Penicillin is the world's first antibiotic. Penicillin has a bactericidal effect, therefore it has been used in the treatment of bacterial infections. Before the discovery of penicillin, infectious diseases caused the death and severe complications of hundreds of millions of people. The introduction of penicillin has revolutionized treatment. Check exactly what action penicillin has, what are the antibiotics that contain penicillin, what are the side effects and contraindications for penicillin use?
Penicillin , specifically penicillins, is the oldest group of antibiotics, produced by brush fungi. There are natural penicillins, obtained by biosynthesis (individual preparations differ mainly in the time of action), and semi-synthetic penicillins, qualitatively different from natural penicillins in terms of the scope of activity or resistance to the action of bacterial enzymes. In addition to natural and semi-synthetic penicillins, this group of penicillins also includes β-lactamase inhibitors, which form combined preparations with penicillins, thanks to which they support their antibacterial activity.
Penicillin - penicillin-containing antibiotics
| Natural penicillins | Semi-synthetic penicillins | Penicillins in combination with β-lactamase inhibitors |
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- carbenicillin- carindacillin- carfecillin- tycarcillin
- azlocillin- mezlocillin- piperacillin- apalcyline
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Penicillin - action and application
Penicillin inhibits the formation of the bacterial cell wall. It makes bacteria unable to multiply and they die. Due to the fact thatpenicillinhas thiseffect , it has foundusedin the treatment of bacterial infections.
1. Natural penicillins
They are natural mold products (Penicillium notepad and P. chrysogenum) and have a relatively narrow antimicrobial spectrum. Natural penicillins are active mainly against gram-positive bacteria (streptococci, staphylococci, pneumococci and anaerobic bacilli) and only against some gram-negative bacteria. Enterococci are resistant to this class of antibiotics.
The indications for the use of procaine benzylpenicillin are:
Penicillin is in the form of tablets, a powder for the preparation of a solution for intravenous / intramuscular / infusion injections.
- streptococcal infections (e.g. angina, tonsillitis, paranasal sinuses, lungs)
- prevention of rheumatic disease
- carrier of diphtheria, gonorrhea, syphilis
- in bacterial endocarditis
- in purulent complications after surgery
- after childbirth
Benzathine benzylpenicillin has similar indications, with the proviso that in acute or severe infections, its administration should always be preceded by treatment with benzylpenicillin.
Other natural penicillins are potassium benzylpenicillin and phenoxymethyl penicillin (phenoxymethylpenicillin).
Worth knowingPenicillin tablets without a prescription?
Penicillin is a prescription-only antibiotic. You cannot get penicillin tablets or any other form without a prescription.
2. Semisynthetic penicillins
Semi-synthetic penicillins with a narrow range of action:
- isoxazole penicillins (oxacillin, cloxacillin, dicloxacillin, flucloxacillin, nafcillin) - are used primarily in the treatment of infections caused by staphylococci, resistant to natural penicillins, because they have an antibacterial effect against staphylococcus and resistance to the natural penicillins). However, they show no antibacterial activity against gram-negative rods and enterococci
Penicillin, while it is the first antibiotic and still perfect, is not an effective antibiotic against all types of microorganisms.
Broad-spectrum semi-synthetic penicillins :
- aminopenicillins - fight streptococci(pneumococci and enterococci), gonorrhea, coryneus, diphtheria, anthrax, enterobacteria, pale spirochetes that cause syphilis and bacteria that cause Lyme disease. They are the drugs of choice for the treatment of e.g. acute bronchitis. Amoxicillin (Amoxicillinum) is currently the most important aminopenicillin used in medicine
- carboxypenicillins, such as ticarcin, are effective against, among others, blue oil bacteria,Proteusand Escherichia coli
- ureidopenicillins (acylaminopenicillins) - the antibacterial activity of ureidopenicillins (azlocillins, meslocillins and piperacillins) is very wide and covers the range of action of aminopenicillins and carboxypenicillins. The indications for their use are, among others severe infections of the respiratory tract, bile ducts, urinary tract, meningitis
- amidinopenicillins - work mainly against gram-negative microorganisms, including: E. coli, Salmonella, Shigella, Klebsiella and others. These antibiotics are not absorbed from the gastrointestinal tract and resistance is rapidly developed after its use. May prove effective in urinary tract infections after parenteral administration
3. Penicillins in combination with β-lactamase inhibitors
Penicillins combined with β-lactamase inhibitors are more effective and have the broadest range of antibacterial activity.
Worth knowingPenicillin - dosage
The dosage of penicillin depends on the specific type and age of the patient. For example, the dosage of phenoxymethyl penicillin (known as Ospen) is as follows: children usually 50,000-100,000 IU / kg / day in 2-3 doses. division Adolescents and adults - 3,000,000-4,500,000 IU / day in 2-3 doses. division In both adults and children, the daily dose of the drug should not be lower than 25,000 IU / kg body weight.
