Broad spectrum antibiotics
Introduction - What is a Broad-Spectrum Antibiotic?
An antibiotic is an active ingredient that is used against bacteria. Antibiotics reduce the metabolic activity of the bacteria and thereby lead to a reduced reproduction of the bacteria, which can prevent the survival of a bacterial colony. Broad-spectrum antibiotics (also called broad-spectrum antibiotics) have - as the name suggests - a broad spectrum of activity.
They can therefore be used for a particularly large number of different groups of bacteria. The individual types of bacteria have many different defense mechanisms and differ in their metabolic properties. Broad spectrum antibiotics can, with their mechanism of action, override the various defense mechanisms of the bacteria and thereby kill many different types of bacteria.
Read more on the subject at: Antibiotics
Indications
The indications for the use of broad-spectrum antibiotics are diverse. These versatile drugs are substances that can be used in many infectious areas. A broad spectrum antibiotic is typically administered, for example, to an infection in which the exact pathogen is not yet known.
For example, if a person with pneumonia or urinary tract infection needs treatment, a broad-spectrum antibiotic is selected first. In most cases, this will improve the symptoms, since the broad-spectrum antibiotic can very likely kill the underlying germ. In outpatient treatment, a broad-spectrum antibiotic is often chosen, which has the highest degree of effectiveness on the type of bacteria that are most common in the disease to be treated.
If an affected person is treated in hospital, blood samples and samples are usually taken from the infected areas of the body. A so-called culture is obtained from this in which the infecting bacteria grow. You can then test which antibiotics work best. Since this process takes a few days, affected people are first treated with a broad-spectrum antibiotic; if the exact bacteria detection is available, they can switch to a more specific antibiotic.
Broad-spectrum antibiotics are also used in all areas in which people with a weakened immune system are. In oncology, for example, several broad-spectrum antibiotics are often given simultaneously during chemotherapy. Affected people have a very weak immune system due to chemotherapy. In order to prevent all kinds of bacterial infections, antibiotics are used that are effective against as many pathogens as possible. Broad-spectrum antibiotics can also be used in other areas with immunosuppression (reduced function of the immune system). People with chronic inflammatory diseases are often treated immunosuppressively. Bacterial infections are also common after transplants or cortisone therapy, which is why broad-spectrum antibiotics are used there.
Active ingredient and effect
Broad-spectrum antibiotics can neither be reduced to a specific active ingredient nor to a specific mode of action. There are many different broad-spectrum antibiotics, but none of the antibiotics are effective against all types of bacteria. A broad spectrum antibiotic must also be chosen in such a way that the most likely underlying bacterial species can best be combated with the antibiotic.
The broad-spectrum antibiotics include aminopenicillins (amoxicillin, ampicillin), which prevent the bacteria from forming a cell wall and thus kill the germs. The group of cephalosporins (ceftriaxone, cefotaxime, ceftazidime) also inhibit cell wall formation, as does the group of carbapenems (meropenem).
In addition, the various classes of active ingredients can disable additional defense mechanisms of the bacteria. Carbapenems, for example, are beta-lactamase-resistant. Beta-lactamase is an enzyme in bacteria that forms a special defense mechanism against some antibiotics. However, the beta-lactamase-solid broad-spectrum antibiotics cannot be prevented from working by this enzyme.
The group of fluoroquinolones (ciprofloxaxin, levofloxacin), on the other hand, has a different mechanism of action: these broad-spectrum antibiotics inhibit what is known as bacterial gyrase. This is also an enzyme in bacteria. The bacteria need the gyrase to read from their cell's own blueprint (DNA) the information that is needed to build new cells.
Side effects
The side effects of broad-spectrum antibiotics, like their effects, are based on their influence on the bacteria. Because antibiotics not only kill harmful bacteria, but also the "good" bacteria that the body needs for various processes are attacked by antibiotic therapy. This mainly affects the so-called natural intestinal flora, which is a large number of bacteria that occur naturally in our gastrointestinal tract and support our body with digestion. Treatment with broad-spectrum antibiotics kills these beneficial bacteria, which can lead to digestive problems and associated symptoms such as diarrhea, nausea, etc.
Read more on the subject at: Side effects of antibiotics
In addition, antibiotic therapy promotes an imbalance in the bacteria in the digestive tract. Everyone has some bacteria in their digestive tract that are resistant to various antibiotics, so these drugs cannot kill them. In most cases this is not a problem as the resistant bacteria are also good for our digestion. Therapy with broad-spectrum antibiotics, however, kills many other bacteria, so that the resistant germs gain the upper hand. Therefore, many people who are frequently treated with antibiotics are affected by colonization with such resistant bacteria.
Read more on the subject at: Antibiotic resistance
Broad-spectrum antibiotics are also used more frequently in people with poor immune system performance. The antibiotics also have an impact on the natural skin bacteria. These natural skin bacteria are important for protecting our skin. If they are attacked by the broad-spectrum antibiotic, pathogens that cause skin diseases can settle on the skin instead. The most common types of fungi such as Candida.
