Antibiotics

context: The emergence of resistance of bacteria to antibiotics is a common phenomenon. Emergence of resistance often reflects evolutionary processes that take place during antibiotic therapy. The antibiotic treatment may select for bacterial strains with physiologically or genetically enhanced capacity to survive high doses of antibiotics. Under certain conditions, it may result in preferential growth of resistant bacteria, while growth of susceptible bacteria is inhibited by the drug. For example, antibacterial selection for strains having previously acquired antibacterial-resistance genes was demonstrated in 1943 by the Luria–Delbrück experiment. Antibiotics such as penicillin and erythromycin, which used to have a high efficacy against many bacterial species and strains, have become less effective, due to the increased resistance of many bacterial strains.
qas: answers: text: resistance of bacteria
question: What is a modern common occurence with antibiotics?

answers: text: evolution
question: What is resistance to antibiotics a cause of?

answers: text: 1943
question: When was the Luria-Delbruck experiment?

answers: text: penicillin and erythromycin
question: Which two antibiotics that have high efficacy are much less useful now?

answers: text: evolutionary processes
question: What does emergence of resistance reflect?

answers: text: survive high doses of antibiotics
question: What is the purpose of antibiotic treatment?

answers: text: 1943
question: When was antibacterial-resistance demonstrated?

answers: text: Luria–Delbrück
question: Who made the demonstration in 1943?

context: The successful outcome of antimicrobial therapy with antibacterial compounds depends on several factors. These include host defense mechanisms, the location of infection, and the pharmacokinetic and pharmacodynamic properties of the antibacterial. A bactericidal activity of antibacterials may depend on the bacterial growth phase, and it often requires ongoing metabolic activity and division of bacterial cells. These findings are based on laboratory studies, and in clinical settings have also been shown to eliminate bacterial infection. Since the activity of antibacterials depends frequently on its concentration, in vitro characterization of antibacterial activity commonly includes the determination of the minimum inhibitory concentration and minimum bactericidal concentration of an antibacterial. To predict clinical outcome, the antimicrobial activity of an antibacterial is usually combined with its pharmacokinetic profile, and several pharmacological parameters are used as markers of drug efficacy.
qas: answers: text: concentration
question: What does the potency of antibacterials depend upon?

answers: text: bacterial infection
question: What does this eliminate?

answers: text: bacterial growth phase
question: What does the bactericidal activitty of antibacterials depend on what?

answers: text: division of bacterial cells
question: What besides ongoing metabolic activity is required in bactericidal activity?

answers: text: concentration
question: What does the activity of antibacterials depends on?

answers: text: host defense mechanisms, the location of infection, and the pharmacokinetic and pharmacodynamic properties of the antibacterial
question: What does a successful treatment using antibiotics entail?

answers: text: several pharmacological parameters are used as markers of drug efficacy
question: How do you predict the clinical result?

context: Antibacterial antibiotics are commonly classified based on their mechanism of action, chemical structure, or spectrum of activity. Most target bacterial functions or growth processes. Those that target the bacterial cell wall (penicillins and cephalosporins) or the cell membrane (polymyxins), or interfere with essential bacterial enzymes (rifamycins, lipiarmycins, quinolones, and sulfonamides) have bactericidal activities. Those that target protein synthesis (macrolides, lincosamides and tetracyclines) are usually bacteriostatic (with the exception of bactericidal aminoglycosides). Further categorization is based on their target specificity. "Narrow-spectrum" antibacterial antibiotics target specific types of bacteria, such as Gram-negative or Gram-positive bacteria, whereas broad-spectrum antibiotics affect a wide range of bacteria. Following a 40-year hiatus in discovering new classes of antibacterial compounds, four new classes of antibacterial antibiotics have been brought into clinical use in the late 2000s and early 2010s: cyclic lipopeptides (such as daptomycin), glycylcyclines (such as tigecycline), oxazolidinones (such as linezolid), and lipiarmycins (such as fidaxomicin).
qas: answers: text: bacterial functions or growth processes
question: What do anitibiotics mostly target?

answers: text: penicillins and cephalosporins
question: Which two types of antibiotics target the cell wall?

