What are Antibiotics?
The word “antibiotics” comes from the Greek anti (“against”) and bios (“life”). Antibiotics are drugs that either destroy bacteria or prevent their reproduction. Antibiotics that kill bacteria are called “bactericidal” and the ones that stop the growth of bacteria are called “bacteriostatic”.
Since penicillin’s introduction during the 1940s, scientists developed numerous other antibiotics. Today, over 100 different antibiotics are available. About 90% of antibiotics are made from living organisms such as bacteria, others are produced synthetically, either in whole or in part.
Antibiotics classification
Although there are several classification schemes for antibiotics, based on bacterial spectrum (broad, narrow) or route of administration (injectable, oral, topical), or type of activity (bactericidal, bacteriostatic), the most useful is based on chemical structure. Antibiotics within a structural class will generally have similar patterns of effectiveness, toxicity, and allergic potential.
Most commonly used types of antibiotics are: Penicillins, Fluoroquinolones, Cephalosporins, Macrolides, and Tetracyclines. While each class is composed of multiple drugs, each drug is unique in some way.
Penicillins
The penicillins are the oldest class of antibiotics. Penicillins have a common chemical structure which they share with the cephalopsorins. Penicillins are generally bactericidal, inhibiting formation of the cell wall.
There are four types of penicillins:
The natural pencillins are based on the original penicillin-G structure. Penicillin-G types are effective against gram-positive strains of streptococci, staphylococci, and some gram-negative bacteria such as meningococcus.
Penicillinase-resistant penicillins are active even in the presence of the bacterial enzyme that inactivates most natural penicillins.
Extended spectrum penicillins which are effective against a wider range of bacteria.
Aminopenicillins such as ampicillin and amoxicillin have an extended spectrum of action compared with the natural penicillins.
Penicillins side effects
Penicillins are among the least toxic drugs known. The most common side effect of penicillin is diarrhea. Nausea, vomiting, and upset stomach are also common. In rare cases penicillins can cause immediate and delayed allergic reactions – specifically, skin rashes, fever, and anaphylactic shock. Penicillins are classed as category B during pregnancy.
Cephalosporins
Cephalosporins have a mechanism of action identical to that of the penicillins. However, the basic chemical structure of the penicillins and cephalosporins differs in other respects, resulting in some difference in the spectrum of antibacterial activity. Like the penicillins, cephalosporins interfere with synthesis of the bacterial cell wall and so are bactericidal.
Cephalosporins are among the most diverse classes of antibiotics, they are grouped into “generations” by their antimicrobial properties. Each generation has a broader spectrum of activity than the one before.
The first generation cephalosporins include: cephalothin, cefazolin, cephapirin, cephradine, cephalexin, cefadroxil. Their spectrums of activity are quite similar. They possess generally excellent coverage against most gram-positive pathogens and variable to poor coverage against most gram negative pathogens.
The second generation cephalosporins include: cefaclor, cefamandole, cefonicid, ceforanide, cefuroxime. In addition to the gram-positive spectrum of the first generation cephalosporins, these agents have expanded gram-negative spectrum. Cefoxitin and cefotetan also have good activity against Bacteroides fragilis.
The third generation cephalosporins have much expanded gram-negative activity. However, some members of this group have decreased activity against gram-positive organisms. The third generation cephalosporins include: cefcapene, cefdaloxime, cefditoren, cefetamet, cefixime, cefmenoxime, cefodizime, cefoperazone, cefotaxime, cefpimizole, cefpodoxime, ceftibuten, ceftriaxone. They have the advantage of convenient dosing schedules, but they are expensive.
The fourth generation cephalosporins are extended-spectrum agents with similar activity against gram-positive organisms as first-generation cephalosporins. They also have a greater resistance to beta-lactamases (bacterial enzymes that may destroy antibiotic before it can do its work) than the third generation cephalosporins. Many fourth generation cephalosporins can cross blood brain barrier and are effective in meningitis. The fourth generation cephalosporins include: cefclidine, cefepime, cefluprenam, cefozopran, cefpirome, cefquinome.
