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WHO AWaRe
The WHO AWaRe Classification is a method to categorize antibiotics into three groups in an effort to improve appropriate antibiotic use. The classification is based, in part, on the risk of developing antibiotic resistance and their importance to medicine. It does not reflect effectiveness or strength. It is accompanied by a book that outlines which and how to use antibiotics in 34 common infections. The three groups are "access", meaning use can be unrestricted, "watch", meaning care should be taken, and "reserve" meaning use should be saved for cases in which other options are not possible. The recommendation is that greater than 60% of antibiotics used within a country come from the "access" group. The classification was developed by the World Health Organization (WHO) and launched in 2017. It is an aspect of the WHO Model List of Essential Medicines. The classification as of 2021 covers 258 items. Challenges in its implementation include lack of awareness, little politica ...
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World Health Organization Logo
The world is the totality of entities, the whole of reality, or everything that Existence, exists. The nature of the world has been conceptualized differently in different fields. Some conceptions see the world as unique, while others talk of a "plurality of worlds". Some treat the world as #Monism and pluralism, one simple object, while others analyze the world as a complex made up of parts. In #Scientific cosmology, scientific cosmology, the world or universe is commonly defined as "the totality of all space and time; all that is, has been, and will be". #Theories of modality, Theories of modality talk of possible worlds as complete and consistent ways how things could have been. #Phenomenology, Phenomenology, starting from the horizon of co-given objects present in the periphery of every experience, defines the world as the biggest horizon, or the "horizon of all horizons". In #Philosophy of mind, philosophy of mind, the world is contrasted with the mind as that which is ...
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Metronidazole
Metronidazole, sold under the brand name Flagyl and Metrogyl among others, is an antibiotic and antiprotozoal medication. It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. It is effective for dracunculiasis, giardiasis, trichomoniasis, and amebiasis. It is an option for a first episode of mild-to-moderate Clostridioides difficile infection, ''Clostridioides difficile'' colitis if vancomycin or fidaxomicin is unavailable. Metronidazole is available oral administration, orally (by mouth), as a cream or gel, and by slow intravenous infusion (injection into a vein). Common side effects include nausea, Dysgeusia, a metallic taste, Anorexia (symptom), loss of appetite, and headaches. Occasionally seizures or allergies to the medication may occur. Some state that metronidazole should not be used in early pregnancy, while others state doses for trichomoniasis are safe. Metronidazole is generally considered com ...
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Linezolid
Linezolid is an antibiotic used for the treatment of infections caused by Gram-positive bacteria that are resistant to other antibiotics. Linezolid is active against most Gram-positive bacteria that cause disease, including streptococci, vancomycin-resistant enterococci (VRE), and methicillin-resistant ''Staphylococcus aureus'' (MRSA). The main uses are infections of the skin and pneumonia although it may be used for a variety of other infections including drug-resistant tuberculosis. It is used either by injection into a vein or by mouth. When given for short periods, linezolid is a relatively safe antibiotic. It can be used in people of all ages and in people with liver disease or poor kidney function. Common side effects with short-term use include headache, diarrhea, rash, and nausea. Serious side effects may include serotonin syndrome, bone marrow suppression, and high blood lactate levels, particularly when used for more than two weeks. If used for longer period ...
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Polymyxin B
Polymyxin B, sold under the brand name Poly-Rx among others, is an antibiotic used to treat meningitis, pneumonia, sepsis, and urinary tract infections. While it is useful for many Gram negative infections, it is not useful for Gram positive infections. It can be given by injection into a vein, muscle, or cerebrospinal fluid or inhaled. The injectable form is generally only used if other options are not available. It is also available as the combinations bacitracin/polymyxin B and neomycin/polymyxin B/bacitracin for use on the skin. Common side effects when given by injection include kidney problems, neurological problems, fever, itchiness, and rash. Injections into muscle may result in significant pain. Other serious side effects may include fungal infections, anaphylaxis, and muscle weakness. It is unclear if use during pregnancy is safe for the baby. Polymyxin B works by breaking down the cytoplasmic membrane which generally results in bacterial cell death. Polymyxin B ...
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Colistin
Colistin, also known as polymyxin E, is an antibiotic medication used as a last-resort treatment for multidrug-resistant Gram-negative infections including pneumonia. These may involve bacteria such as ''Pseudomonas aeruginosa'', ''Klebsiella pneumoniae'', or ''Acinetobacter''. It comes in two forms: colistimethate sodium can be injected into a vein, injected into a muscle, or inhaled, and colistin sulfate is mainly applied to the skin or taken by mouth. Colistimethate sodium is a prodrug; it is produced by the reaction of colistin with formaldehyde and sodium bisulfite, which leads to the addition of a sulfomethyl group to the primary amines of colistin. Colistimethate sodium is less toxic than colistin when administered parenterally. In aqueous solutions, it undergoes hydrolysis to form a complex mixture of partially sulfomethylated derivatives, as well as colistin. Resistance to colistin began to appear as of 2015. Common side effects of the injectable form include kidne ...
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Ceftazidime/avibactam
Ceftazidime/avibactam, sold under the brand name Avycaz (by AbbVie) among others, is a fixed-dose combination medication composed of ceftazidime, a cephalosporin antibiotic, and avibactam, a Beta-lactamase inhibitor, β-lactamase inhibitor. It is used to treat complicated intra-abdominal infections, urinary tract infections, and pneumonia. It is only recommended when other options are not appropriate. It is given by infusion into a vein. Common side effect include nausea, fever, liver problems, headache, trouble sleeping, and pain at the site of infusion. Severe side effects may include anaphylaxis, seizures, and Clostridioides difficile infection, ''Clostridioides difficile''-associated diarrhea. While use appears to be safe in pregnancy the medication has not been well studied in this group. Doses should be adjusted in those with kidney problems. Ceftazidime works by interfering with the building of the bacterial cell wall while avibactam works by preventing ceftazidime's brea ...
