In itself, the detection of mycoplasma in a patient is not a reason for treatment, therefore, sumamed for mycoplasmosis, like other broad-spectrum antibiotics, is prescribed only if diseases such as pyelonephritis, inflammation of the appendages and uterus, gardnerellosis, urethritis and other causes that lie in the pathogenic microflora in the form of this bacterium. Of course, mycoplasma does not always lead to the occurrence of such diseases, but such a possibility should not be dismissed.

Treatment of mycoplasma with sumamed, today, is one of the most common methods of therapy for this microflora. This drug is attributed to a subgroup of macrolide antibiotics, a feature of which is the provision of a bactericidal action when a high concentration accumulates in inflamed tissues.

Sumamed can be produced in five different forms - in tablets of 500 and 125 mg, 1 type in capsules of 250 mg and 2 types in vials of 100 and 200 mg. In the treatment of mycoplasmosis, all forms of release are used, depending on the degree of development of the disease, the sex and weight of the patient.

After taking the tablets, the active ingredient is rapidly absorbed in the gastrointestinal tract and enters the bloodstream, where its maximum concentration is reached by the end of the third hour after taking the drug. Then the quantitative indicator of sumamed in the blood decreases, being absorbed in the tissues and cells of the body. Due to its composition, the concentration of the antibiotic at the location of the mycoplasma, where the tissues are inflamed, exceeds the same indicator in healthy organs by 1/4. The absorbed drug accumulates in the tissues for five days, so therapeutic courses are prescribed no more than once every 3 days.

Sumamed is not prescribed for mycoplasma if the type of mycoplasma is immune to erythromycin or the patient has serious damage to the kidneys, liver, cardiac arrhythmia, the patient is a nursing mother, a pregnant woman.

If sumamed with mycoplasmosis is taken together with other antacid drugs, then a minimum break of 2 hours should be taken between the drugs. The same period of time is maintained between taking the medicine and eating.

Long-term use of the drug can lead to side effects such as abdominal pain, diarrhea, nausea, flatulence or vomiting, in some cases skin rashes may be recorded. In case of side effects, it is necessary to consult a doctor for correction of the treatment regimen.

» Study of the effectiveness of complex therapy in patients with urogenital chlamydia, mycoplasmosis and ureaplasmosis using Sumamed

Study of the effectiveness of complex therapy in patients with urogenital chlamydia, mycoplasmosis and ureaplasmosis using Sumamed

The positive experience of using complex therapy with the use of the antibiotic of the macrolide group SUMAMED in 129 patients with urogenital chlamydia, mycoplasmosis and ureaplasmosis was shown. High efficiency (91.1-97.0%) and good tolerability of the drug in patients were noted.

INTRODUCTION

Currently, among sexually transmitted diseases, mixed sexual infections caused by chlamydia, ureaplasmas, mycoplasmas, anaerobic opportunistic microorganisms, Trichomonas and viruses are of the greatest interest.

In most countries of the world, these diseases are on the rise, especially among young people who have just entered the period of sexual activity. The resulting disease can adversely affect both their health and the health of their offspring. The slow development of the symptoms of the disease, often the complete absence of severe symptoms, leads to a belated visit to the doctor, or to an accidental diagnosis. The features of the course of these diseases include the absence of any specific manifestations and severe clinical symptoms.

The mechanism of pathogenesis of urogenital ureaplasmosis and mycoplasmosis is similar and has not been fully elucidated.

That is why the optimal therapy for chlamydia, ureaplasmosis and mycoplasmosis must meet the following requirements: antibacterial agent should have the highest degree of penetration into the cell; the duration of antibiotic therapy should not be less than 3 life cycles microorganism.

3. Depending on the clinical form, localization of lesions, severity of the process, the following ways to increase the effectiveness of antibiotic therapy are used: changing the route of administration and dosage form drug; the appointment of agents that increase the permeability of cellular and tissue barriers and enhance the penetration of the drug into the affected organs (enzymes, systemic polyenzymes, vasoactive drugs).

One of the most important factors of treatment is the impact on the immune system by interferon inducers and the nonspecific resistance of the body by biogenic stimulants and vitamins. The success of chlamydia treatment also depends on the detection and simultaneous treatment of concomitant urogenital infections (trichomoniasis, gardnerellosis, candidiasis, etc.), examination and simultaneous treatment of all sexual partners. The criterion for the effectiveness of treatment is resolution clinical symptoms diseases and elimination of microorganisms from the body. Control of cure (monitoring studies) is carried out no earlier than 4-6 weeks after the end of antibiotics.

When interpreting the results of all methods for detecting chlamydial antigen, it should be borne in mind that non-viable forms of microorganisms are cytologically indistinguishable from viable ones and can give false-positive results when staining preparations according to Romanovsky-Giemsa, with immunofluorescent, enzyme immunoassay molecular methods of research; the average time for the elimination of "fragments" of microorganisms from cells and tissues is 4-6 weeks; a decrease in the titer of anti-chlamydial antibodies by 4 or more times is considered diagnostic and prognostically significant; in some cases, "immune memory" of previously transferred chlamydia, manifested by low titers of anti-chlamydial antibodies, can persist for a long time (months, years) and does not require active treatment tactics.

Clinical picture chronic mixed sexual infection is usually characterized by a latent course. The pathological process remains unrecognized for a long time, and belated treatment is often ineffective. That is why, despite the increase in antibacterial drugs, claiming to be the most effective remedy in the treatment of chlamydia, mycoplasmosis and ureaplasmosis, the problem of a guaranteed cure for these diseases remains relevant.

The gold standard for the treatment of intracellular infections in the world are macrolides, which do not have allergic cross-reactions with antibiotics containing ?-lactam ring, which allows them to be used in people allergic to penicillin, cephalosporins and other drugs. The low toxicity of macrolides allows the use of some of them in diseases of the liver and kidneys in men. Even with prolonged use of macrolides, there are rare cases of intestinal dysbacteriosis.

One such drug for the treatment of urogenital chlamydia, mycoplasmosis and ureaplasmosis is azithromycin.

Pharmacodynamics. Azithromycin is a representative of a new subgroup of macrolide antibiotics - azalides. It binds to the 50S subunit of the 70S ribosome of sensitive microorganisms, inhibiting RNA-dependent protein synthesis, slows down the growth and reproduction of bacteria, and at high concentrations a bactericidal effect is possible.
It has a wide spectrum of antimicrobial activity. Gram-positive coci are sensitive to the drug - Streptococcus pneumoniae, S.pyogenes, S.agalactiae, streptococci of groups C, F and G, S.viridans; Staphylococcus aureus; gram-negative bacteria - Haemophilus influenzae, H.parainfluenzae, Moraxella catarrhalis, Bordatella pertussis, B.parapertussis, Legionella pneumophila, H.ducrei, Campylobacter jejuni, Neisseria gonorrhoeae, Gardnerella vaginalis; some anaerobic microorganisms - Bacteroides bivius, Clostridium perfringens, Peptostreptococcus species, as well as Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi. Does not affect gram-positive microorganisms resistant to erythromycin.

Pharmacokinetics. After oral administration, Azithromycin is rapidly absorbed from the alimentary canal. Bioavailability is approximately 37% (first pass effect). The maximum concentration in blood serum is reached after 2.5-3 hours and is 0.4 mg / l when 500 mg of azithromycin is taken orally. The drug penetrates well into the respiratory tract, organs and tissues of the urogenital tract, in particular into the prostate gland, into the skin and soft tissues. The concentration of the drug in tissues and cells is 10-100 times higher than in blood serum. A stable plasma level is reached after 5-7 days. The drug accumulates in large quantities in phagocytes, transporting it to sites of infection and inflammation, where it is gradually released during phagocytosis.

