Antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages are prescribed immediately after diagnosis, without waiting for the results of the analysis of the type of bacteria and their susceptibility to the drug.

Treatment with antibiotics is usually used for acute inflammatory processes, but sometimes such drugs are also prescribed for exacerbation of the chronic form.

In case of inflammation of the appendages, specialists usually prescribe broad-spectrum drugs that are active against most bacteria that provoke diseases of the genitourinary system. The ability of antibiotics to affect the pathogens of mycoplasma, chlamydia, ureaplasma is also taken into account, since in most cases these microorganisms cause inflammation.

After receiving the test results, the specialist can adjust the treatment (prescribe a different type of antibiotic, depending on the pathogen and its susceptibility).

It is also necessary to change the treatment in cases where the patient’s condition does not improve despite the prescribed treatment.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ]

Indications for the use of antibiotics for inflammation of the appendages

Adnexitis or inflammation of the appendages is an infectious inflammation of the ovaries and fallopian tubes, therefore antibiotics are required for this disease.

Antibiotics for inflammation of the appendages are prescribed depending on the pathogen; as a rule, several drugs are used for maximum effectiveness.

Release form

The form of release of antibacterial drugs used for adnexitis may be different. Most often, at the beginning of treatment, antibiotics for inflammation of the appendages are prescribed in the form of injections (intramuscular, intravenous, ready-made solutions or powders from which the solution is prepared), then the doctor may prescribe tablets. In addition, there are suspensions and suppositories with antibiotics.

[ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ]

Pharmacodynamics of antibiotics in inflammation of the appendages

Antibiotics for inflammation of the appendages of the tetracycline series suppress the ability of pathogenic microorganisms to reproduce. Preparations from this group are active against staphylococci, streptococci, gonococci, whooping cough bacilli, enterobacteria, klebsiella, salmonella, chlamydia, mycoplasma, spirochetes.

Macrolides exhibit high activity against staphylococci and streptococci. According to the latest data, resistance to drugs from this group of pathogenic microorganisms has begun to increase, but some macrolides retained activity against pneumococci and pyogenic streptococci.

Drugs in this group suppress the ability of bacteria to reproduce and are effective only if the infectious agent is a reproducing type of bacteria.

Fluoroquinolone antibiotics destroy bacteria by inhibiting DNA gyrase and topoisomerase, disrupting DNA synthesis.

Fluoroquinolones are active against most bacteria (gram-positive aerobes, gram-negative). Also, drugs of this group are active against microorganisms resistant to first-generation quinolones.

The third and fourth generation of fluoroquinolones are more active against pneumococci, intracellular microorganisms (mycoplasma, mycobacteria, etc.) in comparison with the second generation drugs of this group.

Enterococci have varying degrees of sensitivity to fluoroquinolones.

Pharmacokinetics of antibiotics in inflammation of the appendages

Antibiotics for inflammation of the appendages from the tetracycline series, when taken orally, are absorbed in the gastrointestinal tract by an average of 70%. The active substance is quickly distributed throughout the body's fluids and tissues, and overcomes the placental barrier.

Tetracycline is excreted mainly in feces and urine unchanged.

The absorption of macrolide antibiotics is influenced by a number of factors (food intake, dosage form, type of drug).

Food intake can significantly affect the bioavailability of some drugs, in particular esithromycin.

The bioavailability of clarithromycin, josamycin and some other drugs is practically independent of food intake.

Most macrolides accumulate significantly in tissues; in the blood serum, roxitoromycin reaches maximum concentrations, and azithromycin reaches minimum concentrations.

Macrolides are well distributed throughout tissues and organs, especially during inflammatory processes; they penetrate cells and accumulate in them in fairly high concentrations.

Drugs of this group are able to overcome the placental barrier, but practically do not penetrate the blood-brain and blood-ophthalmic barriers.

Splitting occurs in the liver, excretion is carried out mainly by the gallbladder.

The half-life ranges from 1 to 55 hours depending on the drug.

For most macrolides, these parameters do not change in renal failure.

