Oral administration: Amoxicillin, Azithromycin, Roxithromycin, Norfloxacin, Oxytetracycline, etc. External use: erythromycin ointment (eye ointment), chlortetracycline eye ointment, Baiduobang, etc.
1, penicillin
Commonly used are penicillin G, penicillin V, methicillin (Xinqing I), ampicillin (ampicillin), amoxicillin (amoxicillin), ticarcillin (carboxythiophene penicillin), piperacillin (piperacillin) and so on. Suitable for respiratory tract, skin and soft tissue, urogenital tract infection, etc. The main advantages of penicillins are strong bactericidal action, less toxic and side effects, safer use for pregnant women and children, and no influence on liver function. However, it should be noted that the main adverse reactions are allergic reactions, including allergic dermatitis. Serum sickness, rash, contact dermatitis, etc. Use with caution in patients with severe renal insufficiency.
2. Aminoglycosides
Aminoglycosides are broad-spectrum antibiotics, which have a good bactericidal effect on gram-negative bacilli and are suitable for lower respiratory tract, urinary tract and intestinal infections. Different varieties have different characteristics. Gentamicin, tobramycin, netilmicin and amikacin are commonly used varieties, among which netilmicin has strong antibacterial activity and low otonephrotoxicity. Streptomycin is now mainly used to treat tuberculosis. Spectinomycin (Spectinomycin) can be used to treat gonorrhea. Neomycin is only used for oral administration and topical application because of its high ototoxicity. The main adverse reactions of aminoglycosides are allergic reaction, ototoxicity (which can cause deafness), nephrotoxicity and neurotoxicity. Those who are allergic to this kind of drugs are forbidden, and those with renal insufficiency, the elderly and pregnant women should use it with caution.
3. Cephalosporin antibiotics; Cephalosporin family antibiotics
Can be divided into four generations. Cefazolin (Pioneer 5) and cefradine (Pioneer 6) are the first generation cephalosporins, and cefalexin (Pioneer 4), cefradine (Pioneer 6) and cefadroxil are taken orally. Suitable for respiratory tract, skin and soft tissue, urogenital tract infection, etc.
Compared with the first generation, the second generation cephalosporins have wider antibacterial spectrum, stronger antibacterial effect and lower nephrotoxicity. Use cefuroxime, cefamandole, cefoxitin and cefmetazole, and take cefuroxime axetil and cefmetazole orally.
The third generation cephalosporins have the characteristics of broad antibacterial spectrum, strong antibacterial activity, wide distribution in the body and low toxicity to human body. Cefotaxime, ceftazidime, ceftriaxone, cefoperazone, ceftizoxime and cefodizime were used, and cefixime was taken orally. Cefpodoxime axetil, cefteram axetil, cefetamet axetil, etc. Can be used for respiratory tract, skin and soft tissue, urogenital system, gastrointestinal tract infection and septicemia.
The fourth generation cephalosporins are superior to the first three generations because of their special mode of action and extensive antibacterial spectrum. Because there is little possibility of cross-allergy with penicillin, it can be used for patients who are allergic to penicillin. At present, the useful cefepime and pilocarpine have been on the market.
Cephalosporins have the advantages of broad antibacterial spectrum, strong antibacterial effect, low toxicity and less allergic reaction than penicillin, but they are more expensive. Cross-allergic reaction may occur to penicillin, so those with a history of penicillin allergy should use it with caution. The application of the third and fourth generation cephalosporins can kill normal beneficial bacteria in the body, which is easy to lead to flora imbalance and double infection, which should be paid attention to. In addition, there are many β -lactamase inhibitors, such as sulbactam, clavulanic acid, penicillin and cephalosporins, such as amoxicillin/clavulanic acid, ticarcillin/clavulanic acid, ampicillin/sulbactam, amoxicillin/sulbactam and so on. The combination of them can enhance the antibacterial effect and expand the antibacterial spectrum.