Antibiotics

Synonym

against life

Definition

Antibiotics are a large substance class of drugs that are mainly used to combat bacterially caused diseases (infections). Antibiotics refer to the large group of drugs and substances which, if one were to translate the name, are used “against life” (bios = life).

Field of application

Antibiotics are always used when there has either been a bacterial infection in the body, or when there is an increased risk of an imminent bacterial infection, e.g. after an operation. Antibiotics are therefore used therapeutically and prophylactically for bacterial infections. Antibiotics do not help against viruses.

Effect

Depending on the group of antibiotics, the effect on the bacteria also differs. The group of glycopeptides, penicillins, cephalosporins and carbapenems have an inhibitory effect on the formation of the bacteria‘s cell wall and thus cause them to die. Lincosamines, tetracyclines, macrolides and aminoglycosides inhibit the protein synthesis of the bacteria and thus disturb their regulated biological process. Gyrase inhibitors, nitroimidazoles and rifampicin interfere with the genetic process of the bacteria and thus make survival impossible. Finally, Cotrimoxazol acts on the folic acid metabolism, which is important for the bacterium, thus causing it to die.

Classification

There are numerous preparations of antibiotics, all of which are divided into specific groups. These groups usually differ in their mode of action, their germ spectrum and thus in their area of application. The three groups of penicillins, cephalosporins and carbapenems are grouped together under the umbrella term beta-lactam antibiotics.

The probably best known antibiotics and also with one of the oldest are the penicillins. They inhibit the bacterial cell wall and are mainly used to treat infections: Thus, severe infections such as pneumonia (pneumococcus), erysipelas (streptococci) or syphilis (gonococcus) can be treated. The carbapenems, to which meropenem and imipenem belong, are used for severe infections, mostly acquired in hospital (e.g. anaerobes, pseudomonas etc).

Cephalosporins form another large group of antibiotics. They are divided into corresponding subgroups. Cefazolin (group 1) is used in the treatment of pneumonia acquired on an outpatient basis as well as in the prophylaxis after operations.

Cefuroxime and cefotiam (group 2) are also used in the treatment of outpatient acquired pneumonia and as prophylaxis during surgery, but also for urinary tract infections caused by the germ E. coli. – Streptococci

  • Staphylococci or
  • Gonococcus. Cefotaxime and ceftriaxone (group 3a) is used for purulent inflammation of the gallbladder, meningitis and borreliosis.

Ceftazidim belongs to group 3b. It has a broad spectrum of activity and is used for severe infections caused by pseudomonas. In addition to the beta-lactam antibiotics, there are also the aminopenicillins (ampicillin, amoxicillin), which are used in the treatment of streptococcal pneumonia, ENT infections and urinary tract infections, especially during pregnancy.

The acylaminopenicillins (mezlocillin, piperacillin) are used for severe infections. Vancomycin belongs to the group of glycopeptides. The germ spectrum is particularly important in the case of gram-positive germs, which can, for example, trigger a so-called pseudomembranous colitis.

Betalactamase inhibitors include This combination antibiotic is frequently used in the clinic for the treatment of pneumonia and urinary tract infections, but also for infections whose pathogen is unknown. The special feature of clindamycin (from the lincosamine group) is its good tissue mobility. The substance is therefore always used when bone or tooth infections are present.

Cotrimoxazol is used less frequently. It is used for rare diseases such as Wegner’s granulomatosis or Pneumocystis jiroveci pneumonia. Doxycycline belongs to the group of tetracyclines.

A special field of application is the prevention treatment of malaria. Erythromycin, clarithromycin and roxithromycin belong to the group of macrolides. Areas of application are pneumonia acquired on an outpatient basis, ENT infection in case of penicillin allergy and all possible infections during pregnancy, for which there are contraindications for most other antibiotics.

Aminoglycosides (gentamycin+streptomycin) are used in severe diseases such as blood poisoning, inflammation of the inner wall of the heart or bone infections. A special field of application is tuberculosis, which has become rare today. Gyrase inhibitors (ciprofloxacin, moxifloxacin) are used for urinary tract infections, pseudomonas infections and inflammation of the gall bladder.

Finally, metronidazole should be mentioned, which belongs to the group of nitroimidazoles. It is used for Helico-Bacter gastritis, sexually transmitted infections and amoebic dysentery. – Sulbactam,

  • Tazobaktam and the
  • Clavulanic acid. – Ornitosis,
  • The trachoma, or the
  • Lyme disease to the area of application.