What are the common types of antibiotics. How do antibiotics work against bacterial infections. When should antibiotics be used or avoided. What are the top 10 infections treated with antibiotics. Which are the most frequently prescribed generic and brand-name antibiotics.

Understanding Antibiotics: A Crucial Weapon Against Bacterial Infections

Antibiotics are a cornerstone of modern medicine, playing a vital role in treating various bacterial infections. These powerful medications have revolutionized healthcare, saving countless lives since their discovery. However, their effectiveness and proper use are subjects of ongoing discussion in the medical community.

Antibiotics specifically target bacterial infections, either by killing bacteria (bactericidal) or preventing their growth and reproduction (bacteriostatic). It’s crucial to understand that antibiotics are ineffective against viral infections, such as the common cold or flu.

How do antibiotics work?

Antibiotics function by targeting specific components or processes within bacterial cells. Some common mechanisms include:

• Inhibiting cell wall synthesis
• Disrupting protein synthesis
• Interfering with DNA replication
• Altering cell membrane permeability

By exploiting these vulnerabilities, antibiotics can effectively eliminate harmful bacteria from the body, allowing the immune system to recover and restore health.

When to Use Antibiotics: Guidelines for Appropriate Prescription

The decision to prescribe antibiotics should be made carefully by healthcare professionals. Antibiotics are indicated for bacterial infections that are unlikely to resolve on their own or could lead to serious complications if left untreated.

Are antibiotics always safe to use?

While antibiotics are generally safe when used correctly, they can cause side effects ranging from mild to severe. Some common side effects include:

• Gastrointestinal disturbances (nausea, diarrhea)
• Allergic reactions
• Yeast infections
• Photosensitivity

In certain patient groups, such as infants, the elderly, pregnant women, and those with kidney or liver disease, antibiotic doses may need to be adjusted to ensure safety and efficacy. Drug interactions are also a concern, making it essential for healthcare providers to review a patient’s complete medical history and current medications before prescribing antibiotics.

The Dangers of Antibiotic Misuse: When Not to Use These Medications

Antibiotic resistance is a growing global health threat, largely fueled by the misuse and overuse of these medications. It’s crucial to understand when antibiotics should not be used to prevent contributing to this problem.

Why shouldn’t antibiotics be used for viral infections?

Antibiotics are ineffective against viral infections such as:

• Common colds
• Influenza (flu)
• Most sore throats
• Acute sinusitis
• Many cases of bronchitis

Using antibiotics for these conditions not only fails to provide any benefit but also increases the risk of antibiotic resistance, reduces future treatment options, and exposes patients to unnecessary side effects and costs.

Viral infections are typically self-limiting, meaning the body’s immune system can fight them off without medication. Symptomatic treatment and rest are often the best approaches for these conditions.

Top 10 Infections Commonly Treated with Antibiotics

While antibiotics should be used judiciously, there are many bacterial infections for which they are the appropriate and necessary treatment. Here are ten common infections often treated with antibiotics:

1. Urinary Tract Infections (UTIs)
2. Streptococcal Pharyngitis (Strep Throat)
3. Skin and Soft Tissue Infections
4. Bacterial Pneumonia
5. Sexually Transmitted Infections (STIs)
6. Otitis Media (Ear Infections)
7. Bacterial Sinusitis
8. Acne
9. Traveler’s Diarrhea
10. Bacterial Conjunctivitis (Pink Eye)

How are these infections diagnosed and treated?

Diagnosis typically involves a combination of clinical symptoms, physical examination, and sometimes laboratory tests or cultures. Treatment depends on the specific infection, its severity, and the patient’s overall health. Healthcare providers choose the most appropriate antibiotic based on the likely causative bacteria and local resistance patterns.

Most Commonly Prescribed Antibiotics: Generic and Brand Names

Understanding the landscape of commonly prescribed antibiotics can help patients be more informed about their treatments. Here are lists of the top generic and brand-name antibiotics:

Top 10 Generic Antibiotics

1. Amoxicillin
2. Doxycycline
3. Cephalexin
4. Ciprofloxacin
5. Clindamycin
6. Metronidazole
7. Azithromycin
8. Sulfamethoxazole/Trimethoprim
9. Amoxicillin/Clavulanate
10. Levofloxacin

Top 10 Brand Name Antibiotics

1. Augmentin (amoxicillin/clavulanate)
2. Flagyl (metronidazole)
3. Amoxil (amoxicillin)
4. Cipro (ciprofloxacin)
5. Keflex (cephalexin)
6. Bactrim (sulfamethoxazole/trimethoprim)
7. Levaquin (levofloxacin)
8. Zithromax (azithromycin)
9. Avelox (moxifloxacin)
10. Cleocin (clindamycin)

Is there a difference between generic and brand-name antibiotics?

Generic and brand-name antibiotics contain the same active ingredients and are equally effective. The main differences lie in their inactive ingredients, appearance, and cost. Generic antibiotics are typically much less expensive than their brand-name counterparts, making them a more accessible option for many patients.

Antibiotic Classes: Understanding the Different Types

Antibiotics are grouped into classes based on their chemical structure and mechanism of action. Understanding these classes can provide insight into how different antibiotics work and their potential uses.

What are the main antibiotic classes?

The top 10 antibiotic classes include:

1. Penicillins
2. Tetracyclines
3. Cephalosporins
4. Quinolones
5. Lincomycins
6. Macrolides
7. Sulfonamides
8. Glycopeptides
9. Aminoglycosides
10. Carbapenems

Each class has its own spectrum of activity, potential side effects, and appropriate uses. For example, penicillins are effective against many gram-positive bacteria, while quinolones have a broader spectrum that includes many gram-negative bacteria.

Can antibiotics within the same class be interchanged?

While antibiotics within the same class may have similar properties, they are not always interchangeable. Different antibiotics, even within the same class, can have varying spectrums of activity, side effect profiles, and dosing schedules. The choice of antibiotic should be based on the specific infection being treated, local resistance patterns, and individual patient factors.

Antibiotic Resistance: A Growing Global Concern

Antibiotic resistance is one of the most pressing public health issues of our time. It occurs when bacteria evolve to survive in the presence of antibiotics, rendering these drugs ineffective.

How does antibiotic resistance develop?

Antibiotic resistance can develop through several mechanisms:

• Natural selection of resistant bacteria
• Genetic mutations
• Transfer of resistance genes between bacteria
• Overuse and misuse of antibiotics

The overuse and misuse of antibiotics, both in healthcare and agriculture, accelerate the development of resistance. This includes using antibiotics for viral infections, not completing prescribed courses, and using antibiotics in livestock for growth promotion.

What are the consequences of antibiotic resistance?

The consequences of antibiotic resistance are far-reaching and severe:

• Increased mortality from previously treatable infections
• Longer hospital stays and higher medical costs
• Need for more toxic or expensive antibiotics
• Potential inability to perform routine medical procedures safely

Combating antibiotic resistance requires a multifaceted approach, including responsible antibiotic use, development of new antibiotics, and improved infection prevention and control measures.

The Future of Antibiotic Development and Use

As antibiotic resistance continues to pose challenges, researchers and healthcare professionals are exploring new strategies to combat bacterial infections and preserve the effectiveness of existing antibiotics.

What new approaches are being developed to fight bacterial infections?

Several innovative approaches are being investigated:

• Bacteriophage therapy: Using viruses that specifically infect bacteria
• CRISPR-Cas9 technology: Targeting and disabling antibiotic resistance genes
• Antibiotic adjuvants: Substances that enhance the effectiveness of existing antibiotics
• Novel drug delivery systems: Improving the targeting and efficacy of antibiotics
• Antimicrobial peptides: Naturally occurring molecules with antibacterial properties

These approaches, along with continued research into new antibiotic classes, offer hope for the future of infectious disease treatment.

How can we preserve the effectiveness of current antibiotics?

Preserving the effectiveness of current antibiotics requires a multifaceted approach:

• Antibiotic stewardship programs in healthcare settings
• Public education on appropriate antibiotic use
• Improved diagnostic tools for rapid identification of bacterial infections
• Reduction of antibiotic use in agriculture
• International cooperation to combat antibiotic resistance

By implementing these strategies, we can help ensure that antibiotics remain effective tools in the fight against bacterial infections for generations to come.

In conclusion, antibiotics are invaluable tools in modern medicine, but their use must be judicious and appropriate. Understanding the types of antibiotics, their proper use, and the dangers of misuse is crucial for both healthcare providers and patients. As we face the challenge of antibiotic resistance, ongoing research and responsible antibiotic stewardship will be key to preserving these life-saving drugs for the future.

Antibiotics: List of Common Antibiotics & Types

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on June 11, 2019.

When To Use|When NOT To Use|Top 10 Infections Treated|Top 10 Generic Drugs|Top 10 Brand Drugs|Antibiotic Class Types|OTC Options |More Resources

Taking Antibiotics

You’ve most likely taken an antibiotic or anti-infective at least once in your lifetime. From treatments for painful strep throat or ear infections as a child, to burning urinary tract infections or itchy skin infections as an adult, antibiotics are one of the most highly utilized and important medication classes we have in medicine.

Understanding the vast world of antibiotics and anti-infectives is no easy task. Anti-infectives are a large class of drugs that cover a broad range of infections, including fungal, viral, bacterial, and even protozoal infections.

• Athletes foot? That’s a common fungal infection.
• HIV? Antiviral medications are always needed.
• Bladder infection? Yes, that may need a common oral antibiotic.
• Head lice? A topical anti-parasitic can alleviate the itching.