answers: text: polymyxins
question: Which type of antibiotic goes after the cell membrane?

answers: text: (macrolides, lincosamides and tetracyclines
question: What 3 types go after protein synthesis?

answers: text: mechanism of action
question: Besides sprectrum of activity and chemical structure, how can antibacterial antibiotics classified?

answers: text: penicillins and cephalosporins
question: What is another name used for bacterial cell wall?

answers: text: polymyxins
question: whats another word for cell membrane?

answers: text: four
question: How many new classes of antibacterial antibiotics was introduced in the late 2000's/

answers: text: mechanism of action, chemical structure, or spectrum of activity
question: What three ways are antibiotics classified?

context: With advances in medicinal chemistry, most modern antibacterials are semisynthetic modifications of various natural compounds. These include, for example, the beta-lactam antibiotics, which include the penicillins (produced by fungi in the genus Penicillium), the cephalosporins, and the carbapenems. Compounds that are still isolated from living organisms are the aminoglycosides, whereas other antibacterials—for example, the sulfonamides, the quinolones, and the oxazolidinones—are produced solely by chemical synthesis. Many antibacterial compounds are relatively small molecules with a molecular weight of less than 2000 atomic mass units.[citation needed]
qas: answers: text: semisynthetic modifications
question: What are antibiotics in chemical terms?

answers: text: beta-lactam antibiotics
question: What type of antibiotics include penicilin?

answers: text: aminoglycosides
question: What are the type of antibiotics which are taken from still living things?

answers: text: synthesis
question: How are the slufonamides,quinolones, and oxazolidinones created?

answers: text: various natural compounds
question: Besides semisytetic modifications, what advances in medicinal chemistry regarding antibacterials?

answers: text: 2000 atomic mass units
question: What is the molecular weight loss of antibacterial compounds?

answers: text: penicillins
question: What is included in the beta-lactam antibiotics?

answers: text: fungi
question: What is penicillins produced by?

context: Antibiotics revolutionized medicine in the 20th century, and have together with vaccination led to the near eradication of diseases such as tuberculosis in the developed world. Their effectiveness and easy access led to overuse, especially in livestock raising, prompting bacteria to develop resistance. This has led to widespread problems with antimicrobial and antibiotic resistance, so much as to prompt the World Health Organization to classify antimicrobial resistance as a "serious threat [that] is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country".
qas: answers: text: tuberculosis
question: What is one disease that has been nearly eradicated thanks to vaccines and antibiotics?

answers: text: overuse, especially in livestock raising, prompting bacteria to develop resistance
question: What is one issue that can arise from overuse of antibiotics?

answers: text: World Health Organization
question: What organization called antimicrobial resistance a 'serious threat?'

answers: text: 20th century
question: In which century were antibiotics first introduced?

answers: text: anyone, of any age, in any country
question: What can be affected by issues resulting from overuse of antibiotics?

answers: text: develop resistance
question: What does there medicines do for livestock?

answers: text: World Health Organization
question: What organization classifies this as a current serious threat in the whole world??

answers: text: 20th
question: In what century did antibiotics revolutionized medicine?

answers: text: antibiotic resistance
question: Besides antimicrobial, what did the overused medicine cause? 

answers: text: vaccination
question: What other medicine worked along antibiotics to eradicate diseases like tuberculosis?

answers: text: 20th century
question: When did antibiotics revolutinzed medicine?

answers: text: develop resistance
question: What happened when antibiotics was over used in livestock?

answers: text: World Health Organization
question: What organization stated that the world has this serious problem?

answers: text: every region of the world
question: What regions in the world does this apply in?

answers: text: 20th century
question: When were antibiotics created?

answers: text: antimicrobial and antibiotic resistance
question: What is a common problem in antibiotic use?

answers: text: livestock raising
question: Who else uses antibiotics besides the medical industry?

answers: text: tuberculosis
question: What disease did antibiotics help eliminate?

