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Antibiotics

Antibiotics are substances produced by microorganisms that inhibit or kill other microorganisms at low concentrations, excluding certain natural substances. They can be derived from fungi, bacteria, and actinomycetes, and work through various mechanisms such as inhibiting cell wall synthesis and interfering with DNA function. Therapeutically, antibiotics are used for treating infections, prophylaxis against specific organisms, and preventing infections in high-risk situations, although their general preventive use is often deemed unsatisfactory.

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93 views3 pages

Antibiotics

Antibiotics are substances produced by microorganisms that inhibit or kill other microorganisms at low concentrations, excluding certain natural substances. They can be derived from fungi, bacteria, and actinomycetes, and work through various mechanisms such as inhibiting cell wall synthesis and interfering with DNA function. Therapeutically, antibiotics are used for treating infections, prophylaxis against specific organisms, and preventing infections in high-risk situations, although their general preventive use is often deemed unsatisfactory.

Uploaded by

Mohit MIshra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Antibiotics

These are substances produced by microorganisms, which selectively suppress


the growth of or kill other microorganisms at very low concentrations. This
definition excludes other natural substances which also inhibit microorganisms
but are produced by higher forms (e.g. antibodies) or even those produced by
microbes but are needed in high concentrations (ethanol, lactic acid, H 2O2).

(The term Antimicrobial agent (AMA) is used to designate synthetic as well as


naturally obtained drugs that attenuate microorganisms.)

Antibiotics are obtained from:

1.Fungi
Penicillin Griseofulvin
Cephalosporin
2.Bacteria
Polymyxin B Tyrothricin
Colistin Aztreonam
Bacitracin
3.Actinomycetes
Aminoglycosides Macrolides
Tetracyclines Polyenes
Chloramphenicol

Mechanism of action
1. Inhibit cell wall synthesis: Penicillins, Cephalosporins, Vancomycin.
2. Cause leakage from cell membranes: Amphotericin B, Hamycin.
3. Inhibit protein synthesis: Tetracyclines, Chloramphenicol, Erythromycin.
4. Cause misreading of m-RNA code and affect permeability:
Aminoglycosides— Streptomycin, Gentamicin, etc.
5. Inhibit DNA gyrase: Fluoroquinolones— Ciprofloxacin and others.
6. Interfere with DNA function: Rifampin.
7. Interfere with DNA synthesis: Acyclovir
8. Interfere with intermediary metabolism: Sulfonamides

THERAPEUTIC USE OF ANTIBIOTICS


1.To reduce severity or incidence of adverse effects
2.Initial treatment of severe infections
3.PROPHYLACTIC USE OF ANTIBIOTICS
This refers to the use of antibiotics for preventing the setting in of an infection
or suppressing contacted infection before it becomes clinically manifest. The
latter is also called ‘preemptive therapy’, which capitalizes on the small
population of pathogen in the body before the disease is manifest.
A. Prophylaxis against specific organisms
Cholera: tetracycline prophylaxis may be given to close contacts of a
case.
Tuberculosis: Children, HIV positive and other susceptible contacts of
open cases need to be protected. Isoniazid alone or with rifampin is
recommended.
Rheumatic fever: A long acting penicillin G is the drug of choice for
preventing infection by group A streptococci which cause recurrences.

B. Prevention of infection in high risk situations


Catheterization or instrumentation of urinary tract: prophylaxis with
cotrimoxazole or norfloxacin decreases the risk of urinary tract infection
(UTI). Patients with cardiac valvular lesions may be protected with
ampicillin, gentamicin or vancomycin during catheterization.
Chronic obstructive lung disease, chronic bronchitis:
ampicillin/doxycycline/ciprofloxacin has been used to prevent acute
exacerbations
 Immunocompromized patients (receiving corticosteroids or antineoplastic
chemotherapy or immunosuppressants after organ transplantation, neutropenic
patients): penicillin/cephalosporin ± an aminoglycoside or fluoroquinolone are
often used to prevent respiratory tract infections and septicaemia, but incidence
of superinfections is high.
C. Prophylaxis of surgical site infection
Surgical site infection (SSI) includes superficial incisional infections (e.g. stitch
abscess), deep incisional infection (of soft tissue) and organ/ space infection.
The purpose of surgical prophylaxis is to reduce the incidence of SSI with
minimal alteration of normal microbial flora of the host and minimal adverse
effects.
D. Prevention of infection in general This is highly unsatisfactory in most
cases and must be condemned. Examples are:
(a) Neonates, especially after prolonged or instrumental delivery.
(b) To prevent postpartum infections in the mother after normal delivery.
(c) Viral upper respiratory tract infections: to prevent secondary bacterial
invasion.
(d) To prevent respiratory infections in unconscious patients or in those on
respirators.

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