Treatment of joint and heart rheumatism with antibiotics and other agents

A common systemic disease of connective tissue and blood vessels is rheumatism. Let's consider the features of its treatment with antibiotics, types of drugs.

Most often, rheumatism has an infectious-allergic origin. The disease can develop as a result of complications of acute streptococcal infection in children and adolescents aged 7-15 years, people with a weakened immune system, and elderly patients.

The main factors in the development of rheumatism:

• Hereditary predisposition.
• The age of patients ranged from 3 to 15 years.
• Frequent infectious diseases of the nasopharynx and diseases of streptococcal etiology.
• Female gender.
• The presence of the B-cell marker protein D8/17 in the body.

In most cases, rheumatism occurs due to a previous acute or chronic infection of the nasopharynx caused by streptococcal microorganisms and their toxins.

The following main types of localization of the inflammatory process are distinguished:

• Rheumocarditis is a pathology that affects the membranes of the heart (myocardium, pericardium, endocardium).
• Rheumopleurisy is a disease of the lungs, pleura and bronchi.
• Rheumatoid arthritis is a cutaneous form of rheumatism.
• Rheumatic polyarthritis is a disease of the joints.
• Rheumochorea is a rheumatic form of vasculitis of small vessels of the brain.

In rare cases, rheumatic damage to internal organs is diagnosed, as well as rheumonephritis, rheumohepatitis. To identify diseases of connective tissue and blood vessels, the following diagnostic methods are used: ECG, X-ray, ultrasound, various laboratory tests.

At the first suspicion of rheumatism, it is necessary to begin treatment. Without proper diagnosis and timely therapy, the pathology can lead to serious problems. The most serious complication is a severe heart defect. Treatment is carried out by a rheumatologist.

Indications antibiotics for rheumatism

The main indications for the use of antibiotics in rheumatism are based on infectious lesions of connective tissue and blood vessels.

The main stages of treatment:

1. Since all forms of the disease are associated with streptococcal infection, all efforts are made to suppress it. For this purpose, various antibacterial drugs are used.
2. At the second stage, hormonal agents are used that stop the intense inflammatory process and prevent destructive changes.
3. At the last stage, immunomodulatory therapy is carried out. Physiotherapy, sanatorium-resort and dispensary treatment may be prescribed.

The first stage lasts 1-3 months and can be carried out in a hospital setting. If rheumatism of the heart is diagnosed, then treatment is carried out in cardiorheumatology clinics. The drug basis of antirheumatic therapy is antimicrobial, antibiotic, anti-inflammatory, corticosteroid, painkillers and antihistamines.

To eliminate streptococcal infection, i.e. the primary cause of rheumatism, beta-lactam antibiotics are most often used: Amoxicillin, Phenoxymethylpenicillin, Cefadroxil, Benzathinepenicillin and others. If the disease is protracted or has a chronic form, then cytostatics are used: Endoxan, Azathioprine, 6-mercaptopurine, Chlorbutin and others. In especially severe cases, immunosuppressants are indicated. They suppress the immune system's hyperreaction to the infectious agent.

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Release form

Antibiotics for rheumatism come in several forms. Depending on the type of disease and its location, the doctor selects the drugs. The main forms of medications are:

• Tablets, capsules, suspension and granules for solution for oral use.
• Intravenous and intramuscular injections.
• Ointment, cream and gel for local use.

Based on the stage of the rheumatic process and the patient's body characteristics, the doctor prescribes a medicine. A correctly selected drug eliminates the infectious agent and prevents the development of complications.

Names

There are many antibiotic drugs for the treatment of rheumatic diseases of connective tissue and blood vessels. The names of the drugs are in most cases based on the active components included in their composition or depending on the pharmacotherapeutic group.

Let's look at the names of the most effective drugs and the features of their use:

1. Oxacillin

An antibiotic drug of the penicillin group. Effective against microorganisms that are resistant to benzylpenicillin and phenoxymethylpenicillin. Low toxicity. Available in the form of tablets and capsules of 250 mg, in vials of 250 mg complete with distilled water 500 mg.

• Indications for use: various infectious diseases caused by bacteria resistant to benzylpenicillin and phenoxymethylpenicillin. Inflammation of the bone marrow and adjacent bone tissue, pneumonia, empyema, phlegmon, cholecystitis, wound infections, pyelitis, cystitis, infected burns. The method of administration and dosage are individual for each patient. The duration of treatment is usually 7-10 days, but if necessary, it can be extended to 2-3 weeks.
• Side effects: skin allergic reactions, various gastrointestinal disorders.
• Contraindications: hypersensitivity to the components of the drug, history of allergic reactions.

2. Penicillin

An antibiotic with bactericidal properties. Has a broad spectrum of action. Active against streptococci and treponemas. Available in the form of a dry substance for injection in vials. A solvent is included with the powder.

• Indications for use: various infectious and inflammatory diseases, treatment and prevention of rheumatism, scarlet fever, erysipelas, tonsillitis and other pathologies.

• Method of administration: children under 12 years of age, 1-2 injections of 0.6 million IU every 4 weeks. Children over 12 years of age and adults, 1-2 injections of 1.2 million IU every 4 weeks. The course of treatment is individual for each patient and is determined by the doctor.
• Side effects: various allergic reactions, stomatitis, erythema multiforme, local reactions.
• Contraindications: hypersensitivity to penicillin antibiotics, history of allergic reactions.

