In 1928, penicillin was discovered. Note that not invented, not invented, and it is open. After all, the fact is that antibiotics existed and exist in nature as long as there is nature itself. Certain microorganisms can produce substances that protect them from the damaging effects of other microorganisms. These substances and are inherently antibiotics.
His lab was small and dark. He never closed the door to her – a typical thoroughfare. His name was Alexander Fleming. Then he became a Nobel laureate, and Sir Alexander Fleming. That tendency to Fleming “labor unrest” has led to the discovery that, soon, shocked the world. Fleming was a bacteriologist. How to study the bacteria? Take a certain environment in which it is assumed the presence of bacteria (this medium can be anything – soil, water, food, blood, etc.), and placed on a flat dish with special nutrients, which bacteria need to multiply the expected. Bacteria grow and the cup are formed clearly visible points of different sizes – colonies of microbes. Colonies applied to specific slides, color special dyes and then examined under a microscope. Many cups of their end-accumulates in the laboratory. One of them was infected with mold. Fleming “only” drew attention to the fact that the bacterial colonies (they were staphylococci) around the mold disappeared – ie, bacteria were killed. The conclusion of the scientist that mold produces a substance capable of destroying microbes, led to the discovery of penicillin.
In the case of the discovery of penicillin in this, “producer” of the antibiotic appeared a special type of mold. It remains “very little” – to borrow the mold only her inherent weapons, learn to create these weapons in quantities adequate to the needs of mankind, and learn how to use these weapons. Since 1943, it began commercial production of penicillin. And from that time antibiotics have become a compulsory component of modern medicine. After a seemingly simple and logical, it looks to use these funds. There is a germ that causes the disease. There is medicine that can kill germs that cause disease. Prescribe medication, kills germs, disease disappears. Very simple and nice turns. But the more and assign the more we destroy, the more problems there … for antibiotics – a very serious weapon. And one must use a serious weapon skillfully.
Hence, it would seem quite natural and logical conclusion – to use antibiotics can only be a specialist, the case is properly trained, in short, a physician. In practice, however, this is not so. The theoretical possibility of people to fight infections so much that a person has never tried any microbe “crush” in itself alone, is almost impossible to meet. Any antibiotic in any pharmacy you will be sold without a prescription. The number of fans to be treated independently decreases slowly due to the overall decline in the solvency of the population, but children do not spare the money, and the doctors are offended if they do not prescribe anything serious.
The author does not aim to teach readers to use antibiotics! The problem is seen in the fact that:
– Once again stress the complexity and insecurity of antibiotic therapy;
– Pay attention to the obvious: the fact itself the destination, and the dose and timing of use, and direct selection of antibiotic – requires highest professionalism – specific and considerable knowledge, experience, intuition and common sense;
– Explain the meaning of some very wise words of health, be sure to accompany the process of treatment with antibiotics;
– Enumerate and insist on the implementation of the mandatory rules of the use of antibiotics. Regulation, it is urgent for the one who is treated with antibiotics (knowledge of the rules to those who treat with antibiotics, it is understood).
Antibiotics – is not the only means that can destroy the body pathogens. The theoretical possibility of the use of any antimicrobial agents based on the fact that in certain bacterial cell, there are certain structures that have no analogues in the human body. Simply put, you need to find something in a microorganism (a protein enzyme), without which it can not exist, but that “something” must be peculiar to the microbe – that in man such enzymes or proteins such should not be.
Example: The cell wall of certain bacteria, in its anatomy, has nothing to do with any cells of any mammal. Naturally, it is possible (though not easy) the creation of a substance that destroys skin bacteria, but not at the same time damaging human cells. By the way, just the way destroying skin bacteria are well-known penicillin, ampicillin, tseporin.
Another example: in almost all bacteria has an enzyme that has a complicated name “DNA gyrase.” Without it, the bacteria lose their ability to proliferate and die quickly. Established drugs that destroy the DNA gyrase, and, of course, have strong antibacterial effect on many bacteria – zanotsin, tsifran, norfloxacin, ofloxacin, etc.
But, just listed drugs, antibiotics are not ??!
This situation is not too clear, and demands an explanation.
I emphasize again: antibiotics – substances that some microorganisms produce to destroy other microorganisms.
Some fungi (penitsilium, tsefalosporium, etc.) produce antibiotics – such as penicillin, cephalosporin. Some bacteria (Actinomycetes) produce antibiotics – such as tetracycline, streptomycin.
At the same time, any natural antibiotic scientists trying to upgrade (modify, improve, make more active against microbes and less dangerous to humans). Thus, by changing the structure of penicillin, derived its synthetic derivatives – oxacillin, ampicillin; by varying the tetracycline – doxycycline, methacycline, etc. Thus, antibiotics are the natural and synthetic.
At the same time, the antimicrobial agent may not have anything to do with nature – it could be a product solely of the human mind, that is, It is a substance that man invented himself. On many of these drugs you take, of course, we heard. It is well-known sulfonamide (streptocid, etazol, Biseptol), nitrofurans (furazolidone, furagin), fluoroquinolones (already named by us zanotsin, tsifran etc.).