There is no one type of antibiotic that cures every infection. Antibiotics specifically treat infections caused by bacteria, such as Staph., Strep., or E. coli., and either kill the bacteria (bactericidal) or keep it from reproducing and growing (bacteriostatic). Antibiotics do not work against any viral infection.

When To Use Antibiotics

Antibiotics are specific for the type of bacteria being treated and, in general, cannot be interchanged from one infection to another. When antibiotics are used correctly, they are usually safe with few side effects.

However, as with most drugs, antibiotics can lead to side effects that may range from being a nuisance to serious or life-threatening. In infants and the elderly, in patients with kidney or liver disease, in pregnant or breastfeeding women, and in many other patient groups antibiotic doses may need to be adjusted based upon the specific characteristics of the patient, like kidney or liver function, weight, or age. Drug interactions can also be common with antibiotics. Health care providers are able to assess each patient individually to determine the correct antibiotic and dose.

When NOT To Use Antibiotics

Antibiotics are not the correct choice for all infections. For example, most sore throats, cough and colds, flu or acute sinusitis are viral in origin (not bacterial) and do not need an antibiotic. These viral infections are “self-limiting”, meaning that your own immune system will usually kick in and fight the virus off. In fact, using antibiotics for viral infections can increase the risk for antibiotic resistance, lower the options for future treatments if an antibiotic is needed, and put a patient at risk for side effects and extra cost due to unnecessary drug treatment.

Antibiotic resistant bacteria cannot be fully inhibited or killed by an antibiotic, even though the antibiotic may have worked effectively before the resistance occurred. Don’t share your antibiotic or take medicine that was prescribed for someone else, and don’t save an antibiotic to use the next time you get sick.

To better understand antibiotics, it’s best to break them down into common infections, common antibiotics, and the top antibiotic classes as listed in Drugs.com.

Top 10 List of Common Infections Treated with Antibiotics

1. Acne
2. Bronchitis
3. Conjunctivitis (Pink Eye)
4. Otitis Media (Ear Infection)
5. Sexually Transmitted Diseases (STD’s)
6. Skin or Soft Tissue Infection
7. Streptococcal Pharyngitis (Strep Throat)
8. Traveler’s diarrhea
9. Upper Respiratory Tract Infection
10. Urinary Tract Infection (UTI)

Top 10 List of Generic Antibiotics

1. amoxicillin
2. doxycycline
3. cephalexin
4. ciprofloxacin
5. clindamycin
6. metronidazole
7. azithromycin
8. sulfamethoxazole and trimethoprim
9. amoxicillin and clavulanate
10. levofloxacin

Top 10 List of Brand Name Antibiotics

1. Augmentin
2. Flagyl, Flagyl ER
3. Amoxil
4. Cipro
5. Keflex
6. Bactrim, Bactrim DS
7. Levaquin
8. Zithromax
9. Avelox
10. Cleocin

Top 10 List of Antibiotic Classes (Types of Antibiotics)

1. Penicillins
2. Tetracyclines
3. Cephalosporins
4. Quinolones
5. Lincomycins
6. Macrolides
7. Sulfonamides
8. Glycopeptides
9. Aminoglycosides
10. Carbapenems

Most antibiotics fall into their individual antibiotic classes. An antibiotic class is a grouping of different drugs that have similar chemical and pharmacologic properties. Their chemical structures may look comparable, and drugs within the same class may kill the same or related bacteria.

However, it is important not to use an antibiotic for an infection unless your doctor specifically prescribes it, even if it’s in the same class as another drug you were previously prescribed. Antibiotics are specific for the kind of bacteria they kill. Plus, you would need a full treatment regimen to effectively cure your infection, so don’t use or give away leftover antibiotics.

1. Penicillins

Another name for this class is the beta-lactam antibiotics, referring to their structural formula. The penicillin class contains five groups of antibiotics: aminopenicillins, antipseudomonal penicillins, beta-lactamase inhibitors, natural penicillins, and the penicillinase resistant penicillins.

Common antibiotics in the penicillin class include:

Certain penicillinase-resistant penicillins (such as oxacillin or dicloxacillin) are inherently resistant to certain beta-lactamase enzymes by themselves. Others, for example, amoxicillin or ampicillin have greater antibacterial activity when they are combined with a beta-lactamase inhibitor like clavulanate, sulbactam, or tazobactam.

View all penicillin drugs

2. Tetracyclines

Tetracyclines are broad-spectrum against many bacteria and treat conditions such as acne, urinary tract infections (UTIs), intestinal tract infections, eye infections, sexually transmitted diseases, periodontitis (gum disease), and other bacterial infections. The tetracycline class contains drugs such as:

View all tetracycline drugs

3. Cephalosporins

There are five generations of cephalosporins, with increasing expanded coverage across the class to include gram-negative infections. Newer generations with updated structures are developed to allow wider coverage of certain bacteria. Cephalosporins are bactericidal (kill bacteria) and work in a similar way as the penicillins. Cephalosporins treat many types of infections, including strep throat, ear infections, urinary tract infections, skin infections, lung infections, and meningitis. Common medications in this class include:

The fifth generation (or next generation) cephalosporin known as ceftaroline (Teflaro) is active against methicillin-resistant Staphylococcus aureus (MRSA). Avycaz contains the the beta-lactamase inhibitor avibactam. 

View all cephalosporin drugs

4. Quinolones

The quinolones, also known as the fluoroquinolones, are a synthetic, bactericidal antibacterial class with a broad-spectrum of activity. The quinolones can be used for difficult-to-treat urinary tract infections when other options are aren’t effective, hospital-acquired pneumonia, bacterial prostatitis, and even anthrax or plague.

The FDA has issued several strong warnings about this class due to potential disabling side effects. Learn More: Fluoroquinolone Antibacterial Drugs for Systemic Use: Drug Safety Communication – Warnings Updated Due to Disabling Side Effects

Common drugs in the fluoroquinolone class include:

Several quinolones are also available in drop form to treat eye or ear infections.

View all quinolone drugs

5. Lincomycins

This class has activity against gram-positive aerobes and anaerobes (bacteria that can live without oxygen), as well as some gram-negative anaerobes. The lincomycin derivatives may be used to treat serious infections like pelvic inflammatory disease, intra-abdominal infections, lower respiratory tract infections, and bone and joint infections. Some forms are also used topically on the skin to treat acne. These drugs include:

View all lincomycin drugs

6. Macrolides

The macrolides can be use to treat community-acquired pneumonia, pertussis (whooping cough), or for uncomplicated skin infections, among other susceptible infections. Ketolides are a newer generation of antibiotic developed to overcome macrolide bacterial resistance. Frequently prescribed macrolides are:

View all macrolide drugs

7. Sulfonamides

Sulfonamides are effective against some gram-positive and many gram-negative bacteria, but resistance is widespread. Uses for sulfonamides include urinary tract infections (UTIs), treatment or prevention of pneumocystis pneumonia, or ear infections (otitis media). Familiar names include:

View all sulfonamides drugs

8. Glycopeptide Antibiotics

Members of this group may be used for treating methicillin-resistant staphylococcus aureus (MRSA) infections, complicated skin infections, C. difficile-associated diarrhea, and enterococcal infections such as endocarditis which are resistant to beta-lactams and other antibiotics. Common drug names include:

View all glycopeptide drugs

9. Aminoglycosides

Aminoglycosides inhibit bacterial synthesis by binding to the 30S ribosome and act rapidly as bactericidal antibiotics (killing the bacteria). These drugs are usually given intravenously (in a vein through a needle). Common examples in this class are:

View all aminoglycoside drugs

10. Carbapenems

These injectable beta-lactam antibiotics have a wide spectrum of bacteria-killing power and may be used for moderate to life-threatening bacterial infections like stomach infections, pneumonias, kidney infections, multidrug-resistant hospital-acquired infections and many other types of serious bacterial illnesses. They are often saved for more serious infections or used as “last-line” agents to help prevent resistance. Members of this class include:

View all carbapenems drugs

Are There Any Over-the-Counter Antibiotics?

Over-the-counter (OTC) oral antibiotics are not approved in the U.S. A bacterial infection is best treated with a prescription antibiotic that is specific for the type of bacteria causing the infection. Using a specific antibiotic will increase the chances that the infection is cured and help to prevent antibiotic resistance. In addition, a lab culture may need to be performed to pinpoint the bacteria and to help select the best antibiotic. Taking the wrong antibiotic — or not enough — may worsen the infection and prevent the antibiotic from working the next time.

There are a few over-the-counter topical antibiotics that can be used on the skin. Some products treat or prevent minor cuts, scrapes or burns on the skin that may get infected with bacteria. These are available in creams, ointments, and even sprays.

Common OTC topical antibiotics:

• Neosporin (bacitracin, neomycin, polymyxin B)
• Polysporin (bacitracin, polymyxin B)
• Triple antibiotic, generic (bacitracin, neomycin, polymyxin B)
• Neosporin + Pain Relief Ointment (bacitracin, neomycin, polymyxin B, pramoxine)

There are some OTC antibacterials for treating acne, too. They contain the antibacterial benzoyl peroxide, which also has mild drying effect for acne. Many products are found on the pharmacy shelves as gels, lotions, solutions, foams, cleaning pads, and even facial scrubs.

Common OTC antibacterials for acne:

See Also

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

List of Glycopeptide Antibiotics + Uses, Types & Side Effects

Glycopeptide antibiotics are a type of antibiotic that inhibits bacterial cell wall formation by inhibiting peptidoglycan synthesis. They are used for treating multi-resistant Staphylococcus aureus (MRSA) infections and enterococcal infections, which are resistant to beta-lactams and other antibiotics. They are also used in cases where there is an allergy to beta-lactams.

What are glycopeptide antibiotics used for?

