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A
FAR.REACHING
DISCUSSION ONTHE
CLINICAL
USE OF
ANTIBIOTICS
Penicillins were the
first
etfective
antibiotics
-
they
kill
bacteria
(bactericidal)
rather than
just
keeping
them
at
bay.
As bacteria
acquired
enzymes,
e.9.,
beta-lactamase, to
inactivate them, newer
antibiotics
came, e.9., Cephalosporins
that
has a
"broad-spectrum"
of
bacterial coverage.
"Gram-positive" and "gram-negative"
refer
to whether gram stains are picked
up
for bacterial microscopy; some anti-
biotics kill "gram-positive", others,
the
"gram negative" bacteria. Serious infec-
tions demand antibiotic sensitivity tests
that
require
considerable time:
a
sample
ol the infective material
is
cultured; the
pure
strain of
bacteria so grown
is
tesled against several antibiotics
for
the
best killing effect. Most of
the
antibiotic
metabolites are excreted through the
kidneys and some, through
the
liver.
Thus, any functional
impairment
demands appropriate antibiotic dose
reduclion. Allergic or hypersensitivity
reactions are not
uncommon with
antibiotics, especially
the
penicillin
group. Hoigne syndrome
is
a "pseudo"
allergic
reaction following
procaine
penicillin administration. Amongst
the
adverse effects, some antibiotics
are
kidney
toxic and others, induce
nerve
deafness
or
cause blood cell depletion.
Any pregnancy should
be
reported
promptly
to the doctor
prescribing
antibiotics, as these may affect
the
fetus.
For long-term use, e.9., for bone
infections, narrow-spectrum antibiotics
avoid
killing of
the
normal gut bacteria
otherwise
diarrhea
results.
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