What pills to take for the treatment of mycoplasma? Antibiotics for the treatment of ureaplasmosis and mycoplasmosis Effective antibiotic for mycoplasma genitalia

Quantity infectious diseases with sexual transmission is growing every year, and the structure of these infections is constantly changing. Today, an increasing role in the development of inflammation of the urogenital tract is acquired by microorganisms, the pathogenicity of which was previously underestimated.

In particular, this applies to mycoplasma infection, due to its wide prevalence and frequent resistance to antibiotic therapy.

According to modern epidemiological studies, in more than 40% of cases of chronic inflammation of the urogenital tract, mycoplasma infection is detected during diagnosis.

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  1. Features of the pathogen affecting the choice of treatment tactics

  Mycoplasmas belong to the Mycoplasmataceae family, which in turn is divided into, each of which includes more than one hundred species.

  Mycoplasmosis is prone to an asymptomatic chronic course and is often resistant to standard antibiotic therapy regimens, which requires constant correction and adherence to modern recommendations.

  2. Indications and requirements for therapy

  Treatment of infection must be carried out taking into account all clinical data and the results of a comprehensive study of the body for obligate pathogens and common opportunistic microorganisms.

  Thus, M. Hominis infection is treated only when bacteria are detected in a titer of more than 10x4 CFU / ml. There is no minimum titer for M. Genitalium; this species is classified as an obligate pathogen.

  If Clinical signs Since the inflammatory reaction cannot be detected, and mycoplasmas are secreted in a diagnostically significant amount, then the absolute indications for the start of therapy are a violation of human reproductive health and a burdened gynecological anamnesis.

  1. 1 Treatment of urogenital mycoplasmosis should be complex, that is, include etiotropic agents, correction of immunity and lifestyle.
  2. 2 The selection of medicines should be made taking into account the biological characteristics of the pathogen and the state of the macroorganism as a whole.
  3. 3 When selecting drugs, the severity of clinical picture inflammation and the form of the disease.
  4. 4 The number of courses and their total duration are selected individually, it is rarely possible to cure an infection with 1 course of antibiotics.
  5. 5 Treatment of the sexual partner is mandatory, regardless of the presence or absence of symptoms of infection.
  6. 6 After completion of the course of therapy, an assessment of its effectiveness is mandatory.

  3. Antibacterial sensitivity of mycoplasmas

  The choice of antibiotic therapy for mycoplasmosis is currently being actively discussed. The analysis of etiotropic treatment should begin with the groups of antimicrobial agents to which mycoplasmas are resistant.

  Due to the absence of a cell wall, mycoplasmas are completely insensitive to antibiotics, the main mechanism of action of which is to inhibit the biosynthetic processes of bacterial cell walls. These include penicillins, cephalosporins, and sulfonamides.

  Mycoplasma M. Hominis on this moment completely resistant to the following drugs:

  1. 1 Spiramycin;
  2. 2 According to Medscape, mycoplasma hominis (M. Hominis) are resistant to many 14 and 15-membered macrolides, which were actively used several years ago (erythromycin, azithromycin, roxithromycin, clarithromycin).

  The very first antibacterial drug used to treat infection was tetracycline. Currently, about 45-50% of mycoplasmas are completely resistant to it.

  According to R. Hannan, the most effective drugs for the treatment of mycoplasmosis are antibacterial agents that affect the synthesis of ribosomal bacterial proteins.

  Thus, in case of mycoplasma infection, the following groups of antibiotics are of particular importance:

  1. 1 Tetracyclines (Unidox Solutab);
  2. 2 Fluoroquinolones (Ofloxacin, Levofloxacin);
  3. 3 Macrolides (Vilprafen, Sumamed, Zitrolide, Hemomycin).

  In in vitro studies, it has been shown that macrolides and new generations of fluoroquinolones have the most pronounced antimicrobial action against mycoplasmas.

  Among the commonly used drugs, josamycin demonstrates consistently high rates of therapy efficiency (94-95%).

  Doxycycline is also gradually increasing its position - the number of strains susceptible to it is gradually increasing (from 93 to 97%).

  At the same time, the sensitivity of mycoplasmas to tetracycline has sharply decreased today and does not exceed 45-50%.

  3.1. Tetracyclines

  The tetracycline group includes a number of synthetic and semi-synthetic derivatives that inhibit the synthesis of bacterial proteins by binding to S70 and S30 ribosomal subunits. They have a pronounced bacteriostatic effect and have a wide antimicrobial spectrum.

  In mycoplasmosis, the most effective and frequently used are doxycycline hydrochloride and doxycycline monohydrate, which differ from tetracycline in a greater level of safety and better pharmacological properties.

  In this case, it is preferable to use exactly the monohydrate (Unidox Solutab), which does not lead to the appearance of symptoms of esophagitis and minimally affects the intestinal microflora.

