Botulism

Botulism leads to muscle paralysis. It is caused by Clostridium botulinum bacteria that are found in improperly canned foods. The symptoms of botulism are abdominal cramps, vomiting, nausea and difficulty in breathing and speaking. As treatment, Botulinus antitoxin is given.

Botox

Botox is the brand name for Botulinum Toxin Type A. It is a protein complex produced by the bacterium 'Clostridium botulinum' - the same bacterium that causes the form of food poisoning known as botulism. Botox, however, is a purified form of this bacterium. Dermatologists used it to treat muscle disorders such as uncontrolled blinking. Botox was approved by the FDA in 1989 to treat eye muscle disorders such as blepharospasm, uncontrollable blinking, and strabismus, - crossed eyes. In 2000, it was approved to treat cervical dystonia (a disorder that causes severe neck and shoulder contractions). As an unusual side effect of the eye disorder treatment, doctors observed that Botox softened the frown lines between the eyebrows.

When Botox is injected through the skin into the muscle with a needle, it keeps the muscle from contracting. Because of this temporary paralysis, wrinkles become less obvious. A trained doctor will inject small amounts of Botox into a small part of the muscle to render it immobile. The horizontal wrinkles of the forehead, the vertical 'frown' wrinkles of the brow (between the two eyebrows) and crow's feet beside the eyes are the areas best suited to Botox cosmetic.

Small doses of botox are injected directly into the muscles of the face. Prior to injecting botox, the doctor will first determine the area of injection based on the person's ability to move certain muscles in the brow area. An improvement in frown lines will be noticed within 3- 7 days and could last up to 4 months. However results may vary. Although there is no chance of contracting botulism from Botox injections, there are some risks associated with the procedure. If too much toxin is injected or if it is injected into the wrong facial area, a person can end up with droopy eyelid muscles that could last for weeks. This particular complication was observed in clinical trials. Other botox side effects are:

• Headache
  
• Flu like symptoms
  
• Temporary eyelid drop
  
• Nausea
  
• Squint/Double vision
  
• Twitching of eye
  
• Facial pain
  
• Redness at injection site
  
• Muscle weakness
  

Botox procedures are not recommended for pregnant women or those suffering from neurological disorders. Possible allergies must also be looked into. A qualified dermatologist is the best person to administer botox treatments. This minimizes the potential for misuse. Botox treatment is resorted to by those who do not wish to face the risk of surgery and prefer being treated for a few minutes every three to four months.

List of general Antibiotics

Antibiotics are primarily used to treat bacterial infections. They may have secondary uses - treatment of the Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion with Declomycin. Some antibiotics are also used to prevent infection (antibiotic prophylaxis) before any surgery or in the case of weakened immune systems. There was a study which indicated that about 300 million prescriptions for antibiotics are issued every year in the US alone and the wide spread use or abuse of the antibiotics is a serious issue. For example, an antibiotic can seriously deplete the normal intestinal micro flora which can result in vaginal yeast infection in susceptible women. Indiscriminate use of antibiotics can bring about increased incidences of Streptococcal disease in children apart from enhanced drug resistance.

Antibiotics Classification: Antibiotics are classified under many categories. Commonly they are grouped based on chemical structure and Antibiotics within the same class exhibit similar kind of effectiveness, allergic potential and toxicity. The exhaustive list below also contains drug allergy or other reactions possible for susceptible individuals as appropriate under each class.


Other types of classification:
Bacterial Spectrum: Broad Spectrum Antibiotics are capable of targeting many types of bacteria while narrow spectrum antibiotics target specifically a single class of bacteria. It is generally preferable to use a specific antibiotic for the specific class of bacteria.

Type of Activity: Bactericidal drugs are intended to kill bacteria while bacteriostatic drugs are intended to inhibit the growth of bacteria.

Broad Spectrum Antibiotics: According to a Swiss Study, this class of Antibiotics which act against Gram+ and Gram- bacteria is prone to misuse. Broad Spectrum Antibiotics - specifically the antipseudomonal agents (i.e. cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, piperacil lin/tazobactam) plus trovafloxacin were found to be misused.

The following list shows the generic names of common antibiotics prescribed and available under various trade names in the US. We have broadly classified them under the common 'family' names.

