What antibiotic is best to take for a sore throat? Rules for the treatment of sore throat with antibiotics in children and adults. Errors in antibacterial treatment of respiratory tract infections in outpatient practice Levofloxacin or amoxicillin, which is better
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According to the instructions for use, the medication is an original broad-spectrum antibiotic that is active against a number of pathogens of infectious processes in the human body.
The drug Levofloxacin, analogs of which can be presented in different release forms, is effectively used for diseases of the ENT system. Thus, quite often this drug is prescribed to patients for otitis media, sinusitis, sinusitis, pharyngitis, etc. The active ingredient of this medicine will be no less effective in relation to skin infectious lesions, as well as diseases of the urinary and reproductive systems (prostatitis, pyelonephritis, chlamydia, etc.).
According to statistics, today Levofloxacin has several medicinal analogues, which can be presented in the form of drops and tablets, and also have a cheaper price. Reviews about these medications can be read on numerous patient forums. At the same time, more than 60% of adults are regularly exposed to infectious lesions of various body systems, so the need for the use of Levofloxacin is more than in demand today.
Levofloxacin, analogues of which also have a wide therapeutic spectrum of action, is produced in the form of tablets, injection solution, and eye drops. As for the pharmacological effect, this drug is a potent antibiotic that helps destroy pathogenic infectious foci.
Levofloxacin, like its main substitutes, is contraindicated during pregnancy, childhood, severe kidney and liver diseases. Elderly people should take this drug strictly under the supervision of a doctor.
Analogs
All Levofloxacin analogues (synonyms for therapeutic effect) are divided into two separate subgroups:
- Analogues of the active substance of the drug.
- Analogs by pharmacological group.
According to active substance
Analogs of Levofloxacin, which will be presented below, can be prescribed for the treatment of pneumonia, sinusitis, prolonged bronchitis, all kinds of urological lesions, as well as pyelonephritis. It is prohibited to prescribe such drugs to children under eighteen years of age, pregnant women, as well as in cases of individual intolerance to the active substance of the drug.
The most effective analogues of Levofloxacin (according to the active substance) are:
- Amoxiclav.
- Astrapharm.
- Levoten.
- Ciprofloxacin.
- Eleflox.
- Flexid.
- Ofloxacin.
- Tigeron.
Levofloxacin, like generics, should be taken in the morning before meals. For acute infectious lesions, the permissible dosage of the drug is 250 mg (1 tablet per day). The duration of therapy is determined by the attending physician. On average, it takes five to ten days to completely suppress the infection.
As for the side effects from Levofloxacin analogues, compared to drugs of the previous generation, these drugs are much better tolerated and provoke unwanted reactions in no more than 1.5% of all cases. In this case, patients may experience nausea, abdominal pain, improvement in the functioning of the heart, kidneys and digestive system.
By generation of quinolones
A striking analogue of Levofloxacin in the generation of quinolones is the drug Sparfloxacin. Just like Levofloxacin, it belongs to the latest, third generation of antibiotics. This drug is most effective against gram-negative foci of infection, in particular staphylococci.
Sparfloxacin is prescribed for the same patient indications as Levofloxacin (analogs can be prescribed by a doctor). Thus, this antibiotic can be used to treat chlamydia, leprosy, inflammatory diseases of the urethra and respiratory system.
As for contraindications, in addition to the standard prohibitions that are attributed to Levofloxacin, Sparfloxacin also has a prohibition in the form of bradycardia and hepatitis.
The price for such an analogue of the drug is 340 rubles per package (6 tablets).
Tavanic or Levofloxacin: which is better, characteristics and features of the best antibiotic analogues
One of the most popular foreign analogues of Levofloxacin is the drug Tavanik, which is produced by a French manufacturer. Many patients do not know whether Tavanic or Levofloxacin is better.
A detailed study of both of these drugs should say that, unlike Levofloxacin, Tavanic has only one dosage form (solution for infusion). This is a disadvantage of this medicine.
Tavanic or Levofloxacin (which is better for adults, the attending physician must decide in each specific case) have very similar indications for use, since both drugs are approved for use in prostatitis, sinusitis, respiratory and genitourinary infections. Moreover, both drugs are available for sale in pharmacies.
When asked whether Tavanic or Levofloxacin is better, it is also important to note the cost of the first drug, which can reach up to 1200 rubles, which will be significantly higher than the average price for Levofloxacin.
Another analogue of Levofloxacin, which has a similar therapeutic effect, is the drug Moxifloxacin. It has a pronounced antibacterial effect against infectious pathogens of different classes.
Compared to Levofloxacin, Moxifloxacin has the following advantages:
- The drug has a wider spectrum of action.
- Does not provoke allergies when exposed to ultraviolet radiation.
- Can be used in conjunction with other antibiotics without causing negative reactions.
In turn, the following disadvantages of this analogue are highlighted in comparison with Levofloxacin:
- Less effective for urinary tract infections.
- Does not have complete safety of reception.
- It has a large list of contraindications.
- Has a bad effect on vitamin metabolism when taken.
As for eye drops, Levofloxacin in this release form has analogues in the form of Floxal, Signicef and Ofloxacin. The use of these drugs is allowed only as prescribed by a doctor, with strict adherence to the dosage. If it is necessary to treat children, it is important that the therapy is supervised by a specialist.
In clinical practice, the use of antimicrobial agents can be empirical (drugs are selected taking into account the spectrum of action on the suspected pathogen) or etiological, based on the results of bacteriological culture to determine the sensitivity of the flora to antibacterial drugs.
Many infectious diseases, such as pneumonia or pyelonephritis, require the use of a combination of antibiotics.
To competently draw up such treatment regimens, it is necessary to clearly understand the types of pharmacological interactions between drugs and know which drugs can be used together and which are strictly contraindicated.
Also, when drawing up complex therapy, not only the underlying disease and its causative agent are taken into account, but also:
- patient’s age, pregnancy and lactation period;
- clinical contraindications and history of allergic reactions;
- kidney and liver function;
- chronic diseases and basic medications taken by the patient (hypertensive therapy, correction of diabetes mellitus, anticonvulsants, etc.), prescribed antibiotics (hereinafter referred to as ABP) should be well combined with planned therapy.
The result of pharmacodynamic interaction of drugs can be:
- synergism (increased pharmacological effect);
- antagonism (reduction or complete elimination of drug effects on the body);
- reducing the risk of side effects;
- increased toxicity;
- lack of interaction.
As a rule, pure bactericidal (destroying pathogens) and bacteriostatic agents (suppressing the growth and reproduction of representatives of pathogenic flora) are not combined with each other. This is explained, first of all, by their mechanism of action. Bactericidal drugs act most effectively on organisms at the stage of growth and reproduction, so the use of bacteriostatics can cause the development of drug resistance.
It is important to understand that this division according to the type of effect on bacteria is not absolute, and different antibacterial drugs may have different effects depending on the prescribed dose.
For example, increasing the daily dose or duration of use of a bacteriostatic agent leads to its bactericidal effect.
Also, selectivity of action on certain pathogens is possible. Being bactericidal antibiotics, penicillins have a bacteriostatic effect against enterococci.
Antibiotic compatibility table by type of action
Bactericidal | Bacteriostatic |
The combination of antibiotics with each other, taking into account the dosage and type of action on the flora, allows you to expand the spectrum of action and increase the effectiveness of the therapy. For example, in order to prevent antibacterial resistance in Pseudomonas aeruginosa, it is possible to combine antipseudomonas cephalosporins and carbapenems, or aminoglycosides with fluoroquinolones.
- Rational combinations of antibiotics for the treatment of enterococci: the addition of penicillins with aminoglycosides or the use of trimethoprim in combination with sulfamethoxazole.
- The second generation combination drug has an extended spectrum of action: it combines Tinidazole ®.
- A combination of cephalosporins and metronidazole ® is effective. Tetracyclines are combined with gentamicin to enhance the effect on intracellular pathogens.
