Ofloxacin or amoxiclav which is better. Amoxiclav or levofloxacin which is better for pneumonia. Tactical errors of antibiotic therapy

In our time, the question of the choice of antibiotics is quite acute. With each passing day, the resistance of microorganisms to drugs is growing, and it is becoming increasingly difficult to choose the right one. Thanks to modern technologies, new groups of antibiotics are being discovered, as well as modifying and supplementing existing species.

Levofloxacin

Levofloxacin is a fully synthetic agent belonging to the group fluoroquinolones. The substance has a wide spectrum of action, therefore it can be used for most known infections, and also as a preliminary therapy in a period when the exact pathogen is not identified.

Levofloxacin is available in three forms: oral tablets, injection, and eye drops. The choice of form is made on the basis of the localization of the infection, as well as its severity.

The mechanism of action of levofloxacin is based on the inhibition of the main enzymes of bacteria necessary for their reproduction. Interfering with the growth and reproduction of bacteria is called bacteriostatic action, however, in high doses, the drug can be bactericidal, that is, destroy bacteria.

Due to its chemical composition, drug resistance rarely develops. In addition, cross-resistance with fluoroquinolone drugs is also quite rare. All this makes it necessary to leave levofloxacin as a backup method of fighting infection, when other drugs, to which resistance has already begun to develop, cannot cope.

Levofloxacin has a number of serious side effects and, in this regard, a number of contraindications. The pathological effect of the drug on tendons and cartilage has been proven, so the drug is contraindicated in the following people:

• Those with a history of tendon injury as a result of taking fluoroquinolones.
• Children under 18 years old.
• Pregnant.
• Nursing.

The drug has a certain effect on the central nervous system, therefore its use is limited among people with epilepsy, increased epileptic readiness of the brain, as well as myasthenia gravis and other diseases associated with the central nervous system.

It was revealed that a rapid intravenous infusion of levofloxacin leads to a sharp critical decrease in blood pressure. In this regard, if intravenous administration of the drug is necessary, it should be infused slowly, over 60-90 minutes.

Due to its high efficiency, the use of the drug is possible even in people with a high risk of side effects. In this case, the possible consequences should be less significant than the disease against which levofloxacin is used.

Amoxiclav

Amoxiclav is combination drug. It consists of two active substances that complement each other. The drug is an antibiotic of the penicillin series, since it contains amoxicillin.

It has long been known that there are a number of bacteria that produce beta-lactamase, which can destroy penicillin. To combat such bacteria, a beta-lactamase inhibitor is added to the composition of simple antibiotics, which significantly increases the effectiveness of the drug.

Amoxiclav is one such antibiotic. In addition to amoxicillin, the composition contains clavulanic acid protecting the main active substance from aggressive bacteria. Clavulanic acid allows you to expand the spectrum of the drug, by using it against those bacteria that are usually resistant to penicillins.

The drug is available in two main forms: tablets and powders. Powders can be both for the preparation of suspensions for oral administration, and for solutions for intravenous administration.

The mechanism of action of amoxiclav is based on the fact that it stops the growth of the bacterial cell wall. As a result, the framework becomes unstable, becomes thinner, and then the bacterium lyses, that is, it dies.

There are no highly specific contraindications for taking amoxiclav. It should be used with caution in persons with chronic or acute diseases of the liver and gastrointestinal tract. Pregnant women are prescribed the drug only if the threat to the mother outweighs the threat to the child from taking the antibiotic.

Similarities and differences

Levofloxacin and amoxiclav are drugs of different pharmacological groups and generations. However, their scope is quite similar, since they are more often prescribed in cases where classical penicillins do not work.

The choice of a particular drug depends, first of all, on the sensitivity of the bacteria. According to the spectrum of action, both drugs are quite similar, so you should choose based on indications and contraindications.

At the age of 12 to 18 years, amoxiclav will be the drug of choice, since it is quite difficult to justify the use of levofloxacin in children. Penicillin will also be more preferable in the treatment of pregnant and lactating mothers, despite certain contraindications.

Restrictions on the use of these antibiotics practically do not overlap, so the choice of a specific one will be based, firstly, on the sensitivity of bacteria, and secondly, on the presence of contraindications to one of them in the patient.

Scope and what to choose

Levofloxacin is widely used in ophthalmology both in the form of drops and as a systemic antibiotic. In addition, the drug successfully copes with complicated bronchitis and pneumonia. It has been proven effective against diseases such as anthrax and tuberculosis. It has also found wide application in the treatment of the genitourinary system:

• Prostatitis.
• Tubulointerstitial nephritis.
• Urinary tract infection of unspecified localization.

Amoxiclav is often used for ear infections of the nasopharynx:

• Acute sinusitis.
• Acute pharyngitis.
• Acute suppurative otitis.
• Acute tonsillitis.
• Chronic otitis, sinusitis, pharyngitis, tonsillitis.

The drug is used in gynecology, urology, as well as orthopedics, for the treatment of osteomyelitis and other diseases of the musculoskeletal system.

The choice of the best remedy is based on the disease to be treated. In the treatment of pathology of the upper respiratory tract, Amoxiclav will be much more effective, but it will be useless for ophthalmic diseases. In addition, amoxiclav remains the drug of choice in the treatment of children and pregnant women. Levofloxacin should be chosen in extreme cases of bronchitis and pneumonia, as well as in rare infectious diseases.

Levofloxacin is an effective antibacterial agent based on ofloxacin. But its effectiveness in the fight against bacteria is much higher than that of its component.

Its popularity is due to such factors as ease of use and the absence of a large number of contraindications. Because of this, the antibiotic Levofloxacin has become one of the most widely used drugs in its group.

Pharmacokinetics, form of release and indications for use

A drug such as Levofloxacin has the feature of being almost completely absorbed after ingestion. This process is little influenced by food intake, so it almost does not matter whether the drug was taken after or before a meal.

The active substance very quickly and effectively penetrates into the tissues of organs:

• into bone tissue
• into the fluid of the spinal cord;
• the prostate gland;
• lungs;
• bronchi;
• sputum;
• genitourinary system;
• macrophages, etc.

In the liver region, a small amount of the substance is oxidized. It is excreted from the body by the kidneys. Almost 90 percent of the oral dose is excreted in the urine within 2 days. After 72 hours, about 4-5 percent is still excreted with feces.

Among the entire group of antibiotics, Levofloxacin has an extensive spectrum of action. Its effectiveness is very well manifested during the treatment of diseases of this type:

• respiratory diseases - pneumonia, with chronic bronchitis, and even for the treatment of certain forms of tuberculosis;
• diseases of the genitourinary organs;
• kidney disease (inflammatory processes in this organ);
• sinusitis, otitis and other diseases of the upper respiratory tract;
• diseases in the area of ​​soft tissues in the form of suppuration, tumors, cysts;
• prostatitis.

Taking Levofloxacin for some infectious diseases can be "optional". This means that this drug can replace another of a similar type.

For certain types of infections, there are several types of formulations of this drug. So, for each individual case, it is necessary to select the most suitable form. You can choose from the following:

In addition to the main active ingredient, the medicine also includes additional elements, including:

• titanium dioxide;
• sodium chloride;
• water that has undergone deoinization;
• iron.

In the form of a solution and drops, the saturation of the active substance is 5 times greater than in tablets.