Cephalosporin side effects
Cephalosporins generally cause few side effects. Common side effects associated these drugs include: diarrhoea, nausea, mild stomach cramps or upset. Approximately 5Ц10% of patients with allergic hypersensitivity to penicillins will also have cross-reactivity with cephalosporins. Thus, cephalosporin antibiotics are contraindicated in people with a history of allergic reactions (urticaria, anaphylaxis, interstitial nephritis, etc) to penicillins or cephalosporins. Cephalosporin antibiotics are classed as pregnancy category B.
Fluroquinolones
Fluoroquinolones are the newest class of antibiotics. Their generic name often contains the root “floxacin”. They are synthetic antibiotics that belong to the family of antibiotics called quinolones. The older quinolones are not well absorbed and are used to treat mostly urinary tract infections. The newer fluroquinolones are broad-spectrum bacteriocidal drugs that are chemically unrelated to the penicillins or the cephaloprosins. Because of their excellent absorption fluroquinolones can be administered not only by intravenous but orally as well.
Commonly used fluoroquinolones include ciprofloxacin, levofloxacin, lomefloxacin, norfloxacin, sparfloxacin, clinafloxacin, gatifloxacin, ofloxacin, trovafloxacin.
Fluoroquinolones side effects
Fluoroquinolones are well tolerated and relatively safe. The most common side effects include nausea, vomiting, diarrhea, abdominal pain. Other more serious but less common side effects are central nervous system effects (headache, confusion and dizziness), phototoxicity (more common with lomefloxacin and sparfloxacin). All drugs in this class have been associated with convulsions. Fluoroquinolones are classed as pregnancy category C.
Tetracyclines
Tetracyclines got their name because they share a chemical structure that has four rings. They are derived from a species of Streptomyces bacteria. Tetracycline antibiotics are broad-spectrum bacteriostatic agents, that inhibit bacterial protein synthesis. Tetracyclines may be effective against a wide variety of microorganisms, including rickettsia and amebic parasites.
Tetracyclines are used in the treatment of infections of the respiratory tract, sinuses, middle ear, urinary tract, skin, intestines. Tetracyclines also are used to treat Gonorrhoea. Their most common current use is in the treatment of moderately severe acne and rosacea.
The most commonly prescribed tetracycline antibiotics are: tetracycline, doxycycline, minocycline, oxytetracycline.
Tetracycline side effects
Drugs in the tetracycline class become toxic over time. Expired drugs can cause a dangerous syndrome resulting in damage to the kidneys.
Common side effects associated with tetracyclines include cramps or burning of the stomach, diarrhea, sore mouth or tongue. Tetracyclines can cause skin photosensitivity, which increases the risk of sunburn under exposure to UV light. This may be of particular importance for those intending to take on holidays long-term doxycyline as a malaria prophylaxis. Rarely, tetracyclines may cause allergic reactions. Very rarely severe headache and vision problems may be signs of dangerous secondary intracranial hypertension.
Tetracycline antibiotics should not be used in children under the age of 8, and specifically during periods of tooth development. Tetracyclines are classed as pregnancy category D. Use during pregnancy may cause alterations in bone development.
Macrolides
The macrolide antibiotics are derived from Streptomyces bacteria, and got their name because they all have a macrocyclic lactone chemical structure. The macrolides are bacteriostatic, binding with bacterial ribosomes to inhibit protein synthesis. Erythromycin, the prototype of this class, has a spectrum and use similar to penicillin. Macrolide antibiotics are used to treat respiratory tract infections (such as pharyngitis, sinusitis, and bronchitis), genital, gastrointestinal tract, and skin infections.
The most commonly prescribed macrolide antibiotics are: erythromycin, clarithromycin, azithromycin, roxithromycin, troleandomycin.
