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What are the anti-infection pills. Is there a universal cure for bacteria, viruses and other infections? Treatment of infections with antibiotics

What are the anti-infection pills. Is there a universal cure for bacteria, viruses and other infections? Treatment of infections with antibiotics

Content

Burning and itching on the feet and in the nail area, delamination or thickening of the nail plate, the appearance of an unpleasant odor are symptoms of the most common fungal disease: onychomycosis. There are many more problems that the fungus can provoke - some of its varieties even affect the internal organs, and if local medicines do not cope, the doctor prescribes pills. Which one is the most effective?

What is a fungus

The reasons

The causative agents of fungal diseases are pathogenic and opportunistic microorganisms: the latter are representatives of the genus Candida (yeast fungi), which are part of the mucosal flora of a healthy person. As soon as immunity decreases, they become pathogenic and provoke a disease called candidiasis, better known as thrush. Common fungal diseases include:

Onychomycosis - damage to the nail plate by a mold microorganism, yeast or dermatophyte, infection through contact with personal hygiene items, visiting public places with high humidity. For molds, the presence of open wounds on the surface of the skin that is in contact with the infected surface is important.
Epidermophytosis (a type of dermatophytosis), the causative agent is Epidermophyton achorionum. The disease is highly contagious, affecting the feet or groin. Infection occurs through household items, personal hygiene, in gyms, baths and pools.
Trichophytosis, causative agent - Trichophyton. It is transmitted from rodents, cattle, through hay and straw during field work in autumn. The disease is considered highly contagious.
Microsporia - the causative agent is Microsporum. It is transmitted from homeless animals, mainly cats. From a sick person, the infection rarely passes.
Pityriasis versicolor and seborrheic dermatitis (keratomycosis) are caused by yeast-like microorganisms from the genus Malassezia furfur, which affect the hair follicles and the top layer of the skin. In infection, heredity plays a role, the pathogen is transmitted through personal hygiene items.
Intestinal candidiasis - similar in symptoms to dysbacteriosis, infection occurs through the use of contaminated food (raw meat, dairy group, vegetables and fruits), or against the background of long-term antibiotic treatment.
Candidiasis of the oral mucosa - affects mainly newborns, can be transmitted in utero or during feeding (from contact with the skin of the nipple).
Candidiasis of the genital organs - affects both men and women, is transmitted sexually.

Treatment

It is difficult to influence a fungal disease due to violations of cellular immunity, therefore therapy is always long and requires specific means. Antifungal drugs (antimycotics) can be used topically or given systemically, depending on the severity of the disease and the location of the pathogen. Additionally:

It may be necessary to prescribe antibiotics, corticosteroids, antihistamines.
The processing of personal hygiene items is important to prevent re-infection.

If a pathogenic microorganism has affected the skin or nail plate, the use of local medicines is mandatory - therapy will be based on this. Vaginal infections are treated with suppositories, for other cases, ointments, creams, varnishes, solutions are provided. When internal organs are infected, oral dosage forms are required.

Pills for fungal diseases

Therapeutic measures are mainly based on the local use of antimycotics, but if the infection zone is extensive, or the disease does not go away with the external use of drugs, but progresses, the doctor prescribes systemic treatment. Such drugs can be based on natural or synthetic components, and according to the principle of action are divided into:

killing the fungus (polyenes, allylamines) - terbinafine, naftifine, natamycin, amphotericin;
stopping the growth of pathogenic microorganisms (azoles) - itraconazole, fluconazole, ketoconazole.

Effective fungal pills are always toxic, so they are resorted to only when absolutely necessary and strictly follow the instructions prescribed by the doctor. In some situations (infection with Cryptococcus, Microsporum), a long course of treatment of 8-12 months is necessary, and in case of onychomycosis, local and internal therapy are necessarily combined. It is important to remember that systemic drugs are contraindicated in:

pregnancy;
lactation;
renal failure;
liver damage.

nail

In the systemic treatment of onychomycosis, drugs of 2 groups can be used - azoles and allylamines, which, when taken for a long time, accumulate in the keratin of the nail and continue to act even after several weeks of withdrawal. The most effective antifungal agents for toenails and hands:

Rumikoz (on itraconazole, a representative of azoles) - prohibited during pregnancy and lactation, has a wide range of applications, affects dermatophytes and yeast. Among the contraindications is only hypersensitivity to the composition.
Terbinafine (allylamine) - has a minimal amount adverse reactions well tolerated. These fungal remedies are considered to be the most effective when used against Epidermophyton, Microsporum, Trichophyton.

Skin

Most antifungal drugs affect all types of mycoses, so it is easier to find effective pills for skin fungus than for onychomycosis or thrush. It all depends on the specific pathogen:

Nizoral (azole) - especially effective against lichen on the scalp, although it can also be prescribed as a remedy for fungus on the legs. The downside is high toxicity.
Griseofulvin (antibiotic) - requires taking with fish oil or olive oil, during treatment it is necessary to use vitamin complexes. Adverse reactions are rare, but have big number contraindications.

mucous membranes

Polyenes are the main group of drugs used against fungal diseases that affect the mucous membranes. Some doctors prefer to prescribe azoles (Vfend, Diflucan, Flucostat), which have a wider spectrum of action. Systemically used:

Amphotericin B - is prescribed for severe forms of fungal diseases, effective against leishmania and amoebae, histoplasma. Cannot be used in diabetes, liver and kidney problems.
Natamycin - affects Candida and Trichomonas, is considered the safest of all polyenes, having a minimum number of contraindications and side effects.
Vfend (azole) - on voriconazole, a triazole antibiotic, is prescribed against candidiasis and aspergillosis, histoplasmosis. Causes a large number of adverse reactions, requires caution when combined with other drugs.

The most effective remedy for fungus

It is impossible to choose an effective medicine without specifying which pathogen it should act against: Amphotericin B will not give a result in dermatophytosis, and allylamines in onychomycosis give a less obvious result than azoles. by the most effective pills for a long time, drugs based on ketoconazole (Mycozoral, Nizoral) were considered from the fungus, but in modern pharmacology drugs with a lesser degree of toxicity have appeared, so fluconazole and itraconazole have replaced ketoconazole in terms of versatility and strength of action.

