leads to the development of a second infection.

Naturally, a person should avoid those with an infection, since there is a risk of transmitting the virus, as a result of which he himself may end up in an infectious diseases hospital. It is precisely because of the existence of superinfection that doctors in such hospitals ask patients not to leave the room unnecessarily, since re-infection is possible, which cannot be cured with antibiotics.

Organs that are predisposed to damage by the disease:

• respiratory tract organs;
• genitourinary system;
• gastrointestinal tract;
• eyes;
• skin covering;
• mucous

People with weakened immune systems are at risk.

These include:

• children;
• old people;
• pregnant women;
• sick;
• and infected.

The development of superinfection with syphilis is a fairly common phenomenon. Previously, it was believed that there was no innate immunity to syphilitic infection, which led to the absence of a protective reaction after treatment and the possibility of repeated infection (reinfection).

Complications from syphilis can occur:

• during the early period of syphilis (during the incubation period in the first two weeks of the primary period);
• with tertiary and congenital syphilis (due to decreased immunity in the later stages of the disease);
• during a breakdown of immunity due to inadequate treatment of patients (especially the first days of the disease).

According to experts, such a disease is always secondary and can only manifest itself against the background of a primary pathology.

The need for antibiotic treatment in children

According to statistics, up to 70-85% of children with purely viral infections in Russia receive antibiotics, that is, antibiotics were not indicated for these children. At the same time, it is known that it is antibacterial drugs that provoke the development of bronchial asthma in children! In reality, antibiotics need to be prescribed to only 5-10% of children with ARVI, and only if a complication occurs in the form of a bacterial outbreak. According to statistics, complications are detected in only 2.5% of children not treated with antibiotics, and complications are registered twice as often in those treated without any reason.

A doctor and only a doctor identifies indications for prescribing antibiotics in a sick child: this could be an exacerbation of chronic bronchitis, chronic otitis media, sinusitis and sinusitis, developing pneumonia, and the like. You should also not hesitate to prescribe antibiotics for mycobacterial infection (tuberculosis), where specific antibacterial drugs are key in the treatment regimen.

Ways to prevent the development of superinfection

Basic information

The occurrence of superinfection is associated with weakened immunity, so prevention of this phenomenon should be based on strengthening it.

The main preventive measures include the following:

• playing sports, regular physical activity;
• daily walks in the fresh air;
• gradual hardening of the body with cold water;
• proper nutrition with a predominance of fresh fruits and vegetables that are rich in fiber;
• taking immunomodulators, including those of natural origin (as prescribed by a doctor);
• compliance with hygiene rules, thorough hand washing with soap after visiting public places, especially during the period of intensification of viral diseases;
• refusal of frequent uncontrolled use of antibacterial drugs (due to the fact that bacteria, less often “encountering” such drugs, have less incentive to develop and transfer the ability to protect themselves from them);
• taking vitamins B and C during antibacterial therapy (this especially applies to people who are at risk);
• limiting communication with virus carriers: visiting patients suffering from viral diseases should only be carried out wearing a special mask;
• preventive gargling, as well as rinsing the nasal passages with a soda-saline solution;
• regular wet cleaning and ventilation of the living space;
• the use of protective masks during the period when one of the family members becomes ill with a viral infection.

It is important to create preventive conditions within a medical institution, especially if a child was brought to the department. If there is a suspicion of infection, he is placed in a box, and if the infection is confirmed, he is placed in a specialized department (intestinal, hepatitis).

If an infection has been introduced into the department, then urgent measures must be taken to prevent its spread. The ward in which a case of an infectious disease was registered is quarantined.

When visiting a medical facility with children, it is important to ensure that they do not touch any objects in the corridors or doctors’ offices.

Superinfection is a phenomenon that is always secondary in nature, that is, it develops only against the background of the presence of a specific viral disease. This condition is quite difficult to describe and treat. It can cause serious complications. Superinfections should be treated only under the supervision of a specialist.

