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CERTIFICATE

This is to certify that SHARANK SANTHOSH KUMAR student of

class XII has successfully completed his/her Biology project
titled A GUIDE THROUGH ANTIBIOTICS AND IT’S EFFECTS The
project was completed under the guidance and supervision
of ........................... as a requirement for the AISSCE PRACTICAL
EXAMINATION 2023-24.

Internal Examiner:

Date:

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 INDEX

1. INTRODUCTION

2. HISTORY OF ANTIBIOTICS

3. TYPES OF ANTIBIOTICS AND ITS CAUSES

4. WORKING OF AN ANTIBIOTIC

5. SIDE EFFECTS AND ALLERGIES

6. RECENT RESEARCH ON ANTIBIOTICS

7. CASE STUDY

8. BIBLIOGRAPHY

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 INTRODUCTION
You've most likely taken an antibiotic at least once in your
lifetime. From treatments for painful strep throat or ear
infections as a child, to burning urinary tract infections or
itchy skin infections as an adult, antibiotics are one of the
most highly utilized and important medication classes we
have in medicine.
Understanding the vast world of antibiotics and anti-infective
is no easy task. Anti-infective are a large class of drugs that
cover a broad range of infections, including fungal, viral,
bacterial, and even protozoal infections. Athlete's foot? That's
a common fungal infection. HIV? Antiviral medications are
always needed. Bladder infection? Yes, that may need a
common antibiotic. And head lice? A topical anti-parasitic can
alleviate the itching. There is no one type of antibiotic that
cures every infection. Antibiotics specifically treat infections
caused by bacteria, such as Staph., Strep., or E. coli., and
either kill the bacteria (bactericidal) or keep it from
reproducing and growing (bacteriostatic). Antibiotics do not
work against any viral infection.
(i)In 3500 BC the Sumerian doctors would give patients beer
soup mixed with snakeskins and turtle shells. (ii)Babylonian
doctors would heal the eyes by using an ointment made of
frog bile and sour milk. (iii)The Greeks used many herbs to
heal ailments. (iv)All of these "natural" treatments contained
some sort of antibiotic.

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 History of Antibiotics

1. Louis Pasteur was one of the first recognized physicians

who observed that bacteria could be used to kill other
bacteria.
2. In 1929 Sir Alexander Fleming, a Scottish bacteriologist,
went on a action and left a petri dish of staphylococci
bacteria uncovered. When he returned, he noticed that
there was mold growing on it. Upon further examination,
he saw that the area around the mold had no bacteria
growing. He named the mold Penicillium, and the chemical
produced by the mold was named penicillin, which is the
first substance recognized as an antibiotic.
3. Almost immediately after penicillin was introduced,
resistance in certain strains of staphylococci was noticed.
4. In 1935, Domagk discovers synthetic antimicrobial
chemicals (sulfonamides). During World War II, because of
need for antibiotic agents, penicillin was isolated and
further tested by injection into animals. It was found to be
extremely useful in curing infections, and to have
extremely low toxicity to the animals. Because of these
findings, use of penicillin greatly increased. This also
spurred a search of other chemical agents of similar use.
5. In the late 1940's through the early 1950's, streptomycin,
chloramphenicol, and tetracycline were discovered and
introduced as antibiotics.

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6. In 1953, during a Shigella outbreak in Japan, a certain
strain of dysentery bacillus was found to be resistant to
chloramphenicol, tetracycline, streptomycin, and the
sulfanilamides.
7. By the 1950's it was apparent that tuberculosis bacteria
was rapidly developing resistance to streptomycin, which
had commonly been used to treat it.

Antibiotics have revolutionized medical care in the 20th

century, but in recent years bugs have been winning We
haven't always relied on the latest new medicines to remedy
what ails us.

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 Penicillin-THE FIRST MIRACLE
ANTIBIOTIC

Penicillin (sometimes abbreviated PC or pen) is a group

of Beta-lactam antibiotics used in the treatment of
bacterial infections caused by susceptible, usually Gram-
positive organisms. "Penicillin" is also the informal name
of a specific member of the penicillin group Penam
Skeleton, which has the molecular formula R-CHINO4S,
where R is a
variable side chain.
Penicillin was first ever “true” antibiotic and it was
discovered by a Scottish bacteriologist, Alexander Fleming
in 1928. It was widely used to treat the different types of
bacterial infections that plagued man. Ironically, Penicillin
was an accidental discovery, but it was a landmark

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 discovery in the field of medicine. Penicillin is acquired
from a mould called Penicillium notatum (also known as
Penicillium chrysogenum).

