The first antibiotic available to mankind was called penicillin. At one time, it turned out to be a real salvation for millions of people on the planet. Diseases formerly considered lethal became curable: pulmonary inflammation, blood poisoning, tuberculosis. However, not everything is so simple: it is necessary to use the drug, clearly following the instructions for use. Injections, doses of penicillin are chosen by the doctor based on the diagnosis, the nuances of the microflora, and the characteristics of the human condition. Self-administration leads to undesirable consequences.
general information
Nowadays, the term "penicillins" refers to a whole group of antimicrobial drugs. The antibiotic, which is their main component, was first discovered as a product produced by varieties of mold. Studies have shown that penicillins are characterized by activity relative to a number of gram-positive life forms, as well as a slightly less narrow spectrum of gram-negative. In the instructions for use for penicillin injections, you can find recommendations on the use of the composition for infection with strepto-, staphilo-, meningo-, gonococci, spirochetes.
The penicillin series belongs to a large category of beta-lactam drugs. Their distinctive feature is the specific structure of the molecule’s ring of the same name. Currently, it is penicillins that are the most numerous category of antibacterial agents. Following the instructions for use, penicillin for children and adults is used exclusively actively with a wide range of pathological conditions associated with infection of the body. The effectiveness of the funds is due to the ability to inhibit the biological processes of synthesis in the bacterial cell wall.
Trade name and active substance
As a rule, when prescribing penicillin in ampoules to the patient according to the instructions, the doctor refers to the sodium salt of benzylpenicillin. Tests have shown that benzylpenicillin is characterized by pronounced activity against pneumo-, strepto-, staphylococci, microflora, causing diphtheria, anthrax. The drug shows the effect of infection with anaerobic microorganisms and spore-generating sticks, meningo-, gonococci, spirochetes, actinomycetes. When infected with other forms of life, it is reasonable to conduct a preliminary sensitivity analysis. With a positive result, benzylpenicillin can be used with other forms of invasion.
The lack of effectiveness, as specified in the instructions for penicillin powder, is observed if the disease is due to fungi, protozoa, has a viral etiology. Benzylpenicillin is ineffective when infected with rickettsia and most of the varieties of gram-negative microflora.
Application Nuances
As follows from the instructions for penicillin injections, the active compound is rapidly absorbed into the circulatory system when the drug is injected into muscle tissue. Soon, benzylpenicillin can be detected in various tissues and biological fluids. In small volumes, the substance seeps into the spinal cord. The highest blood levels are recorded on average half an hour or an hour after administration.
Following the instructions for use, benzylpenicillin can be administered subcutaneously. For this version of the procedure, the suction rate is somewhat unstable. In most cases, the highest concentration in the circulatory system is fixed an hour after the injection. 3-4 hours after a single use, only traces of the drug can be found in the body. To achieve a lasting therapeutic effect, administration should be repeated at 3-4-hour intervals. Intravenous use is accompanied by a rapid decrease in the concentration of benzylpenicillin in the circulatory system. The use of the substance orally is undesirable - absorption is slow and ineffective, the drug compound is rapidly destroyed under the influence of gastric juice and a specific enzyme produced by bacteria in the intestinal tract. Elimination is via the kidneys.
The nuances of kinetics
In the instructions for use with penicillin, the manufacturer specifies: the duration of the circulation of the compound, the concentration in the circulatory system, is largely determined by the dosage. The good permeability of various organic tissues and liquids has been established. If you use the drug against the background of inflammatory processes in the membranes of the spinal cord, penicillin penetrates into this organ in a greater amount than in the absence of a focus of inflammation.
Certain staphylococcal strains show penicillin resistance. The instructions for the use of tablets, injections, and powder by adults specify that this applies to life forms that produce penicillinase, an enzyme that can destroy a drug compound. It is the production of this enzyme that provides increased resistance to the preparation of Pseudomonas aeruginosa, intestinal bacteria and some other microflora.
When will it help?
