20 Facts to Know About Antibiotics

Antibiotics play a very important role of modern medicine. These medications are used to fight many infections caused by bacteria. The following facts about antibiotics will help you understand how these drugs work, their possible side effects and the importance of taking antibiotics as directed by your doctor. 1. Antibiotics belong to a class of drugs called Antimicrobials. Other drugs in this group include antifungals, antiprotozoals and antivirals. 2. Antibiotics are medicines that kill bacteria. These drugs do not work on viruses. A bacterium is a living, reproducing lifeform. A virus is just a piece of DNA (or RNA). A virus injects its DNA into a living cell and has that cell reproduce more of the viral DNA. With a virus there is nothing to "kill," so antibiotics don t work on it. 3. There are many types of antibiotics. Each works a little differently and acts on different types of bacteria. Some antibiotics are effective against only certain types of bacteria; others can effectively fight a wide range of bacteria. 4. While the use of antibiotics did not begin in the 20th century, early folk medicine included the use of mouldy foods or soil for infections. In ancient Egypt, for example, infections were treated with mouldy bread. 5. Originally noticed by a French medical student, Ernest Duchesne, in 1896, penicillin was rediscovered by bacteriologist Alexander Fleming working at St. Mary s Hospital in London in 1928. He observed that a plate culture of Staphylococcus had been contaminated by a blue-green mold and that colonies of bacteria adjacent to the mold were being dissolved. 6. A broad spectrum antibiotic is one that can kill many different types of bacteria. A broad spectrum antibiotic is useful for treating infections that might be caused by many different types of bacteria such as ear infections. A narrow spectrum antibiotic is one that kills only a small variety of germs. 7. Antibiotics must be taken for the full amount of time prescribed by your doctor. Many times, patients will stop the use of an antibiotic when they begin to feel better and it seems that the illness has gone. However, even after the symptoms are gone, the bacteria may still be present in small amounts and an infection can return if use of the antibiotic is stopped. Not completing the prescribed dose also may promote resistance. 8. There are two major drawbacks of antibiotics: * Bacterial resistance * Harmful side effects

9. Bacteria may be naturally resistant to different classes of antibiotics or may acquire resistance from other bacteria through exchange of resistant genes. 10. Antibiotics generally are safe. The most common side effects of antibiotics include stomach upset, nausea, and diarrhea. An increased sensitivity to sunlight is common with tetracyclines (e.g. doxycycline, minocycline) and fluoroquinolones (e.g. ciprofloxacin , ofloxacin, levofloxacin). Although most sideeffects may be mild in appearance, some may be severe like allergic reactions and it may even be lifethreatening allergic reactions. Should you experience any unexpected reaction to an antibiotic you use for the first time, immediately consult with your health professional. 11. Antibiotics can kill most of the bacteria in your body that are sensitive to them, including "good" bacteria. By destroying the bacterial balance, they may cause stomach upsets, diarrhea, yeast infections or other problems. 12. Any antibiotic can suppress the healthy bacteria in your colon. Usually this problem surfaces when the newer, more powerful antibiotics are prescribed, or when multiple antibiotics are used for serious infections. Almost any antibiotic can cause antibiotic-associated colitis (also called pseudo membranous colitis, or Clostridium difficile colitis)., but the following have been implicated in most cases: clindamycin, lincomycin, ampicillin, cephalosporins. The aminoglycosides (amikacin, gentamicin), erythromycin, trimethoprim-sulfamethoxazole, and fluoroquinolones (ciprofloxacin , levofloxacin) seem less likely to be the cause. 13. Antibiotic associated diarrhea can occur within two days of completing a course of antibiotics or even up to six weeks later. The risk of antibiotic associated diarrhea rises with how often and how long the antibiotics are taken. Even the gentlest antibiotics, given for a short period of time, can occasionally lead to this problem. Therefore, if you have new symptoms of diarrhea, it is important that you make your doctor aware of any antibiotics you may have taken in the last several months. 14. Yeast Overgrowth. One of the most common side effects of antibiotics is yeast overgrowth. Women who use antibiotics often develop bowel and vaginal yeast infections. Children treated repeatedly with antibiotics for ear infections often develop yeast and fungal infections of the middle ear. 15. Antibiotics can, in some cases, hinder the immune response. For example, children given amoxicillin for chronic earaches suffer two to six times the rate of recurrent middle ear effusion than children who took a placebo. According to Carol Jessop, MD, Clinical Professor at the University of California at San Francisco, 80% of her patients who suffer from chronic fatigue syndrome (or chronic fatigue immunodeficiency syndrome) had a history of recurrent antibiotics treatment as a child, adolescent or adult. 16. Antibiotics will not cure viral illnesses, such as: * Colds or flu * Most coughs and bronchitis * Sore throats not caused by strep * Runny noses

