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This article is about treatment of bacterial infection. For antitumor

antibiotics, see Chemotherapy Cytotoxic antibiotics.

Testing the susceptibility of Staphylococcus aureus to antibiotics by

the Kirby-Bauer disk diffusion method antibiotics diffuse from
antibiotic-containing disks and inhibit growth of S. aureus, resulting
in a zone of inhibition.

Antibiotics, also called antibacterial, are a type

of antimicrobial[1] drug used in
the treatment and prevention of bacterial infections.[2][3] They may
either kill or inhibit the growth of bacteria. A limited number of
antibiotics also possess antiprotozoal activity. Antibiotics are not
effective against viruses such as the common cold or influenza, and
their inappropriate use allows the emergence of resistant
organisms.[2] In 1928, Alexander Fleming identified penicillin, the
first chemical compound with antibiotic properties. Fleming was
working on a culture of disease-causing bacteria when he noticed
the spores of a little green mold (Penicillium chrysogenum), in one of
his culture plates. He observed that the presence of the mold killed or
prevented the growth of the bacteria.

Antibiotics revolutionized medicine in the 20th century, and have

together with vaccination led to the near eradication of diseases such
as tuberculosis in the developed world. Their effectiveness and easy
access led to overuse, especially in livestock raising, prompting
bacteria to develop resistance. This has led to widespread problems
with antimicrobial and antibiotic resistance, so much as to prompt
the World Health Organization to classify antimicrobial resistance as
a "serious threat [that] is no longer a prediction for the future, it is
happening right now in every region of the world and has the
potential to affect anyone, of any age, in any country".

The era of antibacterial treatment began with the discovery

of arsphenamine, first synthesized by Alfred Bertheim and Paul
Ehrlich in 1907, and used to treat syphilis. The
first systemically active antibacterial drug, prontosil was discovered
in 1933 by Gerhard Domagk, for which he was awarded the
1939 Nobel Prize. All classes of antibiotics in use today were first
discovered prior to the mid 1980s.

Sometimes the term antibiotic is used to refer to any substance used

against microbes, synonymous with antimicrobial, leading to the
widespread but incorrect belief that antibiotics can be used against
viruses. Some sources distinguish between antibacterial and
antibiotic; antibacterials are used in soaps and disinfectants, while
antibiotics are used as medicine.

Medical uses :-
Antibiotics are used to treat or prevent bacterial infections, and
sometimes protozoan infections. (Metronidazole is effective against a
number of parasitic diseases). When an infection is suspected of being
responsible for an illness but the responsible pathogen has not been
identified, an empiric therapy is adopted. This involves the
administration of a broad-spectrum antibiotic based on the signs and
symptoms presented and is initiated pending laboratory results that
can take several days.

When the responsible pathogenic microorganism is already known or

has been identified, definitive therapy can be started. This will usually
involve the use of a narrow-spectrum antibiotic. The choice of
antibiotic given will also be based on its cost. Identification is
critically important as it can reduce the cost and toxicity of the
antibiotic therapy and also reduce the possibility of the emergence of
antimicrobial resistance. To avoid surgery antibiotics may be given
for non-complicated acute appendicitis. Effective treatment has been

Antibiotics may be given as a preventive measure (prophylactic) and

this is usually limited to at-risk populations such as those with
a weakened immune system (particularly in HIV cases to
prevent pneumonia), those taking immunosuppressive
drugs, cancer patients and those having surgery.[20] Their use in
surgical procedures is to help prevent infection of incisions made.
They have an important role in dental antibiotic prophylaxis where
their use may prevent bacteremia and consequent infective
endocarditis. Antibiotics are also used to prevent infection in cases
of neutropenia particularly cancer-related.

There are different routes of administration for antibiotic treatment.
Antibiotics are usually taken by mouth. In more severe cases,
particularly deep-seated systemic infections, antibiotics can be
given intravenously or by injection. Where the site of infection is
easily accessed antibiotics may be given topically in the form of eye
drops onto the conjunctiva for conjunctivitis or ear drops for ear
infections and acute cases of swimmer's ear. Topical use is also one of
the treatment options for some skin conditions
including acne and cellulitis. Advantages of topical application
include achieving high and sustained concentration of antibiotic at the
site of infection; reducing the potential for systemic absorption and
toxicity, and total volumes of antibiotic required are reduced, thereby
also reducing the risk of antibiotic misuse. Topical antibiotics applied
over certain types of surgical wounds have been reported to reduce
the risk of surgical site infections.[27] However, there are certain
general causes for concern with topical administration of antibiotics.
Some systemic absorption of the antibiotic may occur; the quantity of
antibiotic applied is difficult to accurately dose, and there is also the
possibility of local hypersensitivity reactions or contact
dermatitis occurring.