It binds to proteins in inverse proportion to the concentration in the blood (7-50% of the drug). About 35% is metabolized in the liver by demethylation, losing activity. More than 50% of the dose is excreted unchanged in the bile, approximately 4.5% - in the urine for 72 hours.

The plasma half-life is 14-20 hours (in the range of 8-24 hours after taking the drug) and 41 hours (in the range of 24-72 hours). Food intake significantly changes the pharmacokinetics. With age, the parameters of pharmacokinetics do not change in men (65-85 years), in women, Cmax increases by 30-50%.

Dosage and administration. Azithromycin for chronic inflammatory diseases genital organs in men and women are taken once a day, one hour before meals or 2 hours after meals, 1 g (4 tablets), and then 500 mg (2 tablets) No. 4 with an interval of 4 days. Total for the course - 3000 mg.

Side effect. Azithromycin rarely causes adverse reactions. Possible complications from the digestive canal (bloating, nausea, vomiting, diarrhea, abdominal pain). In most cases, undesirable effects are mild and do not require discontinuation of the drug. Perhaps a transient, moderate increase in the activity of liver enzymes, neutropenia, rarely - neutrophilia and eosinophilia, cholestatic jaundice, chest pain, palpitations. Sometimes drowsiness, nephritis, vaginitis, candidiasis, desensitization are possible, in children - nervousness, insomnia, conjunctivitis. After 2-3 weeks after stopping treatment, the changed parameters return to normal. Skin reactions (rash) are very rare.

Contraindications. The drug is contraindicated in case of hypersensitivity to macrolide antibiotics; with severe violations of liver function, during pregnancy and lactation (for the duration of treatment, breastfeeding is suspended).

Application features. Due to the peculiarities of the pharmacokinetics of the drug, with the indicated indications for use, there is no need to use the drug for a longer time than indicated in the instructions. For the elderly, there is no need to change the dose. It is not recommended to prescribe the drug during pregnancy and lactation. Azithromycin should be used with caution in patients with severe impairment of the excretory function of the kidneys and liver, with cardiac arrhythmias (ventricular arrhythmias and prolongation of the QT interval are possible). After discontinuation of the drug in some patients, hypersensitivity reactions may persist, which requires specific therapy under the supervision of a physician. With a slight impairment of kidney function (creatinine clearance more than 40 ml / min), there is no need for dose adjustment.

Interaction with other drugs. Antacids slow down the absorption of Azithromycin, so it is necessary to take drugs at least 2 hours apart.
There was no interaction of the drug with theophylline, oral anticoagulants, carbamazepine, phenytoin, triazolam, digoxin, ergotamine, cyclosporine.

MATERIALS AND METHODS

In the clinic of sexopathology and andrology of the Institute of Urology of the Academy of Medical Sciences of Ukraine, 139 patients with chlamydial ureaplasma and mycoplasma infection aged 22 to 43 years with a disease duration of 1 to 10 years were under observation. 63 patients had an acute uncomplicated process with a disease duration of up to 3 months, of which monoinfection was diagnosed in 30 (47.6%) and mixed infection (chlamydia + ureaplasmosis; chlamydia + mycoplasmosis; ureaplasmosis + mycoplasmosis; chlamydia + ureaplasmosis + mycoplasmosis) - in 33 (52.4%). In 66 patients, a chronic complicated genitourinary infection was observed (disease duration from 3 months to 10 years), of which monoinfection was diagnosed in 32 (48.5%) and mixed infection in 34 (51.5%). Laboratory diagnostics chlamydia was carried out using direct immunofluorescence (DIF) and polymerase chain reaction (PCR).

In acute uncomplicated forms of mixed infection, SUMAMED was administered orally once a day, one hour before meals or 2 hours after meals, 1 g (4 tablets), and then 500 mg (2 tablets) No. 4 with an interval of 4 days. Total for the course - 3000 mg.

The treatment of the chronic process, including mixed infections, was carried out by a complex pathogenetic one. As etiotropic agents, SUMAMED was used orally once a day, one hour before meals or 2 hours after meals, 1 g (4 tablets), and then 500 mg (2 tablets) No. 4 with an interval of 4 days. Total for the course - 3000 mg. The total duration of the course of treatment was 20-30 days. In order to correct the immune status and improve the penetration of the antibiotic, immunomodulators were prescribed. Patients also received symptomatic treatment, physiotherapy (endourethral electrical stimulation, laser and magnetic therapy, vibroacoustic therapy), antifungal drugs, and vitamins.

RESULTS

As a result of treatment of patients with chlamydia, ureaplasma or mycoplasma monoinfection with sharp course on the basis of clinical examination data revealed: recovery in 28 (93.3%) of 30 patients; improvement - in 2 patients (6.7%); no change - 0 (0%). At chronic the course of the disease - recovery - in 30 (90.9%) of 33 patients; improvement - in 2 (6.1%); no change — in 1 (3.0%). In the presence of mixed infection in acute course, the following results were revealed: recovery in 31 (93.9%) of 33 patients; improvement - in 2 (6.1%); no change - 0 (0%). In chronic course - respectively: 30 (88.2%) of 34 patients; 3 (8.8%); 1 (3.0%).

As can be seen from the above data, the results of the treatment of chlamydial-ureaplasma-mycoplasmal infection using complex therapy with the use of SUMAMEDA are very positive. In an acute uncomplicated variant of the course of the process, both in the presence of monoinfection and mixed infection, a positive clinical effect was achieved in almost all cases (complete recovery + improvement) in one course of complex treatment. In a chronic complicated course in the presence of monoinfection, in one course of therapy, a positive clinical effect was achieved in the absolute majority of cases - 97% (recovery + improvement), and in case of mixed infection - in 97%.

Data from a PCR study as a result of treatment of patients with chlamydial, ureaplasma or mycoplasma monoinfection at sharp course: recovery in 29 (96.7%) of 30 patients; no change - 1 (3.7%). At chronic the course of the disease - respectively - 32 (97.0%) of 33 patients; and 1 (3.0%). In the presence of mixed infections at sharp The course revealed the following results by the PCR method: recovery in 30 (93.8%) of 32 patients; no change - in 2 (6.2%). At chronic course - respectively: 31 (91.1%) of 34 patients; and 3 (8.9%) (Figure 1).

Figure 1. Data from a study of the effectiveness of the treatment of patients with chlamydial ureaplasma and / or mycoplasma infection by the PCR method (recovery in %).

According to the ELISA method (determination of antibodies to chlamydia), the results of the study of the effectiveness of treatment also corresponded to the data of the PCR method. In the presence of monoinfection with sharp course: recovery in 28 (93.3%) of 30 patients; decrease in antibody titer - 2 (6.7%); high antibody titers - 0 (0%). At chronic the course of the disease - respectively - 29 (85.4%) of 33 patients; decrease in antibody titer - 2 (5.6%); high antibody titers - 2 (5.6%) (Figure 2).

Figure 2. Data from a study of the effectiveness of treatment of patients with chlamydial ureaplasma and/or mycoplasma monoinfection by the ELISA method (in %).

At the presence of mixed infection at sharp the course revealed the following results by the ELISA method: recovery in 30 (93.8%) of 32 patients; decrease in antibody titer - 2 (6.2%); high antibody titers - in 0 (0%). At chronic course - respectively: 29 (85.3%) of 34 patients; decrease in antibody titer - 3 (8.8%); high antibody titers - in 2 (5.9%) (Figure 3).

Figure 3. Data from a study of the effectiveness of treatment of patients with chlamydial ureaplasma and / or mycoplasma mixed infection by the ELISA method (in %).

