By Consultant Surgeon Prof G. Sivakumar
About 2,500 years ago Chinese applied the mouldy curd of soybeans to infections and found that it had certain therapeutic benefits. The Sudanese-Nubian civilization used a type of tetracycline antibiotic as early as 350 A.D.
The real antibiotic era started in 1928, when an English microbiologist, Alexander Flemming, who was working on the growth of certain bacteria went on vacation for two weeks and on his return found that on certain areas of his petri-dishes wherever there was a little mould, the growth of bacteria had been inhibited.
The pioneers in the discovery of antibiotics are Louis Pasteur (1877), Alexander Fleming (1928) and Selman Waxman (1944). After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases. Sir Alexander Fleming, Doctor Chain, and Sir Howard Florey are well-known throughout the world, in the discovery story of penicillin.
It affords a splendid example of different scientific methods cooperating for a great common purpose.
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The discovery of antibiotics was a turning point in the history of the modern world. In July 1941, Florey and Heatley flew to the USA on a mission to convince the medical industry there to start penicillin production. Florey, as usual, was very determined, and after several meetings, the project finally got started. One compelling reason was the attack on Pearl Harbor, after which the American government started encouraging medical companies to cooperate and speed up the production of penicillin.
Antibiotics have given us a powerful way to fight and win against bacterial infections and diseases. There is no argument that the discovery of antibiotics has been one of the most important milestones in the history of health care.
The history of antibiotics:
The term “antibiotic” originally referred to a natural compound produced by a fungus or another microorganism that kills bacteria which cause disease in humans or animals. Antimicrobials are chemical compounds that kill bacteriae. Gerhard Domagk discovered the first sulfa drugs in 1932. The pharmaceutical company Bayer had hired him to work on the problem of infectious diseases caused by the bacterium Streptococcus pyogenes.
In various trials designed to determine the effectiveness of various compounds for bacterial killing, Domagk discovered that a dye called prontosil rubrum prevented S. pyogenes infection in mice. In 1935 Domagk’s daughter was gravely ill due to S. pyogenes infection. The infection was advancing so aggressively that doctors were considering amputating her arm, but instead, she was treated with prontosil rubrum (well before complete clinical trials of the drug had been completed). She made a full recovery. Domagk received the Nobel Prize in 1939.
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Antibiotics fight bacteria, but cannot fight viruses. Ignorance and misuse of antibiotics is, dangerous. To begin with, the resistance was noticed in the hospital setting where antibiotics were used rather intensively. Antibiotic resistance has been called one of the world’s most pressing public health problems. Multi drug resistance in tuberculosis in the world is playing havoc.
Antibiotic use promotes development of antibiotic-resistant bacteria. Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply.
Among the antibiotics used in the community, 60 per cent are given for upper respiratory infections like sore throat and common cold and over 80-90 per cent of these infections are viral in nature where antibiotic has no role.
Drug-resistant bacteria- causes:
Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria.
- It kills good bacteria
- Inadequate dose can make the bacteria develop a resistance
- Misuse of antibiotics help in increasing numbers of “super bacteria”which are resistant to most of the antibiotics.
Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. Antibiotic resistance can develop naturally via natural selection through random mutation. Once such a gene is generated, bacteria can then transfer the genetic information in a horizontal fashion (between individuals) by plasmid exchange.
Smart use of antibiotics is the key to controlling the spread of resistance.
- Use antibiotics when they are likely to be beneficial
- Do not take an antibiotic for a viral infection like a cold or the flu.
- Take an antibiotic exactly as per the prescription.
- Complete the prescribed course of treatment even if you are feeling better
The four main mechanisms by which microorganisms exhibit resistance to antimicrobials are:
- Enzymatic drug inactivation or modification: β-lactamases.
- Alteration of target site
- Alteration of metabolic pathway:
- Reduced drug accumulation
“Staph aureus” and Enterococcus faecium are some of the major resistant pathogens. Antibiotic resistance is an important tool for genetic engineering. The most commonly used antibiotics in genetic engineering are generally “older” antibiotics which have largely fallen out of use in clinical practice.
The development of new antibiotics is crucial to controlling current and future infectious diseases caused by antibiotic-resistant bacteria. But let us not fritter away this wonderful pharmaceutical weapon against diseases by injudicious use.
Pic courtesy: consumerreports.org
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