Introduction Managing patients condition successfully need the expertise of the practitioner to accurately diagnose each condition by identifying the causative microbes and their activities choosing the right antimicrobial therapy and obtaining cost effective agents for the shortest duration of possible treatment identifying drug drug reactions and respond to characteristics therapy that are peculiar to combating antimicrobial agents Within this paper discussions will include identifying different categories of antimicrobial agents distinguishing viral infection from bacterial infections and explaining the importance of accurate identification of the microbial agent towards disease management Antimicrobial agents The word antimicrobial refers to all agents that act against microbial organisms while antibiotics refer to substances produced by microorganisms which act against another microorganism So all antibiotics are antimicrobials but not all antimicrobials are antibiotics Examples of antimicrobial agents include antibacterial drugs antiviral agents antifungal agents and Antiparasitics drugs emedicinehealth 2017 Antimicrobial agents in different categories
Antimicrobial drugs are classified on the basis of their mechanism of action spectrum of activity or effect on bacteria The most common targets for antimicrobial drug actions fall into 5 basic categories A Inhibition of cell wall synthesis Bacterial Enzymes known as autolysins aids in breaking down cell wall A drug that targets cell walls can selectively inhibit the growth of the bacterial organism Laureate Education 2012 The beta lactam antibiotics such as penicillins and cephalosporins bacitracin and vancomycin interrupt specific points in the synthesis pathway for bacterial cell walls and therefore inhibit cell wall production Hagberg K 2018 B Inhibition of protein synthesis Protein synthesis is essential for the multiplication and survival of all bacterial cells Laureate Education 2012 Several antibacterial agents such as macrolides Clindamycin lincosamides streptogramins chloramphenicol and tetracyclines target bacterial protein synthesis by binding to either the 30S or 50S ribosomal subunits to arrest bacterial growth producing a bacteriostatic effect Hagberg K 2018 C Inhibition of nucleic acid synthesis Drugs such as drugs like the fluoroquinolones metronidazole and rifampin work by binding and inhibiting microbes DNA coiling or transcription to RNA They compromise bacterial multiplication and its survival D Effects on cell membrane sterols antifungal agents Amphotericin B Nystatin Polymyxin B binds avidly to membrane sterols Drugs of this class are often poorly selective and could be toxic to the host blood stream Polymyxin B and colistin are used to treat topical infections Imidazole antifungals may inhibit 14 demethylation of lanosterol to ergosterol an essential component of fungal membranes Hagberg K 2018 E Inhibition of unique metabolic process Some antibacterial drugs functions in disrupting biochemical processes essential for bacterial survival For example both sulfonamides and trimethoprim disrupt the folic acid pathway to ensure that folate production which is necessary for the production of nucleic acids is completely inhibited Because bacterial resistance to sulfonamides is widespread trimethoprim sulfa TMS combination has a bacteriostatic effect superior to that produced by either drug alone Laureate Education 2012
Atovaquone inhibits ubiquinone biosynthesis cell respiration in protozoa Isoniazid Ethionamide inhibit mycolic acid biosynthesis in Mycobacterium sp and Metronidazole Nitrofurantoin helps reduced to highly reactive metabolites Hagberg K 2018 Viral and bacterial infections Distinguishing between a viral and a bacterial infection is most important toward finding a cure for the infection Antibiotic drugs usually kill bacteria and are not effective against viruses Bacteria are single celled microbes which live in different types of environments either extremes of cold or heat Some lives in peoples intestines where they digest food Bacteria may lead to infection which causes harm to the body such as strep throat tuberculosis and urinary tract infection Steckelberg J M 2017 Viruses also require a living host to multiply and they are smaller than bacteria Diseases caused by viruses are the common cold HIV and chicken pox However there are certain diseases which can be caused by either bacteria or virus Example of such diseases is pneumonia meningitis and diarrhea Steckelberg J M 2017 Antibiotic resistance may occur with misuse of treating viral infections with antibiotics and vise a vis Identifying the right antimicrobial agent Arcangelo Peterson Wilbur Reinhold 2017 explain that epidemiology of the suspected infection laboratory studies which includes culture and sensitivity test of the most likely organism efficacy toxicity duration of therapy and cost are often used to determine what agent is considered for treatment Patient factors such as age weight diagnosis immune status current state of health site and severity of infection are also used to determine optimal dosage in treatment Arcangelo Peterson Wilbur Reinhold 2017
The gold standard towards accurate diagnosis is the ability to grow the suspected organism in culture and to perform the susceptibility test The culture and sensitivity C S result is often available in 48 to 72 hours after obtaining cultures however starting antibiotic therapy before the C S result is available is often required treatment is targeted at the most likely organism Arcangelo Peterson Wilbur Reinhold 2017 During treatment the caregiver continues to monitor for efficacy resistance and toxicity Presenting sign and symptoms of the infection should resolve with patient response to therapy Conclusion Health care providers prescribe antibiotics antifungal and antiviral to their patients at different occasion of need It is also important to understand antimicrobial stewardship and to identify situations when antimicrobial therapy is not needed Antimicrobial agents should be used in a responsible manner that benefits both the individual patient and the community Leekha Terrell Edson 2011 Early treatment of infection during its initial stage with an antimicrobial drug capable of targeting the suspected causative pathogen at an effective concentration is best At this time the numbers of invading microbes are negligible
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