During the entire course of treatment, the drugs were relatively well tolerated. 7 out of 129 (5.4%) patients had minor side effects in the form of gastric discomfort, headache, sleep disturbances.

CONCLUSIONS

1. Results clinical research complex therapy with the use of SUMAMEDA showed a sufficiently high efficiency in the treatment of patients with both monoinfection and mixed chlamydial-ureaplasma-mycoplasmal infection (91.1-97.0%) after one course of therapy.

2. SUMAMED in complex treatment well tolerated by patients. Only 5.4% of patients had minor side effects.

3. SUMAMED meets all the requirements for modern therapy of genitourinary intracellular infections, which allows us to recommend it for complex therapy of intracellular sexually transmitted infections.

LITERATURE

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Mycoplasmosis - insidious disease because 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 long. The most effective therapeutic method in such a situation is the use of antibacterial drugs. With their help, it is possible to cleanse the body of pathogens. The main thing is to choose the appropriate antibiotics for mycoplasmosis and follow the rules for their use.

In what cases is the treatment of mycoplasmosis necessary?

Mycoplasma belong to the category of opportunistic pathogens. Normally, they can be present in the human body. Therefore, their detection 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 there are signs of inflammation.
• When the concentration of mycoplasma exceeds the established standards.
• If microorganisms are detected during pregnancy planning.
• In case of detection of mycoplasma genitalium. This species is considered the most pathogenic.
• When detecting mycoplasma in the body of a woman who went to the doctor about infertility.

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

Basic principles of treatment

The use of antibiotics should be carried out only 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 found that mycoplasma is most sensitive to antibiotics of the group of tetracyclines, macrolides and fluoroquinolones. The use of such drugs will bring the fastest result.
• The use of antibiotics for mycoplasma is indicated for both sexual partners. Only in this way will it be possible to cope with microorganisms.
• For the period of treatment, it is necessary to completely stop all sexual intercourse, including using a condom.
• When taking drugs, you must strictly follow the dosage prescribed by your doctor. Unauthorized adjustment is prohibited.
• Antibiotics kill not only pathogenic, but also beneficial microflora. Therefore, measures must be taken to restore normal microflora. For this, probiotics are used. A 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 research help to make sure that the disease is defeated.

Treatment with tetracycline antibiotics

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

• Doxycycline. It is used to treat adults and children over 9 years of age from mycoplasmosis. During such therapy, prolonged exposure to the sun is not recommended, since during this period the skin may react negatively to exposure to ultraviolet radiation. Using doxycycline, it is necessary to regularly take blood and urine tests. If the samples show elevated level nitrogen or urea, then the reception is immediately stopped. It will be necessary to note the therapy if side effects appear: stomach cramps, bouts of nausea and vomiting, swelling, skin rashes. Doxycycline is taken twice a day for two weeks. After that, it is necessary to take tests to monitor the effectiveness of treatment.
• Tetracycline. Can be used as tablets or ointment. External use of the product is allowed only on early stages. Sometimes ointments are recommended for use during pregnancy. Most commonly used in tablet form. Tetracycline should not be used if the cause of mycoplasmosis was the development of a fungal infection. In exceptional cases, the manifestation of side effects from the reception is possible. These include: intestinal and stomach pain, inflammation of the oral mucosa, diarrhea, loss of appetite, exacerbation of gastritis and some others. Today, tetracycline belongs to the group of antibiotics of the old generation, so they are used quite rarely.

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

Therapy using a group of macrolides

This group includes a large number of modern drugs. They have a wide spectrum of action, due to which they are 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 and increases its effectiveness. Available in the form of capsules or tablets. 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 those who suffer from kidney damage, arrhythmia or liver failure. In some cases, men and women may experience side effects drug, for example, attacks of nausea and diarrhea, flatulence, pain in the abdomen, 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. It has a wide list 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 components of the drug Rulid. This is a modern antibiotic of semi-synthetic origin. The drug is a new generation, so the mycoplasma has not yet developed immunity to it. It is forbidden to take during pregnancy, with damage to the kidneys and liver, as well as children under two months. Produced in the form of tablets. There were no cases of overdose with Rulid. Sometimes therapy can provoke attacks of nausea, itching, pain in the abdomen, dizziness. This remedy is often used to treat mycoplasmosis in both women and men.
• Josamycin is the main component of Vilprafen. Quickly and effectively copes with all types of mycoplasma. The substance is of natural origin. It quickly penetrates into 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 insufficiency, weight less than 10 kg. The course of treatment is from 10 to 14 days.
• Midecamycin. This substance is part of the drug Macropen. Available in the form of tablets or granules for the manufacture of suspensions. Take three times a day for a week. Midecamycin can provoke the development of side effects: diarrhea, loss of appetite, intestinal inflammation, allergic reactions. Contraindicated during breastfeeding, as well as with serious liver damage.

The use of the above antibiotics from mycoplasma shows a good result. 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 dosage must be strictly adhered to.

Most often, specialists 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 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, allergic rashes, and insomnia may occur. The drug is not approved for use during pregnancy, in adolescence and childhood, as well as with serious damage to the kidneys and liver. Experts do not advise taking ciprofloxacin at the same time as drugs designed to reduce stomach acid.
• Pefloxacin. Completely absorbed 20 minutes after ingestion. Its maximum concentration is observed after two hours. It has a therapeutic effect for 12 hours. It comes out naturally. Such a remedy is contraindicated in case of individual intolerance, epilepsy, anemia, pregnancy. It is not allowed to use it for the treatment of children under 18 years of age.
• Ofloxacin. Allows you to achieve the effect already an hour after taking. 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 increases to 28 days. Every day it is necessary to maintain the same intervals between doses. Side effects on the part of both the male and the female body are observed extremely rarely. If after using the drug there is a sleep disturbance, an allergic reaction or headaches, then the therapy is stopped.
• Levofloxacin. Under its action, there is a blocking of the synthesis of enzymes that are necessary for the vital activity of pathogenic microorganisms. As a result, they not only lose their ability to reproduce, but completely die. It is necessary to carefully monitor the dosage of the drug. With an overdose, convulsions, nausea, dizziness, erosive changes in the 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 insufficiency, epilepsy, pregnancy. For the treatment of mycoplasmosis, it is used once a day for a week.
• Norfloxacin. It is quickly absorbed and effectively fights 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 forbidden to take it during pregnancy. May cause side effects: dyspeptic disorders, headaches, hallucinations, swelling, allergic manifestations, increased skin photosensitivity 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 chosen correctly, and all dosages are observed, then the probability of a quick cure is high. The specialist should focus not only on the type of pathogen and the neglect of the disease, but also on the individual characteristics of the patient's body.

Recovery 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 preparations that will 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, agents that contain bifidobacteria are more often used. The most effective probiotics are Lactobacterin, Sporbacterin, Enterol, Bifidumbacterin.
• Prebiotics. These are drugs, after taking which, a favorable environment is created in the intestine for the active reproduction of beneficial microflora. They include inulin, lactose or oligofructosaccharides. This group includes: Hilak forte, Dufalac and others.
• Symbiotics. Combine the properties of probiotics and prebiotics. This group includes: Bifiform, Polibakterin and others.

Mycoplasma pneumonia requires an integrated approach to the elimination of pathogens. Treatment of atypical pneumonia depends entirely on the results of the diagnosis, the presence of chronic diseases and the general condition of the patient.

