Antibiotics of the latest generation of a broad spectrum of action

Among drugs, an important place is occupied by antibiotics of the last generation, active against many microbes. They are used to treat infectious pathologies, which significantly reduced the death rate of patients from today's commonplace pneumonia and pyelonephritis. Due to antibiotics, the flow is facilitated and recovery is accelerated with bronchitis, sinusitis, and also complicated surgical operations became possible. Even wound infections are successfully treated with antibiotics.

Antibiotics of a wide spectrum (ABSS)

This category of antimicrobial drugs includes substances that are active against gram-negative organisms and Gram-positive. The first are causative agents of intestinal diseases, inflammatory pathologies of the genitourinary and respiratory systems. Gram-positive organisms often cause wound infections and mediate the occurrence of postoperative complications in surgery.

List of ABSS of different release time

Some broad-spectrum antibiotics of the latest generation are also active against protozoal infections. An example is the derivatives of nitroimidazole - tinidazole, ornidazole and metronidazole. The most widely used metronidazole due to affordability. Its class analogue - tinidazole - is similar in the spectrum of antimicrobial activity, but it is not applied parenterally. In general, all groups of broad-spectrum antibiotics are presented as follows:

• Natural penicillins;
• Inhibitor-protected aminopenicillins;
• Antisseinemic penicillins, including inhibitors;
• Cephalosporins of the third generation, cephalosporins of the IV generation ;
• Group of aminoglycosides;
• Antibiotics of the tetracycline series ;
• Macrolide antibiotics;
• Antibiotics of a number of carbapenems;
• Chloramphenicol;
• Phosphomycin;
• Rifampicin;
• Dioxydin;
• Sulfonamides;
• Quinolones, fluoroquinolones;
• Group of nitrofurans;
• Antibiotics of the nitroimidazole series.

This list does not list the names of groups of narrow-spectrum antibiotics. They are specific for a small number of microbes and are effective against them. Narrow spectrum drugs can not be used for the treatment of superinfections and do not apply empirically. They are used as antibiotics of the first row with the established form of pathogen.

List of ABSS of recent generations

The antimicrobial agents given above refer to broad spectrum preparations. This is a complete list of groups of substances that have activity against gram-positive and gram-negative microbes. However, the list includes both the latest generation antibiotics and the earlier members of the group. Of the above, representatives of the latest generations are the following groups of drugs:

• Aminopenicillins resistant to beta-lactamase ("Sulbactam", "Ampicillin", "Clavulanate", "Amoxicillin");
• Cephalosporins of III and IV generations ("Cefotaxime", "Cefoperazone", "Ceftazidim", "Ceftriaxone", "Ceftir", "Cefepime");
• Aminoglycoside antibiotics of the third generation ("Amikatsin", "Netilmitsin");
• 14- and 15-member semisynthetic macrolides ("Roxithromycin", "Clarithromycin", "Azithromycin");
• 16-membered natural macrolide antibiotics ("Midekamycin");
• Fluoroquinolones of III and IV generations ("Levofloxacin", "Sparfloxacin", "Gatifloxacin", "Trovafloxacin", "Moxifloxacin");
• Carbapenems ("Meropenem", "Imipinem-cilastatin", "Ertapenem");
• Nitrofurans (Nitrofurantoin, Furazidine, Ersefuril).

Antibiotic drugs excluded from the list

The previously protected, anti-synergic penicillins have a broad spectrum of activity, but they are used only against Pseudomonas aeruginosa because of the need to reduce the probable contact of the latter with a modern and powerful antibiotic. This prevents the development of drug resistance of the bacterium. The most effective against pseudomonas aeruginosa infection is manifested by Tazobactam. Occasionally, "Piperacillin" or "Clavulanate" is used as the latest generation of antibiotics for pneumonia caused by a hospital strain of the pathogen.

