What is an antibiotic?
An antibiotic is a substance with a pronounced activity against bacteria. Bacteria cause various diseases and antibiotics are the only available today method of their treatment. Antibiotics can be bactericidal and bacteriostatic. Bactericidal cause the death of bacteria and bacteriostatic suppress the replication of bacteria.
When are antibiotics used?
Antibiotics are used only for infections when they are proven to be induced by bacteria. It can be identified only by a doctor. A doctor can identify whether the infection is of bacterial nature visually and using blood and urine tests. For instance, an experienced otolaryngologist can visually identify purulent otitis, acute tonsillitis, and then the antibiotic is prescribed immediately and unconditionally. When the infection is not so obvious, general blood test, urine test, seeding microbes from the bacterial focus, as well as epidemiological indications are used before an antibiotic is appointed.
For airway infections, you can follow an easy formula: if you have flu or common cold that lasts for a week, you don’t need antibiotics but if the symptoms persist over a week or two, there is a high chance that a bacterial infection has added to the initial viral and you need to go to a doctor for a prescription or you can buy antibiotic online without Rx. But it’s always preferable to go to a doctor because the same symptoms can be caused by other diseases that do not require the use of antibiotics. On top of that, only a specialist can correctly decide what medication and in what dosage should be used.
What is a bacterial infection?
Bacterial infection is an infectious disease that is caused by bacteria. Infection with bacteria can occur both from the outside and develop in the body itself in response to weakened immunity. Bacteria are unicellular microorganisms that multiply by division.
The majority of bacteria that are found in the human body are harmless due to the restraining action of the immune system, and some even benefit the body. But a number of bacteria are pathogens for humans. For instance, yearly around the world around 2 million people die from tuberculosis which is caused by a certain type of bacteria.
What are signs of a bacterial infection?
The common symptoms for all bacterial infections are:
– Increased body temperature;
– General weakness, malaise;
– Lack of appetite;
The same symptoms can also occur in viral infection so you have to seek a medical practitioner consultation.
You should remember that if these symptoms develop along with coughing, nasal discharges or congestion, sore throat, and so on, most likely you got a common cold or flu. These conditions do not require the use of antibiotics. But if the symptoms persist or only aggravate within a week, you probably have developed a bacterial infection.
How to choose an antibiotic?
For the majority of infections, bacteriostatic effect (suppression of bacteria replication) is sufficient. But in impaired immune system work for instance in neutropenia or weak protection mechanisms at the site of infection, for instance, meningitis or endocarditis, bactericidal (killing bacteria) antibiotics are used. In low immunity, the use of bacteriostatic medications renders a temporary effect and after their use discontinuation, the pathogens resume to replicate.
Bactericidal and bacteriostatic effects may be selective. For instance, macrolides, Clindamycin, streptogramins, chloramphenicol, and tetracyclines have a bacteriostatic effect, but in some conditions or in relation to certain microorganisms they are bactericidal. Conversely, penicillins, bactericidal antibiotics, act bacteriostatically on enterococci.
In addition, the activity of antibacterial drugs may depend on the concentration: the drug has a bacteriostatic effect in a low concentration in the focus of infection, and a bactericidal effect in a high concentration. Thus, the speed and intensity of the bactericidal action of aminoglycosides, fluoroquinolones and Metronidazole are directly dependent on the concentration of the drug.
Besides, you need to choose an antibiotic that is suitable for the system affected by the bacteria:
– For diseases of the respiratory tract, ear, throat, nose infections, four main groups of antibiotics are used. These are penicillins, cephalosporins, macrolides, and fluoroquinolones. They are convenient because they are available in tablets and capsules, that is, for oral administration, and they can be taken at home. Each group has its own characteristics, but for all antibiotics, there are rules for admission, which must be observed.
– Genitourinary system infections are treated with Amoxicillin + clavulanic acid (Amoxiclav, Augmentin, etc.), ampicillin + sulbactam (Sulbacin, Unazin), II generation cephalosporins: cefuroxime, Cefaclor, Fosfomycin, nitrofuran derivatives: furazolidone, nitrofural (furatsilin), Amoxicillin + clavulanic acid, ampicillin + sulbactam, III generation cephalosporins: cefotaxime, ceftazidime, ceftriaxone, IV generation cephalosporins: Cefixime, netilmicin, amikacin, Carbapenems: imipenem, meropenem.
– For Helicobacter pylori that cause stomach ulceration are used Amoxicillin, Metronidazole, Tetracycline, Bismuth subcitrate, Clarithromycin, and others.
– Tuberculosis is treated with Isoniazid, Rifampicin by Lupin, Streptomycin, Ethambutol, Pyrazinamide, Ofloxacin, ciprofloxacin, and others.
For the best treatment regimen please consult a healthcare specialist and do a susceptibility test that shows to which antibiotic the infection you have is the most responsive.
How to use an antibiotic?
The dosages, number of servings, and the duration of the course depend on the infection treated, antibiotic class, age and weight of a patient, and other factors. But there are several common rules applicable for all antibiotics use:
– The prescribed dosage must never be adjusted without consulting a doctor. If when you started taking the prescribed dosage of an antibiotic you started suffering from negative effects, you must not lower the dosage or take the dosages less frequently than prescribed. Any changes to the therapy without a doctor’s supervision can lead to the lowering of the therapeutic substance in the blood and the pathogens could develop antibiotic resistance. In that case, the infection would be harder to eliminate. In case you use higher dosages than prescribed, you can severely damage your health and in particular the function of liver, kidneys, and intestines.