- Aminoglycosides are combined with rifampicin to enhance the effect on serrations (often recurrent diseases of the upper respiratory tract). Also combined with cephalosporins to increase effectiveness against enterobacteria.
Compatibility of antibiotics with each other: table
Combinations are strictly prohibited | |
Cephalosporins and Aminoglycosides. | Due to the mutual potentiation of the nephrotoxic effect, the development of acute renal failure and interstitial nephritis is possible. |
Chloramphenicol ® and Sulfonamides. | Pharmacologically incompatible. |
, , Aminoglycosides and Furosemide ® . |
A sharp increase in the ototoxic effect, up to complete hearing loss. |
Fluoroquinolones and nitrofurans. | Antagonists. |
Carbapenem ® and other beta-lactams. | Pronounced antagonism. |
Cephalosporins and Fluoroquinolones. | Severe leukopenia, obvious nephrotoxic effect. |
It is forbidden to mix and administer in one solution (syringe): | |
Penicillins are not mixed with ascorbic acid, B vitamins ® , or aminoglycosides. | |
Cephalosporins (especially ceftriaxone ®) are not combined with calcium gluconate. | |
and hydrocortisone. | |
Carbenicillin ® with kanamycin ® , gentamicin ® . | |
Tetracyclines with sulfonamides should not be combined with hydrocortisone, calcium salts, or soda. | |
All antibacterial drugs are absolutely incompatible with heparin. |
Penicillins
Antibiotics of this series are not prescribed simultaneously with allopurinol, due to the risk of developing an “ampicillin rash”.
Additive synergism of antibiotics (summation of the results of action) occurs when prescribed with macrolides and tetracyclines. Such combinations are highly effective for community-acquired pneumonia. Prescription with aminoglycosides is permissible - separately, since when mixing the drugs, their inactivation is observed.
When prescribing oral medications, women need to clarify whether they are using oral contraceptives, since penicillins interfere with their effect. In order to prevent unwanted pregnancy, it is recommended to use barrier methods of contraception during antibacterial therapy.
Penicillins are not prescribed with sulfonamides due to a sharp decrease in their bactericidal effect.
It is important to remember that their administration to patients who have been using anticoagulants, antiplatelet agents and non-steroidal anti-inflammatory drugs for a long time is undesirable due to the potential for bleeding.
Benzylpenicillin salt is not combined with potassium and potassium-sparing diuretics, due to the increased risk of hyperkalemia.
Penicillins and fluoroquinolones are compatible
It is possible to combine protected or extended-spectrum penicillins for oral use with local administration of fluoroquinolones (drops), as well as combined systemic use (Levofloxacin ® and Augmentin ® for pneumonia).
Cephalosporins
Due to the high risk of cross-allergic reactions, the first generation is not prescribed together with penicillins. Prescribe with caution to patients intolerant to beta-lactam antibiotics. in the anamnesis.
Combination with anticoagulants, thrombolytics and antiplatelet agents reduces coagulation and can cause bleeding, usually gastrointestinal due to hypoprothrombinemia.
Combined administration with aminoglycosides and fluoroquinolones leads to a pronounced nephrotoxic effect.
Antib use. after taking antacids, it reduces the absorption of the drug.
Carbapenems
Ertapenem ® is strictly incompatible with glucose solution. Also, carbapenems are not prescribed concomitantly with other beta-lactam drugs due to the pronounced antagonistic interaction.
Aminoglycosides
Due to physical and chemical incompatibility, they cannot be mixed in the same syringe with beta-lactams and heparin.
The simultaneous use of several aminoglycosides leads to severe nephro- and ototoxicity. Also, these drugs are not combined with polymyxin ®, amphotericin ®, vancomycin ®. Not prescribed together with furosemide.
Concomitant use with muscle relaxants and opioid analgesics can cause neuromuscular blockade and respiratory arrest.
Nonsteroidal anti-inflammatory drugs slow down the elimination of aminoglycosides due to slowing renal blood flow.
Group of quinolones (fluoroquinolones)
Concomitant use with antacids reduces the absorption and bioavailability of the antibiotic.
They are not prescribed simultaneously with NSAIDs and nitroimidazole derivatives due to high toxicity to the nervous system and the possible occurrence of seizures.
They are antagonists and derivatives of nitrofuran, so this combination is not prescribed.
Ciprofloxacin ® , Norfloxacin ® , Pefloxacin ® are not used in combination with sodium bicarbonate, citrates and carbonic anhydrase inhibitors, due to the risk of crystalluria and kidney damage. They also disrupt the metabolism of indirect anticoagulants and can cause bleeding.
Prescription to patients receiving glucocorticosteroid therapy significantly increases the possibility of tendon rupture.
They interfere with the action of insulin and sugar-lowering tablets and are not prescribed to diabetics.
Macrolides
Do not use together with antacids, due to reduced effectiveness. Administration with rifampicin ® reduces the concentration of macrolides in the blood. Also not compatible with amphinecol ® and lincosamides. Use in patients receiving statins is not recommended.
Sulfonamides
They have a pronounced toxic effect in combination with anticoagulants, antidiabetic and anticonvulsant drugs.
Not prescribed with estrogen-containing contraceptives due to the risk of uterine bleeding.
It is prohibited to combine with drugs that inhibit bone marrow function.
Sulfamethoxazoline/trimethoprim ® (Biseptol ®) and other sulfonamide antibiotics are compatible with polymyxin B ®, gentamicin ® and sisomycin ®, and penicillins.
Tetracyclines
Not prescribed in conjunction with iron supplements. This is due to impaired absorption and digestibility of both drugs.
Combination with vitamin A can cause pseudotumor cerebri syndrome.
Do not combine with indirect anticoagulants and anticonvulsants, tranquilizers.
Interaction of antibiotics with food, alcohol and herbs
Taking foods that increase the secretion of hydrochloric acid in the stomach (juices, tomatoes, tea, coffee) leads to a decrease in the absorption of semisynthetic penicillins and erythromycin ®.
Dairy products with a high calcium content: milk, cheese, cottage cheese, yoghurts, significantly inhibit the absorption of tetracyclines and ciprofloxacin ®.
When consuming chloramphenicol ® , metronidazole ® , cephalosporins, sulfonamides with alcoholic drinks, an Antabuse-like syndrome may develop (tachycardia, heart pain, skin hyperemia, vomiting, nausea, severe headache, tinnitus). This complication is a life-threatening condition and can cause death.
These drugs should not be combined even with alcoholic tinctures of medicinal herbs.
The combination of sulfonamides and tetracyclines with St. John's wort can provoke a sharp increase in skin sensitivity to ultraviolet rays (drug photosensitization).
Broad-spectrum antibiotics help fight a wide range of infectious diseases. The instructions for use describe Cifran as a combined antibiotic that is effective against a large number of microorganisms.
Ciprofloxacin, what kind of antibiotic?
Cifran combines two antibiotics - ciprofloxacin and tinidazole. This is a broad-spectrum antibiotic. It belongs to the group of fluoroquinolones. Tsifran works by suppressing DNA gyrase and inhibiting DNA synthesis in bacteria.
Effective against most groups of gram-negative microorganisms. It also affects all microorganisms that produce β-lactamase. It is used in the treatment of amebic and bacterial mixed infections, as well as in the combination of aerobic and anaerobic flora.
The main advantage of this medicine is that it is quickly absorbed when taken orally. In this case, it does not matter whether you eat food, since it does not critically affect the absorption rate. Biological availability after administration - 70%. The connection with plasma proteins reaches 40%.
Two hours after use, the maximum concentration of the active substance is observed. Removal of residues is carried out by the kidneys. Most of it is excreted in the urine, but a certain percentage of residual substances are excreted through the intestines.
Penetrates into the cerebrospinal fluid. Its concentration there depends on the presence of inflammation. If the membranes of the spinal cord are inflamed, then it is up to 40%.