Read more on the subject at: Skin fungus - the fungal infection of the skin
interaction
Broad-spectrum antibiotics can interact in a variety of ways. Since the term broad-spectrum antibiotic is a very broad group of drugs, individual chains of interaction cannot be well described. However, interactions are possible via different systems in the body.
A variant of the interaction of broad-spectrum antibiotics is the metabolism of the active ingredient. The antibiotic is absorbed into the body through the mouth and thus through the digestive tract or directly through the blood in the vein. From there it goes to the liver, where the active ingredients are processed by various enzymes. Often, broad-spectrum antibiotics are only converted into an effective form at this point.
If other drugs are taken at the same time, which are also metabolized by these liver enzymes, there may be interactions. Interactions with other drugs can also occur during excretion. For example, other drugs can slow down the excretion of broad-spectrum antibiotics. This leads to an increased dose of the antibiotic in the body, which in turn can cause more severe side effects.
Contraindications - When should broad-spectrum antibiotics not be given?
Broad-spectrum antibiotics may not be given, for example, if the person affected has an allergy to one of the ingredients. Allergies and intolerance to antibiotics from the group of penicillins are particularly common. In this case, however, another broad-spectrum antibiotic can often be used, so that antibiotic therapy does not have to be dispensed with completely.
On the other hand, there are no general contraindications to all broad-spectrum antibiotics. Some active substances from the group of broad-spectrum antibiotics should not be used during pregnancy and breastfeeding. The various antibiotic active ingredients differ so widely that if there are contraindications for one antibiotic, you can usually switch to another.
Read more on the subject at: Antibiotics while breastfeeding
dosage
The dosage of broad-spectrum antibiotics cannot be determined across the board. On the one hand, the dosage depends on the active ingredient used. Penicillins are dosed differently than cephalosporins and these in turn are dosed differently from macrolides. The dosage is also sometimes based on the so-called form of application, i.e. the form in which the active ingredient enters the body. Therapy with broad-spectrum antibiotics in the form of tablets requires a different dosage than therapy via the vein.
Also, the dosage of the broad-spectrum antibiotic may depend on what other medications the affected person is taking. If there is a risk of interactions, either another class of antibiotics must be selected or, alternatively, the dosage can also be adjusted. Further changes in the dosage of broad-spectrum antibiotics must be observed, for example, in the event of impaired kidney or liver function, since the reduced efficiency of the organs can lead to a reduced excretion of the active substances.
price
The price of broad-spectrum antibiotics depends on the type of antibiotic. Dosage form and amount. As a rule, however, antibiotics do not have to be paid for by the affected person themselves, so that the costs are covered by the health insurance company.Only the additional payment of € 5 is often necessary if the drug has to be purchased in the pharmacy. If, on the other hand, therapy with broad-spectrum antibiotics takes place as part of an inpatient stay in the hospital, the additional payment is not due
Broad-spectrum antibiotics and alcohol - are they compatible?
Broad-spectrum antibiotics and alcohol usually do not get along well. Alcohol is a substance that is broken down mainly in the liver. Since many antibiotics are also metabolized in the liver, there can be significant interactions between the active ingredient of the antibiotic and alcohol. Often this means that the substances remain in the body longer, as the liver cannot break them down all at the same time.
As a result, a certain amount of alcohol makes itself much more noticeable because it cannot be broken down from the body as quickly. In addition, regular intake of antibiotics can lead to an increased active level, which in turn causes other side effects (often in the gastrointestinal tract, but occasionally also in other organs such as the eyes and hearing organ).
Alternatives to broad-spectrum antibiotics
The group of broad-spectrum antibiotics consists of a large number of different active ingredients and groups of active ingredients. Therefore, in the event of contraindications to one of the antibiotics, the other broad-spectrum antibiotics should be viewed as alternatives. In addition, once it has been determined which germ is causing the infection, you can often switch to a less broad-based antibiotic.
Is it possible to take it during pregnancy and breastfeeding?
When taking medication during pregnancy, there are a few things to consider, as not all active ingredients are approved during pregnancy and breastfeeding. Often this is mainly due to the fact that no data are available on the harmlessness of the active ingredients for the child.
Nevertheless, therapy with broad-spectrum antibiotics is occasionally necessary during pregnancy and breastfeeding. In this case, the active ingredient must be selected according to the phase of pregnancy in which the affected woman is or whether she is already breastfeeding. However, there are many active ingredients in the group of broad-spectrum antibiotics that can also be taken during pregnancy and breastfeeding. These include some antibiotics from the group of penicillins, as well as many cephalosporins and some macrolides can be taken during pregnancy and breastfeeding. However, a doctor should always be consulted before therapy with broad-spectrum antibiotics.
Read more on the subject at: Antibiotics in Pregnancy
Effectiveness of the pill
The pill can also interact with various broad-spectrum antibiotics. However, this depends on which antibiotic it is and which pill is taken. This information can best be found in the package inserts for the individual active ingredients in the direct case. In addition, people who take the pill should make the attending physician aware of the intake, so a broad-spectrum antibiotic can be selected that has as little effect as possible on the effectiveness of the pill.