– The minimum course of a therapy with antibiotics is 5 days with exception of Azithromycin and a few other medications that are appointed in a separate scheme and are used for 3-6 days. Some patients believe that if they started feeling better they can cease using the drug. But you should take the pills for the whole prescribed time because in a prematurely ended course a complication of the infection or resistance of a pathogen can develop and then you would need another course of a more potent antibiotic. In some cases the treatment duration can be up to four weeks. If your doctor prescribed you this scheme, you should follow it without any changes.
– When using antibiotics, it is important to follow the prescriptions in terms of whether the pills should be taken with, after or before meals. The thing is that antibiotics considerably interact with food – some of them become inactivated when taken after food; others, on the contrary, should be taken only after a meal because they can irritate the mucosa of the stomach otherwise.
Amoxicillin, some macrolides and all cephalosporins can be taken regardless of meals. Some antibiotics, for example, Furazolidone, cannot be combined with cheeses, smoked meats and beans. Alcohol is a drink that must not be consumed during therapy with all antibiotics. It is best to wash down the medicine with large quantities with water. Before taking, be sure to read the instructions, where it is written in detail about what time of the day and how to take the medicine.
– During the use of antibiotics and two weeks after the therapy end, it is advised not to go to solarium, beach, dye hair or do perm. If you take sorbents or antacids, you should be careful as reduce the activity of antibiotics.
Can antibiotics be used for prophylaxis of infections?
No, antibiotics do not have a prophylaxis effect. Moreover, if you have a complication of flu such as bronchitis or rhinitis but you already started using an antibiotic hoping that it’s going to prevent an infection, the disease will still develop but on the background of the medication use it can develop resistance to a certain group of antibiotics.
The use of antibiotics for prophylaxis is reasonable only under a doctor’s supervision in case of open fractures and wounds, including after operations.
For how long an antibiotic can be used?
The treatment course duration is chosen based on the infection type, localization, antibiotic type, dosage, age of the patient, and so on. However, there are some approximate lengths for the most spread infections:
– Ear, throat, and nasal infections usually require the use of a chosen antibiotic for 5-10 days with the continuation of the use for 2-3 days after the symptoms disappear;
– Pneumonia and bronchitis usually require the use of antibiotics for 7-15 days;
– Urinary tract infections are usually treated for 5-15 days depending on severity;
– Skin and soft tissue infections are treated for 5-15 days depending on severity and localization;
– Bone infections require long-term treatment that can last for a year or more;
– Tuberculosis is treated with special antibiotics and the duration is individual due to the therapeutic effect and may be from one year and more.
What is antibiotic resistance?
It is a phenomenon of resistance of the causative agent of infection to the action of one or more antibacterial medications. It can develop after the use of insufficient dosages of a prescribed antibiotic or prematurely discontinued antibiotic use because the surviving bacteria develop resistance and the replicated bacteria inherit this property.
Besides, resistance can develop in overuse of antibiotics. For instance, people who buy antibiotics without prescriptions and use them without control of a specialist for flu or other viral infections increase the chances of antibiotics resistance development.
Can pregnant women use antibiotics?
During pregnancy, the use of antibiotics is contraindicated. Doctors try to avoid prescribing antibiotics for women who expect a baby not to endanger the life of an unborn baby. However, in some cases such as pneumonia, bacterial complications, infections of the urinary tract, antibiotics are prescribed but only a professional can choose the safest option. The medications that can be considered include penicillin antibiotics, cephalosporins, and macrolides. But please keep in mind that without a doctor’s appointment they must not be used.
There is a period during pregnancy when antibiotics must be avoided at all means – the early pregnancy when the forming of the internal organs and systems of the body is made. The second and third trimesters, as well as the breastfeeding period, are considered relatively safe.
What antibiotics can be used for kids?
For kids are chosen the safest to use antibiotics from the group of penicillins, cephalosporins, and macrolides. However, they can be given to children, especially newborns and infants only if a pediatrician prescribes.
When giving antibiotics to kids, you must strictly follow the instruction and give the medicine for the whole prescribed period of time even if it seems that the symptoms are gone.
What are contraindications for antibiotics use?
The contraindications for antibiotics use vary from one antibiotic to another. For instance, you can be hypersensitive (allergic) to one antibiotic but tolerate well another one from the other group. To know whether the medication is safe for you, you should read the instruction that comes with a particular formulation. For instance, some formulation due to dosage per capsule cannot be given to children.
What adverse effects can antibiotics cause?
The common adverse reactions that can occur during antibiotics use are:
– Nausea, vomiting, diarrhea, abdominal pain, loss of appetite, dry mouth, dyspepsia, flatulence, gastritis, colitis, including pseudomembranous enterocolitis, candidal stomatitis, intestinal candidosis, and anal pruritus may develop;
– Transient increase in liver transaminases and alkaline phosphatase, plasma bilirubin level, transient toxic hepatitis, cholestatic jaundice;
– Neutropenia, leukopenia, thrombocytopenia, eosinophilia, agranulocytosis, lymphopenia, pancytopenia, hemolytic anemia, aplastic anemia, an increase in prothrombin time, hemorrhage;
– Hypersensitivity reactions, including allergic reactions in patients with identified penicillin allergy, cephalosporins; skin rash, including erythematous, dermatitis, pruritus, skin flushing, urticaria, edema angioedema, rarely - anaphylactic shock (including bronchospasm, shortness of breath, lowering blood pressure, anaphylactic shock). Usually, allergic reactions disappear after cessation of the therapy.