“University Our Lady Of Good Counsel-UNIZKM”

Subject : English
Pharmacy 1

P
RO
Theme :ANTIBIOTIC

JE Worked by: Fijona Kelo

CT
Accepted by: Shpresa Delija

OBJECTIVES:

1. Definition of antibiotic.

2. Different uses for antibiotics.

3. The first antibiotic created(Pencillin) and how it

was created?

4. Explain antibiotic resistance and why it is a

problem?

5. Explain why new antibiotic creation has slowed

down now?

DEFINITION OF ANTIBIOTICS
An antibiotic is a type of antimicrobial substance
active against bacteria. It is the most important
type of antibacterial agent for fighting bacterial
infections, and antibiotic medications are widely
used in the treatment and prevention of such
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.

Antibiotics should only be prescribed to treat health problems:

 that are not serious but are unlikely to clear up without antibiotics – such as acne
 that are not serious but could spread to other people if not promptly treated – such as the
skin infection impetigo or the sexually transmitted infection chlamydia
 where evidence suggests that antibiotics could significantly speed up recovery – such as
a kidney infection
 that carry a risk of more serious complications – such as cellulitis or pneumonia
 SIDE EFFECT: Antibiotics are screened for any negative effects before their approval for
clinical use, and are usually considered safe and well tolerated. However, some antibiotics
have been associated with a wide extent of adverse side effects ranging from mild to very
severe depending on the type of antibiotic used. Side effects may reflect the
pharmacological or toxicological properties of the antibiotic or may involve hypersensitivity
or allergic reactions. Adverse effects range from fever and nausea to major allergic
reactions, including photodermatitis and anaphylaxis. Common side-effects include diarrhea,
resulting from disruption of the species composition in the intestinal flora, resulting, for
example, in overgrowth of pathogenic bacteria, such as Clostridium
difficile. Taking probiotics during the course of antibiotic treatment can help prevent
antibiotic-associated diarrhea. Some antibiotics may also damage the mitochondrion, a
bacteria-derived organelle found in eukaryotic, including human, cells. Mitochondrial damage
cause oxidative stress in cells and has been suggested as a mechanism for side effects
from fluoroquinolones.
 Do antibiotics treat viral infections? Antibiotics do not work on viral infections. For
example, you shouldn't take antibiotics for:
 Colds and runny noses, even if the mucus is thick, yellow, or green
 Most sore throats (except strep throat)
 Flu
 Most cases of bronchitis

DIFFERENT USES FOR ANTIBIOTICS

Antibiotics are used to treat or prevent bacterial infections, and sometimes protozoan infections.
When an infection is suspected of being responsible for an illness but the responsible pathogen has
not been identified, an empiric therapy is adopted. This involves the administration of a broad-
spectrum antibiotic based on the signs and symptoms presented and is initiated pending laboratory
results that can take several days.Antibiotics may be given as a preventive measure and this is
usually limited to at-risk populations such as those with a weakened immune
system thosetaking immunosuppressive drugs, cancer patients, and those having surgery. Their use
in surgical procedures is to help prevent infection of incisions. They have an important role in dental
antibiotic prophylaxis where their use may prevent bacteremia and consequent infective
endocarditis. Antibiotics are also used to prevent infection in cases of neutropenia particularly
cancer-related.

If you're having an operation

Antibiotics are normally recommended if you're having a type of surgery that carries a high risk of
infection.For example, you may be prescribed antibiotics if you're going to have:

 some types of eye surgery – such as cataract surgery or glaucoma surgery

 joint replacement surgery
 breast implant surgery
 pacemaker surgery

People at risk of bacterial infections

Antibiotics may also be recommended for people who are more vulnerable to the harmful effects of
infection. This may include:

 people aged over 75 years

 babies less than 72 hours old who have a bacterial infection, or a higher than average  risk of
developing one
 people who have to take insulin for diabetes
 people with a weakened immune system – either because of an underlying health condition
such as HIV or as a side effect of certain treatments, such as chemotherapy.
Bites or wounds
Antibiotics may be recommended for a wound that has a high chance of becoming infected –
this could be an animal or human bite, for example, or a wound that has come into contact with
soil or faeces.

The first antibiotic created(Pencillin) and how it was created?

 The first antibiotic ‘penicillin’ was discovered in the year 1929 by Sir Alexander
Fleming. He discovered that an agar plate that has
the bacterium staphylococci on it got contaminated
by a Penicillium mold. This mold, which has formed a
zone around the Staphylococcus, was of interest to
Fleming as he was searching for potential
antibacterial compounds. Fleming was interested in
this observation and he did several experiments to
 prove that culture broth of the mold had
prevented the growth of the Staphylococcus even
after being diluted up to 8,000 times. After many
years, Ernst Chain and Howard Florey were able
to develop a way to isolate penicillin which has
been used to treat bacteria l infections during
World War II. Penicillin was introduced to clinical
use in 1946 where it made a significant effect on
public health. The discovery of penicillin was a
milestone for public health because it reduced the spread of disease. During World War II, there
was a high demand for the production of antibiotics to fight off infections. Big pharmaceutical
companies such as Lederle, Parke-Davis, and Pfizer began seeking for alternatives to penicillin,
with wider therapeutic use.
 Lederle was the first company to offer the antibiotic Aureomycin for sale in December 1948
where it was known as the most versatile antibiotic yet discovered, with a wider range of
activity than other known therapies. Other pharmaceutical companies created their own
broadspectrum antibiotics. Pfizer was able to alter the marketing of antibiotics with the
production of Terramycin in 1950. Other antibiotics were discovered as time went on, including
streptomycin, chloramphenicol, and tetracycline with an effective activity on a full array of
bacterial pathogens. As antibiotics became more popular, the demand for antibiotics also
increased. Antibiotic output and prescribing as a whole was monumental. The consumption of
antibiotics in the United States grew; between the years 1950 and 1956, consumption increased
from 139.8 to 645.2 metric tons.
 During that time, the hea lthcare industry and the role of antibiotics were proven to be growing
and contributing greatly to the care of patients. Antibiotics not only fough infections which were
fatal to many people, but also gave hope to those who were ill, or those who had family
members that were ill. Generally, as antibiotics were becoming popular, the demand on them
started to increase. As a result, new antibiotics were created to meet the needs. For example,
the development of semi-synthetic penicillin and the introduction of methicillin and ampicillin
occurred due to the isolation of 6-aminopenicillanic acid. In addition, new generations of
penicillin or broad spectrum penicillin were developed to fight other forms of bacterial
infections. Eventually, this need has been a
principal reason to induce the creation of other
forms of penicillins, which in turn led to the
finding of the second generation penicillins,
Ampicillin and Amoxicillin.