* Stomach flu (viral gastroenteritis) * Some ear infections 17. When are antibiotics necessary? Here are a few examples: * Ear infections there are several types; many need antibiotics, but some do not. * Sinus infections most children with thick or green mucus do not have sinus infections. Antibiotics are needed for some long-lasting or severe cases. * Strep throat this condition must be diagnosed by a laboratory test. * Urinary tract infections * Many wound and skin infections 18. Sometimes it is very hard to tell when an illness is caused by a viral or bacterial infection. A test called a culture should be done to determine which bacteria, if any, are responsible for your illness. Without a culture, your health care provider must choose an antibiotic based on an educated guess of what bacteria are most likely to be causing your illness. Sometimes, those educated guesses are wrong. 19. Antibiotic resistance occurs when bacteria change in a way that reduces or eliminates the effectiveness of antibiotics. These resistant bacteria survive and multiply causing more harm, such as a longer illness, more doctor visits, and a need for more expensive and toxic antibiotics. 20. Some antibiotics become less effective if they are taken with food. For example, azithromycin (zithromax) capsules should not be mixed with or taken with food, however tablets may be taken without regard to food.

Dosage Instructions: Long term side effects of distributed report may include but are not limited to increased awareness and the prevention of a global catastrophe.
So, first of all, what exactly to antibiotics do? Well, antibiotics are really just chemicals that either kill bacteria or stop their growth, while at the same time providing as little damage to the host (e.g. humans) as possible, if any [11]. However, although side effects or allergies are possible, on the most part antibiotics are gentle cures to bacterial infections [11]. That said, it is essential to note that antibiotics only intended to treat infections caused by bacteria, not those caused by viruses.

Penicillin was the first effective antibiotic ever used, and it was powerful against many different types of bacteria [14]. Its use first became popular for the treatment of WWII wounds [14]. However, there was already evidence of bacteria being able to resist its effects a mere few years after this antibiotics mass production [14]. What is antibiotic resistance, and why should I be concerned with it? Antibiotic resistance is the capability of an organism to survive the harmful effects of antibiotics [6]. Experts say that although this process itself is inevitable, there ways in which we can significantly prevent antibiotic organisms from thriving and becoming a global threat; methods such as public education and infection control [14][2][3]. Even today, infectious diseases continue to be the leading cause of death in the world, and this is especially true in developing countries, where access to adequate health resources are often deficient [10][13]. So you see, evidence of bacteria becoming more and more resistant to antibiotics creates increasing obstacles for treatment of certain infections. How exactly do bacteria learn to survive antibiotics? It all comes down to certain events that change the DNA, or genetic sequence, of bacteria. You see, all living organisms have DNA, a sequence of molecules called nucleic acids, which serve as the blue-print of a cells function [5]. For example, DNA dictates which proteins or enzymes are made, and thus changing a cells DNA through various means can potentially change which proteins are produced by that cell [5]. Proteins are important functional molecules, where different proteins have different roles in a cell [5].

So if a bacterium is able to change or add to its DNA through a certain mechanism, it may be able to gain a new function [4]. DNA can mutate (i.e. change spontaneously), or bacteria can uptake new DNA from components of dead bacteria in the environment [4]. Another way a bacteria can acquire new DNA is through a process called conjugation [15], where DNA can be transferred directly from one bacterium to another [16]. This results in transformation, or the incorporation of new DNA into the bacterias existing DNA [16]. Most importantly, new functions gained may be those that allow a bacterium to become resistant to antibiotics, such as by inactivating antibiotics, decreasing antibiotic uptake, excreting the antibiotic before it has a chance to harm the cell, or even using the antibiotic to its advantage, as a substance that promotes growth, for example [10]. Is there anything being done locally to take action against this issue?

