Immunisation is the best way to ensure that your child is safe from diseases - it is a way to protect your child from serious illnesses. Immunisation can be done through vaccines either in form of injections or administered orally. Here is what you need to know about the inoculation schedule for your child.
1. Bacillus Calmette-Guerin Vaccine (BCG): It is to be given at birth and protects against tuberculosis.
2. Oral Polio Vaccine(OPV): It is to be given at birth, at the age of 6 weeks, at 10 weeks, at 14 weeks, between 15 to 18 months and at 5 years. It protects against polio.
3. Injectable Polio Vaccine (IPV): It is to be given at age of 6 weeks, at 10 weeks, at 14 weeks and between 15-18 months. It requires a total of four doses only and it protects from Polio.
4. Diphtheria, Pertussis and Tetanus vaccine (DPT): It is to be given at age of 6 weeks, at 10 weeks, at 14 weeks, between 16-24 months and at 5 years. It protects against diphtheria, pertussis and tetanus. It may cause fever, pain and swelling at site and in rare cases irritability and convulsions.
5. Hemophilus Influenza B Vaccine (Hib): It is to be given at the age of 6 weeks, at 10 weeks, at 14 weeks and between 15-18 months. It protects against meningitis, pneumania and septicaemia caused by the bacteria Hemophilus influenza B. It may cause slight pain and fever upon administration.
6. Hepatitis B Vaccine (Hep B): It can be given in any one out of the three schedules- at 6, 10 and 14 weeks of age / at birth, 6 and 14 weeks of age/ at birth, 1 and 6 months of age. It protects against liver disease and liver cancer caused by Hepatitis B virus. It sometimes causes mild fever or pain upon administration.
7. Measles Vaccine: It is given at the age of 9 months. It protects against measles. It may cause mild fever and rash may appear after one week, but will be cured by itself.
8. Measles, Mumps and Rubella Vaccine (MMR): It is to be given at ageof 15 months. A second dose can be given at 5 years of age.It protects against measles, mumps and rubella. It may cause mild fever and rash may appear after one week, but will be cured by itself.
9. Typhoid Vaccine: It is to be given at age of 2 plus and repeated after every 3 years. It protects against Typhoid. It may cause mild fever upon administration.
10. Tetanus reduced dose diptheria (dT) / Tetanus toxoid (TT) Vaccine: It is to be given at age of 10 and 16 years. It protects against diphteria and tetanus. It may cause mild pain and fever.
Special Vaccines:
1. Chickenpox Vaccine: It is to be given at age of 1 year. This vaccine protects against chickenpox. It may cause mild rash and fever.
2. Pneumococcal Vaccine: It is to be given at age of 2, 4 and 6 months and 15-18 months. It protects against meningitis, pneumania and septicaemia caused by Streptococcus pneumoniae. It may cause pain, redness and fever upon administration.
3. Hepatitis A Vaccine: It is to be given in two doses 6 months apart, with the first dose given at the age of 18 months. It protects against Hepatitis A virus which can cause acute jaundice.
4. Rotavirus Vaccine: It is to be given in 2-3 doses at 4-8 weeks interval, starting before 6 weeks of age. It protects against diarrhoea caused by Rotavirus. It may cause some stomach discomfort upon administration.
Other special vaccines include influenza vaccine, Human Papilloma Virus (HPV) vaccine, Japanese B encephalitis, Pneumoccocal 23 valent and Rabies vaccines which can be given after consultation with your Paediatrician.
Saturday, February 20, 2010
Friday, February 19, 2010
Healing With YOGA....
Yoga is well known as a stress reducer, especially when combined with meditation and pranayama. Recent studies now show that Yoga can help in treating and preventing a number of ailments, ranging from back pain to Diabetes. Taking a single Yoga class can help you lower levels of cortisol, a stress hormone.
The six well known benefits of Yoga include:
1.Heart health: Heart disease patients who did Yoga for six weeks showed significant increase in artery, resulting in lower blood pressure and increased heart output.
2.Chronic back pain: Chronic lower-back sufferers experienced less pain after practising Yoga twice a week for six months.
3. Asthma and other pulmonary disorders: Practising Yoga for 2-3 hours a week, for ten weeks, helps in reduced symptoms of asthma and other chronic pulmonary disorders.
4. Binge eating: Binge eaters who participated in 10-week Yoga therapy programme showed significant reduction of bingeing episode per month and were also able to manage stress more effectively.
5. Migraine and other headaches: Practising Yoga daily for about four months leads to significant reduction in incidences of headaches due to migraine and tension.
6. Metabolic disorders: People at high risk of developing diabetes, can lower their risk factor for the disease after doing Yoga for three months.
The six well known benefits of Yoga include:
1.Heart health: Heart disease patients who did Yoga for six weeks showed significant increase in artery, resulting in lower blood pressure and increased heart output.