Indications for use:
- Postoperative infections.
- Bacterial infections of the abdominal organs.
- Respiratory tract.
- Acute and subacute conjunctivitis.
- Infections after injuries to the eyes and cornea.
- Support for patients with reduced immunity.
- Infectious lesions of joints, bones and skin.
The drug must be used after consultation with a doctor.
Important! Taking antibiotics that you prescribe for yourself can be dangerous to your health.
Tsifran and all its types
Cifran is produced by the largest Indian pharmaceutical company, Ranbaxy Laboratories Limited. It contains several components, but the active ingredient is ciprofloxacin hydrochloride. The film coating on the tablets contains purified talc, water and Opadry-OY-S58910.
Excipients - magnesium stearate, corn starch, cellulose, purified water and anhydrous flint.
Release form: film-coated tablets. There are two main types of the drug:
- Tablets with an extended mechanism of action (EA) do not contain anything other than ciprofloxacin, and they can be taken once every 24 hours. This form completely suppresses the ability of pathogenic bacteria to grow and multiply. 1 tablet contains 1000 mg of active substance. This type of drug is produced in 5 pieces in a blister. Number of blisters 1 or 2 per package.
- The combined drug ST also contains a second active substance - tinidazole. One tablet of the drug contains 500 mg of ciprofloxacin and 600 mg of tinidazole. The package contains from 1 to 10 blisters, each containing 10 tablets.
A dosage form is also available in the form of eye drops and a solution for injections.
The solution for injection is available in ampoules containing 200 mg of ciprofloxacin per 100 ml of solution.
Eye drops. One 10 ml bottle contains 30 mg of active ingredient. There is also an eye ointment that is used for eyelid infections and bacterial infections of the cornea.
Indications for use
Cifran tablets are prescribed by a doctor and are effective for the following pathologies:
- Mixed and dysentery infections of the gastrointestinal tract.
- Gonorrhea.
- Respiratory tract infections, including those with purulent complications.
- Severe gynecological infections, including complications after abortion.
- It is used for sore throat, pyelonephritis, and many other infections.
The procedure for taking Cifran differs depending on what form of release (OD or ST).
ST should be taken orally after meals with a glass of clean water. The tablets must be swallowed whole, without breaking or chewing. The dosage is as follows: for an adult patient 500+600 mg 2 times a day, or 250+300 mg, two tablets every twelve hours. The course of treatment is 10-14 days.
Receiving OD. Depends on the specific infection and severity of the disease:
- Gonorrhea. If acute - once a day, 500 mg once. Acute complicated - once a day, 500 mg for up to 5 days.
- Acute sinusitis. Once a day for 10 days, 1000 mg.
- Urinary tract diseases. Once a day for 2 weeks. If a difficult case is 1500 mg, in the rest - 1000 mg.
- Bacterial prostatitis in chronic form. For 28 days, 1000 mg once a day.
- Typhoid fever. 10 days, one tablet of 1000 mg once a day.
- Bone and joint infections. 1000 – 1500 mg once a day for up to 6 weeks.
- Infectious diarrhea - 5-7 days, 1000 mg.
- Respiratory tract infections. 1000 – 1500 mg for 2 weeks.
When prescribing this drug, the specialist is guided by the indicators of kidney function, the age and weight of the patient.
Useful video: about the diagnosis and treatment of prostatitis
Indications for the use of injections
Injections of the drug Cifran are given intramuscularly or intravenously. The dosage depends on the severity of the infection and the characteristics of the patient’s body. Injections are prescribed to people over 18 years of age. Children should not inject this substance.
The dosage is as follows:
- Upper respiratory tract diseases - 100 – 200 ml 2 times a day
- Cystitis - once 50 ml.
- Infectious diarrhea - 100 ml 2 times a day. The course of treatment is a week.
- Pulmonary anthrax - 200 ml 2 times a day.
Treatment with injections can last from 1 day to 2 months, but not longer, since the risk of side effects increases and the negative load on the kidneys increases.
Doctors prescribe the longest course for osteomyelitis. The average course is 7-14 days for most infections. If the solution is administered via a dropper, a slight increase in the dosage of the antibiotic is allowed.
Tsifran for prostatitis
Antibacterial treatment is prescribed for prostatitis when inflammation of the prostate occurs due to infection. Its effectiveness in treating this disease has been confirmed by both clinical studies and the experience of many doctors.
The fluoroquinolones group, to which Cifran belongs, has proven itself in the fight against bacterial prostatitis. If the disease is non-bacterial, antibiotics cannot be taken. Bacterial prostatitis can be caused by bacteria of several groups:
- Gram-positive, for example, staphylococcus.
- Gram-negative - salmonella, E. coli.
- Intracellular - chlamydia, brucella.
The advantage of Tsifran over other drugs is its rapid absorption, and also the fact that after a full course, for a few more days, the concentration of the active substance in the blood is high enough to prevent bacteria from multiplying.
Treatment must be started as early as possible, since chronic prostatitis can lead to problems with potency and erectile dysfunction.
It is used both in the form of tablets and injections. The course of treatment for chronic prostatitis is a week. Dosage per day - 250-500 mg. If we are talking about injections, then 200-400 mg.
An increase in dosage is prescribed only by a doctor, in case of complications or an advanced stage of the disease.
The advantages of this medicine for inflammation of the prostate gland are obvious:
- Destroys all bacteria, including inactive ones.
- Combines with other substances and does not affect them.
- Cheap compared to many analogues.
- The bacteria do not have time to get used to the antibiotic and it remains effective.
As a result, all the advantages make Ciprofloxacin a popular substance in terms of the number of prescriptions. Reviews from doctors and patients about the results of the action are positive. The disadvantages of the drug are common to other antibiotics, for example, dysbiosis. Therefore, the choice of Tsifran as a drug for the treatment of prostate infections is completely justified.
Useful video: the benefits and harms of antibiotics
Side effects and contraindications
Side effects of antibiotics are common, so you should consult your doctor before starting treatment. Only a doctor should prescribe a specific drug, as well as its dosage. Side effects can occur in several body systems:
- Gastrointestinal tract - nausea, diarrhea, vomiting.
- Nervous system - increased fatigue, anxiety, dizziness, weakness, and in rare cases, convulsions.
- The cardiovascular system. Arrhythmia, fainting, pain in the chest.
- Circulatory system. A drop in the level of red blood cells, platelets and white blood cells.
- Allergic reactions of varying severity.
- Increased sensitivity to ultraviolet radiation, therefore, when treating with the drug, you should not stay in the sun for a long time without special creams.
If any of the adverse reactions occur, you should immediately consult a doctor, he will either adjust the dose or discontinue this medication.
The product also has contraindications for use:
- pregnancy;
- age up to 8 years;
- blood diseases with inhibition of hematopoietic function;
- seizures and epilepsy;
- lactation;
- mental problems;
- atherosclerosis and other disorders of the brain;
- allergy to the components of the drug.
If there is any contraindication, the medicine is not prescribed and is replaced with another antibiotic.
Analogs
In pharmacies you can easily find several analogues of Ciprofloxacin, both domestic and imported. They are similar in composition and in the principle of influence. There may be differences in price, as well as in the number of side effects.
Cifran or Levofloxacin
Levofloxacin belongs to the same group as the drug in question. The use depends directly on the type of pathogens. For example, Levofloxacin is more effective against pneumococci, as well as atypical pathogens.
In turn, Tsifran will show better results when fighting Pseudomonas aeruginosa. Clinical trials have proven that a pathogen that does not respond to Ciprofloxacin may well be sensitive to Levofloxacin.
Important! Both drugs are well absorbed and do not react to foods other than milk and its components.
Adverse reactions are similar for both drugs.
As for the price, buyers here are on the side of Tsifran, since it is several times cheaper than its modern counterpart. In any case, Ciprofloxacin and Levofloxacin should be prescribed by a doctor, taking into account the individual characteristics of the body and the complexity of the disease.