Application and dosage

Indications for the use of Levofloxacin are quite simple. It must be taken orally during or before meals. Two approaches to taking the drug can be done per day, that is, the daily dose can be divided into 2. Tablets are swallowed without chewing. After taking the drug, it must be washed down with plenty.

If infusion is used, then it is injected into the body intravenously. The dosage and frequency of use depends on the type and severity of the disease and is prescribed only by the attending physician. Usually it is 2 times a day for 0.5 milligrams.

The scheme by which the drug is taken also depends entirely on the severity of the infection, the stage of the disease and the course of the disease. It also takes into account the sensitivity of the body to the drug, its effect on microorganisms and the functionality of the kidneys. If their function is underestimated, then a different dosage is used. In the normal state, the following scheme is used:

In some cases, for greater effectiveness, the drug is supplemented with other antibacterial agents. This is especially true for diseases of the abdominal cavity.

There are cases when Levofloxacin has been effectively used in tuberculosis - in this case, a dose of 0.5 twice a day is prescribed for 90 days. As you can see, this antibiotic has a wide spectrum of action and is used to treat various types of diseases.

Application for pneumonia and bronchitis

Levofloxacin is very widely used for pneumonia. This is due to the good antibacterial activity of the drug, its good tolerance and improved properties (when compared with similar drugs).

A remedy such as Levofloxacin has a unique effect in the treatment of patients with pneumonia through the following factors:

The effectiveness of the drug has already been proven by the fact that it became the first antibacterial drug recommended by the specialists of the Food and Drug Administration of the United States of America. The same experts recognized its effectiveness in the treatment of pneumonia (including its acute form).

It is effective to treat bronchitis with antibiotics only if the disease has become chronic, accompanied by relapses, suppuration. Only a doctor can prescribe any antibiotic.

The appointment of an antibiotic occurs only after a sputum analysis. Thus, it is precisely the infection that has become the causative agent of the disease that is determined. In acute forms of bronchitis, he prescribes a broad-spectrum antibiotic, which is Levofloxacin. He will be able to destroy most of the infections that this disease causes.

Contraindications and adverse reactions

The drug is very well absorbed by the body and almost completely eliminated naturally. For its reception there are such contraindications:

In other cases, there are no negative consequences after taking the drug.

Side effects during the use of the antibiotic Levofloxacin occur in one to ten patients out of 100.

Different systems of the human body react differently to the action of the drug. Side effects in the digestive organs manifest themselves in this way:

• most often - diarrhea, increased activity of kidney enzymes, nausea;
• much less often - an increase in the level of bilirubin in the blood, diarrhea to a complex degree, which is accompanied by bleeding;
• sometimes - vomiting, loss of appetite, pain in the abdomen;
• in very rare cases - the occurrence of hepatitis.

The immune system reacts with the following manifestations:

Side effects in metabolism:

• the level of glucose decreases, which is accompanied by perspiration, nervousness, trembling, manifestations of too much appetite;
• kidney failure;
• increase in creatine.

The central nervous system reacts to the drug as follows:

The musculoskeletal system exhibits side effects as follows:

• tendon tissue lesions appear;
• pain in muscles and joints;
• tendon ruptures are possible (in most cases, Achilles) - occurs in the first two days after the initial administration of the drug;
• muscle weakness.

The cardiovascular system reacts to the drug with such side effects:

• lowering blood pressure (quite rare);
• increased heart rate;
• vascular collapse (occurs very rarely).

The hematopoietic system as a result of taking this remedy may show the following symptoms:

• agranulocytosis;
• there is a decrease in the number of leukocytes in the blood, which can be seen from a blood test;
• high body temperature that does not go away for a long time;
• fever (its repetition);
• neutropenia;
• anemia of hemolytic or pancytopenic type.

Other side effects:

• general weakness in the body;
• a strong increase in temperature;
• fever.

To determine the possibility of side effects on the drug, it is necessary to conduct a large number of medical studies.

Also, during the use of Levofloxacin in the treatment, there is a manifestation of allergic reactions to those substances that the agent contains. This causes the following side effects:

• swelling;
• rash;
• itching, etc.

If a large number of side effects appear at the same time, then the use of the drug should be canceled or suspended for a while.

Use during pregnancy, lactation and in childhood

Specialists have not conducted studies on the question of whether Levofloxacin can be used during pregnancy or not. But it is not recommended to use it at this time, since some components of the antibiotic negatively affect the development of the baby.

Laboratory studies have not shown the presence of drug components in breast milk, but breastfeeding women should take it with extreme caution. The main problem is the presence of Ofloxacin in the preparation. There is a fairly high probability that it will penetrate into milk and affect the health of the baby.

If a child has a rejection of breast milk, then it is necessary to abandon such feeding of the baby, or to replace the antibiotic with another remedy.

Levofloxacin should not be used in children. The risk group includes children and adolescents who are under 18 years of age. This is due to the danger of damage to cartilage tissues and tendons.

At a time when children are actively growing, the use of the drug can cause pathological processes in the articular cartilage. In the future, this can cause dysfunction in the joints.

Overdose and interaction with other drugs

Exceeding the dose of the drug leads to the following consequences:

There is no antidote that would suit this particular medicine, so treatment should be carried out symptomatically. The active component of the drug cannot be removed from the body by hemodialysis.

The use of a drug such as Levofloxacin must be agreed with the doctor, as there are other drugs that can weaken it or, conversely, strengthen it. For example, preparations that contain aluminum or magnesium (antacids) greatly weaken the effect of Levofloxacin. In order to avoid this between the use of drugs, you need to pause at 2-3 hours.

With the simultaneous administration of drugs that can prevent the occurrence of seizures, a decrease in the seizure threshold can be observed. This process occurs while taking drugs such as Fenbufen, Theophylline or other similar drugs that do not contain steroids and have an anti-inflammatory effect.

During the combined use of the antibiotic Levofloxacin with Cimetidine, there is a decrease in renal clearance for this drug. But this only happens if patients have kidney problems, which already determines a very careful and careful administration of the drug.

Glucocorticosteroid agents in combination with Levofloxacin may cause an increased risk of tendon rupture.

Features of taking the drug and its analogues

The group of antibiotics, which includes Levofloxacin, does not accept the use of this drug by children due to the high probability of damage to cartilage tissues. Also, the medicine should be carefully prescribed to the elderly due to the fact that they often have kidney disease.

If the patient has acute pneumonia caused by pneumococci, then the active substance may not give the desired result. For some types of infections, combined treatment is necessary.

If patients have previously had brain damage, then the appointment of taking the drug can cause convulsions. Although the fear of solar and ultraviolet radiation is extremely rare, it is still not recommended for patients to stay in the sun for a long time.

During the use of the drug, tendinitis may occur. This is very rare, but some patients do experience an Achilles tendon rupture. Older people are most prone to this side effect. If the occurrence of this disease is observed, then you should immediately stop taking the medicine. At the same time, treatment of the affected tendons should be started.

Very carefully, Levofloxacin should be prescribed to those patients who suffer from a metabolic disorder that was inherited by them.

The use of this kind of antibiotic affects a person's ability to drive a car. It has side effects such as dizziness, worse reactions, drowsiness, and blurred vision. All these factors affect a person's ability to respond in time to the situation on the road, so driving while taking Levofloxacin is not recommended. The same applies to people who, in the course of their activities, service machines or other equipment, work with which can be dangerous to human life or health.

Among the analogues of Levofloxacin, one can find such antibiotics, the active substance which is similar to the active component of this drug. Such medicines have similar functions and qualities.

