In the article, we consider what antibiotics are prescribed for tuberculosis.
They treat this ailment with the help of specific therapy, which consists of medications of different synthetic structure and mechanism of action. It is based, first of all, on the selection and application of multicomponent regimens that are capable of ensuring the maximum effectiveness of the drug in the healing process. Antibiotics are selected in the presence of tuberculosis, depending on the stage of the disease, the overall picture, the resistance of mycobacteria and the general tolerance of such drugs by the body. The following is a list of antibiotics for tuberculosis.
List of drugs
Today, there are a large number of antibacterial drugs that are used to eliminate pathology. Each of them, as a rule, differs in its origin, mechanism of influence, and, in addition, in composition and effectiveness.
- The chemical group includes Pyrazinamide, Tiamide, Ethambutol, paraaminosalicylic acid and others. They have an exclusively directed effect, affecting the pathogen of infection. These names of antibiotics for tuberculosis are few known.
- Semi-synthetic antibiotics are presented by Cycloserinum and rifamycin, polypeptide, aminoglycoside category medicines. They have a wide range of effects on the diseased organism.
- Basic antibiotics for treating tuberculosis include drugs that are used in the treatment of primary forms of tuberculosis, for example, Streptomycin along with Rifampicin and Rifabutin.
- Reserve antibiotics are used for secondary infections, and at the same time against the background of the development of bacterial resistance to fixed assets or in the presence of intolerance to the patient first-line drugs.
By the strength of the effect, antibiotics for tuberculosis can have low, medium and high efficiency.
"Isoniazid": instructions and effectiveness
The mechanism of action of the first antibiotic effective in tuberculosis is associated with the process of inhibition of mycolic acid synthesis in cell walls. The agent is the bactericidal effect on mycobacteria at the stage of reproduction, as well as the bacteriostatic effect in the resting stage. With monotherapy with this medicine, resistance quickly develops to it. Isoniazid is the most effective drug for any form of active tuberculosis in adults and children. But its activity against atypical parasites is lower.
The medicine is well absorbed in the digestive system, the peak concentration in the blood is reached three hours after administration. It passes through the tissue barrier, penetrates into the cells, as well as into all physiological fluids, into the pleural and ascitic, including. The drug is metabolized within the liver, the inactivation rate is determined by the cytochrome system. Among the patients, fast inactivators are distinguished, in which the half-life of the drug is about an hour and slow - about one hundred and eighty minutes. An antibiotic is excreted by the kidneys.
Indications
Indication for use is the prevention and treatment of active tuberculosis of different localization. Contraindications include individual intolerance along with epilepsy, severe psychoses, a tendency to seizures, a history of polio, toxic hepatitis, and acute kidney and liver failure.
You should consult your doctor if you experience nausea, skin itching, vomiting, and temperature. In case of a child who is breastfeeding, increased irritability, rash or seizures, you should also consult a doctor. Drinking alcohol during treatment with this antibiotic increases the risk of hepatitis. Other drugs based on isonicotinic acid are similar in basic parameters to Isoniazid, but they have much lower effectiveness and are less studied, therefore they are used extremely rarely.
What other antibiotics are effective for tuberculosis?
Instructions and effectiveness of "Rifampicin"
"Rifampicin" is a semi-synthetic derivative. It has been used against tuberculosis since the beginning of the seventies. It has a wide range of activity and good pharmacokinetic properties. However, the rapid emergence of resistance greatly limits the indications for its use. Mostly it should be used in the presence of tuberculosis, atypical mycobacteriosis, and, in rare cases, in the severe form of some other infections, against which alternative therapy is ineffective. The medicine has a bactericidal effect, acts as a specific inhibitor. Indications for use are as follows:
- tuberculosis treatment;
- treatment of atypical mycobacteriosis in HIV-infected patients (usually in this case the medicine is used in combination with Ciprofloxacin and Azithromycin);
- in case of severe forms of staphylococcal infection in combination with Vancomycin and fusidic acid;
- with legionellosis in combination with macrolides;
- as part of the prevention of meningitis among carriers of meningococcus.
Despite the wide medicinal potential of this antibiotic for pulmonary tuberculosis, in each case it is necessary to assess its potential benefits for a particular patient and the risks of the spread of resistance. Contraindications to use are intolerance along with severe liver diseases.
Inside, "Rifampicin" must be taken one hour before a meal (or one hundred and twenty minutes after). When ingestion, it is required to strictly follow medical recommendations. It is worth consulting with a doctor if itching, rash, digestive upset, pain in the liver, jaundice, etc. appear. During therapy, red staining of urine, saliva, tears, sputum, and contact lenses is not ruled out.
Rifabutin
In many of its properties, this antibiotic for tuberculosis is similar to Rifampicin, but it has differences, which are as follows:
- may affect some strains that are resistant to Rifampicin;
- is more active against atypical mycobacteria;
- bioavailability when ingested, in general, does not depend on food intake.
The indication is tuberculosis of different localization, which is caused by rifampicino-resistant but sensitive to “Rifabutin” strains. This tool is suitable for the treatment of infections that are caused by atypical mycobacteria. It, among other things, is used in the prevention of atypical mycobacteriosis in HIV patients. Contraindications are intolerance to the drug along with severe liver diseases, pregnancy, breastfeeding, up to fourteen years of age.
