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Monday, April 24, 2017

Adverse Effects of Anti-Biotics

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1. Definition of anti-biotics
2. What are bacteria?
3. Where do we find bacteria?
4. How do we get infected with bacteria?
5. Is every bacteria harmful?
6. Signs and symptoms of bacterial infection
7. How do we treat bacterial infections
8. Classes of anti-biotics
9. Adverse effects of anti-biotics

1. DEFINITIONS: These are drugs made from micro-organisms to inhibit (bacteriostatic) or to destroy (bactericidal) susceptible bacteria that causes disease to both man and animals.
They could also be drugs used to kill bacteria and infections.

Antibiotics (Greek anti, “against”; bios, “life”) are chemical compounds used to kill or inhibit the growth of infectious organisms.

2. WHAT ARE BACTERIA? These are group of micro-organisms which lack a distinct membrane and most of which have a cell wall of unique composition.
Many anti-biotics act by destroying the bacterial cell wall.
Bacteria may be spherical(coccus), rod shaped (bacillus), spiral (spirillum), coma shaped (vibrio) etc. 

3. Where are Bacteria Found? Bacteria are widely distributed. Some live in soil, air or water. Others are parasites of humans, animals and plants. Many parasitic bacteria do not harm their hosts
Some cause diseases by producing poisons that are toxic to the body (endotoxins or exotoxins).

4. HOW DO WE GET INFECTED BY BACTERIA? Bacteria are found everywhere; in the air, water, soil. This entails that whenever people loose  their guard, infection is imminent.
 Bacterial cells, like all cells, require nutrients to carry out their work.

5. IS EVERY BACTERIA HARMFUL? Our bodies are homes to an estimated 100trillion “good” bacteria, many of which reside in the gut.
Not only do we live in harmony with them, but they are actually essential for our survival
Not every bacteria is harmful, there are some that are of great importance e.g. nitrogen fixing bacteria. Some help in the digestion of food. Help in nutrient absorption in the body.
They produce several vitamins in the intestinal tract e.g. folic acid, niacin, Vit B6, B12.

SIGNS AND SYMPTOMS OF BACTERIAL INFECTION

Fever
Stomach upset
Black, tarry or bloody stools
Diarrhea
Loss of bowel control
Swollen lymph nodes
Headaches
Sudden confusion and disorientation

HOW DO WE TREAT BACTERIAL INFECTION?

1. Antibiotics: In many cases the immune system can wipe out a bacterial infection on its own. But sometimes people become so sick from a bacterial disease that they require medical treatment. Antibiotics and other antibacterial drugs are the major weapons against disease-causing bacteria. Antibiotics act in a number of ways to kill bacteria or suppress their activity.
Over time, however, bacteria can become resistant to antibiotics.

2. Vaccine: Immunization through vaccines is important in the prevention of infectious diseases caused by bacteria. Vaccines expose a human being or other animal to a disease-causing bacterium or its toxins without causing the disease. As a result of this exposure, the body forms antibodies to the specific bacterium. These antibodies remain ready to attack if they meet the bacteria in the future.

3. Public health: availability of clean water, safe food, and up-to-date medical care.

CLASSES OF ANTIBIOTICS

There are 12 classes of anti-biotics which include:
1. Penicillins: these are further categorised into;
  Based on their onset and duration of action
a. short acting penicillins e.g. soluble, sodium, potassium, aqueous penicillins
b. intermediate acting penicillins e.g. Procaine penicillin and procaine penicillin alluminium monostearate
c. long acting penicillin mostly used in the    treatment of syphilis, and rheumatic fever e.g. benzathine and benethamine penicillin).

Classification based on the destruction of bacteria:
 a. e.g. penicillin G, aqueous, soluble, sodium, procaine penicillins etc;
 b. amino penicillin e.g. ampicillin, ampiclox, amoxicillin, augmentin, flucloxacillin;
 c. penicillinase e.g. methicillin, oxacillin, dicloxacillin;
d. antipseudomonal penicillin e.g. piperacillin, ticarcillin, carbenicillin etc).

2. cephalosporins: these are further grouped into 1st (cefazolin, cephalexin), 2nd (cefactor, cefoxitin, cefuroxime), 3rd (ceftriazone, ceftazidine, cefotaxime), and 4th (cefixime) generations.


 Other cell wall inhibitors include; vancomycin, clavulanic acid, salbactams, carbapenems, polymyxin.

3. Aminoglycosides e.g. gentamicin, neomycin, amikacin, tobramycin, streptomycin
4. Tetracyclines e.g doxycyclines, minocycline, tetracycline
5. Chloramphenicol
6. Sulfonamides (sulfans) e.g. sulfacyclines, sulfadiazine, sulfasalazine, sulfamethoxazole, co-trimoxazole.
8. Fluoroquinolones which are further divided into 1st (nalidixic), 2nd (ciprofloxacin, ofloxacin, levofloxacin, endoxacin, norfloxacin), 3rd (gatifloxacin), 4th generations (moxifloxacin, gemifloxacin).
9. Lincosamides e.g. clindamycin
10. Linezolid
11. Bacitracins
12. Streptogramins e.g quinipristin, dalfopristin
Others not classified include: metronidazole(flagyl), rifampicin, isoniazide for TB treatment
.
How do we react to these anti-biotics? Adverse effects..

Side effects of the penicillins include: skin rashes, fever, and anaphylactic shock, which can be fatal.
skin rash and, less frequently, anaphylactic shock accompany several cephalosporins
Rare adverse effects associated with prolonged use of aminoglycosides include damage to the vestibular region of the ear, hearing loss, and kidney damage.

Because of their wide range of effectiveness, tetracycline can sometimes upset the balance of resident bacteria that are normally held in check by the body's immune system, leading to secondary infections in the gastrointestinal tract and vagina.

Side effects of macrolides may include nausea, vomiting, and diarrhea; infrequently, there may be temporary auditory impairment.
Side effects may include disruption of the gastrointestinal tract and hypersensitivity.

Other side effects include: abdominal discomfort, occassional loose stools or diarrhoea, vomitting, urticaria, neutropenia, eosinophilia, polyarthitis.
Dry mouth, glossitis and discoloration of tongue, stomatitis, dyphagia, oesophageal ulceration has been reported in cases where caps or tabs are swallowed with less water.

Abdominal pain, dyspepsia, flatulence
 adverse effects on the nervous system include: ataxia, convulsions, dizziness, headache, hypesthesia, parathesia, peripheral neuropathy, metallic taste, flushing etc.

Effects on GIT include: abdominal pain, anorexia, diarrhoea, furry tongue, glossitis, nausea, stomatitis, vomitting.

The adverse effects of anti-biotics cannot be overemphasized, hence as a way of recommendation noticeable reactions should be reported to the physician and safer anti-biotics should be formulated with less side effects.

This material was compiled and written for presentation in a renowned Hospital in Jos Plateau State.

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