2.Chronic back pain: Chronic lower-back sufferers experienced less pain after practising Yoga twice a week for six months.
3. Asthma and other pulmonary disorders: Practising Yoga for 2-3 hours a week, for ten weeks, helps in reduced symptoms of asthma and other chronic pulmonary disorders.
4. Binge eating: Binge eaters who participated in 10-week Yoga therapy programme showed significant reduction of bingeing episode per month and were also able to manage stress more effectively.
5. Migraine and other headaches: Practising Yoga daily for about four months leads to significant reduction in incidences of headaches due to migraine and tension.
6. Metabolic disorders: People at high risk of developing diabetes, can lower their risk factor for the disease after doing Yoga for three months.
Friday, February 12, 2010
Vital Nutrients For Menopause.
A well balanced diet is important for every individual to maintain good health.But it does happen that a particular stage in life, needs some extra care so as to prevent health problems later. One such stage especially in woman is menopause.
Certain nurients play a very vital role during menopause and their absence or decreased levels in the body can cause some ill effects. Such nutrients include CALCIUM, MAGNESIUM, VITAMIN E, VITAMIN D and PHYTOESTROGENS.
CALCIUM: A healthy premenopausal woman should have about 1,000 mgs of calcium per day. A balanced amount of calcium in the body prevents the development of osteoporosis. Foods high in calcium include milk, yogurt, cheese and other dairy products; oysters, sardines and canned salmon with bones; and dark-green leafy vegetables like spinach and broccoli.
MAGNESIUM: Helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong. Besides this magnesium along with calcium work hand in hand together to maintain bone density which helps to prevent osteoporosis. It is found in wholegrains, milk and milk products, tofu, nuts seeds and legumes, green leafy vegetables like spinach.
VITAMIN D: Vitamin D is also very important for calcium absorption and bone formation. A 1992 study showed that women with postmenopausal osteoporosis who took vitamin D for 3 years significantly reduced the occurrence of new spinal fractures.
This absorption process is done by the skin when it is exposed to sun.
The dietary sources of this vitamin include fortified milk and margarine, eggs and fish oils. High doses of vitamin D can cause kidney stones, constipation, or abdominal pain, particularly in women with existing kidney problems.
VITAMIN E: Considered useful in alleviating hotflushes and thought to offer some heart protection. Although some foods, such as nuts and seeds, egg yolk and wheat germ contain Vitamin E, one need to take a supplement to get the therapeutic dose(400IU twice daily).
PHYTOESTROGENS: These are a group of compounds found in plants, structurally and functionally similar to steroidal estrogens produced by the body. They play a similar role like that of estrogen in the body especially when the is deficiency of this particular hormone. This helps to allevaite the menopausal symptoms and also helps in absorption of calcium in the body. It also protects against heart disease which is very common in women afer menopause.
Foods rich in phytoestrogens include soy foods, flaxseeds, chickpeas and other legumes.
NOTE:The above advice should be followed under strict medical supervision.
Certain nurients play a very vital role during menopause and their absence or decreased levels in the body can cause some ill effects. Such nutrients include CALCIUM, MAGNESIUM, VITAMIN E, VITAMIN D and PHYTOESTROGENS.
CALCIUM: A healthy premenopausal woman should have about 1,000 mgs of calcium per day. A balanced amount of calcium in the body prevents the development of osteoporosis. Foods high in calcium include milk, yogurt, cheese and other dairy products; oysters, sardines and canned salmon with bones; and dark-green leafy vegetables like spinach and broccoli.
MAGNESIUM: Helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong. Besides this magnesium along with calcium work hand in hand together to maintain bone density which helps to prevent osteoporosis. It is found in wholegrains, milk and milk products, tofu, nuts seeds and legumes, green leafy vegetables like spinach.
VITAMIN D: Vitamin D is also very important for calcium absorption and bone formation. A 1992 study showed that women with postmenopausal osteoporosis who took vitamin D for 3 years significantly reduced the occurrence of new spinal fractures.
This absorption process is done by the skin when it is exposed to sun.
The dietary sources of this vitamin include fortified milk and margarine, eggs and fish oils. High doses of vitamin D can cause kidney stones, constipation, or abdominal pain, particularly in women with existing kidney problems.
VITAMIN E: Considered useful in alleviating hotflushes and thought to offer some heart protection. Although some foods, such as nuts and seeds, egg yolk and wheat germ contain Vitamin E, one need to take a supplement to get the therapeutic dose(400IU twice daily).
PHYTOESTROGENS: These are a group of compounds found in plants, structurally and functionally similar to steroidal estrogens produced by the body. They play a similar role like that of estrogen in the body especially when the is deficiency of this particular hormone. This helps to allevaite the menopausal symptoms and also helps in absorption of calcium in the body. It also protects against heart disease which is very common in women afer menopause.