Glycopeptide antibiotics are usually reserved for the treatment of serious infections caused by MRSA, Streptococcus, or Enterococcus bacteria which are resistant to beta-lactams and other antibiotics, such as

• Clostridium difficile-associated diarrhea
• Endocarditis
• Enterocolitis
• Pneumonia acquired during a hospital stay or that develops while using a ventilator
• Severe skin and skin structure infections
• Other serious infections that are not susceptible to other antibiotics.

What are the differences between glycopeptide antibiotics?

Vancomycin was the first glycopeptide antibiotic approved. The other three glycopeptides available in the U.S. (dalbavancin, oritavancin, and telavancin) are structurally related to vancomycin and were developed to improve on vancomycin’s duration of action and tolerability. However, reports suggest that one glycopeptide, telavancin, is no more effective than vancomycin and has more adverse effects.

None are absorbed orally, although vancomycin is effective when given orally for the treatment of Clostridium difficile-associated diarrhea because this infection is localized in the gut. Vancomycin and telavancin are given once daily, whereas dalbavancin is given once weekly or as a single infusion, and oritavancin as a single infusion.

The need for monitoring in patients receiving vancomycin is controversial, and the manufacturer does not consider it necessary. There is not considered any value in monitoring the other glycopeptides.

Are glycopeptide antibiotics safe?

Vancomycin and telavancin may affect kidney function; the risk is greatest in those older than 65 years. Monitoring of kidney function during and immediately following treatment may be required. Studies have reported that telavancin causes more renal adverse effects than vancomycin.

Telavancin can interfere with some clotting tests and can cause prolongation of the QT interval (the measurement on an ECG that represents electrical depolarization and repolarization of the ventricles).

Glycopeptides may be ototoxic (toxic to the auditory nerve, cochlear, or vestibular system of the ear). This may cause transient or permanent hearing loss. The risk is highest in people given large intravenous doses, with pre-existing hearing loss, or receiving another ototoxic agent, such as gentamicin.

Rarely, “Red Man Syndrome” has been associated with vancomycin IV and dalbavancin. Symptoms include flushing of the upper body, shortness of breath, a skin rash, itching, pain, muscle spasms and low blood pressure. Most reactions resolve within 20 minutes; however, some may persist for several hours.

Rarely, some people may develop a super-infection due to overgrowth of a naturally occurring bacterium called Clostridium difficile, following use of any antibiotic, including glycopeptide antibiotics. Symptoms include severe diarrhea.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of glycopeptide antibiotics?

Side effects that have been reported with glycopeptide antibiotics include:

For a complete list of side effects, please refer to the individual drug monographs.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

New Types of Antibiotics Are Key to Fighting Drug Resistant Bacteria

Bacterial resistance to one antibiotic often leads to resistance to similar types of antibiotics, so novel classes of antibiotics—drugs that are significantly different from existing antibiotics in core molecular structure or mode of attack —are critically needed to stay ahead of resistance.

© The Pew Charitable Trusts

Note: This analysis was updated in December 2017 to reflect new data on the number of antibiotics in development belonging to existing classes.

To ensure that we have effective medicines to treat the drug-resistant bacterial infections of today as well as those that emerge in the future, antibiotic innovation must include both the discovery of new types of antibiotics and improvements to existing drugs.

New types of antibiotics are essential

Nearly all of the antibiotics currently available are based on discoveries made over 30 years ago. And of the antibiotics in clinical development for the U.S. market, 75 percent belong to existing types—or “classes”—of drugs against which bacterial resistance has already been observed or could easily develop.

A drug class is a group of antibiotics that share a common core molecular structure, commonly referred to as a scaffold.

Bacterial resistance to one antibiotic often leads to resistance to similar types of antibiotics, so novel classes of antibiotics—drugs that are significantly different from existing antibiotics in core molecular structure or mode of attack are critically needed to stay ahead of resistance.

The challenge is that novel classes of antibiotics are difficult for scientists to find due to key scientific barriers. For example, it is particularly challenging to find antibiotics that work against some of the toughest bugs out there—Gram-negative bacteria, which have a built-in gantlet of defenses that is hard to overcome.

Giving old antibiotics new capabilities can help overcome resistance

Another important source of innovation that can help address resistance in the near term is improving existing drug types to preserve their effectiveness. For example, modifications to antibiotics could enhance their ability to get through to and destroy drug-resistant bacteria. Another approach is to develop therapies that combine the properties of two or more drugs into a joint molecular structure or to augment an antibiotic with an extra molecule that helps stifle the resistance capabilities of bacteria, enabling the drug to do its job effectively. Scientists have had some initial success in this realm, as demonstrated by the approval of Avycaz, a combination of an existing antibiotic (ceftazidime) and a molecule that overcomes resistance (avibactam).

Building a diverse pipeline of new and improved treatments

Patients need new treatments, particularly for hard-to-treat infections such as those caused by Gram-negative ESKAPE, as well as Clostridium difficile, carbapenem-resistant Enterobacteriaceae, and drug-resistant gonorrhea.

Finding new classes of antibiotics will require ambitious efforts to spur early stage antibiotic discovery, such as the targeted, multidisciplinary research initiative that is outlined in The Pew Charitable Trusts’ 2016 report A Scientific Roadmap for Antibiotic Discovery.

Moving forward, efforts like the Combating Antibiotic-Resistant Bacteria Accelerator (CARB-X) program, a global public-private partnership to stimulate the development of promising new therapies, will also be important. Among its priority focus areas, CARB-X aims to support therapeutics to treat Gram-negative bacteria and novel, high-risk products that may not otherwise receive the funding needed for early stage development.

Antibiotic innovation—finding and designing new types of antibiotics and improving existing drugs—is essential to ensure that we have effective antibiotics available to treat serious bacterial infections over the decades to come.

Carolyn Shore works on the antibiotic resistance project for The Pew Charitable Trusts.

Learn about Different Types of IV Antibiotics

Many of you have asked us about IV antibiotic therapy. In this updated post, we will cover the following range of topics:

What are Intravenous Antibiotics?

Intravenous antibiotics are antibiotics that are administered directly into a vein so that they can enter the bloodstream immediately and bypass the absorption in the gut. It is estimated that more than 250,000 patients in the US receive outpatient IV antibiotics to treat bacterial infections. Typically, they are arranged by a physician that specializes in infectious disease.

Types of IV Antibiotics

The main classes of antibiotics are as follows:

• Cephalosporins such as cefepime (maxipime), cefazolin (Ancef), ceftriaxone (Rocephin)
• Fluoroquinolones such as moxifloxacin (Avelox), ciprofloxacin (Cipro) and levofloxacin (Levaquin)
• Penicillin such as piperacillin/tazobactam (Zosyn)
• Glycopeptides such as Vancomycin, Daptomycin, Dalbavancin (Dalvance), Oritavancin (Orbactiv), Telavancin (Vibativ)
• Nitroimidazoles such as metronidazole (Flagyl)
• Oxazolidinone such as Linezolid (Zyvox)
• Carbapenems such as Meropenum (Merrem)

Antibiotic Delivery through IVs

According to the National Library of Medicine, IV antibiotics are often used for bacterial infections in the lungs, hearts, bones, soft tissue, and brain. They can be used to treat bacterial infections that are resistant to traditional oral medications. Likewise, a combination of different antibiotics can be used to treat multidrug-resistant bacterial infections. Antibiotics fight infection caused by bacteria, and intravenous antibiotics are used for infections that are resistant to oral antibiotics or for infections that may require high doses of antibiotics that cannot be taken orally.

Receiving Antibiotic Treatment through IVs

Most of the time, intravenous (IV) antibiotic treatment is provided in a hospital. However, when it is safe and appropriate, antibiotic therapy can effectively treat patients at home or another healthcare facility. Each year, over 250,000 patients are successfully treated with IV antibiotics at home.

The antibiotic is administered through a small narrow flexible tube called a catheter or IV line, which is inserted into a vein using a needle. The needle is removed, and the IV line is left in place and secured by a dressing. There are different types of IV lines available, and the one chosen for your treatment will depend on your veins and how long you will need the antibiotics.

For example, patients with small peripheral veins often utilize something called PICC lines (Peripherally Inserted Central Catheters), where medication is administered directly to the heart. Considering PICC lines must be flushed daily, and their dressings have to be inspected and changed, patients with PICC lines must avoid getting them wet or dirty.

Guidelines for Administering through a PICC Line

• Wash your hands. Use warm water and soap to scrub for 1 minute. Wash between fingers and rinse thoroughly.
• Dry your hands. Use a fresh paper towel and use it to turn off the water so that you do not touch a dirty surface after washing. Set the paper towel aside, and throw it away after the IV care is done.
• Put gloves on. Always wear medical gloves when touching and administering IV antibiotics. Be sure to keep gloves clean at all times and discard after use.
• Prep injection site. Wipe down all IV antibiotics injection sites with alcohol prep before injection. Wipe the PICC line opening with alcohol before attaching it to the IV.
• Hang the IV bag. The drip chamber should be at least 18 inches above your head.
• Make sure everything is clean and sterile. Always clean the catheter port with an alcohol wipe before use. Flush the catheter with saline or heparin as directed by your medical team.
• Attach IV and begin. Attach the IV tubing to your catheter and secure it with tape. Start the medication as directed by your doctor.

Common Concerns and Complaints

The most common risks associated with intravenous catheters include blockages, blood clots, and infection. Patients need to contact a healthcare professional if they notice any fever, swelling, pain, or redness in the arm with the catheter.