In the series of polyenes, there are fewer substances with antimycotic properties than among allylamines or azoles, and nystatin, which is part of the drug of the same name, is the most famous and effective. According to the pharmacological action, it is an antibiotic, it primarily affects yeast-like fungi of the genus Candida. The pharmacological action is based on the incorporation of the active substance molecule into the cell membrane of the fungus and the subsequent increase in the osmolarity of this cell. Because of this, she dies. Indications for the use of Nystatin are:

prevention of the development of candidiasis of the gastrointestinal tract against the background of long-term therapy with penicillins, tetracyclines, chloramphenicol;
candidiasis of the skin (as part of combination therapy with the use of local agents).

Nystatin is considered a very effective drug, resistance to which the fungus develops slowly, so treatment is successful in most cases, even if the course is short. Simultaneously with taking drugs on clotrimazole is not used. Instructions for use:

Dosage: oral daily dose does not exceed 3 million units for an adult, in severe cases of the disease - 6 million units. The optimal dosage is considered to be 500 thousand units with a 4-fold intake or 250 thousand units with an 8-fold dose. Tablets are washed down with water, do not chew. The course of treatment of the fungus with Nystatin is from 10 to 14 days. Use in children is allowed only from the age of 13 at an adult dose.
Contraindications: liver disease, gastric ulcer, pancreatitis, pregnancy, hypersensitivity.
Side effects: diarrhea, nausea, vomiting, pain in the epigastric region, manifestations of allergies, fever, chills.

Pimafucin

A less well-known drug that affects the fungus and also belongs to the group of polyenes is Pimafucin, the active substance of which is natamycin. It is one of the macrolide antibiotics and has a fungicidal effect on the fungus. This substance is considered effective when exposed to Candida (especially Candida albicans), but can also be used against other yeast and yeast-like fungi sensitive to it, protozoa, dermatophytes:

Trichophyton, Microsporum, Epidermophyton;
Torulopsis, Rhodotorula;
Aspergillus, Fusarium (including Fusarium solani), Penicillium, Cephalosporium;
Trichomonas.

Among the indications for the use of Pimafucin, doctors distinguish even eye diseases (blepharitis, conjunctivitis, keratitis), if the causative agent is fusarium solani. The main reasons for prescribing this drug are intestinal and skin candidiasis, long-term antibiotic and corticosteroid therapy, dermatomycosis (in combination with Griseofulvin), otomycosis. With vaginal thrush, tablets are used with suppositories. The medicine has analogues - Ecofucin, Primafungin. Instructions for use Pimafucin:

Dosage: Adults: 1 tablet up to 4 times a day with a glass of large quantity warm water. The course of treatment is 7 days. Children under 5 years old are given 1/2 tablet, but suspension is considered the preferred dosage form for a child under 13 years old.
Contraindications: skin tuberculosis, hypersensitivity.
Side effects: diarrhea, nausea, vomiting.

Irunin

The active substance - itraconazole - belongs to the group of triazoles, has a synthetic origin, and is one of the substances with a wide spectrum of action. Works through inhibition of ergosterol synthesis in the cell membrane of a pathogenic microorganism. Effective tablets based on itraconazole are recognized against 3 categories of fungi:

yeast Candida spp.;
dermatophytes (Epidermophyton floccosum, Microsporum, Trichophyton);
molds (especially Aspergillus, Cryptococcus neoformans, Histoplasma).

In tissues, the concentration of itraconazole is higher than in blood plasma. The high content of the active substance persists for up to 4 weeks if a monthly course of treatment is carried out. Itraconazole is present in nail keratin for six months. For this reason, Irunin and its analogues (Itrazol, Kanditral, Mikokur, Mikonihol, Orungal, Orungamine, Orunit, Rumikoz, Sporagil, Funit) are known mainly as tablets against toenail fungus (onychomycosis) or on the feet (mycosis). Additional indications:

pityriasis versicolor;
systemic mycoses;
fungal keratitis;
visceral candidiasis.

Reception is carried out after a meal. The dosage and duration of the course of treatment is determined by the disease. With vulvovaginal candidiasis, adults take 2 capsules (200 mg) with a frequency of 2 r / day, therapy lasts a day, or 2 capsules 1 r / day for 3 days. For other fungal diseases, 2 capsules 1 r / day for:

weeks with lichen, ringworm;
3 weeks for fungal keratitis;
3 months with onychomycosis;
2-5 months for aspergillosis;
2-12 months with cryptococcosis.

Irunin tablets become most effective when the dosages and duration of the course are individually calculated together with the doctor, especially when it comes to systemic mycoses that require long-term treatment (from 2 months to a year). There are few contraindications to the drug - pregnancy, lactation, hypersensitivity and liver damage, childhood, but it has a large number of side effects:

dyspepsia, nausea, stomach pain;
dizziness, migraine;
violation menstrual cycle;
swelling;
heart failure;
skin allergic reactions.

Fluconazole

Fluconazole is the most widely used synthetic antimycotic in the triazole category. It works by inhibiting the enzyme activity of a pathogenic microorganism, increases the permeability of the cell membrane, blocking its replication and growth. Fluconazole analogues are antifungal drugs under the following names:

Vero-fluconazole;
Diflucan;
Difluzon;
Medoflucon;
Mycomax;
Mycoflucan;
Mycosist;
Flucostat;
Futsis.

The advantage of fluconazole over other antimycotics of the azole series is the minimal suppression of oxidative processes associated with cytochrome P450 and occurring in the liver. The drug can also be used with a weakened immune response (in patients with HIV and those who have undergone organ transplantation), against the background of oncological diseases. Main indications for use:

cryptococcosis and cryptococcal meningitis, prevention of cryptococcal infection in people with AIDS;
generalized candidiasis (most forms of invasive candidal infections);
genital candidiasis;
skin mycoses;
pityriasis versicolor;
sporotrichosis and other endemic mycoses.

Fluconazole and analogues based on the same active substance are not prescribed for children under 4 years of age, are not used in conjunction with terfenadine, and are undesirable for people with sensitivity to azoles. You should consult your doctor about treatment during pregnancy. Adverse reactions on the background of long-term use:

loss of appetite, nausea, vomiting, bloating, stomach pain;
headaches, dizziness;
leukopenia, thrombocytopenia;
skin rash.