3. Piperacillin

A bactericidal antibiotic from the penicillin group for parenteral use. It has a broad spectrum of action, is active against most gram-positive, gram-negative, aerobic and anaerobic microorganisms. It is available in ampoules in the form of powder for injection.

• Indications for use: infections of bones, joints, skin and soft tissues, sepsis, peritonitis, meningitis, empyema of the gallbladder and pleura, endometritis, cholangitis, abscess, prevention of postoperative infections.
• Method of administration: the medication is administered intravenously (drip or jet). For moderate infections, 100-200 mg/kg of body weight is prescribed in 2-4 injections. For severe infections, up to 200-300 mg/kg of body weight in 3-4 injections. The maximum daily dose is 24 g. Children are administered 100-200 mg/kg of body weight 2-4 times a day. In particularly severe cases, the daily dose can be increased to 200-300 mg/kg of body weight in 2-4 injections.
• Side effects: allergic reactions, bronchospasms, conjunctivitis, rhinitis, nausea, vomiting, bowel disorders, changes in blood picture. Local reactions are also possible: phlebitis, inflammation.
• Contraindications: hypersensitivity to penicillins. It is prescribed with special caution during pregnancy and lactation, for patients prone to allergic reactions.

4. Phenoxymethylpenicillin

An antimicrobial agent that is similar in its mechanism of action to benzylpenicillin preparations. It is well absorbed when taken orally, is low-toxic and does not have cumulative properties. It is available in the form of tablets and powder for suspension.

• Indications for use: rheumatism, bone and soft tissue infections, scarlet fever, inflammation of the bronchi and lungs, tonsillitis, erysipelas and other diseases caused by microorganisms sensitive to the drug. The dosage is determined by the attending physician, individually for each patient.
• Side effects: irritation of the oral mucosa and gastrointestinal tract, stomatitis, pharyngitis.
• Contraindications: intolerance to the components of the drug and diseases with impaired absorption from the gastrointestinal tract. It is prescribed with caution in case of allergic reactions in the anamnesis.

5. Erythromycin

An antimicrobial agent similar in action to penicillins. Active against gram-positive and gram-negative microorganisms. Better tolerated than penicillins, so it can be used in case of allergy to this type of antibiotics. Therapeutic doses have a bacteriostatic effect. Resistance to the antibiotic develops quickly. Available in the form of enteric-coated tablets and 1% ointment.

• Indications for use: various infectious diseases, inflammation of the bone marrow and adjacent bone tissue, peritonitis, purulent inflammatory processes, pneumonia, lung diseases, septic conditions, erysipelas, syphilis, meningitis. The ointment is used for pustular skin lesions, infected wounds, bedsores.
• Method of administration: the dose for patients over 14 years of age is 250 mg, for severe diseases 500 mg, every 4-6 hours 1-1.5 hours before meals. Children are prescribed a daily dose of 20-40 mg/kg (in 4 doses).
• Side effects: nausea, vomiting, bowel disorders, liver dysfunction, allergic reactions.
• Contraindications: hypersensitivity to the components of the drug, severe liver dysfunction, history of allergic reactions.

6. Naproxen (not an antibiotic)

A derivative of propionic acid with anti-inflammatory, antipyretic and analgesic properties. It has several forms of release: tablets, suspension for oral use, rectal suppositories.

• Indications for use: various inflammatory and degenerative diseases of the musculoskeletal system. Prescribed for rheumatoid arthritis, osteoarthrosis, severe pain syndrome, infectious and inflammatory diseases of the ENT organs, fever syndrome.
• Method of administration: 500-750 mg twice a day, the maximum daily dosage should not exceed 1.75 g. If the drug is used as maintenance therapy, then 500 mg is prescribed twice a day. For children, the preferred dosage form is a suspension.
• Side effects: erythema of the mucous membrane, nausea, vomiting, painful sensations in the epigastrium, skin allergic reactions, headaches, drowsiness and tinnitus, erosive and ulcerative lesions of the gastrointestinal tract, hearing loss, heartburn. Gastric lavage is indicated for treatment; dialysis is ineffective.
• Contraindications: intolerance to the components of the drug, erosive and ulcerative lesions of the gastrointestinal tract, recurrent polyposis of the nose and paranasal sinuses, pregnancy and lactation, patients under 1 year of age, suppression of bone marrow hematopoiesis.
• Overdose: nausea, vomiting, increased drowsiness, dyspeptic disorders. Gastric lavage and activated charcoal are indicated for treatment.

7. Nimesil (not an antibiotic)

Anti-inflammatory, analgesic and antipyretic agent. Its principle of action is based on inhibition of prostaglandin synthesis. The drug suppresses prostaglandin synthesis at the site of inflammation. Nimesil is available in the form of granules for the preparation of a medicinal suspension.