Among the analogues of the drug can be distinguished:

The spectrum of action of these drugs is similar to that of Levofloxacin. Use these or other antibiotics only after a doctor's prescription.

Self-treatment with such drugs can lead to adverse reactions and further complications of conditions.

In any disease, the cause must be treated, not the symptoms. With sinusitis, inflammation is caused by pathogenic bacteria, so antibiotics for sinusitis are the main key to recovery. Only they are able to suppress the growth and reproduction of bacteria, eliminate the symptoms of the disease. Choosing the right antibiotics for sinusitis is very difficult, despite their huge range in pharmacies.

For sinusitis, antibiotics should be prescribed by a doctor, taking into account the patient's history and the results of a bacterial culture made from nasal mucus. Children, pregnant women, people with chronic ENT diseases and immunodeficiency have their own approach to treatment. In addition, many bacteria are resistant to commonly used antibiotics.

Indications

Antibiotic treatment is carried out:

1. in severe and moderate degree of the disease,
2. with severe facial pain on one side.
3. with severe respiratory symptoms and high fever,
4. with severe headache of a permanent nature.

You do not need to drink antibiotics if the sinusitis is allergic, viral or fungal.

Normally, in a healthy person, the sinuses are sterile, and sinusitis is a bacterial inflammation caused by staphylococci, streptococci, Haemophilus influenzae, moraxella, corynebacteria, chlamydia and mycoplasmas, in a third of all cases inflammation is caused by several bacteria.

Considering that culture of mucus for flora and sensitivity to antibiotics takes at least 3 days, the doctor must correctly prescribe the starting antibiotic for treatment, based on the patient's history and symptoms.

Amoxicillins

Amoxicillins are the drug of first choice for uncomplicated mild forms of sinusitis. They are effective against a wide range of Gram-positive and Gram-negative bacteria; are very cheap. The disadvantages for which they become the drug of choice are the development of resistance in bacteria, the high incidence of side effects - diarrhea occurs in every fifth person.

Scroll:

• Flemoxin Solutab is the best drug, protected by a special film, which prevents its destruction in the stomach and promotes better absorption in the small intestine.
• Amoxicar.
• Ospamox.
• Hyconcil.

Protected amoxicillins / clavunates - Amoxiclav, Arlet, Augmentin, Medoklav, Flemoklav Solutab. In severe cases of sinusitis, they are usually prescribed in the form of injections. Augmentin can be taken as a single antibiotic or combined with others. Augmentin is allowed to treat recurrent sinusitis caused by resistant bacteria - thanks to clavulonic acid, bacteria are unable to destroy the physical and chemical structure of Augmentin.

It is allowed to use newborns and pregnant women - Augmentin does not have a teratogenic effect. Augmentin is distinguished by the richness of its release forms - it is a powder for the preparation of a suspension in three different concentrations, a powder for the preparation of an injection solution, tablets for three age groups.

All amoxicillins are allowed for children from birth, they are available in the form of tablets and powders for oral administration in the form of a suspension. The daily dose is distributed during the day for 2-3 doses.

To maintain the required medicinal dose, any antibiotic must be drunk, strictly observing the intervals, that is, every day at the same time.

For example:

• 2 times a day - at 08:00 and 20:00;
• 3 times a day - at 06:00, 14:00, 22:00;
• 4 times a day - 06:00, 12:00, 18:00, 00:00.

Cephalosporins

Broad-spectrum antibiotics, have a similar bactericidal effect with amoxicillins. They are chosen with bacterial resistance to Amoxicillin and Augmentin, if a person has several exacerbations of sinusitis per year, discharge with pus or amoxicillins did not have a positive effect within 2-4 days.

Recently, the first two generations of cephalosporins (Cefazolin, Cefuroxime, Cefaclor) are used less frequently in the treatment of sinusitis.

Third generation cephalosporins:

• Cefixime, allowed from the age of six months, the daily dose is divided into 1-2 doses;
• Cefotaxime, allowed from the first days of life, the frequency of administration 2-4 times a day;
• Ceftriaxone, approved for newborns. Ceftriaxone is one of the most commonly used injections for sinusitis. Convenient in that the injection can be done only once a day. Ceftriaxone causes severe pain when administered, therefore, for intramuscular administration, it is diluted with novocaine, and Ceftriaxone can also be administered through a catheter intravenously. Ceftriaxone has been successfully used to treat and prevent bacterial infection, even in newborns. If necessary, ceftriaxone can be replaced by cefotaxime. Trade names of Ceftriaxone - Azaran, Lendatsin, Oframax, Torocef, Cefikar, etc.;
• Cefoperazone, these are injections for sinusitis, can be used from birth, is administered intramuscularly and intravenously twice a day.

IV generation cephalosporins:

• Cefepime, allowed for newborns, is given in injections every 12 hours.

Tetracyclines

Broad-spectrum antibacterial tablets for sinusitis, indications for their use have narrowed due to a significant increase in bacterial resistance. Not prescribed for pregnant women, children under 8 years of age, with diseases of the liver and kidneys.

• Doxycycline, used only in adults;
• Rondomycin (Metacycline).

Capsules are taken 4 times a day, on the first day it is customary to give a double dose of the drug.

Fluoroquinolones

They are prescribed for more severe sinusitis, if the disease is caused by antibiotic-insensitive bacteria, with an allergy to penicillin antibiotics. Why do many doctors prefer macrolides over quinolones? They are ineffective against the main pathogens of sinusitis - Haemophilus influenzae and streptococci. Therefore, it is customary to use only new fluoroquinolones III and IV generation.

Names of the most common drugs:

• Levofloxacin;
• Moxifloxacin (Avelox);
• ciprofloxacin,
• ofloxacin,
• Pefloxacin.

Fluoroquinolone injections and tablets for sinusitis are prescribed twice a day.

Macrolides

Very effective pills for sinusitis. In recent years, ENT diseases caused by atypical pathogens - mycoplasmas and chlamydia - have become increasingly common. These infections are characterized by a long chronic course of the disease, are not detected during examination of the patient's sputum, are not susceptible to previous antibiotics (Amoxicillin, Augmentin, Ceftriaxone), but are well treated with macrolides.

Macrolides are effective against gram-positive cocci and intracellular bacteria. They belong to antibiotics that have the least degree of toxicity to the human body, which allows them to be used to treat pregnant, lactating women and even the smallest children. Macrolides penetrate the cell very well and create a high concentration of the antibiotic there, which is detrimental to the pathogen.

Of the macrolides, the best antibiotic for sinusitis is the prolonged form of Clarithromycin Fromilid, which has a number of advantages, among them not at all antibacterial properties - anti-inflammatory and immunomodulatory.

Clarithromycin is contraindicated in pregnant and lactating women, Clarithromycin is allowed for children from 6 months. Unlike the old generation drug Erythromycin, it is more resistant to destruction in the stomach, less dependent on eating, and better tolerated.

Macrolides are taken once a day, which makes them easier to use, since the more pills a day, the more often patients miss them.

Odontogenic sinusitis

If sinusitis is caused by carious teeth, then treatment should begin with Lincomycin and Fusidin sodium. Fusidin is a hormonal antibacterial drug with a narrow spectrum of action, effective against cocci and does not affect the growth of gram-negative flora, therefore it is prescribed only as part of a combined treatment. Contraindicated in newborns and pregnant women.

