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Biological antiseptics. In difference from other types of antiseptics it is not simply biological methods of destruction of microorganisms. The biological antiseptics is divided into two look: a) the substances of a biological origin which are directly influencing microorganisms – biological antiseptics of direct action (antibiotics, proteolytic enzymes, preparations for passive immunization: medical serums, anatoksina, gamma globulins, bacteriophages, hyperimmune plasma); b) the substances and methods of various origin rendering stimulating with impact on an organism – the mediated action (Ural federal district, the laser, transfusion of components of blood, T-aktivin, the interferon, interleykina, preparations stimulating the specific immune answer, vaccines anatoksina).

Slaid 39 Alexander Fleming made discovery of the penicillin mold in 1928. Main groups of antibiotics

• The group of penicillin

• The group of cephalosporines

• Macrolids

• The group of levomycetine

• Tetracyclines

• Riphampicins

• Antibiotics of different groups

• Antibiotics of last generation

• Antifungous antibiotics

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Principles of a rational antibiotikoterapiya:

1) application of antibiotics according to indications,

2) at heavy infections the antibiotikoterapiya is begun with the shock dose exceeding sredneterapevtichesky twice, in the subsequent continue treatment in usual doses according to recommendations in the instruction,

3) to observe within a day frequency rate of introduction, for maintenance of bactericidal concentration of a preparation in blood plasma.

4) At appointment it is necessary to choose an antibiotic on the basis of allocation of microflora and its definition on sensitivity to antibiotics. But what to do if the strain of microorganisms isn't sowed yet and sensitivity isn't defined it? The doctor has to carry out so-called empirical therapy. At empirical therapy there are 2 principles: 1) principle of the maximum range of action, 2) principle of reasonable sufficiency. Therefore at a heavy infection at empirical therapy appoint or a combination of antibiotics of the first stage (penicillin + macroleads + aminoglikozida), or to carry out monotherapy by an antibiotic of the second turn (tsefalosporina, semi-synthetic aminoglikozida), or in hard clinical cases use reserve antibiotics.

Slaid 41 5) In all cases it is necessary to use compatibility of several groups of antibiotics and other anti-septic tanks since antibiotics are capable to strengthen action of each other (sinergizm) or to neutralize action

(antagonism). Compatibility is determined by special tables or it is specified in the instruction on use of a preparation.

6) Treatment duration antibiotics is controlled by clinical efficiency, but even at normalization of temperature it is continued by 3-5 more days.

7) Change of antibiotics with other group is carried out: at sharp pyoinflammatory diseases – in 5-7 days; at an aggravation of chronic processes – in 10-12 days.

8) In all cases from the fifth day of an antibiotikoterapiya it is necessary to appoint antikandiozny treatment "Nystatin" or "Levorin".

9) At emergence the dispepsicheskikh of changes of the patient it is necessary to survey on dysbacteriosis (koprogramm) and in the presence of pathology of intestinal microflora to carry out corrective therapy (at the dysbacteriosis caused by an antibiotikoterapiya "Baktisubtil", "Bifidumbakterin", "Befungin", "Laktobakterin" are most effective.

10. Optimum ways of introduction.

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Sulphanilamid preparations

It is large group with antimicrobial action. They break methabolic processes in bacterial cells and cause bacteriostatic effect. They differ the sulphanilamids of short activity: streptocid, etazol, sulphadimezin and the sulphanilamides of prolonged activity: sulphapiridasin, sulphadimetoxin, sulphalen and others. Because of their bad dissolubility, sediments may fall out thus blocking liver balls.