• Indications for use: pain syndromes of various origins, degenerative-inflammatory diseases of the musculoskeletal system, vascular, gynecological and urological pathologies, infectious and inflammatory diseases.
• Method of administration: the medicine is prescribed only to adult patients. Nimesil is taken orally at 200 mg per day, divided into two doses. The course of treatment is determined by the attending physician.
• Side effects: dizziness and headaches, increased drowsiness, nervousness, tachycardia, hot flashes, nausea, vomiting, bowel disorders, respiratory and visual disturbances, increased liver enzymes, dysuria, anemia, thrombocytopenia.
• Contraindications: gastric ulcer and duodenal ulcer, gastrointestinal bleeding, pregnancy and lactation, intolerance to the components of the drug, type 2 diabetes, heartburn, nausea, diarrhea, congestive heart failure, arterial hypertension, pediatric patients.
• Overdose is manifested by more pronounced side effects. To eliminate them, gastric lavage and intake of enterosorbents are indicated. Subsequently, symptomatic and supportive therapy is indicated.

8. Prednisolone (not an antibiotic)

Synthetic analogue of cortisone and hydrocortisone. Has pronounced anti-inflammatory, anti-shock, antitoxic and anti-exudative, anti-allergic properties. Has several forms of release: tablets, ampoules with suspension for injections, ointment in tubes 0.5%.

• Indications for use: diffuse lesions of connective tissue and blood vessels, rheumatism, infectious nonspecific polyarthritis, leukemia, bronchial asthma, neurodermatitis, eczema, hemolytic anemia, shock and collapse. The drug is used for chronic and atypical conjunctivitis, inflammation of the cornea, symptomatic inflammation of the eyeball.
• Method of administration: the dosage is set individually for each patient. In acute conditions, 20-30 mg per day is prescribed. The maintenance dose is 5-10 mg per day. The suspension for injections is used intra-articularly, intramuscularly and by infiltration (tissue impregnation). The introduction must be in strict compliance with asepsis (sterility). The course of treatment should not exceed 10-14 days.
• Side effects: hirsutism, osteoporosis, hemorrhagic pancreatitis, hyperglycemia, decreased resistance to infections, withdrawal syndrome, adrenal insufficiency.
• Contraindications: severe forms of hypertension, pregnancy, diabetes mellitus, gastric ulcer and duodenal ulcer, active tuberculosis.
• Overdose: No toxic effects were detected. Possible mild gastrointestinal disorders, neuralgia, allergic reactions. Symptomatic therapy is indicated for treatment.

9. Triamcinolone (not an antibiotic)

Glucocorticosteroid with anti-inflammatory, antiallergic and immunosuppressive properties. Available in tablets, ointment and 0.1% cream.

• Indications for use: rheumatism, acute allergic reactions, allergic skin diseases, erythema multiforme, bronchial asthma, diseases of the hematopoietic system, nephrotic syndrome, rheumatoid arthritis, collagenoses, viral hepatitis, acute pancreatitis.
• Method of administration: Adult patients are prescribed 4-40 mg per day. After the patient's condition improves, the dose is reduced by 1-2 mg every 2-3 days to achieve minimum maintenance values. Children are prescribed 0.5-1 mg/kg of body weight per day.
• Side effects: increased blood pressure, exacerbation of peptic ulcer, myopathy, osteoporosis, gastrointestinal ulceration, increased blood glucose levels, headaches and dizziness.
• Contraindications: myasthenia, neoplasms with metastases, duodenal and gastric ulcers, hypertension, renal failure, acute psychosis, active tuberculosis, diabetes mellitus, pregnancy, syphilis, viral diseases, mycoses.

The following antibacterial agents are most often used to treat rheumatism: Azithromycin, Amoxicillin, Clarithromycin, Erythromycin, Bicillin-5. Penicillin drugs are often used. They are used for a long period of time and very often to prevent complications of rheumatic carditis.

In addition to antibiotics, glucocorticosteroid hormones are used for treatment in combination with non-steroidal anti-inflammatory drugs. In this case, the more acute the disease, the better the effect of glucocorticosteroids. Anti-inflammatory drugs: Brufen, Aspirin, Butadion, Indomethacin are used throughout the course of therapy. Complex treatment allows achieving a pronounced and lasting therapeutic effect, both in case of joint damage and the cardiovascular system.

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Pharmacodynamics

The mechanism of action of antibiotics for rheumatism depends on the components that are part of it. The pharmacodynamics of most drugs is presented by the following algorithm:

• Stabilization of lysosome membranes.
• Inhibition of oxidative phosphorylation and reduction of the inflammatory process.
• Inhibition of proteolytic activity.
• Stopping the proliferation of cellular elements in the lesion.
• The effect of active ingredients on the metabolism of collagen proteins and mucopolysaccharides.

Medicines used to treat connective tissue, joint and vascular lesions have a broad spectrum of action. This ensures rapid destruction of the pathogenic infection.

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Pharmacokinetics

The clinical effectiveness of antibiotics used to treat rheumatism depends on their composition. Pharmacokinetics is represented by the processes of absorption, distribution, metabolism and excretion of active components. Most antibiotics penetrate the physiological barriers of the body, that is, they enter all organs, tissues and fluids.

Regardless of the form of release, antibiotics are quickly absorbed and distributed throughout the body, providing a therapeutic effect. The rate of metabolism and excretion depends on the degree of binding to plasma proteins. Antibiotics are subject to enzymatic action, i.e. they are metabolized, forming inactive metabolites and toxic products. A number of drugs have a prolonged effect.

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Dosing and administration

Before prescribing an antibiotic, it is necessary to determine the sensitivity of the microflora that caused the disease. The method of administration and dosage depend on the stage of the rheumatic disease, its localization, the patient's age and other individual characteristics of his body. The dosage is prescribed by a doctor.

