How Do Antibiotics Work? The Truth and the Myths


Flu season is a busy time in any doctor’s office, when medical professionals can come under pressure for a “quick fix” remedy. But are antibiotics really effective in treating influenza? Can they cure the common cold?

From the discovery of penicillin to development of the 100-plus antibiotics available today, we look at the way antibiotics work, what they can cure or treat, and conditions for which they are unsuitable.


The first antibiotic available for prescription was Prontosil.


Although Alexander Fleming’s discovery of penicillin in 1928 led to the development of antibiotics as we know them today, penicillin was not the first antibiotic released for sale to the public. In fact, it took over 10 years for penicillin to be made commercially available to treat bacterial infections.


Prontosil, developed by Gerhard Domagk, a German pathologist, was first released for sale in 1935. Domagk was awarded the Nobel prize for his achievement, but the Nazi government forced him to decline the honor.

Prontosil had only limited success in tackling bacterial infections. However, it was the only established antibiotic in an era where bacterial infections were extremely common in the United States and Europe. In fact, at that time even the slightest scrape or scratch could prove deadly. As a result, Prontosil quickly became the go-to drug in treating staphylococci and other pathogenic infections.


Penicillin did not become available for prescription until 1940. The antibiotic is attributed with saving thousands of soldiers during the latter stages of World War II. To date, experts estimate that penicillin has saved approximately 200 million lives worldwide.


There are seven main types of antibiotics.


Today, there are over 100 different antibiotics on the market. These have been developed from just a few drugs. The main antibiotic groups are: penicillins, cephalosporins, aminoglycosides, fluroquinolones, macrolides, tetracylcines, and sulfonamides.


Different antibiotic groups are more effective in treating different types of infections. Doctors prescribe antibiotics based on the bacteria involved. Sometimes, laboratory tests are conducted to identify which bacteria is responsible for a patient’s condition. This helps doctors prescribe the most effective antibiotic.


Antibiotics are ineffective against many illnesses.



It is a common misconception that antibiotics are an effective “cure all.” They can be very beneficial in treating bacterial infections. However, many illnesses are viral in nature.


Bacteria and viruses are distinct organisms. They have different structures and do not replicate in the same way. Antibiotics work by inhibiting the growth mechanism in bacteria. This approach does not work with viruses.


Common viral illnesses include colds, influenza, measles, chickenpox, shingles, rubella, smallpox, norovirus, rotavirus, hepatitis, herpes, dengue fever, yellow fever, Lassa fever, Ebola, polio, meningitis, encephalitis, and rabies. Antibiotics cannot cure viral diseases. However, they are sometimes prescribed to treat or prevent secondary bacterial infections.



People do not become resistant to antibiotics, bacteria do.



It is a common misconception that misusing antibiotics causes those who use them to become immune to their effect. In fact, it is not the human body that builds up resistance to antibiotics. Rather, it is the bacteria themselves.


Every time we take antibiotics, “sensitive” bacteria (i.e. bacteria vulnerable to antibiotic attack) die off. However, “resistant” bacteria are left behind. Antibiotic resistance occurs when resistant bacteria grow and multiply. This increases the populations of bacteria that are immune to treatment. Misuse of antibiotics can cause bacterial resistance.


Resistance can occur even without antibiotic misuse.


It is important to take antibiotics as prescribed without skipping doses. Finish the course of treatment and never give leftover antibiotics to others. Nevertheless, even when the patient follows the doctor’s instructions to the letter, it is still possible for bacteria to develop antibiotic resistance.


Medical practitioners today only prescribe antibiotics when they are absolutely necessary. Governments around the world are taking steps to improve surveillance of antibiotic resistance and educate the public on the dangers of overuse. Misuse does exacerbate antibiotic resistance, but it can occur naturally.


Antibiotic resistance is one of the biggest threats humankind faces today.


Antibiotic resistance threatens not only human health, but also food security and global development. Antibiotic resistance extends hospital stays and increases medical costs. With antibiotics used to treat animal disease, resistance also affects agriculture.


The fear is that antibiotic resistance could potentially render diseases that are highly treatable today the fatal infections of tomorrow. Studies show that a number of infections are becoming harder to treat because of antibiotic resistance. These include: tuberculosis, gonorrhea, pneumonia, and salmonellosis.

The World Health Organization (WHO) cites antibiotic resistance as one of the biggest threats to man in the 21st century. A United Nations declaration made in New York in September 2016 signaled global commitment to addressing this major threat to health, global development, and agriculture.


Today, government leaders are working with WHO on a number of global initiatives addressing antibiotic resistance. These include World Antibiotic Awareness Week, the Global Antibiotic Research and Development Partnership, and the Global Antimicrobial Resistance Surveillance System.


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