Fluoroquinolones are well absorbed in the digestive system after oral administration. Simultaneous administration may slow down the absorption process, but no significant effect on the bioavailability of the drug is observed.

On average, after two hours, the active substance reaches its maximum concentration in the blood. Drugs of this group penetrate the placenta well.

Excretion is carried out by the kidneys and, to some extent, by the gall bladder.

Fluoroquinolones are well distributed throughout tissues and organs, where they reach fairly high concentrations (except for norfloxacin).

The degree of breakdown depends on the properties of the drug; pefloxacin undergoes the greatest biotransformation, ofloxacin, lomefloxacin, etc. undergo the least.

On average, the half-life is from 3 to 14 hours (for some drugs up to 20 hours).

In case of impaired renal function, the half-life of ofloxacin and levofloxacin increases.

In case of severe renal failure, a specialist should adjust the dosage.

What antibiotics are used for inflammation of the appendages?

Antibiotics for inflammation of the appendages of the tetracycline series show good efficiency, however, as practice shows, the susceptibility of some microorganisms that provoke diseases of the genitourinary system has begun to decrease, in addition, drugs of this group have many side effects.

Most often, when inflammation of the appendages occurs, doctors prefer doxycycline, which causes fewer side effects and is eliminated from the body fairly quickly.

Macrolides also show good efficiency in the treatment of inflammation of the appendages. In addition, these drugs are resistant to the acidic environment of the stomach and have a long half-life, due to which the active substance accumulates in large quantities in the affected organ.

Usually sumamed, klacid, etc. are prescribed.

Macrolide antibiotics are active against most microorganisms that cause diseases of the genitourinary system, including intracellular microorganisms.

Antibiotics from the fluoroquinolone group are considered the most effective for inflammation of the appendages today.

Insensitivity of microorganisms to drugs develops extremely slowly. In the absence of contraindications, specialists prescribe drugs of this group (pefloxacin, ofloxacin, norfoloxacin, lomefloxacin, etc.).

But, as a rule, in case of diseases of the genitourinary system, one antibacterial drug is not enough. Specialists usually prescribe two or more antibiotics, since the disease, in most cases, is provoked by several pathogens, both aerobic and anaerobic.

To destroy all microorganisms, various combinations of antibiotics are prescribed. Tinidazole and metronidazole are highly active against anaerobic bacteria (develop without access to oxygen), so combinations with these drugs are often prescribed.

Name of antibiotics for inflammation of appendages

The main antibiotics for inflammation of the appendages:

• azithromycin, zoomax - active against most bacteria, effective as part of complex treatment of diseases of the genitourinary system;
• ceftributen, cedex - active against streptococci, gonococci, enterococci (usually the drug is prescribed in capsule form);
• erythromycin - effectively treats chlamydia, mycoplasmosis, intravenous injections are prescribed as an adjuvant treatment;
• metronidazole - the drug acts at the site of the lesion;
• Ciprolet, ceftriaxone, ciprofloxacin are the latest generation of drugs, used as an alternative to the above drugs.

Antibiotics are the mainstay of therapy for inflammation of the appendages.

Most often, tetracyclines, penicillins, macrolides, fluoroquinolones, nitroimidazoles, and aminoglycosides are prescribed.

Of the tetracycline group, doxycycline and tetracycline are commonly used, but these drugs cause severe side effects and have a number of contraindications.

Of the penicillins, oxacillin, ampiox, and ampicillin are most often prescribed. These drugs suppress bacterial reproduction and destroy pathogenic microorganisms in cells. New-generation penicillins are active against most bacteria that have developed resistance to penicillins, and these drugs have few side effects.

Among macrolides, azithromycin, erythromycin, and roxithromycin are very popular among doctors. The drugs block the reproduction of pathogenic flora and destroy bacteria that have penetrated the body's cells.

Macrolides are usually prescribed for penicillin allergies, pregnant women and children.

Ofloxacin is prescribed from the fluoroquinolone group, but this drug is contraindicated for pregnant women, in addition, its use can provoke joint pain, inflammation or tendon ruptures.