context: In empirical therapy, a patient has proven or suspected infection, but the responsible microorganism is not yet unidentified. While the microorgainsim is being identified the doctor will usually administer the best choice of antibiotic that will be most active against the likely cause of infection usually a broad spectrum antibiotic. Empirical therapy is usually initiated before the doctor knows the exact identification of microorgansim causing the infection as the identification process make take several days in the laboratory.
qas: answers: text: empirical therapy
question: What is one kind of therapy that may be used when a patience has an infection, but it has not been identified?

answers: text: laboratory
question: Where do doctors perform microorganism identification testing?

answers: text: broad spectrum antibiotic
question: What kinds of antibiotics are most commonly used for empirical therapy?

answers: text: While the microorgainsim is being identified
question: At what stage does a doctor begin empirical therapy?

answers: text: several days
question: How long does the identification process take?

answers: text: broad spectrum antibiotic
question: What happens when a doctor doesn't know the microorganism yet?

answers: text: a patient has proven or suspected infection, but the responsible microorganism is not yet unidentified
question: What happens in empirical therapy?

answers: text: before the doctor knows the exact identification of microorgansim
question: When is empirical started?

context: Antibiotics are screened for any negative effects on humans or other mammals before approval for clinical use, and are usually considered safe and most are well tolerated. However, some antibiotics have been associated with a range of adverse side effects. Side-effects range from mild to very serious depending on the antibiotics used, the microbial organisms targeted, and the individual patient. Side effects may reflect the pharmacological or toxicological properties of the antibiotic or may involve hypersensitivity reactions or anaphylaxis. Safety profiles of newer drugs are often not as well established as for those that have a long history of use. Adverse effects range from fever and nausea to major allergic reactions, including photodermatitis and anaphylaxis. Common side-effects include diarrhea, resulting from disruption of the species composition in the intestinal flora, resulting, for example, in overgrowth of pathogenic bacteria, such as Clostridium difficile. Antibacterials can also affect the vaginal flora, and may lead to overgrowth of yeast species of the genus Candida in the vulvo-vaginal area. Additional side-effects can result from interaction with other drugs, such as elevated risk of tendon damage from administration of a quinolone antibiotic with a systemic corticosteroid. Some scientists have hypothesized that the indiscriminate use of antibiotics alter the host microbiota and this has been associated with chronic disease.
qas: answers: text: fever and nausea
question: What are two examples of minor side effects caused by some antibiotics?

answers: text: disruption of the species composition in the intestinal flora
question: What causes diarrhea?

answers: text: yeast
question: What negative effects can antibiotics have on the vaginal area?

answers: text: a quinolone antibiotic with a systemic corticosteroid
question: What is one example of antibiotics that may have a possible side effect of tendon damage?

answers: text: alter the host microbiota
question: What is one possible serious side effect of over-using antibiotics?

answers: text: negative effects
question: What are antibiotics screened for on mammals and humans?

answers: text: clinical use
question: What do antibiotics need approval for?

answers: text: microbial organisms
question: What besides the individual patient is targeted when antibiotics is being used?

answers: text: Adverse effects
question: Photodermatitis, nausea, allergic reactions and anaphylaxis are all what type of side effect?

answers: text: host microbiota
question: What was altered during the hypothesis of indiscriminate use of antibiotics?

answers: text: negative effects on humans or other mammals
question: Why are antibiotics checked before use?

answers: text: fever and nausea to major allergic reactions, including photodermatitis and anaphylaxis
question: Name some adverse effects?

answers: text: diarrhea
question: Name some side-effects?

answers: text: overgrowth of yeast
question: What can happen to vaginal flora?

answers: text: Additional side-effects
question: What can happen when antibiotics are used with other drugs?

