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ntibiotics,
also known as antibacterials, are medications that destroy or slow down the
growth of bacteria.
They include a range of powerful drugs and are used to treat
diseases caused by bacteria.
Antibiotics cannot treat viral infections, such as cold, flu, and most coughs.
This article will explain what antibiotics are, how they work, any
potential side effects, and antibiotic resistance.
Fast facts on antibiotics
· Alexander
Fleming discovered penicillin,
the first natural antibiotic, in 1928.
· Antibiotics
cannot fight viral infections.
· Fleming
predicted the rise of antibiotic resistance.
· Antibiotics
either kill or slow the growth of bacteria.
· Side effects can
include diarrhea, an upset stomach, and nausea.
What are antibiotics?
Antibiotics are a common medication that doctors prescribe to fight bacteria.
Antibiotics are powerful medicines that fight certain infections and can
save lives when used properly. They either stop bacteria from reproducing or
destroy them.
Before bacteria can multiply and cause symptoms, the immune system can
typically kill them. White blood cells (WBCs) attack harmful bacteria and, even
if symptoms do occur, the immune system can usually cope and fight off the
infection.
Sometimes, however, the number of harmful bacteria is excessive, and the
immune system cannot fight them all. Antibiotics are useful in this scenario.
The first antibiotic was penicillin. Penicillin-based antibiotics, such as
ampicillin, amoxicillin, and penicillin G, are still available to treat a
variety of infections and have been around for a long time.
Several types of
modern antibiotics are available, and they are usually only available with a
prescription in most countries. Topical antibiotics are available in
over-the-counter (OTC) creams and ointments.
Resistance
Some medical professionals have concerns that people are overusing
antibiotics. They also believe that this overuse contributes toward the growing
number of bacterial infections that are becoming resistant to antibacterial
medications.
According to the Centers for Disease Control (CDC), outpatient antibiotic
overuse is a particular problem. Antibiotic use appears to be higher in some
regions, such as the Southeast.
Use of carbapenems, a major class of last-line antibiotics, increased
significantly from 2007 to 2010.
Alexander Fleming, speaking in his Nobel Prize
acceptance speech in 1945, said:
"Then there is the danger that the ignorant
man may easily underdose himself and by exposing his microbes to non-lethal
quantities of the drug, make them resistant."
As the man who discovered the first antibiotic almost 70 years ago
predicted, drug resistance is starting to become commonplace.
How do antibiotics work?
There are different types of antibiotic, which work in one of two ways:
·
A
bactericidal antibiotic, such as penicillin, kills the bacteria. These drugs
usually interfere with either the formation of the bacterial cell wall or its
cell contents.
·
A
bacteriostatic stops bacteria from multiplying.
Uses
Antibiotics are ineffective against viruses.
A doctor prescribes antibiotics for the treatment of a bacterial
infection. It is not effective against viruses.
Know whether an infection is bacterial or viral helps to effectively treat
it.
Viruses cause most upper respiratory tract infections (URTIs), such as the
common cold and flu. Antibiotics do not work against these viruses.
If people overuse antibiotics or use them incorrectly, the bacteria might
become resistant. This means that the antibiotic becomes less effective against
that type of bacterium, as the bacterium has been able to improve its defenses.
A doctor can prescribe a broad-spectrum antibiotic to treat a wide range
of infections. A narrow-spectrum antibiotic is only effective against a few
types of bacteria.
Some antibiotics attack aerobic bacteria, while others work against
anaerobic bacteria. Aerobic bacteria need oxygen and anaerobic bacteria do not.
In some cases, a healthcare professional may provide antibiotics to
prevent rather than treat an infection, as might be the case before surgery.
This is the 'prophylactic' use of antibiotics. People commonly use these
antibiotics before bowel and orthopedic surgery.
Side effects
Antibiotics commonly cause the following side effects:
·
diarrhea
·
nausea
·
vomiting
·
rash
·
upset
stomach
·
with
certain antibiotics or prolonged use, fungal infections of the mouth, digestive
tract, and vagina
Less common side effects of antibiotics include:
·
formation
of kidney stones,
when taking sulphonamides
·
abnormal
blood clotting, when taking some cephalosporins)
·
sensitivity
to sunlight, when taking tetracyclines
·
blood
disorders, when taking trimethoprim
·
deafness, when taking erythromycin and the aminoglycosides
Some people, especially older adults, may experience bowel inflammation, which can lead to severe, bloody
diarrhea.
In less common instances, penicillins, cephalosporins, and erythromycin
can also cause inflamed bowels.
Allergy
Some people may develop an allergic reaction to antibiotics, especially
penicillins. Side effects might include a rash, swelling of the tongue and
face, and difficulty breathing.
Allergic reactions to antibiotics might be immediate or delayed hypersensitivity
reactions.
Anyone who has an allergic reaction to an antibiotic
must tell their doctor or pharmacist. Reactions to
antibiotics can be serious and sometimes fatal. They are called anaphylactic
reactions.
People with reduced liver or kidney function should be cautious when using
antibiotics. This may affect the types of antibiotics they can use or the dose
they receive.
Likewise, women who are pregnant or breast-feeding should speak with a
doctor about the best antibiotics to take.
Interactions
Individuals taking an antibiotic should not take other medicines or herbal
remedies without speaking with a doctor first. Certain OTC medicines might also
interact with antibiotics.
Some doctors suggest that antibiotics can reduce the effectiveness of oral
contraceptives. However, research does not generally
support this.
Nonetheless, people who experience diarrhea and vomiting or are not taking
their oral contraceptive during illness because of an upset stomach might find
that its effectiveness reduces.
In these circumstances, take additional contraceptive precautions.
How to use
People must not stop a course of antibiotics halfway through. If in doubt, they can ask their doctor for advice.
People usually take antibiotics by mouth. However, doctors can administer
them by injection or apply them directly to the part of the body with
infection.
Most antibiotics start combating infection within a few hours. Complete
the whole course of medication to prevent the return of the infection.
Stopping the medication before the course has finished increases the risk
that the bacteria will become resistant to future treatments. The ones that
survive will have had some exposure to the antibiotic and may consequently
develop resistance to it.
An individual needs to complete the course of
antibiotic treatment even after they see an improvement in symptoms.
Do not take some antibiotics with certain foods and drinks. Take others on
an empty stomach, about an hour before meals, or 2 hours after. Follow the
instructions correctly for the medication to be effective. People taking
metronidazole should not drink alcohol.
Avoid dairy products when taking tetracyclines, as these might disrupt the
absorption of the medication.
Q:
Are there any bacteria that are
resistant to all antibiotics?
A:
There are several different types of
bacteria that are resistant to the antibiotics that have been the most
effective against them. Some examples include:
·
ethicillin-resistant Staphylococcus aureus (MERSA); multi-drug-resistant
Mycobacterium tuberculosis (MDR-TB)
·
carbapenem-resistant Enterobacteriaceae (CRE) gut bacteria
·
vancomycin-resistant Enterococcus (VRE)
When one of these bacteria causes an
infection, it can be very difficult, if not impossible, to cure.
Alan Carter, PharmD
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