Treatment can last from 5 to 10 days. In particularly severe cases, therapy is extended to two weeks. To achieve effective results, complex treatment can be prescribed, that is, the use of several drugs of different pharmacotherapeutic groups and forms of release. After taking antibiotics, the patient is prescribed drugs to restore intestinal microflora, drugs containing live bacteria.

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Antibiotics for rheumatism of the joints

Inflammatory joint disease that occurs against the background of multiple infections is rheumatism. Treatment of this pathology is based on suppression of the pathogen and restoration of motor activity. Antibiotics for rheumatism of the joints cope with this task better than other drugs.

This pathology, as a rule, has an infectious-allergic nature and is characterized by the destruction of connective tissue of muscles, joints, internal organs and even the cardiovascular system. The first signs of the disease appear in adolescence and begin with discomfort and crunching in the joints. Very often, such symptoms are not paid attention to, and they begin to progress. Most often, exacerbation begins with the onset of cold weather, since hypothermia is one of the factors that provoke pathology.

The main symptoms of rheumatism of the joints:

• A sharp increase in body temperature to 39 °C.
• Increased weakness and sweating.
• Pain and crunching in the joints.
• Redness and swelling of the skin over the joint.
• Stiffness of movement.
• Deformation of small joints.

The disease is characterized by symmetrical damage to large joints: knees, elbows, ankles. The very first and most important stage of treatment is drug therapy.

Let's look at the most effective antibiotics for rheumatism of the joints:

1. Amoxicillin

A bactericidal antibiotic from the group of semi-synthetic penicillins. It has a broad spectrum of action against gram-positive and gram-negative microorganisms. It is acid-resistant, quickly and completely absorbed in the intestine. It is available in the form of tablets with an enteric coating, capsules, solution and suspension for oral use, and dry substance for injections.

• Indications for use: infections caused by bacteria sensitive to the drug, bronchitis, pneumonia, pyelonephritis, inflammation of the urethra and small intestine, gonorrhea.
• Method of administration: the dosage is determined individually for each patient. Adult patients and children over 10 years old are prescribed 500 mg 2-3 times a day. For children under 10 years old and less than 40 kg in weight, 250-125 mg 2-3 times a day.
• Side effects: skin allergic reactions, conjunctivitis, joint pain, fever, nausea, vomiting, bowel disorders. In rare cases, superinfection may develop.
• Contraindications: penicillin intolerance, infectious mononucleosis. The drug is prescribed with special caution during pregnancy and lactation, with a tendency to allergic reactions to cephalosporins.

1. Ampicillin

Semi-synthetic antibiotic, does not break down in an acidic environment and is well absorbed after oral administration. It acts on gram-positive microorganisms that are sensitive to benzylpenicillin. It is also active against a number of gram-negative microorganisms. It can be used for diseases caused by mixed infections. It is available in the form of tablets and capsules for oral administration, powder for suspension.

• Indications for use: pneumonia, bronchopneumonia, tonsillitis, peritonitis, cholecystitis, sepsis, urinary tract infections, purulent lesions and other inflammatory reactions caused by microorganisms sensitive to the drug.
• Method of administration: for adults 500 mg 4-6 times a day, for children 100/mg kg. The duration of treatment, as a rule, is 5-10 days, but in case of severe infections the drug is taken for 2-3 weeks.
• Side effects: skin allergic reactions, in rare cases – anaphylactic shock. To eliminate them, it is necessary to conduct desensitizing therapy.
• Contraindications: hypersensitivity to penicillins, liver failure, bronchial asthma, hay fever.

3. Benzathine penicillin

A prolonged-action bactericidal agent. It acts on sensitive microorganisms, is active against staphylococci, treponemas, and streptococci. It is produced in the form of a dry substance for injections, complete with a special solvent.

• Indications for use: treatment and prevention of exacerbations of rheumatism, scarlet fever, erysipelas, syphilis, tonsillitis, wound infections, infectious complications during tonsillectomy and after tooth extraction.
• Method of administration: the drug is administered intramuscularly. For rheumatism, patients over 12 years of age are prescribed 1-2 injections of 1.2 million U every 4 weeks. Patients under 12 years of age are prescribed 1-2 injections of 0.6 million U every 4 weeks.
• Side effects: various allergic reactions, stomatitis, dermatitis, erythema multiforme, local reactions.
• Contraindications: hypersensitivity to penicillin antibiotics. The drug is prescribed with caution to patients with intolerance to cephalosporins and a history of allergic reactions.

4. Binoculars

Semi-synthetic antibiotic from the macrolide group. Has bactericidal and bacteriostatic action. Active against gram-positive and gram-negative bacteria, anaerobes and intracellular microorganisms.

• Indications: infectious and inflammatory diseases, sinusitis, otitis, tonsillopharyngitis, lower respiratory tract infections, skin and soft tissue infections, mycobacterial infections. The dosage is individual for each patient, therefore it is prescribed by a doctor.

• Contraindications: severe liver dysfunction, hepatitis, porphyria, early pregnancy, hypersensitivity to the active components of the drug.

• Side effects: nausea, vomiting, bowel disorders, stomatitis, abdominal pain, jaundice, dizziness and headaches, insomnia, skin allergic reactions. Temporary changes in taste sensations are also possible.