One common complaint of using IV antibiotics is the pain and irritation around the IV site. In some cases, the medication can burn as it runs through the veins. When experiencing pain at the IV site, it’s essential that the patient specifies what type of pain is present because a poorly inserted IV can lead to a leakage of medication to the adjacent tissue. When medication is leaking out of the vein, it can damage the surrounding tissues. If this happens, the site can appear swollen and red, and is extremely painful, which in turn means that a new IV needs to be inserted.

Warning Signs and Side Effects

The most common side effects associated with using IV antibiotics include rash, itch, diarrhea. Rarely the medications can cause abnormal kidney or liver laboratory test results. Your doctor may need to monitor for these side effects and adjusts the antibiotic when necessary. However, it is crucial to be aware of warning signs related to receiving IV therapy, including:

• Allergic reactions: itching, swelling of the throat, tongue, rash, etc
• Swelling of your vein or discoloration around the skin
• Numbness or tingling in the arm of the PICC line
• Air embolism (a bubble of air gets into the vein and travels to your heart or lungs)
• If an IV comes out of your vein, first put pressure over the opening where the IV was until the bleeding stops and call your home health care agency or doctor right away.

Call your doctor, nurse, or healthcare professional if you have these signs of infection:

• Redness, swelling or bruising at the site where the needle enters the vein
• Pain
• Bleeding
• Fever over 100.5 °F (38.0 °C)

Call 9-1-1 immediately if you experience:

• Any breathing problems
• A fast heart rate
• Dizziness
• Chest pain

 

Updated: 3/17/2021

Reviewed by: Gregory Weingart, MD, a practicing ER physician, and Assistant Professor at the Eastern Virginia Medical School

 

 

If you are looking for more resources and support for those going using IV Antibitoics, check out our other blogs: 

What is a PICC Line?

Susan’s PICC Line Journey

What It’s Like Living With A Rare Disease: Cystic Fibrosis

Lindsay’s Fearless Fight Against Lyme

We love hearing from our community members! If you have any further questions, feel free to contact us for more information.

Antibiotic Use Questions and Answers | Antibiotic Use

What are the side effects of antibiotics?

Anytime antibiotics are used, they can cause side effects. Common side effects range from minor to very severe health problems and can include:

• Rash
• Nausea
• Diarrhea
• Yeast infections

More serious side effects can include:

• C. diff infection, which causes diarrhea that can lead to severe colon damage and death
• Severe and life-threatening allergic reactions
• Antibiotic-resistant infections

Call your doctor if you develop any side effects while taking your antibiotic.

Why is it important to take antibiotics only when they’re needed?

Antibiotics are important to treat infections and have saved countless lives. However, anytime antibiotics are used, they can cause side effects and contribute to antibiotic resistance, one of the most urgent threats to the public’s health.

When antibiotics are needed, the benefits usually outweigh the risks of side effects or antibiotic resistance. However, too many antibiotics are prescribed unnecessarily and misused, which threatens the usefulness of these important drugs.

This is why it’s important that we all use antibiotics ONLY when we need them to protect us from harms caused by unnecessary antibiotic use and to combat antibiotic resistance.

What is unnecessary antibiotic use?

Unnecessary antibiotic use happens when a person is prescribed antibiotics when they’re not needed, such as for colds and flu.

Unnecessary use also happens when a person is prescribed antibiotics for infections that are sometimes caused by bacteria that do not always need antibiotics, like many sinus infections and some ear infections.

Antibiotics aren’t always the answer when you’re sick. It’s important to use antibiotics only when they are needed to protect yourself from harms caused by unnecessary antibiotic use and combat antibiotic resistance.

What is misuse of antibiotics?

Misuse of antibiotics happens when a person is prescribed

• the wrong antibiotic,
• the wrong dose of an antibiotic, or
• an antibiotic for the wrong length of time.

Talk with your doctor about the best treatment for your illness.

Antibiotics and kids: Myths and facts

While antibiotics have saved millions of lives since they were first prescribed in the 1940s, overuse has made many less effective in killing the bacteria that cause illness. While they still are important weapons in fighting disease, it’s important to understand if, and when, antibiotics are safe for children.

How do antibiotics work?

Both bacteria and viruses cause disease. Bacteria are living, one-celled organisms, and antibiotics kill them by stopping their growth and reproduction. Viruses are different: They are not considered “alive” and grow and reproduce only after they’ve invaded other living cells. While the body’s immune system can fight off some viruses, antibiotics are ineffective against them.

When are antibiotics useful?

Colds, sore throats, coughs, fevers and many ear infections are caused by viruses and should not be treated with antibiotics. But sometimes those symptoms may be part of a more serious condition. For example, pneumonia, whooping cough, urinary tract infections, sinus infections or strep throat have symptoms that mimic those caused by viruses but are caused by bacteria and can effectively be treated with antibiotics. In addition, some children have conditions that make it harder to heal, in which case antibiotics may be prescribed. Those conditions include cleft palate, Down syndrome and immune disorders and having a cochlear implant.

Antibiotics and children

The first three years of life are particularly important to a child’s development, and doctors are very careful about prescribing antibiotics in young children. If an illness is mild, your doctor may recommend observation or non-antibiotic treatment. But there are times when antibiotics are the right treatment for infants, particularly in the case of high fever, moderate to severe ear pain or symptoms of pneumonia.

Types of antibiotics

Different antibiotics work on different types of bacteria. Here’s a list of antibiotics that may be prescribed for children:

• Penicillins (amoxicillin and penicillin G). These are typically prescribed as the first-line therapy for ear infections and bacterial sinus infections, given twice a day, usually for 10 days.
• Beta-lactamase inhibitors (amoxicillin-clavulanic acid or Augmentin). These are usually prescribed for more complicated ear infections, for children with a history of recurrent ear infection, for more complicated sinus infections and for some forms of pneumonia. They’re given twice a day, usually for 10 days.
• Cephalosporins (cefdinir, ceftibuten, etc.). These are also prescribed for complicated ear infections, pneumonia and for children with a history of recurrent ear infection and for bacterial sinus infections.
• Macrolides (azithromycin and erythromycin). These are usually prescribed for whooping cough and milder forms of pneumonia, and can be given for shorter courses, such as three or five days. A one-time dose is sometimes prescribed.
• Sulfa drugs (trimethoprim-sulfamethoxazole). These are typically prescribed to treat resistant staph infections and urinary tract infections.

Disadvantages and side effects of antibiotics

It is possible for problems to occur when antibiotics are used to treat conditions in children. Frequent and inappropriate use of antibiotics can cause bacteria to change and build up resistance to antibiotics, requiring higher doses for effective treatment. Antibiotics also kill the good bacteria in the body, which can cause diarrhea. In some cases, antibiotics cause bad bacteria, like Clostridium difficile (or C. diff), to proliferate and cause infections that are hard to control. Antibiotics can also cause allergic reactions, like rash and nausea in children.

How to use antibiotics

If your child is sick for longer than a few days or if symptoms worsen, see your doctor. Your child may be prescribed antibiotics. If so, follow directions carefully. Make sure to give your child the full prescribed amount of antibiotic each time and for the full prescribed amount of time. Antibiotics take time to work, and your child may not show improvement for a few days after starting the antibiotics. Never save any leftover antibiotics.

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Antibiotic Treatment in the Hospital

Sometimes it can be stopped

Antibiotics are strong drugs. They fight the infections caused by bacteria. But antibiotics can do more harm than good if you don’t need them. So the U.S. Centers for Disease Control and Prevention (CDC) is now urging hospitals to cut back on the drugs when they are not needed. Here’s what you should know.

You might get antibiotics when you check in to the hospital.

This can happen if you have an infection that may be serious, like pneumonia. Your doctor wants to treat you right away, even before you can get test results.

Your doctor may give you more than one antibiotic. Or you may get a “broad-spectrum” antibiotic that kills many types of bacteria.

Doctors should review your drugs after test results are in.

Your test results usually come on your third day in the hospital. At this point the doctor should review your drugs:

If test results don’t show an infection, and you’re doing well, usually the doctor can stop the antibiotics.

If the tests do show an infection, the doctor can often reduce treatment to a single antibiotic. Or the doctor may switch you to a “narrow-spectrum” antibiotic, which kills just one type of bacteria.

Reducing your antibiotics is called “de-escalation.” It can improve your treatment. It also helps to prevent antibiotic overuse.

Antibiotic overuse causes resistance.

Broad-spectrum antibiotics are more likely to lead to bacteria that resist drugs. This leads to infections that last longer and cost more to treat. They can spread to family and friends.

Antibiotics have side effects.

Broad-spectrum antibiotics can lead to a dangerous form of diarrhea, called “C. diff.” It can require removal of the bowel. It kills about 15,000 people in the U.S. each year.

Antibiotics can also cause other side effects, such as vaginal infections, nausea, and vomiting. They can cause serious allergic reactions such as rashes, swelling of the face and throat, and breathing problems. Some antibiotics have been linked to torn tendons and permanent nerve damage.

Antibiotic overuse wastes money.

Broad-spectrum antibiotics:

• Often cost more than narrow-spectrum drugs.
• Need an intravenous (IV) line, so you must stay in the hospital longer.
• May have more costly side effects and complications.

When do you need broad-spectrum antibiotics?

You may need them if:

• You’re not getting better.
• Tests show that drug-resistant bacteria are causing your infection.
• The tests could not be done, or the results were not clear.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2016 Consumer Reports. Developed in cooperation with the Society for Healthcare Epidemiology of America.

2/2016

90,000 Antibiotic resistance

\ n

\ nAntibiotic resistance develops in bacteria, not humans or animals. These bacteria can infect humans and animals, and infections caused by them are more difficult to treat than infections from bacteria that are not so resistant.