Foods rich in phytoestrogens include soy foods, flaxseeds, chickpeas and other legumes.
NOTE:The above advice should be followed under strict medical supervision.
Thursday, February 4, 2010
'Doctors have shorter lifespan than patients'- Stress, poor diet, sedentary lifestyle are taking a toll.
The men and women who help us stay fit and live longer are themselves succumbing to stress, sedentary lifestyles and dying of cardiac arrests.
An observation by the Indian Medical Association's (IMA) Pune chapter says that an Indian doctor's average lifespan is 55-59 years, almost 10 years lesser than that of the general population.
It was based on the analysis of the association's social security scheme (SSS) with 5,500 doctors from Maharashtra, India and over 11,000 from across the country registered.
IMA Pune chapter's president Dr Dilip Sarda told DNA that their data of the last five years indicated that doctors' lifespan was pointing to an alarming trend. "An average Indian lives up to 69-72 years whereas a doctor lives only up to 55 to 59 years which is shocking. It was noticed that most early deaths were due to cardiac arrest," he said.
According to Dr Sarda, every year, 12 to 15 doctors in Maharashtra and around 30 doctors across the country lose their lives in this age-group. Stress, sedentary lifestyle and lack of exercise were the causes of early death, he said.
"They are becoming obese, stressed, hypertensive, diabetic or are undergoing angioplasty which reduces their chances of living longer and staying fit," he said.
Dr Sarda said the doctors themselves were responsible for their poor lifestyle, lack of exercise, stressful careers and an improper diet regime.
This was taking a toll of their health which has affected life expectancy to a great extent, the doctor said.
An observation by the Indian Medical Association's (IMA) Pune chapter says that an Indian doctor's average lifespan is 55-59 years, almost 10 years lesser than that of the general population.
It was based on the analysis of the association's social security scheme (SSS) with 5,500 doctors from Maharashtra, India and over 11,000 from across the country registered.
IMA Pune chapter's president Dr Dilip Sarda told DNA that their data of the last five years indicated that doctors' lifespan was pointing to an alarming trend. "An average Indian lives up to 69-72 years whereas a doctor lives only up to 55 to 59 years which is shocking. It was noticed that most early deaths were due to cardiac arrest," he said.
According to Dr Sarda, every year, 12 to 15 doctors in Maharashtra and around 30 doctors across the country lose their lives in this age-group. Stress, sedentary lifestyle and lack of exercise were the causes of early death, he said.
"They are becoming obese, stressed, hypertensive, diabetic or are undergoing angioplasty which reduces their chances of living longer and staying fit," he said.
Dr Sarda said the doctors themselves were responsible for their poor lifestyle, lack of exercise, stressful careers and an improper diet regime.
This was taking a toll of their health which has affected life expectancy to a great extent, the doctor said.
Friday, January 1, 2010
Ayurvedic approach to treat Gallstones!!!!
The gall bladder stores bile, a digestive fluid that the liver produces, until the fluid is required to help digest dietary fats in the small intestine. Normally, the acidic bile prevents cholesterol from becoming too concentrated. However, if too much cholesterol is present in the bile,it crystallizes in the gall bladder, forming gallstones. Gallstones that remain in the gall bladder typically produce no symptoms.Gallstones usually begin producing symptoms when they obstruct the duct that leads from the liver to the gall bladder or the duct that leads from the gallbladder to the small intestine. Once lodged in one of these ducts, the stones may produce painful spasms and inflammation at the site of the obstruction. To read more about Ayurvedic treatment for Gallstones, please check this article.
Thursday, December 24, 2009
Weight Loss - Myths and Facts!!!!
It is very important to remember there are no magic pills that can melt your fat, overnight. Neither is sudden weight loss caused by excessive dieting, healthy. Healthy weight loss requires dedicated and sustained efforts over a considerable span of time. Here are five factors that are very crucial for successfully losing and controlling weight over a long period of time. Click here for detailed article.
Friday, September 25, 2009
Antibiotics in nutshell!!!
An antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics can be broadly classified as either bactericidal or bacteriostatic. Bactericidals kill bacteria directly where bacteriostatics prevent cell division. Antibiotics which target the bacterial cell wall (penicillins, cephalosporins), or cell membrane (polymixins), or interfere with essential bacterial enzymes (quinolones, fluroquinolone) usually are bactericidal in nature. Those which target protein synthesis, such as the aminoglycosides, macrolides and tetracyclines, are usually bacteriostatic. Anti-bacterial antibiotics can be also categorized based on their target specificity: "narrow-spectrum" antibiotics target particular types of bacteria, such as Gram-negative or Gram-positive bacteria, while broad-spectrum antibiotics affect a wide range of bacteria.
