ANTIMICROBIAL AGENTS / ANTIBIOTICS

Ever since their discovery some decades ago, antimicrobial agents particularly antibiotics have saved mankind from the morbidity and mortality of innumerable infectious diseases and/or pathogenic agents even till date. Irrespective of the fact that pathogenic microorganisms have developed resistance genes or traits that allow them to dodge the antimicrobial onslaught of these agents or drugs, antimicrobial agents (inclusive of antibiotics) with their therapeutic prowess are still invaluable for the management and treatment of diseases caused by pathogenic organisms. Antimicrobial agents are natural or chemical agents that are used to either kill or inhibit the growth of pathogenic microorganisms. Antibiotics are substances produced by microorganisms and which have the ability to kill or inhibit the growth of other organisms.

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The phrase antimicrobial agents can be used interchangeably with antibiotics. While antimicrobial agents include antibiotics, antiseptics, preservatives, sterilants, disinfectants and gases such as ethylene oxide (Et2O) gas that kill or inhibit the growth of microbes; antibiotics are basically naturally or chemically synthesized substances that also kill or inhibit the growth of microbes. Antibiotics include antibacterial agents, antifungal agents, antiviral agents and anti-protozoal agents that specifically kill or inhibit the growth of bacteria, fungi, viruses and protozoa respectively. Antimicrobial agents have both a broader spectrum of activity and narrow spectrum of activity. They are chemical agents that are selectively toxic against pathogenic microorganisms but do not harmfully affect the recipient host cells. Antimicrobial agents can also be called chemotherapeutic agents which may include artificially synthesized drugs that are not naturally produced from microorganisms. Chemotherapeutic agents encompass antibiotics, antimicrobial agents and other drugs used for the treatment of microbial and non-microbial diseases such as cancer.

Chemotherapeutic agents are synthesized chemically from chemical compounds. Chemotherapy simply means the use of drugs to treat microbial diseases or infections. Most new antibiotics are biological products that are either chemically modified or chemically synthesized from their naturally-occurring derivatives. The phrase antimicrobial agents encompass antibacterial agents (which kill or inhibit the growth of bacteria), antifungal agents (which kill or inhibit fungi), antiviral agents (which inactivate viral agents) and antiprotozoal agents (which are used to treat diseases caused by protozoa). Antimicrobial agents also includes other physical or chemical agents such as antiseptics and disinfectants which are not orally or parenterally administered to a sick patient, but can be used to control the activities of pathogenic microorganisms on the body of living organisms as well as eliminate microbes from the environment. Several antimicrobial agents exist for the control of microbes in the environment and also for their removal from the body. However, only the various antimicrobial agents (particularly antibiotics, antiviral agents, antifungal agents and antiprotozoal agents) used in clinical medicine, their mechanism of action, clinical uses and side effects shall be highlighted in this book. While some antimicrobial agents (especially antibiotics) are naturally synthesized by some group of microorganisms, others are synthesized artificially in the laboratory as semi-synthetic or synthetic derivatives of the naturally-synthesized antibiotics.

The serendipitous discovery of penicillin (produced naturally by Penicillium notatum and P. chrysogenum), the first antibiotic by Alexander Fleming in 1929 ushered in the era of antimicrobial agents. This led to the discovery and development of several other drugs that is currently used to control the negative effects of pathogenic microorganisms in living systems and even in the environment. For example, sulpha drugs or sulphonamides (previously known as prontosil), which are synthetic drugs was discovered by Gerhard Domagk in the early 1930s. This also led to the discovery of several synthetic antimicrobial agents including some anti-tuberculosis drugs such as isoniazid. This made penicillin and sulphonamides to be the first antimicrobial agents to be used in clinical medicine to treat a variety of bacterial-related diseases and infections. Paul Ehrlich and colleagues had earlier synthesized Salvarsan (Arsphenamine) in 1910. Salvarsan had activity against syphilis (caused by Treponema pallidum), a sexually transmitted disease (STD). This discovery of Salvarsan by Ehrlich and colleagues coupled with Fleming’s discovery of penicillins as well as the discovery of sulphonamides by Domagk ushered in the era of chemotherapy in clinical medicine.

Though pathogenic microorganisms have become more innovative in evading the action of most antimicrobial agents (especially by developing resistance genes and antibiotic-hydrolyzing enzymes which allows them to remain active even in the face of antimicrobial onslaught), the available drugs used in clinical medicine today still remains the most powerful weapons available to mankind for the effective control and treatment of infectious diseases caused by microbes. The discovery of antimicrobial agents particularly antibiotics has greatly impacted and transformed the practice of medicine. The discovery of novel drugs (though slow when compared with the rate at which pathogens develop resistance to available drugs) has continued to alleviate the sufferings of man in terms of killing and/or inhibiting the growth of pathogenic microorganisms either in vitro or in vivo.

FURTHER READING

Ashutosh Kar (2008). Pharmaceutical Microbiology, 1st edition. New Age International Publishers: New Delhi, India. 

Block S.S (2001). Disinfection, sterilization and preservation. 5th edition. Lippincott Williams & Wilkins, Philadelphia and London.

Courvalin P, Leclercq R and Rice L.B (2010). Antibiogram. ESKA Publishing, ASM Press, Canada.

Denyer S.P., Hodges N.A and Gorman S.P (2004). Hugo & Russell’s Pharmaceutical Microbiology. 7th ed. Blackwell Publishing Company, USA. Pp.152-172.

Ejikeugwu Chika, Iroha Ifeanyichukwu, Adikwu Michael and Esimone Charles (2013). Susceptibility and Detection of Extended Spectrum β-Lactamase Enzymes from Otitis Media Pathogens. American Journal of Infectious Diseases. 9(1):24-29.

Finch R.G, Greenwood D, Norrby R and Whitley R (2002). Antibiotic and chemotherapy, 8th edition. Churchill Livingstone, London and Edinburg.

Russell A.D and Chopra I (1996). Understanding antibacterial action and resistance. 2nd edition. Ellis Horwood Publishers, New York, USA.

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