  Doxycycline is most conveniently administered in the form of dispersible tablets, which makes it possible to use the antibiotic both in tablet form and in the form of a suspension.

  The advantage of the dispersible form is a stable and uniform increase in concentration medicinal product in the blood serum.

  Features of doxycycline:

  1. 1 High antimycoplasma activity;
  2. 2 High affinity for bone tissue, which provides high efficiency in the treatment of arthrosis associated with mycoplasmosis;
  3. 3 Large breadth of distribution throughout the body;
  4. 4 Low toxicity, which makes long-term use possible.

  The disadvantages include the frequent development of photosensitization, a high incidence of complications from the digestive system with prolonged ingestion, and the impossibility of prescribing during pregnancy.

  With mycoplasma urethritis, doxycycline is applied at 100 mg 2 times / day, the duration of the course is 7 days.

  Resistance to doxycycline in mycoplasmas is quite rare, and the increase in the number of susceptible strains is most likely due to the fact that macrolides are more often used in recent years.

  3.2. Fluoroquinolones

  Antibacterial agents of the fluoroquinolone group have a unique mechanism of antimicrobial effect, inhibit the formation of enzymes responsible for the growth and development of bacterial cells.

  They have a wide spectrum of antimicrobial activity and affect most gram-positive and gram-negative microorganisms.

  Their advantages include a minimal effect on the intestinal microflora and a high accumulation rate in body tissues and blood serum.

  Among the disadvantages can be noted the relatively high toxicity, which makes it impossible to use them for a long time.

  Today, fluoroquinolones are classified as alternative, reserve medicines and are not recommended as first-line drugs.

  Among all fluoroquinolones in the Russian Federation for the treatment of urogenital mycoplasmosis, preference is given to ofloxacin (tablets of 300 mg 3 r / day, course of 10 days) or levofloxacin (tablets of 500 mg per day, course of 7-10 days).

  3.3. Macrolides

  The most significant today are macrolides, antibiotics that disrupt the growth and development of bacterial cells at the level of ribosomal subunits.

  The action of macrolides is bacteriostatic, but in high concentrations, they have a bactericidal effect. According to many researchers, it is macrolides that should be used as drugs of choice for the treatment of mycoplasmosis.

  The advantages of this group of antibiotics are:

  1. 1 High bioavailability, low minimum effective concentrations;
  2. 2 Rapid increase in intracellular concentration with the achievement of maximum values ​​in a short time;
  3. 3 Better tolerance rates compared to fluoroquinolones and tetracyclines;
  4. 4 Possibility of long-term use;
  5. 5 High efficiency against mycoplasmas and ureaplasmas;
  6. 6 Moderate anti-inflammatory and immunomodulatory activity.

  For a long time, from the group of macrolides, only azithromycin was used (trade names - Sumamed, Hemomycin, Zitrolide, etc.). He is still one of the drugs present in the recommended regimens.

  In the Russian Federation, it acts as an alternative drug. According to the results of ongoing clinical studies, azithromycin and doxycycline have approximately the same activity.

  Clarithromycin is currently excluded from the standard of therapy for mycoplasmosis. The lowest minimum effective concentration for mycoplasmas has josamycin (trade name - Wilprafen, tablets).

  Josamycin (Wilprafen) acts on all clinically significant strains of mycoplasma, and often on concomitant infectious agents. Its advantage is the less frequent development of resistance. The standard treatment regimen is 500 mg tablets 3 r / s for 7-10 days.

  Despite its widespread use, most strains of mycoplasma and ureaplasma retain high sensitivity to josamycin. It is included in the first line of therapy, according to the domestic recommendations of the Society of Obstetricians and Gynecologists, as well as the Russian Society of Dermatologists.

  Unlike other macrolides, Vilprafen does not adversely affect liver function and has pronounced immunomodulatory properties, which makes it an ideal drug for this infection.

  4. Treatment of mycoplasmosis during pregnancy

  However, if mycoplasma is detected in a diagnostically significant titer, in the presence of symptoms of infection and a burdened obstetric history, treatment is mandatory, including in order to prevent intrauterine infection of the fetus.

  The choice of the drug depends on the gestational age and the expected sensitivity of the bacteria to the therapy.

  Given the often mixed nature of inflammation, preference should be given to drugs with a wide spectrum of activity.

  In the second and third trimester, it is possible to use erythromycin at a dosage of 500 mg 3 r / day. within 10 days.

  Antibacterial therapy is also complemented by the intake of immunomodulators, and after the end of the course of antibacterial treatment, it is necessary to restore the vaginal microflora.

  5. Addition to antibiotic therapy

  Since mycoplasmosis is often combined with a violation of the patient's immune status, in our country, treatment includes other drugs: immunomodulators, enzymes, adaptogens and vitamins, although all these groups of drugs do not have a broad evidence base.

