Infectious Diseases / Bacteria / Viruses

Antibiotics: How Do Antibiotics Work?

Written by Christian Nordqvist
Knowledge center
Last updated: Thu 21 January 2016
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Antibiotics, also known as antibacterials, are types of medications that destroy or

slow down the growth of bacteria.
The Greek word anti means "against", and the Greek word bios means "life" (bacteria
are life forms).
Antibiotics are used to treat infections caused by bacteria. Bacteria are microscopic
organisms, some of which may cause illness. The word bacteria is the plural of
bacterium.
Such illnesses as syphilis, tuberculosis, salmonella, and some forms
of meningitis are caused by bacteria. Some bacteria are harmless, while others are
good for us.

Contents of this article:

What are antibiotics?

How do antibiotics work?
What are antibiotics used for?
What are the side-effects of antibiotics?
Allergic reactions to antibiotics
Antibiotics may clash (interact) with other medicines
How to use antibiotics

What are antibiotics?

The US National Library of Medicine says that antibiotics - powerful medicines that fight
1

bacterial infections - can save lives when used properly. Antibiotics either stop bacteria
from reproducing or kill them. "Your body's natural defenses can usually take it from
there."
Before bacteria can multiply and cause symptoms, the body's immune system can
usually destroy them. We have special white blood cells that attack harmful bacteria.
Even if symptoms do occur, our immune system can usually cope and fight off the
infection. There are occasions, however, when it is all too much and some help is
needed.....from antibiotics.

Alexander Fleming discovered penicillin, the first natural antibiotic, in 1928.

The first antibiotic was penicillin. Such penicillin-related antibiotics as ampicillin,

amoxicillin and benzylpenicilllin are widely used today to treat a variety of infections -
these antibiotics have been around for a long time.

There are several different types of modern antibiotics and they are only available with a
doctor's prescription in most countries.

Overusing antibiotics - There is concern worldwide that antibiotics are being

overused. Antibiotic overuse is one of the factors that contributes towards the growing
number of bacterial infections which are becoming resistant to antibacterial medications.
According to the CDC (Centers for Disease Control and Prevention), outpatient
antibiotic overuse in the USA is a particular problem in the Southeast.
The ECDC (European Centre for Disease Prevention and Control) says that antibiotic
resistance continues to be a serious public health threat worldwide. In a statement
issued in 19th November 2012, the ECDC informed that an estimated 25,000 people
die each year in the European Union from antibiotic-resistant bacterial infections.
New ECDC data has shown that there has been a considerable increase over the last
four years of combined resistance to multiple antibiotics in E. coli and Klebsiella
pneumoniae in over one third of EU and EEA (European Economic Area) nations.
Consumption of carbapenems, a major class of last-line antibiotics, increased
significantly from 2007 to 2010.
Antibiotic resistance: how has it become a global threat to public health? Then
there is the danger that the ignorant man may easily underdose himself and by
exposing his microbes to non-lethal quantities of the drug, make them resistant," said
Alexander Fleming, speaking in his Nobel Prize acceptance speech in 1945. As
predicted almost 70 years ago by the man who discovered the first antibiotic, drug
resistance is upon us.

How do antibiotics work?

Although there are a number of different types of antibiotic they all work in one of two
ways:

A bactericidal antibiotic kills the bacteria. Penicillin is a bactericidal. A bactericidal

usually either interferes with the formation of the bacterium's cell wall or its cell contents.
A bacteriostatic stops bacteria from multiplying.

What are antibiotics used for?

An antibiotic is given for the treatment of an infection caused by bacteria. Antibiotics
target microorganisms such as bacteria, fungi and parasites. However, they are not
effective against viruses.

If you have an infection it is important to know whether it is caused by bacteria or a

virus. Most upper respiratory tract infections, such as the common cold and sore
throats are generally caused by viruses - antibiotics do not work against these viruses.
 Electron micrograph of clumps of
methicillin-resistant Staphylococcus aureus (MRSA) bacteria, which are becoming more resistant to
antibiotics.
Image credit: CDC/ Janice Carr/ Deepak Mandhalapu

If antibiotics are overused or used incorrectly there is a risk that the bacteria will
become resistant - the antibiotic becomes less effective against that type of bacterium.