ANTIBIOTIC RESISTANCE
 The emergence of resistance of bacteria to
antibiotics is a common phenomenon. Emergence
of resistance often reflects evolutionary
processes that take place during antibiotic therapy. The antibiotic treatment may select for
bacterial strains with physiologically or genetically enhanced capacity to survive high doses of
 antibiotics. Under certain conditions, it may result in preferential growth of resistant bacteria,
while growth of susceptible bacteria is inhibited by the drug. Antibiotics such as penicillin and
erythromycin, which used to have a high efficacy against many bacterial species and strains,
have become less effective, due to the increased resistance of many bacterial strains. Resistance
may take the form of biodegradation of pharmaceuticals.The survival of bacteria often results
from an inheritable resistance,but the growth of resistance to antibacterials also occurs through
horizontal gene transfer.
 Horizontal transfer is more likely to happen in locations of frequent antibiotic use. Antibacterial
resistance may impose a biological cost, thereby reducing fitness of resistant strains, which can
limit the spread of antibacterial-resistant bacteria, for example, in the absence of antibacterial
compounds. Additional mutations, however, may compensate for this fitness cost and can aid
the survival of these bacteria.Paleontological data show that both antibiotics and antibiotic
resistance are ancient compounds and mechanisms.
 Useful antibiotic targets are those for which mutations negatively impact bacterial reproduction
or viability. Several molecular mechanisms of antibacterial resistance exist. Intrinsic antibacterial
resistance may be part of the genetic makeup of bacterial strains. Antibacterial-producing
bacteria have evolved resistance mechanisms that have been shown to be similar to, and may
have been transferred to, antibacterial-resistant strains. The spread of antibacterial resistance
often occurs through vertical transmission of mutations during growth and by genetic
recombination of DNA by horizontal genetic exchange.Plasmids that carry several different
resistance genes can confer resistance to multiple antibacterials.

Scope of the problem

 Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance
mechanisms are emerging and spreading globally, threatening our ability to treat common
infectious diseases. A growing list of infections – such as pneumonia, tuberculosis, blood
poisoning, gonorrhoea, and foodborne diseases – are becoming harder, and sometimes
impossible, to treat as antibiotics become less effective
 .Where antibiotics can be bought for human or animal use without a prescription, the
emergence and spread of resistance is made worse.
 Similarly, in countries without standard treatment guidelines, antibiotics are often over-
prescribed by health workers and veterinarians and over-used by the public.Without urgent
action, we are heading for a post-antibiotic era, in which common infections and minor injuries
can once again kill.
 Healthcare industry
To prevent and control the spread of antibiotic resistance, the health industry can:
 Invest in research and development of new antibiotics, vaccines, diagnostics and other tools
 Why is it so difficult to develop new antibiotics?
 No new classes of antibiotics have been
discovered since the 1980s. A class defines a
group of antibiotics that have a certain way of
working – for example by killing bacteria or by
stopping them multiplying – and are effective
against certain types of infections.
 The antibiotics that have been brought to
market in the past three decades are variations
of drugs that have been discovered before.
 Discovering and developing genuinely new
antibiotics is challenging: the science is tricky
and the research and development process is
time-consuming and expensive, and often fails.
 It can take 10-15 years and over $1billion to
develop a new antibiotic.

Recent developments
While there are some new antibiotics in development, none of them are expected to be effective against
the most dangerous forms of antibiotic-resistant bacteria.Given the ease and frequency with which
people now travel, antibiotic resistance is a global problem, requiring efforts from all nations and many

How many new antibiotics are on the horizon?

 At the moment, there aren’t sufficient drugs in development to deal with the growing threat of
antibiotic resistance.
 According to the World Health Organization and the Pew Charitable Trust, there are currently
between 40 and 50 antibiotics in clinical development. Many of these will only bring limited
benefits compared to existing treatments.
 The pre-clinical pipeline includes more innovative and diverse candidates – over 250
antimicrobial agents are in early-stage testing. But it will take up to 10 years for the first of these
drugs to make it to market.
 And many promising candidates will fail along the way. For antibiotics in existing classes, on
average, only one for every 15 drugs in pre-clinical development will reach patients.
 With large pharmaceutical companies continuing to abandon antibiotic research, small and
medium-sized companies now dominate the space – they account for around 90 percent of the
new antibiotics in development. But they face formidable challenges in trying to bring new drugs
to market and making them accessible.