Health advocacy messages such as this one encourage patients to talk
with their doctor about safety in using antibiotics.

Antibiotics are screened for any negative effects before their approval
for clinical use, and are usually considered safe and well tolerated.
However, some antibiotics have been associated with a wide extent of
adverse side effects ranging from mild to very severe depending on
the type of antibiotic used, the microbes targeted, and the individual
patient. Side effects may reflect the pharmacological or toxicological
properties of the antibiotic or may
involve hypersensitivity or allergic reactions.[5] Adverse effects range
from fever and nausea to major allergic reactions,
including photodermatitis and anaphylaxis. Safety profiles of newer
drugs are often not as well established as for those that have a long
history of use.

Common side-effects include diarrhea, resulting from disruption of

the species composition in the intestinal flora, resulting, for example,
in overgrowth of pathogenic bacteria, such as Clostridium
difficile. Antibacterials can also affect the vaginal flora, and may lead
to overgrowth of yeast species of the genus Candida in the vulvo-
vaginal area. Additional side-effects can result from interaction with
other drugs, such as the possibility of tendon damage from the
administration of a quinolone antibiotic with a
systemic corticosteroid.

Antibiotics are a group of medicines that are used to treat infections

caused by germs (bacteria and certain parasites). They do not work
against infections that are caused by viruses - for example, the
common cold or flu. Antibiotics are normally only prescribed for
more serious bacterial infections - for example, pneumonia. When
prescribed, it is important to take the entire course of antibiotics
which helps to prevent resistance developing to that antibiotic. Most
side-effects of antibiotics are not serious - for example, diarrhoea, or
mild stomach upset such as feeling sick (nausea). Although some
people develop a serious allergy to some antibiotics, this is rare.

What are antibiotics?

Antibiotics are a group of medicines that are used to treat infections

caused by germs (bacteria and certain parasites). A parasite is a type
of germ that needs to live on or in another living being (host).
Antibiotics are sometimes called antibacterials or antimicrobials.
Antibiotics can be taken by mouth as liquids, tablets, or capsules, or
they can be given by injection. Usually, people who need to have an
antibiotic by injection are in hospital because they have a severe
infection. Antibiotics are also available as creams, ointments, or
lotions to apply to the skin to treat certain skin infections.
It is important to remember that antibiotics only work against
infections that are caused by bacteria and certain parasites. They do
not work against infections that are caused by viruses (for example,
the common cold or flu), or fungi (for example, thrush in the mouth or
vagina), or fungal infections of the skin.

Occasionally, a viral infection or minor bacterial infection develops

into a more serious secondary bacterial infection.

There are various antibiotics available and they come in various

different brand names. Antibiotics are usually grouped together based
on how they work. Each type of antibiotic only works against certain
types of bacteria or parasites. This is why different antibiotics are
used to treat different types of infection. The main types of antibiotics

As well as the above main types of antibiotics, there are a number of

other antibiotics that specialist doctors or hospital doctors may
prescribe for more uncommon infections such as tuberculosis (TB).

The rest of this leaflet only discusses antibiotics that your GP may
How do antibiotics work?

Some antibiotics work by killing germs (bacteria or the parasite). This

is often done by interfering with the structure of the cell wall of the
bacterium or parasite. Some work by stopping bacteria or the parasite
from multiplying.

When are antibiotics usually prescribed?

Antibiotics are normally only prescribed for more serious infections

with germs (bacterial and some parasitic infections).

Most common infections are caused by viruses, when an antibiotic

will not be of use. Even if you have a mild bacterial infection, the
immune system can clear most bacterial infections. For example,
antibiotics usually do little to speed up recovery from bronchitis, or
most ear, nose,and throat infections that are caused by bacteria.

So, do not be surprised if a doctor does not recommend an antibiotic

for conditions caused by viruses or non-bacterial infections, or even
for a mild bacterial infection.

However, you do need antibiotics if you have certain serious

infections caused by bacteria such as meningitis or pneumonia. In
these situations, antibiotics are often life-saving. When you are ill,
doctors are skilled at checking you over to rule out serious illness and
to advise if an antibiotic is needed.
Antibiotics can also be prescribed to treat acne - a less serious
condition. For acne, antibiotics can be taken by mouth or applied
directly to the skin.

Which antibiotic is usually prescribed?

The choice of antibiotic mainly depends on which infection you have

and the germ (bacterium or parasite) your doctor thinks is causing
your infection. This is because each antibiotic is effective only against
certain bacteria and parasites. For example, if you have pneumonia,
the doctor knows what kinds of bacteria typically cause most cases of
pneumonia. He or she will choose the antibiotic that best combats
those kinds of bacteria.