Side effects of antibiotics:

1. Allergic reactions (anaphylactic shock, allergic dermatoses, Quincke's edema, asthmatic bronchitis) 2. Toxic effect on the liver (tetracyclines, rifampicin, erythromycin, sulfonamides) 3. Toxic effect on the hematopoietic system (chloramphenicol, rifampicin, streptomycin) 4. Toxic effect on digestive system (tetracycline, erythromycin) 5. Complex toxic - neuritis of the auditory nerve, damage to the optic nerve, vestibular disorders, possible development of polyneuritis, toxic damage to the kidneys (aminoglycosides) 6. Jarisch-Heitzheimer reaction (endotoxin shock) - occurs when a bactericidal antibiotic is prescribed, which results in an “endotoxin shock” resulting in massive destruction of bacteria. It develops more often with the following infections (meningococcemia, typhoid fever, leptospirosis, etc.). 7. Intestinal dysbiosis is an imbalance of the normal intestinal flora.

Antibiotics, in addition to pathogenic microbes, kill both representatives of normal microflora and opportunistic microorganisms with which your immune system was already “familiar” and restrained their growth. After treatment with antibiotics, the body is actively populated by new microorganisms, which the immune system takes time to recognize, and those microbes that are not affected by the antibiotic are also activated. Hence the symptoms of decreased immunity during antibiotic therapy.

Causes of superinfection

It has been proven that the disease develops as a result of two main reasons:

• antibiotic treatment;
• contact with a carrier of infection.

While a person takes antibiotics, in addition to the pathogenic flora, the beneficial flora in his body also dies, which stops the development of the pathogenic flora. In this state, opportunistic microorganisms become pathogenic, which leads to the development of a second infection.

Naturally, a person should avoid those with an infection, since there is a risk of transmitting the virus, as a result of which he himself may end up in an infectious diseases hospital. It is precisely because of the existence of superinfection that doctors in such hospitals ask patients not to leave the room unnecessarily, since re-infection is possible, which cannot be cured with antibiotics.

Organs that are predisposed to damage by the disease:

• respiratory tract organs;
• genitourinary system;
• gastrointestinal tract;
• eyes;
• skin covering;
• mucous

People with weakened immune systems are at risk.

These include:

• children;
• old people;
• pregnant women;
• patients with diabetes mellitus;
• HIV and AIDS infected.

The development of superinfection with syphilis is a fairly common phenomenon. Previously, it was believed that there was no innate immunity to syphilitic infection, which led to the absence of a protective reaction after treatment of syphilis and the possibility of repeated infection with it (reinfection).

Complications from syphilis can occur:

• during the early period of syphilis (during the incubation period in the first two weeks of the primary period);
• with tertiary and congenital syphilis (due to decreased immunity in the later stages of the disease);
• during a breakdown of immunity due to inadequate treatment of patients (especially the first days of the disease).

According to experts, such a disease is always secondary and can only manifest itself against the background of a primary pathology.

There are two main types of superinfection, each of which develops under the influence of certain factors - endogenous and exogenous.

Endogenous superinfection is a consequence of the rapid proliferation of pathogenic microorganisms in conditions of suppression of microflora by antibacterial agents. In this case, the causative agents of recurrent disease are E. coli, fungi, and anaerobic bacteria. They are not sensitive to antibiotics and are initially opportunistic. In conditions of weakened immunity, they cause serious consequences.

These pathogenic microorganisms affect the skin, mucous membranes, respiratory and urinary tract. They can cause severe pathological processes, for example, meningitis or brain abscess.

they say if a virus has penetrated into an organism weakened by a disease (usually this happens through the respiratory tract). It is precisely because of the risk of developing superinfection that patients undergoing treatment in infectious diseases departments of medical institutions are not recommended to leave the wards and communicate with other patients.

The special risk group includes the following categories of people:

• children whose immunity is not fully formed;
• those suffering from diseases that provoke a decrease in immunity (diabetes mellitus, cardiovascular diseases);
• elderly people whose protective functions weaken due to age-related changes;
• pregnant women;
• those infected with HIV and suffering from AIDS;
• obese.