• At the first stage, antibacterial drugs are prescribed to destroy the mycoplasma infection. The most commonly used antibiotics are tetracyclines. To determine the most appropriate drug, sputum culture for sensitivity to antibiotics is indicated.
• At the second stage, expectorants are prescribed to patients to thin and accelerate sputum discharge, that is, to improve the drainage function of the bronchi. Also, to eliminate painful symptoms, anti-inflammatory and antihistamines are prescribed.
• To speed up recovery, it is recommended to take general strengthening and fortified preparations. They increase the protective properties immune system. Detoxification therapy is recommended, that is, drinking plenty of water to remove the metabolic products of viruses and bacteria. In especially severe cases, specific immunopreparations are prescribed.

To improve the patient's condition, special physiotherapy is prescribed: breathing exercises, vacuum massage, physical education, mustard plasters, compresses. There are also non-traditional methods of treatment using medicinal herbs. An integrated approach to treatment allows you to eliminate the disease without serious complications.

Mycoplasma pneumonia treatment regimens

After the diagnosis, the doctor evaluates the results and draws up a treatment plan. Treatment regimens for mycoplasma pneumonia depend on the neglect and severity of the disease state, the characteristics of the patient's body and the presence of comorbidities.

The disease requires etiotropic treatment. To eliminate mycoplasmosis, antibiotics from the group of macrolides, fluoroquinolones, tetracyclines are used, both for oral and intramuscular injection. The course of treatment averages 10-14 days.

Patients may be prescribed the following drugs:

• Azithromycin 250 mg once a day.
• Clarithromycin 500 mg 1-2 times a day.
• Erythromycin 500 mg 3-4 times a day.
• Levofloxacin 500 mg once a day.
• Doxycycline 100 mg 1-2 times a day.

The treatment regimen for severe atypical inflammation consists of cephalosporin antibiotics and Levofloxacin.

Determination of sensitivity to antibiotics

When choosing medicines for elimination of Mycoplasma pneumoniae definition of sensitivity to antibiotics is shown. At the initial stage, bacterial culture is carried out to determine the type of pathogen and its concentration in the body. This method has a high specificity with the ability to study any biological fluid.

For bacteriological culture, sputum, mucus from the nose and throat are used. The collected material is placed in special media for deciphering bacterial cultures. If necessary, microscopy of the obtained material can be carried out with coloring, assessment of the shape, color and density of bacterial colonies.

After the pathogen is established, its sensitivity to antibiotics is determined using intradermal tests, mucus from the nasopharynx, blood, and exudate discharged during coughing. The resulting antibiogram takes into account the resistance of bacteria, that is, resistance to the pathogen. Thanks to this, you can choose the most suitable drug for treatment and its dosage.

Medications

Drug therapy for Mycoplasma pneumonia is carried out from the first days of the disease. Medicines are selected by the doctor, individually for each patient. Treatment consists of taking the following groups of drugs:

Antibiotics

1. Azithromycin

A broad-spectrum antibacterial agent from the group of macrolides. Getting into the foci of inflammation creates high concentrations, providing a bactericidal effect.

• Indications for use: infections of the upper and lower respiratory tract and ENT organs, scarlet fever, infections of the skin and soft tissues, infections of the genitourinary system, Lyme disease.
• Method of application: on the first day of therapy 500 mg, on the second day 250 mg, and from the third to the fifth, 500 mg per day. The course dose, as well as the duration of treatment, is determined by the doctor for each patient individually.
• Side effects: nausea, abdominal pain, vomiting, increased gas formation, increased activity of liver enzymes, allergic skin rashes.
• Contraindications: intolerance to the components of the drug, severe impairment of kidney and liver function, pregnancy and lactation. With extreme caution is prescribed for patients with a history of allergic reactions.

The drug is available in the form of tablets, capsules and syrup in vials.

1. Clarithromycin

Macrolide, a semi-synthetic derivative of erythromycin. It has an extended spectrum of antibacterial action, with the creation of maximum concentrations in the lesions.

• Indications for use: pneumonia (including atypical forms), sinusitis, pharyngitis, bronchitis, tonsillitis, folliculitis, streptoderma, erysipelas, dental infections, local and widespread mycobacterial infections.
• Method of application: 250 mg twice a day. In especially severe cases, the dosage may be increased. The drug is taken regardless of food, washed down with water. The duration of therapy is 5-14 days.
• Side effects: pain in the epigastric region, nausea and vomiting, changes in taste sensations, fungal lesions of the mucous membrane oral cavity. Headaches and dizziness, increased anxiety, disorders from the side are also possible. of cardio-vascular system skin allergic reactions.
• Contraindications: hypersensitivity to the components of the drug, the age of patients under 12 years of age, the first trimester of pregnancy and lactation.
• Overdose: nausea, vomiting, diarrhea. For treatment recommended gastric lavage and further symptomatic therapy.

The drug is available in tablet form with an enteric coating of 250 and 500 mg.

1. Spiramycin

Macrolide antibiotic with bacteriostatic properties. The destruction of pathogenic microorganisms occurs due to the inhibition of intracellular protein synthesis. The drug is active against Mycoplasma pneumoniae, but is resistant to Pseudomonas, Enterobacteriaceae spiramycin.

• Indications for use: atypical pneumonia (associated with legionella, mycoplasma, chlamydial infection), pharyngitis, bronchitis, toxoplasmosis, skin and soft tissue infections, tonsillitis, arthritis, urethritis, otitis media, diseases of the upper respiratory tract and gynecological infections.
• The method of application and dosage are set individually for each patient. The duration of treatment is 10-14 days, the prophylactic course is 5 days.
• Side effects: skin rashes, ulceration of the gastrointestinal mucosa, nausea and vomiting, diarrhea, transient paresthesia, angioedema, thrombocytopenia. An overdose is manifested by an increase in the above reactions. There is no antidote, treatment is symptomatic.
• Contraindications: hypersensitivity to drug components, pediatric practice, pregnancy and lactation, G6PD deficiency. With special care is prescribed for liver failure and obstruction of the biliary tract.

Available in tablets, 10 capsules per pack.

If the disease is mild, then oral antibacterial drugs are prescribed: tablets, syrups. In complicated cases, intramuscular injections are indicated.

Non-steroidal anti-inflammatory drugs

They are used to eliminate a pronounced intoxication syndrome: fever, chills, fever.

1. Ibuprofen

Pain reliever, antipyretic and anti-inflammatory agent. Its mechanism of action is based on inhibition of prostaglandin biosynthesis through inhibition of the cyclooxygenase enzyme.

• Indications for use: neuralgia, complex therapy of diseases of the upper respiratory tract, traumatic inflammation of soft tissues and the musculoskeletal system, bursitis, sciatica, arthritis, adnexitis, osteoarthritis, dental and headache.
• Method of application: for pain syndrome of moderate intensity take 400 mg 2-3 times a day. The maximum daily dosage should not exceed 2.4 g.
• Side effects: nausea, vomiting, diarrhea, heartburn and other disorders of the gastrointestinal tract. Headaches and sleep disturbances, skin allergic reactions. V rare cases there are erosive and ulcerative lesions of the gastrointestinal tract, bronchospasm.
• Contraindications: hypersensitivity to the drug, diseases of the optic nerve, severe impairment of kidney / liver function, patients under 6 years of age, hematopoietic disorders, "aspirin" triad. Use during pregnancy and lactation is possible only for medical purposes.
• Overdose: abdominal pain, nausea and vomiting, drowsiness, headaches and tinnitus, acute kidney failure, respiratory arrest, metabolic acidosis, lethargy. For treatment, gastric lavage and further symptomatic therapy are indicated.

Ibuprofen is available as enteric-coated tablets with 200 mg of active ingredient per capsule.

1. Paracetamol

Antipyretic, analgesic and anti-inflammatory agent. Its mechanism of action is based on inhibition of the thermoregulatory center and inhibition of the synthesis of inflammatory mediators and prostaglandins.

