Antibiotic

An antibiotic is a type of antimicrobial substance active

against bacteria and is the most important type of antibacterial agent
for fighting bacterial infections. Antibiotic medications are widely used
in the treatment and prevention of such infections.[1][2] They may
either kill or inhibit the growth of bacteria. A limited number of
antibiotics also possess antiprotozoalactivity.[3][4] Antibiotics are not
effective against viruses such as the common cold or influenza; drugs
which inhibit viruses are termed antiviral drugs or antivirals rather
than antibiotics.
Sometimes, the term antibiotic which means "opposing life", based
on Greekroots, (ἀντι-) anti: "against" and (βίος-) biotic: "life", is
broadly used to refer to any substance used against microbes, but in
the usual medical usage, antibiotics (such as penicillin) are those
produced naturally (by one microorganism fighting another), whereas
nonantibiotic antibacterials (such as sulfonamides and antiseptics)
are fully synthetic. However, both classes have the same goal of killing
or preventing the growth of microorganisms, and both are included
in antimicrobial chemotherapy. "Antibacterials"
include antiseptic drugs, antibacterial soaps, and
chemical disinfectants, whereas antibiotics are an important class of
antibacterials used more specifically in medicine[5] and sometimes in
livestock feed.
Medical uses
Antibiotics are used to treat or prevent bacterial infections,
[12]
and sometimes protozoan infections. (Metronidazole is
effective against a number of parasitic diseases). When an
infection is suspected of being responsible for an illness but
the responsible pathogen has not been identified, an empiric
therapy is adopted.[13] This involves the administration of
a broad-spectrum antibiotic based on the signs and symptoms
presented and is initiated pending laboratory results that can
take several days.[12][13]
When the responsible pathogenic microorganism is already
known or has been identified, definitive therapy can be
started. This will usually involve the use of a narrow-spectrum
antibiotic. The choice of antibiotic given will also be based on
its cost. Identification is critically important as it can reduce
the cost and toxicity of the antibiotic therapy and also reduce
the possibility of the emergence of antimicrobial resistance.
[13]
To avoid surgery, antibiotics may be given for non-
complicated acute appendicitis.[14]
Antibiotics may be given as a preventive measure and this is
usually limited to at-risk populations such as those with
a weakened immune system (particularly in HIV cases to
prevent pneumonia), those taking immunosuppressive
drugs, cancerpatients, and those having surgery.[12] Their use
in surgical procedures is to help prevent infection of incisions.
They have an important role in dental antibiotic
prophylaxis where their use may prevent bacteremia and
consequent infective endocarditis. Antibiotics are also used to
prevent infection in cases of neutropenia particularly cancer-
related.
Side-effects
Antibiotics are screened for any negative effects before their
approval for clinical use, and are usually considered safe and
well tolerated. However, some antibiotics have been
associated with a wide extent of adverse side effects ranging
from mild to very severe depending on the type of antibiotic
used, the microbes targeted, and the individual patient.[21]
[22]
Side effects may reflect the pharmacological or
toxicological properties of the antibiotic or may involve
hypersensitivity or allergic reactions.[4]Adverse effects range
from fever and nausea to major allergic reactions,
including photodermatitis and anaphylaxis.[23] Safety profiles
of newer drugs are often not as well established as for those
that have a long history of use.[21]
Common side-effects include diarrhea, resulting from
disruption of the species composition in the intestinal flora,
resulting, for example, in overgrowth of pathogenic bacteria,
such as Clostridium difficile.[24] Antibacterials can also affect
the vaginal flora, and may lead to overgrowth of yeast species
of the genus Candida in the vulvo-vaginal area.[25] Additional
side-effects can result from interaction with other drugs, such
as the possibility of tendon damage from the administration
of a quinolone antibiotic with a systemic corticosteroid.
Classes
Antibiotics are commonly classified based on their mechanism
of action, chemical structure, or spectrum of activity. Most
target bacterial functions or growth processes.[54] Those that
target the bacterial cell wall (penicillins and cephalosporins)
or the cell membrane (polymyxins), or interfere with essential
bacterial enzymes (rifamycins, lipiarmycins, quinolones,
and sulfonamides) have bactericidal activities. Protein
synthesis inhibitors (macrolides, lincosamides,
and tetracyclines) are usually bacteriostatic (with the
exception of bactericidal aminoglycosides).[55] Further
categorization is based on their target specificity. "Narrow-
spectrum" antibiotics target specific types of bacteria, such
as gram-negative or gram-positive, whereas broad-spectrum
antibiotics affect a wide range of bacteria. Following a 40-year
break in discovering new classes of antibacterial compounds,
four new classes of antibiotics have been brought into clinical
use in the late 2000s and early 2010s: cyclic lipopeptides (such
as daptomycin), glycylcyclines (such
as tigecycline), oxazolidinones (such as linezolid),
and lipiarmycins (such as fidaxomicin).
Production
With advances in medicinal chemistry, most modern
antibacterials are semisynthetic modifications of various
natural compounds. These include, for example, the beta-
lactam antibiotics, which include the penicillins (produced by
fungi in the genus Penicillium), the cephalosporins, and
the carbapenems. Compounds that are still isolated from
living organisms are the aminoglycosides, whereas other
antibacterials—for example, the sulfonamides,
the quinolones, and the oxazolidinones—are produced solely
by chemical synthesis.[58] Many antibacterial compounds are
relatively small molecules with a molecular weight of less
than 1000 daltons.
Since the first pioneering efforts of Howard
Florey and Chain in 1939, the importance of antibiotics,
including antibacterials, to medicine has led to intense
research into producing antibacterials at large scales.
Following screening of antibacterials against a wide range of
bacteria, production of the active compounds is carried out
using fermentation, usually in strongly aerobic conditions.
References
1. ^ Jump up to:a b c "Antibiotics". NHS. 5 June 2014.
Retrieved 17 January 2015.
2. ^ "Factsheet for experts". European Centre for Disease
Prevention and Control. Retrieved 21 December 2014.
3. ^ For example, metronidazole: "Metronidazole". The
American Society of Health-System Pharmacists.
Retrieved 31 July 2015.
4. ^ Jump up to:a b Chemical Analysis of Antibiotic Residues in
Food(PDF). John Wiley & Sons, Inc. 2012. pp. 1–
60. ISBN 978-1-4496-1459-1.
5. ^ "General Background: Antibiotic Agents". Alliance for the
Prudent Use of Antibiotics. Retrieved 21 December 2014.
6. ^ Gualerzi CO, Brandi L, Fabbretti A, Pon CL (4 December
2013). Antibiotics: Targets, Mechanisms and Resistance.
John Wiley & Sons. p. 1. ISBN 978-3-527-33305-9.
7. ^ "Antibiotics being incorrectly prescribed in Australian
nursing homes, prompting superbug fears". ABC Australia.
10 June 2016. Retrieved 12 June 2016.
8. ^ "UK study warns of threat of antibiotics overuse, lack of
new drugs". CCTV America. 19 May 2016. Retrieved 12
June 2016.