  Adaptogens are specific medicinal substances or plants that can increase the body's nonspecific resistance to the effects of harmful physical and biological environmental factors.

  This pharmacological group includes preparations of both natural and artificial origin. Natural adaptogens include extracts of Eleutherococcus, ginseng, ginger and lemongrass.

  They can be applied 20-30 drops 30 minutes before meals up to 3 times a day. The course of application is about one month, 2-3 courses are carried out per year. Of the synthetic adaptogens, the most famous in Russia is trerezan, which stimulates the production of the body's own interferons, designed to correct immune disorders. Apply it at 0.2-0.6 mg per day for two weeks.

  In addition to antibiotic therapy for mycoplasmosis, proteolytic enzymes, or enzymes, are often prescribed. A group of proteolytic enzymes is used to resorb inflammatory adhesions in the urogenital tract, which helps to release pathogens and make them available for antibiotic action.

  They are believed to have anti-inflammatory and immunomodulatory effects.

  This allows you to reduce the standard dosage of antibacterial agents and increases the effectiveness of the therapy. Most often, among the funds of this group, alpha-chymotrypsin is prescribed (5 ml / m every other day for 20 days) or wobenzym (inside, 5 capsules 3 r / d before meals).

  We repeat once again that adequate studies of these drugs have not been carried out, therefore the need for their appointment is assessed by the attending physician (gynecologist, venereologist, urologist).

  6. Restoration of the microflora of the vagina

  The restoration of the physiological vaginal microflora is an obligatory stage in the treatment of vaginal infections. In every woman, the vaginal biocenosis is normally strictly balanced.

  The constancy of the acidity of the vaginal secretion ensures the inhibition of the growth of opportunistic microflora and prevents the penetration of pathogenic bacteria.

  The vagina simply cannot be sterile; it is home to about nine different types of microorganisms, most of which are lactobacilli.

  The main negative factors suppressing their growth are:

  1. 1 Antibiotic therapy, without subsequent correction of microbiocenosis;
  2. 2 Disturbances in estrogen concentration;
  3. 3 Menstrual irregularities;
  4. 4 Constant alkalization of the internal environment of the vagina (using regular soap to wash away, frequent douching);
  5. 5 Violation of the normal anatomy of the genital organs.

  There is a widespread misconception that after the first stage of treatment (antibacterial therapy), the second stage (microflora restoration) is not required, and the number of lactobacilli will increase over time without outside interference.

  However, the research results demonstrate the opposite, only 13% of women recover the microflora without the use of additional drugs.

  As a second stage of therapy, you can use vaginal suppositories with lactobacilli - lactonorm, acylact, gynoflor.

  7. Criteria for recovery

  After the end of the full cycle of treatment, it is necessary to conduct a control examination of both sexual partners to assess its effectiveness. This is due to the fact that taking antibiotics does not guarantee one hundred percent recovery.

  Diagnostic tests are prescribed no earlier than 1 month after the completion of the course. The control is carried out by the PCR method, and smears from the urethra and vagina serve as the material for the study.

  The sampling of material from women is recommended to be carried out approximately 2-3 days after the end of the next menstruation. A negative PCR result within three reproductive cycles in women and one month in men indicates that there is no infection in the body.

  8. Prevention

  At the moment, the measures for the prevention of mycoplasmosis are no different from the measures for the prevention of other genital infections.

  It is important to remember that the asymptomatic carriage of mycoplasmas in actually healthy people does not diminish their etiological role in the development of chronic infections of the urogenital tract.

  To prevent infection, as well as for the timely detection of mycoplasma infection, it is necessary:

  1. 1 Use of barrier contraception since the onset of sexual activity;
  2. 2 Full examination of the sexual partner, in case of refusal of the barrier method of contraception;
  3. 3 Identification of infections of the urogenital tract before conception, when planning pregnancy;
  4. 4 Health education of the population.

A broad spectrum of action in combination with local therapy. The basis of treatment is antibiotic therapy, which allows you to destroy the pathogenic microorganism and stop the course inflammatory process in the genitourinary organs of men or women. However, in addition to antibiotics, immunomodulators from the interferon group, physiotherapy, and enzyme therapy are used in the treatment of mycoplasmosis.

Immunomodulators in the treatment of mycoplasmosis are necessary in order to activate the work of macrophages and natural killer cells, which destroy cells infected with mycoplasmas. Mycoplasmas are intracellular microorganisms, so the immune system is not able to completely destroy them on its own. In order for immunocompetent cells to be able to recognize structures infected with mycoplasmas and destroy them, the use of immunomodulators is necessary.

Physiotherapy and enzyme therapy can relieve tissue edema, improve blood circulation, and also accelerate the restoration of a normal structure after an inflammatory process. In addition, the preliminary use of physiotherapy and enzyme therapy improves the penetration of antibiotics to the affected tissues and cells, that is, increases the effectiveness of treatment.