5. Brufen (not an antibiotic)

NSAIDs with analgesic, pain-relieving, anti-inflammatory and antipyretic properties. Its mechanism of action is based on the inhibition of prostaglandin synthesis. The drug is available in the form of enteric-coated tablets, dragees, capsules, cream and rectal suppositories.

• Indications for use: rheumatoid arthritis, osteoarthritis, articular syndrome, non-articular rheumatism, damage to soft tissues, tendons, ligaments, conditions with moderate pain syndrome, dental and postoperative pain, migraine, fever, polymyositis, arthrosis, inflammation of soft tissues and joints, lumbago, sports injuries, sprains.
• Directions for use: Adults 1.2-1.8 g in several doses, the maximum daily dose should not exceed 2.4 g. Children are prescribed 20 mg/kg of body weight in several doses. In severe cases of juvenile rheumatoid arthritis, the dosage can be increased to 40 mg/kg per day in several doses. The course of treatment takes 2-3 weeks.
• Side effects: digestive disorders, skin allergic reactions, gastrointestinal bleeding, nephrotic syndrome, thrombocytopenia.
• Contraindications: gastric ulcer and duodenal ulcer, bronchial asthma, bronchospasm, rhinitis, urticaria, pregnancy and lactation. It is prescribed with caution to patients with kidney and liver diseases, heart failure.

6. Butadion (not an antibiotic)

An analgesic, anti-inflammatory and antipyretic agent. Available in the form of tablets with an enteric coating. Used for rheumatism, infectious nonspecific polyarthritis, chorea minor, Bechterew's disease, nodular erythema. The drug is taken 100-150 mg 2-4 times a day, the duration of treatment is 2-5 weeks.

Side effects include stomach pain, skin rashes, and anemia. Ulceration of the gastrointestinal mucosa and hematuria are also possible. Butadion is contraindicated in gastric ulcer and duodenal ulcer, liver and kidney dysfunction, damage to the hematopoietic organs, arrhythmia, and circulatory failure.

7. Voltaren (not an antibiotic)

Anti-inflammatory, analgesic and antipyretic agent from the NSAID group. Contains the active substance - diclofenac. Its mechanism of action is associated with a violation of arachidonic acid metabolism and a decrease in prostaglandin synthesis. It has several forms of release: injection solution, enteric-coated tablets and rectal suppositories.

• Indications for use: osteoarthritis, back pain, rheumatoid arthritis, spondyloarthritis, gout, extra-articular soft tissue diseases of rheumatic nature, primary dysmenorrhea and other gynecological diseases, migraine attacks. The dosage is selected individually for each patient.
• Side effects: various gastrointestinal disorders, skin allergic reactions, headache and dizziness, increased liver enzymes, hypertension, tachycardia, hearing and vision disorders, changes in taste.
• Contraindications: hypersensitivity to the components of the drug, intolerance to analgin, gastric ulcers, disorders of the hematopoietic system, bronchospasms, late pregnancy, patients under 6 years of age, severe impairment of renal, hepatic, and cardiovascular functions.
• Overdose: pain in the epigastric region, nausea, vomiting, convulsions. To eliminate them, enterosorbents, gastric lavage and further symptomatic therapy are indicated.

8. Diclofenac (not an antibiotic)

A nonsteroidal anti-inflammatory drug from the pharmacotherapeutic group of phenylacetic acid derivatives. It has pronounced anti-inflammatory, analgesic and antipyretic properties. Effectively relieves painful sensations that occur at rest and during movement in rheumatic diseases of the joints. A persistent therapeutic effect develops after 10-14 days of using the drug. It is available in the form of an injection solution.

• Indications for use: rheumatism, ankylosing spondylitis, rheumatoid arthritis, inflammation of soft tissues and joints, injuries of the musculoskeletal system, arthrosis, gout, bursitis, postoperative pain syndrome, radiculitis, neuralgia, neuritis, primary dysmenorrhea.

• Method of administration: adult patients are prescribed 75 mg intramuscularly 1-2 times a day. For children over 6 years old, the dosage is 2 mg/kg 2-3 times a day. The course of treatment is 4-5 days.
• Side effects: various dyspeptic disorders, drowsiness, increased irritability, headaches and dizziness, bleeding in the gastrointestinal tract and erosive and ulcerative lesions. Local reactions, phlebitis, a burning sensation during the administration of the drug, and necrosis of adipose tissue are also possible. In case of overdose, these effects are enhanced.
• Contraindications: gastric ulcer and duodenal ulcer, gastrointestinal bleeding, kidney and liver disease, third trimester of pregnancy and lactation, hypersensitivity to the components of the drug, urticaria, rhinitis, patients under 6 years of age.

9. Ibuprofen (not an antibiotic)

A medicinal product with analgesic, antipyretic and anti-inflammatory properties. Its mechanism of action is based on the suppression of prostaglandin biosynthesis through inhibition of the cyclooxygenase enzyme. It is available in the form of enteric-coated tablets. After oral administration, the drug is quickly absorbed from the gastrointestinal tract. The maximum concentration in the blood plasma develops in 1-2 hours. The active components accumulate in the synovial fluid and are metabolized in the liver. The half-life is 1.5-2 hours. It is excreted unchanged by the kidneys.

