First of all, it is necessary to define antibiotics. These are medications that are used to treat bacterial infections. They have the ability to kill bacteria and prevent their proliferation. There are several groups of antibiotics that differ in their properties. However, what they all have in common is that no antibiotic is used to treat viral infections. Thus, many cases when a person with a cold starts taking antibiotics in the hope of recovering faster are pointless and only harmful to the body, since it is fighting not bacteria, but viruses. Yes, a viral infection can lead to the development of bacterial complications, but not earlier than 10 days after the onset of the disease.
In this article we will consider such points as types of antibiotics, mechanisms of their action, possible side effects and contraindications, as well as the very topical issue of antibiotic resistance today.
Interesting Facts about Antibiotics
The first natural antibiotic, penicillin, was discovered by Alexander Fleming in 1928. Fleming even predicted such a phenomenon as the development of antibiotic resistance. Antibiotics cannot fight viral infections; they either kill or slow the growth of bacteria.
The most common side effects from taking antibiotics are upset stomach, diarrhea and nausea.
What Are Antibiotics?
This is perhaps the most basic question that needs to be clarified in order to better understand all other aspects related to antibiotics.
Antibiotics are medications that either stop bacteria from multiplying or kill them. These are serious drugs that treat strictly defined infections and are vital, that is, they are often used to save a person’s life. Antibiotics are used when the number of harmful bacteria is so high that the patient’s immune system cannot cope with them on its own.
Our immune system attacks harmful bacteria with the help of white blood cells, and very often our body will stop the infection on its own before the bacteria can multiply enough to cause unpleasant symptoms.
In addition to treating various diseases, antibiotics are also used for preventive purposes, mainly before and after surgical interventions in order to minimize the risk of suppuration, infection and other complications.
The Mechanism of Action of Antibiotics
The main types of antibiotics, which differ in their mode of action, include bactericidal and bacteriostatic antibiotics. Bactericidal antibiotics kill bacteria, usually by disrupting the formation of the bacterial cell wall or destroying its contents. Such antibiotics, for example, include penicillin.
At the same time, bacteriostatic antibiotics work by stopping the proliferation of bacteria. They usually begin to act more slowly because it takes a certain time for the old bacteria to begin to die in the absence of reproduction.
In addition to destroying the cell wall, antibiotics can act directly on the cell nucleus. The uselessness of antibiotics in the treatment of viral diseases is due to the fact that a virus, unlike bacteria, does not have a cell.
The virus is represented only by a chain of DNA or RNA and a protein shell around it. Therefore, it simply does not have structures that the antibiotic can affect.
The very name “antibiotic” translated from Latin means “against life,” that is, against some living substance. Meanwhile, viruses are not entirely living organisms, because they cannot exist independently and reproduce outside the host cells. This is their key difference from bacteria.
Types of Antibiotics
The ancestor of antibiotics was penicillin, and even today its more modern derivatives, such as ampicillin, amoxicillin and penicillin G, are still actively used to combat various infections. Modern antibiotics can be divided into several types, with oral antibiotics, both in France and in most other countries, sold only by prescription, while topical antibiotics (drops, creams and ointments) are often available without a doctor’s prescription.
In addition to these two main categories, within each there are classes (groups) of antibiotics, depending on the characteristics of their chemical structure. Among them are penicillins, macrolides, cephalosporins, lincosamides, drugs against urinary tract infections, secondary quinolones, beta-lactams with increased activity and some others. In each class there are one or two most common drugs.
Thus, a representative of the group of penicillins is Amoxicillin, macrolides are represented by Erythromycin and Azithromycin, cephalosporins – by Ceftriaxone and Cefdinir, fluoroquinolones – by Ciprofloxacin and Levofloxacin. Beta-lactams with increased activity include Amoxicillin/clavulanate, antibiotics against urinary infections – Nitrofurantoin, and lincosamides – Clindamycin.
It is noteworthy that today there is no unanimously accepted classification of antibiotics into groups; there are still controversial issues. For example, some antibiotics are considered instead of penicillins as subclasses of beta-lactams, and some drugs, on the contrary, are divided into separate groups. Often, classifications may differ at least slightly from country to country.
Development of Antibiotic Resistance
Today, the problem of patient abuse of antibiotics is very relevant. It is necessary to take antibiotics only when it cannot be avoided, when the doctor recommends taking antibacterial drugs to avoid serious complications.