Also in this list there are no antibiotics of the last generation of the group of natural and antistaphylococcal penicillins. The former can not be used in outpatient care because of the need for frequent intravenous or intramuscular injection. Forms that allow to take them orally do not exist. A similar situation has developed with cephalosporins. Having the same spectrum of activity as penicillins, they can not be administered orally due to destruction in the stomach.

Cephalosporins and parenteral penicillins are effective antibiotics of the latest generation in pneumonia. Scientists of the National Academy of Sciences of Belarus have achieved success in developing a medicinal form for their enteral use. However, the results of the studies have not yet been applied in practice, and the drugs of this series can be used so far only in the work of inpatient health care institutions.

Highly effective antibiotics for children

Investigating antibiotics of the latest generation, the list of drugs recommended for children is significantly narrowed. In childhood only representatives of a number of aminopenicillins ("Amoxicillin", "Clavulanate"), cephalosporins ("Ceftriaxone", "Cefepim"), macrolides ("Azithromycin", "Midekamycin", "Roxithromycin", "Clarithromycin") can be used. Fluoroquinolone antibiotics, carbapenems and nitrofurans can not be used because of the inhibition of bone growth, hepatic and renal toxicity.

Systemic nitrofurans are not used because of the lack of scientific evidence confirming the safety of treatment. The exception is only "furatsillin", suitable for local treatment of wounds. Modern and highly effective antibiotics for children of the last generation are the following: macrolides, penicillins, cephalosporins (the names of the drugs are presented above). The remaining groups of antimicrobials should not be used because of the toxic effect and disruption of the development of the skeleton.

ABSS for pregnant women

According to the FDA (USA) classification, only some antibiotics of the latest generation can be used in the treatment of pregnant women, the list of which is extremely small. They belong to categories A and B, that is, their danger is not confirmed or there is no teratogenic effect in animal studies.

Substances with unproved effects on the fetus, as well as with the presence of a toxic effect, can be used only if the therapeutic effect prevails over the side effect (categories C and D). Preparations of category X are distinguished by a proven teratogenic effect on the fetus, therefore, if necessary, their use necessarily interrupts pregnancy.

During pregnancy, the following antibiotics of the latest generation of a broad spectrum of action in tablets are used: protected aminopenicillins (Amoclav, Amoxiclav), cephalosporins (Cephazoline, Ceftriaxone, Cefepime). Macrolides ("Azithromycin", "Clarithromycin", "Midekamycin", "Roxithromycin") are allowed to use in the third trimester of gestation because their teratogenic effect has not yet been fully studied, and its absence can not be unequivocally stated. Also in pregnant women it is safe to use penicillin antibiotics in the absence of allergies.

The use of antibiotics in the treatment of bronchitis

All antibiotics of the latest generation of a broad spectrum of action, theoretically, can be used for bronchitis and pneumonia, if their pharmacodynamic characteristics are optimal for this. However, there are optimal schemes for rational treatment of such diseases. They take into account the options for successful combinations of antimicrobials with a view to wide coverage of microbial strains.

Nitrofurans, nitroimidazole derivatives and sulfonamides are irrationally used in inflammatory diseases of the respiratory system. The most successful combination for bronchitis or pneumonia of the lung course is protected aminopenicillin with macrolide ("Amoclav" + "Azithromycin"). Prolonged bronchitis requires the appointment of cephalosporin instead of aminopenicillin ("Ceftriaxone" + "Azithromycin"). In this scheme, macrolide can be replaced by another class analogue: "Midekamycin", "Clarithromycin" or "Roxithromycin".

All these antibiotics of the last generation with bronchitis have a pronounced effect, although the clinical signs of the disease can continue to be present. The criterion of the effectiveness of treatment is the appearance of a cough with gradually purified sputum and the arrest of fever. With COPD, dyspnea also weakens, appetite improves, and the frequency of coughing decreases.