context: Exposure to antibiotics early in life is associated with increased body mass in humans and mouse models. Early life is a critical period for the establishment of the intestinal microbiota and for metabolic development. Mice exposed to subtherapeutic antibiotic treatment (STAT)– with either penicillin, vancomycin, penicillin and vancomycin, or chlortetracycline had altered composition of the gut microbiota as well as its metabolic capabilities. Moreover, research have shown that mice given low-dose penicillin (1 μg/g body weight) around birth and throughout the weaning process had an increased body mass and fat mass, accelerated growth, and increased hepatic expression of genes involved in adipogenesis, compared to controlled mice. In addition, penicillin in combination with a high-fat diet increased fasting insulin levels in mice. However, it is unclear whether or not antibiotics cause obesity in humans. Studies have found a correlation between early exposure of antibiotics (<6 months) and increased body mass (at 10 and 20 months). Another study found that the type of antibiotic exposure was also significant with the highest risk of being overweight in those given macrolides compared to penicillin and cephalosporin. Therefore, there is correlation between antibiotic exposure in early life and obesity in humans, but whether or not there is a causal relationship remains unclear. Although there is a correlation between antibiotic use in early life and obesity, the effect of antibiotics on obesity in humans needs to be weighed against the beneficial effects of clinically indicated treatment with antibiotics in infancy.
qas: answers: text: increased body mass
question: What is one common result of using antibiotics from a young age?

answers: text: subtherapeutic antibiotic treatment
question: What does STAT stand for?

answers: text: penicillin, vancomycin, penicillin and vancomycin, or chlortetracycline
question: What are some antibiotics can be used for STAT?

answers: text: unclear
question: Do antibiotics cause obesity in humans?

answers: text: weighed against the beneficial effects
question: Why do physicians use antibiotics on infants when the relationship has been proven? 

answers: text: increased body mass
question: What can happen if people are exposed to antibiotics at a young age?

answers: text: Early life
question: When do intestinal microbiota develop?

answers: text: unclear
question: Do antibiotics increase the chance of getting fat for humans?

context: The majority of studies indicate antibiotics do interfere with contraceptive pills, such as clinical studies that suggest the failure rate of contraceptive pills caused by antibiotics is very low (about 1%). In cases where antibacterials have been suggested to affect the efficiency of birth control pills, such as for the broad-spectrum antibacterial rifampicin, these cases may be due to an increase in the activities of hepatic liver enzymes' causing increased breakdown of the pill's active ingredients. Effects on the intestinal flora, which might result in reduced absorption of estrogens in the colon, have also been suggested, but such suggestions have been inconclusive and controversial. Clinicians have recommended that extra contraceptive measures be applied during therapies using antibacterials that are suspected to interact with oral contraceptives.
qas: answers: text: The majority of studies indicate antibiotics do interfere with contraceptive pills
question: Do antibiotics interact with birth control pills?

answers: text: about 1%
question: What percentage of birth control pill failure is attributed to antibiotics?

answers: text: reduced absorption of estrogens in the colon
question: What are the potential effects on intestinal flora?

answers: text: inconclusive and controversial
question: Have these potential effects been proven through testing?

answers: text: extra contraceptive measures
question: What do physicians recommend to counteract this potential issue?

answers: text: contraceptive pills
question: What do antibiotics interfere with?

answers: text: about 1%
question: What percent is the  failure rate of contraceptive pills?

answers: text: absorption of estrogens
question: Whhat does intestinal flora reduce?

answers: text: oral contraceptives
question: In therapy, what does the antibacterial interact with?

answers: text: antibiotics do interfere
question: Do antibiotics mess with birth control pills?

answers: text: extra contraceptive measures
question: What should women do if they are using antibiotics and birth control pills?

answers: text: about 1%
question: What is birth control failure rate due to antibiotics?

context: Interactions between alcohol and certain antibiotics may occur and may cause side-effects and decreased effectiveness of antibiotic therapy. While moderate alcohol consumption is unlikely to interfere with many common antibiotics, there are specific types of antibiotics with which alcohol consumption may cause serious side-effects. Therefore, potential risks of side-effects and effectiveness depend on the type of antibiotic administered. Despite the lack of a categorical counterindication, the belief that alcohol and antibiotics should never be mixed is widespread.
qas: answers: text: decreased effectiveness
question: What is one potential issue with drinking alcohol while taking antibiotics?

answers: text: moderate alcohol consumption is unlikely to interfere with many common antibiotics
question: Do all antibiotics interact dangerously with alcohol?

answers: text: there are specific types of antibiotics with which alcohol consumption may cause serious side-effects
question: Is it OK to drink alcohol while taking any antibiotic?