Penicillin - Pros and Cons
The main advantages of penicillins are: low organ toxicity, good bactericidal effect, good penetration into organs and tissues (especially when inflamed), while the disadvantages are high sensitivity to β-lactamases (these are bacterial enzymes that break the bonds in the antibiotic molecule), quick elimination from the system (the need for frequent dosing), as well as the possibility of allergic reactions.
The ease of developing penicillin allergies is one of the most important limitations of their use. Allergic reactions (erythema, urticaria, fever, joint pain), due to their strength, can be very dangerous and even lead to anaphylactic shock and the patient's death. Therefore, before using penicillins,especially intravenously, allergy tests should be performed.
Penicillin - contraindications
Penicillin should not be used in case of hypersensitivity and in patients allergic to this group of drugs.
Allergic to cephalosporins (patients allergic to cephalosporins may also be hypersensitive to penicillin - cross-allergy).
Administration of oral penicillin is contraindicated in patients with gastrointestinal disturbances causing persistent diarrhea or vomiting due to reduced penicillin absorption.
In addition, be careful with patients:
- for bronchial asthma
- with hypersensitivity to other drugs
- with an interview of allergic diseases
- with kidney failure
- with heart failure
- taking diuretics or medications containing potassium
Penicillin and pregnancy
Hello, I am currently undergoing antibiotic treatment. I am taking two penicillin antibiotics (Calvepen 666 and Floxapen 500 mg). Both are not available in Poland - I live in Ireland. There is a possibility that I may be pregnant. Can penicillin antibiotics of this type harm the fetus?
MD Barbara Grzechocińska, gynecologist - obstetrician: Penicillin antibiotics can be administered during pregnancy.
Penicillin - side effects
Immune system disorders:
- superinfections with resistant bacteria or yeasts
- eruptions (maculopapular rash to exfoliative dermatitis)
- hives
- fever
- chills
- joint pain
- edema, including laryngeal edema, angioedema
- serum sickness-like reactions
Anaphylactic shock with collapse, anaphylactoid reactions (bronchial asthma, purpura, gastrointestinal symptoms) have also been reported.
Digestive system disorders:
- nausea
- diarrhea
- vomiting
- feeling full in the stomach
- antibiotic-related colitis
- pseudomembranous enteritis
- hepatitis
- cholestatic jaundice
Skin and subcutaneous tissue disorders
- inflammatory infiltrates at the injection site (if the antibiotic is used intramuscularly)
- stomatitis
- glossitis
- black hairy tongue
Erythema has also been reportedmultiforme, exfoliative dermatitis. Paraesthesia has been reported with long-term use.
Blood and the lymphatic system disorders
- eosinophilia
- hemolytic anemia
- leukopenia (decrease in white blood cells)
- thrombocytopenia (thrombocytopenia - shortage of blood platelets)
- agranulocytosis
- neutropenia
- coagulation disorders
Nervous system disorders
- neuropathy (if high dose parenteral administration of penicillin)
- convulsions (especially after high doses or administration of phenoxymethylpenicillin in patients with renal impairment)
Renal and urinary disorders
- nephropathy (if penicillin is administered parenterally in high doses)
- interstitial nephritis
Hoigné syndrome - is an intermittent complex of neurological symptoms that occurs after the accidental injection of procaine penicillin into the vessel. These symptoms include restlessness, anxiety, psychomotor agitation, increased heart rate, disturbance of consciousness, headache, dizziness, nausea, tachycardia, cyanosis, paresis, paraesthesia (tingling and numbness), hallucinations.
Penicillin - drug interactions
Penicillin is the opposite of antibiotics such as tetracyclines, macrolytes, lincosamides, sulfonamides and chloramphenicol, so they should not be used together.
Antacids negatively affect the absorption of penicillins, they also reduce their bactericidal effect.
Non-steroidal anti-inflammatory drugs increase their concentration in the blood.
Penicillins with a wide range of effects reduce the effectiveness of oral contraceptives, so when taking both drugs simultaneously, it is advisable to use alternative methods of contraception.
Worth knowingHistory of penicillin
Before the penicillin era, doctors struggled with the problem of fighting infectious diseases in such a way as to destroy bacteria, but in a way that is safe for the human body. In 1928, Fleming, while growing bacteria in his laboratory, discovered penicillin by accident. Arranging the culture dishes, he noticed a growing colony of mold that was killing the bacteria. Later, he conducted further experiments, but he had no money to patent the substances. Only 10 years later, together with Howard W alter Florey and Ernst Boris Chain, they isolated the active substance, and a year later they started producing the antibiotic. In1945 they were awarded the Nobel Prize. The discoverer of penicillin, Alexander Fleming, died on March 11, 1955 of a heart attack. Until the end of his life, he said: "It was nature that produced penicillin, I only discovered it."
Penicillin and other antibiotics - improper use can lead to drug resistance
Source: lifestyle.newseria.pl