Gram-positive bacteria: Gram-positive bacteria are characterized by having as part of their cell wall structure, peptidoglycan as well as polysaccharides and/or teichoic acids. Examples of Gram-positive bacteria include Staphylococcus, Streptococcus, Enterococcus, (which are cocci), and Bacillus, Corynebacterium, Nocardia, Clostridium, Actinobacteria, and Listeria (which are rods). Gram-positive can cause a wide variety of diseases in humans such as food poisoning, wound infection, Urinary tract infections, besides Pneumonia, Meningitis, Osteomyelitis, Endocarditis, Toxic shock syndrome (TSS), Diverticulitis, Septicemia, etc.
Gram-negative bacteria: The cell envelope of Gram-negative Bacteria contains an additional outer membrane composed by phospholipids and lipopolysaccharides which face the external environment. The highly charged nature of lipopolysaccharides confers an overall negative charge to the Gram negative cell wall. Examples of Gram-negative bacteria include Escherichia coli, Salmonella, Shigella, and other Enterobacteriaceae, Pseudomonas, Moraxella, Helicobacter, Neisseria, Klebsiella, Hemophilus, Legionella, etc. The diseases caused by Gram-negative bacteria include Diarrhea, Gastroenteritis, Peritonitis, Septicemia, Pneumonia, Neonatal meningitis, Urinary tract infection, Typhoid fever, food poisoning, Ulcer, Upper and lower respiratory tract infection, burn and wound infection, Otitis media, Meningitis, Sexually transmitted disease like Gonorrhoea and other infections of genital system, etc. Treponema pallidum, which causes Syphilis, a sexually transmitted disease, is classified as Spirochaetes, which belong to a phylum of distinctive Gram-negative bacteria, which have long, helically coiled (spiral-shaped) cells. Other members of this phylum include Leptospira species, which causes Leptospirosis and Borrelia recurrentis, which causes Relapsing fever.
Certain bacteria like Mycobacterium tuberculosis, which cause Tuberculosis (TB) and Mycobacterium leprae, which cause Leprosy, can neither be classified as Gram-positive or Gram-negative. They are classed as Aerobic bacteria as they require high levels of oxygen to grow.
Anaerobic bacteria are bacteria that do not live or grow in the presence of oxygen. The main Anaerobic Gram-positive cocci that produce disease are the peptococci and the peptostreptococci. Clostridium belongs to Gram-positive anaerobic bacteria. The four main spieces of Clostridium known to cause diseases in humans include, C. botulinum-which causes botulism, C. difficile-which causes colitis, C. perfringens-which causes gas gangrene and C.tetani-which causes Tetanus. Anaerobic gram-negative bacilli include Bacteroides fragilis, Prevotella melaninogenica, and Fusobacterium species. Anaerobic bacteria can be the major cause of infection in the pleural spaces and lungs; in Intra-abdominal, Gynecologic, CNS, Upper respiratory tract, and cutaneous diseases; and in Bacteremia. Usually the Anaerobic bacteria are accompanied by Aerobes, and the resulting infection is known as 'Mixed anaerobic infection'. Anaerobic infections can be identified by foul smelling pus at the site of infection, especially in case of infected wounds.
Classification of antibiotics
Penicillins
The penicillins are the oldest classes of antibiotics.Penicillins are generally bactericidal, inhibiting formation of the cell wall. Penicillins are used to treat skin infections, Dental infections, Ear infections, Respiratory tract infections, Urinary tract infections, Gonorrhea, etc.
The types of Penicillins include:
The natural penicillins, which are based on the original penicillin-G structure. Penicillin-G types are effective against gram-positive strains of streptococci, staphylococci, and some gram-negative bacteria such as Meningococcus.
Penicillinase-resistant penicillins, notably Methicillin and Oxacillin, are active even in the presence of the bacterial enzyme that inactivates most natural penicillins. Extended spectrum Penicillins are effective against a wider range of bacteria.
Cephalosporins
Cephalosporins have a mechanism of action identical to that of the penicillins. However, the basic chemical structure of the penicillins and cephalosporins differs in other respects, resulting in some difference in the spectrum of antibacterial activity. Cephalosporins are used to treat Pneumonia, Respiratory tract infections like strep throat, Tonsillitis, Bronchitis; Staph infections, Otitis media, various types of skin infections, Gonorrhea, Urinary tract infections. Cephalosporin antibiotics are also commonly used for surgical prophylaxis. They can also be used to treat Bone infections.
Cephalosporins are grouped into "generations" by their antimicrobial properties. Each newer generation has a broader spectrum of activity than the one before.
The first generation Cephalosporins: They possess generally excellent coverage against most Gram-positive pathogens and variable to poor coverage against most Gram negative pathogens. The first generation Cephalosporins include, Cefazolin, Cephalexin, Cefadroxil.
The second generation Cephalosporins: In addition to the Gram positive spectrum of the first generation Cephalosporins, these agents have expanded Gram negative spectrum. The second generation Cephalosporins include: Cefaclor, Ceforanide, Cefuroxime.