Currently, the Canadian Committee on Antibiotic Resistance (CCAR) is developing a National Action Plan to address some of the problems that are related to antibiotic resistance in Canada [1]. Some of the main issues that are being focused upon include [1]: * Putting into place more stringent ways to observe, monitor, and contain infections by organisms that have multiple antibiotic resistance (when dealing with resistance for both human and animal pathogens); * Ensuring the appropriate use of antibiotics in both humans and animals by the above control & safety mechanisms; * Enhancing methods to prevent infection, especially in hospitals; * Distinguishing and pursuing specific areas of research; * Spreading awareness through a widespread information program across all disciplines. In addition, an organization called CHICA-Canada (Community & Hospital Infection Control Association of Canada) plays a powerful role across the country in spreading awareness of infection control through education, awareness and encouraging research [2] [3]. From a global perspective, how is antibiotic resistance affecting society? The treatment of urinary tract infection (UTI) has become increasingly difficult in countries such as India due to multiple antibiotic resistance by its primary cause, the bacterium Escherichia coli, more commonly known as E. coli [7]. The antibiotics, namely ciprofloxacin, SXT and amoxicillin, that were normally used to treat this infection, now show dramatic lack of response from this bacterial strain [7]. How has antibiotic resistance come to be such a serious issue in the world today? The development and continuing severity of antibiotic resistance has been perpetuated through the over-prescription, the widespread use, and the lack of dose completion of antibiotics [9]. All of these may cause bacteria to undergo a process called selection [9]. This is where an antibiotic would initially kill the less fit bacteria, and not finishing ones antibiotic dose would select for or allow the really strong and persistent remaining bacteria (those few who may be a little more resistant and need longer to die) to survive and multiply [9] [14]. Their progeny will demonstrate identical resistance qualities, and any additional changes to their genes could result in a few being even more resistant to the antibiotic [9]. Thus, this process goes on. Also, since prescribing antibiotics for viral infections has no effect on viruses, this just means that any traces of antibiotics taken would get released into the environment, where it may encounter infectious bacteria and repeat the selection process described above [14]. Other instances where antibiotics may get released into the environment are when they are mass distributed to animals [11]. Hold on!! Arent antibiotics necessary to treat animals when they fall ill? You see, in agriculture, antibiotics have three main functions [11]. First, as mentioned, they are used to treat sick animals. However, this accounts for only 1015% of antibiotics used in agriculture. Second, about 30% are also used to prevent disease, a term we call prophylaxis [11]. The need to do this is more important than many people realize. Lets say you happen to have a rather stringent boss at work who makes you work on your feet for 18 hours a day, seven days a week, conducting interviews and making presentations with never a moments rest, and in a heavily metropolitan setting. That kind of stress is likely to take a toll on your immune system, or your bodys natural ability to fight off diseases, right? Well its a similar story with animals on farms. Instead of wearing business suits, running errands and meeting important people, they serve to constantly build up their bodies to produce meat, eggs or milk. Because of this kind of physical stress and crowded living conditions, their ability to fight off disease is more compromised than their more relaxed counterparts [11]. Thus, from the perspective of farmers, financially, it becomes doubly important to prevent disease and keep animals alive as long as possible. The means to do so that have been undertaken have been through the use of antibiotics. Third, using antibiotics as growth promoters, or for weight gain in animals, has been the most controversial aspect of its agricultural use, and accounts for anywhere from 15% to 50% of agricultural antibiotic use [11]. You may ask, How do antibiotics make animals gain weight?!. I must say, it is a complex answer and has a number of theories, but has much to do with the animals staying healthy, fit and disease free 11. And, mind you, the weight gain itself is minimal, at most 4-5%, although even that little is extremely significant in terms of farming practices [11]. The reason that the agricultural use of antibiotics is so controversial boils down to the fact that society just cant agree on the definition of therapeutic or nontherapeutic use of antibiotics in animals. Or in other words, whether antibiotics are really only being used in life-or-death situations. Some say yes for one application, whereas others would disagree. A significant issue in the world today is that antibiotic resistance could continue to develop to the point where some bacteria are resistant to all antibiotics [9]! So, are there any other diseases where this issue has had an impact? As mentioned, genetic change of bacteria, antibiotic over-use and incompletion are causing strains of Staphylococcus aureus to become resistant to multiple antibiotics [9]. A major example of this is an infection called MRSA [9] [14]. Typically the normal bacterial strain is resistant to perhaps a couple of antibiotics but, with regard to MRSA, it is resistant to many more [9]. What is MRSA? MRSA stands for methicillin-resistant Staphylococcus aureus, which is just a fancy way to describe a type of bacteria called Staphylococcus aureus that has become resistant to a number of antibiotics, including one called methicillin [9]. This is only one example of a bacterial strain that has become resistant to multiple antibiotics; others include Vancomycin Resistant Enterococcus (VRE), and Extended Spectrum Beta Lactamase (ESBL) [2].