Fusidin and Lincomycin can be prescribed by a doctor together and separately. When prescribing one drug, the treatment is supplemented with Metronidazole or Trichopolum. Metronidazole is a carcinogen, so its unreasonable prescription is avoided.

Antibiotics in drops

Topical antibiotics may be given as the sole antibiotic for mild sinusitis or combined with oral antibiotics for more severe cases. Due to the quick and accurate entry into the focus of infection, they are able to eliminate the symptoms of the disease in a very short time.

Mupirocin (Bactroban)

This is a nasal ointment, prescribed for the treatment of Staphylococcus aureus. Treatment lasts no more than a week, a second course of treatment can be carried out only 1 time.

Framycetin (Isofra)

Children spray spray three times a day, adults up to 6 times. A very good drug.

Fusafungin (Bioparox)

It has been used since 2.5 years in patients from the high-risk group - with bronchial asthma, glomerulonephritis. Effective against cocci, Haemophilus influenzae, mycoplasma and Candida fungi. Assign 4 sprays per day.

The drug is used less and less in our country, since a number of bacteria have developed resistance to it, cases are described when the drug caused severe allergic complications.

Fugentin

These are drops containing fusidic acid and gentamicin, they can be dripped into the nose three times a day, or they can be used to wash the sinuses - pour 1-1.5 ml into the sinus.

Antibiotic for washing

When puncturing and draining the sinus, the doctor always flushes it. The best combined medicine for topical use is Fluimucil antibiotic IT (Cedex, Augmentin, Liginten). The introduction of an enzyme and an antibiotic into the sinus ensures the rapid removal of purulent necrotic mucus. During the week, along with washing, it is recommended to do inhalations using the antibiotic Fluimucil.

Duration of antibiotic treatment

It is necessary to treat a person with antibiotics for acute sinusitis from 7 to 14 days, with an exacerbation of chronic sinusitis - up to 21 days. In severe cases of the disease, an antibacterial drug is prescribed in the form of injections or droppers, but after improvement, after 3-4 days, you need to take antibacterial tablets for sinusitis.

Typical mistakes in antibiotic therapy

1. Wrong choice, when it is prescribed without taking into account the pathogen, the activity of the drug is not taken into account. Classic examples:
   • Lincomycin is ineffective in treating acute sinusitis;
   • Oxacillins do not act on pneumococcus and Haemophilus influenzae, and these are the main causative agents of sinusitis;
   • Gentamicin is a powerless medicine against Haemophilus influenzae and streptococcus.
   • Ciprofloxacin treatment of mild sinusitis at home.
2. Incorrect route of administration. Treatment at home and in the clinic should take place with pills; in the hospital, after improvement, injections also need to be changed to pills.
3. Dispensing failure. More often, patients reduce their dosage, do not observe the frequency of administration and the time interval between taking pills - Sumamed (Azithromycin) and Ampicillin should be taken 60 minutes before meals.

From the first day of using antibacterial tablets for sinusitis, a sick person should take care of the gastrointestinal tract and take drugs that restore the intestinal microflora - Lactobacterin, Bifidumbacterin, Linex. In the case of prolonged antibacterial treatment, it makes sense to drink an antifungal drug, since powerful antibacterial therapy promotes the growth and reproduction of fungi and yeast.

The effectiveness of the antibiotic taken can be judged already at the end of the first day - the discharge is easily separated, nasal congestion disappears, the temperature drops, pain and intoxication disappear.

The best antibiotic for sinusitis is selected for each person individually, taking into account the bacteria that caused the inflammation, the antibiotics that the person has taken recently, the degree, form and severity of the disease. It is easy to treat sinusitis if it is done by a specialist.

If bronchitis is caused by a bacterial infection or occurs in a complex form, then antibiotics are necessary to treat it. The choice of antibacterial therapy drugs is quite wide. But which antibiotic is best for treating bronchitis and will it be effective? Effective in bronchitis are drugs of such groups: aminopenicillins, macrolides, cephalosporins, fluoroquinolones.

Features of cephalosporins

Cephalosporins are characterized by the lowest cost, they are broad-spectrum drugs. They have high efficiency against the background of low toxicity. Therefore, they are more often prescribed for.

The antibiotic of this group acts on the destruction of the cells of the membrane of pathogenic bacteria, which leads to their rapid death.

There are three generations of cephalosporins, where the last (III) has a higher therapeutic effect, practically does not cause side effects and is better tolerated by the body.

List of cephalosporins that are used for bronchitis:

• . It belongs to the III generation and is produced in the form of a powder, from which a solution for intramuscular and intravenous injections is prepared. This antibiotic can be used to treat bronchitis in adults and children from infancy;
• Cefazolin. Belongs to the 1st generation, is available in the form of a powder. A solution for injection (intramuscular, intravenous) is also prepared from it. May be used in children but should be used with caution if kidney dysfunction is present. The duration of the course of taking antibiotics should not exceed 10 days;
• Cefalexin is a 1st generation antibiotic, which is produced in the form of tablets, granules, capsules and powder. The dosage is selected strictly individually, and the duration of admission should not exceed 10 days.

How are aminopenicillins used?

These antibiotics are widely used due to the fact that their action is directed strictly to pathogenic cells without harm to the body.

Aminopenicillins are semi-synthetic drugs in which the main active substance isolated from natural sources is improved in the laboratory.

The only drawback of this group of antibiotics is the frequent development of allergic reactions. Mainly appointed:

• , which is produced in the form of a powder for the preparation of suspensions and tablets. Can be used for bronchitis, both in adults and in children, from birth;

• Amoxicillin is available in tablets, capsules and granules. For treatment, both the oral route of administration and the parenteral route can be used. You can prescribe this antibiotic to babies, starting from the age of two;
• Augmentin, which is produced in the form of tablets and powder for suspension. It has a wide spectrum of action and can be prescribed from birth. The maximum course of this drug should not exceed 5 days.

The use of macrolides

Macrolide is an effective antibiotic that occupies an average price category. The destruction of harmful bacteria by the drug is based on bacteriostatic and bactericidal actions. They destroy the production of protein in the cells of the pathogenic flora, which makes it impossible for the further reproduction of bacteria. With bronchitis, they are prescribed in case of intolerance to the penicillin group of antibacterial drugs.

The most common and effective macrolides are:

• (tablets, capsules) can be prescribed to adults and children from an early age. The dosage of this antibiotic should be set depending on the characteristics of the course of the disease and the state of health, but the maximum period of taking azithromycin should not exceed 5 days;
• Macropen (tablets, granules) can be taken by children from birth and adults. Dosage for children should be based on the weight of the child. Duration of therapy - no more than 2 weeks;

• Sumamed (capsules, tablets, powder, lyophilisate) has a bacteriostatic effect. It can be used to treat children from 6 months of age, and it should be taken no more than 1 time per day.

Characteristics of fluoroquinolones

Fluoroquinolones are the most expensive of all antibiotics prescribed for obstructive bronchitis.

In addition to a strong therapeutic effect, they have many side effects, which manifest themselves in the form of gastrointestinal disorders and the appearance of dysbacteriosis. In practice, the following drugs are used:

• Ofloxacin (tablets, powder) has a broad bactericidal effect on most microorganisms. In children, it can only be used for acute and life-threatening bronchitis. After the disappearance of symptoms, ofloxacin should be taken for another 3 days;
• Levofloxacin (tablets, solution) is a synthetic antibiotic that should be given with caution to children and patients with kidney dysfunction. The dosage is prescribed based on personal data, but the course of treatment should not exceed 7 days;

• Moxifloxacin (tablets) has a bactericidal effect. It cannot be used for . With bronchitis, the course of treatment is 5 days with a single dose of medication.

