Antibacterials

Antibacterials are similar to antibiotics but with a difference: originally antibiotics were derived from moulds and fungi, whereas antibacterials were developed from chemicals. Early antibacterials like the sulpha-drugs were derived industrial dyes that was metabolized by the body into sulphanilamide, the active antibacterial ingredient. Sulpha drugs, introduced in the 1930s, have proved to be effective against many bacterial infections.

Sulphonamides followed the original sulpha drugs. Bacterial resistance to sulpha drugs, like that of resistance to antibiotics, have resulted in doctors switching over to antibiotics that are more effective and safe. But the days of the sulphonamide antibacterials are not yet over.

Sulphonamides reach high concentrations in the urine. They are therefore useful in treating infections of the urinary tract. They are also used for chlamydia, pneumonia and for some middle ear infections; sulphacetamide is often included in topical preparations for skin, eye and other ear infections. Sulphamethoxazole, in combination with trimethoprim, often in a single large dose (also known as co-trimoxazole), is used for bladder infections, certain types of bronchitis and some gastrointestinal infections.

There are of course a range of antibacterials that are not sulphonamides: those used against leprosy, TB and malaria; those used against protozoal infections (like metronidazole, diloxanide furoate). There are others, also known as antimicrobials, include metronidazole, used for a variety of genital infections, and some serious infections in the abdomen, pelvic region, the heart and central nervous system. Nalidixic acid and nitrofurantoin are effective as antiseptics for the urinary tract, and are used to cure or prevent recurrent infections.

Antibacterials work by preventing the growth and multiplication of the organisms, somewhat similar to antibiotics.

Antibacterials may take several days to wipe out the bacteria. During this time additional medication to relieve pain and fever is usually advised. Sulphonamides in particular can cause loss of appetite, rash, nausea and drowsiness.

Risks and special precautions of antibacterials include allergic reactions, rashes and fever. The doctor should be consulted in case a change of antibacterial is required.

Serious, but rare risks, with some sulphonamides include formation of crystals in the kidneys, a risk that can be reduced by drinking adequate amounts of fluid during prolonged treatment. Sulphonamides may occasionally damage the liver; they are not usually prescribed for people with liver problems. Damage to bone marrow is another possibility, leading to lowered production of white blood cells and increased chances of infection. Doctors therefore try avoiding use of sulphonamides for long periods. It is advisable to monitor the liver and blood content, during long-term treatment that may be absolutely necessary.

Alliance for the Prudent Use of Antibiotics (APUA) is an international network dedicated to preserving the effectiveness of antibiotics through research and education about their appropriate use and the problem of resistance. APUA provides a scientific network which facilitates global information exchange and supports country-based efforts to curb antibiotic resistance.

Laxatives

A person is said to be suffering from 'constipation' if he/she passes dry, hard stools less frequently than usual (once a day).

Constipation can be actual or chronic.

	a)	Acute Constipation: It may develop suddenly. It could be a part of a more serious illness especially if the patient also suffers from abdominal pain, vomiting and bloating. Such patients should consult the doctor immediately.
	b)	Chronic Constipation: It is the long-standing type of constipation and it occurs due to various reasons:
	1.	Faulty bowel habits - habitually not attending to the nature call in time.
	2.	Faulty diet that is low in roughage, fiber or water content. The simple remedy is more fluid and a diet that contains plenty of foods that are high in fiber. Avoid constipating foods.
	3.	Lack of exercise.
	4.	Painful lesions in the anal region such as cracking of skin near anal region (anal fissure).
	5.	Diseases of the bowel: Constipation may also occur following an attack of diarrhoea or the day after taking a laxative. This needs no treatment.

Constipation that occurs due to certain drugs, e.g., narcotic analgesics, antacids (containing aluminium), tricyclic antidepressants, or constipation that occurs due to certain disease, e.g., hypothyroidism (decreased production of thyroid hormones) and scleroderma (hardening of skin due to chronic inflammation), get cured once the causative drugs are stopped and the causative disease is cured.

Constipation is very common in :

	a)	Old people - due to lack of exercise. It could also be a sign of some serious disease (e.g., cancer). The doctor should be consulted about any persistent change in the bowel habit.
	b)	Pregnant women - because of difficulty in using abdominal muscles during evacuation. Increase in fluid intake as will as high fiber food intake can prove helpful. Take doctor's guidance if the problem is too severe.