The meaning of the above: antibacterial agents and antibiotics – it is not the same thing.
There is a medical term – “chemotherapy”. Chemotherapy – a treatment of infectious disease medicines. And we listed drugs, – and sulfonamides, and antibiotics, and fluoroquinolones, nitrofurans and – represent a chemotherapeutic agent or that a clear anti-microbial agent.
This information has more theoretical than practical significance, since the principles and rules of any antimicrobial agents are the same. Everything we tell about antibiotics equally be extended to the fans and to fans Biseptolum furazolidona, and all other fans to fight germs.
Antibiotics are different and it is quite obvious. But, using a completely certain antibiotics, doctors (I repeat, it is doctors) in each case are based on the quite specific properties of a particular drug. What are these characteristics?
The spectrum of action of antibiotics.
Each antibiotic acts on a strictly certain microorganisms. For example, penicillin is active in the so-called “cocci” – streptococcus, meningococcus, gonococcus, pneumococcus, but has no effect on E. coli, dysentery bacillus, salmonella. Antibiotic polymyxin B, on the contrary, acts on the rods, but does not act on cocci. Chloramphenicol and ampicillin act on first and second. That is, the spectrum of action of chloramphenicol wider than the range of action of penicillin. Hence the obvious notion of “broad-spectrum antibiotic” and “narrow-spectrum antibiotic action.”
Good or bad, broad-spectrum antibiotic? On the one hand very well, because if the pathogen is not known (well, just not clear who caused the particular meningitis, pneumonia or concrete), the use of broad-spectrum antibiotic will be effective more likely. On the other hand, such an antibiotic will destroy not only the pathogen but also “peaceful” intestinal microbes that will manifest itself in the form of dysbiosis. Hence the obvious conclusion – antibiotics are narrow-spectrum (penicillin, oxacillin, erythromycin), are more preferable than broad-spectrum antibiotics (ampicillin, cephalexin, gentamicin, tetracycline, chloramphenicol). But to treat it is narrow-spectrum medical drugs harder – not easier to guess, do not get no help, and be, in the end, sorry.
Mechanism of action of antibiotics.
Some antibiotics are completely inhibit the growth of bacteria – ie, destroy them permanently. These are called bactericidal antibiotics, they are a very important cell structures, destroying microbes quickly and in large quantities. Penicillin destroys skin bacteria and the chances of the existence of the latter is not. It is clear that penicillin – a bactericidal antibiotic, as, indeed, and ampicillin, cephalexin, gentamicin.
Some antibiotics work quite differently – they prevent the growth of bacteria. The colony of microorganisms does not increase bacteria on the one hand, they killed themselves ( “old age”), on the other – actively destroyed immune cells (leukocytes) and the person recovers quickly. Such antibiotics – they are called bacteriostatic, as it helps the body to fight infections. Examples – erythromycin, tetracycline, chloramphenicol. If you stop taking early bacteriostatic antibiotics – the disease would return. The effect of the germicide will come faster.
Distribution of the antibiotic in the body.
Whichever way did not get an antibiotic in the body, it is, after all, is in the blood and spreads throughout the body. At the same time in a certain organ specific antibiotic accumulates in quite a certain amount. And otitis may be treated with penicillin and ampicillin, ampicillin but in the middle ear cavity accumulates better therefore be more effective. Lincomycin antibiotic penetrates well into the bone and is used for the treatment of osteomyelitis (bone suppurative inflammation). Swallowed the antibiotic polymyxin B did not absorbed into the blood and act only in the gut – it is convenient to treat intestinal infections.
Distribution in the body of some modern drugs at all unique. For example, an antibiotic sumamed specifically attached to phagocytes – immune cells that engulf and digest bacteria. If there is inflammation in the body hearth phagocytes move it back and accumulate in large numbers in the inflammatory foci. A sumamed moves with phagocytes – ie pneumonia if the maximum number is namely antibiotic in lungs and pyelonephritis – in the kidney.
ROUTES OF ADMINISTRATION ORGANISM ANTIBIOTIC.
“To send” antibiotic microbial accumulation space can be different. You can spread antibiotic ointment on the skin ulcer. You can be swallowed (tablets, drops, capsules, syrups). You can prick – into a muscle, into a vein, into the spinal canal. The route of administration of the antibiotic does not matter – it is only important to the antibiotic time was in the right place and in the right quantity. That is to say, the strategic goal. But a tactical question – how to achieve it – is no less important. Obviously, any tablet is clearly more comfortable injections. But … Some antibiotics are destroyed in the stomach, such as penicillin. Others are not absorbed, or barely absorbed from the intestine, such as gentamicin. The patient may be vomiting, he may even be unconscious. The effect of the drug ingested will come later than that of the same drugs administered intravenously – it is clear that the more severe the disease, the more reason for the unpleasant injections.
Elimination pathway of antibiotics from the body.
