Antibiotics and Antifungal Drugs
Robin Brain
December 02, 2008
Sulfacetamide (Albucid, Locula)
This is a highly soluble drug used the form of eye drops to treat eye infections. It has been found to be effective in the treatment of trachoma. Allergic reactions due to local use of this drug are quite rare.
Macrolide Antibiotics
Erythromycin (Emycin, Althrocin)
This is a valuable drug for infections of throat, tonsils and airways, particularly in those patients who are allergic to penicillins. It is very effective in whooping cough and atypical pneumonia. Usually it is given in a dose of250-500 mg four times a day in adults and 30 mg/ kg body weight in children. It is available as syrup containing 100 mg in 5 ml for children.
Adverse Effects of Erythromycin: Erythromycin usually affects the gastro-intestinal tract causing nausea, vomiting, and diarrhoea. Erythromycin estolate is reported to be toxic to the liver. Recent reports indicate that it may cause spasms and narrowing of the gastric passage in newborns. Erythromycin inhibits inactivation of theophyline, terfenadine, cisapride, carbamazepine and valproate. Therefore, dose adjustments or change in drug may be required.
Precautions
This drug should be withdrawn if it induces diarrhoea.
Its use should be avoided in newly born and in small children because it may cause stomach spasms.
It should not be taken by a patients who have any pre-existing liver disease.
Never use it with terfenadine, astemizole and or cisapride.
Azithromycin (Azithral), Clarithromycin (Claribid), Roxithromycin (Rroxithro, Roxid)
These are newer type of drugs which have broader activity against many such infections in which erythromycin is not effective. Another advantage is that these are used in a day. These drugs are found in higher amounts in the infected (inflamed) tissues (tonsils, pharynx and soft tissues). Clarithromycin and azithromycin are effective in tuberculosis and peptic causing organism H.pylori. Usual doses are:
New Antibiotics
Cephalosporins, linezolid and quinolones, have been extensively used in recent years as a result of promotional activities by pharmaceutical companies. Their extensive use in developing nations like India is a clear example of economic waste. We feel that these should be reserved for specific indications and may be considered as drugs of first choice only for uncommon situations that cannot be controlled with conventional antibiotics, which can be determined by bacterial culture and sensitivity tests. In view of the fact that a large number of pharmaceutical companies are in the run to manufacture them, their use is bound to increase, whether justified or not.
Cephalosporins
Cephalosporins are divided into four major groups or 'generations', depending mainly on their microbiological spectrum of activity.
First-Generation Cephalosporins
These have a narrow spectrum of activity and include:
Cefadroxil (Droxyl, Odoxil, Lydoxyl, Kefloxin), Cefazolin (Lyzolin, Alzolin), Cephalexin (Sporidex, Alsporin, Betaspor)
The first-generation cephalosporins have a broad spectrum of activity and are relatively non-toxic. Oral drugs may be used for the treatment of urinary tract infections for minor staphylococcal lesions, or for minor poly-microbial infections such as cellulitis or soft tissue abscesses. However, oral cephalosporins should not be relied upon in serious systemic infections.
Second-Generation Cephalosporins
These have an intermediate spectrum of action and include the following drugs:
Cefaclor (Keflor), Cefuroxime (Cefogen, Supacef)
Due to its activity against beta-lactamase-producing H influenza or Branhamella catrarrhalis, cefaclor is used to treat sinusitis and otitis media (inflammation of the middle ear) when patients do not respond to ampicillin or amoxicillin. Cefuroxime is the only second generation drug that crosses the blood-brain barrier well enough to be used for the treatment of meningitis, especially H influenzae meningitis, and sepsis (putrefactive destruction of tissues by disease-causing bacteria.).
Cefuroxime Axetil(Ceftum) is orally effective in resistant infections. Single dose is effective in gonorrhoea. It is commonly used in roadside injuries when mixed infections are usual. It is effective drug for respiratory infections, severe infections of abdomen and meningitis.
