Abstract
Antibiotics as antibacterial drugs have saved many lives, but have also become a victim of their own success. Their widespread abuse reduces their anti-infective effectiveness and causes the development of bacterial resistance. Moreover, irrational antibiotic therapy contributes to gastrointestinal dysbiosis, that increases the risk of the development of many diseases, including neurological and psychiatric. One of the potential options for restoring homeostasis is the use of oral antibiotics that are poorly absorbed from the gastrointestinal tract (e.g., rifaximin alfa). Thus, antibiotic therapy may exert neurological or psychiatric adverse drug reactions which are often considered to be overlooked and undervalued issues. Drug-induced neurotoxicity is mostly observed after beta-lactams and quinolones. Penicillin may produce a wide range of neurological dysfunctions, including encephalopathy, behavioral changes, myoclonus or seizures. Their pathomechanism results from the disturbances of gamma-aminobutyric acid-GABA transmission (due to the molecular similarities between the structure of the β-lactam ring and GABA molecule) and impairment of the functioning of benzodiazepine receptors (BZD). However, on the other hand, antibiotics have also been studied for their neuroprotective properties in the treatment of neurodegenerative and neuroinflammatory processes (e.g., Alzheimer’s or Parkinson’s diseases). Antibiotics may, therefore, become promising elements of multi-targeted therapy for these entities.
Highlights
Antibiotics and Antibiotic-Induced Adverse Drug ReactionsAntibiotics are one of the most widely used classes of drug that have revolutionized the treatment of infectious diseases, enabling the causal treatment of these conditions
These researchers became famous in the history of medicine with the introduction of the first modern, arsenic-based antimicrobial agent named Salvarsan, effective in the treatment of syphilis (Ehrlich; 1909), the discovery of the sulfa drug, sulfonamidochrysoidine (Protonsil), endogenously releasing active sulfanilamide (Domagk; 1935; Nobel Prize laureate in Medicine or Physiology in 1939 for the development of antibacterial effect of Protonsil) and the discovery of penicillin (Fleming; 1929; Nobel Prize laureate in Medicine or Physiology in 1945 for the discovery of penicillin and its curative effect in various infectious diseases) [2,3]
The study of neuroprotective drugs that lead to rescue, recovery or regeneration of the nervous system, its cells, structure and function, has been ongoing for many years. These are based on three main strategies, i.e., the synthesis of new drugs, the use of natural products with as yet unidentified properties, and attempts to develop therapies based on existing drugs, so-called “drug repositioning” or “drug reprofiling”
Summary
Antibiotics are one of the most widely used classes of drug that have revolutionized the treatment of infectious diseases, enabling the causal treatment of these conditions. The beginning of the modern “antibiotic era” and antibiotic therapy used to treat human infections is usually associated with names of Paul Ehrlich, Gerhard Domagk and Alexander Fleming These researchers became famous in the history of medicine with the introduction of the first modern, arsenic-based antimicrobial agent named Salvarsan, effective in the treatment of syphilis (Ehrlich; 1909), the discovery of the sulfa drug, sulfonamidochrysoidine (Protonsil), endogenously releasing active sulfanilamide (Domagk; 1935; Nobel Prize laureate in Medicine or Physiology in 1939 for the development of antibacterial effect of Protonsil) and the discovery of penicillin (Fleming; 1929; Nobel Prize laureate in Medicine or Physiology in 1945 for the discovery of penicillin and its curative effect in various infectious diseases) [2,3]. The triggering factors facilitating the DIND involve drug related factors (e.g., polydrug abuse, formation of neurotoxic metabolites during endogenous drug metabolism) and individual related factors (age, gender, gestational drug exposure, antioxidant status, diet) or influence of environmental conditions (chronic stress, temperature, exposure to environmental toxins and pollutions) [14,15]
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