The doctor can change one drug to another if necessary, but in any case the price category will have to be taken into account.
Tsifran or Tsiprolet
Both medicines contain the same active ingredient. Both drugs have a similar principle of action, side effects, and contraindications. Therefore, you should not use them together, and your doctor should prescribe one of the antibiotics. Tsiprolet does not have a prolonged effect, like one of the types of Tsitrofan.
Since the contraindications are also similar, it is also not recommended to prescribe the second to patients for whom one of the drugs is not suitable. It is worth noting that Tsiprolet is easier to tolerate by patients with gastrointestinal problems. The difference in price is minor, but it is there. Digital is cheaper.
Tsifran or Amoxiclav
Amoxiclav is easier to tolerate by the body and produces fewer side effects. Tsifran has a wider spectrum of action and can fight Pseudomonas aeruginosa, against which Amoxiclav is powerless. Ciprofloxacin is more effective for older people, while its analogue has a more convenient release form - a suspension.
Other analogues
There is more than one drug that is considered an analogue of Tsifran and can successfully replace it:
- Nolicin is a medicine from Slovenia from the group of fluoroquinolones. The active ingredient is norfloxacin. Can be taken at the same time, but under medical supervision.
- Ofloxacin is available only in tablet form, the active ingredient is Ofloxacin. The dosage is prescribed strictly individually.
- Doxycycline is a group of tetracyclines. It has a much gentler effect on the intestinal microflora. It differs in the principle of action, since it affects not the DNA of bacteria, but the proteins of protein cells.
When choosing, you need to pay attention not to personal preferences, but to the doctor’s advice. Any antibiotic should be taken only on the advice of a specialist.
Useful video: effective treatment of prostatitis in men
Conclusion
Antibacterial drugs have filled the shelves of pharmacies. New generation products are appearing that are more effective. Broad-spectrum antibiotics from the fluoroquinolone group are capable of affecting a huge number of different groups of bacteria.
Therefore, Ciprofloxacin is effective against a large number of infectious diseases, including prostatitis. But the medicine must be prescribed strictly by a doctor, based on the specific situation.
Tavanik is an antibiotic with a wide therapeutic effect. It is able to cure many infectious diseases, the pathogens of which are sensitive to levofloxacin.
It copes well with acute sinusitis, bronchitis, pneumonia, as well as infections of the genitourinary system.
Manufacturer and release form
The original drug Tavanik is produced by the German company SANOFI-AVENTIS.
There are two dosage forms available in pharmacies:
- biconvex tablets coated with a dim yellow-pink shell and having dividing grooves. Packed in 3/5/7/10 pieces;
- sterile transparent greenish-yellow injection solution placed in glass vials (100 ml).
The active substance is the antibiotic levofloxacin. Tablets may contain 250 or 500 mg, which is indicated on their packaging. The bottle of solution (100 ml) also contains 500 mg of antibiotic.
The tablets additionally include:
- crospovidone;
- hypromellose;
- cellulose;
- titanium dioxide;
- talc;
- macrogol 8000;
- red/yellow iron dioxide.
The injection solution also contains:
- hydrochloric acid;
- sodium hydroxide/chloride;
- water (deionized).
Therapeutic effect and scope of application
Levofloxacin, like all systemic quinolones belonging to the 3rd generation, has a wide range of therapeutic effects.
It disrupts the DNA structure of harmful microorganisms, causing severe changes in the cytoplasm and cell walls, which leads to their death. By killing pathogens, the drug successfully fights the inflammatory processes caused by them.
Tavanik is effective for:
- sinusitis (acute);
- pneumonia;
- bronchitis;
- urinary tract infections;
- bacterial chronic prostatitis;
- infectious skin diseases;
- sepsis;
- intra-abdominal infections.
Instructions for use, features of reception
The daily dose of the medicine for almost all diseases is 250/500 mg, taken 1 - 2 times.
The tablets are swallowed whole with water (0.5 - 1 glass). It is not recommended to bite or chew them. If you need to take half a tablet, divide it using the dividing groove. Absorption of the drug into the blood occurs quickly and completely.
Taking Tavanik does not depend on food intake. It can be drunk at any time. But if complex therapy is carried out, then when combined with antacid or iron-containing drugs, as well as Sucralfate, the interval between taking them and Tavanik should be 2 hours.
The injection solution should be delivered slowly. At least an hour should be allowed for the complete administration of one bottle. It is not recommended to store this drug in strong light conditions for more than 3 days.
Intravenous administration of Tavanik is allowed together with solutions:
- physiological;
- dextrose (5%);
- Ringer's with dextrose (2.5%);
- nutritious (carbohydrates + microelements + amino acids).
But simultaneous administration with sodium bicarbonate solution is prohibited.
Injections are recommended for severe forms of the disease. When the patient's condition improves, the administration of the solution is replaced by taking tablets. If the patient's body temperature returns to normal, then after 3 days the antibiotic is discontinued.
During treatment, you should not visit a solarium; direct bright sun and ultraviolet radiation should be avoided. Long-term use of the drug sometimes causes dysbacteriosis; a weakened body may be susceptible to fungal infection.
These negative properties of Tavanik can be easily removed by taking them together with Bifidumbacterin, Linex, and antifungal agents. The dose of the drug depends on the nature/severity of the disease, as well as the presence/absence of renal failure.
For patients who do not have kidney problems, daily dosages are as follows:
- sinusitis (acute) – 500 mg/1 time/1.5-2 weeks;
- chronic bronchitis (exacerbation) – 250-500 mg/1 time/7-10 days;
- pneumonia – 500 mg/2 times/1-2 weeks;
- urinary tract infections (uncomplicated) – 250 mg/1 time/3 days;
- bacterial prostatitis (chronic) – 500 mg/1 time/4 weeks;
- skin infections – 250-500 mg/2 times/1-2 weeks;
- sepsis – 500 mg/2 times/1.5-2 weeks;
- infections of the retroperitoneal organs – 500 mg/1 time/1-2 weeks;
- tuberculosis (treatment of resistant forms as part of the complex) – 500-1000 mg/2 times/3 months.
For people with kidney failure, the first dose of the medicine should be taken in accordance with this table, and subsequent doses should be taken at half the dosage. If during treatment the Tavanika tablet was not taken on time, it should be taken as soon as possible, and then follow the established regimen.
Older adults who do not have kidney problems can use this medicine at the usual dosage. But it should not be given to children, since levofloxacin can disrupt the growth of cartilage tissue, which will make the joints fragile.
The drug is prescribed with great caution to people predisposed to seizures. This group includes people who have suffered:
- stroke;
- head injury.
Side effects
Sometimes, with long-term use of Tavanic, pseudomembranous colitis may develop (symptom: bloody diarrhea).
In this case, treatment with the drug should be stopped and the “side effects” should be eliminated. Rare cases of tendinitis that threatens tendon rupture have been observed.
If this happens, stop taking this medication immediately. If problems occur in the nervous system, you should also stop using this drug.
Since Tavanik sometimes has an effect on the central nervous system, which manifests itself in drowsiness, dizziness, slow reaction, while taking it you should not drive a vehicle or engage in other activities that require concentration.
Overdose
Taking an excessive dose of the drug can lead to:
- confusion;
- dizziness;
- hallucinations;
- convulsions;
- tremor;
- nausea, other digestive disorders;
- erosion of the gastrointestinal mucosa.
If these symptoms occur, you should rinse your stomach and take antacids.
For prostatitis
This medicine is very effective in the fight against bacterial prostatitis, especially in combination with a special diet, prostate massage, and other physical procedures.
During a long 4-week course, patients should take a single dose of 500 mg of the drug daily. The success of treatment is assessed by examining prostate secretions.
If it is necessary to speed up the treatment process, and the patient has no special contraindications, the doctor may prescribe another treatment regimen:
- first week – 1000 mg/day;
- the next 10 days – 500 mg/day.