A course of physiotherapy, enzyme therapy and immunomodulators must be applied before starting antibiotics in order to maximize their effectiveness. Among physiotherapeutic procedures for the treatment of mycoplasmosis, magnetotherapy and inductothermy are used. Interferonogens are used to improve the immune response, such as Immunal, Pyrogenal, Likopid, Cycloferon, Imunomax, Isofon, Immunorm, Imudon, Methyluracil, Ribomunil, Poludan, Uro-Vaxom, etc. For enzyme therapy, Phlogenzym, Wobenzym, Lidase, etc. are used.

All of the listed methods of treating mycoplasmosis are auxiliary, since they can increase the effectiveness of antibiotics, increase their absorption and the depth of penetration into tissues. That is why both physiotherapy and the use of enzymes and immunostimulants are carried out before taking antibiotics.

The main course in the treatment of mycoplasmosis is the course of antibiotic therapy. Antibiotics must be taken orally in tablet form. In women, in addition to the systemic intake of antibiotics, local (vaginal) suppositories or tampons with various antibacterial or antiseptic substances are used. For the treatment of mycoplasmosis, it is necessary to take the following antibiotics for 1 to 2 weeks, depending on the severity of the inflammation of the genitourinary organs:

• Doxycycline - take 100 mg twice a day;


• Tetracycline - take 500 mg 4 times a day;


• Azithromycin - take 250 mg twice a day;


• Josamycin - take 500 mg 2-3 times a day;


• Clarithromycin - 500 mg twice daily


• Ofloxacin - take 200 mg twice a day;


• Spiramycin - take 3,000,000 IU 2-3 times a day.

Mycoplasmosis must be treated with only one antibiotic, since the simultaneous use of several drugs does not enhance the effectiveness of therapy. If necessary, any of the above antibiotics for the treatment of mycoplasmosis can be supplemented with Metronidazole. In order to prevent candidiasis during antibiotic therapy, antifungal drugs based on fluconazole (for example, Itraconazole, Fluconazole, Flucostat, etc.) should be taken. During the entire period of treatment, sexual intercourse should be excluded and alcoholic beverages should not be consumed.

In addition, during the period of antibiotic therapy, it is necessary to inject suppositories or tampons with active substances that have a detrimental effect on mycoplasmas into the vagina. Currently, the following are used as local remedies for the treatment of mycoplasmosis:

• Suppositories Betadine - insert into the vagina in the evening before going to bed for two weeks;


• Suppositories Iodoxide - injected into the vagina in the evening before going to bed for two weeks;


• Suppositories Iodovidone - injected into the vagina in the evening before going to bed for two weeks;


• Suppositories Iodosept - insert into the vagina in the evening before going to bed for two weeks;


• Suppositories Geksikon and Geksikon D - enter into the vagina in the evening before going to bed for two weeks;


• Suppositories

Mycoplasmosis is an insidious disease, as it can be asymptomatic for a long time. Symptoms of the disease appear only when it begins to progress. In this case, treatment can be difficult and time-consuming. The most effective therapeutic method in such a situation is the premiere of antibacterial drugs. With their help, it is possible to cleanse the body of pathogens. The main thing is to choose the right antibiotics for mycoplasmosis and follow the rules for their use.

When is the treatment of mycoplasmosis necessary?

Mycoplasma belongs to the category of opportunistic microorganisms. Normally, they can be present in the human body. Therefore, their identification in the course of analyzes is not a direct indication for the use of antibiotic therapy. It is necessary to start treatment as soon as possible in the following cases:

• If signs of inflammation appear.
• When the concentration of mycoplasma exceeds the established standards.
• If microorganisms are detected during pregnancy planning.
• In case of detection of mycoplasma genitalia. This species is considered the most pathogenic.
• When mycoplasma is detected in the body of a woman who consulted a doctor about infertility.

A specialist can prescribe antibiotic therapy only after a thorough examination. It is necessary to identify the specific type of pathogen in the course of laboratory tests. Only in this way will the treatment be effective.

Basic principles of treatment

The use of antibiotics should only be carried out under the supervision of the attending physician. Self-medication in such a situation threatens with serious health consequences. It is necessary to follow the basic rules of therapy:

• In the course of research, it was revealed that mycoplasma is most sensitive to antibiotics of the tetracyclines, macrolides and fluoroquinolones group. The use of such drugs will bring an early result.
• The use of antibiotics for mycoplasma is indicated for both sexual partners. This is the only way to cope with microorganisms.
• For the period of treatment, it is necessary to completely stop all sexual intercourse, including the use of a condom.
• When taking medications, the dosage prescribed by the doctor must be strictly observed. It is forbidden to correct it without permission.
• Antibiotics kill not only pathogenic, but also beneficial microflora. Therefore, you will have to take measures to restore normal microflora. For this, probiotics are used. The specific remedy should also be recommended by a specialist.

