The group of antibiotics under the General name “penicillins” includes the following drugs: amoxicillin, ampicillin, ampicillin with sulbactam, benzylpenicillin, cloxacillin, coamoxylav (amoxicillin with clavualanic acid), Flucloxacillin, methicillin, oxacillin, phenoxymethylpenicillin.
Cephalosporins: cefaclor, cefadroxil, cefixime, cefoperazone, Cefotaxime, cefoxitin, cefpirome, cefsulodin, ceftazidime, ceftizoxime, Ceftriaxone, cefuroxime, cephalexin, cephalothin, of cefamandol, Cefazolin, cefradine. Penicillins and cephalosporins together with the antibiotics monobactam and carbapenem are known as antibiotics (3-lactams. Other antibiotics (3-lactams include aztreonam, imipenem (which is usually used in combination with cilastatin).
Aminoglycosides: amikacin, gentamicin, kanamycin, neomycin, netilmycin, streptomycin, tobramycin.
Macrolides: azithromycin, clarithromycin, erythromycin, josamycin, the roxithromycin.
Lincosamides: clindamycin, lincomycin.
Tetracyclines: doxycycline, minocycline, oxytetracycline, tetracycline.
Quinolones: nalidixic acid, ciprofloxacin, enoxacin, fleroxacin, norfloxacin, ofloxacin, pefloxacin, temafloxacin (withdrawn in 1992).
Others: chloramphenicol, cotrimoxazole (trimethoprim and sulfamethoxazole), mupirocin, teicoplanin, vancomycin.
Penicillin group antibiotics are probably the most popular of all; they include a number of priceless antibiotics that are very effective when properly used. Both ampicillin and amoxicillin are widely prescribed for upper and lower respiratory tract diseases, bladder diseases (such as cystitis), and other infections.
Similar to penicillins, cephalosporins are widely used antibiotics. They are conditionally divided by the time of their appearance (by generation) and by the scale of their activity, especially against gram-negative bacteria. They are widely used in surgical practice, especially for the prevention of surgical infections.
Quinolones (or fluoroquinolones) occupy an important place among the latest synthesized antibiotics, although the first synthesized quinolone – nalidixic acid (nevigramon, negram) – has been around for many years. Nalidixic acid is used in the treatment of certain diseases of the bladder and Shigella dysentery, despite its often occurring side effects and the ease with which resistance to it develops.
- GROUPS OF MACROLIDES AND LINCOSAMIDES
Macrolide antibiotics like erythromycin are useful in the treatment of tissue infections initiated by microorganisms resistant to natural penicillins, or in diseases in patients who are prone to penicillin allergies. However, bacteria quickly form resistance to erythromycin. Increased clinical use of erythromycin has led to rapid emergence of resistance in specific clinical settings (in particular, this applies to staphylococci, group a streptococci and enterococci).
- STREPTOMYCIN AND OTHER AMINOGLYCOSIDES
Medications in this category include gentamicin, amikacin, framycetin, kanamycin, neomycin, netilmycin, paromomycin, sizomycin, and tobramycin. They have a wide spectrum of action, but due to their resistance and serious side effects, their therapeutic use is limited. They can provoke the appearance of deafness, kidney complications, muscle weakness, difficulty breathing with prolonged use and when used in high doses. Such antibiotics are not recommended for people who suffer from kidney disease, as well as allergies, as they can cause complications. They should not be used during pregnancy.
- CHLORAMPHENICOL (LEVOMYCETIN)
Chloramphenicol is a strong, tolerable, toxic broad-spectrum antibiotic that should be used to treat life-threatening infections. This is a valuable drug for the treatment of typhoid and meningitis of a certain type. At the same time, its excessive use is widespread, and its use without consulting a doctor has led in many cases to a fatal outcome due to damage to the bone marrow, which could have been avoided.
Tetracyclines are widespread antibiotics that have become less useful over time as a result of increased bacterial resistance. They are currently used much less than previously, at least in more developed countries. They are used in the treatment of lung inflammation, bronchitis, some atypical cases of pneumonia and acne.
- COTRIMOXAZOLE (TRIMETHOPRIM AND SULFAMETHOXAZOLE)
Despite the fact that cotrimoxazole is a useful medicinal product, the data suggest that it is often possible to use a single trimethoprim with a result that was equal to the effectiveness of the mixed substance and probably with minimal toxicity.
MECHANISMS OF RESISTANCE TO ANTIBACTERIAL DRUGS
The basis of therapeutic action of antibacterial drugs is the suppression of the life activity of the pathogen of an infectious disease as a result of the suppression of a more or less specific metabolic process for microorganisms. Suppression occurs as a result of binding of the antibiotic to the target, which can be based on either an enzyme or a structural molecule of the microorganism. Resistance of microorganisms to antibiotics can be congenital or acquired. This natural stability is characterized by the presence of the target of antibiotic action in microorganisms due to initially reduced availability or enzymatic inactivation. If viruses have natural resistance, antibiotics are clinically ineffective. Natural resistance is a stable species characteristic of microorganisms and is easily predicted. Acquired resistance is understood as the property of individual bacterial strains to maintain viability at those concentrations of antibiotics that depress the main part of the microbial population. Situations where a large number of microbial populations show acquired resistance are acceptable. The appearance of acquired resistance in bacteria is not necessarily accompanied by a decrease in the clinical effectiveness of the antibiotic. In most cases, resistance modeling is caused genetically: by acquiring new genetic information or changing the degree of expression of one’s own genes. The following biochemical mechanisms of bacterial resistance to antibiotics are known
- Modification of the action target.
- Inactivation of the antibiotic.
- Active removal of the antibiotic from the microbial cell (efflux).
- Violation of the permeability of external structures of the microbial cell.
- The formation of metabolic shunt.