• Indications for use: rheumatoid arthritis, gout, osteoarthritis, neuralgia, bursitis, radiculitis, ankylosing spondylitis, myalgia, adnexitis, proctitis, ENT diseases, headaches and toothaches, traumatic inflammation of soft tissues and the musculoskeletal system.
• Method of administration: for rheumatoid arthritis, prescribe 800 mg 3 times a day, for osteoarthritis and ankylosing spondylitis, 400-600 mg 2-4 times a day, for juvenile rheumatoid arthritis, 40 mg/kg of body weight per day, for moderate pain syndrome, 400 mg 3 times a day.
• Side effects: nausea, vomiting, bowel disturbances, headaches and dizziness, sleep disorders, skin allergic reactions, gastrointestinal bleeding, bronchospasms.
• Contraindications: patients under 6 years of age, hypersensitivity to the components of the drug, hematopoiesis disorders, renal and hepatic dysfunction, optic nerve diseases, ulcerative colitis, erosive and ulcerative gastrointestinal lesions.
• Overdose: abdominal pain, nausea and vomiting, lethargy, drowsiness, headaches, tinnitus, hypotension, tachycardia, bradycardia, acute renal failure. Treatment includes gastric lavage, enterosorbents and further symptomatic therapy.

Therapy begins with the use of broad-spectrum antibiotics, NSAIDs, vitamins and desensitizing medications. To combat the infection, penicillin antibiotics may be prescribed: Amoxicillin, Carbenicillin, Piperacillin or macrolides: Binoklar, Vilprafen, Grunamycin. The course of antibiotics lasts 5-10 days. Many doctors claim that for 5 years after the diagnosis of this disease, the patient must periodically take broad-spectrum drugs.

An important component of drug therapy are non-steroidal anti-inflammatory drugs, such as Diclofenac and Ibuprofen. They reduce the severity of the inflammatory process. If the inflammatory process is accompanied by swelling, then diuretics are taken, that is, diuretics: Akripami, Bufenox and others. To relieve severe pain, antibiotics such as Nimesil, Ibuprofen, Diclofenac and others are used.

The duration of treatment and dosage are determined by the doctor, individually for each patient. After drug therapy, additional procedures may be prescribed: paraffin applications for warming up the affected joints, UHF, infrared warming, electrophoresis. Physiotherapy allows you to consolidate the results of the main therapy, eliminate pain syndrome and improve motor activity.

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Antibiotics for rheumatic heart disease

Some streptococcal infections lead to rheumatic lesions of the cardiovascular system. Most often, rheumatic carditis develops after tonsillitis, pharyngitis, sinusitis and nasopharyngeal diseases. Moreover, if the diseases are acute, then rheumatism of the heart occurs in 5% of patients. Getting on the heart membranes, the infection causes pathological changes that lead to changes in the functioning of the entire cardiac apparatus.

Main lesions:

• Myocarditis – muscle tissue is affected.
• Pericarditis is the outer tissue membrane.
• Pancarditis – all tissues of the heart membrane are affected.
• Endocarditis is a lesion of the inner tissue lining.

Depending on which membrane was infected, certain antibiotics are selected. For rheumatism of the heart, the following drugs may be prescribed:

1. Vilprafen

An antibiotic from the macrolide group. It has bacteriostatic properties, which are based on the inhibition of protein synthesis by bacteria. It creates high concentrations in the inflammation site, providing bactericidal activity. It is highly active against intracellular microorganisms, gram-positive and gram-negative aerobic bacteria and some anaerobes. The drug has several forms of release: tablets and suspension for oral administration.

• Indications for use: infectious and inflammatory diseases caused by microorganisms sensitive to the drug. Otitis, sinusitis, bronchitis, pneumonia, gingivitis, diphtheria, scarlet fever, erysipelas, urinary tract and genital infections, joint and soft tissue lesions. The dosage is individual for each patient, therefore it is prescribed by the attending physician.
• The drug is contraindicated in case of hypersensitivity to macrolides and drug components, severe liver dysfunction.
• Side effects: loss of appetite, nausea, vomiting, hearing impairment, candidiasis, increased activity of liver transaminases, impaired bile outflow. Similar reactions are also observed in case of overdose. Symptomatic therapy is indicated to eliminate them.

2. Aspirin Cardio

Antiplatelet agent with the active substance - acetylsalicylic acid. Refers to the category of non-steroidal anti-inflammatory, antiplatelet drugs, the action of which is based on blocking prostaglandin synthetase and inhibiting inflammation factors. After taking, the tablets are quickly and completely absorbed, food slows down this process.

• Indications for use: diseases with a high risk of thrombosis, unstable angina, rheumatic carditis, myocardial infarction, heart and vascular surgery. Neurological pathologies, transient cerebrovascular accidents, cerebral ischemia, pulmonary infarction.
• Directions for use: Tablets should be taken before meals with water, 100-300 mg per day. As a rule, the drug is taken for 1-2 days, but if necessary, the course of treatment can be extended.
• Side effects: various gastrointestinal disorders, hepatitis, pancreatitis, dizziness and headaches, skin allergic reactions, decreased renal excretory function, bronchospasms.
• Contraindications: intolerance to NSAIDs, thrombocytopenia, asthma, gastric ulcer, pregnancy, lactation, renal and hepatic insufficiency. The drug is prescribed with caution to patients with genitourinary diseases, gout, hepatitis, bronchial asthma.
• Overdose: nausea, vomiting, diarrhea, allergic reactions. Treatment includes hemodialysis, oral sorbents and further symptomatic therapy.