• Indications for use: symptomatic therapy pain syndrome of various origins, conditions with hyperthermic reactions in infectious and inflammatory pathologies.
• The method of application depends on the form of release of the drug. For example, tablets are taken 350-500 mg 3-4 times a day. The maximum daily dosage is 3-4 g. The medicine is taken after meals with a liquid.
• Side effects: nausea, vomiting, pain in the epigastric region, increased drowsiness, renal colic, anemia, leukopenia, skin allergic reactions, muscle weakness.
• Contraindications: intolerance to the components of the drug, renal and hepatic insufficiency. It is prescribed with extreme caution during pregnancy and lactation.
• Overdose: increased drowsiness, pallor skin, nausea, vomiting and dizziness, toxic effects on the liver.

Paracetamol has the following forms of release: enteric-coated tablets, capsules and syrup for oral administration, rectal suppositories.

1. Nimesulide

NSAIDs from the group of sulfonanilides. It is used to eliminate pain of various origins, arthralgia and myalgia. The analgesic effect develops within 20 minutes. The medicine is taken 100 mg 3-4 times a day. Maximum daily dose- 400 mg.

• Side effects: increased drowsiness, dizziness and headaches, nausea, vomiting, epigastric pain, allergic skin reactions. Also possible pathological changes blood pictures.
• Contraindications: hypersensitivity to the components of the drug, pregnancy and lactation, children under 12 years of age, renal and hepatic insufficiency. With extreme caution, it is prescribed for ulcerative changes in the gastrointestinal tract, heart failure, arterial hypertension.
• Overdose: nausea, vomiting, abdominal pain, gastrointestinal bleeding, acute renal failure, respiratory depression, increased drowsiness, allergic reactions. Symptomatic therapy is indicated for treatment.

Available in the form of a suspension for the preparation of oral solution, tablets and external gel.

To enhance the antipyretic effect, the above NSAIDs are combined with antispasmodics and antihistamines.

Cough preparations

Antitussives affect the focus of inflammation in the lungs. Their mechanism of action is mucolytic, expectorant and muconitic effect. The drugs inhibit the cough reflex, regulate the function of sputum production and metabolism in the epithelial cells that line the airways.

1. Bronchicum

A drug with antispasmodic, anti-inflammatory, expectorant and sputum thinning properties. Effectively eliminates painful paroxysmal cough.

Indications for use: paroxysmal cough, acute and chronic lesions of the upper and lower respiratory tract. The method of application and dosage are individual for each patient. Side effects are manifested in the form of irritation of the gastric mucosa. Available in the form of drops and elixir for oral use.

1. Carbocysteine

Mucolytic agent, liquefies the bronchial secret and accelerates its excretion from the body. Normalizes the chemical and physical characteristics of sputum. It is used for respiratory diseases with the release of a large viscous secret. Patients are prescribed 1-2 capsules 2-3 times a day until the desired therapeutic effect is achieved.

Side effects are manifested by skin allergic reactions and disorders of the gastrointestinal tract. The drug is contraindicated in gastric ulcers and duodenum. It is not prescribed during pregnancy and lactation. Carbocysteine ​​is available in capsule and syrup form in oral vials.

1. Bromhexine

A drug that increases the secretion of secretion by the bronchial glands. Reduces the viscosity of sputum and has a pronounced expectorant effect. It is used for acute and chronic inflammatory diseases of the lungs, bronchi and trachea. It is prescribed for bronchiectasis, bronchography.

Bromhexine is taken 4-8 mg 3-4 times a day. For patients under 2 years of age, the drug is prescribed in the form of a syrup. Side effects are manifested by bouts of nausea and vomiting, various dyspeptic disorders and allergic reactions.

There are no absolute contraindications for taking the medication. It is prescribed with extreme caution in case of hypersensitivity to the drug, gastrointestinal bleeding, early dates pregnancy and peptic ulcer of the stomach. The medicine is available in the form of tablets and syrup.

Bronchodilators

This group of drugs is most often prescribed for the treatment of atypical inflammation. respiratory system in patients childhood and with a predisposition to bronchial hyperreactivity.

1. Berodual

Expands the lumen of the bronchi with the help of active ingredients - ipratropium bromide and fenoterol. The interaction of these components is effective in the bronchodilator therapy of diseases with increased tone of the bronchial muscles.

• Indications for use: complex maintenance therapy and prevention of respiratory failure in pneumonia, bronchitis, bronchopulmonary diseases, bronchial asthma. It is also prescribed in the preparation of the respiratory tract for aerosol administration of drugs.
• The method of application and dosage are individual for each patient, as they depend on the severity of the disease state and other characteristics of the patient's body. To enhance the therapeutic effect, the drug is recommended to be taken with corticosteroids.
• Side effects: temporary impairment of visual perception, tremor of the extremities, dry mouth, palpitations, increased intraocular pressure.
• Contraindications: hypersensitivity to the components of the drug, the first and last trimester of pregnancy. It is forbidden to take with xanthine derivatives and non-cardioselective beta-blockers.

Produced in the form of an aerosol for inhalation and a solution for inhalation in 20 ml vials.

1. Eufillin

Relieves spasms of smooth muscles of the bronchi, relaxing muscle tissues. Reduces system pressure pulmonary artery dilates the heart vessels. It has a moderate diuretic effect and inhibits platelet aggregation.

• Indications for use: bronchial asthma and bronchospasm, hypertension in the pulmonary circulation, cardiac asthma, respiratory disorders. It is prescribed for relief of cerebral vascular crises, improves renal blood flow.
• The method of application depends on the form of release of the drug. For acute attacks bronchial asthma the drug is administered intravenously, in other cases orally or intramuscularly. The dosage is determined by the doctor for each patient separately.
• Side effects: digestive disorders, headaches and dizziness, convulsions, heart palpitations.
• Contraindications: intolerance to components, reduced arterial pressure, tachycardia, epilepsy, coronary insufficiency, cardiac arrhythmias.

Eufillin has several forms of release: powder for solution, tablets for oral administration, ampoules and solution.

1. Fenoterol

Bronchial beta-adrenergic receptor stimulator. Expands the lumen of the bronchi, effectively relieves bronchospasm of various origins, asthma attacks. Increases the frequency and volume of breathing. Therapeutic action persists for 6-8 hours.

• Indications for use: relief of attacks of bronchial asthma, infectious diseases of the lungs with difficulty breathing, emphysema.
• Method of application: adult patients and children over 6 years of age are prescribed single doses of an aerosol of 0.2 mg. If after a single inhalation the asthma attack does not go away, then after 5-7 minutes the inhalation can be repeated.
• Side effects: tremor of the limbs, increased anxiety, palpitations, fatigue, headache and excessive sweating.
• Contraindications: hypersensitivity to the components of the drug, arrhythmia, severe atherosclerosis.

The medicine is intended for inhalation, therefore it is available in 15 ml aerosol cans. Each package contains 300 single doses. There is also a tablet form of release and ampoules for injection.

Antibiotics for Mycoplasma pneumonia

Antibacterial therapy is the main method of eliminating pathogens. Antibiotics for mycoplasma pneumonia are selected by the doctor, individually for each patient. When choosing a drug, the severity of the disease, the presence of chronic pathologies and other features of the patient's body are taken into account.

Consider the main types of antibiotics used to destroy Mycoplasma pneumoniae:

Tetracyclines

1. doksibene

Antimicrobial agent with bacteriostatic properties. Contains the active ingredient - doxycycline. Its mechanism of action is based on the inhibition of protein synthesis in the cells of pathogens. The drug is active against most gram-positive and gram-negative microorganisms.

