Do you understand antibiotics

The cephalosporin antibiotics in cephalosporins are currently widely used antibiotics. In our lives, we often see examples of these applications of antibiotics. Nowadays, the management of antibiotic application in my country is becoming more and more stringent. In pharmacies in many cities, a doctor’s prescription must be required to purchase antibiotics. Hospitals also have prescribed restrictions on the dosage and indications of antibiotics. But in many cases, as soon as a patient has symptoms such as fever, diarrhea, headache, dizziness, etc., he thinks he has been infected by bacteria. It is unscientific to take some antibiotics first without the guidance of a doctor. Here, let us make a brief introduction to the relevant knowledge of antibiotics.

A long time ago, people discovered that certain microorganisms have an inhibitory effect on the growth and reproduction of other microorganisms, and this phenomenon is called antibiotic resistance. In ancient times, the ancients would use Chinese herbal medicine to treat infectious diseases. Although these Chinese herbal medicines cannot be called antibiotics, they have certain inhibitory and killing effects on the microorganisms that cause disease epidemics.

With the development of science, people have found anti-biotic substances from certain microorganisms, and call this substance an antibiotic. Because some of the antibiotics originally discovered mainly kill bacteria, people once called antibiotics antibiotics, but with the continuous development of antibiotics, antiviral, antichlamydia, antimycoplasma, and even antitumor antibiotics have appeared one after another. Obviously The term antibiotic is not appropriate, but antibiotics are more realistic.

In 1928, British bacteriologist Fleming discovered that the nutrient agar plate for culturing Staphylococcus was contaminated by Penicillium, but the colony of Penicillium could dissolve Staphylococcus and inhibit the growth of surrounding Staphylococcus. After experimental verification, in June 1929, Fleming wrote his findings as a paper and published it. He called the bactericidal substance secreted by the penicillium penicillin as penicillin. Australian pathologist Flori and German biochemist Qian En, who presided over pathological research at the University of Oxford, worked together. After filtration, concentration, purification, and drying, a yellow powder was finally obtained. On February 12, 1941, a 43-year-old London policeman with severe sepsis became the first person in a penicillin clinical trial. Since then, the clinical application of penicillin has greatly reduced the mortality of some infectious diseases, and countless lives have been saved. In 1945, Fleming, Florie and Chann won the Nobel Prize in Physiology or Medicine for their outstanding contributions to the discovery and application of penicillin.

The almost magical effect of penicillin inspires everyone. Doctors believe that the bacterial infection that has harmed countless lives for thousands of years will be brought under control. However, after applying penicillin for a period of time, the doctor found that its effect was not as good as before. Pneumonia, which was once controlled by a small dose of penicillin, was still useless with a large dose. Everyone gradually realized that bacteria have changed due to adapting to penicillin, which is the “drug resistance” that is often mentioned nowadays.

“The road is one foot high, the magic is one foot high”, and then people continue to invent and synthesize new antibiotics to deal with various pathogens. The commonly used antibiotics are roughly divided into the following categories:

◎ β-lactam antibiotics, mainly including penicillins, such as penicillin, amoxicillin; cephalosporin antibiotics; carbapenems and penicillins, such as imipenem; monocyclic antibiotics, such as ammonia Qu Nan.

◎ Macrolide antibiotics, such as azithromycin and roxithromycin.

◎Aminoglycoside antibiotics, such as gentamicin and amikacin.

◎Others, such as tetracyclines, chloramphenicols, lincomycins, rifamycins, peptides, sulfonamides, metronidazoles, etc.

Antibiotics are a powerful weapon against infection, but any medicine should be viewed in two. Unreasonable use can also cause adverse reactions and even life-threatening, so the use of antibiotics should be cautious. How should we choose and reasonably apply antibiotics?

1. The correct choice of antibiotics. According to the type of disease, conventional effective drugs for this disease should be selected, and antibiotics should be reasonably selected in consideration of the drug resistance of the disease. If the course of the disease is long or the condition is serious, bacteria culture and drug sensitivity test should be done, and effective antibiotics should be selected. If there are only cold symptoms such as runny nose, nasal congestion, fever, etc., antibiotics can be avoided if there is no clear bacterial infection. As mentioned earlier, Xiao Wang and Aunt Zhang, it is not advisable to take antibiotics by themselves without the guidance of a doctor and the clear cause of the disease.

2. Choose the appropriate route of administration. When treating mild and moderate infections, try oral administration; for severe infections, intravenous administration should be used. Intravenous administration includes intermittent administration and continuous administration.

3. Reasonably master the dosage. Generally, patients can calculate the dosage of antibiotics based on body weight or body surface area. For newborns, those with renal or liver dysfunction need to be adjusted.

4. Master the course of treatment. Generally, antibiotics should be used until the body temperature is normal and the symptoms disappear for 2 to 3 days. Some studies believe that 4 to 5 days of medication can produce the greatest antibacterial effect, but more than 10 days, there is a risk of drug resistance.

5. If the clinical effect of acute infection is not good after 72 hours of medication, the medication may be adjusted. The use of antibiotics should not be stopped, and the antibiotics should not be changed too frequently. This will not only fail to achieve the therapeutic effect, but will also cause the bacteria to develop drug resistance, causing repeated diseases and delaying treatment.

6. For patients with renal insufficiency, burns, sepsis and other diseases and newborns, they are different from ordinary patients because of changes in the internal environment, changes in the distribution of fluid between blood vessels and tissues, and changes in drug metabolism and excretion. Pharmacokinetic characteristics. For such patients, the dosage and administration of antibiotics can be reasonably adjusted according to PK/PD (an indicator of the efficacy of concentration-dependent and time-dependent antimicrobial drugs), for example, when time-dependent antibiotics (β-lactams) are used , You can use continuous administration instead of intermittent administration, and use smaller doses of drugs to achieve better therapeutic effects.