The principles of admission should be discussed with the doctor for each specific disease, as well as the duration of systemic therapy. In children over 15 years of age and adults, the dosages are the same, treatment can last up to a year. With mycoses, it often takes 4 weeks, the daily dose is 50 mg, a single dose. With onychomycosis, tablets are drunk 1 r / week at 150 mg, and the therapeutic course lasts 3-12 months.

Levorin

Among the effective preparations of the polyene series, doctors also distinguish Levorin tablets - an antibiotic with a strong fungicidal effect, working on the sodium salt of Levorin. It does not have a wide spectrum of action, since it is prescribed mainly against Candida albicans, trichomonas, amoebas, leishmania. There are few indications for use:

treatment of candidiasis of the digestive tract;
treatment of children's oral candidiasis;
systemic mycoses.

The drug is well tolerated, adverse reactions are observed only from the digestive system, but headaches and allergic manifestations on the skin (dermatitis, itching) are not excluded. The course of treatment with Levorin is 1-2 weeks, if the doctor deems it appropriate, after a week's break, the scheme is repeated, but subject to control of blood counts. Instructions for using these effective fungal tablets:

Dosage: 500 thousand units with a frequency of up to 4 r / day for adults, take before meals. If nausea occurs - after or with food. Children over 6 years old are given 250 thousand units with the same frequency. A child aged 2-5 years should receive an individually calculated dose: 25 thousand units / kg per day.
Contraindications: pancreatitis, peptic ulcer, bowel disease in the acute stage (except for candidiasis), liver failure, pregnancy, children under 2 years of age.

Lamisil

By this name, most patients know an antifungal cream, but an oral form also exists. Effective pills for fungal diseases Lamisil work on terbinafine and have a large number of analogues that are not so expensive: Bramisil, Terbinox, Terbizil, Terbinafine, Exitern. The active substance belongs to the group of allylamines, therefore it has a fungicidal and fungistatic effect. With multi-colored lichen, the systemic use of the drug is ineffective. Lamisil is prescribed for:

onychomycosis provoked by dermatophytes;
mycoses of the scalp;
skin lesions of the Candida fungus and ringworm of the feet with extensive infection.

The main contraindications to Lamisil and all terbinafine-based drugs are hypersensitivity to allylamines, renal failure, pregnancy and lactation. In case of liver diseases, care must be taken, since the drug is hepatotoxic. The most common adverse reactions include:

nausea;
pain in the right hypochondrium;
angioedema;
skin reactions.

The dosage and duration of the course of treatment are determined by the doctor. Adults are prescribed 250 mg per day, a single dose. The tablet is washed down with plenty of water. Therapy can last 4-6 weeks for dermatomycosis, 4 weeks for skin candidiasis and mycosis of the scalp. With onychomycosis, treatment lasts up to 12 weeks. For children over 2 years old, the dose of Lamisil is calculated by weight:

up to 20 kg - 62.5 mg;
21-40 kg - 125 mg.

Price

The cost of antimycotics ranges from 100 to 2000 rubles: everything is determined by the popularity of the drug, the active substance, and the spectrum of action. If you are planning to order medicines online, consider the additional shipping cost. You can find effective inexpensive pills for fungus - these are mainly drugs that have the same name as the main component, but even they will cost 100-150 rubles. Price picture for pharmacies in Moscow and St. Petersburg for the most famous drugs:

How to choose effective antifungal pills

Systemic treatment of fungal diseases is used only in relation to severe forms, so you need to select a drug only with a doctor. The information provided in open sources about the features of different drugs is for informational purposes only. A few recommendations:

Itraconazole preparations are recognized as the most versatile - they are used as tablets for the fungus of the foot, nails, scalp, etc.
Combine systemic medications with topical medications as needed, and effective treatment will become if you use funds on the same active substance.
Do not focus on price: effective anti-fungal pills are not always expensive.
If it is not possible to buy pills prescribed by a doctor for a fungus on the nails or feet, look for analogues within the same active ingredient (not a group!). As an example: instead of the advertised Lamisil Fungoterbin or Terbinox.
With thrush, the little-known Diflazon and Fluconazole are no less effective pills for the Candida fungus than the expensive Diflucan.

The drugs most commonly used to treat infectious diseases in newborns are listed in Table 1. 53-1.

Side effects of antibiotics

Allergic reactions (generalized and local).

Toxic effects (hematological, neurological, nephrological, hepatotoxic, gastrointestinal and others, including those manifested in follow-up).

Side effects associated with the biological action of antibiotics (Jarish-Herxheimer reaction, hypovitaminosis, dysbiosis, cross-infection and superinfection, including candidiasis), secondary immunodeficiencies.

Side effects of aminoglycosides (Table 53-2) The toxicity of aminoglycosides increases with renal failure (80-90% of the administered drug is excreted by the kidneys), severe hypoxia, cerebrovascular accidents, and simultaneous administration of furosemide.

Ototoxicity (tinnitus, dizziness, hearing loss due to damage to the VIII pair of cranial nerves) and neurotoxicity (headache, lethargy, neuromuscular blockade with respiratory depression, muscle twitching) develop with long-term maintenance of peak concentrations of gentamicin and tobramycin in the blood serum of more than 10 μg / ml (kanamycin and amikacin - more than 30 μg / ml), and residual, that is, before the next administration, - more than 2 μg / ml (kanamycin and amikacin - more than 10 μg / ml). The frequency of these side effects in premature infants treated with aminoglycosides for more than 4 weeks, according to different authors, ranges from 2 to 7%. The least ototoxic aminoglycoside is netilmicin, followed by tobramycin, sisomicin, gentamicin, kanamycin.

Nephrotoxicity (granular cylindruria, erythrocyturia, proteinuria, oliguria, increased blood urea concentration) is noted in 2-10% of patients treated with aminoglycosides. In view of the foregoing, when prescribing aminoglycosides to newborns, it is recommended to monitor their concentration in the blood (the same applies to chloramphenicol).