\ n

\ nAntibiotic resistance results in higher medical costs, longer hospital stays and higher mortality rates.

\ n

\ nThere is an urgent need to change the way antibiotics are prescribed and used around the world.Even with the development of new drugs, the serious threat of antibiotic resistance will persist if behavior does not change. Behavioral change should also include measures to reduce the spread of infections through vaccinations, hand washing, safer sex and good food hygiene.

\ n

Magnitude of the problem

\ n

\ nAntibiotic resistance is increasing to alarmingly high levels worldwide. New mechanisms of resistance are emerging and spreading everywhere, threatening our ability to treat common infectious diseases.More and more infections – such as pneumonia, tuberculosis, blood poisoning, gonorrhea, foodborne illness – are becoming more difficult and sometimes impossible to treat because antibiotics are less effective.

\ n

\ nWhere antibiotics for humans or animals can be purchased without a prescription, the emergence and spread of resistance is exacerbated. Likewise, in countries where there are no standard treatment guidelines, antibiotics are often over-prescribed by doctors and veterinarians and overused by the population.

\ n

\ nIn the absence of urgent action, a post-antibiotic era will begin to dawn on us, in which common infections and minor injuries can once again be fatal.

\ n

Prevention and Control

\ n

\ nAntibiotic resistance is gaining momentum due to misuse and overuse and poor infection prevention and control. Measures to mitigate the effects of resilience and limit its spread can be taken at all levels of society.

\ n

Population

\ n

\ nTo prevent and control the spread of antibiotic resistance, individuals may:

\ n

\ n
• take antibiotics only as directed by a qualified healthcare professional;

\ n

• Never ask for antibiotics if the healthcare provider says they are not needed;

\ n

• Always follow your healthcare provider’s advice when using antibiotics;

\ n

• Never give your antibiotics to others or use leftover antibiotics;

\ n

• Prevent contamination according to the Five Essential Principles for Safe Food by washing your hands regularly, maintaining good hygiene while preparing food, avoiding close contact with sick people, practicing safer sex and getting vaccinated on time.

\ n

\ n

Policy-makers

\ n

\ nTo prevent and control the spread of antibiotic resistance, policy-makers can:

\ n

\ n
• Ensure an effective national action plan against antibiotic resistance ;

\ n

• Improve surveillance of antibiotic-resistant infections;

\ n

• Strengthen policies, programs and implementation of infection prevention and control measures;

\ n

• to regulate and promote the proper use and handling of quality drugs;

\ n

• Provide information on the consequences of antibiotic resistance.

\ n

\ n

Health Care Providers

\ n

\ nTo prevent and control the spread of antibiotic resistance, health care providers can:

\ n

\ n
• prevent infections by keeping their hands, tools and the environment clean;

\ n

• Prescribe and dispense antibiotics only when necessary, in accordance with current treatment instructions.

\ n

• Inform surveillance teams about antibiotic-resistant infections;

\ n

• Talk with patients about how to take antibiotics correctly, about antibiotic resistance, and the dangers of misusing them;

\ n

• Tell patients how to prevent infections (for example, getting vaccinated, washing your hands, practicing safer sex, and covering your nose and mouth when sneezing).

\ n

\ n

Healthcare Industry

\ n

\ nTo prevent and control the spread of antibiotic resistance, the healthcare industry may:

\ n

\ n
• invest in research and development of new antibiotics, vaccines, diagnostics and other tools.

\ n

\ n

Agricultural Sector

\ n

\ nTo prevent and control the spread of antibiotic resistance, the agricultural sector may:

\ n

\ n
• introduce antibiotics into animals only under veterinary supervision;

\ n

• Do not use antibiotics to stimulate growth or prevent disease in healthy animals.

\ n

• Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when they exist;

\ n

• Promote and apply good practices at all stages of the production and processing of foods of animal and vegetable origin;

\ n

• Improve farm biosecurity and prevent infections by improving animal hygiene and welfare.

\ n

\ n

Recent Developments

\ n

\ nAlthough some antibiotics are under development, none are expected to be effective against the most dangerous forms of antibiotic-resistant bacteria.

\ n

\ nAccording to the ease and frequency of travel by people today, antibiotic resistance is a global issue that requires the efforts of all countries and many sectors.

\ n

Consequences

\ n

\ nIn cases where infections can no longer be treated with first-line antibiotics, more expensive drugs should be used. Longer durations of illness and treatment, often in hospitals, increase medical costs as well as an economic burden on families and communities.

\ n

\ nAntibiotic resistance threatens the advancements of modern medicine. In the absence of effective antibiotics to prevent and treat infections, the risk of organ transplantation, chemotherapy and surgery, such as caesarean section, increases significantly.

\ n

The WHO response

\ n

\ n Addressing antibiotic resistance is an important priority for WHO. In May 2015, the World Health Assembly approved the Global Action Plan on Antimicrobial Resistance, which also includes antibiotic resistance.The Global Action Plan aims to ensure the prevention and treatment of infectious diseases with safe and effective medicines.

\ n

\ nThe Global Action Plan on Antimicrobial Resistance has 5 strategic objectives:

\ n

\ n
• Raise awareness and understanding of antimicrobial resistance;

\ n

• Strengthen surveillance and research;

\ n

• reduce the number of infections;

\ n

• optimize the use of antimicrobial drugs;

\ n

• Ensure sustainable investments to counter antimicrobial resistance.

\ n

\ n

\ n Meeting at the United Nations General Assembly in New York in September 2016, the Heads of State pledged to launch broad and coordinated action to tackle the root causes of antibiotic resistance in a number of sectors, especially in the field of security human and animal health, as well as agriculture. Member States reaffirmed their determination to develop national action plans to combat this phenomenon, based on the global action plan.WHO is supporting Member States in preparing their national action plans to tackle antimicrobial resistance.

\ n

\ nWHO is implementing several initiatives to tackle antimicrobial resistance:

\ n

World Antibiotic Awareness Week

\ n

\ nThis global multi-year campaign has been held annually in November 2015, under the slogan Antibiotics : use carefully! ” Numerous events are held within the theme week.

\ n

The Global Antimicrobial Resistance Surveillance System (GLASS)

\ n

\ n This system, operated by WHO, is based on a standardized approach to collect, analyze and share data on antimicrobial resistance globally … This data is used for decision making at the local, national and regional levels.

\ n

Global Antibiotic Research and Development Partnership (GARDP)

\ n

\ nThis joint initiative of WHO and the Neglected Diseases Medicines Initiative stimulates research and development through public-private partnerships.By 2023, the Partnership plans to develop and market up to four new medicines by improving existing antibiotics and accelerating the development of new antibiotics.

\ n

The Inter-Agency Antimicrobial Resistance Coordination Group (IACG)

\ n

\ nThe United Nations Secretary-General has established the Group to enhance international coherence and to ensure the effectiveness of global efforts to address this health security threat.The team is co-chaired by the UN Under-Secretary-General and the WHO Director-General, and includes high-level representatives from relevant UN agencies and other international organizations, as well as experts from various sectors.,”dateModified”:”2020-07-31T15:13:00.0000000+00:00″,”mainEntityOfPage ” : “https://www.who.int/ru/news-room/fact-sheets/detail/antibiotic-resistance”, “@context”: “http://schema.org”, “@type”: ” Article “};

90,000 What are antibiotics. Dossier – Biographies and information

What are antibiotics?

• Antibiotics are special substances that inhibit the growth of bacteria and cause their death. As medicines, they are used to combat diseases that are caused by pathogens.

What diseases are treated with antibiotics?

• One of the main uses of antibiotics is to treat common diseases such as pneumonia (most commonly caused by bacteria of the staphylococcaceae family), syphilis (treponema pallidum) and tuberculosis (mycobacterium tuberculosis, known as Koch’s bacillus). At the same time, antibiotics are completely useless for viral infections: for example, these drugs will not help with influenza, SARS or hepatitis A, B and C.However, if the flu is causing complications, including pneumonia, your doctor may prescribe an antibiotic.

How many antibiotics are there in the world?

• A total of several thousand various natural and synthetic substances are known that are used as antibiotics, but they are all combined into 16 large classes. For example, penicillin, the first antibiotic discovered in 1928 by Alexander Fleming, belongs to the class of beta-lactam antibiotics. Of the known antibiotics, only a small part is used, no more than 5%, since most of the previously discovered antibiotics have become useless due to antibiotic resistance, i.e.e. resistance of microorganisms to antibiotics.

What is the problem of resistance?

• Microorganisms evolve and sooner or later, as a result of mutations, they adapt to the action of the antibiotic, and for them it becomes harmless. Nowadays, more and more fears of scientists and doctors are caused by the fact that disease-causing bacteria are beginning to adapt to antibiotics faster than new types of drugs are being invented.
• If this continues, any pneumonia or acquired tuberculosis and sepsis will again become a disease with a mortality rate close to 100%, as it was before the invention of penicillin.
• This could lead to epidemics that will claim millions of lives.

Why does resistance arise?

• The main fault in this lies with the doctors and patients themselves. If a person took an antibiotic as prescribed by a doctor until complete recovery, there would be no pathogens left in his body, and there would be no problem. Unfortunately, patients often take antibiotics without a doctor’s instructions, do not finish the course, drink them in insufficient concentrations, so some of the pathogens survive after such treatment, and their carrier remains infectious to others, even if temporarily does not feel unwell.Doctors are also to blame, sometimes prescribing antibiotics unnecessarily for prevention. All this leads to an increase in the number of microorganisms that cannot be taken with simple antibiotics.

Why are they not inventing new antibiotics?