After the course of treatment is completed, you will need to undergo a second examination. Only laboratory tests will help make sure that the disease has been defeated.

Treatment with antibiotics of the tetracyclines group

Drugs in this group are prescribed if the disease proceeds without complications. Most often, doctors prescribe:

• Doxycycline. It is used to treat mycoplasmosis in adults and children over 9 years of age. During such therapy, prolonged exposure to the sun is not recommended, since during this period the skin can negatively react to the effects of ultraviolet radiation. When using doxycycline, it is necessary to have regular blood and urine tests. If the samples show an elevated level of nitrogen or urea, then the intake is stopped immediately. The therapy will also have to be noted when side effects appear: stomach colic, bouts of nausea and vomiting, swelling, skin rashes. Doxycycline is taken twice a day for two weeks. After that, it is necessary to pass tests to monitor the effectiveness of treatment.
• Tetracycline. Can be used as a tablet or ointment. External use of the product is allowed only in the early stages. Sometimes ointments are recommended for use during pregnancy. It is more often used in tablet form. Tetracycline should not be used if the cause of mycoplasmosis was the development of a fungal infection. In exceptional cases, there may be side effects from taking. These include: intestinal and stomach pain, inflammation of the mucous membrane of the mouth, diarrhea, decreased appetite, exacerbation of gastritis and some others. Today tetracycline belongs to the group of old generation antibiotics, therefore it is rarely used.

The specific dosage and duration of therapy is determined by the doctor. It is impossible to shorten or prolong the course of treatment on your own. This can provoke an exacerbation of the disease.

Therapy using the macrolide group

This group includes a large number of modern drugs. They have a wide spectrum of action, which makes them quite effective.

To combat mycoplasmosis, the following substances of this group are used:

• Azithromycin. The most popular on its basis is Summamed. The active substance has the ability to accumulate in the affected tissues, which prolongs the duration of the drug's action and increases its effectiveness. Available in capsule or tablet form. Azithromycin is rapidly absorbed. The maximum concentration in the blood is observed after 3 hours. It is allowed to take the drug no more than once every three days. Summamed is prohibited for use by pregnant women, as well as by those who suffer from kidney damage, arrhythmias or liver failure. In some cases, men and women can observe side effects drug, for example, bouts of nausea and diarrhea, flatulence, pain in the stomach, in such situations, the reception is stopped.
• Clarithromycin. This substance is part of the drug Klacid. Available in the form of capsules, tablets or powder for suspension. It is forbidden to use this remedy during pregnancy, with renal or hepatic insufficiency. Has a wide range of side effects such as headaches, hallucinations, dyspeptic disorders, hearing loss, skin rashes, thrombocytopenia and some others. The maximum duration of treatment is 14 days.
• Roxithromycin. Is the component of the drug Rulid. It is a modern antibiotic of semi-synthetic origin. The drug is of a new generation, so mycoplasma has not yet developed immunity to it. It is forbidden to take during pregnancy, with kidney and liver damage, as well as children under two months of age. Available in pill form. There were no cases of overdose by Rulid. Sometimes therapy can provoke bouts of nausea, itchy skin, pain in the abdomen, dizziness. This remedy is often used to treat mycoplasmosis in both women and men.
• Josamycin is the main component of Wilprafen. Copes quickly and effectively with all types of mycoplasma. The substance has natural origin... It quickly penetrates the cells of the body and accumulates in the affected tissues. Vilprafen is available in tablet form or as a suspension. Among the contraindications are: renal and hepatic failure, weight less than 10 kg. The course of treatment is 10 to 14 days.
• Midecamycin. This substance is part of the Macropen preparation. It is produced in the form of tablets or granules for the manufacture of a suspension. Take three times a day for a week. Midecamycin can provoke the development of side effects: diarrhea, decreased appetite, intestinal inflammation, allergic reactions. Contraindicated during breastfeeding, as well as in severe liver damage.

The use of the above antibiotics for mycoplasma shows good results. The main thing is not to exceed or underestimate the dosage recommended by a specialist.

The use of fluoroquinol antibiotics

When using drugs of this group, there is an accumulation of the active substance in the kidneys and genitals. Therefore, the prescribed dosages must be strictly adhered to.

