The era of antibiotics

Why are not useful ?
Antibiotic resistance - the actual problem today.

GETTING STARTED

introduction of antibiotics is associated with the names of Paul Ehrlich and Alexander Fleming.Ehrlich has been obsessed with the idea of ​​a "magic bullet", aiming beating only pathogens.He argued that it is possible to synthesize these chemicals, which "will be able to have an effect solely on the microbes living in the body.""Salvarsan" (the cure for syphilis) was established on the basis of his research.Another important event in the history of antibiotics occurred Sept. 3, 1928, when Fleming discovered penicillin by accident by growing mold in a Petri dish with the experimental colonies of staphylococci.But few people know that clean it and to organize industrial production was only about 15 years later!By the way, Fleming was also among the first to warn about the possible stability (resistance) to penicillin in case of using it in a very low dose or short-term in the course of treatment.

The vast majority of modern antibioti

cs, even heavily modified, operates on the same processes in the cell, as their predecessors.exposure range is limited to the read process steps of the genetic information of the cell wall biosynthesis, DNA / RNA synthesis and some other processes in the cell.Increasing the number of decoded genomes brings the realization of the idea of ​​a "magic bullet" more perfect way, when the target defined at the molecular level.

OUR RESISTANCE

The main problem that we face in antibiotic therapy, is that after the introduction of a new antibiotic to it sooner or later, there is resistance.Today continues competition between the discovery and improvement of antibiotics and resistant bacteria to their action.Along with the invention of more and more antibiotics, and improved mechanisms to protect them.Evolutionary analysis of the genes of antibiotic resistance of microorganisms allowed to assume that genes encoding resistance to specific groups of antibiotics have existed in nature for a long time, long before the era of antibiotics.

bacteria do not recognize the boundaries of ecological systems, and therefore there is always a continuous flow of genetic information between different ecosystems.After the genome of pathogenic microbiota of animals / plants are introducing the potential of antibiotic resistance genes, even in trace amounts or low frequency of occurrence, the selection of antibiotic immediately leads to copying and distribution of these genes.Although at the beginning of the use of antibiotics has not been extensive data bank of genes of antibiotic resistance, recent research suggests that the most likely cause of these genes - environmental resistance to antibiotics.

doctor recommends

level of antibiotic-resistant infections depends on the frequency of dosing.There are cases when the patients themselves ask their doctor to prescribe antibiotics when they are not necessary, as in cases of viral infections.A particularly serious situation in countries where antibiotics are sold in pharmacies without a prescription.In the absence of control of the decision to buy and drink this drug takes the purchaser, and in the best case it recommends pharmacist.Self eliminates these components of a successful therapy is the correct diagnosis, adequate choice of antibiotic, the scheme and the duration of his admission, control efficiency, thereby leading to the aggravation of the problem.That's why prescribe antibiotics may only doctor.

development of rapid diagnostic techniques (eg, polymerase chain reaction, PCR, real-time) can be a great help in determining the most effective therapy without the risk of a sudden encounter with resistant pathogens.But while rapid methods are expensive and not widely available, doctors use a "reconnaissance in force" - prescribe broad-spectrum antibiotics and observe the effect.If it is, continue treatment under the previous scheme, and if not - picked up a new antibiotic method exceptions based spectrum inefficient drug.

perfection

«In general, modern antibiotics are distinguished by greater security compared to previous generations of drugs.The use of such once po¬pulyar¬nyh drugs like gentamicin and amikacin significantly reduced with the introduction into clinical practice of new classes of antibiotics, which have a similar spectrum of activity, but it is much safer to aminoglycosides.Significantly reduced and the use of erythromycin in connection with the appearance of his "offspring" have better tolerability.Expanding opportunities prescribing antibiotics to children.However, we must remember that most of the antibiotics still contraindicated during pregnancy "- says Matluba Gaffarova.