The third generation Cephalosporins: They have much expanded Gram negative activity. However, some members of this group have decreased activity against Gram-positive organisms.They include, Cefixime, Cefodizime, Cefoperazone, Cefotaxime, Cefpodoxime, Ceftriaxone.
The fourth generation Cephalosporins are extended-spectrum agents with similar activity against Gram-positive organisms as first-generation Cephalosporins. They also have a greater resistance to Beta-lactamases than the third generation Cephalosporins. Many fourth generation Cephalosporins can cross blood brain barrier and are effective in Meningitis. The fourth generation Cephalosporins include, Cefclidine, Cefepime, Cefluprenam, Cefozopran.
Fluroquinolones
Fluoroquinolones (fluoridated quinolones) are the newest class of antibiotics. Their generic name often contains the root "floxacin". They are synthetic antibiotics, and not derived from bacteria. Fluoroquinolones belong to the family of antibiotics called Quinolones. The older Quinolones are not well absorbed and are used to treat mostly urinary tract infections. The newer Fluroquinolones are broad-spectrum bacteriocidal drugs and because of their excellent absorption Fluroquinolones can be administered not only intravenously but orally as well. Fluoroquinolones are used to treat most common Urinary tract infections, Skin infections, and Respiratory infections (such as Sinusitis, Pneumonia, and Bronchitis). Commonly used Fluoroquinolones include Ciprofloxacin, Norfloxacin, Gatifloxacin, Ofloxacin.
Tetracyclines
Tetracyclines got their name because they share a chemical structure that has four rings. They are derived from a species of Streptomyces bacteria. Tetracycline antibiotics are broad-spectrum bacteriostatic agents that inhibit bacterial protein synthesis. Tetracyclines may be effective against a wide variety of microorganisms, including Rickettsia and Amebic parasites. Tetracyclines are used in the treatment of infections of the Respiratory tract, Sinuses, Middle ear, Urinary tract, Skin, Intestines. Tetracyclines also are used to treat Gonorrhoea, Typhus. Their most common current use is in the treatment of moderately severe Acne and Rosacea. The most commonly prescribed Tetracycline antibiotics are, Tetracycline, Doxycycline, Oxytetracycline.
Macrolides
The Macrolide antibiotics are derived from Streptomyces bacteria. The Macrolides are bacteriostatic, binding with bacterial ribosomes to inhibit protein synthesis. Macrolide antibiotics are used to treat Respiratory tract infections (such as Pharyngitis, Sinusitis, and Bronchitis), Genital, Gastrointestinal tract, and Skin infections. The most commonly prescribed Macrolide antibiotics include Erythromycin, Clarithromycin, Azithromycin, and Roxithromycin.
Aminoglycosides
Aminoglycoside antibiotics are used to treat infections caused by Gram-negative bacteria. Aminoglycosides may be used along with Penicillins or Cephalosporins to give a two-pronged attack on the bacteria. Aminoglycosides work quite well, but bacteria can become resistant to them. Since aminoglycosides are broken down easily in the stomach, they can't be given by mouth and must be injected. The most commonly-prescribed aminoglycoside include, Streptomycin, Amikacin, Gentamicin, Neomycin, Tobramycin.
Sulfonamides
They are competitive inhibitors of Folate synthesis. Folate is necessary for the cell to synthesize nucleic acids, and in its absence, cells of the bacteria will be unable to divide. They are used mostly to treat Urinary tract infection and include, Sulfamethizole, Trimethoprim, Trimethoprim-Sulfamethoxazole.
Carbapenems
Carbapenems have bactericidal activity against both Gram-positive and Gram-negative organisms and therefore useful for broad-spectrum antibacterial coverage. These include, Ertapenem, Doripenem, Imipenem, Meropenem.
Polypeptides
They are used to treat eye, ear, skin or bladder infections; usually applied directly to the eye/skin or inhaled into the lungs. These include Bacitracin, Polymyxin B.
Nitro-imidazole antibiotic
Nitro-imidazole antibiotics have a limited spectrum of activity that encompasses various protozoans and most Gram-negative and Gram-positive anaerobic bacteria. It has activity against protozoans like Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. the most commonly prescribed Nitro-imidazole includes Metronidazole, besides Tinidazole and Ornidazole.
Metronidazole is indicated for the treatment of the following infections due to susceptible strains of sensitive organisms such as, Trichomoniasis, acute intestinal Amebiasis (amebic dysentery) and Amebic liver abscess, Anaerobic Bacterial Infections like Intra-abdominal infections, including peritonitis, intra-abdominal abscess, and liver abscess, Skin and skin structure infections, Gynecologic infections, Bacterial Septicemia, Bone and joint infections, as adjunctive therapy, Central Nervous System infections, including Meningitis and brain abscess, Lower Respiratory Tract infections, including Pneumonia, Empyema, and lung abscess, Endocarditis.
