Antibiotics for inflammation of the appendages 5/5 (2)

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Antibiotics for inflammation of the appendages should be given to the patient immediately after an accurate diagnosis is established. At this time, studies can be carried out to determine the type of pathogen, but this is not reflected in the initial treatment. Antibacterial drugs are relevant if the inflammatory process proceeds in an acute form. In some cases, antibiotics are given to patients with an exacerbation of a chronic disease.

  • Types of antibiotics for inflammation of the appendages;
  • Indications for the use of antibiotics;
  • Pharmacodynamics of antibiotics;
  • Pharmacokinetics of antibiotics;
  • Treatment of inflammation of the appendages during pregnancy;
  • Contraindications to the use of antibiotics;
  • Side effects of antibiotics;
  • How to take antibiotics for inflammation of the appendages;
  • Overdose of antibiotics;
  • Interactions of antibiotics with other drugs.

For the treatment of inflammation of the appendages, drugs with a wide spectrum of action are relevant, that is, they kill a number of bacteria that usually lead to diseases of the genitourinary system. Doctors need to remember that the antibiotics chosen for the treatment of the patient must be active against ureaplasma, chlamydia and mycoplasma, because most often it is these organisms that cause the inflammatory process.

The treatment is adjusted after the result of the study, if it is found that another drug is better suited to destroy the identified pathogen. The drug and / or dosage should be changed if the patient’s condition has not improved in a few days, that is, there has been no progress in symptoms and laboratory data.

Types of antibiotics for inflammation of the appendages


In recent years, a number of pathogens have acquired resistance to popular antibacterial drugs of the tetracycline series. It is also worth considering that drugs in this group have a large number of side effects. Specialists in most cases treat inflammation of the appendages with doxycycline (which has minimal side effects and is excreted by the body in a short time).

Another group of effective drugs for the problems under consideration are macrolides. They are not destroyed in the stomach, have a long half-life, therefore they accumulate in the body and thus speed up recovery. The effectiveness of sumamed and klacid has been proven in practice today. Antibacterial drugs from the macrolide group destroy, among other things, organisms that settle inside cells, leading to inflammation.

Fluoroquinolines are the next group that is relevant in the treatment of inflammation of the appendages. The “addiction” of pathogens to these drugs is very, very slow, so there will be no need to change the drug often. If the patient has no contraindications to taking fluoroquinolines, one of these drugs is prescribed:

For the treatment of diseases of the genitourinary system, two or more drugs are used, monotherapy is not indicated. The reason is that the pathogens are often two or more microorganisms, both anaerobes and aerobes. For the destruction of the latter, drugs such as metronidazole and tinidazole are relevant.

Indications for the use of antibiotics

Infectious inflammation of the ovarian appendages is known as adnexitis. For therapy, the use of antibacterial drugs of various forms of release is mandatory. Injectable forms are mostly relevant (into a muscle, into a vein, as well as drugs are available in the form of powders for dilution or ready-made solutions). After a course of injections, the doctor prescribes tablet forms of drugs. Also, in some cases, suppositories or suspensions of antibacterial agents may be prescribed.

The main antibiotics that are prescribed for the inflammatory process in the appendages:

Effective drugs from the group of nitromidazoles:

The doctor prescribes aminoglycosides only if the disease is very severe, or if the infection has spread throughout the body, moving to other organs.

Pharmacodynamics of antibiotics

Antibiotics, which are classified as tetracyclines, kill the ability of the pathogen to multiply. They are effective against such flora:

  • gonococci;
  • streptococci;
  • staphylococci;
  • enterobacteria;
  • whooping cough;
  • salmonella;
  • klebsiella;
  • spirochetes;
  • mycoplasmas;
  • chlamydia;

Antibacterial drugs from the group of fluoroquinols inhibit DNA gyrase and topoisomerase, disrupt DNA synthesis, and through these mechanisms they help to cope with the disease. If the pathogen is resistant to 1st generation quinolines (which is detected during therapy), then the doctor prescribes one of the fluoroquinolones. Kill mycobacteria, mycoplasma and pneumococci drugs of this group, but the 3rd and 4th generation, and the 2nd generation is less effective. Some enterococci can also be destroyed by fluoroquinolones.