Broad Spectrum Penicillins / Amoxicillin : Penicillin Family Antibiotics List

Penicillins - one of the oldest type of broad spectrum antibiotics, share common chemical structure with Cephalopsorins. They are classified as Beta-lactam antibiotics. Aminopenicillins such as Ampicillin and Amoxicillin have extended spectrum of action. Extended Spectrum Penicillins are effective against a broad range of bacteria including Pseudomonas Aeruginosa which affect patients with weakened immune systems.

Allergic reactions are common with Penicillins for susceptible individuals. Cephalosporins can cause seizures or affect the blood clotting time for susceptible patients.

• Ampicillin
  
• Bacampicillin
  
• Carbenicillin Indanyl
  
• Mezlocillin
  
• Piperacillin
  
• Ticarcillin

Penicillins and Beta Lactamase Inhibitors

• Amoxicillin-Clavulanic Acid
  
• Ampicillin-Sulbactam
  
• Benzylpenicillin
  
• Cloxacillin
  
• Dicloxacillin
  
• Methicillin
  
• Oxacillin
  
• Penicillin G
  
• Penicillin V
  
• Piperacillin Tazobactam
  
• Ticarcillin Clavulanic Acid
  
• Nafcillin
  
• Procaine Penicillin - Injectable form of penicillin that contains an anesthetic to reduce the pain of the injection. Procaine Penicillin dosage is usually between 600000 to 1 million units per day Intramuscular (IM) for about 10 days for most Upper respiratory tract infection and other simpler bacterial infections. P Penicillin must never be administered intravenously as it can result in anaphylactic shock.
  

Cephalosporins

Cephalosporins, one of the largest classes of Antibiotics are used to treat a long list of bacterial infections from around the year 1950. The latest in this class, Ceftaroline is a new fifth generation Cephalosporin - a broad spectrum Antibiotics that shows promise against Gram + bacteria including Methicillin Resistant Staphylococcus Aureus (MRSA),Vancomycin Intermediate S.Aureus (VISA), Vancomycin Resistant S.Aureus (VRSA)and Heteroresistant VISA (hVISA).

• Cephalosporin I Generation Antibiotics
  
• Cefadroxil
  
• Cefazolin
  
• Cephalexin
  
• Cephalothin
  
• Cephapirin
  
• Cephradine

Cephalosporin II Generation Antibiotics

• Cefaclor
  
• Cefamandol
  
• Cefonicid
  
• Cefotetan
  
• Cefoxitin
  
• Cefprozil
  
• Ceftmetazole
  
• Cefuroxime
  
• Loracarbef

Cephalosporin III Generation Antibiotics

• Cefdinir
  
• Ceftibuten
  
• Cefoperazone
  
• Cefixime
  
• Cefotaxime
  
• Cefpodoxime proxetil
  
• Ceftazidime
  
• Ceftizoxime
  
• Ceftriaxone

Cephalosporin IV Generation Antibiotics

• Cefepime
  
• Cefluprenam
  
• Cefozopran
  
• Cefpirome
  
• Cefquinome
  

Fourth generation Cephalosporin antibiotics are effective in the treatment of Encephalitis and Meningitis as they cross the blood-brain barrier.

Cephalosporin V Generation Antibioticsor New Generation Cephalosporins - NGCs

• Ceftolozane
  
• Ceftaroline
  
• Ceftobiprole
  

The New Generation Cephalosporins show considerable efficacy against a host of bacteria - from MRSA to respiratory pathogens like Streptococcus Pneumoniae, Haemophilus Influenzae and Moraxella Catarrhalis.
β lactam antibacterial resistance: These fifth generation Cephalosporins inhibit the cell wall synthesis of Penicillin Binding Proteins (PBPs). For example, Ceftaroline's anti MRSA efficacy stems from its high affinity for the MRSA associated (Penicillin Binding Proteins)PBP2a. It may have affinity greater than 256 times over other β lactams.

