Divided into bactericidal and bacteriostatic types.
Bactericidal antibiotics kill bacteria by mechanisms including: interference with cell wall, protein and nucleic acid synthesis.
Bacteriostatic antibiotic inhibit growth of bacteria through inhibition of DNA, RNA or proteins synthesis.
Interfere with cell wall synthesis, or inhibit protein synthesis, or interfere with nucleic acid synthesis, or inhibit a metabolic pathway, or increase cell wall permeability.
Most frequent indication is lower respiratory tract infections, including acute bronchitis, exacerbation of COPD, and bacterial community acquired pneumonia.
As many as 75% of patients with lower respiratory tract infections are treated with antibiotics, but the predominant origin of the infections are viral.
Inappropriate use of antibiotics increases antimicrobial resistance, waste resources, may have adverse effects, negatively affects the microbiome, and distracts from potentially more effective therapies.
Inappropriate antibiotic exposure may be linked to an increased risk of colon cancer by alterations in the microbiome.
Studies have shown an association between antibiotic use and an increased risk for colon cancer.
A Swedish population study from more than 40,000 colorectal cancer patients and 200,000 cancer-free control persons, found that moderate use of antibitotics increased the risk for proximal colon cancer by 9% and that very high antibiotic use increased the risk by 17%.
Procalcitonin levels utilized to reduce use of antibiotics in infections.
Using an algorithm with procalcitonin in patients with lower respiratory tract infections compared with standard guidelines was associated with lower rates of antibiotic exposure and antibiotic adverse effects, but similar rates of adverse outcomes (The ProHosp Randomized Controlled Trial).
Use of antibiotics that disturb gastrointestinal flora associated with diarrhea in as many as 30% of patients so treated.
Inappropriate use of antimicrobials undermines patient safety by increasing the risk of infection with resistant organisms, adverse drug offense and C. difficile infection.
Antibiotics are the most commonly prescribed drugs given to children.
Vast majority of antibioiotic use in children is in the outpatient setting, roughly 75% of which is for acute respiratory tract infections.
The American Academy of pediatrics recommends penicillin, or amoxicillin, as first-line agents for streptococcal pharyngitis, acute sinusitis, and pneumonia in children.
Approximately 50% of children however receive a broader spectrum antibiotics for these common infections then is necessary.
As many as 50% of antibiotic outpatient prescriptions may be unnecessary (Hicks LA ).
From 2010 to 2015, the global consumption of antibiotics increased by 65%.
Randomized clinical trial is confirm that delaying prescribing reduces antibiotic use compared to immediate prescribing and causes only minor reductions in patient satisfaction without increasing rates of complications or consultations.