Antibiotic; Types, Indications/Uses , Side Effects, Interactions

Antibiotic also called an antibacterial is a type of antimicrobial drug used in the treatment and prevention of bacterial infections.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; drugs which inhibit viruses are termed antiviral drugs or antivirals rather than antibiotics.

Sometimes the term antibiotic (which means “opposing life”) is used to refer to any substance used against microbes, synonymous with antimicrobial. Some sources distinguish between antibacterial and antibiotic; antibacterials are used in soaps and disinfectants, while antibiotics are used as medicine

New Antibiotics

ß-Lactam Antibiotics

Beta-lactam class of antibiotics includes penicillins, cephalosporins, monobactams, and carbapenems, all of which contain a β-lactam ring.

Penicillins

Antibiotics of the penicillin class are bactericidal and work by inhibiting the synthesis of bacterial cell walls. Penicillins are among the safest antibiotics.

Major health concerns: hypersensitivity reactions.

Cephalosporins

Cephalosporins are mainly bactericidal and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. Besides true cephalosporins (which are derived from cephalosporin C) this class includes oxacephems and carbacephems.

Major health concerns: platelet function abnormalities (rare).

Monobactams

Carbapenems

Carbapenems have incredibly broad spectrum of antimicrobial activity. Today these agents are among the most powerful antibiotics.

Macrolide Antibiotics

Macrolides are bacteriostatic drugs that inhibit protein synthesis by targeting the 50S subunit.

Major health concerns: erythromycin estolate is hepatotoxic.

Lincosamides

Streptogramins

Aminoglycoside Antibiotics

Aminoglycosides are rapidly bactericidal antibiotics which inhibit protein synthesis. These agents mainly interfere with proofreading process. Aminoglycosides are the only bactericidal class among protein synthesis inhibitors.

Major health concerns: ototoxicity, nephrotoxicity.

Quinolone Antibiotics

Fluoroquinolones directly inhibit the bacterial nucleic acid synthesis.

Major health concerns: QTc prolongation and/or torsade de pointes, tendonitis, tendon rupture, joint arthropathies.

Sulfonamides

Sulfonamides act by inhibiting the pathway that bacteria use to synthesize folic acid. Sulfonamides with trimethoprim produce synergistic antibacterial activity.

Major health concerns: hypersensitivity reactions, renal damage, crystal nephropathy.

Tetracycline Antibiotics

Tetracyclines are protein synthesis inhibitors primary targeting the 30S ribosome. They are essentially bacteriostatic.

Major health concerns: photosensitivity, deposition in developing bones and teeth.

Other Antibiotics

Mechanism of Action of Antibiotics

Antibiotic a beta-lactam antibiotic similar to penicillins, inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding proteins (PBPs) that are located inside the bacterial cell wall. Penicillin-binding proteins are responsible for several steps in the synthesis of the cell wall and are found in quantities of several hundred to several thousand molecules per bacterial cell. Penicillin-binding proteins vary among different bacterial species. Thus, the intrinsic activity of  antibiotic as well as the other cephalosporins and penicillins against a particular organism depends on their ability to gain access to and bind with the necessary PBP. Like all beta-lactam antibiotics, it ability to interfere with PBP-mediated cell wall synthesis ultimately leads to cell lysis. Lysis is mediated by bacterial cell wall autolytic enzymes (i.e., autolysins). The relationship between PBPs and autolysins is unclear, but it is possible that the beta-lactam antibiotic interferes with an autolysin inhibitor.      Antibiotic possesses activity against both Gram-positive and Gram-negative bacteria. The drug retains antibacterial activity in the presence of certain beta-lactamases, both penicillinase and cephalosporinase; however hydrolysis by other beta-lactamases, alteration of the PBP, and decreases permeability results in resistance to cefuroxime.

Indication of Antibiotics

For the treatment of many different types of bacterial infections such as bronchitis, sinusitis, tonsillitis, ear infections, skin infections, gonorrhea, and urinary tract infections.