Antibiotic resistance is a condition in which bacteria no longer respond to an antibiotic to which they were previously sensitive. The main reason for the development of antibiotic resistance is the abuse of the latter, as well as the incorrect prescription of antibiotics. What is inappropriate antibiotic prescribing? This is the prescription of antibiotics without a preliminary analysis of the sensitivity of the pathogen to a particular drug, as well as the use of drugs in too low a dosage. The development of antibiotic resistance is also facilitated by completing a course of treatment too early and taking several antibiotics at the same time.
The possibility of bacterial resistance to antibiotics developing was predicted by Alexander Fleming in 1945 during his Nobel Prize speech. He suggested that taking insufficiently high doses of antibiotics could “train” microbes and make them resistant to antibiotics. Today, what the discoverer of penicillin predicted has already become an everyday reality and one of the most serious challenges facing global health.
Today in France there is still a pressing problem that antibiotic treatment is prescribed to people who can easily get by with other means. This contributes to the development of resistance in the population. In particular, some bacteria, such as those from the order Enterobacterales, can become resistant to carbapenems, which are the main class of last-line antibiotics. Enterobacterales are a whole order of bacteria that cause pneumonia, meningitis and many other diseases. The most common example of Enterobacterales is Escherichia coli (E.coli). The development of carbapenem-resistant Enterobacterales is fraught with the spread of difficult-to-treat nosocomial pneumonia. Antibiotic resistance can lead to an increase in the incidence of diseases, worse treatment outcomes, and a decrease in the effectiveness of first-line antibiotic therapy.
What Infections Are Antibiotics Effective against?
Antibiotics are used to treat bacterial infections, not viruses, so in order to prescribe antibiotic therapy, you need to clearly understand what disease the patient is suffering from. Common illnesses such as flu and colds are mostly caused by viruses that infect the upper respiratory tract. Antibiotics are ineffective against these viruses, especially during the first 7-10 days of the disease, while the likelihood of bacterial complications is low.
Some people tend to believe that if nasal discharge or phlegm is green or yellow in color, it indicates a bacterial infection. In fact, this is not true. Dead leukocytes give mucus a similar color, so it can be observed even on the second and third days of the disease and only indicates that the body is actively fighting the infection.
There are broad-spectrum and narrow-spectrum antibiotics. Broad-spectrum antibiotics are used to treat a wide range of infections, while narrow-spectrum antibiotics are effective against only a few types of bacteria. If it is impossible to test the sensitivity of the pathogen to a particular antibiotic, it is more advisable to prescribe broad-spectrum antibiotics, especially if treatment is necessary immediately. This may happen if the patient’s condition is dangerous. In addition, there are antibiotics that are effective against aerobic and anaerobic bacteria.
Aerobic bacteria are those bacteria that need oxygen to live and reproduce, and anaerobic bacteria are those bacteria that do not need oxygen. This parameter should also be taken into account when prescribing antibiotics.
Antibiotics are among those medications that very often cause side effects. The most common of these are stomach disorders: diarrhea, nausea, vomiting. Skin rashes are also common.
There are certain antibiotics that cause unusual side effects. For example, tetracycline antibiotics can cause increased sensitivity to sunlight. Certain antibiotics, in particular cephalosporins, cause the development of fungal infections in the mouth, digestive tract and vagina.
Serious side effects that can cause taking antibiotics, especially long-term, include a decrease in the number of platelets in the blood (for example, when taking cephalosporins and penicillins), a decrease in white blood cells or taking penicillin, the risk of developing urolithiasis when taking sulfonamides, the risk of hearing loss when taking macrolides or aminoglycosides, muscle pain when taking fluoroquinolones, as well as tendon inflammation and even tendon rupture.
If antibiotics are prescribed to a person with kidney or liver failure, especially in old age, caution should be exercised and the dosage reduced whenever possible. Also, when antibiotics must be taken by pregnant or breastfeeding women, doctors need to exercise increased caution and weigh the risks.
Side effects
Antibiotics are among those medications that very often cause side effects. The most common of these are stomach disorders: diarrhea, nausea, vomiting. Skin rashes are also common.
There are certain antibiotics that cause unusual side effects. For example, tetracycline antibiotics can cause increased sensitivity to sunlight. Certain antibiotics, in particular cephalosporins, cause the development of fungal infections in the mouth, digestive tract and vagina.
