Of great interest is the mechanism of development of fungal and inflammatory diseases of the mucous membrane of the respiratory and digestive tracts. Antibiotics with prolonged use cause the phenomenon of dysbiosis and thereby contribute to the development of bacterial and fungal superinfection. Limited and generalized fungal diseases are observed. With limited mycoses, the mucous membranes of the oral cavity, pharynx and larynx are affected. As for generalized fungal diseases, then the mucous membranes of the respiratory, digestive tract and internal organs are affected. These diseases are caused by yeast-like fungi such as Candida albicans.
Fungi of the genus Candida live on the mucous membranes of the oral cavity and pharynx. They are antagonists of the saprophytic microbial flora there. As long as there is antagonism between different inhabitants, the biological equilibrium established between them is preserved, which characterizes the normal microflora of the oral cavity and pharynx. But this ratio can be broken as a result of the use of antibiotics. Antibiotics suppress the vital activity of microbes sensitive to them, but in this regard, create room for the development of microbes and fungi that are resistant to antibiotic substances. Decreased vital activity or the death of microflora sensitive to antibiotics creates a favorable background for the manifestation of the pathogenic properties of antibiotic-resistant microbes and fungi.
As for inflammatory diseases of the mucous membrane of the oral cavity and pharynx, these are usually caused by staphylococcal infection, which, as it has been revealed recently, shows significant resistance to the action of various antibiotics (I. G. Akimov, G. F. Gauze, Heinberg – Heinberg – and etc.).
Side effects associated with the use of antibiotics, we noted in three patients. One patient had dermatitis, another had pharyngeal candidiasis, which developed after intramuscular injection of a large amount of penicillin, and a third patient had inflammation of the oral mucosa and pharynx after taking biomycin tablets. These complications were quickly eliminated by the use of appropriate therapy.
Antibiotics play and will continue to play a large role in the fight against otogenic meningitis and other infectious diseases. But we should not forget the shady sides of antibiotic therapy, which, however, do not detract from their merits. This fact underlines the importance of the rational use of antibiotics and the prevention of possible complications.
Treatment of allergic diseases caused by the use of antibiotics consists in the fact that antihistamines are prescribed for such patients: diphenhydramine (0.05 3 times a day), 10% calcium chloride per tablespoon 3 times a day, 10% chloride solution calcium intravenously. Cortisone is prescribed on the first day at 0.1 3 times a day, on the second day – at 0.1 2 times, and starting from the 3rd day at 0.1 1 time per day. Adrenocorticotropic hormone 10-20 IU 3-4 times a day intramuscularly Contraindications for the appointment of cortisone and adrenocorticotropic hormone are hypertension, heart failure, acute endocarditis, gastric and duodenal ulcer. In anaphylactic shock, 1 ml of adrenaline (1: 1000), 1 ml of a 10% caffeine solution, intravenously 10 ml of a 20% solution of calcium chloride are injected subcutaneously and inside of 0.1 diphenhydramine. Limited fungal lesions of the oral mucosa and pharynx caused by a fungus of the genus Candida albicans respond well to the local effects of borax in glycerin.
To do this, take a 10% solution of borax in glycerin to lubricate the affected areas of the mucous membrane. For the same purpose, a 10% solution of boric glycerol, a 1% alcohol solution of malachite greens, and a Lugol solution in glycerin are used locally . Gargling with alkaline solutions (2% solution of soda or borax). With extensive candidiasis, a 3-5% solution of sodium iodide or potassium iodide is prescribed (1 tablespoon 3 times a day); produce 10 injections of a polyvalent yeast vaccine (initially intracutaneously in doses of 0.1-0.2-0.3-0.4, and then intramuscularly at 0.5-0.6-0.7-0.8-1.0). In addition, patients are prescribed treatment with the anti-yeast antibiotic nystatin. Patients take nystatin 2 days for 4 tablets, 2 days for 6 tablets, 2 days for 4 tablets, a total of 28 tablets containing 14 million units. Patients take nystatin and iodine preparations after meals and drink them with milk. In addition, such patients are prescribed ascorbic acid, multivitamins, vitamin K.
The following measures are recommended for the treatment of complications arising from the endolumbal administration of penicillin: 1) intramuscular injections of lobelin (adults 0.3-0.5 ml, children 0.1-0.3 ml); 2) injections of 1-2 ml of a 20% solution of caffeine (adults); 3) 25-50 ml of a 2% solution of chloral hydrate in an enema; 4) intramuscular injections of a 10% solution of hexenal (adult patients 8-10 ml, children 2-5 ml).
Some authors, with the aim of preventing complications, recommend giving patients, before subarachnoid administration of penicillin, chloral hydrate in the form of an enema or intramuscularly hexenal.