Presynaptic mechanisms (release of acetylcholine from presynaptic endings) in newborns, especially premature ones, are not yet mature enough, so aminoglycosides can cause a curare-like effect in them: muscle weakness, respiratory failure. When these disorders appear, neostigmine methyl sulfate (9 μg / kg or 0.018 ml / kg of a 0.05% solution intravenously), calcium gluconate (2 ml / kg body weight of a 10% solution, but not faster than 1 ml / min) should be administered intramuscularly for against the background of preliminary intravenous administration of atropine (18 mcg / kg or 0.018 ml / kg of a 0.1% solution). L.S. Strachunsky et al. in 1991, total threshold audiometry was performed in 146 children aged 3.5-7 years who received aminoglycosides in the neonatal period (gentamicin - in 75.6% of cases, kanamycin - in 17.5%).

Hearing loss was detected only in 2 children (1.4%), and they were premature, born in a state of severe asphyxia and suffered numerous childhood infections. Side effects of vancomycin

A nephrotoxic effect (increased serum creatinine concentration) is noted in 5% of newborns treated with vancomycin, but with the simultaneous administration of gentamicin, this figure reaches 35%. Vancomycin is not ototoxic. Rapid intravenous administration of vancomycin can lead to arterial hypotension, bradycardia (and even neonatal shock), rash on the neck (red neck syndrome), head, and limbs, which is associated with the release of large amounts of histamine. Preliminary administration of antihistamines and a decrease in the rate of infusion (one dose should be administered over at least 1 hour) prevent these side effects from occurring.

Side effects of chloramphenicol

Even with the introduction of standard doses of chloramphenicol (25 mg / kg) to newborns, the concentration of the antibiotic in the blood is unpredictable. Abroad, it is considered necessary to monitor the concentration of the drug in the blood, especially in newborns.

At a concentration of chloramphenicol in the blood serum of more than 25 mg / l, hypochromic, hyporegenerative anemia, thrombocytopenia, anorexia occur, and weight gain decreases. Therefore, before and during treatment with chloramphenicol, it is necessary to control the content of reticulocytes in the blood. At a concentration of chloramphenicol in the blood of more than 50 mg / l, after 24 hours, a “gray collapse” occurs (metabolic acidosis, bloating, profuse green stools, hypothermia, respiratory disorders, gray skin color). The frequency of aplastic anemia is 1 in 20,000-40,000 patients treated with chloramphenicol, and does not depend on the dose of the drug and the duration of its use, that is, it develops only in individuals with a hereditary predisposition. Chloramphenicol should not be given to newborns if safer alternatives are available. It should be remembered that currently 50-70% of Shigella strains, 3050% of Salmonella strains and 70% of Escherichia strains are resistant to chloramphenicol. Table 53-1.

: doses (mg/kg or U/kg) and frequency of administration

Notes

1 Optimal doses of aminoglycosides and vancomycin should be determined based on their serum concentrations (especially in children weighing less than 1500 g). In children weighing less than 1200 g during the first week of life, it is advisable to administer the drugs after 24 hours. Doses of aminoglycosides may differ from those recommended, depending on the manufacturer's instructions included in the package.

2 High doses for meningitis Some experts recommend high doses for meningitis caused by group B streptococcus.

3 Safety in infants has not been established. When prescribing carbopenems to newborns, it is preferable to use meropenem.

4 Ceftriaxone is not prescribed for hyperbilirubinemia, especially in preterm infants.

5 Ticarcillin is contraindicated in preterm infants with impaired renal function.

6 Chloramphenicol should not be given to neonates if safer alternatives are available. Doses are given for children without impaired liver and kidney function.

7 For the prevention of candidiasis in children with ENMT in the NICU (with a high incidence of fungal diseases associated with the use of invasive procedures), fluconazole is prescribed at a dose of 3 mg/kg 2 times a week.

Table 53-2.

(in adults, in summers up to 3 months they occur much less frequently)

The use of antibiotics in renal failure

Application Data antibacterial drugs in renal failure are given in table. 53-3.

Table 53-3.

and their excretion from the body in children with severe renal failure before or during PD (Neonatal Formulary // BMG. - 1998.)

Antibacterial therapy for infectious diseases in newborns (Table 54-4)

54-4. Empiric antibiotic therapy for infectious diseases in newborns

Disease options	Drugs of choice	Alternative drugs
	Pneumonia
congenital	Ampicillin
	(ampicillin + sulbactam) + aminoglycoside	mycin!)
	Amoxicillin	Ceftazidime + aminoglycoside
	(amoxicillin + clavulanic	Erythromycin, azithromycin (for myco-
	acid) + aminoglycoside	plasma etiology)
		Benzylpenicillin (for syphilitic
		etiology)
Early fan-	The same	Cefotaxime + aminoglycoside (not Genta-
associated pneumonia		mycin!)
(VAP) in children of the first 3 days		Ceftazidime + aminoglycoside (not gene-
life		tamycin!)
Late VAP	Ceftazidime + aminoglycoside (not Genta-	Vancomycin + aminoglycoside (not Genta-
	mycin!)	mycin!)
	Cefoperazone + aminoglycoside (not Genta-
	mycin!)	Meropenem
		Fluconazole
Out-of-hospital in children of late
neonatal period:
moderate	Amoxicillin	If you suspect chlamydial or
	(amoxicillin + clavulanic acid)	mycoplasma etiology azithromycin
	Cefuroxime, cefotaxime, ceftriaxone	or clarithromycin
heavy	Ampicillin	Cefotaxime,
	(ampicillin+sulbactam)+	ceftriaxone + aminoglycoside (not
	aminoglycoside	gentamicin!)
	Amoxicillin	Vancomycin
	(Amoxicillin + clavulanic	Linezolid
	acid) + aminoglycoside
	Oxacillin + aminoglycoside Cefuroxime
	Sepsis
Early
	Ampicillin + aminoglycoside	Cephalosporin III
		generation + aminoglycoside (not genta-
Late		mycin!)
	3rd generation cephalosporin (cefotaxime,	Carboxypenicillins + aminoglycoside
	ceftriaxone) + aminoglycoside	Glycopeptides

Community-acquired sepsis:
umbilical		Carbapenems
	Cephalosporin II or III	Glycopeptides
	generations + aminoglycoside	Aminoglycosides (not gentamicin!)
		Linezolid

dermal, nasopharyngeal	Aminopenicillin + aminoglycoside	Glycopeptides
	Cephalosporin II	Linezolid
	generations + aminoglycoside
nasopharyngeal, otogenic	Cephalosporin III	Carbapenems
	generations + aminoglycoside
		glycoside (not gentamicin!)
intestinal
	3rd generation cephalosporin	IV generation cephalosporins + amino-
	+ aminoglycoside + metronidazole	glycoside (not gentamicin!)
	InhibitorProtected	Carboxypenicillins inhibitors
	aminopenicillin + aminoglycoside	shielded + aminoglycoside
		Carbapenems
urosepsis	3rd generation cephalosporins
	Aminoglycosides	Carbapenems