Pharmacokinetics of antibiotics

Approximately seventy percent of the taken drug from a number of tetracyclines, which are prescribed by physicians in the diagnosis of inflammation of the appendages, is absorbed in the gastrointestinal tract. The active substance “disperses” through tissues and fluids, and during pregnancy it enters both the placenta and the fetus. Tetracycline antibiotics are excreted unchanged from the body in the urine and feces.

Absorption can be greater or lesser, depending on the type of drug and its form, as well as whether it is taken before, during or after a meal. This point should be indicated by the attending physician when developing a treatment regimen. Especially carefully you need to calculate the time of eating and taking ezithromycin. Josamycin and clarithromycin can be taken without regard to lunch/dinner hours.

Macrolides are collected in large quantities in the blood serum and tissues of the body. During inflammation in the body, macrolides spread well in the air, getting inside the cells and concentrating there. These drugs do not cross the hematoophthalmic barrier. Macrolides break down into simpler elements in the human liver, and are excreted through the gallbladder. The half-life is different for all drugs in the group, but the period is at least 1 hour, maximum 55 hours. Renal failure when taking drugs from the macrolide group does not change the above half-life figures.

The absorption of drugs from the fluoroquinolone group occurs to a large extent in the gastrointestinal tract after the patient drinks the pill. 2 hours after ingestion, the highest concentration of the drug in the patient’s blood occurs. These antibiotics can also affect the fetus, so pregnancy is a contraindication for taking. These drugs are excreted mainly by the kidneys, the gallbladder also plays a small role.

Fluoroquinolones, with the exception of norfloxacin, accumulate in the organs and tissues of the human body. Different drugs from this group have different degrees of disintegration into smaller particles, pefloxacin disintegrates the most. Drugs are excreted by 50% in 3-14 hours, the maximum half-life in some cases is twenty hours. If the patient’s kidney function is impaired, then the drugs are excreted longer, this issue should be clarified with the attending physician and be sure to inform him of all diseases, in addition to inflammation of the appendages. When determining the desired therapeutic dose, one must take into account severe renal failure, if it is present in a patient with inflammation of the appendages.

Treatment of inflammation of the appendages during pregnancy


Pregnancy is a contraindication for the appointment of tetracycline drugs, because these drugs pass through the placenta into the fetus, can be collected in its organs and tissues. Because of this, the unborn child will develop the skeleton incorrectly. Some macrolides are also not used during pregnancy. Clarithromycin has been shown to be harmful to the fetus. And the action of roxithromycin and midecamycin has not been sufficiently studied today.

Relatively safe for the treatment of inflammation of the appendages of pregnant women are such drugs:

If no other treatment is possible, and inflammation of the appendages in a pregnant woman is severe, doctors may resort to prescribing azithromycin. Preparations from the group of fluoroquinolones during pregnancy are prohibited.

Contraindications to the use of antibiotics

Contraindications to the appointment of tetracyclines are:

  • kidney failure
  • hypersensitivity to this drug
  • diagnosis of leukopenia
  • if the patient is less than 8 years old
  • when breastfeeding
  • when carrying a child

Contraindications for treatment with macrolides:

  • pregnancy (only part of the drugs)
  • breastfeeding (clarithromycin and others)

Contraindications for fluoroquinolone therapy:

  • gestation
  • lactation
  • lack of glucose-6-phosphate dehydrogenase
  • the appearance of allergic manifestations in response to taking the drug
  • not suitable for children

Side effects of antibiotics

Tetracycline antibiotics can lead to an increase in pressure inside the skull, to dizziness. In the blood, the number of neutrophils, platelets, and hemoglobin changes. Other side effects of these drugs include:

  • nausea;
  • loss of appetite;
  • inflammation in the gastrointestinal tract;
  • diarrhea or constipation;
  • violation of the functioning of the kidneys;
  • allergic manifestations;
  • anaphylactic shock.