Instructions for the use of penicillin in tablets, ampoules containing a solution for injection, or powder for reconstitution of such a solution are used for pathological conditions provoked by microscopic life forms that are sensitive to the drug compound. You can use the drug if the patient has established pulmonary inflammation of a focal, croupous form, acute or subacute bacterial endocarditis. The drug is prescribed for infection of the wound, suppuration of the skin, soft tissues, mucous membranes. You can use the composition for peritonitis, pulmonary purulent inflammation, septicemia and cystitis. The use of penicillin against the background of pyemia, that is, such a blood poisoning when the flow of fluid transfers the microflora to the internal structures, is widespread. This leads to the formation of a secondary foci of suppuration, cavities filled with such a substance appear.
Penicillin is recommended for children and adults with osteomyelitis in the form of a chronic or acute process, with diphtheria and angina. The drug is prescribed for erysipelas, inflammation and suppuration in the reproductive system, as well as those associated with pregnancy and childbirth. Penicillin has shown its indispensability in the practice of otolaryngologists, ophthalmologists. It is prescribed for meningitis, scarlet fever, syphilis. The penicillin series is effective against anthrax, helps to cope with blenorrhea, gonorrhea, actinomycosis. Penicillins can also be used for some other diseases, after specifying the sensitivity of microflora to the active component.
How to use?
It is undesirable to use the option available in tablets. The instruction for penicillin indicates better digestibility and greater effectiveness of the form for injection. In pharmacies, you can find several tablet releases of the drug, in some cases, the doctor may recommend stopping at them, but this happens extremely rarely.
Before prescribing injections or penicillin tablets according to the instructions, it is necessary to check the sensitivity of microflora. The therapeutic course involves the placement of deep injections into muscle tissue. If it is indicated to inject the substance into a vein, the procedure is done in drops or in a jet. This is relevant for severe diseases, for example, blood poisoning, meningitis.
Doses and rules
The use of injectable formulations for mid-level infections is recommended in the amount of 250-500 thousand units. For a day, the dose is 1-2 million units. If the infection is severe, penicillin recommended a daily dose of 10-20 million in the instructions. Treatment of gas gangrene involves the introduction of 40-60 million units per day.
The introduction of the drug jet into a vein involves the preliminary dissolution of the powder in purified injection water. For 1-2 million, 5-10 ml of liquid is needed. An alternative is sodium isotonic solution. The administration procedure lasts up to five minutes.
Drop application requires a dilution of 2-5 million units of the drug in 100-200 ml of sodium solution. A five percent glucose solution can be used. Penicillin is indicated to be infused per minute in an amount of an average of 70 drops. If the drug is prescribed for a child, a glucose solution in a concentration of 5-10% is used to dilute the powder. Volumes are calculated based on the dose of the drug and the patient's age, usually 30-100 ml.
Nuances and practice
If it is necessary to introduce the drug into the spinal canal, the instruction for penicillin advises the use of 5-10 thousand units for an adult patient. For children, the dose is less - 2-5 thousand. Such treatment is practiced with foci of suppuration in the membranes, the body of the spinal cord, and the brain. The specific dosage is selected, focusing on the diagnosis. The powder must be dissolved in the prepared liquid: sodium chloride or purified water. Dosage - 1 ml per thousand units of medicine. Before the injection, 5-10 ml of fluid should be removed from the spinal canal, injected into the antimicrobial preparation. Injections are shown slow - no more than 1 ml is poured per minute. As a rule, the procedure is repeated daily for up to three days, after which they change shape to injections into muscle tissue.
Penicillin can be used subcutaneously. It is recommended if infiltrate treatment is necessary. The substance is diluted in novocaine solution with a concentration of 0.25-0.5%. For 100-200 thousand units of the antibiotic put 1 ml of liquid.
For oral administration, 10-20 thousand units are dissolved in 1 ml if the patient is an adult, or 2-5 thousand for children. Injection water or sodium chloride is used as the liquid. The duration of the therapeutic course is up to seven days. If necessary, continued use of penicillin is transferred to intramuscular injections.