• Invent. For example, in 2015, it was announced that a new class of antibiotics was immediately discovered – teixobactin, with which scientists pin great hopes, since in laboratory experiments it has never been possible to reveal the appearance of resistance to it in pathogenic bacteria.However, they are unlikely to start treating them earlier than 10 years later due to the required cycle of checks. In addition, this is the first class of antibiotics to be discovered in the last few years, and this is just not enough. It is very expensive to find and test new antibiotics, which is why pharmaceutical companies are currently very reluctant to take on this business. This can only be corrected by a radical reform of the financing of the medical industry at the global level.

How to deal with the problem?

• The American Indian Center for Disease Dynamics, Economics & Policy (CDDEP) in its 2015 Antibiotic Use Report.recommends several ways to solve the problem.
• First of all, the correct use of antibiotics should be obtained from both doctors and patients. Therefore, one of the main tasks is to reduce the global consumption of this type of drugs.
• In the meantime, it continues to grow, from 2000 to 2010, world consumption increased from 50 to 70 billion units, with the main growth accounted for by countries such as India, Egypt, China, Brazil, and African countries.
• The consumption of antibiotics is also growing in Russia.In developed countries, with the exception of the Netherlands and Denmark, consumption is declining. Experts suggest using antibiotics only in life-threatening situations, never prescribing them, even for children, for common coughs, colds or diarrhea, unless there are complications.
• Situations where these medications may be needed should also be avoided. Much of the disease can be prevented by regularly washing your hands with soap and water. In developing countries, dangerous diseases are largely due to lack of access to clean water and poor sanitary and hygienic conditions.Finally, vaccination against certain diseases allows less antibiotic use.
• Experts also recommend reducing the use of antibiotics in agriculture.

History of the discovery of penicillin. Dossier

90,000 The bacteria are antibiotic resistant. What to do? Do not take antibiotics

November 2, 2018

Photo Credit, Getty Images

Scientists are developing a new type of antibiotic that has already shown encouraging results in early trials.The need for new drugs is more urgent than ever when we consider that the increasing resistance of bacteria to antibiotics poses a serious threat.

When antibiotics were first introduced in the 1940s, they were called the miracle cure. But now there are fears that, due to their too frequent use, the bacteria have developed drug resistance.

The chief physician of Great Britain, Sally Davis, said that if antibiotics stop working, medicine will essentially slide into the Middle Ages.But what is the root cause of the problem?

What are antibiotics

Scottish chemist Alexander Flemming invented the first real antibiotic in 1928. It happened almost by accident – in the course of experiments, he found out that mold inhibits the growth of bacteria. This is how penicillin was born.

His discovery revolutionized the treatment of certain types of infectious diseases and helped save countless people.

Antibiotics affect bacteria in different ways: in some cases they destroy them, in others they prevent them from spreading.

But these drugs also have a weak side.

Resistance

Antibiotics effectively neutralize many types of bacteria, but not all. Certain types of bacteria produce genes that protect them from the effects of drugs.

They survive the treatment and reproduce, passing on their genes to the offspring, which further reduces the effectiveness of medications.

If a person becomes infected with these antibiotic-resistant bacteria, it becomes more difficult to treat him with medications.

Currently, other existing antibiotics may come to the rescue, but the options are dwindling as bacteria adapt and develop resistance to more and more drugs.

Over the past four years in England, the number of cases of infection with blood-borne infections with resistance to antibiotics has increased by 35%. This became known largely due to the fact that doctors began to more actively identify cases of sepsis.

Despite the increase in the incidence of such infections, the ratio between blood-borne antibiotic-resistant infections and treatable infections has remained the same.

Health professionals believe that every effort should be made to prevent antibiotic-resistant bacteria from becoming prevalent over others.

In a recent study, researchers found that without effective antibiotics, infections with life-threatening infections during clinical operations could increase.

Public Health England has been actively calling for a reduction in the amount of antibiotics prescribed to patients since 2013.

Doctors say that too frequent use of antibiotics is the main reason for the emergence of resistance to them in microorganisms. The more people use antibiotics, the less effective they become.

It is not uncommon for doctors to prescribe antibiotics to patients who are not infected with bacterial infections, although this is completely useless.

Overall, antibiotic consumption across the UK has declined by about 5% since 2013, but data differ by region.

The more actively doctors prescribe antibiotics for treatment, the more bacteria are resistant to them.

Photo author, Getty Images

Photo caption,

Often doctors prescribe antibiotics to patients who are not infected with bacterial infections, although this is completely useless.

When patients come to their clinics complaining of a cough or cold, about half are prescribed antibiotic treatment.

There are concerns that the problem is exacerbated by patient expectations.

According to the latest data, 38% of patients seeking medical help assume that they will be treated with antibiotics.

Therefore, now in Britain they are not only trying to reduce the amount of prescribed antibiotics in general, but also to create conditions under which clinics will not try to treat them to patients with diseases that pass naturally after a few days.

How are things in other countries?

Antibiotic overuse is not unique to Britain.

The European Antimicrobial Consumption Control Network has identified the spread of antibiotic-resistant bacteria as a public health threat.

It is estimated that about 25,000 people die from related infections in Europe every year.

Antibiotic consumption in Britain today is below average compared to other EU countries.

Many countries with high consumption of antibiotics look to other countries for experience, especially in northern Europe, where their consumption is lower.

Drug-resistant tuberculosis is of particular concern.

According to the World Health Organization (WHO), tuberculosis remains the most deadly infectious disease in the world.

Treatment is paying off – from 2000 to 2017, 54 million lives were saved thanks to the correct diagnosis and successful treatment.

But even taking into account the decrease in the incidence rate in the world by 2% per year, the infection remains in the top ten leading causes of death in the world.

• 1.6 million approximate number of people who died from tuberculosis in 2017

• 47% of patients with multidrug-resistant tuberculosis live in China, India and Russia.

Getty

90,224 In 2017, 10 million people fell ill with tuberculosis, 1.6 million of them eventually died. Most are in developing countries.

According to WHO, 490 thousand patients with multidrug-resistant tuberculosis. In this case, the bacteria do not respond to treatment with two powerful drugs – isoniazid and rifampicin – which are primarily used to treat the infection.

MDR-TB can be treated with second-line anti-TB drugs. But this treatment option can be long and costly.

What the future holds

A new class of antibiotics was last developed 30 years ago.

The bacteria have developed resistance to all existing species.

The production of antibiotics is costly, and it takes a long time from development to implementation.

In 2017, public health in England issued a warning that an urgent need to address the problem of antibiotic resistance, otherwise by 2050, due to this problem, 10 million people will die every year in the world.

As a result, the global decline in labor productivity will cost the global economy $ 100 trillion.

Therefore, healthcare organizations in different countries urge doctors and patients to stop abusing antibiotics.

What antibiotics are best for treating exacerbations in people with cystic fibrosis with persistent pulmonary infection caused by the Burkholderia cepacia complex?

Review Question

We searched for evidence as to which antibiotics are best for treating people with cystic fibrosis at the height of their symptoms who have persistent lung infection with Burkholderia cepacia complex .

Relevance

Cystic fibrosis is a common hereditary disease in which the lungs are often clogged with mucus.This damages the lungs’ defenses and often leads to chronic, persistent infections that cannot be cured with antibiotics. People with cystic fibrosis often require courses of antibiotics to relieve symptoms (such as cough, excess mucus / phlegm, and shortness of breath) during periods of illness or worsening. These episodes are called flare-ups and are usually treated with intravenous antibiotics (through an IV line into a vein). One group of bacteria that can infect the lungs of people with cystic fibrosis is called Burkholderia cepacia complex .These closely related bacteria are widespread in the environment and do not cause infections in healthy people who do not have cystic fibrosis. Infections caused by these bacteria are especially difficult to treat because they are resistant to many commonly used antibiotics. Currently, doctors do not know which antibiotics are best for treating these infections; what combinations of antibiotics should be used; how long antibiotics should be used, and are there additional treatments that might also help.This is an update to a previously published review.

Search date

Evidence is current as of: 29 May 2019.

Characteristics of research

We did not find any trials in people with an exacerbation of cystic fibrosis infected with the bacteria Burkholderia cepacia complex who were randomly assigned to different treatments.

Main results

More research is needed to find out which treatments are best for improving lung function and survival, and reducing side effects and length of hospital stay in people infected with Burkholderia cepacia complex during an exacerbation.

Antibiotics – use with caution!

Here are the basic rules for using antibiotics:

Rule 1: Antibiotics SHOULD BE USED STRICTLY AS INDICATED.

The main indication for the use of antibiotics is serious BACTERIAL infection. It is bacterial, not viral or fungal. For example, pneumonia, with rare exceptions, is caused by bacteria. Therefore, antibiotics are indicated in this case. But with the flu in the early days, no, because the flu is caused by the corresponding virus.Antibiotics do not work on them.

For serious infections. I have friends who drink antibiotics for colds. Here I recall a bearded anecdote: “If you treat a cold, then it will be cured in 7 days. And if not treated, it goes away in a week. ” A cold (according to the doctor’s opinion, an acute respiratory infection – ARVI) is a disease that our body can cope with on its own without antibiotics. In addition, it is not a fact that it will be caused by bacteria, there are also rhinitis (inflammation of the nasal mucosa, accompanied by a runny nose) caused by viruses.It turns out fortune telling on the coffee grounds. Do not forget that the use of the same antibiotic does not go unnoticed. The bacteria get used to them, and as a result, over time, the medicine does not work. The situation is similar to cockroach baiting. For the first time, the poison acts very powerfully on the negligent inhabitants of the apartment. The number of insects decreases sharply.