Information about the features of antibiotics will help determine the drug, which is more suitable for taking a particular patient. But self-medication during antibiotic therapy is strictly prohibited, they should be prescribed only by a doctor.

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Angina is an acute infectious disease manifested by inflammation of the palatine tonsils. Since inflammation of other tonsils (lingual, tubal and laryngeal) develops very rarely, the term angina always means inflammation of the palatine tonsils. If it is required to indicate that the inflammatory process has affected some other tonsil, then doctors talk about lingual, laryngeal or retronasal tonsillitis. Any sore throats are caused by the same pathogenic microorganisms that enter the mucous membrane of the pharynx and oral cavity, so the principles of their therapy are also the same. Therefore, it is advisable to consider the legitimacy and necessity of applying antibiotics with tonsillitis affecting any tonsils.

Antibiotic for angina - when to use?

General rules for the use of antibiotics for angina

The question of the need to use antibiotics for angina should be decided individually in each case based on the following factors:

• The age of the person with angina;
• Type of angina - viral (catarrhal) or bacterial (purulent - follicular or lacunar);
• The nature of the course of angina (benign or with a tendency to develop complications.

This means that in order to make a decision on the need to use antibiotics for angina, it is necessary to accurately determine the age of the patient, determine the type of infection and the nature of its course. Establishing the age of the patient does not constitute any problems, so we will dwell in detail on two other factors that determine whether it is necessary to take antibiotics for the treatment of angina in each case.

So, to resolve the issue of the need to take antibiotics, it is necessary to determine whether angina is viral or bacterial. The fact is that viral tonsillitis occurs in 80 - 90% of cases and does not require the use of antibiotics. And bacterial tonsillitis occurs only in 10 - 20% of cases, and it is she who requires antibiotic treatment. Therefore, it is very important to be able to distinguish between viral and bacterial tonsillitis.

Viral angina is manifested by the following symptoms:

• Sore throat is associated with nasal congestion, runny nose, sore throat, cough and sometimes sores on the oral mucosa;
• Angina began without temperature or against the background of its increase to no more than 38.0 o C;
• The throat is just red, covered with mucus, but without pus on the tonsils.

Bacterial tonsillitis is manifested by the following symptoms:

• The disease began with a sharp rise in temperature to 39 - 40 o C, at the same time, pain in the throat and pus on the tonsils appeared;
• Abdominal pain, nausea and vomiting appeared simultaneously or shortly after the sore throat;
• Simultaneously with the pain in the throat, the cervical lymph nodes increased;
• A week after the onset of a sore throat, the palms and fingers began to peel off;
• Simultaneously with purulent tonsillitis, a small red rash appeared on the skin (in this case, the person fell ill with scarlet fever, which is also treated with antibiotics, like bacterial tonsillitis).

That is, viral sore throat is combined with other symptoms of SARS, such as cough, runny nose and nasal congestion, and with it there is never pus on the tonsils. A bacterial sore throat is never combined with a cough or runny nose, but with it there is always pus on the tonsils. Thanks to such clear signs, it is possible to distinguish viral from bacterial tonsillitis in any conditions, even without special laboratory tests.

The second important factor that determines whether it is necessary to take antibiotics for angina in this particular case is the nature of the course of the disease. In this case, it is necessary to determine whether the sore throat proceeds favorably (without complications) or whether complications have begun to develop in a person. Signs of the onset of complications of angina, requiring the use of antibiotics, are the following symptoms:

• Some time after the onset of the sore throat, ear pain appeared;
• The condition worsens rather than improves as the disease progresses;
• Sore throat increases as the disease progresses;
• There was a noticeable bulge on one side of the throat;
• There were pains when turning the head to the side and when opening the mouth;
• On any day of the course of angina, chest pains, headaches, and pains in one half of the face appeared.

If a person has any of the above symptoms, then this indicates the development of complications, which means that angina is unfavorable and requires antibiotic treatment without fail. Otherwise, when the sore throat proceeds favorably, antibiotics should not be used.

Based on all of the above, we present situations in which it is necessary and not necessary to use antibiotics for angina for people of different ages.

From the point of view of the need to use antibiotics for angina, all people over 15 years old, regardless of gender, are considered adults.

First, if the sore throat is viral and proceeds favorably, then antibiotics should not be used, regardless of the age of the patient. That is, if a child or an adult falls ill with a viral sore throat, which proceeds favorably, without the appearance of signs of complications, then none of them should use antibiotics for treatment. In such cases, the sore throat will pass on its own within 7 to 10 days. Only plentiful drinking and the use of symptomatic remedies that relieve sore throats and reduce fever are justified.

However, if with viral sore throat in an adult or child there are signs of complications, then antibiotics should be started as soon as possible. But you should not drink antibiotics to "prevent" complications, as this is ineffective. It is necessary to start taking antibiotics for viral sore throat only when there are signs of complications.

Secondly, if angina is bacterial (purulent) , then the need for antibiotics is determined by the age of the patient and the nature of the course of the disease.

If purulent tonsillitis has developed in an adult or adolescent over 15 years old, then antibiotics should be used only when signs of the complications indicated above appear. If angina in people over 15 years of age proceeds favorably, then antibiotics should not be used, since the infection will pass without their use. It has been proven that antibiotics reduce the duration of uncomplicated bacterial tonsillitis in people over 15 years of age by only 1 day, so their use is routine, in all cases it is not advisable. That is, all people over 15 years of age should use an antibiotic for angina only if there are signs of complications listed above.

Pregnant women and nursing mothers should take an antibiotic for angina in the same cases as other adults, that is, only with the development of complications from the ears, respiratory and ENT organs.

From the point of view of the need to use antibiotics for angina, all people under the age of 15, regardless of gender, are considered adults.

If a child of any age under the age of 15 develops a viral sore throat, then antibiotics are not needed to treat it. With viral sore throat, antibiotics should be started only if there are signs of complications in the ears, respiratory and other ENT organs.

If a child aged 3-15 years has developed purulent tonsillitis, then it is imperative to use antibiotics to treat it. In children of this age group, the need to use antibiotics for purulent tonsillitis is not associated with the treatment of the disease itself, but with the prevention of possible severe complications in the heart, joints and nervous system.

The fact is that bacterial tonsillitis in children under 15 years of age very often gives complications in the form of infection of the joints, heart and nervous system, causing much more serious diseases, such as rheumatism, arthritis and PANDAS syndrome. And the use of antibiotics for such tonsillitis in children under 15 years of age allows almost 100% to prevent the development of these complications from the heart, joints and nervous system. It is for the prevention of severe complications in children under 15 years of age that it is imperative to use an antibiotic for purulent tonsillitis.

Moreover, in order to prevent complications of bacterial tonsillitis on the heart, joints and nervous system, it is not necessary to start taking antibiotics from the first day of infection. Studies and clinical trials have shown that complications of bacterial tonsillitis in children are effectively prevented if antibiotics are started up to 9 days inclusive from the onset of the disease. This means that it is not too late to start giving your child antibiotics at days 2, 3, 4, 5, 6, 7, 8 and 9 after the onset of the sore throat.