• Acute bacterial exacerbation of chronic bronchitis
• Bacterial infections
• Bloodstream infections
• Bone and joint infections
• Gonorrhea
• Impetigo
• Pneumonia
• Urinary tract infection
• Skin or soft tissue infection
• Skin and structure infection
• Septicemia
• Meningitis
• Joint infection
• Osteomyelitis
• Surgical prophylaxis
• Tonsillitis/pharyngitis
• Sinusitis
• Intra abdominal infection
• Appendicitis
• Wound infection
• Lower respiratory tract infection maxillary sinusitis
• Otitis media bacterial
• Skin and subcutaneous tissue bacterial infections
• Pharyngitis
• Bladder infection
• Epiglottitis
• Kidney infections
• Otitis media
• Peritonitis
• Sepsis
• Skin and structure /soft tissue  infection
• Bacterial Infection
• Bladder Infection
• Acne
• Bronchitis
• Brucellosis
• Bullous Pemphigoid
• Chlamydia Infection
• Ehrlichiosis
• Epididymitis, Sexually Transmitted
• Gonococcal Infection, Uncomplicated
• Helicobacter Pylori Infection
• Lyme Disease, Arthritis
• Lyme Disease, Erythema Chronicum Migrans
• Lyme Disease, Neurologic
• Lymphogranuloma Venereum
• Nongonococcal Urethritis
• Ocular Rosacea
• Ornithosis
• Pelvic Inflammatory Disease
• Pemphigoid
• Pemphigus
• Pneumonia
• Psittacosis
• Rheumatoid Arthritis
• Rickettsial Infection
• Syphilis, Early
• Syphilis, Latent
• Tertiary Syphilis
• Upper Respiratory Tract Infection

Contra Indications of Antibiotics

• History of severe hypersensitivity (e.g. anaphylactic reaction) to any other type of betalactam antibacterial agent (penicillins, monobactams and carbapenems).
• Hemolytic anemia
• Liver problems
• Interstitial nephritis
• Subacute cutaneous lupus erythematosus
• Systemic lupus erythematosus
• Antibiotic use should be avoided in pregnant or lactating women, and in children with developing teeth because they may result in permanent staining (dark yellow-gray teeth with a darker horizontal band that goes across the top and bottom rows of teeth), and possibly affect the growth of teeth and bones.
• Usage during the first 12 weeks of pregnancy does not appear to increase the risk of any major birth defects. There may be a small increased risk for minor birth defects such as an inguinal hernia, but the number of reports is too small to be sure if there actually is any risk.

Side Effects of Antibiotics

The most common side effects 

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• leukopenia/leukemia
• hemolytic anemia
• agranulocytosis
• pain, swelling, irritation where injected
• Abdominal pain
• sweating
• skin color change, mild diarrhea
• mild nausea
• loss of appetite
• vaginal discharge and itching
• swelling of feet or legs
• chest pain
• constipation
• cough
• diarrhea or loose stools
• difficulty with breathing
• dizziness
• heartburn

More common

• Abdominal or stomach pain, discomfort, or tenderness
• chills or fever
• headache, severe and throbbing
• joint or back pain
• muscle aching or cramping
• muscle pains or stiffness
• chest pressure or squeezing pain in chest
• excessive sweating
• feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
• sudden tingling or coldness in an arm or leg
• sudden slow or difficult speech
• sudden drowsiness or need to sleep
• fast breathing
• sharp pain when taking a deep breath
• fast or slow heartbeat
• coughing up blood
• decreased amount of urine

Rare

• Anxiety
• change in vision
• seizures
• tremors
• weight loss
• chest pain or tightness
• confusion
• cough
• Agitation
• blurred vision
• chest pain or discomfort
• convulsions
• extra heartbeats
• fainting
• hallucinations
• headache
• irritability
• lightheadedness
• mood or mental changes
• muscle pain or cramps

Drug Interactions of Antibiotic

Antibiotic may interact with following drugs, suppliments, & may change the efficacy of drugs

• antacids that contain aluminum, calcium, or magnesium
• birth control medications
• bismuth subsalicylate
• calcium supplements
• digoxin
• Rosuvastatin
• Duloxetine
• Albuterol
• Topiramate
• Carbamazepin
• Vitamin D3 (cholecalciferol)
• Alprazolam
• Cetirizine
• insulin
• iron supplements
• penicillin
• vitamin A derivatives (e.g. isotretinoin)
• warfarin
• zinc sulfate or gluconate

References

1. • https://en.wikipedia.org/wiki/Antibiotic
   • ChemIDplus
     https://chem.nlm.nih.gov/chemidplus/sid/0038621522
     https://chem.sis.nlm.nih.gov/chemidplus/chemidheavy.jsp

     https://pubchem.ncbi.nlm.nih.gov

   • MeSH
     https://www.ncbi.nlm.nih.gov/mesh/67054845
     http://www.nlm.nih.gov/mesh/meshhome.html
   • https://pubchem.ncbi.nlm.nih.gov/compound/197178#section=Information-Sources

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