Macrolides side effects
Side effects associated with macrolides include nausea, vomiting, and diarrhea; infrequently, there may be temporary auditory impairment. Azithromycin has been rarely associated with allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions. Oral erythromycin may be highly irritating to the stomach and when given by injection may cause severe phlebitis. Macrolide antibiotics should be used with caution in patients with liver dysfunction. Pregnancy category B: Azithromycin, erythromycin. Pregnancy category C: Clarithromycin, dirithromycin, troleandomycin.
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Women take antibiotics for a number of ailments and reasons, but one has to keep in mind that one must consult a doctor, gynecologist or obstetrician before taking antibiotics during pregnancy and childbirth. Often, even the dentist consults a gynecologist before prescribing an antibiotic to his pregnant patient. He has to be sure that the antibiotics being prescribed by him prescribing are safe antibiotics or not during this time. There are several categories of antibiotics depending on their role and effect in the body of the pregnant women.
Antibiotic Category A
Very few antibiotics fall under this category and this category A signifies that there is no harm that will befall a pregnant woman if she takes these antibiotics. She can take this drug during her first trimester till delivery and it is the safest of all antibiotics.
Antibiotic Category B
The majority of all antibiotics come under this category. There is no proven research to show that this category is harmful to expectant mothers or the unborn kid. This category like the one before is safe to be taken during pregnancy without any untoward side-effect.
Antibiotic Category C
There is not much data on the usage and effects of antibiotics under this category. Hence, antibiotics of category C are strictly prohibited for use during pregnancy and childbirth.
Antibiotic Category D
Any antibiotics under this category are to be avoided under any circumstances during pre-natal care as well as pregnancy. If only there is no better alternative, one can take them but it comes with risks for the unborn child.
Along with information of antibiotics during pregnancy and childbirth, one must also take into consideration these factors.
- The kind of antibiotic being taken
- The dose of antibiotic that is prescribed
- Duration of the medication
- Your pregnancy trimester
The duration of taking an antibiotic is very important since prolong use of an antibiotic can lead to causing certain deformities in the unborn child and in worse cases may lead to a miscarriage. There are certain antibiotics that are safe during certain trimesters hence the trimester is an important factor. The safest antibiotics during pregnancy are penicillin, cephalosporin and erythromycin. Though they are safe, you must take a multivitamin along with. If you are taking a antibiotic to treat an urinary infection, combining it with a 400 ml dose of folic acid is important. Antibiotics that are suggested for the treatment of TB, respiratory infections and acne should be avoided at all costs as they might cause deafness in the child and give permanent discoloration of the baby’s teeth.
It is very important to weight the pros and cons during pregnancy if you have been prescribed to take antibiotics. Any infection affecting the mother will affect the unborn child so one needs to visit the doctor at all times during pregnancy and not self-medicate. The physician can administer the safest medication with the best appropriate dose for the pregnant mother during this time. It is safest to consult your obstetrician and gynecologist before taking any kind of medicines or antibiotics during pregnancy, considering the fact that it may or may not be safe for you or your unborn child.
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Because of the fact that acne breakouts are brought about minimally due to the occurrence of acne bacteria it is relatively useful for some to use antibiotics to help treat the condition. You can find possibilities that can meet your needs, according to what is leading to your own acne along with your physician’s decision on the right way to apply treatment to it. You must always look for a physician to guide in the purchasing of any kind of prescription medication like antibiotics. In the matter of acne usually your family physician is capable of doing this for you or in case he or she thinks it is necessary, direct you to a skin care specialist.
The antibiotics that will be used to be able to deal with acne are provided as possibly a topical item or an antibiotic to be taken orally. It is often demonstrated they offer you close to the same degree of relief regardless of how they are employed.