Some antibiotics – such as penicillin or gentamicin, in unchanged form excreted in the urine. This allows, on the one hand, to successfully treat kidney and urinary tract disease, but, on the other hand, when a substantial breach of the kidneys, with a decrease in amount of urine can lead to excessive accumulation of the antibiotic in the body (overdose). Other drugs, such as rifampicin and tetracycline, derived not only urine but also bile. Again, the obvious efficiency in the liver and biliary tract, but special care with liver failure.
Drugs without the side effects do not exist. Antibiotics – is no exception and it is to put it mildly. Allergic reactions are possible. Some drugs often cause allergies, such as penicillin or cephalexin, other rare, for example, erythromycin or gentamycin. Certain antibiotics have deleterious (toxic) effects on certain organs. Gentamicin – on the kidney and the auditory nerve, tetracycline – the liver, polymyxin B – on the nervous system, chloramphenicol – on hematopoiesis system, etc. After receiving erythromycin often have nausea and vomiting, high doses of chloramphenicol cause hallucinations, and decreased visual acuity, any broad-spectrum antibiotics contribute to the development of dysbiosis …
Now let’s think!
On the one hand, it is obvious the following: receipt of any antimicrobial agent requires mandatory knowledge of all that was listed above. That is all the pros and cons of all should be well known, otherwise – the effects of the treatment can be most unpredictable. But, on the other hand, self-swallowing Biseptol, or on the advice of a neighbor, putting the child in a pill ampicillin, you gave a report of his actions? All of you know that? Of course, we do not know. We do not know, did not think, did not know, like, the best … Better – to know and to think …
WHAT YOU NEED TO KNOW.
– Any antimicrobial agent should be administered only by a physician!
– Inadmissibility of the use of antimicrobials in viral infections, ostensibly in order to prevent – in order to pre-empt the development of complications. It never fails, on the contrary – it only gets worse. Firstly, because there will always be a microbe that survives. Secondly, because, destroying some bacteria, we create the conditions for the reproduction of others, increasing, rather than reducing the probability of the same complications. In short, the antibiotic should be administered when bacterial infection is already there, rather than to supposedly prevent it. The most correct attitude towards prophylactic antibiotics incorporated in the slogan put forward by the brilliant philosopher MM Zhvanetsky: “Trouble have to worry as they come!”.
Prophylactic antibiotics – not always evil. After many operations, particularly in the abdominal cavity, it is vital organs. During the plague mass reception tetracycline can protect against infection. It is only important not to confuse concepts such as preventive antibiotic therapy in general, and the prophylactic use of antibiotics for viral infections in particular.
– If we give you antibiotics (take), in any case do not stop treatment immediately after it becomes a little easier. The required duration of treatment can be determined only by the doctor.
– Do not beg for something stronger.
The concept of the strength and weakness of the antibiotic is largely arbitrary. For the average of our national strength antibiotic is largely due to its ability to empty his pockets and purses. People really want to believe in the fact that if an antibiotic, for example, “tienam” 1000 times more expensive than penicillin, and it is a thousand times more effective. Yes it was not there … The antibiotic treatment there is such a thing as “the antibiotic of choice.” Those. for each infection, each specific for bacteria antibiotic is recommended to be used in the first place – and it is called antibiotic selection. If this is not possible – for example, allergies, antibiotics are recommended second line, etc. Angina – penicillin, otitis – amoxicillin, typhoid fever – chloramphenicol, whooping cough – erythromycin, plague – tetracycline, etc. Everything is very expensive drugs are used only in a very serious and fortunately not very frequent situations when a particular disease is caused by a microbe resistant to most antibiotics, when there is a marked reduction of immunity.
– Assigning any antibiotic, the doctor can not foresee all the possible consequences. There are cases of individual intolerance of a specific person of a particular drug. If this has happened, and after a single oral erythromycin, the child vomited all night and complained of abdominal pain, the doctor is not to blame. Treat pneumonia can be hundreds of different drugs. And less than an antibiotic is used, the wider the range of its activities and, consequently, the higher the price, the greater the likelihood, that will help. But, the greater the likelihood of toxic reactions, goiter, immune system suppression. Injections are more likely to quickly and lead to recovery. But it hurts, but there may be festering in the place where pricked. And if you are allergic – after pill washed stomach, and after the injection – that the wash? The relatives of the patient and the doctor is mandatory must find a common language. With antibiotics, the doctor always has the opportunity to play it safe – injections instead of pills, 6 times a day instead of 4, cephalexin penicillin instead of 10 days instead of 7 … but the golden mean, matching the risk of failure and the likelihood of rapid recovery is largely determined by the behavior of the patient and his relatives . Who is to blame, if the antibiotic is not helping? Surely only a doctor? What is this for such a body, which, even with the strongest drugs could not cope with the infection! Well this is what life had to organize to bring the immune system to the extreme … And I do not mean that all doctors are angels, and mistakes, unfortunately, not uncommon. But to shift the emphasis necessary for a particular patient does not give an answer to the question “Who is guilty?”. The question “what to do?” – Always up to date. But, time and again:
– “It was necessary to appoint injections!”;
– “What are you, in addition to other penicillin drugs do not know?”;