Hospital sepsis:	Cephalosporin with antipseudomonal effect + aminoglycoside Inhibitor-protected carboxypenicillin + aminoglycoside	Carbapenems Carbalenems + vancomycin or linezolid
abdominal	III generation cephalosporin with antipseudomonal effect + aminoglycoside + metronidazole Inhibitor protected carboxypenicillin + aminoglycoside	IV generation cephalosporin + metronidazole Carbalenems + metronidazole
post-catheterization	Glycopeptides + aminoglycoside	Linezolid + aminoglycoside
pulmonary (IVL-associated)	Cephalosporin with antipseudomonal effect + aminoglycoside (not gentamicin!) Inhibitor-protected carboxypenicillin + aminoglycoside (not gentamicin!)	Carbalenems + vancomycin Lincosamides
	Miscellaneous diseases
Vesiculopustulosis	Skin toilet, oxacillin, amoxicillin, ampicillin (optimally both protected, that is, with inhibitors (i-lactamase), cephalosporins of the second generation
Pemphigus	Same
Enterocolitis	Amoxicillin + clavulanic acid, cefotaxime, ceftriaxone, ceftazidime
Meningitis	For early onset: ampicillin (200 mg/kg/day + aminoglycoside). With late onset: III-generation cephalosporins or carbapenems (merolenem) + aminoglycoside (not gentamicin!) + if staphylococcal etiology is suspected - vancomycin, linezolid, if candidal etiology is suspected - fluconazole, amphotericin B
Necrotizing enterocolitis, peritonitis	Cefotaxime (ceftriaxone) + aminoglycoside (not gentamicin!) + metronidazole or ceftazidime + aminoglycoside (not gentamicin!) and vancomycin or linezolid
Conjunctivitis	Eye drops (0.5% chloramphenicol solution and erythromycin ophthalmic ointment, or 20% sulfacetamide) + macrolides orally or intravenously for chlamydia or benzylpenicillin intravenously for gonococcal conjunctivitis
urinary tract infection	Amoxicillin + clavulanic acid, cefotaxime (ceftriaxone), ceftazidime
Omphalitis	Oxacillin + aminoglycoside (not gentamicin!), amoxicillin + clavulanic acid + aminoglycoside (not gentamicin!)
osteomyelitis, arthritis	Oxacillin + aminoglycoside (not gentamicin!), vancomycin, linezolid

Antifungal drugs (Table 53-5)

Table 53-5. Doses and frequency of administration of antifungal drugs (Recommendations of the Committee on Infectious Diseases of the American Academy of Pediatrics // Red Book. - 27th edition -2006.)

A drug	Route of administration	Daily dose	Adverse reactions
Amphotericin B	Intravenously	0.25-0.5 mg/kg with an increase in tolerance up to 0.5-1.5 mg/kg; each dose is administered over 2 hours; maintenance dose - 0.5-10 mg / kg once a week	Fever, chills, phlebitis, gastrointestinal dysfunction, headache, arterial hypotension, renal dysfunction, hypokalemia, anemia, cardiac arrhythmias, anaphylactic reactions, neurotoxicity
	Intrathecal	0.025 mg, increasing to 0.5 mg twice a week	Headache, gastrointestinal dysfunction, arachnoiditis/sciatica
Amphotericin B liposomal-^12	Intravenously	3-5 mg/kg administered over 1-2 hours	Fever, chills, other reactions associated with amphotericin B, but less nephro- and hepatotoxicity
clotrimazole,	oral	10 mg 5 times a day (tablet slowly dissolve in the mouth)	Gastrointestinal dysfunction, hepatotoxicity
Fluconazole	Intravenously	3–6 mg/kg once daily (up to 12 mg/kg for severe infections)	Skin rashes, gastrointestinal dysfunction. hepatotoxicity, Stevens-Johnson syndrome, anaphylactic reactions

Notes

	oral	6 mg/kg once on the first day and then 3 mg/kg once for oropharyngeal and esophageal infections, 612 mg/kg for systemic candidiasis; 6 mg/kg as maintenance therapy in children with HIV infection and cryptococcal meningitis
flucytosine	orally	50-150 mg/kg, divided into 4 doses 6 hours later (dose adjusted in renal failure)	bone marrow suppression; renal dysfunction, gastrointestinal dysfunction, hepatotoxicity, neuropathies, hallucinations, stupor
Ketoconazole,3	oral	Children: 3.3-6.6 mg/kg once a day Adults: 200 mg twice a day for 2 days, then 200 mg once a day	Hepatotoxicity, gastrointestinal dysfunction, anaphylactoid reactions, thrombocytopenia, hemolytic anemia, gynecomastia, adrenal insufficiency
Nystatin	Orally intravenously	Infants: 200,000 IU 4 times a day after meals Children and adults: 400,000-600,000 IU 3 times a day after meals Children: 6-8 mg / kg every 12 hours on the first day, then 7 mg / kg every 12 h Adults: 6 mg/kg every 12 hours on the first day, then 4 mg/kg every 12 hours	Gastrointestinal dysfunction, skin rashes
voricanazole	oral	Children: 8 mg/kg every 12 hours on the first day, then 7 mg/kg every 12 hours Adults: less than 40 kg, 200 mg every 12 hours on the first day, then 100 mg every 12 hours; more than 40 kg -400 mg every 12 hours on the first day, then 200 mg every 12 hours	Visual disturbances, photosensitive rashes, liver dysfunctions

1 Safety in neonates not established.

2 For children under 2 years of age, a safe dose has not been established. Limited information on use in neonates

Table 53-6. Doses and frequency of administration of antiviral drugs (Recommendations of the Committee on Infectious Diseases of the American Academy of Pediatrics // Red Book. 27th edition - 2006.)

