which summarizes them thus:
A major drawback to the use of tetracycline antibiotics in young children and pregnant women is that they can discolour developing teeth. When given by mouth they have to be administered in high doses to reach effective levels in the blood (because they are poorly absorbed through the intestines). Such high doses increase the likelihood of diarrhoea.
Short-term reactions include:
Long-term problems relate to the demolition job that tetracyclines do on the bowel flora, the friendly bacteria which detoxify our intestines and manufacture B-vitamins for us, and above all which keep yeasts under control.
When tetracycline drugs are used, often for months on end to treat acne, for example, an overgrowth of yeast in the bowel is almost certain, and it can take years to put this right. (See Chapters 7 and 8 for details of aspects of these effects and what you can do about them, as well as Chapter 9 for probiotic strategies to help reverse this damage.)
CEPHALOSPORINS
As mentioned above, the cephalosporins (such as cefaclor) were first extracted from fungal spores found in sewage in the mid-1940s. They were initially fairly toxic, but with steady development of more refined versions they have become less so.
Cephalosporins act in similar ways to penicillin-type drugs, have a wide spectrum and are fairly well tolerated. Their use is mainly in treatment of infections of the chest, urinary tract, liver and gall bladder, as well as for gonorrhea. They are commonly being used prophylactically, before surgery for example, and are frequently used when penicillin antibiotics fail to control infection. They can be administered either by mouth or by injection.
Side-effects include:
Resistance is gradually building to many of the major drugs in this group, in a number of important disease-causing microbes, including Staphylococcus aureus, Klebsiella, E. coli and Pseudomonas aeruginosa.
THE MACROLIDE, GLYCOPEPTIDES AND LINCOSAMIDE DRUGS
In the early 1950s, drugs in the class of broad-spectrum antibiotics known as macrolides appeared. The most notable of these, and the only one still in major use, is erythromycin.
Erythromycin is used as an alternative to penicillin and cephalosporin drugs and has a particular usefulness in the treatment of Legionnaires’ disease (a rare form of pneumonia). It carries risks relating to liver damage and so is used cautiously.
The glycopeptide drugs include the toxic, expensive and hence very rarely used vancomycin. Its potency against superbugs such as S. aureus (see Chapter 2) makes this a drug held in reserve, and because of this resistance to it is low. Once again we see the irony of the savior drug being so toxic that it carries dangers all its own.
Among the side-effects of vancomycin are:
But remember – it could save your life at the same time.
The lincosamide drugs such as lincomycin appeared in the early 1960s, and are used mainly for treatment of extremely serious infections of bones, joints and the abdomen which fail to respond to other antibiotics. They too are therefore ‘kept in reserve’ because of their side-effects.
As the British Medical Association explains, ‘they are more likely to cause serious disruption of bacterial activity in the bowel than other antibiotics.’ This highlights the vital importance of maintaining the health of the friendly bacteria, and since all antibiotics damage these it is safe to assume that the lincosamide antibiotics are absolutely devastating.
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