Serious side effects that can cause taking antibiotics, especially long-term, include a decrease in the number of platelets in the blood (for example, when taking cephalosporins and penicillins), a decrease in white blood cells or taking penicillin, the risk of developing urolithiasis when taking sulfonamides, the risk of hearing loss when taking macrolides or aminoglycosides, muscle pain when taking fluoroquinolones, as well as tendon inflammation and even tendon rupture.
If antibiotics are prescribed to a person with kidney or liver failure, especially in old age, caution should be exercised and the dosage reduced whenever possible. Also, when antibiotics must be taken by pregnant or breastfeeding women, doctors need to exercise increased caution and weigh the risks.
Allergy
Allergic reactions can develop to different antibiotics, but allergic reactions to penicillin are most often observed. They can appear in the form of cough, allergic rash, swelling of the tongue and face, wheezing, and difficulty breathing. In addition to immediate ones, there are also delayed allergic reactions, that is, not those that develop within one to three hours after taking the medicine, but those that a person encounters several weeks after the start of treatment.
Because taking antibiotics can cause life-threatening allergic reactions, including anaphylactic shock, patients with a history of allergic reactions to antibiotics should tell their doctor before prescribing any drug.
Anaphylactic anaphylactic shock can be life-threatening. Its symptoms develop suddenly and vary, but often include rapid shallow breathing, tachycardia, clammy sweat, anxiety, dizziness, swollen lips and tongue, and blue or bloodless lips. In severe cases, fainting and even coma are possible.
In case of anaphylactic shock, it is imperative to call emergency assistance and, if possible, use an adrenaline pen, which should be in the first aid kit of any allergy sufferer. If the person is unconscious, position them on their side. This is important so that if he vomits, he does not choke.
Drug Interaction
The interaction of antibiotics with other drugs should definitely be discussed with your doctor. Even harmless over-the-counter medications can interact with antibiotics. For example, drugs containing magnesium interfere with the absorption of fluoroquinolones. It should be noted that quite often taking antibiotics reduces the effectiveness of oral contraceptives, despite the fact that the antibiotics themselves do not affect the effect of hormonal drugs to prevent unwanted pregnancy. Diarrhea or vomiting, which may occur while taking antibiotics, prevents the complete absorption of oral contraceptives, which leads to a decrease in their effectiveness.
In parallel with antibacterial therapy, it is advisable to carry out the prevention of dysbiosis because, along with pathogenic ones, good bacteria that form the basis of human microflora are also often destroyed. Taking medications containing lacto and bifidobacteria helps reduce the severity of side effects that appear in the gastrointestinal tract, and also minimizes the damage that antibiotics cause to the body.
It is often recommended to avoid taking many drugs used to treat various chronic diseases along with antibiotics. In particular, these are antacids (means to reduce the acidity of gastric juice), calcium-containing drugs (since calcium neutralizes the antibacterial effect of many antibiotics), vitamins B and C and some others.
To prevent or minimize the negative effects of antibiotics on the liver, doctors often recommend taking hepatoprotectors after or during a course of antibiotic treatment. This is especially important if long-term antibacterial therapy is necessary, for example in the case of Helicobacter pylori eradication.
Usage Guide
The most common way to take antibiotics is orally. However, it is possible to inject antibiotics or apply them to one or another part of the body, that is, application, for which ointments and gels are used. Some antibiotics come as drops into the eyes or nose, or into the ears.
Most antibiotics begin to act within a few hours after administration. However, bacteriostatic antibiotics may not manifest their effect so quickly. It is important that, regardless of which antibiotic is used in the treatment of a particular disease, it is necessary to take it for at least another 2-3 days after the symptoms of this disease have completely disappeared, because otherwise the disease may not go away completely, but the course of treatment will continue in vain. Moreover, an incomplete course will contribute to the development of resistance.
Before taking any antibiotic, regardless of the doctor’s prescription, you must carefully study the instructions for use, because the doctor may not know something about your body, concomitant diseases and medications that you take on an ongoing basis, which only you know. In addition to the standard recommendations given in the instructions for use, it is advisable to remember a few useful tips for the effective use of antibiotics. For example, when taking metronidazole you should avoid drinking alcohol. When taking tetracycline, it is better not to eat dairy products, because this will interfere with the absorption of the drug into the blood. Of course, any drug must be taken at approximately the same time of day or after a more or less equal number of hours.