answers: text: widespread
question: How common is the belief that alcohol and antibiotics should never be mixed?

answers: text: decreased effectiveness of antibiotic therapy
question: What can alcohol and certain antibiotics cause?

answers: text: alcohol consumption
question: What is unlikely to interfere with  with many common antibiotics?

answers: text: alcohol and antibiotics
question: What belief should bever be mixed widespread?

answers: text: alcohol
question: What common drug can reduce antibiotic effectiveness?

answers: text: specific types of antibiotics with which alcohol consumption may cause serious side-effects
question: What type of antibiotic is most likely to be a problem with alcohol?

answers: text: alcohol and antibiotics should never be mixed
question: Should alcohol be used while on antibiotics?

context: Several molecular mechanisms of antibacterial resistance exist. Intrinsic antibacterial resistance may be part of the genetic makeup of bacterial strains. For example, an antibiotic target may be absent from the bacterial genome. Acquired resistance results from a mutation in the bacterial chromosome or the acquisition of extra-chromosomal DNA. Antibacterial-producing bacteria have evolved resistance mechanisms that have been shown to be similar to, and may have been transferred to, antibacterial-resistant strains. The spread of antibacterial resistance often occurs through vertical transmission of mutations during growth and by genetic recombination of DNA by horizontal genetic exchange. For instance, antibacterial resistance genes can be exchanged between different bacterial strains or species via plasmids that carry these resistance genes. Plasmids that carry several different resistance genes can confer resistance to multiple antibacterials. Cross-resistance to several antibacterials may also occur when a resistance mechanism encoded by a single gene conveys resistance to more than one antibacterial compound.
qas: answers: text: Intrinsic antibacterial resistance
question: What is part of hje the make up of bacterial strains?

answers: text: antibacterial resistance genes
question: What is exchanged between between bacterial strains or species via plasmids that have this resistance?

answers: text: antibiotic target
question: What can be absent from the bacterial genome?

answers: text: vertical transmission
question: When does the spread of antibacterial resistance frequently occurs/

answers: text: mutation
question: What does some resistance come from?

answers: text: vertical transmission of mutations
question: What method of spread can occur in antibacterial resistance?

answers: text: carry several different resistance genes
question: What do plasmids do in resistance?

context: Antibacterial-resistant strains and species, sometimes referred to as "superbugs", now contribute to the emergence of diseases that were for a while well controlled. For example, emergent bacterial strains causing tuberculosis (TB) that are resistant to previously effective antibacterial treatments pose many therapeutic challenges. Every year, nearly half a million new cases of multidrug-resistant tuberculosis (MDR-TB) are estimated to occur worldwide. For example, NDM-1 is a newly identified enzyme conveying bacterial resistance to a broad range of beta-lactam antibacterials. The United Kingdom's Health Protection Agency has stated that "most isolates with NDM-1 enzyme are resistant to all standard intravenous antibiotics for treatment of severe infections."
qas: answers: text: superbugs
question: What are strains that are resistant to antibiotics called sometimes?

answers: text: tuberculosis
question: What was a once almost controlled disease that is coming back do to resistance?

answers: text: half a million
question: How many new infections of resistant TB are reported per year?

answers: text: MDR-TB
question: What is the acronym used to describe resistant TB?

context: Inappropriate antibiotic treatment and overuse of antibiotics have contributed to the emergence of antibiotic-resistant bacteria. Self prescription of antibiotics is an example of misuse. Many antibiotics are frequently prescribed to treat symptoms or diseases that do not respond to antibiotics or that are likely to resolve without treatment. Also, incorrect or suboptimal antibiotics are prescribed for certain bacterial infections. The overuse of antibiotics, like penicillin and erythromycin, has been associated with emerging antibiotic resistance since the 1950s. Widespread usage of antibiotics in hospitals has also been associated with increases in bacterial strains and species that no longer respond to treatment with the most common antibiotics.
qas: answers: text: Inappropriate antibiotic treatment and overuse
question: What are the two biggest reasons for resistance?

answers: text: Self prescription
question: What is a common method of misuse?

answers: text: overuse of antibiotics
question: What is an example of bad treatment causing resistance?

