DETAILED OUTLINE

Name: Lai Kian Ming

Class: ___________

Chemistry Issue Topic:

Should we significantly reduce the use of antibiotics such as penicillin and tetracycline to
prevent antibiotic resistance?

Introduction
The word "antibiotics" comes from the Greek anti ("against") and bios ("life"). The noun
antibiotic was suggested in 1942 by Dr. Selman A. Waksman, soil microbiologist.
An antibiotic is a drug that kills or slows the growth of bacteria. Antibiotics are one class of
antimicrobials, a larger group which also includes anti-viral, anti-fungal, and anti-parasitic drugs.
Antibiotics are chemicals produced by or derived from microorganisms (i.e. bugs or germs such
as bacteria and fungi). The first antibiotic was discovered by Alexander Fleming in 1928 in a
significant breakthrough for medical science. Antibiotics are among the most frequently
prescribed medications in modern medicine.
Antibiotics are used to treat many different bacterial infections. Antibiotics cure disease by
killing or injuring bacteria. Bacteria are simple one-celled organisms that can be found, by the
billions, all around us: on furniture and counter-tops, in the soil, and on plants and animals. They
are a natural and needed part of life. Bacteria cause disease and infection when they are able to
gain access to more vulnerable parts of our bodies and multiply rapidly. Bacteria can infect many
parts of the body: eyes, ears, throat, sinuses, lungs, airways, skin, stomach, colon, bones,
genitals.

Antibiotic Resistance
Antibiotics are extremely important in medicine, but unfortunately bacteria are capable of
developing resistance to them. Antibiotic-resistant bacteria are germs that are not killed by
commonly used antibiotics. When bacteria are exposed to the same antibiotics over and over, the
bacteria can change and are no longer affected by the drug.
Bacteria have number of ways how they become antibiotic-resistant. For example, they possess
an internal mechanism of changing their structure so the antibiotic no longer works, they develop
ways to inactivate or neutralize the antibiotic. Also bacteria can transfer the genes coding for
antibiotic resistance between them, making it possible for bacteria never exposed to an antibiotic
to acquire resistance from those which have. The problem of antibiotic resistance is worsened
when antibiotics are used to treat disorders in which they have no efficacy (e.g. antibiotics are
not effective against infections caused by viruses), and when they are used widely as prophylaxis
rather than treatment.
Resistance to antibiotics poses a serious and growing problem, because some infectious diseases
are becoming more difficult to treat. Resistant bacteria do not respond to the antibiotics and
continue to cause infection. Some of these resistant bacteria can be treated with more powerful
medicines, but there some infections that are difficult to cure even with new or experimental
drugs.

Interaction between tetracycline and penicillin

Tetracyclines (bacteriostatic) have been reported to inhibit the bactericidal activity of
penicillins. The interaction between tetracyclines & penicillins is noted in the PDR (& on
rxlist.com postings of PDR information, below). Clinical examples of increased mortality in
pneumococcal meningitis, and higher reinfection rates in streptococcal infections have also been
reported when tetracyclines & penicillins are combined (see journal references below). It has
been proposed that the administration of a bacteriostatic agent, such as tetracycline can interfere
with the bactericidal effect of cell wall synthesis inhibitors, which require active cell wall
synthesis (and actively growing & dividing bacteria) to be effective (Piscitelli & Rodvold, 2001).
Other mechanisms cannot be excluded. Tetracyclines may interfere with the bactericidal activity
of aminoglycosides as well.

Penicillin
The penicillins are the oldest class of antibiotics. Penicillins have a common chemical structure
which they share with the cephalosporins.
Penicillins are generally bactericidal, inhibiting formation of the cell wall. Penicillins are used to
treat skin infections, dental infections, ear infections, respiratory tract infections, urinary tract
infections, gonorrhea.
There are four types of penicillins:

The natural penicillins are based on the original penicillin-G structure. Penicillin-G
types are effective against gram-positive strains of streptococci, staphylococci, and some gramnegative bacteria such as meningococcus.

Penicillinase-resistant penicillins, notably methicillin and oxacillin, are active even in

the presence of the bacterial enzyme that inactivates most natural penicillins.