3. Bicillin

An antimicrobial agent that is similar in its mechanism of action to benzylpenicillin. Available in 300,000 IU and 600,000 IU vials.

• It is used for diseases caused by microorganisms sensitive to the drug. Bicillin is effective in the treatment and prevention of rheumatism, syphilis and gonorrhea.
• The recommended dosage is 2,400,000 IU 2 times a month. For the prevention of rheumatism, 600,000 IU are administered once a week, injections are repeated 6 times. Injections are combined with acetylsalicylic acid and other NSAIDs. Children are prescribed once a week at a rate of 5000-10,000 IU/kg or 20,000 IU/kg 2 times a month.
• Contraindications: bronchial asthma, allergic diseases, intolerance to benzylpenicillin preparations, hay fever. Side effects manifest themselves in the form of various allergic reactions.

4. Grunamycin

An antibiotic from the macrolide group, has bacteriostatic properties. Its mechanism of action is based on the destruction of peptide bonds between amino acid molecules and blocking the synthesis of proteins in microorganisms. High doses of the drug have a bactericidal effect. It has a wide range of action: gram-positive, gram-negative microorganisms.

Contains the active ingredient erythromycin. Available in the form of tablets, granules for oral suspension, lyophilisate for intravenous solution, rectal suppositories and powder for injection solution.

• Indications for use: various bacterial infections caused by pathogens sensitive to the drug. Urogenital infections, ENT lesions, whooping cough, diphtheria, trachoma, infectious and inflammatory diseases of the skin, soft tissues, bones and joints, infected wounds, bedsores, burns, exacerbation of streptococcal infection.
• Method of administration and dosage: single dose for adults and children over 14 years of age 250-500 mg every 6 hours. Duration of treatment is 5-14 days.
• Contraindications: intolerance to the components of the drug, pregnancy, hearing loss. It is prescribed with caution in case of renal or hepatic insufficiency, breastfeeding, jaundice, arrhythmia, prolongation of the QT interval.
• Side effects: nausea, vomiting, bowel disorders, headaches and dizziness, decreased visual and hearing acuity, skin allergic reactions. Careful monitoring of the respiratory system, intake of enterosorbents, gastric lavage are indicated for treatment.

5. Indomethacin (not an antibacterial agent)

Active NSAID, strong inhibitor of prostaglandin biosynthesis. Has pronounced analgesic activity. Available in the form of tablets, capsules, rectal suppositories and injection solution.

• Indications for use: rheumatoid arthritis, periarthritis, spondylitis, thrombophlebitis, osteoarthrosis. Nephrotic syndrome, back pain, neuralgia, myalgia, traumatic inflammation of soft tissues, rheumatism, diffuse connective tissue diseases, infectious and inflammatory diseases of the ENT organs, cystitis, adnexitis, prostatitis.
• Directions for use: The drug is recommended to be taken after meals, initial dosage 25 mg 2-3 times a day with a gradual increase to 100-150 mg in 3-4 doses per day.
• Side effects: headaches and dizziness, drowsiness, nausea, vomiting, bowel disorders. Symptomatic therapy is indicated for treatment.
• Contraindications: intolerance to the components of the drug, gastric ulcer and duodenal ulcer, bronchial asthma, pregnancy and breastfeeding.

6. Ketanol (not an antibacterial agent)

A medicinal product with anti-inflammatory, antipyretic and analgesic properties. Available in the form of capsules and tablets for oral administration, injection solution, suppositories.

• Indications for use: rheumatoid arthritis, psoriatic and reactive arthritis, gout, bursitis, spondyloarthritis, tendinitis, severe pain syndrome with algomenorrhea, after operations and injuries. The dosage and form of release of the drug are individual for each patient, therefore, they are prescribed by the attending physician.
• Side effects: various dyspeptic disorders, headaches and dizziness, suppression of hematopoiesis, anemia, bronchospasms, insomnia, asthenia, visual impairment and tinnitus, liver and kidney dysfunction.
• Contraindications: intolerance to the components of the drug, gastric ulcer and duodenal ulcer, non-ulcer dyspepsia, bleeding, renal and hepatic insufficiency, asthma attacks, pregnancy and lactation, patients under 14 years of age.
• Overdose: various gastrointestinal disorders, confusion, renal dysfunction. Treatment consists of gastric lavage and sorbent intake.

7. Meloxicam (not an antibacterial agent)

A drug from the pharmacotherapeutic group of oxicams. NSAIDs have a pronounced anti-inflammatory effect. It has several forms of release: tablets for oral use and ampoules for intramuscular injections.

• Indications for use: rheumatoid arthritis, Bechterew's disease, chronic polyarthritis, exacerbations of arthrosis. Tablets are taken 1 time per day at 15 mg. The course of treatment is individual for each patient.
• Side effects: blood count disorders, changes in visual acuity, headaches and dizziness, tinnitus, nausea, vomiting, pain in the epigastric region, cardiovascular disorders, allergic skin reactions.
• Contraindications: ulcers in the digestive system, intolerance to the components of the drug, gastrointestinal bleeding, pregnancy and lactation, patients under 15 years of age, severe renal or hepatic insufficiency, cerebrovascular bleeding.
• Overdose: nausea, vomiting, increased drowsiness, abdominal pain. Symptomatic therapy, gastric lavage, and enterosorbents are indicated for treatment.

