It is common to use antibiotics without a prescription. Here we will explain why it is not convenient to do so.

What is an antibiotic and what is it for?

The term antibiotic refers to a group of compounds capable of preventing the growth of bacteria.

To indicate these two terms are used, sometimes without distinction: antibacterial and chemotherapeutic.

Antibacterials of natural origin, the first to be discovered, are molecules that other microorganisms, mainly certain types of microscopic fungi (belonging to the group of molds), produce to defend themselves against bacterial infections.

The historical example of this group is penicillin, identified in 1928 by Alexander Fleming and so named because it is produced by a fungus of the genus Penicillium.

Since then, through modifications of the chemical structure specifically designed to increase their effectiveness, compounds have been derived from the original molecules that, precisely because of their “mixed” origin, are defined as semisynthetic antibiotics.

How Antibiotics Work

The now very numerous molecules available inhibit the growth of bacteria through different mechanisms of action, which, however, essentially have two objectives:

• Destroy the outer protective envelope of the bacterial cell;
• Interfere with the biochemical reactions that allow it to survive and reproduce.

Depending on the final effect on the bacterial cell, the various drugs are divided into:

• Bactericides, they directly cause the death of the bacterial cell.
• Bacteriostatic, they stop their growth (which leaves the immune system to eliminate it permanently).

Depending on the chemical structure and mechanism of action, each molecule is selectively effective on individual species or groups of bacteria or simultaneously on a wide range of bacteria.

Antibacterials of this second type are defined as “broad spectrum”.

Types of antibiotics

We have explained that antibiotics are divided into the following types

• Low-spectrum antibiotics: They only attack bacteria of a specific type

• Broad spectrum antibiotics: They attack bacteria of different types

• Bactericidal antibiotics: They are capable of eliminating bacteria

• Bacterostatic antibiotics: They block the growth and multiplication of harmful bacteria.

When and how to use Antibiotics

The intake of antibacterial drugs is appropriate only in infections caused by bacteria, and is unnecessary and inappropriate in the course of diseases caused by different infectious agents (viruses, fungi, protozoa), unless there is a risk that these will complicate the overlapping bacterial infections.

The use of broad-spectrum antibacterials is indicated for infections in which the identity of the responsible bacteria is unknown and which can be caused by many different bacteria.

The use of a more selective antibacterial is obviously the best option: it is possible in case of diseases with the most probable infectious agent and especially when, when analyzing in the laboratory a sample of infected organic material (respiratory secretions, mucus). vaginal, urine, blood, etc.), it is possible to accurately identify the bacterial strain involved and even test its sensitivity to different drugs (using a test called a bacterial culture with antibiogram).

Antibacterial medications should only be used with a prescription and it is important that they are taken on time and in the prescribed doses.

 Antibiotic resistance

The problem of resistance. In the last century, pharmaceutical research has made available numerous antibacterial molecules, which pursue the goal of creating increasingly more specific, more effective and less toxic substances.

At the same time, bacteria have set in motion their biological countermeasures (genetic modifications, biochemical adaptations) to reduce their susceptibility to the effect of drugs.

Currently, this phenomenon, called drug resistance, is one of the greatest obstacles in the control of bacterial infections and, consequently, one of the main health emergencies.

Among the main causes of the development of forms of resistance by bacteria is the improper use of antibiotic drugs : when it is not necessary, at doses other than those prescribed, with inadequate methods of ingestion, for insufficient periods of time or too long , etc.

Conclusion on antibiotics

Therefore, as you will see, antibiotics should not be given without being prescribed by a specialist. It is clear that the doctor must first diagnose if the disease is due to a bacteria or a virus. Many times a laboratory test is needed to define it. It will be the physician who decides whether or not to prescribe antibiotics.

In these cases, it is good clinical sense and knowledge of the epidemiology and severity of the different ways to decide whether or not to prescribe antibiotics. The case of respiratory infections in children is typical, very frequent and often widely recurrent. In these cases, it is known that the forms are due in more than 80% of cases to viruses, which are usually very mild, than the few Bacterial forms are generally more severe and last longer, and tend to worsen if not try. This explains why pediatricians do not prescribe antibiotics in most cases of upper respiratory infection and flu-like forms, simply administering these drugs only in severe cases and those in which 48-72 hours after onset , the disease was not cured spontaneously.

Unfortunately, not all doctors can resist the temptation to prescribe antibiotics from the first hours of the fever, even in cases of obvious low clinical importance in the erroneous presumption of protecting the patient from nonexistent risks.

It should, indeed, be remembered that the administration of antibiotics in viral forms does not reduce the risk that bacteria may overlap with the virus so that interventions of this type are doubly wrong, do not cure the initial infection and do not prevent, as Sometimes it happens, bacteria can infect the respiratory tract injured by viruses. The overuse of antibiotics has two important consequences. The first is to increase health care costs for no reason; the second is to make prescription drug useless, slowly but inexorably. In general, an antibiotic active in a specific bacterial species is capable of eliminating all the microorganisms that belong to that species.

Over time, however, bacteria, continually exposed to a certain drug that kills them, learn to defend themselves by changing their characteristics. They emerge, that is, sturdy jambs.

As long as they are a minority, their practical impact remains modest. However, if you continue to use that antibiotic, this will continue to kill the sensitive bacteria, but it will not affect those that progressively become the majority. At this point, the antibiotic is lost because using it means exposing the patient to a high risk of treatment failure. The phenomenon of resistance selection is inevitable because antibiotics have an undeniable utility and there are conditions in which they are indispensable. However, misuse accelerates selection and inevitably shortens the half-life of a drug, making it increasingly difficult to address the diseases for which antibiotics really serve.

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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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