Most often, experts use the following substances in the treatment of mycoplasmosis:

• Ciprofloxacin. This substance becomes the main components of the drug Tsiprobay, Tsiprolet and Tsiprinol. They have a wide spectrum of action, quickly cope with the causative agent of the disease. The treatment of ureaplasma in men is especially successful with their help. These funds are available in tablet form. It is recommended to take them on an empty stomach, since at this time the absorption reaches its maximum. Completely excreted from the body after a day. The dosage is selected based on the type of pathogen. The drug rarely causes side effects. In extreme cases, itching may appear, allergic rashes, insomnia. The drug is not approved for use during pregnancy, adolescence and childhood, as well as with serious kidney and liver damage. Experts do not advise taking ciprofloxacin at the same time as drugs designed to reduce gastric acidity.
• Pefloxacin. Completely absorbed 20 minutes after ingestion. Its maximum concentration is observed in a series of two hours. Has a therapeutic effect for 12 hours. Displayed naturally... Such a remedy is contraindicated in case of individual intolerance, epilepsy, anemia, pregnancy. It is not allowed to be used to treat children under 18 years of age.
• Ofloxacin. Allows you to achieve the effect already one hour after ingestion. It is recommended if treatment with other antibiotics has not helped to cope with mycoplasmosis. Ofloxacin is taken twice a day for 10 days. In special cases, the course is increased to 28 days. Every day it is necessary to maintain equal intervals of time between doses. Side effects from both male and female bodies are extremely rare. If, after using the drug, sleep disturbance, manifestation of an allergic reaction or headaches appear, then the therapy is stopped.
• Levofloxacin. Under its action, the synthesis of enzymes is blocked, which are necessary for the vital activity of pathogenic microorganisms. As a result, they not only lose their ability to reproduce, but completely die. You must carefully monitor the dosage of the drug. In case of an overdose, convulsions, nausea, dizziness, erosive changes in mucous surfaces appear. The use of levofloxacin in conjunction with non-steroidal anti-inflammatory drugs and antacids is not recommended. This remedy is contraindicated in case of individual intolerance, renal or hepatic failure, epilepsy, pregnancy. For the treatment of mycoplasmosis, it is used once a day for a week.
• Norfloxacin. It is quickly absorbed and effectively fights against the causative agent of mycoplasmosis. Contraindicated in renal and hepatic insufficiency, individual intolerance. Since studies have shown that the drug is more capable of negatively affecting the development of the joints of the fetus, it is prohibited to take it during pregnancy. May cause side effects: dyspeptic disorders, headaches, hallucinations, swelling, allergic manifestations, increased photosensitivity of the skin and others. For the treatment of mycoplasmosis, the drug is prescribed twice a day. The duration of the course is 10 days.

If the drug is selected correctly, and all dosages are observed, then the likelihood of a quick cure is high. The specialist should be guided not only by the type of pathogen and the neglect of the disease, but also by the individual characteristics of the patient's body.

Restoration of microflora after antibiotics

After the use of antibiotics in the body, not only pathogens, but also beneficial microorganisms die. This leads to indigestion and other health problems. Therefore, it is necessary to take special medications that fill the digestive tract with beneficial bacteria. They are divided into three main classes:

• Probiotics. They contain one or more strains of beneficial bacteria. Preparations with lactobacilli can be taken simultaneously with antibiotics. In pediatrics, drugs are more often used, which include bifidobacteria. The most effective probiotics are Lactobacterin, Sporbacterin, Enterol, Bifidumbacterin.
• Prebiotics. These are drugs, after taking which, a favorable environment for the active reproduction of beneficial microflora is created in the intestine. They include inulin, lactose or oligofructosaccharides. This group includes: Hilak Forte, Duphalac and others.
• Symbiotics. Combines the properties of probiotics and prebiotics. This group includes: Bifiform, Polibacterin and others.

Mycoplasmosis is a sexually transmitted disease that affects the functioning of the genitourinary system. Like most other STDs, the symptoms of mycoplasmosis are blurry and similar to the manifestations of other diseases, so if a person begins to feel any discomfort or inflammation of the urinary tract, a change in the smell of discharge or the appearance of unusual discharge, it is better to see a doctor immediately. All the necessary tests will be prescribed, then the doctor will choose an individual treatment regimen for each specific case. The latter is especially important in the fight against mycoplasma, which can be resistant to the effects of many drugs, be caused by various strains, and develop against the background of another more severe infection that weakened the immune system.

First of all, antibiotics are prescribed, however, as already mentioned, in order not to carry out an unsuccessful course of treatment with drugs to which the bacterium is resistant, preliminary tests are carried out. With antibiotic resistance, drugs from other groups may be prescribed. Treatment of mycoplasma with ofloxacin is used in this case, as well as if it has developed against the background of another fungal infection.

With mycoplasma, ofloxacin has a good antibacterial effect already in the first hours after administration, even if previous courses of treatment with sulfonamides and antibiotics were unsuccessful. Since this representative of fluorochilones has a half-life from the body not exceeding 7 hours, for successful treatment and maintaining its constant indicator in inflamed tissues, it is necessary to take 1 tablet of ofloxacin twice a day, trying to maintain the same time intervals between doses.

The standard course of treatment for mycoplasmosis with ofloxacin is 10 to 28 days, depending on the severity of the disease and when the symptoms indicating the presence of mycoplasma in the body began to disappear.