But those units remain that have been found to be insensitive to the poison. She multiplies and there are a lot of cockroaches that are not susceptible to this poison.And you need to buy another product. The same thing happens with antibiotics.

Therefore, antibiotics should be used for an infection that really threatens health – pneumonia, cystitis, pyelonephritis, purulent inflammation, etc. And the cold will go away by itself on antipyretic drugs in a week.

Rule 2: in the first days, preparations of a WIDE SPECTRUM of action are used, and in the subsequent days, those to which the flora (bacteria) is sensitive.

A very important rule, which, unfortunately, can only be fully applied in a medical institution.The fact is that there are antibiotics that kill VERY MANY different microbes (for example, the drug amoxicillin), and there are those that act on single species (for example, anti-tuberculosis drugs act only on Koch’s bacillus). At the beginning of an infectious disease, it is UNKNOWN what kind of bacteria caused the disease (and there are a huge number of types of bacteria). Therefore, they use drugs that kill as many BACTERIA of different types as possible. And they hope that as a result of such an “atomic explosion” among the innocent, the “villainous bacteria” that caused the infection will die.This is also a fortune-telling, but there is no better way out at the moment.

The most tested option is BEFORE you start taking antibiotics , take the environment of the body, where the infection occurs, for inoculation (for example, purulent contents of the wound). The detached piece is placed on a nutrient medium, where bacteria grow after a few days. So you can determine who exactly caused the infection, the sensitivity of bacteria to antibiotics (in other words, which of all antibiotics best destroys the specific bacteria that caused the disease).As soon as the results of the study become known, new antibiotics are prescribed, which more selectively destroy the “evil” bacteria. The analysis is done on average 3-4 days. Naturally, it is done only in a medical institution, and even then not in all cases. Therefore, most often they dispense with a broad-spectrum antibiotic, which is chosen by an experienced (at random) way.

Rule 3: the three-day rule.

According to this rule, the effectiveness of the antibiotic is determined by on 3 DAY from the moment of its appointment.The drug is canceled after 3 DAYS from the moment the symptoms of the disease cease.

If after the start of taking an antibiotic within 3 days the symptoms of the disease decrease: the fever stops, the degree of weakness decreases, cough, shortness of breath, etc., then this means that ANTIBIOTIC WORKS on bacteria, and it is effective. The third day from the moment of admission is the last day on which the symptoms MUST decrease. If this does not happen (fever, cough, shortness of breath, weakness, muscle pain, etc.)it is necessary TO CHANGE antibiotic to another with DIFFERENT mechanism of action (for example, change bactericidal to bacteriostatic) also WIDE SPECTRUM of action. Replacement is necessary because you misunderstood the drug. Got one to which the bacteria are already immune. And with an infectious disease, early initiation of therapy is important. You cannot wait long for the infection to spread even more in the body, which will happen when taking a drug that does not act on microorganisms.

Antibiotics are discontinued, as a rule, after 3 days from MOMENT OF CUTTING ALL symptoms of infection (fever, shortness of breath, weakness, cough, etc.). In some cases, the admission continues further (for severe infectious diseases that are treated in a hospital).

Rule 4: Take antibiotic by the hour.

The antibiotic intake should be distributed by the hour. In the annotation to any antibiotic in the “Pharmacokinetics” section, the duration of the drug action is indicated.For example, the drug amoxicillin lasts about 6-8 hours. In order for the bacteria to CONSTANTLY WORK with the antibiotic , it must be used continuously. In a specific example, every 8 hours, i.e. 3 times a day, strictly by the hour. Let’s take the interval after 8 hours: 7:00, 15:00, 23:00. If the drug acts every 12 hours, then it should be taken 2 times a day every 12 hours. You can also focus on the half-life indicator. But I offer the simplest option: in any annotation to the drug it is indicated in what dosage and HOW MANY TIMES A DAY you need to drink the antibiotic.Divide 24 hours by the number of indicated receptions there, and it will become clear in what intervals you need to drink the medicine. For example, it is specified 6 times a day – 24 hours: 6 = 4 hours. Therefore, an antibiotic should be taken every 4 hours. If specified once a day – every 24 hours, etc. An important rule that many do not follow. But if the concentration of the drug in the blood is not constant, this can lead to the fact that at some hours the drug will not act on bacteria. And this can lead to the development of RESISTANCE of microorganisms to the destroying action of the drug.This should not be allowed.

Rule 5: The use of drugs together with antibiotics to eliminate the symptoms of an infectious disease.

To eliminate the symptoms of the disease, other drugs are also used in conjunction with antibiotics. For example, in pneumonia, the main symptoms are fever, shortness of breath, cough with phlegm, and chest pain is possible. To eliminate FEVER , ANTI-REDUCING drugs are used, COUGH with sputum – MUCOLYTICS for faster sputum separation, CHEST PAIN – ANALYSIS which are also anti-inflammatory drugs, anti-inflammatory drugs, and anti-inflammatory drugs anti-inflammatory).This is necessary to alleviate the patient’s condition, as well as a speedy recovery.

Rule 6: After a course of antibiotics, restoration of intestinal microflora with probiotics is shown.

A rule that most people never follow. The fact is that in addition to the “harmful” bacteria, antibiotics also affect the “good” ones that are in our gastrointestinal tract. The collection of beneficial bacteria is called normal MICROFLORA. This microflora performs a lot of useful functions – it protects the gastrointestinal tract from the growth of “harmful” bacteria in it due to competition with them, forms some vitamins, participates in the digestion of certain nutrients, stimulates immunity, etc.When using antibiotics, part of this microflora also dies, since the drug acts on many types of bacteria (broad spectrum of action). And this leads to the development of INTESTINAL DYSBACTERIOSIS . The condition may not manifest itself in any way, but it can also lead to the development of infections of the gastrointestinal tract (since instead of the dead microflora, many “harmful bacteria” are ingested with food, which populate empty spaces in the intestines), dyspeptic disorders (bloating, diarrhea or constipation, violation of the assimilation of nutrients), decreased immunity.Intestinal dysbiosis is not a disease, it can be in varying degrees – from mild to severe. But it is known for sure that after taking antibiotics, it develops in 99.9% of cases. To prevent this AFTER THE COURSE OF ANTIBIOTICS PROBIOTICS are used – preparations containing live beneficial bacteria. For example, such drugs include linex, bifidumbacterin, lactobacterin, and others. Reception should be from the day the antibiotic is canceled DURATION for at least 21 days.New beneficial bacteria in the medicine will take the place of the dead. And dysbiosis will be eliminated.

Rule 7: If the duration of effective antibiotic intake is more than 10 days, it is changed to a drug with the opposite mechanism of action.

It should be noted here that in case of acute infections that are treated at home, taking an antibiotic is usually no more than 5-10 days. Long-term admission is used already in a medical institution, if there is evidence for this.Therefore, this does not concern an ordinary person. About how many days and in what dosage it is worth using the antibiotic. It is better to trust the information that is indicated in the annotation to the drug.

You can also use drugs that stimulate the immune system. If you wish. Do not forget that using CONSTANTLY for the same infection, the same antibiotic is NOT . This will lead to habituation of the microflora to it. And in the end, at some point, the drug will not work.Therefore, if you use the same antibiotic more than 3-4 times, it is better to change it to a drug from another group, also with a broad spectrum of action.

Antibiotics – causes, diagnosis and treatment

In Russia, as in many other countries of the world, antibiotics are sold without a prescription. And if, on the one hand, this simplifies their use, on the other hand, due to the usual human carelessness, it only contributes to the development of resistance to them in various pathogens. Often, especially suspicious parents treat children with such drugs.It seems to them that the temperature, which lasts for several days, is already a tragedy. Antibacterial drugs work only on bacteria. Therefore, it is inappropriate to use them, for example, for influenza, ARVI and other viral infections.

Nevertheless, doctors warn – you need to be especially careful in choosing therapy, since uncontrolled use of antibiotics can adversely affect both the body itself and the disease that they tried to cure. For example, if you do not drink the course of antibiotic therapy to the end, then some microorganisms can survive, acquiring resistance to the antibiotic used.And now, not only do the treatment need to be started anew (and this is plus everything else and the toxic effect both on the body itself as a whole, and on those bacteria that normally should live with us), but also change the antibacterial drug to more powerful or newer, to which most microorganisms have not yet developed resistance. So antibiotics should only be taken on the recommendation of a doctor.

What do antibiotics work against?

Microorganisms differ significantly in the severity of their pathogenic properties.Some of them are able to overcome the defenses of the human body and cause extremely serious and even fatal diseases (pathogens of plague, meningitis), the body copes with others without assistance (for example, pathogens of colds).

Depending on the internal organization, microorganisms are divided into 4 groups: bacteria, viruses, fungi and protozoa (amoeba, lamblia, etc.).

Bacteria, fungi and protozoa have a cellular structure, contain DNA and RNA, protein synthesis systems and ATP (“fuel” for biochemical reactions), and therefore are capable of independent reproduction.

Viruses lack cellular organization. They are a DNA or RNA molecule surrounded by a protein capsule and are absolute parasites, that is, they are able to show signs of life (first of all, multiply), only after penetrating into the cells of the “host” (plant, animal, human), using their cells as biochemical “Mini-factories”.

Features of medical terminology

The first substances that have a detrimental effect on microorganisms, but acceptable for humans, were found among the derivatives of synthetic dyes, they were used to treat syphilis and were called “chemotherapy”, and the treatment process was called chemotherapy.Today, chemotherapy usually means the treatment of cancer, which is not entirely true.