There are other factors that influence the choice of an antibiotic.

These include:

How severe the infection is.

How well your kidneys and liver are working.
Dosing schedule.
Other medications you may be taking.
Common side-effects.
A history of having an allergy to a certain type of antibiotic.
If you are pregnant or breast-feeding.

Even if you are pregnant or breast-feeding there are a number of

antibiotics that are thought to be safe to take.
Doctors sometimes choose certain antibiotics if they know there is a
certain pattern of infection in your community.

When taking an antibiotic

It is important to take antibiotics in the correct way. If you do not, this

may reduce how well they work. For example, some antibiotics need
to be taken with food and others should be taken on an empty
stomach. If you do not take your antibiotics in the right way it will
affect how much of them get into your body (their absorption) and
therefore they may not work as well. So, follow the instructions as
given by your doctor and on the leaflet that comes with the antibiotic
you are prescribed.

Always take the entire course of antibiotics as directed by your

doctor. Even though you may feel better before your medicine is
entirely gone, follow through and take the entire course. This is
important for your healing. If an antibiotic is stopped in mid-course,
germs (bacteria) may be partially treated and not completely killed.
Bacteria may then become resistant to that antibiotic. Overuse of
antibiotics has led to some bacteria changing their form or structure
(mutating) and becoming resistant to some antibiotics, which may
then not work when really needed. For example, meticillin-
resistant Staphylococcus aureus (MRSA) is a bacterium that has
become resistant to many different antibiotics and is difficult to treat.
What are the possible side-effects?

It is not possible to list all the possible side-effects of each antibiotic

in this leaflet. However, as with all medicines, there are a number of
side-effects that have been reported with each of the different
antibiotics. If you want more information specific to your antibiotic
then you should read the information leaflet that comes with the

Most side-effects of antibiotics are not serious. Common side-effects

include soft stools (faeces), diarrhoea, or mild stomach upset such as
feeling sick (nausea). Less commonly, some people have an allergic
reaction to an antibiotic and some have died from a severe allergic
reaction - this is very rare.

Antibiotics can kill off normal defence bacteria which live in the
bowel and vagina. This may then allow thrush or other bad bacteria to

You should tell your doctor if you have any of the following side-

Severe watery diarrhoea and tummy (abdominal) cramps: signs

of a serious bacterial infection of the gut - Clostridium
difficile infection.
Shortness of breath, hives, rash, swelling (of the lips, face, or
tongue), fainting: signs of an allergic reaction.
Vaginal itching or discharge: signs of vaginal thrush.
White patches on the tongue: signs of oral thrush.
Being sick (vomiting).

Some antibiotics may interact with other medicines that you might
take. This may cause reactions, or reduce the effectiveness of one or
other of the treatments. So, when you are prescribed an antibiotic you
should tell a doctor if you take other medicines.

Oral contraceptive pill

In the past it was recommended that, if you were taking antibiotics

and were also taking the pill, you should use additional contraception.
This is no longer the current recommendation after more recent
evidence has been reviewed. Antibiotics (other than one
called rifampicin) do not interfere with the effectiveness of the pill.
You should continue taking your pill as normal if you also need to
take any antibiotics.

Can I buy antibiotics?

No, they are only available from your chemist, with a doctor's

What is the usual length of treatment?

The length of treatment varies a lot. It depends on what kind of

infection you have, how severe it is and how quickly you get better
after starting treatment. Treatment can be:
For just a few days ('water' infection - urinary tract infection).
For one or two weeks (pneumonia)
For a few months (bone infections)
For many months (acne).

Who cannot take antibiotics?

It is very rare for anyone not to be able to take some type of

antibiotic. The main reason why you may not be able to take an
antibiotic is if you have had an allergic reaction to an antibiotic in the
past. Even if you have had an allergic reaction to one antibiotic, your
doctor will usually be able to choose a different type of antibiotic,
which you will be able to take.

How to use the Yellow Card Scheme

If you think you have had a side-effect to one of your medicines you
can report this on the Yellow Card Scheme. You can do this online at
the following web address:

The Yellow Card Scheme is used to make pharmacists, doctors and

nurses aware of any new side-effects that medicines or any other
healthcare products may have caused. If you wish to report a side-
effect, you will need to provide basic information about:

The side-effect.
The name of the medicine which you think caused it.
The person who had the side-effect.
Your contact details as the reporter of the side-effect.

It is helpful if you have your medication - and/or the leaflet that came
with it - with you while you fill out the report.