8. Nise (not an antibacterial agent)

An anti-inflammatory agent with analgesic and antiplatelet properties. Suppresses the formation of prostaglandin in the inflammation focus. Available in the form of tablets, dispersible capsules, suspension and 1% gel.

• Indications for use: osteoarthrosis, bursitis, osteoarthritis, tendovaginitis, rheumatism, muscle pain, post-traumatic pain syndrome, spinal pain, infectious and inflammatory diseases, fever, neuralgia, myalgia. For degenerative and inflammatory diseases of the musculoskeletal system, gel is most often used.
• Directions for use: 100 mg per day, if necessary, the daily dosage can be increased to 400 mg. The gel is applied to the skin, evenly distributing it over the painful area. The procedure can be performed 3-4 times a day. The course of treatment is up to 10 days.
• Side effects: drowsiness, dizziness, nausea and vomiting, heartburn, ulceration of the gastrointestinal mucosa, purpura, anemia, leukopenia, high activity of liver transaminases, skin allergic reactions. Local allergic reactions may occur when using the gel.
• Contraindications: gastrointestinal ulcer, hypersensitivity to the components of the drug, liver failure, asthma, congestive heart failure, pregnancy and lactation, type 2 diabetes, arterial hypertension.
• Overdose: renal dysfunction, liver failure, gastrointestinal irritation, convulsions, increased blood pressure, respiratory depression. There is no antidote. Hemodialysis and diuresis do not bring the desired results.

Rheumatic heart disease is classified by severity. The disease has several forms: acute, subacute, protracted and latent. The acute stage has a sudden onset and pronounced symptoms. The incubation period of the protracted form lasts about 12 months. The latent form does not manifest itself in any way, so it is very difficult to diagnose. It is this form that leads to the development of the defect.

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Use antibiotics for rheumatism during pregnancy

Rheumatism during pregnancy should not be ignored. Since hormonal changes in the female body can aggravate and even worsen the course of the disease. It is also possible that the pathology will affect the outcome of pregnancy. Most often, exacerbation is observed in the early stages and the last weeks of gestation.

The use of antibiotics during pregnancy is not advisable. Antirheumatic treatment is determined individually for each patient. It is permissible to conduct therapy with pyrazolone series drugs, steroid hormones, salicylates. All drugs are prescribed by a rheumatologist, taking into account the form of the disease, the duration of pregnancy and a number of other features.

Contraindications

Antibiotics prescribed for the treatment of rheumatism have certain contraindications for use. The drugs are not used in case of individual intolerance to their components, severe liver dysfunction. Antibacterial therapy is carried out with special caution in case of allergic reactions in the anamnesis, for children and elderly patients.

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Side effects antibiotics for rheumatism

Failure to follow doctor's recommendations for the use of antibiotics can cause various disorders. Side effects most often manifest themselves in the following symptoms:

• Dizziness and headaches.
• Tinnitus and decreased visual acuity.
• Bronchospasms.
• Stool disorders, nausea, vomiting.
• Impaired liver function.
• Skin allergic reactions.

In rare cases, superinfection may develop. To eliminate side effects, stop taking the drug and seek medical help.

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Overdose

The use of increased doses of the drug often causes symptoms of overdose. Most often it manifests itself as follows:

• Gastrointestinal disorders: nausea, vomiting, diarrhea.
• Dizziness.
• Skin rashes.
• Changes in water-electrolyte balance.
• Renal failure.

Symptomatic therapy is indicated to eliminate overdose. In some cases, hemodialysis, gastric lavage, and enterosorbent administration are effective.

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Interactions with other drugs

To achieve a positive result in the treatment of rheumatism, antibiotics are often combined with other types of medications. Complex therapy has a more effective effect on the pathogen and promotes the recovery of the body. All interactions with other drugs should be monitored by the attending physician. This is due to the risk of developing side effects.

Most often, patients are prescribed antibiotics from the penicillin group. They are not used simultaneously with aminoglycosides, since inactivation of the active components is possible. Macrolides and tetracyclines act as antagonists. NSAIDs and diuretics reduce the excretion of penicillins, which increases the risk of side effects.

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Storage conditions

According to the storage conditions, tablets, capsules, granules, suspensions and other oral forms must be kept in a place protected from sunlight, moisture and inaccessible to children. The same conditions must be observed when storing ointments, creams and gels. The temperature should not be higher than 25 °C. Injectable forms of drugs can be kept at room temperature.

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Shelf life

The antibiotic's shelf life depends on its form of release. Tablets and capsules must be used within 24-36 months from the date of their production. Prepared suspensions can be stored for no more than a week at a temperature of 25 °C and no more than two weeks at 2-8 °C. Injection solutions can be kept at room temperature, but in a place protected from sunlight. Prepared injections should be used within 6-8 hours.

If the first symptoms of rheumatism are left unattended, this can lead to serious complications. Most often, patients encounter the following pathologies:

• The disease becomes chronic, the treatment of which can last several years.
• Heart defect and heart failure.
• Disorders in the functioning of the circulatory system, which entail a number of other diseases: varicose veins, stroke, pathologies of the internal organs, respiratory organs and vision.

Antibiotics for rheumatism help prevent all the above complications that can lead to death. Timely therapy relieves discomfort and restores normal joint mobility.

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