Some of these antibiotics, prescribed for inflammation of the appendages, lead to candidiasis, the development of excessive susceptibility to ultraviolet rays. Tetracyclines in babies can disrupt the formation of bones, including teeth, the shade of enamel changes.

Macrolides can lead to such side effects:

  • allergic manifestations;
  • reinfection with pathogen resistance to erifomycin;
  • pain in the gastrointestinal tract;
  • nausea;
  • drooping of the upper eyelid;
  • vision problems;
  • a significant expansion of the pupil;
  • paralysis of the oculomotor muscles.

Fluoroquinolones also cause a number of side effects, one or some of which may be noted in the patient:

  • loss of appetite;
  • pain in the gastrointestinal tract;
  • diarrhea or constipation;
  • nausea;
  • poor sleep, or awakenings in the middle of the night;
  • headache;
  • convulsions;
  • trembling in the body;
  • decreased vision;
  • Allergy manifestations.

Rare side effects of taking fluoroquinolones include:

  • inflammation in the tendons, joints;
  • negative impact on the functioning of the kidneys;
  • tendon ruptures;
  • problems with heart rhythm;
  • diseases of the large intestine;
  • oral candidiasis;
  • thrush in female patients.

How to take antibiotics for inflammation of the appendages

Medicines classified as tetracyclines should be taken after meals or with meals. For adult patients, the doctor prescribes 100 mg of the drug, the dose is divided into three or four doses. If the child is over 8 years old, the dose for him is calculated according to the formula for a maximum of 25 mg / kg. The course of treatment with drugs of this group is 5-7 days, no more. But this should be indicated directly by your attending physician, self-medication with antibiotics is life threatening!

Treatment with tetracycline antibacterial drugs is canceled if a person develops such manifestations of allergies as burning, itching, redness of the skin. It is better not to take these drugs with milk or products based on it (kefir, fermented baked milk), otherwise the product will be absorbed much worse.

A number of macrolide antibiotics should be taken 2 hours after or 60 minutes before a meal. Erythromycin is recorded with water in an amount of more than two hundred milligrams. Suspensions for internal use must be diluted, before use, read the instructions, which indicate the features of administration and dosage. The doctor prescribes a specific treatment regimen that must be strictly followed. The medicine is taken at certain time intervals, and this plan cannot be deviated from, only in this way the desired concentration of the medicine in the blood and tissues is achieved.

Macrolides are not taken with antacids. The latter are prescribed in the presence of acid-dependent diseases of the gastrointestinal tract. Fluoroquinolones are also washed down with water in large quantities, taken 2 hours before meals. When treating with antibiotics, you need to drink one and a half liters of water or more per day.

Antibiotic overdose

If an overdose of tetracyclines occurs, the side effects of the drugs become stronger. Side effects are listed above. Treatment consists of taking medications to relieve symptoms. An overdose of antibiotics from a number of macrolides is not life-threatening. There are stool disorders, nausea, the heart rhythm changes.

Fluoroquinols in excessive dosage for the life of the patient do not pose a threat. The resulting symptoms are treated outside the hospital. Very rarely, epileptic seizures can occur. An overdose of these drugs affects the joints, liver, cardiovascular system and tendons.

Interactions of antibiotics with other drugs
Tetracyclines should not be combined with therapy with drugs containing such substances:

  • calcium;
  • magnesium;
  • iron;
  • zinc;
  • other metal ions.

The effect of tetracycline drugs is adversely affected by concurrent therapy with barbiturates and carbamazepine. It should be borne in mind that antibiotics from this series reduce the effectiveness of oral contraceptive pills. It is impossible to combine treatment with macrolides and aminoglycosides. Tetracyclines and chloramphenicol or lincomycin are not prescribed together. There are a number of other features of the interaction of antibiotics and other drugs that the attending physician should talk about, given the patient’s medical history and current diseases, in addition to inflammation of the appendages.

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