What is an overview of antibiotics?

From the Guidelines

Antibiotics are a crucial component in the treatment of various infections, but their misuse has led to the emergence of antimicrobial resistance, making it essential to use them judiciously.

Overview of Antibiotics

• Antibiotics can be categorized into different groups based on their spectrum of activity, such as narrow-spectrum and broad-spectrum antibiotics 1.
• The choice of antibiotic depends on the type of infection, the causative organism, and the patient's individual risk factors, such as recent exposure to antibiotics or known colonization with resistant bacteria 1.
• Community-acquired infections are typically treated with narrower spectrum antibiotics, while healthcare-associated infections require broader spectrum antibiotics due to the higher risk of resistant organisms 1.

Classification of Antibiotics

• The AWaRe framework categorizes antibiotics into three groups: Access, Watch, and Reserve, based on their potential to contribute to resistance and the need to preserve their use as a last resort for multidrug-resistant infections 1.
• Access antibiotics are recommended as first- or second-choice treatment options for common clinical infections and should be widely available, affordable, and of assured quality 1.
• Watch antibiotics have a higher risk of selection of antibiotic-resistant bacteria and should be targets of antimicrobial monitoring and stewardship programs 1.
• Reserve antibiotics are last-resort options that should only be used to treat confirmed or suspected infections due to multidrug-resistant bacteria 1.

Principles for Selecting Antibiotics

• The selection of antibiotics should be based on guiding principles, including the prevention of the emergence and spread of antibiotic resistance, parsimony, benefits and harms, feasibility, and alignment with WHO guidelines 1.
• Antibiotics with a narrower spectrum of activity should be prioritized, and fluoroquinolone- and carbapenem-sparing therapies should be used where appropriate 1.

Conclusion is not allowed, so the response will continue without a conclusion section, and the references will be included in the text as in-text citations.

The use of antibiotics should be rational and appropriate, taking into account the patient's clinical condition, the individual risk for infection by resistant pathogens, and the local resistance epidemiology 1. In patients with intra-abdominal infections, the choice of empiric antibiotic regimens should be based on the clinical condition of the patient and the individual risk for infection by resistant pathogens 1. Carbapenems offer a wide spectrum of antimicrobial activity, but their use should be limited to preserve their effectiveness against multidrug-resistant infections 1. Aminoglycosides are effective against gram-negative bacteria, but their use is limited due to their toxic side effects 1. Tigecycline is a viable treatment option for complicated intra-abdominal infections due to its favorable in vitro activity against anaerobic organisms and enterococci 1. The AWaRe framework provides a tool for optimizing the quality of global antibiotic prescribing and reducing inappropriate use by encouraging the use of Access antibiotics where appropriate 1.

From the Research

Overview of Antibiotics

• Antibiotics are low-molecular-weight bioactive agents that have been used to cure bacterial infections for over 70 years 2
• They have been used for a variety of other medicinal applications and have saved millions of lives 2
• Antibiotics represent a frequently employed therapeutic modality for the management of bacterial infections across diverse domains, including human health, agriculture, livestock breeding, and fish farming 3
• The efficacy of antibiotics relies on four distinct mechanisms of action, which include inhibiting cell wall synthesis, interfering with protein synthesis, inhibiting DNA replication, and disrupting cell membrane function 3

History and Development of Antibiotics

• Antibiotics have transformed modern medicine and are essential for treating infectious diseases and enabling vital therapies and procedures 4
• The discovery and development of antibiotics are no longer cost-effective using traditional reimbursement models, resulting in a dwindling number of companies and laboratories dedicated to delivering new antibiotics 4
• The future of antibiotics requires innovation in a field that has relied on highly traditional methods of discovery and development 4

Mechanisms of Action and Resistance

• Antibiotics efficiently inhibit the growth and multiplication of pathogenic microbes without causing adverse effects on the host 5
• Understanding the mode of action of antibiotics and their interaction with targets is complex, but necessary to fulfill the constant need for novel therapeutic alternatives to address the inevitable development of resistance 5
• Bacteria have developed defense mechanisms against antibiotics, rendering them ineffective, and antibiotic resistance can spread among bacteria through various routes 3

Current Scenario and Future Prospects

• The overuse of antibiotics has led to a marked increase in bacterial resistance, becoming a global problem and a major threat to human health 6
• New antibiotics have been developed through improvements to traditional antibiotics and the discovery of antibiotics with novel mechanisms to address the decrease in the efficacy of traditional antibiotics 6
• The current deficiencies, opportunities for improvement, and prospects of antibiotics are being thoroughly discussed to provide new insights for the design and development of safer and more potent antibiotics 6