Get more information on Generic Drugs and Generic Drug Development.
This is a highly soluble drug used the form of eye drops to treat eye infections. It has been found to be effective in the treatment of trachoma. Allergic reactions due to local use of this drug are quite rare.
Macrolide Antibiotics
Erythromycin (Emycin, Althrocin)
This is a valuable drug for infections of throat, tonsils and airways, particularly in those patients who are allergic to penicillins. It is very effective in whooping cough and atypical pneumonia. Usually it is given in a dose of250-500 mg four times a day in adults and 30 mg/ kg body weight in children. It is available as syrup containing 100 mg in 5 ml for children.
Adverse Effects of Erythromycin: Erythromycin usually affects the gastro-intestinal tract causing nausea, vomiting, and diarrhoea. Erythromycin estolate is reported to be toxic to the liver. Recent reports indicate that it may cause spasms and narrowing of the gastric passage in newborns. Erythromycin inhibits inactivation of theophyline, terfenadine, cisapride, carbamazepine and valproate. Therefore, dose adjustments or change in drug may be required.
Precautions
This drug should be withdrawn if it induces diarrhoea.
Its use should be avoided in newly born and in small children because it may cause stomach spasms.
It should not be taken by a patients who have any pre-existing liver disease.
Never use it with terfenadine, astemizole and or cisapride.
Azithromycin (Azithral), Clarithromycin (Claribid), Roxithromycin (Rroxithro, Roxid)
These are newer type of drugs which have broader activity against many such infections in which erythromycin is not effective. Another advantage is that these are used in a day. These drugs are found in higher amounts in the infected (inflamed) tissues (tonsils, pharynx and soft tissues). Clarithromycin and azithromycin are effective in tuberculosis and peptic causing organism H.pylori. Usual doses are:
New Antibiotics
Cephalosporins, linezolid and quinolones, have been extensively used in recent years as a result of promotional activities by pharmaceutical companies. Their extensive use in developing nations like India is a clear example of economic waste. We feel that these should be reserved for specific indications and may be considered as drugs of first choice only for uncommon situations that cannot be controlled with conventional antibiotics, which can be determined by bacterial culture and sensitivity tests. In view of the fact that a large number of pharmaceutical companies are in the run to manufacture them, their use is bound to increase, whether justified or not.
Cephalosporins
Cephalosporins are divided into four major groups or 'generations', depending mainly on their microbiological spectrum of activity.
First-Generation Cephalosporins
These have a narrow spectrum of activity and include:
Cefadroxil (Droxyl, Odoxil, Lydoxyl, Kefloxin), Cefazolin (Lyzolin, Alzolin), Cephalexin (Sporidex, Alsporin, Betaspor)
The first-generation cephalosporins have a broad spectrum of activity and are relatively non-toxic. Oral drugs may be used for the treatment of urinary tract infections for minor staphylococcal lesions, or for minor poly-microbial infections such as cellulitis or soft tissue abscesses. However, oral cephalosporins should not be relied upon in serious systemic infections.
Second-Generation Cephalosporins
These have an intermediate spectrum of action and include the following drugs:
Cefaclor (Keflor), Cefuroxime (Cefogen, Supacef)
Due to its activity against beta-lactamase-producing H influenza or Branhamella catrarrhalis, cefaclor is used to treat sinusitis and otitis media (inflammation of the middle ear) when patients do not respond to ampicillin or amoxicillin. Cefuroxime is the only second generation drug that crosses the blood-brain barrier well enough to be used for the treatment of meningitis, especially H influenzae meningitis, and sepsis (putrefactive destruction of tissues by disease-causing bacteria.).
Cefuroxime Axetil(Ceftum) is orally effective in resistant infections. Single dose is effective in gonorrhoea. It is commonly used in roadside injuries when mixed infections are usual. It is effective drug for respiratory infections, severe infections of abdomen and meningitis.
Get more information on Generic Drugs and Generic Drug Development.