Usually, when treating mycoplasma with ofloxacin, side effects of the drug are not observed, however, in some cases, patients may complain of rash and itching of the skin, swelling of the face, nausea, sleep disturbances, vomiting, headache, abdominal pain, and in the analyzes the doctor can observe thrombocytopenia and agranulocytosis. Upon detection side effects, the course of therapy is adjusted by replacing the drug with other drugs.

Prevention of mycoplasmosis
Since any disease is much easier to prevent than to cure, it is worth worrying in advance about how to prevent it. How...

• IN 1 pill- 200 and 400 mg ofloxacin ... Corn starch, MCC, talc, magnesium stearate, aerosil, as auxiliary components.
• In 100 ml solution- 200 mg of active substance. Sodium chloride and water as auxiliary components.
• 1 g ointments- 0.3 g of active substance. Nipagin, petroleum jelly, nipazole, as auxiliary components.

Release form

• ointment in tubes of 3 g or 5 g;
• coated tablets of 200 and 400 mg;
• solution for infusion in bottles of 100 ml.

pharmachologic effect

Bactericidal, antimicrobial.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Is ofloxacin an antibiotic or not? This is not, but an antibacterial agent from the group fluorinated quinolones , which is not the same thing. It differs from antibiotics in structure and origin. Fluoroquinolones have no analogue in nature, and antibiotics are products of natural origin.

The bactericidal effect is associated with inhibition of DNA gyrase, which entails a violation of DNA synthesis and cell division, changes in the cell wall, cytoplasm and cell death. The inclusion of a fluorine atom in the quinoline molecule has changed the spectrum of antibacterial action - it has expanded significantly and also includes microorganisms that are resistant to antibiotics and strains that produce beta-lactamases.

Gram-positive and gram-negative microorganisms are sensitive to the drug, as well as chlamydia , ureaplasma , mycoplasma , gardnerella ... Suppresses the growth of mycobacteria. Does not work on Treponema pallidum... Microflora resistance develops slowly. A pronounced postantibiotic effect is characteristic.

Pharmacokinetics

Absorption after oral administration is good. Bioavailability 96%. A small part of the drug binds to proteins. The maximum concentration is determined after 1 hour. It is well distributed in tissues, organs and fluids, penetrates into cells. Significant concentrations are observed in saliva, sputum, lung, myocardium, intestinal mucosa, bones, tissue prostate, female genital organs, skin and fiber.

It penetrates well through all barriers and into the cerebrospinal fluid. Biotransformed in the liver about 5% of the dose. The half-life is 6-7 hours. With repeated administration, the cumulation is not expressed. It is excreted by the kidneys (80-90% of the dose) and a small part in the bile. With renal failure, T1 / 2 increases. With liver failure, excretion may also slow down.

Indications for use

• , pneumonia ;
• diseases of ENT organs (, sinusitis , otitis , );
• diseases of the kidneys and urinary tract (,);
• infections of the skin, soft tissues, bones;
• , salpingitis , parametritis , oophoritis , epididymitis , orchitis ;
• corneal ulcers blepharitis , barley , chlamydial eye lesions, prevention of infection after injuries and operations (for ointments).

Contraindications

• age under 18;
• hypersensitivity;
• or increased convulsive readiness after traumatic brain injury, cerebrovascular accident and other diseases of the central nervous system;
• previously noted tendon damage after ingestion fluoroquinolones ;
• peripheral neuropathy ;
• intolerance lactose ;
• age up to 1 year (for ointment).

It is prescribed with caution for organic diseases of the brain, myasthenia gravis , severe violations of liver and kidney function, hepatic porphyria , heart failure , paroxysmal ventricular, bradycardia , in old age.

Side effects

The most common adverse reactions are:

• nausea , decreased appetite;
• vomit ;
• , abdominal pain;

Less common and very rare side reactions:

• increased activity transaminase , cholestatic jaundice ;
• , hemorrhagic colitis , pseudomembranous colitis ;
• headache , ;
• anxiety, irritability;
• , intense dreams;
• anxiety, phobias;
• , convulsions;
• limb paresthesia , peripheral neuropathy;
• conjunctivitis ;
• noise in ears, hearing impairment ;
• violation of color perception, double vision;
• taste disturbances;
• tendonitis , myalgia , arthralgia , pain in the limbs;
• tendon rupture;
• palpitations hypertension ;
• , bronchospasm ;
• petechiae ;
• leukopenia , anemia , thrombocytopenia ;
• impaired renal function, dysuria , ;
• rash, itchy skin,;

Instructions for the use of Ofloxacin (Way and dosage)

Ofloxacin ointment, instructions for use

For the lower eyelid, 1-1.5 cm of ointment is laid 3 times a day. In the presence of chlamydial eye lesions - 5 times a day. Treatment is carried out for no more than 2 weeks. With the simultaneous use of several drugs, the ointment is used last.

