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Antib iotics are chemicals used to fight diseases caused by pathogens such as bacteria, fungi, or protozoa. Only a few antibiotics are effective against just a few viruses. Antibiotics can be used to fight infections because they are toxic to specific microbes. They may be prescribed to prevent infection when the immune system is impaired, or when there is a risk of endocarditis (inflammation of the lining of the heart). Before the advent of modern antibiotics, many patients experienced a uniform progression of the disease to the death. Antibiotics were originally produced from selected mold and fungi found in the earth, air, or water.
Since the 1930s, thousands of antibiotics have been found in nature; however, only a few (over 60) have been found to be safe for use as medicines. Most modern antibiotics are made synthetically by chemical means. Millions of tons of antibiotics are manufactured every year in a process that brews a culture of the microbe that produces the chemical that is the active agent in fighting a disease. After the antibiotic broth is filtered, the antibiotic molecules are combined with a resin that is washed to collect the pure antibiotic crystals.
In the late 1800s, a Danish bacteriologist, Hans Gram, classified bacterial infections as either gram positive (G+) or as gram negative (G-). Bacteria in these categories are sensitive to some drugs, and not to others. If an antibiotic fights only a few bacteria infections, it is called a limited-spectrum drug. If it fights a wide variety of bacteria that are both G+ and G-, it is called a broad-spectrum antibiotic.
Bactericidal antibiotics are drugs that kill bacteria by causing a disruption in its cell walls, causing the bacterial cell wall to turn into water and allowing water to flood the cell. It then explodes, killing the bacteria. They do not have any affect upon human tissue. Other antibiotics are bacteriostatic drugs, which work by disrupting the growth of bacteria. This allows the immune system to have time for fighting successfully the infection. The most common forms of antibiotics include aminoglycosides, macrolides, penicillins, tetracyclines, and cephalosporins. Each works in a different way.
The aminoglycosides include drugs such as gentamicin, anikacin, and tobramycin, which prevent bacteria from producing protein; however, they can damage internal ear nerves and the kidneys. Macrolides also disrupt protein production by bacteria. Erythromycin, a macrolide, can cause bowel discomfort.
Sir Alexander Fleming discovered penicillin in 1928. Many kinds of bacteria are destroyed with penicillin drugs, which destroy bacteria cell walls. However, it can cause side effects ranging from a rash or fever, to life-threatening allergic reactions (anaphylaxis). Tetracyclines can destroy both bacteria and other organisms, and prevent the production of protein in many germs. However, side effects such as gastric discomfort, sensitivity of skin to sunlight, liver damage, or kidney damage may occur. The cephalosporins, which disrupt bacteria cell wall formation, are antibiotics that are effective against a wide range of bacteria. Cefaclor is a commonly prescribed cephalosporin. At times, physicians will prescribe a combination of antibiotics in order to ensure the destruction of the infectious bacteria and to reduce the risk of drug resistance. This can happens if a bacteria simply mutates, or if it is able to develop a growth mechanism that allows it to grow unaffected by the drug. Or, the bacteria may produce an enzyme that neutralizes the drug.
Antimicrobial resistance to antibiotics drugs is a growing, global problem that has alarmed some health care professionals, because diseases once “conquered” are returning in the form of strains that are resistant to older antibiotics. It has arisen because bacteria not killed by a specific antibiotic were able to reproduce, carrying that characteristic that resisted the drug. If a patient fails to take a full course of medicine or take it as directed, resistance may develop. Resistance has been found in strains of tuberculosis, sexually transmitted diseases (STDs), and other diseases that now pose a renewed threat to human and animal health.
While powerful antibiotics are available, serious questions have been raised about the wisdom of administering these drugs to patients with lifestyles that suggest they may not follow proper treatment procedures and may increase the likelihood of new strains of resistant bacteria developing and transmitting to others. The consequences could be the spread of diseases for which there are few, if any, treatments available.
The overuse of antibiotics has exacerbated this problem, with widespread prescription of antibiotics by physicians for conditions that rarely respond to the treatment, such as childhood ear infections. Antimicrobial soaps and other commercial consumer products may also accelerate the evolution and adaptation of various microbes toward immunity. Antibiotics have been used as a food preservative by the food industry, and ranchers and farmers also use antibiotics in order to stimulate animal growth.
The degree to which this widespread use may further influence the resistance of microbes remains a controversy, especially as the livestock industry has rapidly industrialized.
Besides side effects, antibiotics can have other negative consequences. For instance, some antibiotic drugs may become toxic if they are taken after their effective date. Since 1900, the world’s population has grown enormously. Antibiotics have played a major role in that growth. However, the emergence of resistant microbes poses a grave threat to the future of human life and health.
- Harry F. Dowling, Fighting Infection: Conquests of the Twentieth Century (iUniverse, 2000);
- Norbert Gualde, Resistance: The Human Struggle against Infection (Dana Press, 2006);
- Milton Wainwright, The Story of Antibiotics and the Golden Age of Antibiotics (Oxford-Blackwell, 1990).