Others
Others include antituberculosis antibiotics like Ethambutol, Isoniazid, Rifampicin, Pyrazinamide. Chloramphenicol is used for treating various Gram-positive, Gram-negative and Anaerobic infections, besides Meningitis, MRSA and Cholera. Clindamycin and Lincomycin are used specially for treating Acne infections.
Side effects of antibiotics
Although antibiotics are generally considered safe and well tolerated, they have been associated with a wide range of adverse effects. Side effects may vary and can be very serious depending on the antibiotics used and the microbial organisms targeted. Side effects can range from fever and nausea to major allergic reactions. One of the more common side effects is diarrhea, sometimes caused by the anaerobic bacterium Clostridium difficile, which results from the antibiotic disrupting the normal balance of the intestinal flora, such overgrowth of pathogenic bacteria may be alleviated by ingesting probiotics during a course of antibiotics.
Alcohol and antibiotics
Alcohol can interfere with the activity or metabolization of antibiotics. It may affect the activity of liver enzymes, which break down the antibiotics. Moreover, certain antibiotics, including metronidazole, tinidazole, co-trimoxazole, cefoperazone, amoxicillin, cefmenoxime, and furazolidone, chemically react with alcohol, leading to serious side effects.
Resistance to antibiotics
The emergence of antibiotic resistance is an evolutionary process that is based on selection for organisms that have enhanced ability to survive doses of antibiotics that would have previously been lethal. Antibiotics like Penicillin and Erythromycin which used to be one-time miracle cures are now less effective because bacteria have become more resistant. Inappropriate antibiotic treatment and overuse of antibiotics have been a contributing factor to the emergence of resistant bacteria. One solution to combat resistance currently being researched is the development of pharmaceutical compounds that would revert multiple antibiotic resistances. These compounds include among others, Efflux inhibitors and Beta Lactamase inhibitors - Including Clavulanic acid and Sulbactam.
Latest development in antibiotics
In the last few years three new classes of antibiotics have been brought into clinical use. These new antibiotics are of the following three classes: cyclic lipopeptides (daptomycin), glycylcyclines (tigecycline), and oxazolidinones (linezolid). Tigecycline is a broad-spectrum antibiotic, while the two others are used for Gram-positive infections. These developments show promise as a means to counteract the bacterial resistance to existing antibiotics.
Gram-positive bacteria: Gram-positive bacteria are characterized by having as part of their cell wall structure, peptidoglycan as well as polysaccharides and/or teichoic acids. Examples of Gram-positive bacteria include Staphylococcus, Streptococcus, Enterococcus, (which are cocci), and Bacillus, Corynebacterium, Nocardia, Clostridium, Actinobacteria, and Listeria (which are rods). Gram-positive can cause a wide variety of diseases in humans such as food poisoning, wound infection, Urinary tract infections, besides Pneumonia, Meningitis, Osteomyelitis, Endocarditis, Toxic shock syndrome (TSS), Diverticulitis, Septicemia, etc.
Gram-negative bacteria: The cell envelope of Gram-negative Bacteria contains an additional outer membrane composed by phospholipids and lipopolysaccharides which face the external environment. The highly charged nature of lipopolysaccharides confers an overall negative charge to the Gram negative cell wall. Examples of Gram-negative bacteria include Escherichia coli, Salmonella, Shigella, and other Enterobacteriaceae, Pseudomonas, Moraxella, Helicobacter, Neisseria, Klebsiella, Hemophilus, Legionella, etc. The diseases caused by Gram-negative bacteria include Diarrhea, Gastroenteritis, Peritonitis, Septicemia, Pneumonia, Neonatal meningitis, Urinary tract infection, Typhoid fever, food poisoning, Ulcer, Upper and lower respiratory tract infection, burn and wound infection, Otitis media, Meningitis, Sexually transmitted disease like Gonorrhoea and other infections of genital system, etc. Treponema pallidum, which causes Syphilis, a sexually transmitted disease, is classified as Spirochaetes, which belong to a phylum of distinctive Gram-negative bacteria, which have long, helically coiled (spiral-shaped) cells. Other members of this phylum include Leptospira species, which causes Leptospirosis and Borrelia recurrentis, which causes Relapsing fever.
Certain bacteria like Mycobacterium tuberculosis, which cause Tuberculosis (TB) and Mycobacterium leprae, which cause Leprosy, can neither be classified as Gram-positive or Gram-negative. They are classed as Aerobic bacteria as they require high levels of oxygen to grow.
