An Appropriate Antimicrobial Drug, Essay Example

Choose an appropriate antimicrobial drug for each of the following situations and describe your rationale:

A Urinary Tract Infection

Urinary tract infections are caused by bacteria that live in the urinary tract of humans, clogging them and causing painful urination. Antibiotics taken orally are used to treat urinary tract infections. However, since the infection can be caused by one of several strains of bacteria, the antibiotic used to treat it depends on the microbial culprit. If an ampicillin-resistant strain such as E. coli is behind the infection, then a sulfa antibiotic such as sufisoxazole or trisulfapyrimides is preferred. Other strains not amipicillin-resistant can be treated with cephalosporin or Augmentin (McCracken, 1989).

A Herpes Infection

Since Herpes is caused by a virus it can only be treated with antiviral medication. Those who suffer from frequent, recurrent outbreaks can take medication daily (suppressive therapy) to reduce their overall outbreaks, their frequency and duration.  Orally active antiviral medication such as acyclovir has shown to be safe and effective for long-term use (WebMD, 2009).

Athletes Foot

Athletes foot, a fungus that thrives in warm, moist areas, is often found on the feet of athletes who sweat regulary while wearing shoes and socks. Since it is caused by a fungus it can be treated with an over-the-counter anti-fungal cream such as terbinafine, miconazole or clotrimazole. A prescription strength anti-fungal cream such as butenafine can be used if a non-prescription cream fails to work (WebMD, 2008).

Gonorrhea

Gonorrhea is a painful sexually transmitted disease that is caused by the bacteria Neisseria gonorrhoeae. Unfortunately, this bacteria has recently developed resistance to many of the antibiotics used to treat it in the past. Today, only one class of antibiotics is recommended by the CDC STD treatment guidelines, and that is the orally active cephalosporin antibiotics. Symptoms of gonorrhea can mimic urinary tract infections but will not respond to the antibiotics used to treat UTI’s because of the bacteria’s resistance to those treatments.

Amoebic Dysentery

Amoebic dysentery is caused by group of small, single-celled parasites called amoebas. These amoebas are found in water contaminated by human fecal matter. There are several antibiotics that are likely to be beneficial in the treatment of Amoebic dysentery, including metronidazole, secnidazole and tinidazole. Effectiveness of the antibiotic depends on the amoeba that is causing the dysentery and its resistance to the treatment used.

Leprosy

Historically there was no cure for the complex, degenerative disease of leprosy which affects the skin, nerves and mucous membranes. Today, however, the culprit behind leprosy has been identified as the bacteria Mycobacterium leprae and antibiotic medication has been developed to effectively treat infected individuals. Typical antibiotics used in leprosy treatment include dapsone or clofazimine. However, since some strains of M. leprae can be resistant to some antibiotics, several antibiotics are typically combined to ensure effective treatment.

Compare and contrast endotoxins and exotoxins, providing examples.

Exotoxins and endotoxins are substances that are toxic to a host organism that are produced by invading bacteria. Exotoxins are produced by both gram-positive bacteria as well as gram-negative bacteria.  The exotoxin is excreted by the bacteria and can cause damage to cellular metabolism. An example of an exotoxin is Shiga toxin, excreted by Shigella dysenteriae, which inhibits protein synthesis within target cells. An exotoxin similar to Shiga is released by other bacteria including E. coli. Endotoxins are similar to exotoxins except that they are only made by gram-negative bacteria. While exotoxins target specific receptor on host cells, endotoxins can affect a diverse range of systems and cells within the host. Exotoxins, however, are heat labile and can be destroyed by body defense such as fever. Endotoxins, on the other hand, are heat stable and can survive increases in body temperature. Endotoxins are found integrated into the outer membrane of the cell whereas exotoxins are substances released by the bacteria itself. Examples of endotoxins include lipopolysaccharide and lipooligosaccharide, both of which are important to the ability of the bacteria to cause disease.

Clinical Situation

When traveling overseas, it is often possible to contract infections of all types. If you are out in a remote village, you are likely to find a local pharmacy but not a doctor or lab to identify the exact cause of your infection. In order to treat yourself, you will need to know at least whether your infection is viral, fungal, bacterial or parasitic. Depending on which it is, you can then ask for the proper medication at the local pharmacy. When traveling once in Guatemala, I contracted what I was pretty sure was a urinary tract infection. Having remembered that these bacterial infections respond best to sulfa antiobiotics, I looked online to find the trade name that sufisoxazole was sold under in Guatemala. It was Bactrim. I went to the local pharmacia, asked for the drug, and went home and followed the directions I had read on the Internet. Luckily, I was right about my self diagnosis and I started feeling better almost immediately. This was a time when it payed to be aware the exact culprit behind an illness.

References

Antiviral Medicines for Genital Herpes (January, 2009) WebMD Online. Retrieved from http://www.webmd.com/genital-herpes/antiviral-medications-for-genital-herpes

Athlete’s Food Medications (July, 2008). WebMD Online. Retrieved from http://www.webmd.com/skin-problems-and-treatments/tc/athletes-foot-medications

Basic Information about Antibiotic-Resistant Gonorrhea (September, 2010) CDC Online. Retrieved from http://www.cdc.gov/std/Gonorrhea/arg/basic.htm

Mackey-Lawrence, Nicole and Petri, William Arthur (January, 2011) Amoebic Dysentery. British Medical Journal Online. Retrieved from http://clinicalevidence.bmj.com/ceweb/conditions/ind/0918/0918.jsp

McCracken, George H. (August, 1989) Options in Antimicrobial Management of Urinary Tract Infections in Infants and Children. The Pediatrics Infectious Disease Journal 8(8), 552-555. Retrieved from http://www.cirp.org/library/disease/UTI/mccracken/

Pathogenic Microbiology: Comparison of Bacterial Exotoxins and Endotoxin (September, 2003) University of Maryland Online. Retrieved from http://www.life.umd.edu/classroom/bsci424/HostParasiteInteractions/ExovsEndo.htm

Schoenstadt, Arthur (March, 2009) Treatment of Leprosy.  eMedTV Online. Retrieved from http://diseases.emedtv.com/leprosy/treatment-of-leprosy.html