Normally, the bacterium Staphylococcus aureus is harmless, and lives on the surface of peoples skin and nose of some people [9.] It is when it enters a cut or wound of someone who is already very ill or recovering from surgery, that it may cause infection because that individuals immune system cannot fight off invading organisms too well due to their circumstance [9]. This kind of infection begins with deep skin lesions, and upon entering the bloodstream, can infect the lungs, skin, heart or bones [8]. Why are antibiotic resistant organisms (AROs) particularly important in hospitals? Well, in hospitals antibiotic resistant organisms pose as a serious threat in three ways [9]: * Most patients in hospitals have very poor immune systems and thus have the potential to become infected with other pathogens that are brought into contact with them, especially those as lethal or as powerful as organisms that are resistant to multiple antibiotics. * Secondly, medical apparatuses such as an intravenous drip or a catheter in patients can serve as portals of entry through which AROs or any other infectious agent can infect them. * Often, patients are treated in close living quarters, which significantly increases the chances of AROs spreading among patients. That is why keeping patients known to be infected with any AROs are isolated immediately. * Lastly, and perhaps most ominously, hospitals are unfortunately an ideal environment for bacteria such as Staphylococcus aureus to easily come across a great number of antibiotics. Consequently, AROs can develop through genetic selection and survival of the fittest bacteria. How is MRSA treated? As you can imagine, it is much more difficult to treat MRSA since it is resistant to so many different antibiotics [9]. But its important to note that MRSA is not resistant to every single antibiotic out there (most strains can still be treated with a few antibiotics, such as vancomycin and teicoplanin [9]). The terrifying thought, though, is what will happen if MRSA becomes resistant to those last couple of antibiotics? As mentioned, patients in hospitals or individuals with poor immune systems are at a higher risk of infection with MRSA [9]. Thus, some healthy people get a swab taken of their skin or inside of their nose to see if they are carrying MRSA, which, as you recall, is harmless on the skin [9]. If so, an antibiotic cream applied can reduce the chance of the bacteria entering the body through an open wound and spreading MRSA to other people who are susceptible to it [9]. Is there anything people can do to help combat this issue? To help prevent this potential catastrophe, the following preventative measures need to be taken: First, it is important that medical professionals try to put a halt to prescribing antibiotics for viral infections [9]. As you may recall, antibiotics have absolutely no effect on viruses, such as the common cold. At one time, antibiotics were administered to help prevent a secondary infection with bacteria, which also increases the development of resistance [9]. A secondary infection is one in which a bacterium takes advantage of an already ill host to invade. Secondly, in the instance that individuals do acquire bacterial infections, having them finish their entire dose of antibiotics, whether or not they feel better early, is critical [9]. Doing so stops resistant bacteria in their tracks from surviving and multiplying [9]. Like bouncers at a night club, finishing ones antibiotic dose takes care of those last tough stragglers, until the partys over. And thirdly, measures to control infections in hospitals include frequent hand washing (especially of healthcare staff between patients) [9]. This has been proven to drastically decrease or stop the chances of any particular resistant bacterium infecting multiple patients [9]. Why cant we just make more antibiotics? This certainly seems like an obvious question, however, researching and developing new drugs is not only very difficult and expensive (the cost to bring a drug from initial research to the public is about $900 million US), but also there is often little guarantee that these funds can be recovered through sales of the drug, due to the unpredictable risk of an antibiotic becoming completely resisted by bacteria and thus potentially useless [12]. In addition, there are only so many types of antibiotics; as the years progress, it is becoming increasingly difficult to find completely new ways in which they can be effective [12].