Anaerobic bacteria are bacteria that do not live or grow in the presence of oxygen. The main Anaerobic Gram-positive cocci that produce disease are the peptococci and the peptostreptococci. Clostridium belongs to Gram-positive anaerobic bacteria. The four main spieces of Clostridium known to cause diseases in humans include, C. botulinum-which causes botulism, C. difficile-which causes colitis, C. perfringens-which causes gas gangrene and C.tetani-which causes Tetanus. Anaerobic gram-negative bacilli include Bacteroides fragilis, Prevotella melaninogenica, and Fusobacterium species. Anaerobic bacteria can be the major cause of infection in the pleural spaces and lungs; in Intra-abdominal, Gynecologic, CNS, Upper respiratory tract, and cutaneous diseases; and in Bacteremia. Usually the Anaerobic bacteria are accompanied by Aerobes, and the resulting infection is known as 'Mixed anaerobic infection'. Anaerobic infections can be identified by foul smelling pus at the site of infection, especially in case of infected wounds.
Classification of antibiotics
Penicillins
The penicillins are the oldest classes of antibiotics.Penicillins are generally bactericidal, inhibiting formation of the cell wall. Penicillins are used to treat skin infections, Dental infections, Ear infections, Respiratory tract infections, Urinary tract infections, Gonorrhea, etc.
The types of Penicillins include:
The natural penicillins, which are based on the original penicillin-G structure. Penicillin-G types are effective against gram-positive strains of streptococci, staphylococci, and some gram-negative bacteria such as Meningococcus.
Penicillinase-resistant penicillins, notably Methicillin and Oxacillin, are active even in the presence of the bacterial enzyme that inactivates most natural penicillins. Extended spectrum Penicillins are effective against a wider range of bacteria.
Cephalosporins
Cephalosporins have a mechanism of action identical to that of the penicillins. However, the basic chemical structure of the penicillins and cephalosporins differs in other respects, resulting in some difference in the spectrum of antibacterial activity. Cephalosporins are used to treat Pneumonia, Respiratory tract infections like strep throat, Tonsillitis, Bronchitis; Staph infections, Otitis media, various types of skin infections, Gonorrhea, Urinary tract infections. Cephalosporin antibiotics are also commonly used for surgical prophylaxis. They can also be used to treat Bone infections.
Cephalosporins are grouped into "generations" by their antimicrobial properties. Each newer generation has a broader spectrum of activity than the one before.
The first generation Cephalosporins: They possess generally excellent coverage against most Gram-positive pathogens and variable to poor coverage against most Gram negative pathogens. The first generation Cephalosporins include, Cefazolin, Cephalexin, Cefadroxil.
The second generation Cephalosporins: In addition to the Gram positive spectrum of the first generation Cephalosporins, these agents have expanded Gram negative spectrum. The second generation Cephalosporins include: Cefaclor, Ceforanide, Cefuroxime.
The third generation Cephalosporins: They have much expanded Gram negative activity. However, some members of this group have decreased activity against Gram-positive organisms.They include, Cefixime, Cefodizime, Cefoperazone, Cefotaxime, Cefpodoxime, Ceftriaxone.
The fourth generation Cephalosporins are extended-spectrum agents with similar activity against Gram-positive organisms as first-generation Cephalosporins. They also have a greater resistance to Beta-lactamases than the third generation Cephalosporins. Many fourth generation Cephalosporins can cross blood brain barrier and are effective in Meningitis. The fourth generation Cephalosporins include, Cefclidine, Cefepime, Cefluprenam, Cefozopran.
Fluroquinolones
Fluoroquinolones (fluoridated quinolones) are the newest class of antibiotics. Their generic name often contains the root "floxacin". They are synthetic antibiotics, and not derived from bacteria. Fluoroquinolones belong to the family of antibiotics called Quinolones. The older Quinolones are not well absorbed and are used to treat mostly urinary tract infections. The newer Fluroquinolones are broad-spectrum bacteriocidal drugs and because of their excellent absorption Fluroquinolones can be administered not only intravenously but orally as well. Fluoroquinolones are used to treat most common Urinary tract infections, Skin infections, and Respiratory infections (such as Sinusitis, Pneumonia, and Bronchitis). Commonly used Fluoroquinolones include Ciprofloxacin, Norfloxacin, Gatifloxacin, Ofloxacin.
Tetracyclines
Tetracyclines got their name because they share a chemical structure that has four rings. They are derived from a species of Streptomyces bacteria. Tetracycline antibiotics are broad-spectrum bacteriostatic agents that inhibit bacterial protein synthesis. Tetracyclines may be effective against a wide variety of microorganisms, including Rickettsia and Amebic parasites. Tetracyclines are used in the treatment of infections of the Respiratory tract, Sinuses, Middle ear, Urinary tract, Skin, Intestines. Tetracyclines also are used to treat Gonorrhoea, Typhus. Their most common current use is in the treatment of moderately severe Acne and Rosacea. The most commonly prescribed Tetracycline antibiotics are, Tetracycline, Doxycycline, Oxytetracycline.