Special occasion
If it is necessary to prescribe penicillin, the child needs to take a daily dosage based not only on the diagnosis, but also on the age of the patient. So, children under the age of one should be assigned 50-100 thousand units for each kilogram, and 50,000 per kg over one year. In case of a severe infection, the daily dosage is allowed to increase to 200-300 thousand per kilogram. If there are vital signs or an exceptional case, the child is shown up to 500,000 per 1 kg of weight. It is necessary to divide the dose shown for the day into 4-6 procedures.
Pulmonary, ENT and ophthalmic diseases
When lung tissue is infected, penicillin is often used in the form of an aerosol. For adults for a single use, 100-300 thousand units are diluted in 3-5 ml of liquid. The frequency of procedures is a couple of times a day, the duration of one event is up to half an hour. With suppuration in the lung area, the administration of an antibiotic solution is indicated intratracheally. It is first necessary to anesthetize the pharynx, trachea, and larynx. The optimal dose is 100,000 units per 10 ml of sodium chloride.
In acute conjunctivitis, ulceration of the cornea, gonoblennore, inflammatory processes provoked by sensitive microflora, eye drops with penicillin can be used. The drug is available in the form of 20-100 thousand units per 1 ml of liquid. In one procedure, the introduction of 1-2 drops. Repetition rate - up to 8 times a day.
For instillation into the ear, the nose uses penicillin in the form of a solution, each milliliter of which contains 10-100 thousand units of the active component.
Therapy Rules
Penicillin solution must be used immediately after preparation. Do not add other medicines to the medication. The therapeutic course is shown to some as a week or a week and a half duration, in other cases it can reach a couple of months, and sometimes it lasts even longer. The most prolonged treatment requires blood poisoning, bacterial endocarditis and similar severe pathologies. If the first five days of using the drug do not allow you to notice a pronounced effect, it is necessary to change penicillin to other, stronger antibiotics. An alternative is a combination of penicillin and other synthetic antimicrobial agents indicated for a specific diagnosis.
Undesirable consequences
Penicillin and all medications based on it can cause unpleasant, negative responses from the body. They are most pronounced in individuals who are characterized by hypersensitivity to antibiotics and drugs in general. As a rule, in this case, the course of treatment is accompanied by headache and joint pain, fever and skin rashes. Possible urticaria, eosinophilia. There is a risk of angioedema and other allergic responses of the body. In clinical practice, an immediate allergic reaction was observed in the form of anaphylactic shock, which caused a fatal outcome.
With a pronounced manifestation of allergy, the patient is shown adrenaline, hormonal anti-inflammatory and antihistamines, as well as calcium chloride. Diphenhydramine can be used. In some cases, the penicillinase enzyme is used. With a severe response of the body to a therapeutic course, “Prednisone” should be administered. Assessing the reaction of internal systems and organs, other glucocorticosteroids can be prescribed.
If anaphylactic shock is suspected, first aid should be urgently given to the patient. The introduction of adrenaline, calcium chloride. You should use drugs with diphenhydramine, a means to activate and stabilize cardiac function. Ventilation, warming and other support measures are needed. As soon as asphyxia is overcome, 1 million units of penicillinase should be injected.
Important aspects
The use of penicillin in high dosage can cause neurotoxic effects. Particularly high probability of such side effects with the introduction of the drug into the spinal cord. To prevent such consequences, it is important to carefully calculate the dose and administer the drug.
Before starting the antimicrobial course, it should be clarified whether there were any previous complications against the background of penicillin use.
The antimicrobial course increases the likelihood of complications in the form of fungal invasion, in which mucous membranes and skin are affected. The risks of this outcome are higher in the treatment of newborns and the elderly, as well as weak patients. To reduce the danger, it is necessary to combine an antimicrobial drug and vitamin complexes. Ascorbic acid and B vitamins are considered the most useful. In some cases, Levorin and Nystatin should be used.
Strongly impossible!
Penicillin and all penicillin preparations should not be used if hypersensitivity to this active compound is established. In addition, the drug is not recommended against the background of bronchial asthma and hay fever. Penicillin should not be used for urticaria and other diseases of an allergic nature. With increased sensitivity, inadequate and unstable, atypical reactions to antimicrobial agents of different groups, as well as other drugs, penicillin is recommended not to be used. The introduction into the spinal cord is prohibited by patients with epilepsy.