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Introduction and Medical Uses of Antibiotics
- Etymology: Antibiosis was first observed in 1877 by Louis Pasteur and Robert Koch. The term antibiotic was first used in 1942 by Selman Waksman.
- Usage: Antibiotics are used to treat or prevent bacterial and sometimes protozoan infections. Empiric therapy and definitive therapy are two approaches to antibiotic treatment.
- Routes of Administration: Antibiotics can be taken orally, intravenously, or topically depending on the severity and location of the infection.
Antibiotic Resistance
- Impact of Resistance: Overuse and easy access to antibiotics have led to the emergence of antibiotic resistance. The World Health Organization considers antimicrobial resistance a widespread serious threat. Global deaths attributable to antimicrobial resistance numbered 1.27 million in 2019.
- Types of Antibiotics: Antibiotics can be classified into different types, such as penicillins, cephalosporins, tetracyclines, macrolides, and fluoroquinolones. Combination therapy may be necessary for certain infections or to prevent the emergence of resistance.
Side Effects and Interactions
- Side Effects: Antibiotics can have mild to severe side effects, including fever, nausea, and allergic reactions. Common side effects of oral antibiotics include diarrhea and overgrowth of pathogenic bacteria. They can also affect the vaginal flora and lead to yeast overgrowth.
- Interactions: Some antibiotics may interact with oral contraceptives, potentially increasing the risk of contraceptive failure. Alcohol can also interact with certain antibiotics, causing serious side effects or reducing their efficacy.
Pharmacodynamics and Combination Therapy
- Pharmacodynamics: The successful outcome of antimicrobial therapy depends on various factors, including the bactericidal activity of antibiotics and their pharmacokinetic profile.
- Combination Therapy: Combination therapy is used to delay or prevent the emergence of resistance and can improve treatment outcomes through synergistic effects. However, some combinations may be antagonistic and less effective than monotherapy.
Antibiotic Production, Misuse, and Impact on Health
- Antibiotic Production: Most modern antibiotics are semisynthetic modifications of natural compounds. Antibacterials are produced through fermentation in aerobic conditions.
- Misuse: Inappropriate antibiotic treatment and overuse contribute to antibiotic-resistant bacteria. Common forms of misuse include self-prescribing and excessive prophylactic use.
- Impact on Health: Antibiotic-resistant strains contribute to the emergence of diseases that were previously controlled. Multidrug-resistant tuberculosis and newly identified enzymes like NDM-1 are examples of antibiotic resistance.