Of the nitroimidazoles, preference is given to trichopolum, metronidazole, and metrogyl. The drugs have high activity against anaerobic and microorganisms

Kanamycin and gentamicin, which belong to the aminoglycoside group, are used in severe cases, in advanced forms of the disease, when the infection spreads to other internal organs.

The drugs are quite effective, but they are highly toxic and have a negative effect on the kidneys, liver, and may also cause deafness. As a rule, these drugs are prescribed in exceptional cases.

Method of administration and dosage

Antibiotics for inflammation of the appendages of the tetracycline group are usually prescribed during or after meals.

Adult patients are prescribed 100 mg of the drug in 3-4 doses (0.25 mg each). Children over eight years of age are prescribed no more than 25 mg/kg per day.

The duration of treatment with tetracyclines is from 5 to 7 days.

If redness, burning or itching occurs, stop treatment.

Tetracyclines should not be taken with dairy products or milk, as this will interfere with the absorption of the antibiotic.

Most macrolides are taken two hours after or one hour before meals.

Clarithromycin, spiramycin, josamycin have no restrictions and can be taken at any time, regardless of food intake.

Erythromycin must be taken with plenty of water (at least 200 ml).

Suspensions for internal use must be diluted and taken according to the attached instructions.

Throughout the course of treatment, it is important to adhere to the duration, regimen and treatment regimen (do not miss the time of administration, take the drug at a certain interval).

Macrolides should not be taken simultaneously with antacid drugs (taken for acid-dependent gastrointestinal diseases).

Fluoroquinolones should be taken with plenty of water and at least two hours before meals (or six hours after taking antacids and drugs containing bismuth, zinc, iron).

During the treatment period, it is important to follow the regimen and regimen of taking the drug. During treatment, it is necessary to drink a sufficient amount of liquid (1.5 liters per day).

[ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ], [ 23 ]

Use of antibiotics for inflammation of the appendages during pregnancy

Antibiotics for inflammation of the appendages of the tetracycline group are contraindicated during pregnancy, since tetracyclines overcome the placental barrier and can accumulate in the tissues of the fetus (bones, tooth buds), causing a violation of mineralization and severe disturbances in bone development.

Some macrolides (clarithromycin) may have a negative effect on the unborn child. No studies have been conducted regarding the safety of using midecamycin, roxithromycin during this period.

Erythromycin, spiramycin, josamycin do not have a negative effect on the fetus and are used during pregnancy, azithromycin is prescribed only in extreme cases.

Fluoroquinolones can disrupt the normal development of the fetus, so drugs in this group are not prescribed to pregnant women.

Contraindications to the use of antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages of the tetracycline series are not used in cases of increased susceptibility to the drug, renal failure, in children under 8 years of age, with leukopenia, and the drug is also contraindicated for pregnant women and during breastfeeding.

Macrolides are contraindicated in case of allergies; some drugs are not used during pregnancy (roxithromycin, clarithromycin, etc.) and breastfeeding (clarithromycin, spiramycin, etc.).

Fluoroquinolones are not prescribed to pregnant or lactating women, in case of allergic reactions, glucose-6-phosphate dehydrogenase deficiency, or in childhood.

[ 14 ], [ 15 ], [ 16 ]

Side effects of antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages from the tetracycline group cause dizziness, increased intracranial pressure, changes in the level of platelets, neutrophils, and hemoglobin in the blood.

These drugs can also cause loss of appetite, nausea, bowel disorders, inflammatory processes in the digestive tract, and kidney dysfunction. Tetracyclines can cause allergic reactions, anaphylactic shock, severe redness on the skin, etc.

Some medications may cause increased sensitivity to ultraviolet radiation, fungal infections of the mucous membranes (candidiasis), disruption of the formation of teeth and bones in children, and changes in the color of tooth enamel.

Macrolides cause various allergic reactions. With prolonged use of a macrolide drug, a repeated infection may develop, in which microorganisms will be resistant to erifomycin.

It is also possible that nausea, pain in the gastrointestinal tract, visual impairment, drooping of the upper eyelid, paralysis of the oculomotor muscles, and severe dilation of the pupil may occur.