Oral antibiotics may be advantageous in addition to topical ointment treatments. For those who have a considerable region which is in need of management, these will likely be really quite tough to deal with with topical creams. With this scenario it is typically more convenient as well as a good deal more powerful all around, to just simply take the medicine orally. Some of the oral choices to relieve acne breakout consist of tetracycline or erythromycin. They are the most frequently used selections of oral antibiotics for acne healing. Most of these medications can be of help to you to cut back on the acne bacteria on your skin triggering the preliminary infection. Unfortunately this solution individually does not improve the acne that you have.
On the contrary, topical cream remedies might basically be more beneficial for many people mainly because they do not produce the uncomfortable side effects which consuming the antibiotics can sometimes trigger, for instance stomach complaints plus drug interactions because of various other medicines that you happen to be taking. The most typical categories of antibiotics meant for topical treatments meant for acne include things like erythromycin, clindamycin and in some cases tetracycline.
Just like countless alternatives which are generally provided in an effort to get rid of acne, utilizing antibiotics is firmly confined to getting rid of the signs or symptoms of the situation and not the real basic cause. Antibiotics may help with the alleviation of acne but they do even better when they are coordinated with other programs that happen to be aimed towards the origin of the acne.
More often than not, the answer to the problem depends upon figuring out precisely why the oil glands are generating such an over-production of oil that the skin pores are not able to handle and they are becoming blocked. It is this particular scenario that makes it possible for the acne bacteria to take hold in the beginning causing the need pertaining to the antibiotics.
That exploration with regard to the cause of ones own acne regularly points to the correlation between hormones and acne breakouts. Most varieties of an individuals acne could be tracked to a hormonal imbalance starting a cycle of events bringing about an acne breakout. Still the significant factor you are interested in is actually what is driving the hormonal imbalance to begin with.
The moment you have discovered that central trigger, whether or not it is emotional stress, diet regime, digestion troubles, vitamin and mineral imbalances or whatever you can subsequently get started on a serious treatment of the condition. That is exactly why it is normally a good idea to adopt and abide by an recognized acne treatment system that includes every factor behind the cause of acne.
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Asthma in our children is an epidemic. I have long argued that the asthma epidemic in American children is a result of the incompetent practice of medicine that relies on the use of highly toxic antibiotics in children. My position is now confirmed by a new Yale University study1 that followed 1400 children from birth until 6 years of age.
The study is significant because it distinguishes between antibiotics for respiratory infections wherein the respiratory infection may have been the first sign of asthma. The researchers simply eliminated those from the study who were given antibiotics for respiratory infection.
The researchers found that a single course of antibiotics given within the first six months of life resulted in a 52% increased risk of developing asthma by age 6. To the surprise of the researchers, in families with no history of asthma the risk was even higher – 89%.
“What we think is that antibiotics interfere with the beneficial bacteria found in the gut. These bacteria aid in helping the baby’s immune system to mature. When the bacteria are affected, it can cause the child to have an “immature” immune system, which in turn leads to allergic reactions,” said lead study author Kari Risnes.
I would concur with that hypothesis and add that the use of antibiotics enable germ gangs2 to form and take over territory in the GI tract. Particularly problematic is the overgrowth of Candida albicans. When Candida reproduces is generates an inflammatory compound called oxylipin3 which researchers at the University of Michigan have shown to cause respiratory inflammation and asthma. In fact, Candida oxylipins can cause inflammation anywhere in your body by directly interacting with the human genome and tilting immune cells into an inappropriate pro-inflammatory pattern.
If a child has truly needed antibiotics for some reason then parents have an extra responsibility to ensure their child’s GI tract has recovered. Parents allow far too much germ-building junk in a child’s diet which includes fruit juice instead of fresh fruit, sugary drinks, sugary foods, foods with food coloring, and junk fats. Eliminating all the garbage would go a long way towards helping to develop a healthier GI tract. If problems have occurred, then extra work is needed to get the GI tract back on the right path of development. This also improves the overall immune response and helps make the child more resistant to fighting bugs. There is nothing worse for a child’s health in the short term or the long run than repeated antibiotic use in the formative years.
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