As a result, the course of treatment is shortened to 2.5 weeks. When treating acute prostatitis, the first half of the course should be given injections of the drug, and then proceed to taking tablets.
In the chronic course of the disease, you can limit yourself to only the tablet form of Tavanik. The drug enters the prostate quite quickly and in large volumes, outstripping the strength of many antibiotics used for diseases of this organ.
For cystitis and chlamydia
For uncomplicated (no blood/pus in urine) acute cystitis, the drug should be taken for 3-5 days. 250 mg once a day. In case of chronic cystitis and the presence of complications, the same dose of medication should be taken for 1.5-2 weeks.
For the genital form of the disease, take 500 mg of Tavanik for 10 days. The pulmonary form, which causes pneumonia, requires intravenous administration of the same volume of medication for 7-10 days.
Alcohol compatibility
Ethanol increases the likelihood of side effects, while reducing the therapeutic effectiveness. Therefore, you should stop using it for the entire period of treatment.
Contraindications
Tavanik has a number of absolute contraindications, in which its use is unacceptable, and relative contraindications, in which the drug should be taken with caution.
Absolute is the presence of:
- epilepsy;
- tendinitis;
- pregnancy;
- under 18 years of age;
- allergic reaction to Tavanik.
The following are considered relative:
- predisposition to seizures;
- renal/heart failure;
- low magnesium/potassium levels;
- taking sugar-lowering drugs;
- the presence of pseudoparalytic myasthenia gravis.
Video on the topic
Doctor's reviews about the drug Tavanik:
Tavanic is an effective antibiotic that confidently copes with pathogens of many diseases. But it can also cause unwanted reactions. Therefore, only a doctor should prescribe it.
Canephron (tablets): composition, principle of action of the drug, indications and features of use
In the vast majority of cases, doctors are wary of herbal medicine, preferring stronger drugs with proven activity and experience in clinical use.
However, the effectiveness of the drug Canephron (tablets) has been confirmed by its long-term use for the treatment of various diseases of the urinary system.
Moreover, this medicine in the form of pills or drops is recommended both for their therapy (usually in combination with other medications) and for prevention.
Until recently, the use of medicinal plants was mainly limited to taking infusions and decoctions prepared at home. But patients usually do not pay due attention to the principles of storing herbs and make mistakes in dosage and manufacturing technology. This simply nullifies the effectiveness of such treatment. Such flaws are eliminated when using a ready-made herbal medicine - Canephron tablets.
However, when prescribing them, the following rules must be observed:
- In the acute period, tablets are taken only with antibiotics or uroseptics.
- Combinations with other drugs should be selected carefully, taking into account the possible impact on effectiveness and the risk of complications.
- Accurately calculate the dosage, which depends on age and the presence of concomitant diseases.
- The course of treatment should be long enough to provide the desired effect, but not very long due to the likely risk of developing resistance of the pathogenic flora of the urinary tract to the action of the drug.
With adequate selection of the dose and combination with an antibacterial drug, Canephron tablets enhance and maintain the antimicrobial activity of the antibiotic for a certain time (essential oils destroy the membrane of the pathogenic cell). At the same time, the herbal medicine is devoid of serious side effects that antibacterial drugs have. First of all, it has a negative effect on the digestive and immune systems.
In addition, Canephron tablets have the following additional effects:
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- diuretic due to improved blood flow in the kidneys and accelerated filtration in the glomerular system;
- antispasmodic and, as a result, analgesic;
- anti-inflammatory;
- nephroprotective;
- stimulates the secretion of uric acid salts and normalizes urine pH, that is, it affects the main causes of urolithiasis.
Canephron (tablets) are safe for almost all categories of patients, since the drug contains only herbal ingredients. This:
- Centaury herb (Centaurium umbellatum) contains bitterness, flavonoids, alkaloids and other beneficial substances. It has moderate antibacterial activity against the main pathogens of urinary tract diseases, stops inflammatory processes, normalizes the condition of the walls of blood vessels in the kidneys and stimulates diuresis.
- Lovage root (Levisticum officinale) owes its diuretic effect to a large number of essential oils; foreign medical articles repeatedly emphasize the antimicrobial activity of this plant.
- Rosemary leaves (Rosmarinus officinale) contain alkaloids and tannins, but their main component is essential oil, which stimulates blood flow in the renal vessels, promotes urine output, relieves spasms and symptoms of inflammation. But its main effect is its pronounced activity against almost all representatives of the pathogenic flora of the urinary tract, in particular, staphylococcus and streptococcus.
First of all, Canephron tablets act on neurotropic bacteria, even those that form a protective film. Also, the components of the drug relieve spasms of the urinary tract, activate the emptying of the bladder from residual urine, which is an excellent breeding ground for the development of bacteria.
Canephron tablets also have a therapeutic anti-inflammatory effect, stopping the synthesis of leukotrienes, prostaglandins, cytokines, toxic enzymes and other mediators that stimulate swelling and pain. The manufacturer of the drug is a German company specializing in the production of herbal medicines, Bionorica.
The main principle of the corporation's work is phytoniring, that is, a strictly scientific approach and the use of modern technologies to get the maximum effect from a combination of plant components. For ease of use at any age, Canephron is available in the form of tablets and solution (drops).
According to the annotation, the indications for use of the medicine are:
- cystitis;
- pyelonephritis;
- uric acid diathesis (presence of sand in the kidneys or bladder);
- recovery after stone removal (by any means);
- kidney inflammation of non-bacterial etiology (for example, glomerulonephritis or interstitial nephritis);
- treatment and prevention of relapse of urolithiasis.
In the presence of microbial flora in the acute phase of the inflammatory process, Canephron tablets are used only in combination with basic antibacterial therapy.
Most patients do not experience any complications while taking the drug. If you are prone to allergic reactions, itchy rashes may appear on the skin. The components that make up the medicine stimulate the digestive tract, so patients may experience nausea, or less often, vomiting or diarrhea.
If blood appears in the urine or acute pain in the lower abdomen, you should immediately stop taking Canephron tablets and consult a doctor.
Contraindications to the use of the drug are:
- hypersensitivity to both the main ingredients of the drug and auxiliary components (including sucrose, lactose, castor oil);
- stomach ulcer during exacerbation;
- swelling caused by pathologies of the cardiovascular system.
Patients with diabetes should take Canephron tablets with caution, since their shell contains small amounts of sucrose. In addition, the drug is strictly contraindicated for monotherapy of renal failure.
Canephron: instructions for use, tablets and drops
In accordance with the instructions for use, the dosage of Canephron tablets is standard and does not depend on the disease. When the first symptoms appear, 2 tablets are prescribed three times a day. Moreover, the drug should be continued for at least 2-4 weeks after all clinical manifestations of the pathology have disappeared.
But it is worth noting that for cystitis, Canephron is recommended to be taken only in combination with uroseptics. The fact is that the antibacterial activity of the plant components of the medicine may not be enough to suppress pathogenic microflora, and this can lead to the disease becoming chronic. Usually a combination of an antibiotic, uroseptic, antispasmodic or analgesic is prescribed.
Antibacterial drugs prescribed for cystitis include:
- II - III generation cephalosporins (Zinnat, Tseklor, Suprax, Tsedex), the dosage is calculated individually, in some cases the maximum allowable amount of medication is required;
- fluoroquinolones (Ciprofloxacin, Levofloxacin);
- penicillins (Augmentin, Amoxiclav), usually used for the first episode of cystitis;
- uroseptics, fosfomycin (Monural), furazidin (Furamag) are often prescribed.
In case of severe cystitis, combine an antibacterial agent and Canephron tablets in a dosage according to the instructions for use. Doctors emphasize that the effectiveness of the herbal medicine is not enough to eliminate edema of renal etiology. Additionally, diuretics are prescribed (Lasix, Mannitol, Veroshpiron, Triamterene). In addition, therapy is necessary for the underlying disease, which provoked the development of such symptoms.
