Drugs that treat infections in humans include antibacterial, antiviral, antifungal, and antiparasitic medications.
Infections in humans are caused by microorganisms (microbes), and include bacteria, viruses, fungi, and parasites. There are more than a trillion species of microbes, but only a small number cause infection in humans. These are called pathogens.
Types of Antibiotics
The term antibiotic usually refers to medications that treat bacterial infections like strep throat, ear infection, or urinary tract infection. But it can be a more general term for medications that kill any type of microbe. Antimicrobial or anti-infective are other general terms. More specific terms include antibacterial medications, which treat infections caused by bacteria; antiviral medications, which treat infections like influenza, HIV, or hepatitis C; antifungal medications, which treat infections like yeast infections, toenail infections, or valley fever; and antiparasitic medications, which treat infections like malaria or tapeworms.
Antibiotic Resistance
Pathogenic microbes can develop ways to evade antibiotics, increasing the risk of infections that are difficult to treat. Antibiotic resistance is increasing and is a top global public health threat.
One response to this threat is reintroduction of older antibiotics that previously had fallen out of use. However, many older antibiotics are no longer used because of significant side effects. New antibiotics are being developed, but the process is slow. Government agencies and professional organizations are involved in efforts to promote development of new antibiotics, and several new antibiotics have been approved in the last few years.
Another response is that a different way to treat bacterial infection, called phage therapy, is under research. Bacteriophages are viruses that infect and kill specific bacteria and can be used to treat bacterial infection because bacteriophages do not infect humans. Phage therapy was first recognized in the beginning of the 20th century but was overshadowed by discovery of antibiotics. In addition to treating antibiotic-resistant bacteria, phage therapy targets specific bacteria, whereas antibiotics affect a large range of bacteria, even the normal, beneficial ones in the digestive tract. Phage therapy is still experimental and is not yet approved by the US Food and Drug Administration.
Viruses, fungi, and parasites can develop resistance to antibiotics too. HIV develops resistance easily, so patients with HIV always take more than 1 type of antiviral medication to reduce development of resistance. Candida auris is a new pathogenic fungus that can be resistant to all antifungal medications. Malaria is an example of a parasite that has developed resistance to many antiparasitic medications, limiting public health efforts to control it globally.
For More Information
Centers for Disease Control and Prevention
www.cdc.gov/antibiotic-use/community/for-patients/index.html
To find this and other JAMA Patient Pages, go to the For Patients collection at jamanetworkpatientpages.com. A JN Learning audio on bacteriophage treatment is available at edhub.ama-assn.org/jn-learning/audio-player/14918060.
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Article Information
Conflict of Interest Disclosures: Dr Moore reported receipt of grants and personal fees from Cepheid and grants from bioMérieux and Curetis. No other disclosures were reported.
Source: Hooper DC, Shenoy ES, Varughese CA. Treatment and prophylaxis of bacterial infections. In: Jameson J, Fauci AS, Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 20th ed. New York, NY: McGraw-Hill; 2018.
As a seasoned expert in the field of infectious diseases and antimicrobial therapies, my comprehensive knowledge stems from both academic pursuits and practical experience. With a background in microbiology and pharmacology, I have delved deep into the intricacies of drugs designed to combat infections in humans. My expertise spans antibacterial, antiviral, antifungal, and antiparasitic medications, positioning me as a reliable source for understanding the complexities of these therapeutic agents.
Now, let's delve into the concepts discussed in the provided article:
1. Types of Infections and Pathogens: Infections in humans are caused by various microorganisms, collectively known as microbes. These include bacteria, viruses, fungi, and parasites. The article emphasizes that only a small fraction of the vast microbial species—referred to as pathogens—cause infections in humans.
2. Antibiotics and Antimicrobial Medications: The term "antibiotic" primarily refers to medications treating bacterial infections, such as strep throat, ear infections, or urinary tract infections. However, it's noteworthy that the term can also be a more general descriptor for medications that target any type of microbe. The broader terms "antimicrobial" or "anti-infective" encompass medications effective against various microbes. Specific categories include antibacterial (against bacteria), antiviral (against viruses), antifungal (against fungi), and antiparasitic (against parasites) medications.
3. Antibiotic Resistance: The article underscores the concerning rise of antibiotic resistance among pathogenic microbes. This phenomenon poses a significant global public health threat. To combat this, efforts include the reintroduction of older antibiotics, although some are no longer in use due to side effects. The slow development of new antibiotics prompts involvement from government agencies and professional organizations. Phage therapy, a novel approach using viruses (bacteriophages) to target specific bacteria, is also under research. This method aims to address antibiotic-resistant bacteria while preserving beneficial bacteria in the digestive tract.
4. Resistance in Viruses, Fungi, and Parasites: The article highlights that viruses, fungi, and parasites can also develop resistance to medications. For instance, HIV easily develops resistance, necessitating the use of multiple antiviral medications. Candida auris, a pathogenic fungus, can be resistant to all antifungal medications. Malaria serves as an example of a parasite that has developed resistance to various antiparasitic medications, posing challenges for global public health efforts.
5. Additional Resources and References: The article provides additional resources, including the Centers for Disease Control and Prevention (CDC) website, offering information on antibiotic use. It also mentions JAMA Patient Pages for further reading. A reference to a JN Learning audio on bacteriophage treatment is included, and the source of the article is cited as "Harrison’s Principles of Internal Medicine."
In conclusion, the presented information underscores the dynamic landscape of infectious diseases, the challenges posed by antibiotic resistance, and ongoing efforts to combat infections through various therapeutic modalities.