Effective treatment of pneumonia

Pneumonia of mild degree is treated according to the principle of bronchitis, but with the use of cephalosporin and macrolide. In case of moderate or severe pneumonia of out-of-hospital origin cephalosporin ("Ceftriaxone" or "Cefepime") is appointed with a representative of a number of fluoroquinolones ("Ciprofloxacin" or "Levofloxacin"). These antibiotics of the latest generation of a wide spectrum of action well suppress out-of-hospital microflora, and the effect of their application is noticeable on the second day of treatment.

Modern antibiotics of the latest generation in pneumonia (the names are presented above) affect the pathogen, suppressing its life activity or killing it. The first substances are called bacteriostatics, and the second ones are bactericidal preparations. Cephalosporins, aminopenicillins and fluoroquinolones are bactericidal substances, and macrolides are bacteriostatics. And combining antibiotics aims not only to expand the spectrum of activity, but also to observe the rules of combining: one bactericidal drug with one bacteriostatic.

Treatment of severe pneumonia in OITR

In intensive care, where there may be patients with severe pneumonia and distress syndrome in the background of intoxication. The main contribution to the severity of the condition of such patients is made by pathogenic microflora resistant to the majority of antimicrobial agents. In such situations, carbapenems are used ("Imipinem-cilastatin", "Tienam", "Meropenem"), which are unacceptable for use in outpatient settings.

Treatment of sinusitis and sinusitis

Modern antibiotics of the latest generation for sinusitis or sinusitis are used to kill microbes. In such cases, one bactericidal antibiotic can be used. However, with antritis the main difficulty is the access of the antimicrobial drug to the site of inflammation. Therefore, the most commonly used drug cephalosporin series. An example is Ceftriaxone or Cefepime. Fluoroquinolone III generation - "Levofloxacin" may also be prescribed.

Treatment of angina with modern antimicrobial agents

Antibiotics of the latest generation in angina are prescribed for the same purpose. Moreover, with the genyantritis and tonsillitis, the same antimicrobial agents can be used. The only difference is that in the case of inflammation of the tonsils, antiseptics can also be used, for example, "Furacillin" is a preparation of a number of nitrofurans. Although with angina, aminopenicillins protected with sulbactam or clavulanic acid (Amoclav, Amoxiclav, Ospamox) can also be used successfully. And the drugs should be prescribed for 10-14 days.

Therapy of pyelonephritis and infections of the genitourinary system

Due to the dissemination of urinary tract microbes, the latest generation of antibiotics for pyelonephritis is necessary for their treatment. The greatest therapeutic value here are cephalosporins, fluoroquinolones and nitrofurans. Cephalosporins are used in the relatively easy flow of pyelonephritis, and fluoroquinolones (Ciprofloxacin, Levofloxacin, Ofloxacin, Moxifloxacin) - with worsening of the condition against the background of therapy already in progress.

The most successful drug, suitable both for monotherapy and for combination with "Ceftriaxone", is any representative of a number of nitrofurans - "Furamag"). Quinolone - "Nalidixic acid" can also be used. The latter create high concentrations in the urine and are active against the causative agents of urinary infections. Also, occasionally, gardnellosis and dysbacteriosis of the vagina "Metronidazole" is used.

Drug resistance and its effect

In connection with the constant change in the genetic material of microorganisms, mainly bacteria, the effectiveness of many antimicrobial agents is significantly reduced. Acquiring resistance to drugs, bacteria are able to survive in the human body, mediating the deterioration of the state of infectious diseases. This forces researchers to look for and introduce into practice new antibiotics of the latest generation.

In total, during the period of the existence of antimicrobial agents, about 7,000 substances have been developed, which are used in medicine in a certain way. Some of them came out of use because of clinically important side effects or because the microbes acquired resistance against them. Therefore, to date, about 160 preparations are used in medicine. About 20 of them are antibiotics of the last generation, the names of which often appear in medical manuals on the antimicrobial therapy of infectious diseases.