Antibiotics Introduction

Antibiotics, also known as antibacterials, are types of medications that destroy or slow down
the growth of bacteria. The Greek word anti means "against", and the Greek word bios means
"life" (bacteria are life forms).
Antibiotics are among the most frequently prescribed medications in modern medicine.
Antibiotics cure disease by killing or injuring bacteria. The first antibiotic was penicillin, discovered
accidentally from a mold culture. Today, over 100 different antibiotics are available to cure minor, as well
as life-threatening infections.
Although antibiotics are useful in a wide variety of infections, it is important to realize that
antibiotics only treat bacterial infections. Antibiotics are useless against viral infections (for example, the
common cold) and fungal infections (such as ringworm). Your doctor can best determine if an antibiotic is
right for your condition.
The first antibiotic was penicillin. Such penicillin-related antibiotics as ampicillin, amoxicillin
and benzyl penicilllin are widely used today to treat a variety of infections - these antibiotics have been
around for a long time.
Types of Antibiotics
Although there are well over 100 antibiotics, the majority come from only a few types of drugs. These
are the main classes of antibiotics.

Penicillins such as penicillin and amoxicillin

Cephalosporins such as cephalexin(Keflex)
Macrolides such as erythromycin (E-Mycin), clarithromycin (Biaxin), and azithromycin (Zithromax).

Fluoroquinolones
such
as ciprofloxacin
(Cipro), levofloxacin (Levaquin),
ofloxacin (Floxin).
Sulfonamides such as co-trimoxazole (Bactrim) and trimethoprim (Proloprim)

Tetracyclines such as tetracycline(Sumycin, Panmycin) and doxycycline(Vibramycin)

Aminoglycosides such as gentamicin (Garamycin) and tobramycin (Tobrex)

and

Most antibiotics have 2 names, the trade or brand name, created by the drug company that manufactures
the drug, and a generic name, based on the antibiotic's chemical structure or chemical class. Trade names
such as Keflex and Zithromax are capitalized. Generics such as cephalexin and azithromycin are not
capitalized.
How do antibiotics work?
Some antibiotics work by killing 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.

New Antibiotics

Class

Generic/Brand

Lipopeptides

Daptomycin (Cubicin), 2003

Fluoroquinolone

Gemifloxacin (Factive), 2003

Lipoglycopeptides

Telavancin (Vibativ), 2009

Cephalosporin
(5th generation)

Ceftaroline (Teflaro), 2010

Macrocyclics

Fidaxomicin (Dificid), 2011

-Lactam Antibiotics
Beta-lactam antibiotics include penicillins, cephalosporins, monobactams, and carbapenems.
Penicillins

Generic

Brand Name

Amoxicillin

Amoxil, Polymox, Trimox, Wymox

Ampicillin

Omnipen, Polycillin, Polycillin-N,

Principen, Totacillin

ntibiotics work in two different ways either by killing the bacteria or blocking its function. They only
attack the bacterial population present in the body and causing the disease, they do not affect the cell of
the body. It is an unfortunate fact that though antibiotics are being used constantly but now bacteria have
developed resistance against these drugs. It is a very natural process that new antibiotics with more
effectiveness are being developed and bacterial genome is revolutionizing against these newly
synthesized
antibiotics.
An antibiotic has also the ability to convert glucose in the body into energy. It produces a protective wall
against bacteria and does not allow them to enter the cell. It also protects the body from further infection
and prevents the bacteria to multiply in number.
Though antibiotics are useful in curing the human body against bacterial infections but they also have
some side effects. A patient can suffer from slight headache to extreme allergic reaction. Another side
effect is diarrhea in which the balance of the intestinal flora gets affected and disrupts the function of the
useful bacteria present in the intestine. In some cases, antibiotics can react with other drugs administered
along with them and cause other infections.
In the past before the discovery of antibiotics, the diseases like cholera and diarrhea would be fatal as
these diseases dehydrate the body and makes the individual weak. Antibiotics have the credit of saving so
many lives by killing the microbes causing certain diseases. In the disease of tuberculosis, antibiotics
play an important role in eradicating the bacteria. To protect the patient from having side effects, doctors
prescribe such antibiotics which suit persons body.
A summary of the main effector defense mechanisms against extracellular bacteria. Bacteria that avoid
destruction by the classical or alternative complement pathways may be opsonized by acute phase
reactants or specific antibodies and engulfed by phagocytes expressing receptors for the Fc region of
these antibodies.

he first generation cephalosporins include: Their spectrums of activity are quite similar. They possess
generally excellent coverage against most gram-positive pathogens and variable to poor coverage against
most gram negative pathogens. The first generation includes:
cephalothin
cefazolin
cephapirin
cephradine
cephalexin
cefadroxil
The second generation cephalosporins. In addition to the gram positive spectrum of the first
generation cephalosporins, these agents have expanded gram negative spectrum. Cefoxitin and
cefotetan also have good activity against Bacteroides fragilis. Enough variation exists between
the second generation cephalosporins in regard to their spectrums of activity against most species
of gram negative bacteria, that susceptibility testing is generally required to determine sensitivity.
The second generation includes:
o
o

cefaclor
cefamandole

cefonicid
ceforanide
cefuroxime
The third generation cephalosporins have much expanded gram negative activity. However, some
members of this group have decreased activity against gram-positive organisms. They have the advantage
of convenient administration, but they are expensive.
o
o
o

Overusing antibiotics - There is concern worldwide that antibiotics are being overused. Antibiotic
overuse is one of the factors that contributes towards the growing number of bacterial infections which
are becoming resistant to antibacterial medications.
Antibacterial action generally falls within one of four mechanisms, three of which involve the inhibition
or regulation of enzymes involved in cell wall biosynthesis, nucleic acid metabolism and repair, or protein
synthesis, respectively. The fourth mechanism involves the disruption of membrane structure. Many of
these cellular functions targeted by antibiotics are most active in multiplying cells. Since there is often
overlap in these functions between prokaryotic bacterial cells and eukaryotic mammalian cells, it is not
surprising that some antibiotics have also been found to be useful as anticancer agents.