• Indications for use: infectious diseases caused by viruses and bacteria sensitive to the drug. It is prescribed for atypical forms of pneumonia, typhus, bacterial conjunctivitis, Lyme disease. Effective in otolaryngological, urological, venereological and gynecological practice.
• Method of application: for patients weighing more than 70 kg, 200 mg per day is prescribed at a time or divided into two doses. Patients weighing 50 to 70 kg, 200 mg on the first day of therapy, followed by a dosage of 100 mg per day. For patients less than 50 kg, 4 mg/kg body weight. The course of treatment is 7-14 days.
• Side effects: disorders of the cardiovascular system, decreased visual acuity, leukopenia, leukocytosis, paresthesia, convulsions, increased pressure and excitability. There may also be violations of the urinary system, skin allergic reactions, muscle pain, candidiasis.
• Contraindications: intolerance to the components of the drug, severe violations of the liver and kidneys, patients under 8 years of age, pregnancy and lactation. It is prescribed with extreme caution for arrhythmias, for patients exposed to excessive ultraviolet radiation.
• Overdose: violation of the liver and gastrointestinal tract. There is no specific antidote, gastric lavage and further symptomatic therapy are indicated.

Doxibene is available in the form of capsules for oral administration of 100 and 200 mg of the active ingredient.

1. Doxycycline

Semi-synthetic broad-spectrum antibiotic with bacteriostatic properties. Active against gram-positive microorganisms, aerobic and anaerobic cocci, aerobic and anaerobic spore-forming bacteria, as well as Mycoplasma pneumoniae.

• Indications for use: acute bronchitis, pneumonia, pleurisy, pleural empyema, infections of the gastrointestinal tract and ENT organs, urinary tract. Effective in inflammatory diseases of the pelvic organs, purulent infections soft tissues. Also used in the prevention of surgical infections.
• Method of application: the drug is taken orally after a meal, washed down with water to reduce irritation of the esophagus. The medicine is taken at 100-200 mg, depending on the severity of the disease. The course of treatment is 10-14 days.
• Side effects: nausea, vomiting, abdominal pain, stool disorders, allergic skin reactions, rashes, excessive sweating, headaches and dizziness.
• Contraindications: intolerance to the components of the drug, the last trimesters of pregnancy and lactation, the age of patients under 9 years. Leukopenia, severe renal failure, porphyria.

The drug is available in the form of capsules for oral administration.

1. minocycline

An antibacterial agent that stops the reproduction of bacteria and has a wide spectrum of action. Active against most pathogens.

• Indications for use: infections of the upper and lower respiratory tract, psittacosis, infectious-allergic disease, inflammation urinary tract, conjunctivitis, trachoma, inflammation of the inguinal lymph nodes, brucellosis, skin and soft tissue infections, meningococcal infection.
• Method of application: the dosage is 200 mg on the first day of treatment and 100 mg thereafter. The duration of treatment is 5-12 days.
• Side effects: appetite and stool disorders, nausea, vomiting, increased activity of liver enzymes, skin allergic reactions, joint and muscle pain.
• Contraindications: hypersensitivity to drugs from the tetracycline group, pregnancy and lactation, patients under 8 years of age.

The medicine has a tablet form of release in packs of 50 and 100 pieces. There is also a suspension for oral administration in 5 ml vials.

macrolides

1. Azicin

Broad-spectrum antimicrobial agent. Contains the active ingredient - azithromycin. It has high acid resistance. Inhibits the growth and reproduction of pathogenic microorganisms.

• Indications for use: pulmonary mycoplasmosis and other diseases of the respiratory system, infections of soft tissues and skin, urethritis, colpitis, bacterial prostatitis, ulcerative lesions of the gastrointestinal tract, the initial stages of Lyme disease.
• Method of application: the medicine is taken on an empty stomach, drinking plenty of liquid. In case of infectious pathology of the respiratory tract, 500 mg are prescribed for three days. The total course dose is 1500 mg. For children, the drug is prescribed at a dosage of 10 mg / kg of body weight 1 time per day, the duration of therapy is 3 days.
• Side effects: dizziness and headaches, insomnia, irritability, tremor of the limbs. Tachycardia, neutropenia, gastrointestinal and liver disorders, conjunctivitis, allergic skin reactions.
• Contraindications: intolerance to the components of the drug, patients under 3 years of age, pregnancy and lactation, severe liver dysfunction.
• Overdose: nausea, vomiting, diarrhea, headaches, temporary hearing loss, hepatitis. There is no specific antidote, gastric lavage and enterosorbents are taken.

The medicine has a tablet form of release, 3 capsules in a blister, 1 blister in a package.

1. macrofoam

Macrolide antibiotic to the active substance - midecamycin. Has a wide spectrum of action. After oral administration, it is rapidly and completely absorbed from the gastrointestinal tract, reaching a maximum concentration in 1-2 hours. An increased content of the drug is observed in places of inflammation, in bronchial secretions and skin.

• Indications for use: infections of the respiratory tract, mucous membranes and skin, genitourinary system, diphtheria, whooping cough and other infectious pathologies caused by microorganisms sensitive to the drug.
• The method of application and dosage is calculated individually for each patient. This takes into account the age of the infected and the severity of the disease state. The course of treatment does not exceed 7-12 days.
• Side effects: appetite disorders, nausea and vomiting, allergic skin reactions, increased levels of liver enzymes.
• Contraindications: intolerance to the components of the drug, severe liver failure. The drug is taken during pregnancy when the potential benefit to the mother is higher than the risk to the fetus.
• Overdose: nausea and vomiting. There is no specific antidote. The intake of sorbents is shown to accelerate the excretion of the drug from the body.

Macropen is available in the form of tablets of 400 mg of the active ingredient each and as granules for suspension.

1. Roxithromycin

Semi-synthetic antibacterial agent. It has a wide spectrum of action against most pathogens.

• Indications for use: infections of the upper and lower respiratory tract, including atypical forms. Infections of the skin and soft tissues, urinary tract. Prevention of meningococcal meningitis.
• Method of application: adult patients are prescribed 150 mg twice a day before meals. In especially severe cases, the dosage may be increased.
• Side effects: nausea, vomiting, pain in the abdomen, skin allergic reactions, transient increase in the level of alkaline phosphatase and transaminases.

Contraindications: hypersensitivity to the components of the drug, pregnancy and lactation. It is prescribed with caution for patients with a history of allergic reactions.

Roxithromycin has a tablet form of release with different dosages.

Fluoroquinolones

1. Gatispan

Antibacterial agent with a wide spectrum of action. After oral administration, it is rapidly absorbed from the gastrointestinal tract. Absolute bioavailability is over 96%. The maximum plasma concentration is reached within 2-3 hours after ingestion. Plasma protein binding is about 20%. Excreted as metabolites in urine and feces.

• Indications for use: pneumonia, bronchitis, COPD, cystic fibrosis, lung abscess, sinusitis. Infections of the urinary system, skin and soft tissues, chronic infections of the urinary tract, bones and joints, STDs.
• Method of application: the drug is taken in a dose of 200-400 mg 1 time per day. The course of treatment depends on medical indications, the severity of the disease and the characteristics of the patient's body.
• Side effects: nausea, vomiting, abdominal pain, appetite and stool disorders, flatulence, gastritis, stomatitis, bleeding from the gastrointestinal tract. Sleep disturbances, increased anxiety, headaches and dizziness, muscle cramps. Arterial hypertension, bone pain, bronchospasm, swelling of the face and mucous membranes, allergic reactions.
• Contraindications: patients under 18 years of age, pregnancy and lactation, individual intolerance to the components of the drug.
• Overdose is manifested by more pronounced adverse reactions. To improve the patient's condition, gastric lavage and further symptomatic therapy are recommended.

