Antibiotics

Antibiotics are derived from living organism but are usually improved by chemical processes.
They can be divided into two groups: Bacteriostatic ( stops bacteria growth) and bactericidal
(kills bacteria)
They affect some aspect of growth or metabolism of the target bacterium by:
- interfering with the synthesis of bacterial cell walls (penicillin, cephalosporin, vancomycin)
Bacterial cell walls are made of peptidoglycans (long molecules containing peptides and
sugars, held together by cross-links between them). Penicillin prevents the cross-links
between them from forming by inhibiting the enzyme that makes cross-links.
So, when the cell walls expand during growth and enzymes called autolysins make holes in
the cell wall to allow for this expansion (stretching) the cell wall becomes progressively
weaker until it bursts due to the osmotic pressure.
Our cells have no cell walls so penicillin does not damage our cells. It also does not affect
viruses (no cells).
- affecting the activity or proteins in the cell surface membrane.
- affecting enzyme action.
- interfering with DNA synthesis (quinolones)
- interfering with protein synthesis (chloramphenicol, erythromycin, tetracycline, streptomycin,
rifampicin (transcription inhibitor))

Why antibiotics only affect bacteria:

- The virus uses the host cells mechanisms for transcription and translation and thus the
antibiotics do not bind to the proteins on the host cells and are ineffective.

- Eukaryotic cells have different cell surface proteins than bacteria so they are also not affected
by antibiotics.
Antibiotic resistance:
- Features which help cause resistance include:
Thick cell walls cause the bacterial cell walls to be less permeable.
The bacterium may contain a gene which codes for an enzyme that catalyses the
breakdown of penicillin (above two are reasons why penicillin has no effect on M.
tuberculosis).
Proteins in the membranes of bacteria can inactivate antibiotics so they have no effect.
Bacterial membranes can have proteins that pump out antibiotics if they enter the
cytoplasm.
Antibiotics may simply not be able to bind to the intended site of action.
- Bacteria sensitive to an antibiotic are called susceptible.

- Vertical transmission: The spreading of antibiotic resistance in a population through asexual

reproduction.
Bacteria have only one copy of each gene in their single loop of double-stranded DNA. So,
these genes will have an immediate effect on any bacteria with it (no heterozygotes).
They reproduce asexually by binary fission (bacterial chromosome replicates and then the
cell divides into two), so each offspring will be identical to its parent.
- Horizontal transmission: The spreading on antibiotic resistance due to the transfer of part of
the DNA from the bacterial chromosome or a plasmid (can happen between different species).
Plasmids are transferred between different bacteria in a step called conjugation, where a
tube forms between two bacteria and allow the movement of DNA.
If the plasmid of a antibiotic resistant bacteria is transferred to another species of bacteria,
that species could also become antibiotic resistant.
- Soil bacteria have many resistance mechanisms because they go in an environment
where there are many molecules that interfere with their metabolism. Many of the
antibiotic-resistance-conferring mutations of pathogenic bacteria come from soil
bacteria. The enzyme beta-lactamase (breaks down penicillin) was transferred from
soil bacteria to other bacteria when antibiotics were introduced.
- Antibiotic resistance is more likely to occur in hospitals and prisons.
- Bacteria resistant to many antibiotics are said to have multiple resistance.
An example of this is methicillin-resistant Staphylococcus aureus (MRSA), which often
causes infections after surgery. It was controlled with vancomycin (a last-resort drug).
Recently, the bacterium Enterococcus faecalis transmitted its resistance to MRSA and
caused it to become resistant to vancomycin.
Now, carbapens are used to treat multiple drug resistance. And, now carbapen-resistant
Klebsiella pneumoniae has been discovered.
How
to reduce the number of opportunities drug resistant bacteria have to develop:

- Use antibiotics only when necessary (not for viruses).

- Reducing the number of places which give antibiotics with no prescriptions.
- Avoid using wide-spectrum antibiotics.
- Make sure patients complete their course of medication.
- Make sure patients do not self-medicate.
- Use a variety of different antibiotics for a certain diseases (at different times).
- Dont use antibiotics as prophylactics in farming.