Antibiotic Grouping By Mechanism

Cell Wall Synthesis

Penicillins
Cephalosporins
Vancomycin
Beta-lactamase Inhibitors
Carbapenems
Aztreonam
Polymycin
Bacitracin

Protein Synthesis Inhibitors

Inhibit 30s Subunit

Aminoglycosides (gentamicin)
Tetracyclines
Inhibit 50s Subunit
Macrolides
Chloramphenicol
Clindamycin
Linezolid
Streptogramins

DNA Synthesis Inhibitors

Fluoroquinolones
Metronidazole

RNA synthesis Inhibitors

Rifampin

Mycolic Acid synthesis inhibitors

Isoniazid

Folic Acid synthesis inhibitors

Sulfonamides
Trimethoprim

Antibiotic Classification & Indications

Inhibits Cell Wall Synthesis
Penicillins
(bactericidal: blocks cross linking via competitive inhibition of the transpeptidase enzyme)
Class/Mechanism
Drugs
Indications (**Drug
Toxicity
of Choice)
Penicillin

Aminopenicillins

Penicillin G
Aqueous
penicillin G
Procaine
penicillin G
Benzathine
penicillin G
Penicillin V

Strep. pyogenes
Hypersensitivity reaction
(Grp.A)**
Hemolytic anemia
Step. agalactiae
(Grp.B)**
C.
perfringens(Bacilli)**

Ampicillin
Amoxicillin

Above +
Gram-negative:
E. faecalis**
E. Coli**

Above

Based on the prevalence of bacteria in ear and throat infections, and considering that pneumococcal vaccine is now preventing
many bacterial infections, the researchers estimated that 27.4% of US children with ARTI have bacterial illness.

Medicines and treatments for a throat infection

A sore throat will often get better by itself, as the bodys immune system can usually take care of the
infection without any treatment. Antibiotics arent helpful for most people with a throat infection.
ANTIGEN
An antigen is any substance that causes your immune system to produce antibodies against it. An antigen
may be a foreign substance from the environment, such as chemicals, bacteria, viruses, or pollen. An
antigen may also be formed inside the body, as with bacterial toxins or tissue cells.

An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by
the immune system, specifically by antibodies, B cells, or T cells. For example, the epitope is the
specific piece of the antigen that an antibody binds to. The part of an antibody that binds to the
epitope is called a paratope. Although epitopes are usually non-self proteins, sequences derived
from the host that can be recognized (as in the case of autoimmune diseases) are also epitopes.
The epitopes of protein antigens are divided into two categories, conformational epitopes and linear
epitopes, based on their structure and interaction with the paratope.

A conformational epitope is composed of discontinuous sections of the antigen's amino

acid sequence. These epitopes interact with the paratope based on the 3-D surface features and
shape or tertiary structure of the antigen. The proportion of epitopes that are conformational is
unknown.
By contrast, linear epitopes interact with the paratope based on their primary structure. A linear
epitope is formed by a continuous sequence of amino acids from the antigen.

T cell epitopes
T cell epitopes are presented on the surface of an antigen-presenting cell, where they are bound
to MHC molecules.
The paratope is the part of an antibody which recognizes an antigen, the antigen-binding site of an
antibody. It is a small region (of 1522 amino acids) of the antibody's Fv region and contains parts of
the antibody's heavy and light chains.
antigenic determinant a site on the surface of an antigen molecule to which a single antibody molecule
binds; generally an antigen has several or many different antigenic determinants and reacts with many
different antibodies.

antigens
Any molecule that can be specifically identified by the adaptive immune system. An
antigen is a substance that activates lymphocytes by interacting with the TCR or the
BCR.
Immune tolerance or immunological tolerance describes a state of unresponsiveness of the
immune system to substances or tissue that have the capacity to elicit an immune response.
It contrasts with conventional immune-mediated elimination of foreign antigens. Tolerance is
classified into central tolerance or peripheral tolerance depending on where the state is originally
inducedin the thymus and bone marrow (central) or in other tissues and lymph nodes (peripheral).
The mechanisms by which these forms of tolerance are established are distinct, but the resulting
effect is similar.
Immune tolerance is important for normal physiology.
Antibiotic resistance is a quickly growing, extremely dangerous problem. World health leaders have
described antibiotic-resistant bacteria as "nightmare bacteria" that "pose a catastrophic threat" to
people in every country in the world. Each year in the United States, at least 2 million people become
infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a
direct result of these infections. Many more people die from other conditions that were complicated
by an antibiotic-resistant infection.
In addition, almost 250,000 people who are hospitalized or require hospitalization get Clostridium
difficile each year, an infection usually related to antibiotic use. C. difficile causes deadly diarrhea

and kills at least 14,000 people each year. Many C. difficile infections and drug-resistant infections
can be prevented.

How Bacteria Become Resistant