Unsurprisingly as a result, experimental undertaking into developing new antibiotics has more than halved in the past ten years alone 12. Pharmaceutical companies prefer to instead focus their efforts on drugs that have more public appeal, and thus guaranteed profit [12].

We are all familiar with the term antibiotics . Antibiotics are medicines that are frequently prescribed by physicians to cure minor ailments as well as life threatening

diseases. However, these pills are taken for granted and they are consumed like sweets for every minor ailment. But the question arises, are antibiotics really good? Let s first understand: what is the role of antibiotics? The human body has white blood cells that naturally attack harmful bacteria present in our body. When the body s immunity is low and the white blood cells are unable to fight off the infection, they need help from antibiotics. Antibiotics are drugs used to treat infections caused by bacteria. They either kill the bacteria or stop them from multiplying thus protecting us from the infection. It is necessary to understand that antibiotics are used to treat ailments caused by bacteria but they do not work against illness like running nose, flu, sore throat, etc, that are caused by virus.
Though antibiotics safeguard our health, why is it advised not to have antibiotics regularly?

A good immune system helps to fight against bacteria that enter our body. It is generally advised not to consume antibiotics regularly as it is important to let the body work in its natural way and not get used to external helping agents. Antibiotics are not suitable for diseases like common cold and flu and other viral infections. Having regular antibiotics can lead to side effects; secondly, the germs get used to the antibiotics and develop antibiotic resistance.
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It is also seen that most individuals stop taking medicines when they start feeling better and do not complete the antibiotic course recommended by the physician. Is it safe to discontinue antibiotics if you are already feeling well?

When people consume medicines they generally start feeling better when the antibiotics attack the germs. It is important to remember that these antibiotics do not kill 100% of the germs at a time. If the medications are stopped before the dose is completed, a certain amount of germs are still left in the body and they start growing. These germs develop resistance to this antibiotic and do not respond to the regular treatment and may cause severe conditions. Hence it is very essential to complete the antibiotic dosage to ensure that the body is free from almost all of the infectious bacteria.
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It has been seen that parents self medicate antibiotics to their children. Is it safe to start the antibiotic course without the consent of the doctor?

Children generally have viral infections that are transmitted from one person to another. Viral infections do not need antibiotics except if there is a secondary problem. Parents should not self medicate medicines for ailments like cold, sore throat etc He adds Children who are immunized well need antibiotics on fewer occasions. Parents

generally use antibiotics that are previously recommended by doctors. Previously used antibiotics may not solve the problem but aggravate the same because:
1. 2. 3.

Parents tend to wait for a few days after the giving the medicine. This increases the severity of the illness and leads to a longer time to recover. Children develop resistance to the antibiotics which are used frequently and develop resistance to these drugs which in turn develops the need of higher doses. The most important point to remember before giving medicines is that the child suffers the most as there are side effects to the antibiotics like loss of appetite, loose motions, etc, that cause discomfort to the child.

What are the important points to remember before taking antibiotic?

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Always have antibiotics exactly as prescribed by the doctor. Ensure that you have the correct dosage. Some antibiotics are consumed an hour before the meal while some antibiotics need to be taken after meals, it is necessary that you follow the instructions correctly for medications to be effective. Take the medicine for as long as prescribed by the physician. Even though you may start feeling better it is necessary that you complete the prescribed dosage. It is necessary to remember that the bacteria that the antibiotic cannot kill can redevelop if you take only part of the antibiotic prescription. If the antibiotics cause severe side effects that affect your daily routine call your doctor for guidance.

Antibiotics are like double edged knives; they fight against severe infection but could be dangerous to your health. It is the responsibility of every individual to become educated, change behavior, and reap the benefits of effective antibiotics to treat bacterial illnesses.