Macrolides
The Macrolide antibiotics are derived from Streptomyces bacteria. The Macrolides are bacteriostatic, binding with bacterial ribosomes to inhibit protein synthesis. Macrolide antibiotics are used to treat Respiratory tract infections (such as Pharyngitis, Sinusitis, and Bronchitis), Genital, Gastrointestinal tract, and Skin infections. The most commonly prescribed Macrolide antibiotics include Erythromycin, Clarithromycin, Azithromycin, and Roxithromycin.
Aminoglycosides
Aminoglycoside antibiotics are used to treat infections caused by Gram-negative bacteria. Aminoglycosides may be used along with Penicillins or Cephalosporins to give a two-pronged attack on the bacteria. Aminoglycosides work quite well, but bacteria can become resistant to them. Since aminoglycosides are broken down easily in the stomach, they can't be given by mouth and must be injected. The most commonly-prescribed aminoglycoside include, Streptomycin, Amikacin, Gentamicin, Neomycin, Tobramycin.
Sulfonamides
They are competitive inhibitors of Folate synthesis. Folate is necessary for the cell to synthesize nucleic acids, and in its absence, cells of the bacteria will be unable to divide. They are used mostly to treat Urinary tract infection and include, Sulfamethizole, Trimethoprim, Trimethoprim-Sulfamethoxazole.
Carbapenems
Carbapenems have bactericidal activity against both Gram-positive and Gram-negative organisms and therefore useful for broad-spectrum antibacterial coverage. These include, Ertapenem, Doripenem, Imipenem, Meropenem.
Polypeptides
They are used to treat eye, ear, skin or bladder infections; usually applied directly to the eye/skin or inhaled into the lungs. These include Bacitracin, Polymyxin B.
Nitro-imidazole antibiotic
Nitro-imidazole antibiotics have a limited spectrum of activity that encompasses various protozoans and most Gram-negative and Gram-positive anaerobic bacteria. It has activity against protozoans like Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. the most commonly prescribed Nitro-imidazole includes Metronidazole, besides Tinidazole and Ornidazole.
Metronidazole is indicated for the treatment of the following infections due to susceptible strains of sensitive organisms such as, Trichomoniasis, acute intestinal Amebiasis (amebic dysentery) and Amebic liver abscess, Anaerobic Bacterial Infections like Intra-abdominal infections, including peritonitis, intra-abdominal abscess, and liver abscess, Skin and skin structure infections, Gynecologic infections, Bacterial Septicemia, Bone and joint infections, as adjunctive therapy, Central Nervous System infections, including Meningitis and brain abscess, Lower Respiratory Tract infections, including Pneumonia, Empyema, and lung abscess, Endocarditis.
Others
Others include antituberculosis antibiotics like Ethambutol, Isoniazid, Rifampicin, Pyrazinamide. Chloramphenicol is used for treating various Gram-positive, Gram-negative and Anaerobic infections, besides Meningitis, MRSA and Cholera. Clindamycin and Lincomycin are used specially for treating Acne infections.
Side effects of antibiotics
Although antibiotics are generally considered safe and well tolerated, they have been associated with a wide range of adverse effects. Side effects may vary and can be very serious depending on the antibiotics used and the microbial organisms targeted. Side effects can range from fever and nausea to major allergic reactions. One of the more common side effects is diarrhea, sometimes caused by the anaerobic bacterium Clostridium difficile, which results from the antibiotic disrupting the normal balance of the intestinal flora, such overgrowth of pathogenic bacteria may be alleviated by ingesting probiotics during a course of antibiotics.
Alcohol and antibiotics
Alcohol can interfere with the activity or metabolization of antibiotics. It may affect the activity of liver enzymes, which break down the antibiotics. Moreover, certain antibiotics, including metronidazole, tinidazole, co-trimoxazole, cefoperazone, amoxicillin, cefmenoxime, and furazolidone, chemically react with alcohol, leading to serious side effects.
Resistance to antibiotics
The emergence of antibiotic resistance is an evolutionary process that is based on selection for organisms that have enhanced ability to survive doses of antibiotics that would have previously been lethal. Antibiotics like Penicillin and Erythromycin which used to be one-time miracle cures are now less effective because bacteria have become more resistant. Inappropriate antibiotic treatment and overuse of antibiotics have been a contributing factor to the emergence of resistant bacteria. One solution to combat resistance currently being researched is the development of pharmaceutical compounds that would revert multiple antibiotic resistances. These compounds include among others, Efflux inhibitors and Beta Lactamase inhibitors - Including Clavulanic acid and Sulbactam.
Latest development in antibiotics
In the last few years three new classes of antibiotics have been brought into clinical use. These new antibiotics are of the following three classes: cyclic lipopeptides (daptomycin), glycylcyclines (tigecycline), and oxazolidinones (linezolid). Tigecycline is a broad-spectrum antibiotic, while the two others are used for Gram-positive infections. These developments show promise as a means to counteract the bacterial resistance to existing antibiotics.
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