Aminopenicillins such as ampicillin and amoxicillin have an extended spectrum of action

compared with the natural penicillins. Extended spectrum penicillins are effective against a wider
range of bacteria.
Formula of penicillin g is C16H18N2O4S

Diagram 1. Penicillin chemical formula

Tetracycline
Tetracyclines got their name because they share a chemical structure that has four rings. They are
derived from a species of Streptomyces bacteria.
Tetracycline antibiotics are broad-spectrum bacteriostatic agents and work by inhibiting the
bacterial protein synthesis. Tetracyclines may be effective against a wide variety of
microorganisms, including rickettsia and amebic parasites.
Tetracyclines are used in the treatment of infections of the respiratory tract, sinuses, middle ear,
urinary tract, skin, intestines. Tetracyclines also are used to treat Gonorrhoea, Rocky Mountain
spotted fever, Lyme Disease, typhus. Their most common current use is in the treatment of
moderately severe acne and rosacea.
Tetracycline antibiotics are:

tetracycline

doxycycline

minocycline

oxytetracycline
Molecule formula of tetracycline is C22H24N2O8.

Diagram 2. Tetracycline chemical formula

Tetracycline side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives;
difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using tetracycline and call
your doctor at once if you have any of these serious side effects:

severe headache, dizziness, blurred vision;

fever, chills, body aches, flu symptoms;
severe blistering, peeling, and red skin rash;
urinating less than usual or not at all;
pale or yellowed skin, dark colored urine, fever, confusion or weakness;
severe pain in your upper stomach spreading to your back, nausea and vomiting, fast
heart rate;
loss of appetite, jaundice (yellowing of the skin or eyes); or
easy bruising or bleeding, unusual weakness.

Penicillin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to penicillin V:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once
if you have any of these serious side effects:

diarrhea that is watery or bloody;

fever, chills, body aches, flu symptoms;

easy bruising or bleeding, unusual weakness;

urinating less than usual or not at all;

severe skin rash, itching, or peeling;

agitation, confusion, unusual thoughts or behavior; or

seizure (black-out or convulsions).

How do bacteria develop resistance?

The widespread use of antibiotics around the world promotes the development of antibiotic
resistance. Bacteria can develop drug resistance when:

Antibiotics are used too often or without a purpose (e.g. to treat a viral infection)
An antibiotic is stopped too early
The dose or schedule instructions for an antibiotic are not followed

When antibiotics are used too often or used improperly, they can kill the vulnerable bacteria in
the body, but leave some of the resistant ones to grow and spread. Resistant bacteria can persist
in the body and cause infection in the same person, or spread to other people and make them sick
with a bacteria that is more difficult to treat.
Bacteria are very resilient. They can:

Neutralize antibiotics before they kill the bacteria

Change the antibiotic attack site so it cannot affect the bacteria
Pump the antibiotic out of their cells
Prevent the antibiotic from getting into their cells

These techniques allow resistant bacteria to thrive in the presence of antibiotics.

Conclusion
Everyone has a role to play in using antibiotics responsibly. Here are some tips:
Use antibiotics wisely: Dont expect to get antibiotics every time you have a respiratory
infection. Know when its effective to use antibiotics and dont use them for viral infections
such as colds, flu, coughs, and most sore throats. Even with some bacterial infections, you will
usually recover just as quickly without antibiotics
Treat viral infections responsibly: Dont pressure your doctor for antibiotics when you have a
viral infection. Instead, talk to your doctor or pharmacist about ways to feel better when you are
ill. There are medicines you can take to relieve your symptoms.
Take antibiotics exactly as prescribed: If you are prescribed antibiotics, follow the dose and
schedule instructions exactly. Finish all the antibiotics you are given, even if you start to feel
better. Do not share them with someone else or save them for another time.
Never take antibiotics without a prescription: In many countries, it is possible to get antibiotics
without a prescription. Using antibiotics when you dont need them is a significant contributor
to antibiotic resistance and will not make you feel better.
Stay at home if youre sick: Prevent the spread of germs by staying at home when youre sick,
washing your hands frequently, and practicing good hygiene. (Antibiotic Use & Resistance.
(n.d.). Retrieved March 18, 2015, from http://antibioticawareness.ca/?page_id=14)

References & Resources

1. The Merck Manual of Medical Information. Mark H. Beers et al., eds. 2nd Home
Edition. Whitehouse Station, NJ: Merck; 2003.

2. Antibiotics: MedlinePlus. U.S. National Library of Medicine

3. Physicians' Desk Reference. 59th ed. Montvale, N.J.: Thomson PDR, 2005.

4. Waksman SA. Mycologia Vol. 39, No. 5 (Sept.-Oct. 1947): 565-569.

5. Antibiotic Use & Resistance. (n.d.). Retrieved March 18, 2015, from
http://antibioticawareness.ca/?page_id=14