People who suffer from respiratory diseases, as well as smokers, are more likely to experience exogenous infections.

The highest probability of developing superinfection is in an inpatient setting of an infectious diseases hospital (or department). Infection with respiratory viruses occurs when a patient comes into contact with medical personnel or relatives, who can also be carriers of pathogenic microorganisms. To prevent the development of superinfection, patients are prescribed the drug Viferon during antiviral therapy.

The mechanism of development of superinfection can be considered using the example of re-infection with syphilis. It may occur under the following conditions:

• in the early stages of the disease, in the so-called “latent” period, when there is not yet sufficient immunity;
• with insufficient treatment, which does not contribute to the destruction of pathogens, but reduces their antigenic properties;
• breakdown of immunity due to alcoholism and the presence of chronic diseases.

Also in clinical practice, pulmonary superinfections of a bacterial nature are often encountered. Most often they arise as a result of typhoid fever, sepsis, and measles. This kind of superinfection affects older people, as well as children.

Staphylococcal superinfections are also widespread and often occur in healthcare settings, especially in pediatric and surgical departments. The main factor in their development is the carriage of various forms of staphylococci resistant to external conditions by medical workers.

The most dangerous type of staphylococcal superinfection is sepsis.

People with reduced or developing immunity are most susceptible to superinfection:

• elderly and children;
• pregnant women;
• diabetic patients;
• patients with cardiovascular diseases and those on dialysis;
• suffering from obesity of varying degrees.

Exogenous infections more often affect those diagnosed with respiratory diseases such as asthma, emphysema, and chronic obstructive pulmonary disease. Smokers are also at risk.

Superinfection is a re-infection of the body that occurs against the background of incomplete primary infections. The nature, localization and course of superinfections are different. They are often a complication of antibiotic treatment.

In medicine, the term “superinfection” refers to secondary infections caused by bacteria that develop while the body continues to fight the primary infection.

Superinfections can be caused by the effects of drug therapy (in fact, they are a side effect of the drug) or re-infection against a background of weakened immunity. In everyday life, superinfections are often called complications.

Endogenous, that is, coming from within the body, superinfection is caused by the rapid proliferation of existing apathogenic or conditionally pathogenic bacteria against the background of normal microflora suppressed by antibiotics, tuberculostatic drugs and sulfonamide drugs.

Endogenous superinfection can be caused by Pseudomonas aeruginosa and Escherichia coli, enterobacteria, anaerobic bacteria, pathogenic fungi, and so on.

The localization of such a superinfection, as well as the course of the secondary disease, are different. Endogenous superinfection can affect the respiratory, urinary and biliary tracts, ENT organs, mucous membranes and skin, causing meningitis and brain abscesses.

A special case of endogenous superinfection is the bacteriolysis reaction or the Jarisch-Herxheimer reaction. It occurs due to large amounts of endotoxin released as a result of massive death of microbes due to massive antibiotic treatment.

Exogenous, that is, external, superinfection can be caused by the same pathogen that led to the primary infection, only with a different sensitivity to antibiotics, or by a new microorganism that takes advantage of the patient’s weakened immunity.

Basically, exogenous superinfections enter the body through the respiratory tract. In a healthy person, the mucous membrane of the lungs and paranasal sinuses is covered with a protective layer, but after the flu or even a common cold, it can be compromised, which can lead to infection with bacterial sinusitis, sinusitis, sore throat or pneumonia.

Unlike endogenous, exogenous infection can be transmitted by airborne droplets.

At-risk groups

People with reduced or immature immunity are most susceptible to superinfections:

• elderly people and children;
• pregnant women;
• diabetic patients;
• patients with cardiovascular diseases and those on dialysis;
• suffering from obesity of varying degrees.