A drug	Indications	Route of administration	Age	Doses
Acyclovir12	Herpetic encephalitis	Intravenously	From 3 months to 12 years	60 mg/kg daily) in 3 injections for 14-21 days
	neonatal herpes	Intravenously	From birth to 3 months	60 mg/(kghd) in 3 injections for 14-21 days
	Chickenpox in immunocompetent patients4	Oral Intravenous	Over 2 years old	80 mg/kg in 4 doses for 5 days (maximum dose 3200 mg/day) 30 mg/(kgxday) in 3 injections for 7-10 days or 1500 mg/m body surface area in 3 injections for 7-10 days
	Chickenpox in immunocompromised patients4	intravenously	Any age	30 mg/(kgxday) in 3 injections for 7-10 days or 1500 mg/m2 body surface in 3 injections for 7-10 days

	Shingles	Intravenously	Any age	As in patients with
	in a patient with			immunodeficiency in chickenpox
	normal	orally	Over 12 years old	smallpox
	immunity			4000 mg/day in 5 divided doses
				within 5-7 days
	Shingles	Intravenously	Up to 12 years old	60 mg / (kghsut) in 3 injections per
	in patients with			within 7-10 days
	immunodeficiency
		Intravenously	Over 12 years old	30 mg / kghsut) in 3 injections during
				7-10 days
	herpetic	Intravenously	Up to 12 years old	30 mg / (kghsut) in 3 injections per
	infection in patients			within 7-10 days
	with immunodeficiency
	(local,	Intravenously	Over 12 years old
	progressive,			within 7-10 days
	generalized)
		orally	Over 2 years old	1000 mg / day in 3-5 doses for
				7-14 days
	Prevention	orally	Over 2 years old	600-1000 mg/day in 3-5 divided doses
	herpetic			during the period of risk
	infections in patients
	with immunodeficiency
	Herpes-	Intravenously	Any age	15 mg/(kghd) for a period
	seropositive			risk
	Patients
	Genital herpes,	orally	Over 12 years old	1000-1200 mg / day in 3-5 doses
	first clinical			7-10 days. For children: 40-80
	episode			mg / (kghsut) in 3-4 doses per
				within 5-10 days (maximum
				- 1 g/day)
		Intravenously		15 mg / (kghsut) in 3 injections per
				within 5-7 days
	Genital herpes,	orally	Over 12 years old
	relapse			1000-1200 mg/day in 3-5 divided doses
				within 3-5 days
	recurrent	orally	Over 12 years old
	genital and			800-1200 mg/day in 3 divided doses
	skin (eye)			for several months (up to
	herpes in people with			1 year)
	frequent relapses,
	long-term therapy
	immunosuppressants
	; any form
	herpes (local,
	progressive,
	generalized)
	patients with
	immunodeficiency
Amantadine	Influenza A	orally	1-9 years old
	(treatment and pro-			5 mg / (kghsut) (no more than 150
	phylaxis)			mg/day) in 2 divided doses
Famciclovir	Genital herpes	orally	over 9 years old
				With body weight up to 40 kg - 5
				mg / (kghsut), with a body weight of more than
	episodically recurrent			40 kg - 200 mg / day in 2 divided doses;
	vivacious			alternative prevention
	genital herpes			with a body weight of more than 20 kg - 100
				mg/day
	Daily Therapy	orally
	immunosuppressants			750 mg/day in 3 doses for
			adult doses	7-10 days

Intestinal infection is a very common health disorder. This term means a complex of diseases with similar symptoms. They appear to be malfunctioning. gastrointestinal tract and intoxication of the body. As a result, drugs against intestinal infections have several directions of action: restoration of water-salt balance; elimination of infection; cleansing the body of toxins; restoration of normal intestinal microflora. Let us consider in more detail the preparations of each of these groups.

To restore the water-salt balance

Regidron

The drug restores the acid-base balance, which is necessarily disturbed by profuse and frequent vomiting and diarrhea.

How to take: the package is dissolved in 1 liter of boiled water, the cooled liquid is taken, shaking each time beforehand.

Regidron is taken in a dose that is calculated for adults and children, based not on age, but on weight. Every hour the patient takes the amount of solution at the rate of 10 ml per 1 kilogram of body weight. After vomiting and each liquid stool, you need to drink an additional portion from the same calculation.

There are no side effects, it is contraindicated in excess of potassium, diabetes mellitus, hypertension, renal failure. Pregnant and lactating women can.

Regidron has an advantage over other drugs and is better than drinking salt water, because it contains a lower dose of sodium and an increased dose of potassium, which is more suitable for the needs of the body in intestinal infections.

Regidron can be replaced with Gemodez, Citroglucosolan, Trihydron, Hydrovit Forte, mineral water, saline, drinking water with salt, soda and sugar.

Antibacterial drugs

As for antibiotics, they are prescribed only after vomiting subsides, if any. In addition, adults are prescribed these drugs only in severe cases, and children more often, but not always.

Levomecithin

Bacteriostatic antibiotic. Available in tablets. The main substance is chloramphenicol (levomycetin).

For adults, a single dose of 250-500 mg half an hour before meals.

Children aged 3 to 8 years are usually prescribed 125 mg of the drug 3-4 times a day.
Children and adolescents aged 8 to 16 years are usually prescribed 250 mg of Levomycetin 3-4 times a day.
The course of treatment is usually 1-1.5 weeks. You can take 3 times a day. You can not use the drug for influenza, pregnancy, psoriasis, renal failure.

Doxycycline

An antibiotic active against gram-positive bacteria. on the 1st day of treatment, the dose is 200 mg of the drug. In the following days - 100-200 mg per day, depending on the severity of the course of the disease. You can also calculate the dose by weight: for children over 9 years old and weighing more than 50 kg, the daily dose of the drug is 4 mg / kg on the 1st day of treatment, on the following days - 2-4 mg per kg of body weight per day, depending on the severity illness. Contraindications - age up to 9 years (or until the age when molars are formed), pregnancy and lactation, impaired kidney and liver function, leukopenia, porphyria.

Antivirals

Cycloferon

Antiviral drug with the active ingredient meglumine acridone acetate. It has an immunomodulatory, anti-inflammatory, antitumor effect. Tablets can be taken 1-2 times a day. Contraindications - pregnancy, allergies, lactation.