For edema of renal origin, Canephron tablets are taken according to the instructions for use - 2 tablets three times a day. Pathology of the urinary system often occurs in childhood. In girls, this is usually associated with poor perineal hygiene, with the bacterial flora spreading upward after vulvovaginitis. This is often the cause of not only cystitis, but also pyelonephritis.
Sometimes such pathologies are caused by congenital structural features of the pelvic organs. At an early age, inflammatory diseases of the urinary tract tend to recur frequently. Canephron will help you avoid long-term use of antibiotics and other synthetic medications. Unlike adults, it is dangerous to give pills to a child, so doctors recommend using drops. They are more convenient and safer in terms of dosage.
Canephron tablets are contraindicated for the treatment of kidney and bladder diseases in children under 6 years of age.
The dosage of the solution is 15-25 drops (depending on age) three times a day. Children under 3-4 years of age should use the drug with caution due to the ethanol content. A positive property of Canephron tablets is the possibility of use during pregnancy and lactation.
Gynecologists often prescribe this medication to women with a history of kidney disease and cystitis, when urolithiasis is detected, for prevention and as part of complex therapy for preeclampsia in a standard dosage. The pills also need to be taken up to 2 weeks after birth. As a preventative measure, the amount of medication is reduced to 2 pills per day (morning and evening). However, taking Canephron tablets on your own, even according to the instructions for use, and in combination with other drugs is unacceptable.
Medicine Canephron: analogues, cost, reviews
In addition to the drug Canephron, doctors may also suggest other herbal remedies. The most common is Cyston. The composition of this herbal medicine is more diverse. It contains more than 10 active components.
Among them:
- Flowers of double-carp. The plant regulates calcium metabolism and increases the effectiveness of urolithiasis therapy. Also has antimicrobial activity.
- Saxifraga herb. In folk medicine it is widely used as a bactericidal and anti-inflammatory agent.
- Madder herb. Usually they use infusions and decoctions from the roots of the plant, ignoring its above-ground part. Madder leaves and stems remove toxins and have a general tonic effect.
- Rhizomes of satiety membranous. It has long been used in oriental medicine as an anti-inflammatory and antiseptic agent.
- Seeds of rough strawflower have diuretic, antispasmodic, antipyretic and antimicrobial effects.
- Flowers, leaves and stems of Onosma bracts promote rapid healing of the epithelium of the ureters and urethra damaged after the passage of the stone, and has a general tonic effect.
- Vernonia ashy (whole plant) is known for its antibacterial activity.
- Mumiyo. Many people note the stimulating and tonic effect of this remedy; with long-term use, mumiyo strengthens the immune system and increases the body's resistance to various pathogenic factors.
The indications for taking Cyston are the same as for the drug Canephron. For urolithiasis, take 2 tablets three times a day for six months or until the stones leave the kidneys completely.
After surgical removal of stones, Cyston is taken in the same dosage for a month, then 1 tablet twice a day for another 5 weeks.
For bacterial urinary tract infections it is also prescribed in combination with antibiotics. The course of treatment is up to 3 months in the amount of 2 pills 2-3 times a day. Taking Cyston, like the medicine Canephron, is not contraindicated during pregnancy and breastfeeding. But this drug is produced only in tablet form, so its use in children is limited.
Another herbal preparation for the treatment of various urinary tract diseases is Phytolysin, which contains:
- goldenrod herb, stimulates metabolic processes, removes toxins and has a general anti-inflammatory effect;
- horsetail herb, a diuretic known in folk medicine;
- knotweed grass (knotweed), fenugreek seeds and wheatgrass rhizomes regulate salt metabolism, promote the prevention and slow dissolution of kidney stones;
- onion peel, relieves spasms of the urinary tract, has a mild bactericidal and diuretic effect;
- birch leaves and parsley root have a diuretic and antiseptic effect.
In addition, Phytolysin contains general tonic ingredients - peppermint, pine, and orange oils. The disadvantages of the drug include the release form; it is produced in the form of a paste, which is not convenient for everyone to take. The Ukrainian pharmaceutical company relatively recently mastered the production of a complete analogue of the drug Canephron - Trinephron. But today the drug is not registered in Russia, although it costs less than the original medicine.
As for the price of Canephron, you will have to pay about 450 rubles for a package containing 60 tablets, and 430 rubles for a bottle of drops (100 ml). Feedback from patients after therapy with this herbal medicine is overwhelmingly positive. This is especially true for the treatment of young children. When monitoring the child for a year, not a single case of relapse was identified. But doctors note that the effect of Canephron, like any other herbal medicine, develops slowly. Therefore, it is important to follow the dosage and regimen of use.
The drug of choice for pneumonia in adults is the beta-lactam penicillin antibiotics amoxicillin + clavulanic acid (drugs with the names Augmentin, Flemoklav solutab). Antibiotics are produced in tablet form, which allows them to be used as prescribed by a doctor at home and for children.
Groups of antibiotics for pneumonia
Pneumonia is caused by pathogens of several groups. Especially often, community-acquired pneumonia (occurring outside the walls of the hospital, as opposed to a hospital infection) is provoked by Streptococcus pneumonia, Haemophilus influenza, Staphilococcus aureus, Pseudomonas aeroginosa and other protozoa, including mycoplasma, legionella, chlamydia.
There is no single antibiotic that can act equally effectively on all pathogens of pneumonia; for each type of infection, the most effective drug is empirically selected.
Several groups of antibiotics are used to treat pneumonia:
It is impossible to differentiate which antibiotics are the best for pneumonia and which are ineffective, since in each case the outcome of treatment is determined not only by the type of pneumonia pathogen, but also by the reactivity of the immune system, concomitant chronic diseases, and care features.
Beta-lactam antibiotics
The main drugs for the treatment of pneumonia are beta-lactam antibacterial agents, combined based on the presence of a beta-lactam ring in the molecule.
The drugs have a similar mechanism of action and differ in sensitivity to beta-lactamase enzymes, which are produced by bacteria.
Amoxicillin antibiotics are highly effective against pneumococci, which often cause pneumonia; in the absence of allergies, they serve as the drug of choice in children and pregnancy.
Beta-lactam drugs include:
- penicillins;
- natural – benzpenicillin, oxacillin;
- ampicillin;
- amoxicillins – Hiconcil, Flemoxin solutab;
- inhibitor-protected – Augmentin, Timentin;
- antipseudomonal ureidopenicillins – azlocillin, piperacillin;
- cephalosporins;
- 1st generation – cefazolins (Kefzol, Cefamezin), Cephalexin;
- 2nd generation – products with cefuroxime (Zinnat, Ketocef);
- 3rd generation – cefotaxime (Claforan), ceftriaxone (Rocephim), ceftazidime (Fortum);
- 4th generation - cefepimes (Maxipim).
Beta-lactam antibacterial agents are highly effective, but can cause allergies, which is why they are replaced with macrolides or fluoroquinolones. Macrolides are the drugs of choice if an atypical form is suspected, caused by chlamydia, legionella, and mycoplasma.
The advantages of these antibacterial agents include a significant post-antibiotic effect, in which a high concentration of the drug is created in the blood, which remains in a therapeutic dose after discontinuation of the drug.
For example, Azithromycin has a post-anibiotic effect of 4 days, which allows the course of therapy to be reduced to 5 days.
Features of community-acquired pneumonia
Pneumonia can develop rapidly, leaving no time to conduct diagnostic tests to determine pathogenic microflora. The first prescription of an antibiotic in both a private clinic and a public hospital is done empirically.
When choosing which antibiotics to take, the doctor proceeds from the clinical picture of the disease, the prevalence of pneumonia pathogens in the area, the most typical pathogens, and the presence of a history of chronic diseases in adults.
Treatment of pneumonia is carried out in tablet forms; the drugs of choice are penicillins and 2nd generation cephalosporins. Treatment in the form of injections is resorted to when treatment with tablets is impossible, as well as when the disease is severe.