Types of Penicillin
There are different types of penicillin, which are grouped based
on their effectiveness.
Penicillin VK and Penicillin G are natural Penicillin

 Penicillin VK – It is used to fight against bacterial

infections. Example: Ear infection.
 Penicillin G – More effective against gram-positive and
gram-negative cocci bacterial infections. Example:
susceptible bacterial infections in the stomach.

Penicillium chrysogenum

Penicillium chrysogenum, species of fungus in the

genus Penicillium (kingdom Fungi) that occurs across a variety
of habitats and is especially common in moist areas, including
forests and damp indoor environments. Penicillium
chrysogenum is very closely related to P. rubens and P.
notatum and has, at various times, been considered
synonymous with either or both.

P. chrysogenum is a source of the antibioticpenicillin. The

species was in fact the source from which
Scottish bacteriologist Alexander Fleming originally discovered
the antibiotic, although in 1928, at the time of Fleming’s
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discovery, the strain was named P. notatum. P.
chrysogenum also is a common contaminant of foodstuffs and
indoor environments, where its presence on surfaces or in the
air can have negative effects on human health.

In addition to penicillin, P. chrysogenum produces various other

substances. Among these substances are a yellow pigment
known as chrysogine and an antibiotic known as xanthocillin.

Penicillium chrysogenum

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 Types of Antibiotics and it’s
causes
1. Synthetic Antibiotics
2. Natural Antibiotics
3. Semi Synthetic Antibiotics

 Chemotherapeutic agents (Synthetic Antibiotics) :

antimicrobial agents of synthetic origin useful in the
treatment of microbial or viral disease. Examples are
sulfonamides, isoniazid, ethambutol, AZT, nalidixic
acid and chloramphenicol. Note that the
microbiologist's definition of a chemotherapeutic
agent requires that the agent be used for antimicrobial
purpose and excludes synthetic agents used for
therapy against diseases that are not of microbial
origin. Hence, pharmacology distinguishes the
microbiologist's chemotherapeutic agent as a
"synthetic antibiotic"
 Natural Antibiotics: antimicrobial agents produced by
microorganisms that kill or inhibit other
microorganisms. This is the microbiologist's definition.
A more broadened definition of an antibiotic includes

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 any of natural origin (from any type of cell) which has
the effect to kill or inhibit the growth of other types
cells. Since
most clinically-useful antibiotics are produced by
microorganisms and are used to kill or inhibit
infectious Bacteria, we will follow the classic
definition. Note also (above), pharmacologists refer to
any antimicrobial chemical used in the treatment of
infectious disease as antibiotic.
 Semisynthetic antibiotics :are molecules produced my
a microbe that are subsequently modified by an
organic chemist to enhance their antimicrobial
properties or to render them unique for a
pharmaceutical patent.

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 Working of an Antibiotic
Although there are a number of different types of antibiotic,
they all work in one of two ways:
 A bactericidal antibiotic (penicillin, for instance) kills
the bacteria; these drugs usually interfere with either
the formation of the cell wall of bacteria or its cell
contents.
 A bacteriostatic stops bacteria from multiplying, i.e.
retards its growth.

An antibiotic is given for the treatment of an infection caused

by bacteria. It is not effective against viruses. Most common
infections are caused by viruses, when an antibiotic will not
be of use. Even if you have a mild bacterial infection, the
immune system can clear most bacterial infections. For
example, antibiotics usually do little to speed up recovery
from bronchitis, or most ear, nose, and throat infections that
are caused by bacteria. So, do not be surprised if a doctor
does not recommend an antibiotic for conditions caused by
viruses or non-bacterial infections, or even for a mild
bacterial infection. However, you do need antibiotics if you
have certain serious infections caused by bacteria such as
meningitis or pneumonia. In these situations, antibiotics are
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often life-saving. When you are ill, doctors are skilled at
checking you over to rule out serious illness and to advise if
an antibiotic is needed. If you have an infection, it is
important to know whether it is caused by bacteria or a virus.
Most upper respiratory tract infections, such as the common
cold and sore throats are caused by viruses - antibiotics do
not work against these viruses. If antibiotics are overused or
used incorrectly, there is a risk that the bacteria will become
resistant - the antibiotic becomes less effective against that
type of bacterium. A broad-spectrum antibiotic can be used
to treat a wide range of infections. A narrow-spectrum
antibiotic is only effective against a few types of bacteria.
Some antibiotics attack aerobic bacteria, while others work
against anaerobic bacteria. Aerobic bacteria need oxygen,
anaerobic bacteria do not. In some cases, antibiotics may be
given to prevent rather than treat an infection, as might be
the case before surgery. This is called 'prophylactic' use of
antibiotics. They are commonly used before bowel and
orthopedic surgery.