context: Common forms of antibiotic misuse include excessive use of prophylactic antibiotics in travelers and failure of medical professionals to prescribe the correct dosage of antibiotics on the basis of the patient's weight and history of prior use. Other forms of misuse include failure to take the entire prescribed course of the antibiotic, incorrect dosage and administration, or failure to rest for sufficient recovery. Inappropriate antibiotic treatment, for example, is their prescription to treat viral infections such as the common cold. One study on respiratory tract infections found "physicians were more likely to prescribe antibiotics to patients who appeared to expect them". Multifactorial interventions aimed at both physicians and patients can reduce inappropriate prescription of antibiotics.
qas: answers: text: prophylactic antibiotics
question: What is a way of improperly using antibiotics for those traveling?

answers: text: failure of medical professionals to prescribe the correct dosage
question: What can happen if a doctor doesn't prescribe to a person's weight and prior use?

answers: text: failure to take the entire prescribed course of the antibiotic, incorrect dosage and administration, or failure to rest for sufficient recovery
question: What are 3 other common forms of bad antibiotic practices?

answers: text: Inappropriate antibiotic treatment
question: What happens when a cold is treated with antibiotics?

answers: text: prescribe antibiotics
question: What do doctors usually do when a patient seems to want antibiotics even though they may not be right?

context: Several organizations concerned with antimicrobial resistance are lobbying to eliminate the unnecessary use of antibiotics. The issues of misuse and overuse of antibiotics have been addressed by the formation of the US Interagency Task Force on Antimicrobial Resistance. This task force aims to actively address antimicrobial resistance, and is coordinated by the US Centers for Disease Control and Prevention, the Food and Drug Administration (FDA), and the National Institutes of Health (NIH), as well as other US agencies. An NGO campaign group is Keep Antibiotics Working. In France, an "Antibiotics are not automatic" government campaign started in 2002 and led to a marked reduction of unnecessary antibiotic prescriptions, especially in children.
qas: answers: text: US Interagency Task Force on Antimicrobial Resistance
question: What is the name of a US government agency tasked with trying to stop improper use of antibiotics?

answers: text: US Centers for Disease Control and Prevention, the Food and Drug Administration (FDA), and the National Institutes of Health (NIH)
question: Which agencies control this task force?

answers: text: 2002
question: When did the French start going after overuse of antibiotics?

context: The emergence of antibiotic resistance has prompted restrictions on their use in the UK in 1970 (Swann report 1969), and the EU has banned the use of antibiotics as growth-promotional agents since 2003. Moreover, several organizations (e.g., The American Society for Microbiology (ASM), American Public Health Association (APHA) and the American Medical Association (AMA)) have called for restrictions on antibiotic use in food animal production and an end to all nontherapeutic uses.[citation needed] However, commonly there are delays in regulatory and legislative actions to limit the use of antibiotics, attributable partly to resistance against such regulation by industries using or selling antibiotics, and to the time required for research to test causal links between their use and resistance to them. Two federal bills (S.742 and H.R. 2562) aimed at phasing out nontherapeutic use of antibiotics in US food animals were proposed, but have not passed. These bills were endorsed by public health and medical organizations, including the American Holistic Nurses' Association, the American Medical Association, and the American Public Health Association (APHA).
qas: answers: text: 2003
question: When did the EU ban antibiotics for speeding up growth?

answers: text: Swann report 1969
question: What report caused the UK to worry about resistance?

answers: text: American Society for Microbiology (ASM), American Public Health Association (APHA) and the American Medical Association (AMA)
question: What 3 US organizations have called for the banning of antibiotics in the production of food animals?

answers: text: S.742 and H.R. 2562
question: Name two US bills that want to ban antibiotics in food production?

answers: text: American Holistic Nurses' Association, the American Medical Association, and the American Public Health Association (APHA)
question: What 3 medical associations supported the bills?