Superinfection is always secondary and can only occur against the background of a primary disease. Its occurrence is indicated by the following symptoms that appear shortly after or during successful treatment:

• headache;
• fever, chills;
• shortness of breath, wheezing, difficulty breathing;
• cough;
• pain in the chest or intestines;
• painful sensations when pressing on the maxillary sinuses or brow ridges;
• yellowish-green nasal discharge.

If any symptoms of superinfection occur, contact your doctor immediately.

Exogenous superinfections can be prevented by maintaining strict hygiene:

• wash your hands thoroughly and as often as possible;
• change clothes;
• carry out wet cleaning and ventilation of the room.

During and after illness, you should not attend social events and various public institutions. It has been proven that disinfectant gargles and nasal rinses also help reduce the risk of developing superinfection.

To avoid endogenous superinfections, foods and medications that normalize microflora should be introduced into the diet: natural yogurt, yogurt. You can also take antiviral drugs and multivitamin complexes.

Recommendations for patients after a course of antibiotic therapy:

After any course of antibiotic treatment, recovery is necessary. This is due, first of all, to the inevitable side effects of drugs of any severity.

1. Follow a gentle diet, avoiding spicy, fried, salty foods and frequent (5 times a day) small portions for 14 days. 2. In order to correct digestive disorders, enzyme preparations are recommended (Creon, Micrazim, Ermital, pancitrate 10 thousand IU or 1 capsule 3 times a day for 10-14 days). 3. In order to correct intestinal dysbiosis (disturbances in the ratio of representatives of normal flora), probiotics are recommended. — Baktisubtil 1 caps 3 times a day for 7-10 days, — Bifiform 1 tablet 2 times a day for 10 days, — Linnex1 caps 2-3 times a day for 7-10 days, — Bifidumbacterin forte 5-10 doses 2 times a day day for 10 days, - Acipol 1 caps 3-4 times a day for 10-14 days. 4. After taking hepatotoxic drugs (for example, tetracycline, erythromycin, sulfonamides, rifampicin), it is recommended to take plant-based hepatoprotectors: hepatrin, ovesol (1 caps or tablet 2-3 times a day), Karsil (2 tablets 3 times a day) within 14-21 days. 5. After a course of antibiotics, it is recommended to take herbal immunomodulators (immunal, echinacea solutions) and avoid hypothermia.

Infectious disease doctor N.I. Bykova

Can an infant have worms?

Symptoms of helminthic infestation in an infant under one year old do not appear in every case. The course of the disease, as a rule, is asymptomatic, since the period of development of helminths in the human body has a certain period. Thus, some types of parasites have a life cycle of about a year, so symptoms of the presence of worms in infants begin to appear after they reach one year of age.

Only in some cases, with increased vigilance of parents, can a mother detect a parasitic worm in the baby’s stool and begin treatment immediately. As a rule, these are pinworms. Whipworms or other types of helminths are much less common. Photos of parasites are easy to find on thematic sites dedicated to parasites.

Visible manifestations of helminthiasis in newborns indicate that the body can be severely affected by parasites that settled in the child’s body even before birth and developed together with the baby’s body. In this case, the carrier of worms is the mother, who may not even be bothered by the symptoms of her own disease.

Signs of helminth infection in children under one year of age appear rather weakly, and in some cases are completely absent. Detecting worms in infants is a complicated matter. Basically, the mother pays attention to the child’s poor appetite or complete refusal to eat, a high degree of salivation, poor sleep and slight weight gain. Also, a breastfed baby has unhealthy pale skin and bluish circles under the eyes. The child is nervous and often screams for no apparent reason.

The last thing a mother thinks about is that these may be signs or symptoms of helminthiasis, since the child has no other food other than breast milk. This is why every visit to the pediatrician is so important during the infancy period, the utmost attentiveness of parents to their own child and regular consultations with a doctor who, if necessary, will prescribe the correct treatment.