Gatispan is available as enteric-coated tablets of 200 mg and 400 mg each.

1. Zoflox

A drug with a fluoroquinolone derivative and a bactericidal effect. It has a wide spectrum of action, but is especially active against mycobacteria SARS and beta-lactamase.

• Indications for use: pneumonia, bronchitis, orchitis, sinusitis, urethritis, soft tissue infections and infectious dermatological lesions, pyelonephritis, joint infections. It is used to prevent infectious complications in immunodeficiency states.
• Method of application: tablets are taken orally, and the solution for infusion is intravenously drip. The standard dosage is 200-600 mg / day, the course of treatment is 8-10 days.
• Side effects: skin allergic reactions, various disorders of the gastrointestinal tract and central nervous system, pain in the abdominal region, tremor of the limbs, paresthesia, and more.
• Contraindications: hypersensitivity to the components of the drug, recent traumatic brain injury, history of epilepsy and stroke, inflammation in the central nervous system, pediatric practice, pregnancy and lactation. With special care it is prescribed for violations of cerebral circulation.
• Overdose: symptoms of CNS depression, nausea and vomiting. Treatment is symptomatic, gastric lavage. Hemodialysis is ineffective.

Zoflox is available in tablets and as a solution for infusion.

1. Factive

Broad spectrum antibiotic. Used for many infectious diseases including atypical pneumonia.

• Indications for use: diseases caused by susceptible microorganisms, community-acquired pneumonia, Chronical bronchitis, sinusitis in the acute stage.

• Method of application: tablets are taken orally, regardless of food, without chewing. The daily dosage is 320 mg, the course of treatment is 7-10 days. In severe renal impairment, the dose should be reduced to 160 mg.

• Side effects: skin allergic reactions, disorders of the digestive system, flatulence. In rare cases, the drug causes malignant exudative erythema, appetite disorders, increased activity of liver enzymes. An overdose is manifested by an increase in the above reactions. Treatment is symptomatic.

• Contraindications: Allergy to drug components and other fluoroquinolones. Prolonged QT interval and tendon pathology. The drug is not used in pediatric practice. It is prescribed with extreme caution for patients with epilepsy, with a tendency to convulsions, arrhythmias. It is not prescribed during pregnancy and lactation.

Factive is available in the form of enteric-coated tablets of 160 and 360 mg. active substance. One package may contain 5 or 7 tablets of the drug.

Wilprafen

An antibacterial agent from the group of macrolides. Vilprafen has bacteriostatic properties, which are due to the inhibition of protein synthesis by bacteria. Highly active against most intracellular pathogens, including Mycoplasma pneumoniae.

After oral administration, it is well absorbed from the gastrointestinal tract, the maximum concentration in blood plasma is observed 1-2 hours after ingestion. Plasma protein binding is at the level of 15%. The active ingredient, josamycin, penetrates well through biological membranes and accumulates in tissues. Particularly high concentrations are determined in the lungs, saliva, sweat, tears. Absorbed in the liver, excreted in the bile and urine as active metabolites.

• Indications for use: atypical form of pneumonia, pharyngitis, tonsillitis, otitis media, sinusitis, diphtheria, scarlet fever, bronchitis, whooping cough, gingivitis, skin and soft tissue infections, urethritis, gonorrhea, prostatitis. The drug is effective for mycoplasma, ureaplasma, chlamydial and mixed infections of the genitourinary system.
• The method of application and dosage depend on the age of the patient. For patients older than 14 years, 500 mg 2-4 times a day are prescribed. Tablets are recommended to be taken between meals with water. For patients under 14 years of age and infants, the drug is prescribed in the form of a suspension. The daily dosage is 30 mg / kg of body weight for three doses. The course of treatment is 5-10 days.
• Side effects: appetite disorders, nausea, vomiting, dysbacteriosis, violation of the outflow of bile, allergic reactions, hearing impairment, candidiasis. An overdose is manifested by the same symptoms. Treatment is symptomatic.
• Contraindications: individual intolerance to the components of the drug, severe liver dysfunction. The use of an antibiotic during pregnancy and lactation is possible only on medical prescription, taking into account the risks to the fetus.

Vilprafen is available in the form of tablets and oral suspension.

Klacid

Semi-synthetic macrolide antibiotic with the active substance - clarithromycin. It has antibacterial properties, inhibits the synthesis of bacterial proteins. Tablets are a homogeneous crystalline mass. The active ingredient is released during passage through the gastrointestinal tract and has a broad antibacterial effect.

• Indications for use: pneumonia, bronchitis, polysinusitis, pharyngitis, monosinusitis, skin and soft tissue infections, chlamydial infections of the urogenital tract, gastric and duodenal ulcers.
• Method of application: one capsule at a dosage of 500 mg 1-2 times a day. Tablets should be taken with meals, swallowed whole, that is, without breaking or chewing.
• Side effects: ventricular arrhythmia and tachycardia, abdominal pain, diarrhea, vomiting, stomatitis and pancreatitis, oral candidiasis. Headaches and dizziness, increased anxiety, insomnia, noise and ringing in the ears, convulsions, temporary hearing loss and allergic skin reactions may also occur. Treatment is symptomatic.
• Contraindications: hypersensitivity to active ingredients, severe renal failure, porphyria, pregnancy and lactation.
• Overdose: decrease in potassium in the body and a decrease in the level of oxygen in the blood, abdominal pain, nausea and vomiting. For treatment, gastric lavage is indicated with further supportive therapy.

Klacid is available in the form of tablets of 500 mg in a blister of 5, 10 and 14 pieces, 1-2 blisters per pack.

Sumamed

A broad-spectrum antibiotic from the macrolide group. Getting into the focus of inflammation creates high concentrations, providing a bactericidal effect. Sumamed is active against gram-positive cocci, streptococci, gram-negative bacteria, anaerobic microorganisms, including Mycoplasma pneumoniae.

At oral administration it is quickly absorbed from the gastrointestinal tract, as it is resistant to an acidic environment and lipophilic. The maximum plasma concentration is reached after 2-3 hours, bioavailability is 35%. The active components of the preparations are quickly distributed throughout the body, penetrating into the respiratory tract, organs and tissues of the urogenital tract, skin and soft tissues.

The concentration of the active substance in the foci of infection is 25% higher than in healthy tissues.

The main feature of Sumamed is that its bactericidal concentrations remain in the focus of inflammation for 5-7 days, which allows for short courses of treatment.

• Indications for use: pathologies of an infectious nature caused by pathogens sensitive to the drug. The drug is prescribed for infections of the upper respiratory tract and ENT organs, for infections of the lower respiratory tract, SARS, skin and soft tissue infections, urinary tract infections, Lyme disease.
• Method of application: the drug is taken once a day one hour before a meal or 2-3 hours after a meal. With inflammation of the lungs, adult patients are prescribed 500 mg, and for children, 10 mg / kg for 3 days.
• Side effects: nausea, vomiting, stool disorders, increased gas formation, transient increase in liver enzymes, skin rashes. Treatment is symptomatic.
• Contraindications: hypersensitivity to the components of the drug and macrolides. It is prescribed with caution for severe violations of the kidneys and liver, as well as for allergic reactions to the drug in history. The use of Sumamed during pregnancy is possible only for medical purposes, when the potential benefit outweighs the possible risks.
• Overdose: nausea, vomiting, diarrhea, temporary hearing loss. For treatment, gastric lavage and further symptomatic therapy are indicated.