Ingavirin

Antiviral agent in the form of capsules. The medicine relieves inflammation and fights viruses. Take the medicine should be 90 mg once a day. Do not drink during pregnancy and allergies.

Arbidol

The main substance is umifenovir. Helps with acute intestinal infections in children and adults caused by rotavirus. Take the medicine should be 1-2 capsules, but it all depends on the appointment of a specialist and the condition of the patient. Contraindications - hypersensitivity and age up to three years. For babies from birth to 3 years, the drug of choice from interferons is Viferon suppositories with a dosage of 150,000 IU.

Sorbents

They are prescribed to bind toxins in the intestines. Among the most effective drugs:

Smecta;
Polyphepan;
Enterosgel;
Activated carbon;
Carbolong.

These medicines are suitable for both adults and children. They are harmless. These drugs adsorb poisons and toxins, viruses and bacteria, increase the amount of mucus and improve its gastroprotective properties.

Restoration of the microflora of the gastrointestinal tract

Prebiotics and probiotics work in this direction. They contain live bacteria that strengthen the immune system, normalize bowel function and improve metabolism:

Bificol is a remedy from the group of eubiotics. Composition - Escherichia coli and bifidobacteria bifidum. The product is available in the form of a lyophilizate for the preparation of a suspension. Used for inflammatory diseases of the digestive system. It is necessary to drink three times a day for several doses (the doctor will definitely prescribe).
Linex is a drug for the normalization of the intestinal flora. Released in capsules. Used in the treatment of dysbacteriosis. You can take one or two capsules a day. Contraindications - hypersensitivity to the components. It is extremely rare to have an allergy.
Lactobacterin helps eliminate problems with the intestinal microflora. The drug is used for dysbacteriosis, colitis. You can use the remedy in the amount of 4-10 tablets, depending on the doctor's prescription. Side effects include nausea and general malaise.

In addition, medications may be prescribed to relieve associated symptoms. That is, antipyretic (Paracetamol), antiemetic (Aminazine, Metoclopramide), antidiarrheal (Imodium, Indomethacin, Loperamide). It all depends on the severity of the condition and the specific case.

What is the best choice for the treatment of intestinal infections? It all depends on the type of pathogen, condition and age of the patient. Therefore, it is necessary to consult a doctor and strictly follow his recommendations.

The materials posted on this page are for informational purposes and are intended for educational purposes. Site visitors should not use them as medical advice. Determination of the diagnosis and choice of treatment method remains the exclusive prerogative of your attending physician.

For adults

Bacterial infections have been affecting humans since their existence. At the same time, the number of bacteria grows, they evolve, disguise themselves and adapt to life in unfavorable conditions for them.

Antibacterial drugs cannot kill all types of bacteria, since they only affect some of their groups. Broad-spectrum anti-infective drugs for adults come to the rescue. They act on a large number of pathogens, are used in the treatment of many pathologies.

On a note! Broad-spectrum antibiotics help when it becomes necessary to deal with several pathogens at once. In this case, doctors manage to avoid prescribing a large number of pills and injections.

To be treated effectively and inexpensively, you need to know the active substance.

In pharmacology, the following assets are highlighted:

Interferons- proteins that fight viruses. Thanks to them, cells become immune to viral attack. These include Grippferon, Wellferon, Betaferon, Ingaron, Neovir;
Nucleosides- substances that have antibiotic activity: Acyclovir, Zidovudine, Gancilovir, Entecavir, Gancilovir;
Products containing lipids- Nutriflex, Pravastatin, Saquinavir;
Derivatives from adamantane- Adapromin, Remantadine, Mitantan, Gludantan;
Ladolcarbolic acid;
Thiosemicarbazone;
Ligosin, Flacoside, Cholepin, Alpidarin containing herbal ingredients.

In the treatment of many infectious diseases, as well as in the absence of an accurate diagnosis, broad-spectrum anti-infective drugs are prescribed. Unfortunately, they not only destroy pathogenic microorganisms, but also affect the microflora that is not affected by bacteria.

In medical practice, antibiotics are most often used. They are an excellent antibacterial agent that can cope with various diseases, from bronchitis to sepsis.

Therefore, the natural question is which of the antibacterial agents is better?

Due to the fact that broad-spectrum antibiotics can fight several types of bacterial infections at the same time, doctors prefer them. They are shown in such cases:

A bacterial infection was diagnosed, but the causative agent was not identified.
The disease is caused by infectious pathogens that are resistant to narrow-spectrum drugs.
The disease is caused by several types of pathogens.
In order to prevent in the lesion.

Anti-infective drugs are divided into several groups (depending on the chemical composition):

Penicillins. Developed on the basis of waste products. They are classified into natural and semi-synthetic. The ancestor is considered to be benzylpenicillin. They play the role of enzymes in the synthesis of a biopolymer. Influence the mechanism of formation of bacterial walls, and block its synthesis. This leads to the death of the bacterial form. Most often used Ampicillin, Amoxicillin, Amoxiclav.
Cephalosporins. The second type in terms of frequency of use, since they have low toxicity and high efficiency. Use Ceftriaxone, Cefotaxime, Cefuroxime.
Macrolides. They interfere with protein synthesis on ribosomes. They have antibacterial, anti-inflammatory and immunomodulatory effects. Means of this group are taken with caution. Despite the fact that they are the most effective drugs, there is a high risk of allergic reactions and side effects. One of the most famous is Azithromycin, which is used in the treatment of bacterial infections. For example, its use is effective for infections of the lymph nodes, for various purulent diseases of the internal organs.
Aminoglycosides. First obtained in 1944. They are the oldest of all groups of antibiotics. They are divided into 3 generations:

Streptomycin, Neomycin, Kanamycin.
Gentamicin, Tobramycin, Netilmicin.
Amikacin.

Fluoroquinolones. Violate DNA synthesis, have strong antibacterial properties. Used since the 60s of the last century. They fight severe forms of diseases by acting on atypical bacteria. Share 4 generations of drugs. Modern - these are drugs of the 3rd and 4th generation. These include Levofloxacin and Moxifloxacin.

Attention! Any of the types of antibacterial agents has contraindications, so it is forbidden to use them without a doctor's prescription.

A person is unlikely to be able to completely get rid of infectious diseases. But pharmaceutics, new technologies and methods will allow you to be always ready to fight back and fight them.