In a child under one year old, especially in those children who are breastfed, the level of infection with helminths is significantly lower than in their artificially raised peers. This is explained by the absence of pathogenic microflora of the stomach, thanks to mother's milk. Naturally, the exception is mothers infected with the parasite, who may not experience symptoms of infection, says pediatrician at the Moscow MEDSI clinic in Shchelkovo, infectious disease specialist Olga Vladimirovna Gruzdova.

Diagnosis of helminthiasis in children under one year of age

Analysis of stool for the content of parasite eggs does not always show the true result. This is due to the fact that helminths, such as pinworms or roundworms, do not lay eggs every day. The microscopy process is quite complex due to the thoroughness of the analysis. Laboratory assistants can obtain reliable results only through a series of daily tests. The minimum series is daily delivery of stool for analysis to the laboratory for three days in a row.

Most children under one year of age are diagnosed with round parasite infection. In the photos presented on the Internet, the difference between females and males is clearly visible.

Roundworms are small, milky-white helminths that can be visually observed in a child’s stool. The situation is much worse if children are infected with another type of helminth - Giardia. Microscopic worms that affect not only the gastrointestinal tract, in particular the intestines, but also the gallbladder and liver. Treatment in this case is complicated by the fact that the main medications have age restrictions and can be prescribed to a small patient no earlier than he reaches two years of age.

In such cases, the removal of worms from infants who are fed with mother's milk is carried out by prescribing treatment to the nurse. A specialist prescribes the modern drug Vormil, which has no contraindications during lactation, to a nursing mother.

Treatment, doses and timing of medications for a nursing mother are determined by the doctor.

Treatment of infants with traditional methods

A helminthic infestation does not go away over time, and worms are reluctant to leave the human body unless treated. Especially a small child whose body has not yet adapted to adult life.

In this case, herbal remedies act as preventive and safest anthelmintic drugs:

• pumpkin seeds;
• dried walnut peel;
• fruits of the clove tree;
• garlic cloves;
• flowers of wormwood.

Since taste qualities are of great importance for young children in the first year of life, as a rule, as a preventive anthelmintic, preference is given to unroasted pumpkin seeds ground into flour. They are odorless and have a subtle taste.

In conclusion, it should be noted that starting to give pumpkin seeds to a small child should be done with extreme caution. Add a very small amount of powder to complementary foods for a child under one year old on the tip of a knife, or mix with milk, juice, grated apple, gradually increasing the dose to a quarter of a teaspoon. The duration of preventive measures is 21 days.

Author: Voitenko A.

The mechanism of antimicrobial action of caa.

β-lactams interact with enzymes that are involved in the synthesis of murein (carboxypeptidase, transpeptidase), causing their acetylation, resulting in an irreversible block of synthesis and disruption of the formation of the microbial wall, which leads to the death of the microorganism.

Penicillins are a group of antibiotics that are derivatives of 6-aminopenicillanic acid.

Para-aminobenzoic acid (PABA)

Dihydrofolic acid (DHFA)

Dihydrofolate-(-) Trimethoprim

reductase

Tetrahydrofolic acid (THFA)

Purines and pyrimidines

DNA and RNA

The mechanism is based on structural similarity to PABA, which is required for the synthesis of DHPA. Sulfonamides competitively displace folic acid from the synthesis process and cannot perform the function of PABA.

As a result, the synthesis of THPA is disrupted, which leads to inhibition of the synthesis of nucleic acids of microorganisms and this ultimately manifests itself in a retardation of the growth and development of microbes, i.e. bacteriostatic action.

Conditions necessary for the antibacterial action of SAA to occur:

• microorganisms can use CAA instead of PABA if the concentration of the drug in tissues is 2000-5000 times higher than the concentration of PABA;
• in the presence of pus, blood and tissue breakdown products, the effectiveness of sulfonamide is sharply reduced due to the high concentration of PABA in these products;
• CAA have an antimicrobial effect only against those microorganisms that themselves synthesize DHPA;
• in microorganisms resistant to SAA, increased synthesis of PABA is observed;
• the use of CAA in low concentrations contributes to the formation of resistance in microorganism strains and leads to the ineffectiveness of CAA.