Thus, hospital forms of pneumonia in adults begin to be treated with the administration of antibiotics in injections, and switch to taking tablets only on the 3rd day after the symptoms of inflammation have subsided.
Treatment of pneumonia in adults at home
The effectiveness of the antibiotic is assessed 3 days after the start of therapy. During this time, the necessary therapeutic concentration is created in the blood, and the medicine acts with maximum results.
For mild pneumonia caused by pneumococci and streptococci, oral medications are used containing:
- amoxicillins - Amoxicillin Sandoz, Flemoxin Solutab, Hiconcil, Amosin, Ospamox - 0.5 g at intervals of 8 hours;
- amoxicillins + clavulanate – Augmentin, Betaklav, Flemoklav Solutab, Ecoclave, Amoxiclav – 0.65 g, intervals - 8 hours;
- Cefuroxime axetil - dosage 0.5 g, intervals - 12 hours.
If there is no result after 3 days of use, there is a possibility of atypical pneumonia, adults are prescribed:
- tetracyclines - Doxycycline orally 0.1 g at intervals of 12 hours;
- macrolides:
- clarithromycin - Klacid, Fromilid, Fromilid Uno, Romiclar, Clarithromycin Sandoz, Clarbact 0.5 g at intervals of 12 hours;
- azithromycin - Sumamed, Azitral, Hemomycin, Zitrolide Forte, Azitormicin Zentiva, Azitrox, Zitorlide 0.5 g 1 day once, subsequent days - 0.25 g 1 time per day;
- midecamycin – Macropen 0.4 g after 8 hours;
- spiramycin – Spiramycin-Vero, Rovamycin 3 million IU at intervals of 12 hours;
- roxithromycin - Brilid, Rulid, Rulitsin, Esparoxi 0.15 every 12 hours;
- erythromycin – 0.5 g at intervals of 6 hours Erythromycin tablets;
- josamycin – Vilprafen, Vilprafen solutab 0.5 g with an interval of 8 hours;
- Fluoroquinolones:
- gatifloxacin – Zarquin, Gatispan 0.4 g 1 time/day;
- levofloxacin - Tavanic, Flexid, Floracid, Levolet, Glevo 0.5 g 1 time per day;
- moxifloxacin - Avelox, Hynemox 0.4 g 1 time / day.
Pneumonia in the elderly
For pneumonia in adults over 65 years of age with a mild form, protected aminopenicillins Augmentin or Amoxiclav, Cefuroxime Axetil or one of the fluoroquinolones in the usual dosage are prescribed from the first day of treatment.
Alternative drugs for elderly patients are Doxycycline or Cefaclor.
Pneumonia during pregnancy
During pregnancy, women with pneumonia must be hospitalized. Antibacterial drugs are used in pregnant women only when indicated.
For treatment, medications are chosen that have the maximum effect, but do not cause harm to the developing fetus.
Acceptable antibiotics for the treatment of pneumonia during pregnancy include:
- amoxicillins - table. 0.5 g at intervals of 8 hours;
- amoxicillin + clavulanate – after 8 hours;
- cefuroxime axetil – 0.5 g every 12 hours;
- ampicillin – 1 g injection every 6 hours;
- ceftriaxone - 1 g injection at intervals of 24 hours;
- cefutaxime - 1 g injection at intervals of 8 hours;
- cefuroxime – injections 1.5 every 8 hours.
An alternative drug for allergies to beta-lactam penicillins in pregnant women is spiramycin, which is prescribed for oral administration after 12 hours in a suspension of 3 million IU.
Severe pneumonia
For severe community-acquired pneumonia, Cefepime, Ceftriaxone or Cefotaxime are prescribed as the drug of choice. In addition to the main drug, an antibiotic from the macrolide group is used - clarithromycin, spiromycin or erythromycin.
The most severe course of pneumonia is observed when infected with staphylococcus, pneumococcus, enterobacteria, and legionella. In severe forms of inflammation, medications are administered intravenously; pairs of drugs are used:
- amoxicilling + clavunate and macrolide injection;
- cefotaxime + macrolide;
- ceftriaxone + macrolide;
- ciprofloxacin (ofloxacin) + 3rd generation cephalosporin (or levofloxacin, moxifloxacin).
Replacing antibiotics
The effect of using an antibiotic is to reduce the symptoms of intoxication and lower the temperature. If this does not happen after 3 days, then the drug is replaced.
Ampicillin is often the drug of choice; if there is no result, it is replaced with a macrolide or added additionally. And in case of severe pneumonia, instead of ampicillin, a macrolide + one of the 3rd generation cephalosporins is used.
If the patient was immediately prescribed amoxicillin or cefuroxime, then to achieve the effect, a drug from the macrolide group is added to it.
The reason for changing the antibiotic may be developing renal failure in the patient due to the nephrotoxicity of the drug. Nephrotoxic drugs include cephalosporins and fluoroquinolones.
How long does therapy last?
Provided the temperature normalizes within 4 days, the total duration is 7-10 days. The duration of the course for mycoplasma pneumonia is 2 weeks.
If infected with enterobacter, staphylococcus, legionella, the course of treatment can be extended to 3 weeks.
Recovery criteria
Signs of normalization of the patient’s condition are:
- temperature reduction to values not exceeding 37.5 0 C;
- decrease in respiratory rate to 20 or less breaths per minute;
- absence of pus in the sputum;
- reduction of signs of intoxication of the body.
The use of antibiotics serves an important, but only one purpose - the destruction of infection. The task of restoring lung function is solved by drugs from other groups - anti-inflammatory, expectorant, bronchodilator drugs. The overall result of treatment depends on the correctly chosen treatment regimen, age, and immunoreactivity of the patient.
Antibiotics for pneumonia, bronchitis and bronchopneumonia
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Antibiotics for bronchitis and pneumonia, as well as bronchopneumonia, remain the most effective treatment if the nature of the disease is bacterial. However, the key to successful treatment without unnecessary damage to the body is choosing the right drug that is most suitable for the patient and the disease.
To determine the type of pathogen and its sensitivity to drugs, as a rule, general blood and urine tests are performed, as well as sputum examination (bacterioscopy and culture).
When choosing a particular drug, it is necessary to take into account contraindications, toxicity of the drug, individual intolerance, spectrum of action, and effectiveness. In bronchopneumonia, the rate of accumulation of the required dose in the lesions is also important.
Against bronchitis
It should be remembered that the acute form of bronchitis is often caused not only by a bacterial infection, but also by a viral one. In this case, antiviral treatment is used, and antibacterial agents only cause harm.
Amoxicillin treats inflammation of the bronchial mucous tissues
Antibiotic treatment of inflammation of the bronchial mucous tissue is carried out with the following drugs - Amoxicillin, Clavulanate, Levofloxacin, Moxifloxacin, Ciprofloxacin, Erythromycin. The drugs of choice are Doxycycline, Clarithromycin, Azithromycin.
As a rule, when children have bronchitis, they try not to use antibiotics if possible because of their side effects. If you cannot do without antibacterial drugs, then the latest generation drugs with a milder effect are used as prescribed by the doctor - “Erespal”, “Ceftazidime”.
When treating a chronic form of the disease, antibiotic medications cannot be avoided. Polysynthetic penicillins (Ampiox), cephalosporins (Cefotaxime), aminoglycosides (Amikacin, Gentamicin), macrolides (Oleandomycin, Erythromycin), long-acting tetracyclines (Doxycycline, Metacycline) are used. .
For pneumonia
Treatment of pneumonia necessarily includes the use of antibacterial drugs, as well as their combination. Amoxicillin, Clavulanate, Ampicillin, Axetil, Benzylpenicillin, Doxicillin, Levofloxacin, macrolides, Sulbactam, Ceftriaxone, Cefotaxime, Cefuroxime are used.