As for tonsillitis in children under 3 years of age, they should use antibiotics only if there is pus on the tonsils or if complications develop in the ears, respiratory and ENT organs. Since there are practically no purulent bacterial tonsillitis in children under 3 years of age, in fact, antibiotics should be used in them to treat inflammation of the tonsils only with the development of complications from the respiratory and ENT organs.

Thus, antibiotics for angina in people of any age and gender should be used only in the following cases:

• Purulent (follicular or lacunar) tonsillitis, even with a favorable course in children aged 3 to 15 years;
• The development of complications of angina on the ears, respiratory and ENT organs in people over 15 years old;
• Complications of tonsillitis in the ears, respiratory and ENT organs in children under 3 years of age.

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Antibiotics for purulent tonsillitis (follicular and lacunar)

There are no differences in the rules for the use of antibiotics for the treatment of lacunar and follicular tonsillitis. Therefore, both of these varieties of angina are often combined with one common term "purulent", and treatment tactics are considered together. The need for antibiotics in follicular and lacunar tonsillitis is determined by the age of the patient and the nature of the infection. So, the age of a person is of decisive importance for resolving the issue of the need to take antibiotics for purulent sore throat. Moreover, a teenager over 15 years old, from the point of view of the need to use antibiotics for purulent tonsillitis, is considered an adult, and under 15 years old, respectively, a child. Consider the rules for the use of antibiotics for angina in adults and children.

Antibiotic for angina for adults

If follicular or lacunar tonsillitis has developed in a person over 15 years old, then antibiotics should be used to treat it only in cases where there are signs of complications in the ears, respiratory and ENT organs. That is, if purulent tonsillitis in any person over 15 years old, regardless of gender, proceeds favorably, without complications to the ears and other ENT organs, then it is not necessary to use antibiotics for its treatment. In such situations, antibiotics are practically useless, since they do not reduce the risk of complications in the ears and ENT organs and do not speed up the healing process.

Accordingly, in people over 15 years of age of both sexes, it is necessary to use antibiotics for purulent tonsillitis only with the development of complications in the ears, respiratory and ENT organs. Given this rule on the use of antibiotics for purulent tonsillitis in people over 15 years old, it is necessary to be able to distinguish between a favorable course of infection and the development of complications. To do this, you need to know the signs of the onset of complications in which you need to take antibiotics. So, the symptoms of complications of follicular or lacunar tonsillitis on the ears, respiratory and ENT organs, with the appearance of which it is necessary to start taking antibiotics, are the following:

• There was pain in the ear;
• After 2 - 4 days after the onset of angina, the state of health worsened;
• The pain in my throat got worse;
• When examining the throat on one of its sides, a noticeable bulge is visible;
• There was pain when opening the mouth or turning the head to the right or left;
• After 2-3 days of antibiotics, the condition did not improve;
• Sore throat and body temperature above 38 o C last longer than 7 - 10 days;
• There were chest pains, headaches, and pains in one half of the face.

Any of the above symptoms indicates the development of complications of purulent tonsillitis, in which it is imperative to start taking antibiotics. If these symptoms are absent in a person over 15 years of age with purulent tonsillitis (follicular or lacunar), then antibiotics are not needed.

Antibiotics for angina in children

If purulent tonsillitis (follicular or lacunar) has developed in a child of any gender aged 3 to 15 years, then antibiotics must be used to treat it, regardless of the presence of complications in the ears, respiratory and ENT organs.

The fact is that at a given age, purulent tonsillitis can give much more severe complications compared to otitis media, abscesses and others characteristic of adults over 15 years old, because due to the imperfection of the lymphoid tissue, pathogenic bacteria from the tonsils can penetrate with the blood and lymph into kidneys, heart, joints and central nervous system, causing inflammatory processes in them, which are very difficult to treat and often become the cause of chronic diseases of these organs.

If the pathogen that provoked purulent tonsillitis enters the kidneys, then it causes glomerulonephritis, the outcome of which is often acute renal failure with a transition to chronic. If the microbe enters the heart, then it causes an inflammatory process in the tissues of the valves and partitions between the chambers, which lasts for years, as a result of which the structures of the heart change and defects form. From the moment the microbe-causative agent of purulent tonsillitis enters the heart until the development of the defect, it takes from 20 to 40 years. And a person already in adulthood is faced with the consequences of a purulent tonsillitis suffered in childhood, which are rheumatic heart defects.

When a microbe from the tonsils enters the joints, acute arthritis develops, which disappears after a while, but creates fertile ground for joint diseases in the future. And when a microbe from the tonsils enters the central nervous system, the PANDAS syndrome develops, characterized by a sharp decrease in emotional stability and cognitive functions (memory, attention, etc.), as well as the appearance of spontaneous uncontrolled movements and actions, for example, involuntary urination, tongue twitching, etc. In some children, PANDAS syndrome completely resolves within 6 to 24 months, while in others, to varying degrees of severity, it remains for many years.

Thus, in children aged 3-15 years, the most dangerous complications in purulent tonsillitis are complications on the kidneys, heart, joints and nervous system, and not on the ears, respiratory and ENT organs. Accordingly, the treatment of angina should be directed not so much to the infection itself, which in most cases resolves on its own without special therapy, but to the prevention of these complications from the heart, joints and central nervous system. And it is precisely at the prevention of these severe complications that the mandatory use of antibiotics for purulent tonsillitis in children 3-15 years old is directed.

The fact is that the use of antibiotics for purulent tonsillitis in children 3-15 years old can reduce the risk of developing these severe complications in the heart, joints and nervous system to almost zero. Therefore, doctors consider it necessary to give antibiotics to children aged 3 to 15 years with purulent tonsillitis without fail.

It is necessary to know that prevention and reduction in the risk of severe complications are achieved when antibiotics are started, not only from the first day of the development of angina. So, in the course of research and clinical observations, it was found that the prevention of complications is effective if antibiotics are given to the child up to and including 9 days from the onset of angina. That is, in order to prevent complications in the heart, joints and central nervous system, you can start giving your child antibiotics at 1, 2, 3, 4, 5, 6, 7, 8 and 9 days from the onset of a sore throat. Late initiation of antibiotics is no longer effective in preventing heart, joint, and CNS complications.

If for some reason parents do not want to use antibiotics for purulent tonsillitis in a child of 3-15 years old, despite the high risk of complications in the heart, joints and central nervous system, then they may not do this. However, if the child shows signs of complications from the ears, respiratory and ENT organs (increased pain in the throat, deterioration of well-being, pain in the ear, chest, half of the face, etc.), then you should definitely resort to the use of antibiotics.

Rules for the treatment of angina with antibiotics

If the sore throat is viral, then, regardless of the age of the patient, antibiotics should be taken only from the moment when signs of complications from the ears, respiratory and other ENT organs became noticeable (increased sore throat, pain in the ear, on one side of the face or in the chest, deterioration of health, fever, etc.). If there are no signs of complications with viral sore throat, then you do not need to take antibiotics.

If the sore throat is bacterial (purulent), then a child aged 3 to 15 years should start giving antibiotics as soon as possible. However, if it was not possible to start the use of antibiotics from the first days of a sore throat, then this can be done up to 9 days inclusive from the onset of an infectious disease. That is, with purulent tonsillitis, a child of 3-15 years old can begin to give antibiotics from 1, 2, 3, 4, 5, 6, 7, 8 and 9 days of illness.