Ofloxacin tablets, instructions for use

The tablets are taken orally, whole, before or during meals. The dose is selected depending on the severity of the infection, liver and kidney function. The usual dose is 200-600 mg per day, divided into 2 doses. For severe infections and overweight patients daily dose increases to 800 mg. At gonorrhea 400 mg is prescribed at one time, once, in the morning.

Children are prescribed for health reasons, if there is no replacement by other means. The daily dose is 7.5 mg per kg of body weight.

Patients with impaired renal function undergo a correction of the dosage regimen. In patients with severe hepatic dysfunction, the daily dose should be no more than 400 mg. The duration of treatment is determined by the severity of the disease. Treatment continues for another 3 days after the temperature has returned to normal or after laboratory tests confirming eradication of a microorganism ... Most often, the duration of the course of treatment is 7-10 days, with salmonellosis 7 days, with urinary tract infections up to 5 days. Treatment should not be more than 2 months. In the treatment of some diseases, Ofloxacin is first prescribed intravenously 2 times a day with a switch to oral administration.

Drops with active substance ofloxacin issued under the name, Floxal , Uniflox ... See the instructions for use of these drugs.

Overdose

It appears dizziness , lethargy , sleepiness , disorientation , convulsions , vomit ... Treatment consists in gastric lavage, forced diuresis and symptomatic therapy. With convulsive syndrome use Diazepam .

Interaction

Solutions for infusion: Oflo , Ofloxabol .

An analogue of Ofloxacin, produced in the form of an eye ointment - in the form of eye / ear drops - Dancil , Uniflox .

Reviews of Ofloxacin

Fluoroquinolones occupy a leading place among antimicrobial agents and are considered as an alternative to highly active antibiotics in the treatment of severe infections. Currently, the monofluorinated representative of the II generation has not lost its leading position - ofloxacin .

The advantage of this drug over other fluoroquinolones is its very high bioavailability, as well as slowly and rarely developing resistance to it of microorganisms.

Given the high activity against STI pathogens, this drug is widely used in dermatovenerology in the treatment of STIs: urogenital chlamydia , gonorrhea , gonorrheal-chlamydial, mycoplasma and ureaplasma infections. Chlamydia eradication is observed in 81-100% of cases and is considered the most effective of all fluoroquinolones. This is evidenced by the reviews of Ofloxacin:

• « ... I took this drug, treated mycoplasma and ureaplasma. Effectively»;
• « ... It helped me, I drank with cystitis, there are no side effects. The drug is inexpensive and effective».

A wide spectrum of action, good penetration into the tissues of the genital organs, urinary system, prostate secretion, long-term preservation of concentrations in the focus leads to its use in urological and gynecological diseases. So, there are reviews that taking this drug for 3 days has shown high efficiency in recurrent cystitis in women. It was prescribed for prophylactic purposes after diathermocoagulation of cervical erosions after administration, after, it was successfully used for, epididymitis .

Not being an antibiotic, it does not affect the vaginal and intestinal flora, does not cause. According to patient reports, this agent is poorly tolerated. Most often, side effects from the gastrointestinal tract were noted, less often from the central nervous system and skin-allergic reactions, very rarely - transient changes in liver test indicators. The drug does not have hepato-, nephro- and ototoxic effects.

• « ... there was nausea, my stomach was seething, there was no appetite»;
• « ... I felt very sick, could not eat anything, but I finished the course of treatment»;
• « … After taking it, insomnia appeared. I suspect that from the drug, since I slept well before»;
• « ... it was hot and cold sweat, there was a panic fear».

Many patients with conjunctivitis , blepharitis and keratitis appointed eye drops with active substance ofloxacin (Uniflox , Dancil ), reviews of which are positive. Patients used them 4-5 times a day at blepharitis and conjunctivitis and noted significant improvement within 2-3 days. Due to the high bioavailability of the active substance, drops can be used for deeper lesions - uveitis , sclerites and .

Ofloxacin price where to buy

You can buy the drug at any pharmacy. The cost depends on the manufacturer. The price of Ofloxacin in tablets of 200 mg of Russian production (Ozone, Makiz Pharma, JSC Sintez) ranges from 26 rubles. up to 30 rubles. for 10 tablets, and the cost of 400 mg tablets No. 10 is from 53 to 59 rubles. Ofloxacin Teva, produced only in 200 mg tablets, is more expensive - 163-180 rubles. Eye ointment (Kurgan JSC Sintez) costs from 38 to 64 rubles. in different pharmacies.

The price of Ofloxacin in Ukraine is 11-14 UAH. (tablets), 35-40 UAH (solution for infusion).

• Online pharmacies in Russia Russia
• Online pharmacies of Ukraine Ukraine
• Internet pharmacies in Kazakhstan Kazakhstan

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