In severe cases, drugs are combined and can also be administered by injection.
Against bronchopneumonia
Bronchopneumonia (focal pneumonia) is inflammation of individual small areas of the lung. Since the disease is multivariate, the nature of treatment may also be different.
In case of bronchopneumonia, the causative agents of the disease can also be not only bacteria, but viruses and fungi. Therefore, it is important to conduct high-quality research to determine the most effective treatment.
Therapy without hospitalization for bronchopneumonia uses Fluoroquinolone, Aminopenicillin, Clarithromycin, Doxycycline (for moderate and mild forms of the disease), Azithromycin, Ceftriaxone, Cefotaxime (for severe forms).
Treatment in a hospital setting involves the use of first-line antibiotics - Ceftazidime, Cefepime, Amoxicillin, Penicillin. Alternative drugs (if individual intolerance) - Ticarcillin, Ciprofloxacin, Cefotaxime. Also, as prescribed by a doctor, a combination of several medications can be used.
In case of ineffectiveness (severe bronchopneumonia, combined pathogen), second-line drugs are used - Meropenem, Ticarcillin, Fluoroquinolone.
Choice of antibiotic for pneumonia in adults and children
The infectious origin of the disease determines the use of antibiotics for its treatment, carefully selected in accordance with the type of pathogen.
At the beginning of treatment, when the pathogen has not yet been identified, it is necessary to use broad-spectrum drugs in the form of injections - intravenous and intramuscular. Then you can switch to taking antibiotic tablets.
Antibiotics for pneumonia (pneumonia) in adults
Of the modern types of drugs, the following are most often used:
Penicillins. Can cause allergies, dyspepsia, dysbacteriosis, colitis.
- natural (benzylpenicillin) – for pneumococcal infection;
- semisynthetic penicillinase-resistant (oxacillin, cloxacillin) - for staphylococcus;
- semisynthetic broad-spectrum (ampiox, ampicillin, amoxicillin) – for gram-negative microbes.
Cephalosporins. Increasingly chosen due to their broad antimicrobial action:
- I generation (cefazolin, cephapirin) – against cocci;
- II generation (ceforanide, cefuroxime) – against Escherichia coli and Haemophilus influenzae, Klebsiella, gonococci;
- III generation - gram-negatively active, but little effective against cocci (cefotaxime, ceftriaxone, ceftazidime);
- IV generation (cefpirom) - with a broad antimicrobial spectrum, but does not act on enterococci.
Carbapenems. Tienam has a wide spectrum of activity and is used for severe infections, especially with polymicrobial flora.
Aminoglycosides (tobramycin, gentamicin, amikacin) - with a wide range of activity, especially against gram-positive microbes. May be nephro- and ototoxic.
Tetracyclines (tetracycline, doxycycline) are highly active, used for mixed infections, treatment until the pathogen is identified. Particularly effective against mycoplasmas and chlamydia. May have toxic side effects.
Macrolides (azithromycin, erythromycin) are highly effective. Used in complex therapy of severe infections, resistance to other drugs, allergies, mycoplasmas, chlamydia.
Lincosamines (lincomycin, clindamycin) are especially active against staphylococci resistant to other antibiotics.
Ansamycins (rifampicin, rifaprim) – against mycoplasmas, legionella, pulmonary tuberculosis. They have many side effects.
Fluoroquinolones (moxifloxacin, levofloxacin, ciprofloxacin) - due to their broad action, have become the main drugs.
Imidazole (metronidazole) – for anaerobic infections.
The choice of antibiotic depending on the pathogen and type of pneumonia in adults:
In modern medicine, broad-spectrum antibiotics – Ciprofloxacin and Amoxiclav – are very popular. Specific medications are especially effective against aerobic and anaerobic bacteria and strains. The main goal of antibacterial treatment is to destroy pathogenic flora and ensure the removal of microbes from the body without harm to health.
Comparison of drugs
Many patients, for medical reasons, ask the main question: which is better to buy Ciprofloxacin or Amoxiclav, which antibiotic to give their preference? Both medications are indicated to be taken for sore throat, tonsillitis, pharyngitis, laryngitis, and other infectious diseases of the lower respiratory tract.
These antibiotics fall into the “good medicine” category and are recommended for use by adults and children, according to the prescribed dosages. When prescribing an antibiotic, it is important to follow not so much the instructions for use, but the recommendations of the attending physician. Below are the main differences between the two medications that will help the patient make a choice.
Main differences
- Amoxiclav is a prominent representative of the penicillin series, while the medical drug Ciprofloxacin belongs to the pharmacological group of broad-spectrum fluoroquinolone antibiotics.
- The active components of Amoxiclav are amoxicillin and clavulanic acid, which support the therapeutic effect of the antibiotic. The active substance of Ciprofloxacin is ciprofloxacin, which inhibits the activity of the enzyme responsible for the synthesis of bacterial DNA.
- The prescription of Amoxiclav is appropriate for increased activity of staphylococci, streptococci, echinococci, Proteus, Shigella. Taking the medication Ciprofloxacin is more suitable for infection with gram-positive and gram-negative bacteria.
- The use of Amoxiclav is appropriate during pregnancy if the daily dosage has been agreed upon with the attending physician. The use of a second general antibiotic during pregnancy and breastfeeding is contraindicated.
- Oral administration of Amoxiclav is permitted for use by patients from 3 months of age, while treatment with Ciprofloxacin is permitted starting from the age of 18 years.
Reviews about Ciprofloxacin
These tablets help to successfully cure throat infections, and many patients over 18 years of age have turned to its help. Doctors warn about side effects due to the systemic action of the antibiotic, but in practice such anomalies are extremely rare. Reviews from specialists are positive, but here is what patients write after completing the course of treatment:
- The drug Ciprofloxacin is reliable, improvements began already on the 3rd day after starting treatment, although before that I could not get out of bed for almost a week, the temperature was very high, I constantly felt sick, I did not eat anything.
- The antibiotic does not cause side effects when taken orally and helps to overcome a sore throat. In this way, I cured tonsillitis in a week; it’s still not recommended to take the medication orally for longer.
Reviews about Amoxiclav
Real notes about a typical medication on thematic forums are often left by young parents who gave Amoxiclav to their children. There are no complaints about such home treatment; the antibiotic acts gently and purposefully. Here's what patients write:
- In this way, I cured a sore throat for a 2-year-old child in 5 days, acting strictly according to the indications and recommendations of the pediatrician. I am satisfied with the treatment, there were no complications.
- Amoxiclav removes infection from the body, helps normalize high temperature and remove inflammation. The effect of the tablets is almost instantaneous.
What's better?
The answer to this question depends on medical indications, the age of the patient and the individual characteristics of each organism. For example, Amoxiclav or analogues of the drug are allowed to be given to young children and pregnant women with obvious benefits of such a prescription. If it is not Amoxiclav, infections can be successfully treated with Flemoxin Solutab and Augmentin.
Ciprofloxacin is a more serious antibiotic with strict contraindications and an extensive list of side effects. Its complete analogue, identical in chemical composition, is Tsiprolet, produced in the form of tablets. Both medications should be prescribed by a doctor to patients over 18 years of age, and daily doses should be adjusted individually. Otherwise, symptoms of overdose are observed, represented by increased side effects.
What is more effective?
Both antibiotics are highly effective, but taking them in the same intensive care regimen is strictly contraindicated. An increase in the concentration of active components of synthetic origin in the blood leads to poisoning of the entire body. Due to the systemic action of both medications, side effects can affect the nervous system, gastrointestinal tract, cardiovascular and respiratory systems.
Each patient independently determines which antibiotic is best. Amoxiclav acts gently, but the therapeutic effect does not occur immediately. The action of Ciprofloxacin is more radical and targeted, but the number of complaints from patients about such a prescription is much greater in extensive medical practice. Otherwise, the specialist has the final say.
Rate Ciprofloxacin or Amoxiclav?!
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