After using fluoroquinolones, pain in the digestive tract, loss of appetite, nausea, upset stomach, headaches, sleep disturbances, vision problems, tremors, convulsions, and various allergic reactions may occur.

In rare cases, inflammatory processes in the joints, tendons, tendon ruptures, kidney dysfunction, and changes in heart rhythm are observed.

Often after using such antibiotics, women develop thrush, oral candidiasis, and colon disease.

Overdose

Antibiotics for inflammation of the appendages of the tetracycline group, when overdosed, cause increased side effects (nausea, vomiting, pain in the stomach, upset stool, change in the color of tooth enamel, dizziness, headaches, changes in the level of platelets, hemoglobin, increased susceptibility to ultraviolet radiation, skin rashes and itching, candidiasis). Treatment in this case is symptomatic.

Overdosing on macrolides is usually not life-threatening. Often, when the dosage is exceeded, nausea, bowel disorder, and heart rhythm disturbances occur.

Fluoroquinolones in high doses do not pose a danger to life; if symptoms of an overdose appear, a doctor may prescribe treatment at home.

In extremely rare cases, epileptic seizures occur.

High doses of fluoroquinolones have serious negative effects on the liver, joints, tendons, heart and blood vessels.

Interactions of antibiotics with other drugs in inflammation of the appendages

Antibiotics for inflammation of the appendages of the tetracycline group are not prescribed with drugs that contain magnesium, calcium, zinc, iron and other metal ions.

Concomitant use of carbamazepine and barbiturates reduces the antibacterial effect of tetracyclines.

Not prescribed simultaneously with penicillin drugs.

Tetracyclines reduce the effectiveness of oral contraceptives.

Macrolides are not prescribed simultaneously with aminoglycosides.

The effectiveness of chloramphenicol and lincomycin is reduced when taken simultaneously with tetracyclines.

Erythromycin reduces biotransformation and increases concentrations in the body of cyclosporine, warfarin, caffeine, aminophylline, and theophylline.

Macrolides increase the effectiveness of glucocorticosteroid drugs.

A combination of erythromycin with tetracyclines, polymyxins, and sulfonamides is allowed.

The bioavailability of fluoroquinolones when taken simultaneously with drugs containing zinc, bismuth, magnesium, and iron is reduced.

Some fluoroquinolones (norfloxacin, ciprofloxacin) reduce the excretion of methylxanthines (caffeine) and increase the toxicity of the drug.

Nonsteroidal anti-inflammatory drugs, nitroimidazole derivatives, methylxanthines increase the toxic effect of fluoroquinolones.

Not prescribed simultaneously with nitrofuran derivatives.

It should be used with caution with drugs that increase the QT interval due to the possible development of arrhythmia.

Glucocorticosteroids with fluoroquinolones increase the risk of tendon ruptures, especially in the elderly.

Citrates, sodium bicarbonate, carbonic anhydrase inhibitors when taken simultaneously with fluoroquinolones increase the risk of developing a toxic effect on the kidneys and the appearance of salt crystals in the urine.

The elimination of fluoroquinolones is reduced by cimetidine and azlocillin, while the concentration of fluoroquinolones in the blood increases.

Storage conditions for antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages are stored in a dry place, protected from light, at room temperature.

All antibacterial drugs should be kept out of the reach of children.

[ 24 ], [ 25 ], [ 26 ], [ 27 ], [ 28 ], [ 29 ], [ 30 ], [ 31 ]

Best before date

Antibiotics for inflammation of the appendages are stored for 2-3 years, depending on the drug.

The expiration date is indicated on the packaging. Storage conditions must be observed, do not use the drug after the expiration date or if the storage conditions and integrity of the packaging are violated.

Antibiotics for inflammation of the appendages are prescribed as the main treatment for acute and, in some cases, chronic forms of the disease.

You need to take antibiotics for a few more days after the main symptoms of the disease (pain, fever, bloody discharge) have disappeared.

If the course of antibiotic treatment is interrupted or the regimen and time of administration are violated, the microorganisms that caused the disease will become resistant to the drug and may cause a repeated infectious and inflammatory process (treatment in this case is longer and more difficult).