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 Side effects and Allergies
If you are experiencing a bothersome or serious antibiotic
side effect, you should contact
your health care provider to discuss your symptoms. The
outcomes may include:

 Staying on the same antibiotic and managing the

side effect
 Adjusting the dose
 Switching to a different antibiotic

Usually, antibiotic treatment should not be stopped without a

health care provider's
approval; all medication should be finished. Stopping
antibiotics early due to side effects
may allow the infection to worsen and may lead to antibiotic
resistance, making an
antibiotic less effective. Even if the infection appears to have
cleared up before all of the
medication is gone, the full course of antibiotic treatment
should always be completed
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unless you are told otherwise by your doctor.

Antibiotic Allergies:

Antibiotic allergies or hypersensitivity reactions are some of

the most common side
effects of antibiotics leading to emergency room admission.
Always tell your doctor of
any previous allergic reaction to any medication, including
antibiotics. Mild allergic
reactions may only result in a skin rash. A more severe allergic
reaction called
anaphylaxis is a medical emergency that requires immediate
medical attention.

Anaphylactic reactions due to antibiotics may include:

 Shortness of breath
 Wheezing
 Nausea/vomiting
 Light headedness, dizziness
 Fast heart rate
 Swelling of the face, lips or tongue
 Shock

Immediately call for medical help if any of these symptoms

should appear after taking an
antibiotic.

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Recent research on Antibiotics
About the study

In the present study, researchers sub-cultured colonies

detected after 12 weeks of incubation on agar plates overlaid
with Staphylococcus aureus. Bioassay-guided fractionation of
the extract from these microbial colonies yielded Kalimantan, a
previously known antibiotic originating
from Pseudomonas and Alcaligenes. Initially, kalimantacin was
more abundant in the extract; however, when the researchers
disrupted the first gene in the kalimantacin/batumin operon,
viz. bat1, it reduced kalimantacin production below detectable
levels. Further fermentation yielded a novel depsi-peptide
compound like teixobactin with a unique mass of 903.5291
[M+H]+, which the researchers named clovibactin.

Study findings

Structurally, clovibactin featured two D-amino acids, d-alanine,

and d-glutamic acid, in its four amino acid long linear N
terminus and D-3-hydroxy asparagine, a unique amino acid
residue. Sequencing of the E. terrae ssp. carolina genome
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revealed 19 predicted biosynthetic gene clusters (BGCs) in
clovibactin, and BLASTN alignment revealed 72% identity
between the clovibactin and teixobactin BGCs. Clovibactin was
active against Bacillus subtilis, unlike kalimantacin. To exert its
antibiotic effects, it blocked cell wall synthesis by binding the
pyrophosphate (PPi) moiety of multiple cell wall lipid
precursors, including undecaprenyl phosphate (C 55PP), lipid II,
and lipid IIIWTA(wall teichoic acid). Clovibactin molecules
antiparallelly arranged themselves to selectively bind to the PPi
moiety of lipid precursors, resulting in a supramolecular
complex that subsequently oligomerized into a stable higher-
order fibrillar assembly using its short N terminus acts as
oligomerization domain. These supra-structures appear to be
an essential part of the killing mechanism of clovibactin.
However, a detailed structural analysis of clovibactin could only
uncover how it manages to bind PPi of lipid II tightly and
selectively. Another striking feature of clovibactin was its
exceptional ability to cause cell lysis in a mechanistically distinct
manner from teixobactin.

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 CASE STUDY
A 25-year-old woman reporting an allergy to penicillin

During routine antenatal screening of a 25-year-old woman in

her first trimester of pregnancy, positive results are obtained on
serologic testing for syphilis, and after investigation, late latent
syphilis is diagnosed. Standard treatment for this stage of
syphilis in pregnancy consists of three weekly intramuscular
injections of penicillin G benzathine. 1 The patient reports that
her mother told her she had an allergic reaction to penicillin as
a child, the details of which neither can recall.

On the basis of her history, is this patient likely to have an

allergy to penicillin?
Allergy to penicillin is self-reported by about 10% of the general
population, but only 10% of those reporting an allergy have a
positive result on penicillin skin testing. When assessing a

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patient with reported penicillin allergy, the clinician must obtain
a detailed history. Important questions to be asked are listed
in Box 1. Commonly, as in this patient, the history of allergic
reactions is remote and difficult to recall. Features of
hypersensitivity reactions mediated by immunoglobulin E (IgE)
(i.e., type 1 reactions) include urticaria, angioedema,
gastrointestinal symptoms and bronchospasm. These reactions
usually occur within one hour of exposure and can lead to
anaphylaxis. Some IgE-mediated reactions may occur 1–72
hours after administration. Delayed (non–IgE-mediated)
reactions occur hours to days after exposure.