A broad-spectrum antibiotic can be used to treat a wide range of infections. A narrow-

spectrum antibiotic is only effective against a few types of bacteria. There are antibiotics
that attack aerobic bacteria, while others work against anaerobic bacteria. Aerobic
bacteria need oxygen, while anaerobic bacteria don't.

Antibiotics may be given beforehand, to prevent infection, as might be the case before
surgery. This is called 'prophylactic' use of antibiotics. They are commonly used before
bowel and orthopedic surgery.

What are the side-effects of antibiotics?

Below is a list of the most common side-effects of antibiotics:

Diarrhea - researchers from Stanford University School of Medicine found that a rise
in sugars in the gut following antibiotic treatment allows harmful bacteria to get a
foothold and cause infection. Harmful bacteria thrive on sugar.
Feeling and being sick.

Fungal infections of the mouth, digestive tract and vagina.

Below is a list of rare side-effects of antibiotics:

 Formation of kidney stones (when taking sulphonamides).
Abnormal blood clotting (when taking some cephalosporins).
Sensitivity to sun (when taking tetracyclines).
Blood disorders (when taking trimethoprim).
Deafness (when taking erythromycin and the aminoglycosides).

Some patients, especially elderly ones, may experience inflamed bowels (a type of
colitis) which can lead to severe diarrhea. Clindamycin, an antibiotic used for the most
serious infections, commonly has this side effect. However, although much less
common, penicillins, cephalosporins and erythromycin might do too.

In August 2012, Scientists from the NY School of Medicine found that babies who are
exposed to antibiotics have a greater risk of becoming overweight or obese
children. Their study was published in the International Journal of Obesity.

Allergic reactions to antibiotics

Some patients may develop an allergic reaction to antibiotics - especially penicillins.
Side effects might include a rash, swelling of the tongue and face, and difficulty
breathing.

Allergic reactions to antibiotics may be immediate or delayed hypersensitivity reactions . 2

If you have ever had an allergic reaction to an antibiotic you must tell your doctor and/or
pharmacist. Reactions to antibiotics can be very serious, and sometimes fatal - they are
called anaphylactic reactions.

Use antibiotics with extreme caution and ensure you inform your
doctor/pharmacist if:
You have reduced liver or kidney function.

You are pregnant

You are breastfeeding

Antibiotics may clash (interact) with other

medicines
If you are taking an antibiotic do not take other medicines or herbal remedies without
telling your doctor first. OTC (over the counter, non-prescription) medicines might also
clash with your antibiotic.

Penicillins, cephalosporins, and some other antibiotics may undermine the effectiveness
of oral contraceptives. If the antibiotic has caused diarrhea/vomiting the absorption of
contraceptives may also be disrupted. If you are taking any of these drugs you should
consider taking additional contraceptive precautions.

Recent developments on antibiotics from MNT news

One course of antibiotics disrupts gut microbiome for a year

A single course of antibiotics is strong enough to disrupt the normal makeup of

microorganisms in the gut for up to a year, potentially leading to antibiotic resistance,
says research published in mBio.

Blood test could identify which patients need antibiotics

One of the main drivers of antibiotic resistance is overprescription and misuse of

antibiotics. But in a new study, researchers reveal how they are a step closer to
developing a blood test that can identify whether a respiratory illness is caused by a
viral or bacterial infection, allowing more accurate antibiotic prescribing.

How to use antibiotics

Antibiotics are usually taken by mouth (orally); however, they can also be administered
by injection, or applied directly to the affected part of the body.

Most antibiotics start having an effect on an infection within a few hours. It is important
to remember to complete the whole course of the medication to prevent the infection
from coming back.

If you do not complete the course, there is a higher chance the bacteria may become
resistant to future treatments - because the ones that survive when you did not
complete the course have had some exposure to the antibiotic and may consequently
have built up a resistance to it. Even if you are feeling better, you still need to complete
the course.

Some antibiotics should not be consumed with certain foods and drinks. Others should
not be taken with food in your stomach - these would normally be taken about an hour
before meals, or two hours after. It is crucial that you follow the instructions correctly if
you want the medication to be effective. If you are taking metronidazole do not consume
alcohol.

Dairy products should not be consumed if you are taking tetracyclines, as they might
affect the absorption of the medication.