Available in the form of tablets for oral administration of 125, 250 and 500 mg, as well as capsules for oral administration of 250 mg. Children's release form - vials with powder for suspension preparation. Their pharmacies are dispensed by prescription.

vitamins

Atypical pneumonia, like any other disease, requires an integrated approach to treatment. Vitamins are necessary to normalize metabolism and improve the body's tolerance to antibacterial drugs. Useful substances not only contribute to recovery, but also increase the protective properties of the immune system.

Most often, patients are prescribed such vitamins:

• A, C, E - reduce the degree of damage to vascular membranes and improve their condition.
• B1 - reduces the accumulation of metabolic products of pathogens. Normalizes the metabolism of the liver and heart.
• B2 - improves the condition of the mucous membranes internal organs and skin, activates metabolic processes.
• B6 - enhances metabolic processes, regulates the work of the central nervous system.
• B12 - regulates hematopoiesis and metabolic processes, improves the functioning of the central nervous system, liver and other organs.

Multivitamin complexes have a complex effect: Multi-tabs, Vitrum, Neurovitan, Duovit and others. Along with vitamins and minerals, a balanced diet should be followed to improve well-being and prevent infectious processes.

Physiotherapy treatment

To speed up recovery and minimize the risk of developing severe complications of pneumonia, physiotherapy is recommended. Physiotherapy treatment has a desensitizing and bacteriostatic effect, helps to strengthen the immune system.

With mycoplasma pneumonia, the following methods can be prescribed:

• Inductothermy - the lesion is exposed to a high-frequency magnetic field. This enhances microcirculation and lymph flow, reduces bronchospasm, increases metabolism and improves sputum discharge. Physiotherapy helps to relax muscles, stops inflammatory processes.
• UHF electromagnetic field - used in the acute course of inflammation. The electric field reduces tissue swelling and exudation, restores microcirculation.
• Ultraviolet irradiation - has anti-inflammatory properties and promotes the resorption of infiltrates, activates local blood circulation. The action of radiation is directed to the anterior and posterior surface of the chest.
• Electrophoresis - this method is very often combined with the UHF electromagnetic field. The procedure is based on the effect on the body of a drug through which an electric current is passed. It has anti-inflammatory and analgesic properties.
• Decimeter wave treatment - has an anti-inflammatory effect, improves tissue metabolism and increases blood circulation in the lungs. The procedure has pronounced anti-inflammatory properties.
• Magnetotherapy - is prescribed for severe intoxication processes. Removes swelling, improves metabolic processes and capillary circulation.
• Thermal applications - are prescribed to eliminate the residual symptoms of the disease. On the chest apply applications of mud, paraffin and other active ingredients.
• Inhalations are the most affordable, but at the same time effective physiotherapy. The method improves the functioning of upper breathing and has a bacteriostatic effect. The impact on the affected mucous membranes occurs by inhalation of medications.

Physiotherapy treatment is carried out only for medical purposes, as it has certain contraindications: heat body, bleeding, cardiac or pulmonary insufficiency 2-3 degrees, severe disorders of the cardiovascular system, bullous emphysema, neoplasms, blood diseases. Duration of therapy and frequency medical procedures individual for each patient.

Alternative treatment

One of the non-traditional, but quite popular methods of eliminating SARS is folk treatment. Most often, with mycoplasma infection of the respiratory tract, the following recipes are used:

• Dissolve a teaspoon of honey in a glass of warm water and add a couple of drops of lemon juice. Drink the drink 3-4 times a day during the entire course of treatment and after it.
• Pour 2 figs into a glass of milk and simmer for 15-20 minutes. Take ½ cup 2 times a day.
• Take 50 g of walnuts and fill them with 500 ml of red wine. Boil the product over low heat for 20-30 minutes. Take a tablespoon for 2-3 months.
• Finely chop a couple of aloe leaves and mix with a glass of honey. Add 500 ml of warm water to the mixture and boil for 1-2 hours over low heat. The finished medicine should be consumed 1-2 tablespoons 2-3 times a day. The product can be stored in the refrigerator.
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• Pour 2 parts of St. John's wort, 3 parts of black elderberry and 4 parts of herbaceous elderberry roots with 1 liter of purified water. Boil the remedy for 20-30 minutes, strain and consume throughout the day.
• Take equal parts of wintergreen, hogweed and winter-loving. Pour the mixture with 750 ml of boiling water and insist until cool. Strain and take 100 ml 3-4 times a day. The course of treatment is 28 days.
• Blue cornflower has pronounced healing properties. Two tablespoons of dried flowers, pour 500 ml of boiling water, carefully wrap. After cooling, strain and take ½ cup 3-4 times daily.
• Herbal inhalations have medicinal properties. Mix in equal proportions such herbs: chamomile, St. John's wort, calendula, celandine, needles, eucalyptus. Pour raw materials with boiling water. Inhalations should last 10-20 minutes, procedures should be carried out daily. The infusion can be used to wash the sinuses and gargle.
• It has immunomodulatory properties drug collection from mint, lemon balm, chestnut color and Ivan-tea. Take 5 tablespoons of the mixture and pour 1 liter of boiling water. The tool is better to insist in a thermos. After 2-3 hours, strain and take 150 ml 3-4 times a day.

Before starting herbal treatment, you should consult with your doctor, as some herbal ingredients can cause allergic reactions and other adverse reactions.

Homeopathy

Treatment of atypical pneumonia involves a comprehensive comprehensive approach. Homeopathy refers to alternative methods therapy. To eliminate the infectious process, the following drugs are used:

• Aconite - is prescribed at the initial stage of the disease, can be replaced by Briony or Belladonna.
• Phosphorus, Ipecac - used for sputum with bloody clots.
• Sanguinaria - the secreted exudate has a rusty tint.
• Antimonium Tartaricum - the disease proceeds with moist rales, heavy breathing and poor sputum discharge.
• Veratrum Viride, Camphor - pneumonia with severe cardiovascular insufficiency.
• Iodum, Kalium Yodatum - paroxysmal cough with severe pain in the chest, feverish condition.

If antibiotic therapy is ineffective in eliminating the infection, then homeo-drugs can be prescribed: Sulfur, Arsenicum Album, Iodatum and others. Everything medicines are used only for the purpose of a homeopath, who selects the dosage and determines the duration of treatment.

Surgery

To eliminate Mycoplasma pneumoniae is indicated drug therapy. Surgery carried out only in the presence of serious complications, such as:

1. Lung abscess - inflammation of the lung tissue with the formation and melting of purulent-necrotic cavities. For treatment, bronchoscopy is performed with aspiration and washing of the cavities with antiseptic solutions. If the lesion is large, then a transthoracic puncture is indicated. In especially severe cases, a resection is performed, that is, the removal of part of the organ.
2. Pleural empyema - accumulation of pus in the anatomical cavities of the lung. Treatment is aimed at removing purulent exudate, straightening the tissues of the organ and reducing signs of intoxication. For this, a thoracostomy is performed, that is, open drainage. Pleurectomy, lung resection, intrapleural thoracoplasty, and bronchopleural fistula closure are also possible.
3. Synpneumonic pleurisy - purulent complication caused by an infectious agent. For treatment, intrapleural administration of antibiotics and lung drainage are indicated. When draining, an underwater valve is installed with which the amount of sputum is noted. The drainage is removed after the process of exudation stops.
4. Pyopneumothorax is a breakthrough of the contents of the lung cavity into pleural cavity. Treatment consists of draining the purulent cavity and eliminating painful symptoms. With tension pneumothorax, emergency decompression is performed, that is, the installation of drainage.
5. Cancer - oncological complications of mycoplasmal pneumonia are extremely rare. Surgical treatment is the main method of therapy, in combination with chemotherapy. The operation is aimed at removing the tumor formation with the affected part of the organ.