Adults over 15 years of age with purulent sore throat should use antibiotics only if there are signs of complications from the ears, respiratory and other ENT organs. That is, if a person over 15 years old with purulent tonsillitis has no signs of complications, then it is not necessary to use antibiotics at all.

What antibiotics are needed for angina

Since in 90 - 95% of cases, bacterial angina or viral complications are provoked by group A beta-hemolytic streptococcus or staphylococci, then antibiotics that are detrimental to these bacteria must be used for treatment. Currently, the following groups of antibiotics are detrimental to beta-hemolytic streptococci and staphylococci, and, accordingly, effective for the treatment of angina:

• Penicillins(for example, Amoxicillin, Ampicillin, Amoxiclav, Augmentin, Oxacillin, Ampiox, Flemoxin, etc.);
• Cephalosporins(for example, Cifran, Cefalexin, Ceftriaxone, etc.);
• Macrolides(for example, Azithromycin, Sumamed, Rulid, etc.);
• Tetracyclines(for example, Doxycycline, Tetracycline, Macropen, etc.);
• Fluoroquinolones(for example, Sparfloxacin, Levofloxacin, Ciprofloxacin, Pefloxacin, Ofloxacin, etc.).

The drugs of choice for purulent tonsillitis are antibiotics from the penicillin group. Therefore, if a person is not allergic to penicillins with purulent sore throat, penicillin antibiotics should always be used in the first place. And only if they turned out to be ineffective, you can switch to the use of antibiotics of other indicated groups. The only situation when the treatment of angina should be started not with penicillins, but with cephalosporins, is angina, which is very difficult, with high fever, severe swelling of the throat and severe symptoms of intoxication (headache, weakness, chills, etc.).

If cephalosporins or penicillins were ineffective or a person is allergic to antibiotics of these groups, then macrolides, tetracyclines or fluoroquinolones should be used to treat angina. At the same time, with angina of moderate and mild severity, antibiotics from the groups of tetracyclines or macrolides should be used, and in severe infections, fluoroquinolones. Moreover, it should be borne in mind that macrolides are more effective than tetracyclines.

Thus, we can conclude that in severe cases of angina, antibiotics from the groups of cephalosporins or fluoroquinolones are used, and in mild and moderate cases, macrolides, penicillins or tetracyclines are used. At the same time, antibiotics from the groups of penicillins and cephalosporins are the drugs of choice, the first of which are optimal for the treatment of moderate and mild angina, and the second for severe infections. If penicillins or cephalosporins are ineffective or cannot be used, then it is optimal to use antibiotics from the fluoroquinolone groups for severe angina and macrolides for mild to moderate severity. The use of tetracyclines should be avoided whenever possible.

How many days to take?

With purulent tonsillitis or with complications of infection, any antibiotics must be taken for 7 to 14 days, and optimally - 10 days. This means that any antibiotic must be taken within 10 days, regardless of the day from the moment the angina appeared, antibiotic therapy was started.

The only exception is the antibiotic Sumamed, which only needs to be taken for 5 days. The remaining antibiotics should not be taken for less than 7 days, since with shorter courses of antibiotic therapy, not all pathogenic bacteria may die, from which antibiotic-resistant varieties are subsequently formed. Due to the formation of such antibiotic-resistant varieties of bacteria, subsequent sore throats in the same person will be very difficult to treat, as a result of which drugs with a wide spectrum of action and high toxicity will have to be used.

Also, you can not use an antibiotic for angina for longer than 14 days, because if the drug did not lead to a complete cure within 2 weeks, this means that it is not effective enough in this particular case. In such a situation, it is necessary to conduct an additional examination (sowing discharge from the throat with the determination of sensitivity to antibiotics), based on the results of which, choose another drug to which the sore throat pathogen has sensitivity.

Names of antibiotics for angina

Here are the names of antibiotics for the treatment of angina in several lists, formed on the basis of the belonging of each specific drug to a particular group (penicillins, cephalosporins, macrolides, tetracyclines and fluoroquinolones). In this case, the list will first indicate the international name of the antibiotic, and next to it in brackets are listed the commercial names under which drugs containing this antibiotic as an active substance are sold in pharmacies.

Names of penicillins

So, among the antibiotics of the penicillin group for the treatment of angina, the following are used:

• Amoxicillin (Amoxicillin, Amosin, Gramox-D, Ospamox, Flemoxin Solutab, Hikoncil, Ecobol);
• Amoxicillin + clavulanic acid (Amovikomb, Amoksivan, Amoxiclav, Arlet, Augmentin, Baktoclave, Verklav, Klamosar, Liklav, Medoklav, Panklav, Ranklav, Rapiclav, Fibell, Flemoklav Solutab, Foraklav, Ecoklav);
• Ampicillin (Ampicillin, Standacillin);
• Ampicillin + Oxacillin (Ampiox, Oxamp, Oxampicin, Oxamsar);
• Benzylpenicillin (Benzylpenicillin, Bicillin-1, Bicillin-3 and Bicillin-5);
• Oxacillin (Oxacillin);
• Phenoxymethylpenicillin (Phenoxymethylpenicillin, Star Pen, Ospen 750).

Names of cephalosporins

Among the antibiotics of the cephalosporin group, the following drugs are used to treat angina:

• Cefazolin (Zolin, Intrazolin, Lisolin, Nacef, Orizolin, Orpin, Totacef, Cesolin, Cefazolin, Cefamezin);
• Cefalexin (Cephalexin, Ecocephron);
• ceftriaxone ) ;
• Ceftazidime (Bestum, Vicef, Lorazidim, Orzid, Tizim, Fortazim, Fortoferin, Fortum, Cefzid, Ceftazidime, Ceftidine);
• Cefoperazone (Dardum, Medocef, Movoperiz, Operaz, Tseperon, Cefobide, Cefoperabol, Cefoperazone, Cefoperus, Cefpar);
• Cefotaxime (Intrataxim, Kefotex, Clafobrin, Klaforan, Liforan, Oritax, Oritaxime, Rezibelacta, Tax-o-bid, Talcef, Tarcefoxime, Cetax, Cefabol, Cefantral, Cefosin, Cefotaxime).

Names of macrolides

For the treatment of angina, the following antibiotics of the macrolide group are used:

• Erythromycin (Eomycin, Erythromycin);
• Clarithromycin (Arvicin, Zimbaktar, Kispar, Klabaks, Klarbakt, Clareksid, Clarithromycin, Claritrosin, Claricin, Claritsit, Claromin, Clasine, Klacid, Clerimed, Coater, Lecoclar, Romiclar, Seydon-Sanovel, Fromilid, Ecozitrin);
• Azithromycin (Azivok, Azimycin, Azitral, Azitrox, Azithromycin, Azitrocin, AzitRus, Azicid, Zetamax, Zitnob, Zi-factor, Zitrolide, Zitrocin, Sumaklid, Sumamed, Sumametsin, Sumamox, Sumatrolide Solutab, Sumatrolide Solution, Tremak-Sanovel, Hemomycin, Ecomed);
• Midecamycin (Macropen);
• Josamycin (Vilprafen, Vilprafen Solutab);
• Spiramycin (Rovamycin, Spiramisar, Spiramycin-Vero);
• Roxithromycin (Xitrocin, Remora, Roxeptin, RoxyGeksal, Roxithromycin, Roxolit, Romik, Rulid, Rulicin, Elrox, Esparoxy).