Somewhat later, scientists learned to use for their own purposes such a phenomenon as the opposition (antagonism) of bacteria. The fact is that bacteria are widespread in nature almost everywhere (in soil, water, etc.), just like other living things, they are forced to fight among themselves for existence. And the main weapon in this fight is special substances produced by some types of bacteria, and destructively acting on other species.It is these substances that are called antibiotics.

Unfortunately, antibacterial drugs have not yet been found that would suppress the vital activity of both bacteria and viruses, since the differences in the structure and characteristics of metabolism in these microorganisms are of a fundamental nature. Despite the significant advances in molecular biology and biochemistry, there are still clearly not enough drugs that can effectively act on viruses, and their effectiveness is not high.

So, there are antibiotics – these are substances of natural origin – and chemotherapy drugs are artificially created substances of similar action, united by the general term “antibacterial drugs”. The peculiarities of the terminology can cause difficulties for the layman. Sometimes in a pharmacy you can hear how a customer is trying to get an answer from a pharmacist: “Is Biseptol (or, for example, ciprofloxacin) an antibiotic or not?” The fact is that both of these drugs are antibacterial drugs from the group of chemotherapy drugs.But for treatment, the distinction between antibiotics and chemotherapy is not very important, so the division between antibiotics and chemotherapy is slowly but surely becoming part of history.

What antibiotics are there?

It is important to know that the vital processes of human cells are fundamentally different from the vital processes of a bacterial cell. Antibacterial drugs have a selective effect on the vital processes of bacteria, suppressing them, and do not affect the processes occurring in the cells of the human body.Therefore, currently known antibacterial drugs are classified on the basis of their mechanism of action and chemical structure.

So, some antibacterial drugs suppress the synthesis of the outer shell (membrane) of a bacterial cell – a structure that is completely absent in a human cell. The most important among these drugs are antibiotics of the penicillin group, cephalosporins and some other drugs.

Other antibacterial drugs suppress various stages of protein synthesis by bacterial cells: these are drugs belonging to the group of tetracyclines, macrolides, aminoglycosides.

Antibacterial drugs differ significantly in their main property – antibacterial activity. The instructions for each antibacterial drug include a list of bacteria sensitive to it – its spectrum of action; some antibiotics (broad spectrum) act on many types of bacteria, others (narrow spectrum) – only on certain types of microbes.

Resistance of microorganisms to antibiotics

All living things, including bacteria, quickly adapt to unfavorable environmental conditions.The development of resistance to antibacterial drugs is one of the most striking examples of such a device. It can be argued that sooner or later any kind of bacteria will become insensitive to any antibacterial drug. Moreover, in relation to each drug, the process proceeds the faster, the larger the amount of this substance is used. As bacteria develop resistance to antibiotics, humanity is forced to invent new drugs. Therefore, we can assume that if today we uncontrollably prescribe antibacterial drugs to all children, then tomorrow we will have nothing to treat our grandchildren with.

In the course of this race, conflicts of interest arise in society. Society as a whole has a vested interest in reducing the cost of antibiotic therapy and balancing the cost and effectiveness of treatment. To achieve this goal, it is necessary to limit the use of antibacterial drugs to strict indications, which will avoid unnecessary costs for the development and manufacture of new drugs. Manufacturers of antibacterial drugs, on the contrary, are interested in increasing sales (by expanding indications), which will inevitably lead to a more rapid spread of drug resistance of microorganisms and, as a consequence, the need to develop more and more new drugs.

Unfortunately, the massive and uncontrolled use of antibacterial drugs has already led to widespread resistance of microorganisms to them. Moreover, in Russia, the uncontrolled use of antibacterial drugs (pharmacies can supply them without a prescription, which is unacceptable according to international rules) is combined with a shortage of funds for health care. Today, in our country, most of the causative agents of the most common infections are resistant to drugs such as biseptol, gentamicin, to drugs of the tetracyclines group.

It would seem that this problem is easily solved by laboratory research. But, alas, with the use of modern research methods, the answer can be received only after 2-3 days. As a consequence, in real life, antibacterial drugs are prescribed empirically, i.e. based on available practical experience.

But even the most brilliant doctor cannot independently accumulate experience in the use of all possible antibacterial drugs and confidently say that drug A is better than drug B.In addition, it must be considered how widespread drug resistance is among bacteria in a particular geographic region. The doctor inevitably has to rely on the results of special studies, their critical analysis, international and national experience, as well as recommendations for treatment standards developed by experts.

Sources

• Cheng J., Mackie A., Chang AB., Grimwood K., Scott M., King A., Goyal V., Marchant JM., O’Grady KF. Medication and healthcare use, parent knowledge and cough in children: A cohort study.// Pediatr Pulmonol – 2021 – Vol – NNULL – p .; PMID: 33

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• Werner M., Unterer S. [Use of antimicrobials in acute canine diarrhea – overview of potential risks, indications and alternatives]. // Tierarztl Prax Ausg K Kleintiere Heimtiere – 2021 – Vol49 – N2 – p.110-120; PMID: 33
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• Mahony M., Lean D., Pham L., Horvath R., Suna J., Ward C., Veerappan S., Versluis K., Nourse C. Infective Endocarditis in Children in Queensland, Australia: Epidemiology, Clinical Features and Outcome. // Pediatr Infect Dis J – 2021 – Vol – NNULL – p .; PMID: 33
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• Clemons M., Fergusson D., Joy AA., Thavorn K., Meza-Junco J., Hiller JP., Mackey J., Ng T., Zhu X., Ibrahim MFK., Sienkiewicz M., Saunders D. , Vandermeer L., Pond G., Basulaiman B., Awan A., Pitre L., Nixon NA., Hutton B., Hilton JF. A multi-center study comparing granulocyte-colony stimulating factors to antibiotics for primary prophylaxis of docetaxel-cyclophosphamide induced febrile neutropenia. // Breast – 2021 – Vol58 – NNULL – p.42-49; PMID: 33
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  Why do some bacteria become resistant to antibiotics?

  Doctors strongly recommend drinking the entire course of antibacterial drugs, without stopping after the onset of improvements.If the treatment is interrupted, this gradually leads to mutations in bacteria, to resistance. But is it?

  Experts unanimously answer – yes, it is. But even if you fully adhere to the rules of taking antibiotics, it will not save you from gradual resistance. And the main thing in this process is natural selection. We are used to thinking that if we don’t kill all the bacteria, there will be no recovery. When the rules for taking medications are changed, pathogens do not die completely, they mutate and adapt to their environment.

  This is not actually the case. There are many bacteria in the human body, some of which have antibiotic protection. The bulk of such mechanisms does not have, therefore, it dies after taking a course of drugs. But bacteria with protection survive. And not always human immunity can cope with them in a natural way. And then the disease blooms even while taking antibacterial drugs. Thanks to natural selection, the strongest bacteria survived and multiplied, while the weak died.In this case, it will be more difficult to defeat the disease not only for a particular patient, but also for the people around him, who can get infected from him.

  This is how particularly resistant strains develop that have nosocomial spread: from patients to hospital staff and new patients. And the more complex and diverse the antibiotics, the stronger the bacteria that survived the selection process become. It is the person who is the culprit in the formation of resistant strains. Without human intervention, bacteria could not have evolved so much.They are able to transmit genetic resistance to drugs using plasmids – small DNA molecules. Bacteria of different types exchange them with each other. Some microorganisms are capable of carrying resistance to several types of antibiotics.

  What does this scenario threaten people with? For mankind, there is a great risk of again facing diseases for which cures have already been found. For example, sexually transmitted infections, syphilis, or gonorrhea. This is a natural development, the appearance of which was warned by Alexander Fleming, the man who discovered the first antibiotic in history to the world.Medicine is constantly faced with this phenomenon, scientists are forced to constantly improve antibacterial drugs.

  Most antibiotics are created on the basis of natural competition of microorganisms in nature, like mold containing penicillin and staphylococcus aureus. Microorganisms have been developing weapons and defense mechanisms against their own kind for millions of years. And only 90 years old mankind has been using antibiotics. The genetics of microorganisms is such that in nature there is a variety of antibiotic resistance genes.And most of them are resistant to several types of antibiotics. It is possible that nature already has mechanisms of protection against new types of antibiotics. We just don’t know yet how fast it spreads among the rest of the bacteria. Of course, humanity has put its hand here too, constantly polluting the environment, water and soil.

  Medicine is not the only branch of widespread use of antibiotics. They are no less used in industrial animal husbandry for the treatment of animals and the prevention of diseases.The scale is enormous. And this is already yielding negative results. The constant war with bacteria is forcing people to look for more and more new types of antibiotics. Previously, this was facilitated by scientific discoveries: tetracyclines, cephalosporins, macrolides, fluoroquinolones, carbapenems. But recent decades have not brought new types of weapons to man. And humanity is gradually losing the war. Many pharmaceutical companies do not finance this industry, it is simply unprofitable for them financially. After all, the search and development of new antibiotics require a lot of financial, human and time resources.And the profit may not recoup the investment.

  One of the alternatives to fight bacteria is bacteriophages. These are viruses that infect bacterial cells. Scientists are conducting clinical trials and developing in this direction. So there is hope. In 2018, doctors began the second phase of using lysine enzymes to fight Staphylococcus aureus.

  The medical community is constantly conducting educational work among patients. Their goal is the controlled rational use of antibiotics.In 2018, WHO published a concise guideline for taking antibacterial drugs:

  • take antibiotics strictly as directed by your doctor;
  • Do not transfer unused drugs to others;
  • Do not take antibiotics unless prescribed by a doctor;
  • observe personal hygiene, avoid places of potential infection, get vaccinated in a timely manner.

  Many countries have laws that control the use of antibiotics in animal husbandry.Israel has taken all the necessary measures to effectively prevent the development of nosocomial epidemics.