Chapter 10 Flashcards
Ancient history of antibiotics
- ancient Egyptians, Chinese, and Indians of Central America used molds to treat infected wounds
Ancient history of antibiotics
- tetracycline
- red soils found in Jordan
- traditional Chinese Medicine (TCM)
Tetracycline found in bones 350-550 CE Late Roman period
• Only comes from ingesting the compound
• Incorporate into mineral portion of bone, enamel
Red soils in Jordan
• Antibiotic producing bacteria
• Actinomycin peptides (bind to forms of replicating DNA)
Traditional Chinese Medicine (TCM)
• Qinhaosu (artemisinin) extracted from plants
• Anti-malarial drug
History of antibiotics - anti and bios
- an antibiotic is a chemical substance produces by one organism that is destructive to another.
- anti: against
- bios: life
- antibiotic came from the word antibiotics, which means a process by which life could be used to destroy life
- not just ‘the golden era’ of microbiology
The history of antibiotic agents
- Paul Ehrlich
- “magic bullets”
- arsenic compounds that killed microbes
The history of antibiotic agents
- Alexander Fleming
- penicillin released from penicillium
The history of antibiotic agents
- Gerhard Domagk
- he discovered sulfanilamide
The history of antibiotic agents
- Selman Waksman
- antibiotics
- antimicrobial agents were produced naturally by organisms
The foundation of the antibiotic era
Paul Ehrlich- Had an idea of magic bullet that would selective target only disease- causing microbes
• Synthetic dyes could stain specific microbes, but not others
1904-large –scale screening program to find drug against syphilis
• STD-caused by spirochete Treponema pallidum
• Mercury salts
1909: drug 606, cured syphilis-infected rabbits
• Hoechst manufactured and named Salvarsan, Neosalvarsan
Screening programs still remain
Sulfa drugs: sulfaanilamide
Antimicrobial chemotherapy
Goal of antimicrobial chemotherapy:
• Administer a drug to an infected person that destroys the infective agent without harming the host’s cells
A drug must be able to:
• Be easy to administer and able to reach the infectious agent anywhere in the body
• Be absolutely toxic to the infectious agent and absolutely nontoxic to the host
• Remain active in the body as long as needed and be safely and easily broken down and excreted
Characteristics of the ideal antimicrobial drug
• Toxic to the microbe but nontoxic to host cells
• Microbicidal rather than microbistatic
• Relatively soluble; functions even when highly diluted in body fluids
• Remains potent long enough to act and is not broken down or excreted prematurely
• Does not lead to the development of antimicrobial resistance
• Complements or assists the activities of the host’s defenses
• Remains active in tissues and body fluids
• Readily delivered to the site of infection
• Does not disrupt the host’s health by causing allergies or predisposing the host to other infection
Prophylaxis
Use of a drug to prevent infection of a person at risk
action taken to prevent disease, especially by specified means or against a specified disease.
- something like taking an antibiotic to prevent illness before having dental work done if you have metal in your body
Antimicrobial chemotherapy
Antimicrobials
Antimicrobial chemotherapy - the use of drugs to control infection (not just cancer treatment, but the use of drugs to eliminate infection)
Antimicrobials - all-inclusive term for any antimicrobial drug, regardless of its origin
Antibiotics
Substances produced by the natural metabolic processes of some microorganisms that can inhibit or destroy other microorganisms; generally, the term is used for drugs targeting bacteria and not other types of microbes
Semisynthetic drugs
Synthetic drugs
Semisynthetic - drugs that are chemically modified in the laboratory after being isolated from natural sources (modified after they come from a natural source like a lab)
Synthetic - drugs produced entirely by chemical reactions (produced entirely in the lab)
Narrow-spectrum (limited spectrum)
Broad-spectrum (extended spectrum)
Narrow - Antimicrobials effective against a limited array of microbial types - for example, a drug effective mainly against gram-positive bacteria
Broad - Antimicrobials effective against a wide variety of microbial types - for example, a drug effective against both gram-positive and gram-negative bacteria
Before therapy can begin what three factors should be considered
• The identity of the microorganism causing the infection
• The degree of the microorganism’s susceptibility (also called sensitivity) to various drugs
• The overall medical condition of the patient
Identifying the agent
Identification of infectious agents should begin as soon as possible:
- first need to know if it is Gram-positive or Gram-negative
• Should occur before antimicrobial drugs are given, before their numbers are reduced
• Direct examination of body fluids, sputum, or stool samples is a rapid method for detection
• Doctors often begin therapy on the basis of immediate findings and informed guesses
• Epidemiological statistics may be required
Testing for drug susceptibility
- four organisms it is necessary for
Testing is necessary for the following organisms:
• Staphylococcus species
• Neisseria gonorrhoeae
• Enterococcus faecalis
• Aerobic, gram-negative intestinal bacilli
If the treatment is ineffective for fungal or protozoal infections initially, drug testing is essential. In general, these tests involve exposing a pure culture of the microbe to several different drugs and observing the effects of the drugs on growth.
The Kirby-Bauer Technique
• Surface of an agar plate is spread with test bacterium (for example)
• Small discs containing a prepared amount of antibiotic are placed on the plate
• Zone of inhibition surrounding the discs is measured and compared with a standard for each drug
- this is qualitative technically, but in this scenario in bio it is quantitative. The zone for the antibiotic is specific to that antibiotic
What is the tube dilution test
- More sensitive and quantitative than the Kirby-Bauer test
- Antimicrobial is diluted serially in tubes of broth
- Each tube is inoculated with a small uniform sample of pure culture, incubated, and examined
Minimum inhibitory concentration (MIC)
- the smallest concentration (highest dilution) of drug that visibly inhibits growth
- useful in determining the smallest effective dosage and providing a comparative index against other Antimicrobials
Response to treatment
- in vitro activity of a drug is not always correlate with the Vivo effect
Failure or antimicrobial treatment is due to:
• The inability of the drug to diffuse into that body compartment (brain, joints, skin); this can include the possibility that the microbes are in a biofilm
• Resistant microbes in the infection that did not make it into the sample collected for testing
• An infection caused by more than one pathogen (mixed), some of which are resistant to the drug
• In outpatient situations you have to also consider the possibility that the patient did not take the antimicrobials correctly
The goals of antimicrobial drugs
• Disrupt cell processes or structures of bacteria, fungi, or protozoa
• Inhibit virus replication
• Interfere with the function of enzymes required to synthesize or assemble macromolecules
• Destroy structures already formed in the cell
• Selectively toxic: kill or inhibit microbial cells without damaging host tissues
What are interactions between the drug and the microbe
Drugs with excellent selective toxicity block the synthesis of the bacterial cell wall (penicillins):
• Human cells lack the chemical peptidoglycan and are unaffected by the drug
Drugs most toxic to humans:
• Drugs that act upon a structure common to both the infective agent and the host cell (cytoplasmic membrane)
• As characteristics of the infectious agent are more and more similar to the host cell, selective toxicity becomes more difficult to achieve
Drugs that target the cell wall
- penicillin
Penicillin and its family are known to inhibit bacterial cell wall synthesis
- Penicillins G and V
• Ampicillin, carbenicillin, amoxicillin
• Nafcillin, cloxacillin
• Clavulanic acid
Drugs that target the cell wall
- carbapenems
Carbapenems target and inhibit bacterial cell-wall biosynthesis inhibitors
- Doripenem, imipenem
• Aztreonam