Antibiotics

The impact of infectious diseases remains a significant burden of morbidity and mortality in developed and developing countries worldwide. Early in the history of human societies, the extreme burden of infectious diseases was related to ineffective treatments to eliminate or curtail pathogens in affected people. In the mid-1900s, Alexander Fleming discovered—by accident—strains of Penicillium fungus that inhibited the growth of bacteria, changing medical practice forever. He brought the principles to humanity for the development of chemicals (antibiotics) that were able to control (bacteriostatic) or to eliminate (bactericide) microbes.

Antibiotics are antimicrobial drugs that affect the growth of bacteria and other organisms by different cellular mechanisms at different structural components at a given moment and place or at different moments and places. Antibiotics can also be defined as “a substance produced by or a semisynthetic substance derived from a microorganism and able in dilute solution to inhibit or kill another microorganism.”

Doctors depend on antibiotics to treat illnesses caused by bacteria. If there is any doubt whether the infection is bacterial or viral in origin, clinicians may be tempted to prescribe antibiotics just to be on the safe side, to eliminate the risk of a life-threatening bacterial infection. Treating viral illnesses or noninfective causes of inflammation with antibiotics is ineffective, however, and contributes to the development of antibiotic resistance, toxicity, [Page 25]and allergic reactions, leading to increasing medical costs. A major factor behind unnecessary use of antibiotics is, of course, incorrect diagnosis. For this reason, timely and accurate information on whether the infection is bacterial in origin is highly beneficial in the fight against antibiotic resistance.

Unnecessary prescription of antibiotics could also represent an environmental issue, particularly when used in animals, where significant quantities of antibiotics could enter the environment. This is an environmentally important aspect for global public health that should be considered in the new perspectives of a more ecologically green world in which such environmental threats should be significantly reduced or even eliminated.

Use of antibiotics, however, is currently very important because their availability for proper use is associated with a significant reduction of infections, particularly those caused by bacteria. This is also related to countries’ development. The majority of developed countries have undergone a prototypical epidemiologic and demographic transition. Host-infectious agent relations have evolved over centuries, but these transitions are largely attributed to a decrease in the burden and mortality from infectious diseases. As a result, life expectancy has radically changed over the past century, with a significant increase in longevity. Although we welcome these improvements in health status, we never imagined that prolongation of life due to fewer infectious diseases would have disadvantages in future generations. It has become evident that inflammatory disorders, including both autoimmune and allergic diseases, have increased in prevalence to epidemic proportions, particularly in more affluent, industrialized countries, over the past 40 years. At the same time, the rate of allergic diseases in the developing world has not changed over the same period of time. There is current scientific evidence that this tendency can be partially explained by the significant decreased incidence of infectious diseases.

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