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Multi-drug-resistant Organisms
Multiple drug resistance (MDR), multidrug resistance or multiresistance is antimicrobial resistance shown by a species of microorganism to at least one antimicrobial drug in three or more antimicrobial categories. Antimicrobial categories are classifications of antimicrobial agents based on their mode of action and specific to target organisms. The MDR types most threatening to public health are MDR bacteria that resist multiple antibiotics; other types include MDR viruses, parasites (resistant to multiple antifungal, antiviral, and antiparasitic drugs of a wide chemical variety). Recognizing different degrees of MDR in bacteria, the terms ''extensively drug-resistant'' (''XDR'') and ''pandrug-resistant'' (''PDR'') have been introduced. ''Extensively drug-resistant (XDR)'' is the non-susceptibility of one bacteria species to all antimicrobial agents except in two or less antimicrobial categories. Within XDR, ''pandrug-resistant (PDR)'' is the non-susceptibility of bacteria to a ...
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Vancomycin
Vancomycin is a glycopeptide antibiotic medication used to treat certain bacterial infections. It is administered intravenously ( injection into a vein) to treat complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, and meningitis caused by methicillin-resistant ''Staphylococcus aureus''. Blood levels may be measured to determine the correct dose. Vancomycin is also taken orally (by mouth) to treat ''Clostridioides difficile'' infections. When taken orally, it is poorly absorbed. Common side effects include pain in the area of injection and allergic reactions. Occasionally, hearing loss, low blood pressure, or bone marrow suppression occur. Safety in pregnancy is not clear, but no evidence of harm has been found, and it is likely safe for use when breastfeeding. It is a type of glycopeptide antibiotic and works by blocking the construction of a cell wall. Vancomycin was approved for medical use in the United States in 1 ...
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Clarithromycin
Clarithromycin, sold under the brand name Biaxin among others, is an antibiotic used to treat various bacterial infections. This includes strep throat, pneumonia, skin infections, '' H. pylori'' infection, and Lyme disease, among others. Clarithromycin can be taken by mouth as a tablet or liquid or can be infused intravenously. Common side effects include nausea, vomiting, headaches, and diarrhea. Severe allergic reactions are rare. Liver problems have been reported. It may cause harm if taken during pregnancy. It is in the macrolide class and works by slowing down bacterial protein synthesis. Clarithromycin resistance is already a major challenge to healthcare systems and such resistance is spreading, leading to recommendations to test the susceptibility of pathogenic organisms to the antibiotic before commencing clarithromycin therapy. Clarithromycin was developed in 1980 and approved for medical use in 1990. It is on the World Health Organization's List of Essential Med ...
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Ciprofloxacin
Ciprofloxacin is a fluoroquinolone antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra-abdominal infections, certain types of infectious diarrhea, respiratory tract infections, skin infections, typhoid fever, and urinary tract infections, among others. For some infections it is used in addition to other antibiotics. It can be taken by mouth, as eye drops, as ear drops, or intravenously. Common side effects include nausea, vomiting, and diarrhea. Severe side effects include tendon rupture, hallucinations, and nerve damage. In people with myasthenia gravis, there is worsening muscle weakness. Rates of side effects appear to be higher than some groups of antibiotics such as cephalosporins but lower than others such as clindamycin. Studies in other animals raise concerns regarding use in pregnancy. No problems were identified, however, in the children of a small number of women who took the medication. It appear ...
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Cephalosporin
The cephalosporins (sg. ) are a class of β-lactam antibiotics originally derived from the fungus '' Acremonium'', which was previously known as ''Cephalosporium''. Together with cephamycins, they constitute a subgroup of β-lactam antibiotics called cephems. Cephalosporins were discovered in 1945, and first sold in 1964. Discovery The aerobic mold which yielded cephalosporin C was found in the sea near a sewage outfall in Su Siccu, by Cagliari harbour in Sardinia, by the Italian pharmacologist Giuseppe Brotzu in July 1945. Structure Cephalosporin contains a 6-membered dihydrothiazine ring. Substitutions at position 3 generally affect pharmacology; substitutions at position 7 affect antibacterial activity, but these cases are not always true. Medical uses Cephalosporins can be indicated for the prophylaxis and treatment of infections caused by bacteria susceptible to this particular form of antibiotic. First-generation cephalosporins are active predominant ...
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Cefixime
Cefixime, sold under the brand name Suprax among others, is an antibiotic medication used to treat a number of bacterial infections. These infections include otitis media, strep throat, pneumonia, urinary tract infections, gonorrhea, and Lyme disease. For gonorrhea typically only one dose is required. In the United States it is a second-line treatment to ceftriaxone for gonorrhea. It is taken by mouth. Common side effects include diarrhea, abdominal pain, and nausea. Serious side effects may include allergic reactions and ''Clostridioides difficile'' diarrhea. It is not recommended in people with a history of a severe penicillin allergy. It appears to be relatively safe during pregnancy. It is in the third-generation cephalosporin class of medications. It works by disrupting the bacteria's cell wall resulting in its death. Cefixime was patented in 1979 and approved for medical use in the United States in 1989. It is on the World Health Organization's List of Essential Medi ...
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