Names of fluoroquinolones

For the treatment of angina, the following antibiotics of the fluoroquinolone group are used:

• Levofloxacin (Ashlev, Glevo, Ivacin, Lebel, Levolet R, Levostar, Levotek, Levoflox, Levofloxabol, Levofloxacin, Leobag, Leflobakt, Lefoktsin, Maklevo, OD-Levox, Remedia, Signicef, Tavanic, Tanflomed, Flexid, Floracid, Hyleflox, Ecolevid , Elefloks);
• Lomefloxacin (Xenaquin, Lomacin, Lomefloxacin, Lomflox, Lofox);
• Norfloxacin (Loxon-400, Nolicin, Norbactin, Norilet, Normax, Norfacin, Norfloxacin);
• Ofloxacin (Ashof, Geoflox, Zanocin, Zoflox, Oflo, Oflox, Ofloxabol, Ofloxacin, Ofloxin, Oflomak, Oflocid, Tarivid, Tariferid, Taricin);
• Ciprofloxacin (Basigen, Ificipro, Quintor, Procipro, Ceprova, Ciplox, Cipraz, Cyprex, Cyprinol, Ciprobay, Ciprobid, Ciprodox, Ciprolaker, Ciprolet, Cypronate, Cipropan, Ciprofloxabol, Ciprofloxacin, Cifloxinal, Cifran, Cifracid, Ecocifol).

Names of tetracyclines

For the treatment of angina, the following antibiotics of the tetracycline group are used:

• Minocycline (Minoleksin).

Names of antibiotics for angina in children

In children of different ages, the following antibiotics can be used:

1. Penicillins:

• Amoxicillin (Amoxicillin, Amosin, Gramox-D, Ospamox, Flemoxin Solutab, Hikoncil) - from birth;
• Amoxicillin + clavulanic acid (Amovikomb, Amoxiclav, Augmentin, Verklav, Klamosar, Liklav, Fibell, Flemoclav Solutab, Ecoclave) - from 3 months or from birth;
• Ampicillin - from 1 month;
• Ampioks - from 3 years;
• Ampicillin + Oxacillin (Oxamp, Oxampicin, Oxamsar) - from birth;
• Benzylpenicillin (Benzylpenicillin, Bicillin-1, Bicillin-3 and Bicillin-5) - from birth;
• Oxacillin - from 3 months;
• Phenoxymethylpenicillin (Phenoxymethylpenicillin, Star Pen) - from 3 months;
• Ospen 750 - from 1 year.

2. Cephalosporins:

• Cefazolin (Zolin, Intrazolin, Lisolin, Nacef, Orizolin, Orpin, Totacef, Cesolin, Cefamezin) - from 1 month;
• Cefalexin (Cephalexin, Ecocephron) - from 6 months;
• ceftriaxone ) - for full-term babies from birth, and for premature babies from the 15th day of life;
• Ceftazidime (Bestum, Vicef, Lorazidim, Orzid, Tizim, Fortazim, Fortoferin, Fortum, Cefzid, Ceftazidime, Ceftidine) - from birth;
• Cefoperazone (Dardum, Medocef, Movoperiz, Operaz, Tseperon, Cefobid, Cefoperabol, Cefoperazone, Cefoperus, Cefpar) - from the 8th day of life;
• Cefotaxime (Intrataxim, Kefotex, Clafobrin, Claforan, Liforan, Oritax, Oritaxime, Rezibelacta, Tax-o-bid, Talcef, Tarcefoxime, Cetax, Cefabol, Cefantral, Cefosin, Cefotaxime) - from birth, including premature babies.

3. Macrolides:

• Erythromycin (Eomycin, Erythromycin) - from birth;
• Azithromycin (Sumamed and AzitRus injections) - from the moment when the child's body weight is more than 10 kg;
• Azithromycin (oral suspension Zitrocin, Hemomycin, Ecomed) - from 6 months;
• Macropen in the form of a suspension for oral administration - from birth;
• Spiramycin (Spiramisar, Spiromycin-Vero) - from the moment when the child's body weight becomes more than 20 kg;
• Roxithromycin (Xitrocin, Remora, Roxeptin, RoxiGexal, Roxithromycin, Roxolit, Romic, Rulid, Rulicin, Elrox, Esparoxy) - from 4 years.

4. Tetracyclines:

• Minocycline - from 8 years.

In this list, the international names are listed first, then the commercial names of the drugs under which they are sold are given in parentheses. After that, the age at which the listed antibiotics can be used in children is indicated.

It should be remembered that fluoroquinolones should not be used for children under 18 years of age, and other antibiotics can usually be used from 12 or 14 years of age.

Antibiotic in an adult with angina in tablets

Antibiotics for the treatment of angina from various groups, intended for adults, are shown in the table.

Penicillins	Cephalosporins	Macrolides	Fluoroquinolones	Tetracyclines
Amoxicillin: Amoxicillin Amosin Ospamox Flemoxin Solutab Hikoncil Ecoball	Cefalexin	Erythromycin: Eomycin Erythromycin	Levofloxacin: Glevo Lebel Levostar Levotek Levoflox Levofloxacin Leflobact Lefoktsin Maklevo OD-Levox Remedia Tavanik Tanflomed Flexid Floracid Hyleflox Elefloks Ecovid	minocycline
	Ecocephron
		Clarithromycin: Arvicin Klabaks clarbact Clarexide Clarithromycin Claricin Claricite Claromin Klasine Klacid clerimed Coater Seidon-Sanovel Lecoclar Fromilid Ecositrin
Amoxicillin + clavulanic acid: Amoxiclav Augmentin Arlet bactoclav Medoklav panclave ranclave Rapiclav Flemoklav Solutab Ecoclave
			Lomefloxacin: Xenaquin Lomacin Lomefloxacin Lomfloks Lofox
		Azithromycin: Zimbaktar Kispar SR-Claren Sumamed macrofoam Azivok Azimicin Azitral Azitrox Azithromycin Azitrocin AzitRus Azicide Z-factor Zitrolide Sumaklid sumamecin sumamox Sumatrolide Solutab Tremak-Sanovel Hemomycin Ecomed Zitnob Sumatrolide Solution
Ampicillin: Ampicillin Standacillin
Ampicillin + Oxacillin: Ampiox Oksamp			Norfloxacin: Lokson-400 Nolicin Norbaktin norilet Normax Norfacin Norfloxacin
Oxacillin
Phenoxymethylpe- nicillin
			Ofloxacin: Geoflox Zanocin Zoflox Oflo Oflox Ofloxacin Ofloksin Oflomak Oflocid Tarivid Tariferid
			Ciprofloxacin: Ificipro Quintor Procipro Tseprov Ziplox Tsipraz Cyprex Tsiprinol Tsiprobay Cyprobid Cyprodox Tsiprolet Cypronate Cipropane Ciprofloxacin Cifran
		Josamycin: Wilprafen Wilprafen Solutab
		Spiramycin: Rovamycin Spiramisar Spiramycin-Vero
		Roxithromycin: Xytrocin Remora Roxeptin RoxyHexal Roxithromycin Roxolit Romik Rulid Rulicin
		Midecamycin: macrofoam

The best antibiotic for angina

Since purulent tonsillitis is most often caused by beta-hemolytic streptococcus type A and staphylococcus aureus, the best antibiotics for treating infection will be those that have a detrimental effect on these pathogens. Currently, the most effective antibiotics for the treatment of angina of different groups are the following: