In a group like macrolides, list of drugs high that speaks about sufficient breadth of therapeutic application. These medicinal substances are safe and used in many diseases of infectious nature, including those caused by intracellular parasitic bacteria. They are suitable for the treatment of diseases of the skin, joints, the respiratory system, including bronchitis and pneumonia of varying severity.
In severe pneumonias macrolides are also used, the list of drugs specified in standard treatment protocols. However, they contain information about the necessity of combination with other antimicrobials. Most often they are used along with cephalosporins. This combination allows both sides to increase the effectiveness of both drugs, without increasing toxicity.
The Most competent and convenient classification of this group of drugs is chemical. It reflects differences in the structure and the origin of group antibiotics called "Macrolides". The list of products is given below, and the substances are distinguished:
2. Azulene (15-membered) macrolides: azithromycin.
3. 16-membered macrolides
This classification reflects the structural features of drugs class. The list of trade names given below.
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Macrolides - drugs, a list of which is very wide. As of 2015, there are 12 drugs of this class. And the number of preparations containing these various substances is much higher. Many of them can be found in the pharmacy network and to accept the treatment of several diseases. And some drugs are not available in CIS, as it is not registered in the Pharmacopoeia. Examples of trade names of drugs containing macrolides, the following:
This specific pharmaceutical group - macrolides - has a bacteriostatic effect on susceptible cell of the pathogen of infectious diseases. Only in high concentration can provide a bactericidal effect, although it is only shown in in vitro studies. The only mechanism of action of macrolides – this inhibition of protein synthesis of microbial cells. This violated all the processes of life virulent microorganism, with the result that after a while it dies.
The Mechanism of inhibition of protein synthesis is associated with the accession to the 50S-subunit of bacterial ribosomes. They are responsible for increasing polypeptide chain during the synthesis of DNA. Thus impaired synthesis of structural proteins and virulence factors for bacteria. The high specificity specifically to the bacterial ribosome determines the relative safety of macrolides for a human body.
Macrolides similar in properties to the tetracyclines, but more secure. They do not violate the development of the skeleton in childhood. As with tetracyclines and fluoroquinolones, macrolides (drug list above) is able to penetrate the cells and create a therapeutic concentration in the three compartments of the body. This is important in the treatment of Mycoplasma pneumonia, legionellosis, campylobacteriosis and chlamydial infection. While macrolides - fluoroquinolones safer, though less effective.
All macrolides are more toxic than penicillins, but the most safe from the point of view of the probability of Allergy development. While penicillin antibiotics are the Champions of safety, but tend to cause allergies. Thus, having a similar spectrum of antimicrobial activity, macrolidescan replace aminopenicillin with infections of the respiratory system. Moreover, laboratory studies suggest that macrolides reduce the effectiveness of penicillins when mixed reception, although modern treatment protocols allow for their combination.
Macrolides are safe drugs along with cephalosporins and penicillins. This allows their use during pregnancy and in the treatment of children. They do not disrupt the development of bone and cartilage of the skeleton, does not have teratogenic properties. Only azithromycin should be restricted to use in the third trimester of pregnancy. At children's therapy and penicillins, and cephalosporins, and macrolides, which are listed in the standard protocols for the treatment of diseases can be used without risk of toxic lesions of the body.
Macrolides (drugs that list we cited above) in clinical practice are widely used, including in the CIS. Most commonly used 4 representative: clarithromycin and azithromycin, and erythromycin midecamycin. Much less frequently used spiramycin. The efficacy of macrolides is about the same, although it is achieved differently. In particular, clarithromycin and midecamycin to achieve the clinical effect need to be taken twice a day, whereas azithromycin is valid for 24 hours. Only one admission per day for the treatment of infectious diseases.
Erythromycin is the most transient of all the macrolides. It should be taken 4-6 times a day. Because it is most often used in local forms for the treatment of acne and skin infections. It is noteworthy that macrolides for kids safe, although they can cause diarrhea.
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