1 – at the level of inclusion of PABA in the synthesis of DHPA;

2– at the level of formation of tetrahydrofolic acid from DHPA.

The second mechanism is achieved by changing the drug Trimethoprim (TMP), an antimalarial drug.

TMP has a similar antimicrobial effect to CAA and is 20 to 100 times more active. The most justified is the combination of TMP with sulfamethoxazole in a ratio of 1:5.

Thus, a combination drug Biseptol was created, which is a combination of TMP with sulfamethoxazole 1: 5 (80 mg 400 mg). This combination has a bactericidal effect, although each of the components exhibits a bacteriostatic effect.

Features of combining CAA drugs.

• Effective even in conditions of resistance to CAA drugs;
• Resistance to combination drugs develops more slowly.

It has an effect on the cell walls of mycobacteria. Inhibits the synthesis of mycolic acid, which is one of the components of the cell wall of mycobacteria. The drug is integrated into the synthesis of the cell wall, the structure of the cell wall is disrupted.

Being structural analogues, antimetabolites are able to enter into competitive relationships with structurally similar metabolites of the body, which causes a deficiency of the corresponding metabolite, which prevents the division of tumor cells and their death.

Folic acid antagonists.

Methotrexate. The structure is similar to folic acid (antifolic drug). (see mechanism of action of sulfonamides)

Prescribed mainly for leukemia in children, as well as for uterine epithelioma (postpartum disease - precancerous conditions).

Purine antagonists.

Mercaptocurine. It has antitumor effects due to the fact that it prevents the use of purines (adenine, guanine) in the synthesis of RNA and DNA.

Pyrimidine antagonists.

Fluorouracil, ftorafur. Their antitumor effect is that they prevent the use of pyrimidines (cytosine and uracil) in the synthesis of DNA and RNA.

They are used mainly for true tumors.

When is medical help needed?

Medical attention is necessary in all cases of antibiotic overdose.

To speed up the removal of the drug from the body, extracorporeal detoxification methods are used:

• forced diuresis;
• plasmapheresis;
• hemosorption;
• hemodialysis;
• peritoneal dialysis.

In some cases, exchange blood transfusion is indicated.

Therapy is carried out aimed at maintaining and restoring impaired functions. For this purpose, hepatoprotectors, cardioprotectors, antioxidants, vitamin preparations, and agents that improve capillary blood flow and metabolic processes in tissues are used.

Effect on potency

How antibiotics affect potency is a question that every man asks when starting to take medications. The main harm from them is observed from the effect on the liver and intestines. Treatment should only be carried out when there is no other option.

It is known that the action of antibiotics suppresses the growth of living cells in the body. Various active ingredients of the drug affect potency in men in different ways.

These medications have both advantages and significant disadvantages.

They effectively cope with certain diseases, but if certain conditions arise, they can worsen the condition of the sexual sphere.

Only 10% of these drugs can cause changes in the sexual sphere.

However, after treatment is completed, it is possible to restore an erection. In the future, this period will not affect the quality of sexual life in any way.

Important! Interrupted treatment provokes further development of the infection, and this will quickly worsen the erection.

According to statistics, if the result of taking an antibacterial drug is a temporary weakening of erection in a small number of patients, then for some time male strength is restored.

The question is not a point effect, but a structural effect on the body. Patients felt general weakness and malaise throughout the body. At the end of the full course, the condition changed for the better - everything returned to normal.

However, there is a problem. A certain proportion of patients noted the effect of antibiotics on potency, which was expressed in the absence of a persistent erection and sexual apathy.

Under their influence, there may be a decrease in libido or a complete absence of sexual desire for a short period.

Potency returned to its previous level after stopping medication.

Another group of men experienced changes in sperm composition. Therefore, it is recommended to give up trying to conceive during this period.

In the third group, recovery agents did not have a positive effect. These men underwent a comprehensive course on the treatment of sexually transmitted diseases.