Along with an increase in the level of knowledge about antibiotics continue to develop new products and the improvement of the already known.For example, the use of certain enzymes in the destination of ampicillin intravenously can prevent the emergence of resistant intestinal microflora to antimicrobial drugs.Medicaments originally created for other purposes have been used as antimicrobial agents.Known history, when the antibiotic is initially tested for cholesterol lowering.Now it is considered a drug - contender for the treatment of serious hospital-acquired infections.You can work on themselves mechanisms of antibiotic resistance, for example, to slow down their excretion from the body or inhibit the production of substances by bacteria that destroy antibiotics.In addition, approaches aimed not only for specific purposes, and in biological systems can help to create new types of antibiotic therapy.Thus, developed a combination therapy combining an antibiotic with specific viruses - bacteriophages, potentiating their action, or enzyme that destroys microbial biofilm bacteria and makes more vulnerable to antibiotics.

Although most infections have been brought under control, the balance in this game fragile, as for nearly 4 billion years of evolution of the microbial world has accumulated a huge variety of metabolic and defense mechanisms, they can be mobilized in response to a strong breeding selection.We must learn to strike the dot pathogens and limit the uncontrolled use of antimicrobials and other methods that accelerate the emergence of new mechanisms of resistance.The study of the surrounding microcosm for possible mechanisms of resistance to antibiotics and the spread - good help in the development of measures to maintain the effectiveness of antimicrobial use and antibiotic therapy.

Bad, but the fact

Antibiotic resistance, unfortunately, is not the only problem of the use of antimicrobials.Today, biotechnology and pharmacology have not managed to create a highly selective antibiotics, which would operate only at one specific pathogen.Any antibiotic besides pathogenic bacteria and destroys the body's own microflora.Most often suffer from intestinal flora: abdominal pain, flatulence, antibiotic-associated diarrhea - these are just a few symptoms of intestinal dysbiosis.

helps prevent the development of dysbiosis intake of probiotics, prebiotics and ¬eubiotikov.Preference should be given to modern drugs, they are protected by special beneficial bacteria membranes from the damaging effect of acidic gastric juice and of the antibiotic.Reception these drugs should be started from the first day of use of antibiotics and continue for at least 10-14 days.However, low-cost drugs containing lactobacilli and bifidobacteria, too, can take advantage of, but their use will be effective only after the course of antibiotic therapy.

INSTRUCTIONS FOR USE

Taking antibiotics is recommended, usually after a meal, drinking a moderate amount of non-carbonated water.Multiplicity reception is dictated by the duration of action of the drug throughout the day.Most antibiotics have legacy short period, about four to five hours, so they have to take four times a day.Each missed pill causes a sharp decrease in the concentration of the drug in the blood and give pathogens a chance to generate drug resistance.Take the drug on the clock, of course, uncomfortable, therefore growing in popularity gaining sustained release formulations that work 12 hours or even a whole day.They typically contain a sufficiently high dose of the active substance and can cause discomfort subjectively - a metallic taste in the mouth, nausea and so on.To smooth the peak of these phenomena, drugs are prescribed for the night, and in the dream does not feel discomfort.

Another important point - before taking an antibiotic is necessary to consider the compatibility of the dosage.Usually indicate the impossibility of joint use of drugs are described in detail in the instructions.Most unwanted combination - with antidepressants, anticancer drugs individual statins, any drugs with a high liver toxicity and, of course, with other antibiotics.Two antibacterial drugs prescribed by a doctor only in exceptional cases, because some antibiotics inhibit and even neutralize each other at a joint reception.Drugs that are commonly used to combat heartburn and foodborne diseases - sorbents, antacids - may slow the absorption of the antibiotic.When there is need of food infections and sorbents, and antibiotics, so taking these drugs is better spread over time.For example, take the sorbent for an hour before a meal, and antibiotics - 30 minutes after ingestion.

Prophylactic antibiotics for viral infections, "not to ache," completely unacceptable - these drugs are prescribed only when already developed a bacterial infection.

Source: kiz.ru

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