"Rifabutin" is allowed to be taken on an empty stomach, exactly as during or after a meal. It is important to strictly follow the treatment regimen. During treatment, staining of urine, tears, skin, sweat and saliva in scarlet is not excluded. Against the background of the occurrence of uveitis, the reception of the medication in question should be temporarily stopped. Be sure to consult a doctor if symptoms appear that indicate a worsening condition.
Antibiotics for pulmonary tuberculosis can be difficult to find in pharmacies.
Pyrazinamide
This agent may have a weak bactericidal effect, but produces a pronounced sterilizing effect, especially inside macrophages and in the focus of fresh tuberculous inflammation. It has an effect on slowly multiplying bacteria, including those located intracellularly. The persistent form has the greatest effect in an acidic environment. The exact mechanism of exposure has not been established.
Properties and mechanism of action
This antibiotic effective in treating tuberculosis is active against mycobacterium tuberculosis. The medicine is well absorbed in the digestive system. Its maximum level in blood plasma is reached after three hours. The medication quickly penetrates into the tissues, just like in the biological fluids of the human body. Metabolized substance in the liver. A large proportion of the metabolic product (about seventy percent) is excreted in the urine. The elimination half-life is twelve hours, with kidney failure, time increases. It is removed as part of hemodialysis.
Undesirable reactions include nausea and vomiting. It is also possible metabolic disorders in the form of hyperuricemia, manifested arthralgia and myalgia (in contrast to gout, large and small joints can be affected). In addition, porphyria is associated with side effects along with increased transaminase activity, dose-dependent hepatotoxicity, hematological reactions in the form of thrombocytopenia, sideroblastic anemia with erythroid hyperplasia, drug fever and dysuria.
The main indication for this antibiotic is combination therapy for tuberculosis. Contraindications include individual intolerance along with severe kidney and liver diseases, gout, impaired digestive system function, hypothyroidism, epilepsy and psychosis. During the treatment period, it is very important to observe the treatment regimen, as well as inform the doctor about all the symptoms.
What antibiotics for tuberculosis are better to take, the doctor will tell.
Ethambutol
The activity of Ethambutol is directly related to the inhibition of enzymes that are involved in the synthesis of cell walls of mycobacteria. The drug may have a bacteriostatic effect. Active only against breeding bacteria, the action develops in two days. This medicine is well absorbed in the digestive system, the maximum concentration in the blood plasma is created after four days.
This antibiotic used in tuberculosis can penetrate most tissues and biological fluids of the human body. Intracellular concentrations are two times higher than extracellular. A medication, as a rule, can circulate in the blood for a long time due to deposition in red blood cells. The drug is excreted mainly by the kidneys in an unchanged form (about fifty percent), and, in addition, in the form of metabolites, which is (from eight to fifteen percent). Part of the drug is excreted unchanged by the digestive system. The elimination half-life is three hours, but this can greatly increase with kidney failure.
Adverse reactions include dizziness along with retrobulbar neuritis, peripheral polyneuropathies, paresthesia, depression, nausea, vomiting, rash, and increased coughing with an increase in sputum volume. Ethambutol is an antibiotic that can be used in several regimens for chemotherapy for tuberculosis, which are often recommended at the present time. The drug is especially indicated for the alleged resistance to its analogues.
Contraindications
Among the contraindications, it is worth mentioning individual intolerance along with optic neuritis of various etiologies, cataracts, diabetic retinopathy, inflammatory eye diseases and under two years of age. In therapy, it is necessary to control visual acuity. In case of violation of this function, immediately inform the doctor about the problem.
Antibiotic Capreomycin
Antibiotic for tuberculosis for adults “Capreomycin” can have a bacteriostatic effect. It is worth noting that this medicine is rather poorly absorbed in the digestive system. With intramuscular administration, the peak concentration in blood serum is reached after two hours. The medication, as a rule, does not pass through the BBB and penetrates the placenta. The drug is not metabolized in any way, it is excreted through the kidneys in an active state. The half-life is four to six hours.
Undesirable reactions include kidney failure along with tinnitus, hearing loss, dizziness, nerve and muscle blockage, hives, maculopapular rash, fever, eosinophilia, as well as pain at the injection site, infiltrates and sterile abscesses. The main purpose of this tool is that it is intended for the treatment of tuberculosis.
Contraindications are individual intolerance along with pregnancy, breast-feeding and childhood. It is imperative to consult a doctor if improvement does not occur within two to three weeks or any new symptoms appear. Next, we find out what people write about antibiotics for pulmonary tuberculosis in adults.
Reviews
Speaking about antibiotics, it is always difficult to say which one is the most effective. In the treatment of tuberculosis, however, as with other diseases, doctors primarily repel the degree of sensitivity of pathogenic bacteria to a particular drug.
In this regard, in reviews, people write about various antibiotics that have been effective in treating such an insidious disease as tuberculosis. For example, quite often in the comments, good performance is mentioned against the background of the use of such drugs as Pyrazinamide, Streptomycin, and Rifampicin.
But it is worth emphasizing once again that the effectiveness of antibiotic treatment for tuberculosis depends on each specific case and the degree of neglect of the disease.