It is important to remember that you can protect yourself from bacteria and infections by maintaining a healthy lifestyle. If the disease could not be avoided, you should not self-medicate, do not try to use methods traditional medicine. Only qualified medical assistance can be effective.

Publication date: 26-11-2019

What are the cures for intestinal infection for adults and children?

Medications for intestinal infections are taken to eliminate the unpleasant symptoms caused by various pathogenic bacteria. In addition to the therapeutic effect, they remove toxins from the body and help restore the water-salt balance.

To effectively fight the infection, it is necessary to take medicines in a complex manner. The entire volume of drugs is divided into 4 categories:

for first aid to the patient;
to remove accumulated toxins;
to eliminate individual symptoms;
to normalize the intestinal microflora.

Primary Care Products

Frequent acts of defecation (more than 8 times a day), in which there are stool liquid consistency, accompanied by general weakness of the body and symptoms of poisoning, indicate a critical stage of infection and require emergency assistance to stabilize the patient's condition.

The complex of first aid for intestinal infections includes activities aimed at relieving pain and restoring the body's water balance. To eliminate discomfort and reduce temperature, injections of a lytic mixture are indicated. The medicine contains standard components: analgin, papaverine and diphenhydramine. The mixture has a strong effect and is used only in extreme cases.

To solve the problem of dehydration, injections of isotonic sodium chloride solution are indicated. The dosage of the drug is set individually depending on the degree of infection. Its use effectively restores the water-salt balance, but due to the osmotic pressure equal to blood plasma, it is quickly excreted from the body.

Powdered medicines have a rehydration effect: Regidron, Polysorb, Albumin, etc. In addition to stabilizing the water balance, their use is aimed at restoring potassium and sodium reserves, excreted along with the liquid.

The intake of these funds most often leads to the rapid elimination of obvious symptoms of intoxication, the removal of waste products from the body. pathogenic bacteria. Insufficient effectiveness of drugs indicates a severe stage of infection and requires hospitalization in a medical facility.

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Detox products

To remove poisons and toxins, sorbents are prescribed - drugs that absorb harmful elements into themselves for their subsequent removal from the body. The choice of this or that remedy depends on the individual characteristics of the patient, his age and the form of infection. All sorbents can be divided into the following categories:

carbonaceous;
ion exchange;
based on natural ingredients;
other means.

The first type of sorbents is the most effective and popular among this group of drugs. Its action is based on the absorption of harmful components and preventing further intoxication. Examples of this group are Activated carbon and other preparations based on it: Sorbeks, Antralen, etc.

The action of the second type of medicines is to mix them with poisons and toxins to carry out chemical reaction, as a result of which they break up into simple, harmless elements for the body. Such drugs are Cholestyramine, Choleziviliam, etc.

Sorbents based on natural components, unlike the previous ones, do not interact with the waste products of pathogenic bacteria, but play the role of an adhesive tape for them. A medicine based on natural ingredients most often contains pectin, cellulose, fiber, etc. Examples of these agents are: Filtrum, Laktofiltrum, Zosterin, Extralact, etc.

The last group consists of drugs with a different spectrum of action. They have been used since ancient times and, in addition to the cleansing effect, have a nourishing effect on the body. Such medicines are: Polysorb, Smecta, etc.

Drugs for the treatment of various infections

To completely eliminate the consequences of intoxication of the body, the use of special drugs aimed at combating pathogens is indicated. These drugs are a group of the most potent drugs that quickly eliminate unpleasant symptoms, replenish the lack of fluid and normalize the general condition of the patient. Depending on the principle of action, this category of drugs is presented:

The first group of drugs has a strong effect, due to which not only pathogenic, but also beneficial bacteria are removed from the body. For this reason, antibiotics are most often prescribed for the treatment of the most severe forms of intestinal infections. For the appointment of antibiotics, it is necessary to confirm the bacterial source of infection - other pathogens of the pathology are not amenable to its action. It is recommended to be especially careful when prescribing antibiotics to children. In the treatment of young patients, drugs are used in the form of tablets or syrup. The following medications effectively fight intestinal infections: Levomycetin, Ampicillin, Amoxicillin, Augmentin, Cefix, etc.

The use of the latter group of drugs is due to the viral origin of the infection. In this case, treatment is carried out similar to therapy colds. The patient is prescribed a complex of antiviral and strengthening medicines: Anaferon, Arbidol, Amiksin, Rinicold, etc.

Means for restoring intestinal microflora

Therapy of infectious diseases, in addition to removing toxins, is accompanied by the simultaneous removal of beneficial bacteria, which leads to the development of dysbacteriosis. To maintain a weakened body and prevent the development of a new pathology, an additional course of treatment is carried out aimed at restoring the normal intestinal microflora.

Therapy is carried out by 2 groups of drugs: probiotics and prebiotics. The difference between these funds is a different principle of action. The former are characterized by an effect on the body by introducing beneficial bacteria into the mucous membrane. With a positive course of the recovery process, they gradually take root and begin to divide. The composition of the product can include both one and several cultures. Examples of the first medicines are such drugs for intestinal infections as Lactobacterin, Biobacton, Profibor, etc.

But these funds are not compatible with the simultaneous use of antibiotics. They are ineffective in case of severe infections. Therefore, for the rapid restoration of microflora, preparations containing several bacteria are most often used: Linex, Acilact, Bifilong, etc. These types of medicines can be prescribed for any form of infection, for patients of all ages. The only limitation of the use of probiotics is the presence in the patient of violations of the defense system or allergies.

In this case, prebiotics are prescribed, the action of which is aimed at stimulating the independent production of beneficial bacteria. They are a nutrient for the intestinal microflora and, in addition to medicines, are found in many products: dairy food, bakery products, cereals, etc. The following types of prebiotics are prescribed to maintain the health of the patient: Inulin, Prelax, Portalak, Livoluk, etc.

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Prebiotics are not digested in the upper gastrointestinal tract and reach the lower gastrointestinal tract unchanged. For this reason, they are not prescribed to patients who are simultaneously suffering from diabetes mellitus, fructose intolerance, intestinal obstruction or bleeding.

These drugs are prescribed only by a doctor on the basis of a medical examination. Do not take self-selected medications. Improper diagnosis and treatment of intestinal infections can cause severe consequences.