Ceftaroline is effective against the following:

Gram Positive Bacteria which cause skin infections:
Methicillin Resistant Staphylococcus Aureus (MRSA) and resistant isolates
Streptococcus Pyogenes
Streptococcus Agalactiae

Gram Positive Bacteria which cause Community Acquired Bacterial Pneumonia (CABP):
Streptococcus Pneumoniae
Staphylococcus aureus(methicillin susceptible isolates)

Gram Negative Bacteria:
Klebsiella Pneumoniae
Klebsiella Oxytoca
Escherichia Coli
Haemophilus Iinfluenzae
Escherichia Coli

Macrolides and Lincosamines

Macrolide Antibiotics have macrocyclic lactone chemical structure. Erythromycin and the newer antibiotics belonging to this broad spectrum class - Azithromycin and Clarithromycin are widely used for their higher level of lung penetration. Erythromycin may rarely result in Myasthenia gravis while Azithromycin may rarely result in Angioedema (Patches of swelling of the skin, mucus membranes and internal organs), Anaphylaxis (hypersensitive reaction due to contact through allergens) or other allergic reactions.

• Azithromycin
  
• Clarithromycin
  
• Clindamycin
  
• Dirithromycin
  
• Erythromycin
  
• Lincomycin
  
• Troleandomycin

Quinolones and Fluoroquinolones

Fluoroquinolones are synthetically manufactured broad spectrum Antibiotics. Lomefloxacin is reported to cause increased photosensitivity and in some cases may result in convulsion.

• Cinoxacin
  
• Ciprofloxacin
  
• Enoxacin
  
• Gatifloxacin
  
• Grepafloxacin
  
• Levofloxacin
  
• Lomefloxacin
  
• Moxifloxacin
  
• Nalidixic acid
  
• Norfloxacin
  
• Ofloxacin
  
• Sparfloxacin
  
• Trovafloxacin
  
• Oxolinic acid
  
• Gemifloxacin
  
• Perfloxacin

Beta lactam Antibiotics: Carbepenems

Imipenem-Cilastatin
Meropenem

Monobactams
Aztreonam

Aminoglycosides : These antibiotics are specifically used to target aerobic, Gram-negative bacteria. Generally useful against Pseudomonos, Acinetobacter and Enterobacter amongst others. Streptomycin is effective to control tuberculosis causing mycobacteria. Antibiotic treatment with Aminoglycosides often involves the use of another antibiotics for overall better synergetic effect.

• Amikacin
  
• Gentamicin
  
• Kanamycin
  
• Neomycin
  
• Netilmicin
  
• Streptomycin
  
• Capreomycin Sulfate
  
• Tobramycin
  
• Paromomycin

Details on Specific Antibiotic Therapy

Gentamicin: Gentamicin is the antibiotic of choice for the treatment of some kind of blood infections caused by gram negative bacilli like the following:

• Citrobacter freundii
  
• Acinetobacter species
  
• Enterobacter species
  
• Escherichia coli
  
• Klebsiella pneumoniae
  
• Proteus mirabilis
  
• Providencia stuartii
  
• Pseudomonas Aeruginosa
  
• Serratia species
  

Gentamicin is often used along with beta-lactam antibiotics for better efficiency.

Conventional Dosage: It should be noted that a typical dosage of Gentamicin is usually given 2 to 3 times a day by IV (intravenous) or IM (intramuscular) injections to achieve peak blood concentration between 5.0 μg/mL and 12.0 μg/ml. The dosage mentioned here depends on the type of infection and on other factors like the patient's renal function. Gentamicin is sometimes given at a higher dose than the suggested common dosage - 5-7mg/kg of body weight once per day - termed as pulse dosing for patients with good tolerance and good renal function. Risk of excessive dosage in the case of Gentamicin is Ototoxicity (damage to the inner ear) and Nephrotoxicity (damage to kidneys).

Glycopeptides
Teicoplanin
Vancomycin

Tetracyclines

• Demeclocycline
  
• Doxycycline
  
• Methacycline
  
• Minocycline
  
• Oxytetracycline
  
• Tetracycline
  
• Chlortetracycline

Tetracyclines are not normally prescribed for children under the age of 8 due to the permanent tooth discoloration these drugs cause.

