Antimicrobial spectrum

The antimicrobial spectrum of an antibiotic means the range of microorganisms it can kill or inhibit. Antibiotics can be divided into broad-spectrum antibiotics, extended-spectrum antibiotics and narrow-spectrum antibiotics based on their spectrum of activity. Detailedly, broad-spectrum antibiotics can kill or inhibit a wide range of microorganisms; extended-spectrum antibiotic can kill or inhibit Gram positive bacteria and some Gram negative bacteria; narrow-spectrum antibiotic can only kill or inhibit limited species of bacteria.[1][2][3]

A simplified diagram showing common disease-causing bacteria and the antibiotics which act against them.

Currently no antibiotic's spectrum can completely cover all types of microorganisms.[4]

Determination

The antimicrobial spectrum of an antibiotic can be determined by testing its antimicrobial activity against a wide range of microbes in vitro . Nonetheless, the range of microorganisms which an antibiotic can kill or inhibit in vivo may not always be the same as the antimicrobial spectrum based on data collected in vitro.[2][5]

Significance

Narrow-spectrum antibiotics have low propensity to induce bacterial resistance and are less likely to disrupt the microbiome (normal microflora).[3] On the other hand, indiscriminate use of broad-spectrum antibiotics may not only induce the development of bacterial resistance and promote the emergence of multidrug-resistant organisms, but also cause off-target effects due to dysbiosis.[3][6] They may also have side effects, such as diarrhea or rash.[7] Generally, a broad antibiotic has more clinical indications, and therefore are more widely used.[2][8] The Healthcare Infection Control Practices Advisory Committee (HICPAC) recommends the use of narrow-spectrum antibiotics whenever possible.[9]

Examples

See also

References
  1. Michelle A. Clark; et al. (2009). Pharmacology (5th ed.). USA: Lippincott Williams & Wilkins. pp. 375–376. ISBN 978-1-4511-4320-1.
  2. David Warrell; Timothy M. Cox; John Firth; Estée Török (11 October 2012). Oxford Textbook of Medicine: Infection. OUP Oxford. p. 39. ISBN 978-0-19-965213-6.
  3. Melander, Roberta J.; Zurawski, Daniel V.; Melander, Christian (2018). "Narrow-Spectrum Antibacterial Agents". MedChemComm. 9: 12–21. doi:10.1039/C7MD00528H. ISSN 2040-2503. PMC 5839511. PMID 29527285.
  4. Erich Lück; Martin Jager (1997). Antimicrobial Food Additives: Characteristics, Uses, Effects. Springer Science & Business Media. p. 39. ISBN 978-3-540-61138-7.
  5. Wiley W. Souba; Douglas W. Wilmore (23 February 2001). Surgical Research. Elsevier. p. 909. ISBN 978-0-08-054214-0.
  6. Francino, M. P. (2015). "Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances". Frontiers in Microbiology. 6: 1543. doi:10.3389/fmicb.2015.01543. ISSN 1664-302X. PMC 4709861. PMID 26793178.
  7. "Comparing Broad- and Narrow-Spectrum Antibiotics for Children with Ear, Sinus, and Throat Infections". www.pcori.org. 2014-10-08. Retrieved 2020-09-05.
  8. Andrew Hitchings; Dagan Lonsdale; Daniel Burrage; Emma Baker (30 March 2014). The Top 100 Drugs e-book: Clinical Pharmacology and Practical Prescribing. Elsevier Health Sciences. p. 94. ISBN 978-0-7020-5515-7.
  9. "Antibiotic Stewardship Statement | HICPAC | CDC". www.cdc.gov. 2019-04-15. Retrieved 2020-09-05.
  10. Zhanel, George; Critchley, Ian; Lin, Lynn-Yao; Alvandi, Nancy (January 2019). "Microbiological Profile of Sarecycline, a Novel Targeted Spectrum Tetracycline for the Treatment of Acne Vulgaris". Antimicrobial Agents and Chemotherapy. 63 (1). doi:10.1128/AAC.01297-18. ISSN 1098-6596. PMC 6325184. PMID 30397052.
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