baden baden podcast and i am its host konstantin severinov. today we will talk about antibiotics and we will talk with sergei vasilyevich tsarenko, the chief resuscitator. these are prokaryotes, bacteria, antibiotics are against them, although in general there are antibiotics and antitumor agents, but mainly against bacteria, who produces them, these are chemists made, where do these substances come from, well, to begin with, actually, they were found in nature, this is a way for bacteria to coexist with each other, some bacteria produce antibiotics to drive other bacteria out of their habitats, a fight for food, for a place to live, and so on, and what do medicines have to do with it, we also have microbes on us, inside us, and we also have antibiotics inside us, well , our bacteria also produce them, but actually, the most powerful antibiotics, of course, our bacteria do not produce, which live in us, basically they are antibiotics produced by bacteria living in the soil, accordingly they are found there, after that there are two options for them... and these are some kind of factories , microbiological industry or chemical factory, which makes a substance, this is some kind of molecule, but this is a molecule, yes, you are a resuscitator, you encounter antibiotics in your medical work, this is generally one of the main points of attention, as a resuscitator. mine, because without antibiotics modern resuscitation will die, we use antibiotics in several situations: the first is a prophylactic prescription of an antibiotic, for example, a patient goes for a planned surgical operation, this is accompanied by a skin incision before the surgical intervention, therefore, preoperative prophylaxis with antibiotics exists as a reasonable measure to reduce potential, but this is in hospitals, that is, this. as i understand it, they are not taken prophylactically at home, no, this concerns a specific surgical intervention, and this antibiotic is administered there half an hour before the operation with the expectation that it will only work for the duration of the surgical intervention, this is a single administration, this is a single or, in extreme cases, a double administration during the operation, it is repeated again if the operation is long, and if the antibiotic does not work, then what, and if one antibiotic does not work, then some inflammatory... we can select for a long time, because we live in the era of multiresistant bacteria, this means that bacteria have multiple resistance to different groups of antibacterial drugs, therefore here is such a selection, as i said, it is of course not so blind, they simply prescribed one, threw out another, it is selected based on the results of certain bacteriological studies, but nevertheless the number of antibiotics that we can use in our clinical practice is now very limited, and for some reason... as i understand it, well, there are a lot of microbes around us, give, and you said that they communicate with each other with the help of antibiotics, it's just that microbes in general have come up with few antibiotics, four or five pieces, microbes have come up with many antibiotics, the topic of creating an antibiotic turned out to be very economically inexpedient, unfortunately, this topic was already heard before the pandemic, the idea of what kind of pharmaceutical company that develops antibiotics... options for bringing the drug to the market, they carry a lot of restrictions, this is very reasonable, since this is a way to protect the patient from some unwanted side effects, everything must be studied in sufficient detail, the moment when the company finally went through this thorny path, a lot of money was spent, antibiotics are released into wide clinical practice, unfortunately, bacteria that live much longer than you and me... longer, yes, in terms of time, i mean in the evolutionary sense, they appeared much earlier, in fact, they are the main inhabitants of our extra-planet, and not you and me, as we think, although we call ourselves kings there, in general, kings are bacteria, in fact, they have many mechanisms to interfere, and what does this mean, you say that development is underway, scientists the company made an antibiotic, but we are forced to take into account the fact that these antibiotics must appear on the market, so the company that brings it to the market must spend this money, and accordingly, when the antibiotic stops functioning after 2-3 years, it turns out that the money is thrown away, well, not to the wind, but in any case it is not very profitable compared to the fact that, for example, a company took and released a drug that lowers blood pressure, what you are saying sounds terrible, not all antibiotics stop. a giant dose of antibiotic, it will be simply toxic, so i work with those doses that are non-toxic for it. in these conditions there is always a possibility, unfortunately, this is a biological law, that some bacterial cell will show resistance, wants to live and will give offspring that will be resistant to this antibiotic. another question is that if the patient is not very seriously ill, then he begins to recover, he has enough strength to cope with the infection. well, relatively speaking, on his own, and the need for a change there is no antibiotic, but in cases of severe patients, complex ones, well, the same covid patients, and they were on artificial ventilation of the lungs due to severe viral damage to the lungs, they had an intubation tube through which bacteria entered from the external environment, and we could not wean them off artificial ventilation of the lungs, because they did not have enough of their own reserves, so during the treatment he recovered, but with... and the lung damage was high enough that i could wean him off artificial ventilation of the lungs, accordingly, he developed a new wave of bacterial infection, these waves, they eventually overwhelmed him and the person died. we watch the badenodcast, i am its host, konstantin severinov, we talk about antibiotics resistant to antibiotics, bacteria with sergei vasilyevich tsarenko. chief resuscitator of the ministry of health of the russian federation, this is what you are describing, it feels like the game over is coming soon, the game will end, yes, if there are no new ones, that is, little by little all the bacteria in the scenario that you are describing should become resistant, insofar as we use antibiotics, you use antibiotics, doctors, yes, and, insofar as antibiotic-resistant microbes arise, that's right, and then it should end soon, yes, and that's very sad. from the market from this, but it means that they have these antibiotics, they just it means that they find it economically inappropriate to develop them, to develop - it means to look for new ones, to look for new ones, yes, for which there is no resistance, for which there is no resistance yet, but this is such a bad infinity, but you will find what you describ