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'''Antibiotics''' are defined as "substances that reduce the growth or reproduction of bacteria."<ref>{{cite web |url=http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?term=antibiotics |title=Antiobiotics|author=National Library of Medicine |accessdate=2007-11-15 |format= |work=}}</ref>  They interfere with the life cycle of bacteria in a number of different ways.  Some antibiotics, like [[penicillin]], interfere with cell wall synthesis, while other are [[reverse transcriptase]] inhibitors that interefere with the production of viral RNA and DNA.  Other antibiotics are [[nucleoside analog]]s that get incorporated into the viral RNA or DNA and act a chain terminators.
'''Antibiotics''' are "substances that reduce the growth or reproduction of bacteria."<ref>{{cite web |url=http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?term=antibiotics |title=Antiobiotics|author=National Library of Medicine |accessdate=2007-11-15 |format= |work=}}</ref>  They interfere with the life cycle of bacteria in a number of different ways.  Some antibiotics, like [[penicillin]], interfere with cell wall synthesis, while others are [[reverse transcriptase]] inhibitors that interefere with the production of viral RNA and DNA.  Other antibiotics are [[nucleoside analog]]s that get incorporated into the viral RNA or DNA and act a chain terminators.


==Misuse==
==Misuse==
One study on [[respiratory tract infection]]s found "physicians were more likely to prescribe antibiotics to patients who they believed expected them, although they correctly identified only about 1 in 4 of those patients".<ref name="pmid17467120">{{cite journal |author=Ong S, Nakase J, Moran GJ, Karras DJ, Kuehnert MJ, Talan DA |title=Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction |journal=Annals of emergency medicine |volume=50 |issue=3 |pages=213-20 |year=2007 |pmid=17467120 |doi=10.1016/j.annemergmed.2007.03.026}}</ref> Multifactorial interventions aimed at both physicians and patients can reduce inappropriate prescribing of antibiotics. <ref name="pmid17509729">{{cite journal |author=Metlay JP, Camargo CA, MacKenzie T, ''et al'' |title=Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments |journal=Annals of emergency medicine |volume=50 |issue=3 |pages=221-30 |year=2007 |pmid=17509729 |doi=10.1016/j.annemergmed.2007.03.022}}</ref> Delaying antibiotics for 48 hours while observing for spontaneous resolution of [[respiratory tract infection]]s may reduce antibiotic usage; however, this strategy may reduce patient satisfaction.<ref name="pmid17636757">{{cite journal |author=Spurling G, Del Mar C, Dooley L, Foxlee R |title=Delayed antibiotics for respiratory infections |journal=Cochrane database of systematic reviews (Online) |volume= |issue=3 |pages=CD004417 |year=2007 |pmid=17636757 |doi=10.1002/14651858.CD004417.pub3}}</ref>  
One study on [[respiratory tract infection]]s found "physicians were more likely to prescribe antibiotics to patients who they believed expected them, although they correctly identified only about 1 in 4 of those patients".<ref name="pmid17467120">{{cite journal |author=Ong S, Nakase J, Moran GJ, Karras DJ, Kuehnert MJ, Talan DA |title=Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction |journal=Annals of emergency medicine |volume=50 |issue=3 |pages=213-20 |year=2007 |pmid=17467120 |doi=10.1016/j.annemergmed.2007.03.026}}</ref> Multifactorial interventions aimed at both physicians and patients can reduce inappropriate prescribing of antibiotics. <ref name="pmid17509729">{{cite journal |author=Metlay JP, Camargo CA, MacKenzie T, ''et al'' |title=Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments |journal=Annals of emergency medicine |volume=50 |issue=3 |pages=221-30 |year=2007 |pmid=17509729 |doi=10.1016/j.annemergmed.2007.03.022}}</ref> Delaying antibiotics for 48 hours while observing for spontaneous resolution of [[respiratory tract infection]]s may reduce antibiotic usage; however, this strategy may reduce patient satisfaction.<ref name="pmid17636757">{{cite journal |author=Spurling G, Del Mar C, Dooley L, Foxlee R |title=Delayed antibiotics for respiratory infections |journal=Cochrane database of systematic reviews (Online) |volume= |issue=3 |pages=CD004417 |year=2007 |pmid=17636757 |doi=10.1002/14651858.CD004417.pub3}}</ref>  


== Catagories of antibiotics ==
== Classes of antibiotics ==


=== Penicillin-like, beta-[[lactam]] drugs ===
=== Penicillin-like, beta-[[lactam]] drugs ===

Revision as of 12:59, 11 July 2008

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Antibiotics are "substances that reduce the growth or reproduction of bacteria."[1] They interfere with the life cycle of bacteria in a number of different ways. Some antibiotics, like penicillin, interfere with cell wall synthesis, while others are reverse transcriptase inhibitors that interefere with the production of viral RNA and DNA. Other antibiotics are nucleoside analogs that get incorporated into the viral RNA or DNA and act a chain terminators.

Misuse

One study on respiratory tract infections found "physicians were more likely to prescribe antibiotics to patients who they believed expected them, although they correctly identified only about 1 in 4 of those patients".[2] Multifactorial interventions aimed at both physicians and patients can reduce inappropriate prescribing of antibiotics. [3] Delaying antibiotics for 48 hours while observing for spontaneous resolution of respiratory tract infections may reduce antibiotic usage; however, this strategy may reduce patient satisfaction.[4]

Classes of antibiotics

Penicillin-like, beta-lactam drugs

The core structure of penicillin

Cephalosporins

(CC) Image: David E. Volk
Base structure of all cephalosporins.

Cephalosporins are a class of antibiotic compounds sharing a common base structure, 7-aminocephalosporanic acid (7-ACA), that was derived from the first cephalosporin discovered, cephalosporin C. Penicillins are very similar, although they contain a five-membered ring in place of the six-membered ring present in the cephalosporin. The activity of cephalosporins, penicillins, and some other antibiotics are due to the presence of a beta-lactam, which binds irreversibly, via acylation, to penicillin-binding proteins, thereby inhibiting the peptidogycan layer of bacterial cell wall synthesis. Cephalosporins are often made semisynthetically. Cephalosporins and the very closely relatedcephamycins are collectively referred to as cephems. In general, second generation and later cephalosporins have a broader spectrum of activity against Gram-negative bacteria.

Nomenclature

Because the original cephalosporins used the "ceph" form of the spelling and were often trademarked, the International Nonproprietary Names (INN) suggested by the World Health Organization use the "cef" spelling for the generic drug name of all cephalosporins.


Aminoglycosides

Tetracyclines

(CC) Image: David E. Volk
Minocycline, a tetracycline drug.

Fluoroquinalones

Other Antibiotics

References

  1. ↑ National Library of Medicine. Antiobiotics. Retrieved on 2007-11-15.
  2. ↑ Ong S, Nakase J, Moran GJ, Karras DJ, Kuehnert MJ, Talan DA (2007). "Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction". Annals of emergency medicine 50 (3): 213-20. DOI:10.1016/j.annemergmed.2007.03.026. PMID 17467120. Research Blogging.
  3. ↑ Metlay JP, Camargo CA, MacKenzie T, et al (2007). "Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments". Annals of emergency medicine 50 (3): 221-30. DOI:10.1016/j.annemergmed.2007.03.022. PMID 17509729. Research Blogging.
  4. ↑ Spurling G, Del Mar C, Dooley L, Foxlee R (2007). "Delayed antibiotics for respiratory infections". Cochrane database of systematic reviews (Online) (3): CD004417. DOI:10.1002/14651858.CD004417.pub3. PMID 17636757. Research Blogging.
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