Antibacterial therapy in the practice of dermatovenereologist
Nowadays it is hard to imagine practical activity of dermatovenereologist without antibacterial therapy.
Today approximately 160 antibiotics from about 20000 describes antibiotic substances are used in clinical practice. Antibiotics of dermatovenereological spectrum differ as for their structure and mechanism of action and belong to different groups of antibacterial agents.
In the practice of dermatovenereologist antibiotics enjoy wide use for treatment of both infectious dermatosis, and diseases due to sexually transmitted infections.
Rational antibacterial therapy in the practice of dermatovenereologist was the topic of the report made by the Head of dermatovenereology department of Donetsk National Medical University named after M. Gorky, Honored Worker of Science and Technology of Ukraine, Doctor of Medical Sciences, Professor Ayzyatulov Roman Fedorovich at the advanced training courses for doctors dermatovenereologists in Cherkassy on February 14, 2011.
As we know, the most important principles of rational antibacterial therapy include the following ones:
– for treatment or prevention of the infectious disease we should use the preparation, to which causative agent is most susceptible;
– pharmacokinetics of the preparation should provide its concentration in tissues that is sufficient for growth inhibition of the infectious agent;
– the antibiotic should be indicated in medium-therapeutic doses with accurate following of the preparation’s administration order;
– the preparation should have a good safety profile.
As it was noted by Pr. Ayzyatulov Roman Fedorovich, today two groups of antibiotics are most frequently used (except syphilis treatment) in the practice of dermatovenereologist, such as macrolides and fluoroquinolones.
Nowadays fluoroquinolones is one of most important groups of antibacterial agents, and one of them is preparation Gatilin (gatifloxacin), as it has a very broad antibiotic spectrum – from “classical” gram-negative and gram-positive bacteria to “atypical” causative agents (clamydia, ureaplasms, mycoplasms) and anaerobes. Gatilin (gatifloxacin) has high bactericidal effectiveness against infections that are resistant to other classes of antibiotics, including poly-resistant strains. It is conditioned by the dual mechanism of its action, which lies in inhibiting of microbial cell enzymes (DNA–gyrases and topoisomerases – IV), responsible for the process of DNA replication, which naturally result in disturbed vital activity of causative agent.
Pharmacokinetic properties of Gatilin also correspond to modern requirements applied to antibiotics. In case of Gatilin use, its high level concentration in blood, other biological liquids, organs and tissues are maintained for a long time. It penetrates intracellularly and is slowly excreted from the organism; it is effective at rather low doses with administration once a day. Gatilin has a broad spectrum of indications for use. It should be noted that Gatilin has low rate of side effects, most of which are associated with gastric disorders and do not require discontinuation of the treatment. However, Gatilin is not used in diabetic patients, pregnant women or in pediatric patients.
Pharmacodynamic and pharmacokinetic properties of the preparation Gatilin meet the principles of rational antibioticоtherapy.
As it was noted by Pr. Ayzyatulov Roman Fedorovich, Gatilin is a highly effective preparation for treatment of urogenital infections, as well as for pyodermias (unlike ineffectiveness of other groups of antibiotics). After the end of the report practical doctors dermatovenereologists asked questions and shared their experience of use of the preparation Gatilin.