Brave Soldiers

The word antibiotic comes from the Greek anti meaning 'against' and bios meaning 'life' (a bacterium is a life form).' Antibiotics are also known as antibacterials, and they are drugs used to treat infections caused by bacteria. Bacteria are tiny organisms that can sometimes cause illness to humans and animals. The singular word for bacteria is bacterium. We can assume bacteria as an enemy and antibiotic as a brave soldiers.

Antibiotics generally work in one of five ways. These are:

• Inhibition of nucleic acid synthesis (e.g. Rifampicin; Chloroquine)
• Inhibition of protein synthesis (e.g. Tetracyclines; Chloramphenicol)
• Action on cell membrane (e.g. Polyenes; Polymyxin)
• Interference with enzyme system (e.g. Sulphamethoxazole)
• Action on cell wall (e.g. Penicillin; Vancomycin)

Antibiotic Ressistant
Antibiotics are important medicines that help fight infections caused by bacteria. Because bacteria are clever they adapt and find ways to survive the effects of an antibiotic. The more we use antibiotics, the more they become "antibiotic resistant" so that the antibiotic no longer works. This means that antibiotics are becoming less effective at fighting infections.

Mechanism of bacterial resistant

• target alteration - alteration of Penicilin Binding Protein(PBP)—the binding target site of penicillins—in Methicillin Resisstant Streptococcus Aureus (MRSA) and other penicillin-resistant bacteria.

• enzymatic inctivation - enzymatic deactivation of Penicillin G in some penicillin-resistant bacteria through the production of β-lactamases.

• decrease access to target - by decreasing drug permeability and/or increasing active efflux(pumping out) of the drugs across the cell surface

• miscellaneous - some sulfonamide-resistant bacteria do not require para-aminobenzoic acid (PABA), an important precursor for the synthesis of folic acid and nucleic acids in bacteria inhibited by sulfonamides. Instead, like mammalian cells, they turn to utilizing preformed folic acid.

Antibiotic Stewardship

An effective antimicrobial stewardship program, with appropriate drug product selection, dosing, route of administration, and duration of antimicrobial therapy, in conjunction with a comprehensive infection control program has been shown to limit the emergence and transmission of antimicrobial-resistant microorganisms.

Tools for good antibiotic Stewardship

• Guideline
• Restriction
• Area specific practices
• Combination treatment - Indication is to prevent emergence of resistant organism, polymicrobial infections, synergism, decrease toxicity and for severe or very severe infectious

It is not necessary to prescribe antibiotic in common cold patient. Most colds last about two weeks and end with a cough and coloured sputum. You need to see your doctor if your cough lasts more than three weeks, or you become very short of breath or develop chest pains, or you already have a chest complaint. Even if a cold goes to your chest, it is still unlikely that you would need an antibiotic but you should see your doctor if you are worried about your symptoms.

Refferences

1. http://www.scq.ubc.ca/attack-of-the-superbugs-antibiotic-resistance/

2. http://www.ashpadvantage.com/podcasts/handouts/07568.pdf

3. Lecture Note Antibiotic Use In hospital, Consequence and role of Drug Formulary in Controlling Drug use by dr Iwan