Sulfonamides

• Mafenide
  
• Silver Sulfadiazine
  
• Sulfacetamide
  
• Sulfadiazine
  
• Sulfamethoxazole
  
• Sulfasalazine
  
• Sulfisoxazole
  
• Trimethoprim-Sulfamethoxazole
  
• Sulfamethizole

Rifampin

Rifabutin
Rifampin also known as Rifampicin (Rifadin)
Rifapentine

Oxazolidonones

Linezolid
Streptogramins
Quinopristin Dalfopristin


Other Antibiotics

• Bacitracin
  

• Chloramphenicol : Chloramphenicol is another strong broad spectrum antibiotic. Chloramphenicol may be the antibiotic of choice for the following conditions :
  Bacterial meningitis: Chloramphenicol can be used to treat bacterial meningitis, which is an infection of the membranes that surround the brain and spinal cord.
  Typhoid fever: Chloramphenicol can be used to treat typhoid fever, which is a bacterial infection that can cause high fever, headache, and gastrointestinal symptoms.
  Rickettsial infections: Chloramphenicol can be used to treat rickettsial infections, which are bacterial infections that are spread by ticks, lice, fleas, and other insects.
  Bacterial conjunctivitis: Chloramphenicol can be used to treat bacterial conjunctivitis, which is an infection of the eye that can cause redness, discharge, and irritation.
  The recommended dosage of Chloramphenicol will depend on the specific condition being treated, the age and weight of the patient and other individual factors.
  
  Dosage:
  For bacterial meningitis in children: The recommended dosage is 50-100 mg/kg/day, given in 4 divided doses.
  For typhoid fever: The recommended dosage is 50-75 mg/kg/day, given in 4 divided doses for 14 days.
  For bacterial conjunctivitis: The recommended dosage is 1-2 drops of a 0.5% ophthalmic solution in the affected eye(s) every 2-4 hours.
  For acne: The recommended dosage is 50-100 mg orally, 2-4 times daily, for several weeks.
  
  Caution: Some of the common side effects of Chloramphenicol include - Nausea, vomiting, Diarrhea, Headache, Dizziness, Rash, Blood disorders, such as anemia or low white blood cell count. In rare cases, Chloramphenicol can also cause serious side effects, such as aplastic anemia, which is a condition where the bone marrow stops producing new blood cells.

  
  
• Fosfomycin, Fosfomycin Tromethamine
  
• Isoniazid
  
• Methenamine
  
• Metronidazol
  
• Mupirocin
  
• Nitrofurantoin
  
• Nitrofurazone
  
• Novobiocin
  
• Polymyxin
  
• Spectinomycin
  
• Trimethoprim
  
• Colistin
  
• Colistimethate
  
• Cycloserine
  
• Capreomycin
  
• Ethionamide
  
• Pyrazinamide
  
• Para-aminosalicyclic acid
  
• Erythromycin ethylsuccinate

Topical Antibiotics: Many Antibiotics are available for external application on the skin which include:

Erythromycin
Clindamycin
Tetracycline
Meclocycline
Sodium sulfacetamide

Topical medications that act as Comedolytics as well as antibiotics:

Benzoyl peroxide
Azelaic acid
Benzoyl peroxide

Recommended Dosage : Antibiotics dosage is based on many factors:

• Target Pathogen
  
• Choice of Drug
  
• Area of Infection
  
• Severity of infection
  
• Pertinent Patient conditions such as age, renal function
  
• Route of administration
  

Many antibiotics can be administered parenterally - either through Intravenous (IV) or Intra muscular (IM) injections.

You may find some typical usage instructions, dosage, contra indications and side effects - if any for some of the antibiotics listed above in these pages.

Antibiotics for Anaerobic infections

Anaerobes - the kind of bacteria which can not grow in the presence of oxygen, can infect deep wounds and internal organs - sometimes resulting in gangrene, botulism, tetanus and almost all dental infections.
Some common Anaerobic infections

• Pneumonia, Empyema, Bronchiectasis
  
• Appendicitis, Peritonitis
  
• Endometritis, Pelvic abscesses
  
• Necrotizing Fascitis (destructive infection of the deep skin), Bacteremia (presence of Anaerobic bacteria in the blood)
  

Many antibiotics do not inhibit/control Anaerobes. But Chloramphenicol, Imipenem, Metronidazole, Clindamycin and Cefoxitin are effective against these bacteria.

New Antibiotics in pipeline: Pseudouridimycin (PUM) is a promising new Antibiotic which inhibits bacterial RNA polymerase (RNAP). What is more, PUM in the research shows its ability to act against drug resistant bacterial pathogens.