ANTIBIOTIC THERAPY

Antibiotics, also known as antibacterial, are medications that destroy or slow down the growth of
bacteria. They include a range of powerful drugs and are used to treat diseases caused by bacteria.
Antibiotics cannot treat viral infections, such as cold, flu, and most coughs.

Antibiotics are powerful medicines that fight certain infections and can save lives when used properly.
They either stop bacteria from reproducing or destroy them.

Before bacteria can multiply and cause symptoms, the immune system can typically kill them. White
blood cells (WBCs) attack harmful bacteria and, even if symptoms do occur, the immune system can
usually cope and fight off the infection.

Sometimes, however, the number of harmful bacteria is excessive, and the immune system cannot fight
them all. Antibiotics are useful in this scenario.

Some medical professionals have concerns that people are overusing antibiotics. They also believe that
this overuse contributes toward the growing number of bacterial infections that are becoming resistant
to antibacterial medications.

The first antibiotic was penicillin. Penicillin-based antibiotics, such as ampicillin, amoxicillin, and
penicillin G, are still available to treat a variety of infections and have been around for a long time.

Several types of modern antibiotics are available, and they are usually only available with a prescription
in most countries. Topical antibiotics are available in over-the-counter (OTC) creams and ointments.

Some medical professionals have concerns that people are overusing antibiotics. They also believe that
this overuse contributes toward the growing number of bacterial infections that are becoming resistant
to antibacterial medications.

There are different types of antibiotic, which work in one of two ways:

A bactericidal antibiotic, such as penicillin, kills the bacteria. These drugs usually interfere with either the
formation of the bacterial cell wall or its cell contents.

A bacteriostatic stops bacterium from multiplying. Antibiotics are ineffective against viruses.

A doctor prescribes antibiotics for the treatment of a bacterial infection. It is not effective against
viruses. Know whether an infection is bacterial or viral helps to effectively treat it. Viruses cause most
upper respiratory tract infections (URTIs), such as the common cold and flu. Antibiotics do not work
against these viruses.

If people overuse antibiotics or use them incorrectly, the bacteria might become resistant. This means
that the antibiotic becomes less effective against that type of bacterium, as the bacterium has been able
to improve its defenses.

A doctor can prescribe a broad-spectrum antibiotic to treat a wide range of infections. A narrow-
spectrum antibiotic is only effective against a few types of bacteria.
In some cases, a healthcare professional may provide antibiotics to prevent rather than treat an
infection, as might be the case before surgery. This is the ‘prophylactic’ use of antibiotics. People
commonly use these antibiotics before bowel and orthopaedic surgery.

Antibiotics commonly cause the following side effects:

 Diarrhoea
 Nausea
 Vomiting
 Rash
 Upset stomach

With certain antibiotics or prolonged use, fungal infections of the mouth, digestive tract, and vagina

 Less common side effects of antibiotics include:

 Formation of kidney stones, when taking sulphonamides
 Abnormal blood clotting, when taking some cephalosporins)
 Sensitivity to sunlight, when taking tetracyclines
 Blood disorders, when taking trimethoprim
 Deafness, when taking erythromycin and the aminoglycosides

Some people, especially older adults, may experience bowel inflammation, which can lead to severe,
bloody diarrhoea.

In less common instances, penicillin, cephalosporins, and erythromycin can also cause inflamed bowels.

Route of administration

The route of administration of the drugs to be used is determined by the site and severity of the
infection. For example, mild impetigo affecting a small area of skin can be treated by short-term topical
antibiotic preparations. Choice of oral or i.v. therapy will depend on the drug levels required at the site
of infection, the potential for absorption from the GI tract, and the severity of the disease process. I.M.
therapy is rarely used. Ciprofloxacin has good bioavailability when taken enterally, and results in similar
blood levels and AUC values compared with i.v. administration (absorption may be reduced by antacid
use). Parenteral administration may be required for severe life-threatening infections, or where the oral
route is not available.

Duration of treatment

Antibiotics should be continued until resolution of the infection is achieved. This can be judged by
means of a clinical assessment, for example, improvements in gas exchange, resolving pyrexia,
decreasing secretions, and resolution of infiltrates on the chest X-ray in ventilator-associated
pneumonias. This clinical information is often supplemented with laboratory data such as decreasing
white cell counts and C-reactive protein assays. The duration of therapy required varies enormously
between different anatomical sites and organisms. An uncomplicated lower urinary tract infection will
resolve after 3 days of antibiotic therapy, whereas patients with infective endocarditis will require many
weeks of treatment. The recommendation for pulmonary TB is for 6 months of quadruple therapy.