How can a type 1 allergic reaction to penicillin be excluded in

this patient?

When a clear history cannot be elicited, skin testing is currently

the method of choice for excluding type 1 reactions to
penicillin. This most often requires the help of an expert in
allergy. Penicillin skin testing consists of prick testing followed
by intradermal instillation of small quantities of major
(penicilloyl–polylysine) and minor (penicillin G, penicilloate and
penilloate) determinants and observation for a wheal.

A negative result on skin testing with both major and minor

determinants has a negative predictive value for an immediate
hypersensitivity reaction nearing 100%. For safety reasons, a
negative skin test result is typically followed by a graded
challenge, which involves administration of several
incremental, subtherapeutic doses of penicillin. For patients

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who tolerate this graded challenge, penicillin can be
prescribed. Skin testing or graded challenges should not be
performed in patients with a history suggestive of severe
delayed hypersensitivity reactions such as Stevens–Johnson
syndrome. Skin testing can be safely performed in pregnancy.

If this patient has a positive result on skin testing for penicillin

allergy, can she still be treated safely with penicillin?

The positive predictive value of a penicillin skin test ranges

from 40% to 100%. Therefore, if a patient has a positive skin
test result, penicillin can still be administered through a
carefully observed desensitization process, which would be
performed by an allergy expert. Desensitization involves
administering incremental doses of the drug in a monitored
setting until the therapeutic dose is achieved. The purpose of
desensitization is to induce tolerance without triggering
adverse effects, and this is maintained only if the drug is
administered continually. Desensitization can be safely
performed in pregnancy.

If this patient has a positive result on skin testing, can she be

treated with other β-lactam antibiotics in the future?

It was previously believed that individuals with penicillin allergy

had a 10% risk of immediate hypersensitivity with the
administration of cephalosporins. However, this belief was
based on studies in which the cephalosporin administered
contained trace amounts of penicillin. Currently, it is believed
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that the rate of cross-reactivity is closer to 1%. Data suggest
that characteristics of the side chains, and not the β-lactam ring
itself, are most responsible for cross-reactivity between various
β-lactam antibiotics. Patients with a prior history suggestive of
IgE-mediated penicillin allergy have only a 2% risk of IgE-
mediated reaction to carbapenems. Aztreonam does not cross-
react with other β-lactam agents except for ceftazidime. If a
patient has a positive result on penicillin skin testing and
treatment with a cephalosporin or carbapenem is indicated, he
or she can undergo a graded challenge.

The case revisited

The patient was referred to an allergist for penicillin skin

testing, the result of which was negative. This was followed by a
graded challenge, which was tolerated. The patient was
subsequently treated with intramuscular penicillin G benzathine
for her late latent syphilis, without adverse event. Her allergy
history was updated in her clinic records to indicate that she did
not have an allergy to penicillin.

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 CONCLUSION
In conclusion, antibiotics stand as indispensable agents in
modern medicine, revolutionizing the treatment of bacterial
infections and significantly improving overall public health.
Their discovery marked a transformative milestone, rendering
once-fatal diseases treatable and surgery safer. However, the
escalating concern lies in the emergence of antibiotic-
resistant strains, a consequence of overuse, misuse, and
inadequate regulatory measures. This resistance jeopardizes
the effectiveness of antibiotics, creating a pressing global
health crisis.

To mitigate this threat, a comprehensive and collaborative

approach is imperative. Implementing judicious antibiotic
stewardship programs, educating healthcare professionals
and the public on responsible use, and fostering research into
alternative therapies are crucial steps. International
cooperation is essential to address the transboundary nature
of antibiotic resistance. Additionally, incentivizing
pharmaceutical research for novel antibiotics and promoting
sustainable agricultural practices can contribute to reducing
the selective pressure driving resistance.

As we confront the challenges of antibiotic resistance, a

concerted effort is needed to strike a delicate balance
between the benefits and risks associated with these life-

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saving drugs. The future hinges on our ability to implement
multifaceted strategies, ensuring the continued efficacy of
antibiotics and preserving the foundation of modern
medicine for generations to come.

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 BIBLIOGRAPHY
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592298/

https://byjus.com/biology/antibiotics/

https://www.slideshare.net/guest08f61f/project-
antibioticsbyharkiran-presentation

https://www.slideshare.net/riyarc/antibiotics-84457188

https://www.youtube.com/watch?v=CFVyvlQH-oc

https://en.wikipedia.org/wiki/Antibiotic

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