context: There has been extensive use of antibiotics in animal husbandry. In the United States, the question of emergence of antibiotic-resistant bacterial strains due to use of antibiotics in livestock was raised by the US Food and Drug Administration (FDA) in 1977. In March 2012, the United States District Court for the Southern District of New York, ruling in an action brought by the Natural Resources Defense Council and others, ordered the FDA to revoke approvals for the use of antibiotics in livestock, which violated FDA regulations.
qas: answers: text: animal husbandry
question: What besides sick people are antibiotics used for?

answers: text: 1977
question: When was resistance first discussed as a problem in the raising of farm animals?

answers: text: March 2012
question: When did a district court order the FDA to stop approving antibiotics in animals?

context: Before the early 20th century, treatments for infections were based primarily on medicinal folklore. Mixtures with antimicrobial properties that were used in treatments of infections were described over 2000 years ago. Many ancient cultures, including the ancient Egyptians and ancient Greeks, used specially selected mold and plant materials and extracts to treat infections. More recent observations made in the laboratory of antibiosis between microorganisms led to the discovery of natural antibacterials produced by microorganisms. Louis Pasteur observed, "if we could intervene in the antagonism observed between some bacteria, it would offer perhaps the greatest hopes for therapeutics". The term 'antibiosis', meaning "against life", was introduced by the French bacteriologist Jean Paul Vuillemin as a descriptive name of the phenomenon exhibited by these early antibacterial drugs. Antibiosis was first described in 1877 in bacteria when Louis Pasteur and Robert Koch observed that an airborne bacillus could inhibit the growth of Bacillus anthracis. These drugs were later renamed antibiotics by Selman Waksman, an American microbiologist, in 1942. Synthetic antibiotic chemotherapy as a science and development of antibacterials began in Germany with Paul Ehrlich in the late 1880s. Ehrlich noted certain dyes would color human, animal, or bacterial cells, whereas others did not. He then proposed the idea that it might be possible to create chemicals that would act as a selective drug that would bind to and kill bacteria without harming the human host. After screening hundreds of dyes against various organisms, in 1907, he discovered a medicinally useful drug, the synthetic antibacterial salvarsan now called arsphenamine.
qas: answers: text: medicinal folklore
question: What methods did people use before antibiotics to treat infections?

answers: text: over 2000 years ago
question: When were some kinds of antimicrobials first used?

answers: text: mold and plant materials and extracts
question: What type of things did Egyptians and Greeks use?

answers: text: against life
question: What does antibiosis mean?

answers: text: Jean Paul Vuillemin
question: Who came up with the term antibiosis?

context: The effects of some types of mold on infection had been noticed many times over the course of history (see: History of penicillin). In 1928, Alexander Fleming noticed the same effect in a Petri dish, where a number of disease-causing bacteria were killed by a fungus of the genus Penicillium. Fleming postulated that the effect is mediated by an antibacterial compound he named penicillin, and that its antibacterial properties could be exploited for chemotherapy. He initially characterized some of its biological properties, and attempted to use a crude preparation to treat some infections, but he was unable to pursue its further development without the aid of trained chemists.
qas: answers: text: mold
question: What type of organism has been reported to have worked on infections?

answers: text: Alexander Fleming
question: Who noticed in a lab the antibacterial characteristics of mold?

answers: text: penicillin
question: What mold did Fleming notice had antibacterial properties?

answers: text: chemotherapy
question: What did Fleming initially think a good use would be for it?

context: The first sulfonamide and first commercially available antibacterial, Prontosil, was developed by a research team led by Gerhard Domagk in 1932 at the Bayer Laboratories of the IG Farben conglomerate in Germany. Domagk received the 1939 Nobel Prize for Medicine for his efforts. Prontosil had a relatively broad effect against Gram-positive cocci, but not against enterobacteria. Research was stimulated apace by its success. The discovery and development of this sulfonamide drug opened the era of antibacterials.
qas: answers: text: Prontosil
question: What was the first available antibiotic?

answers: text: IG Farben
question: What company developed Prontosil?

answers: text: Gerhard Domagk
question: Who led the team that came up with Prontosil?

answers: text: 1939 Nobel Prize for Medicine
question: What prize did Domagk get for his work?

context: In 1939, coinciding with the start of World War II, Rene Dubos reported the discovery of the first naturally derived antibiotic, tyrothricin, a compound of 20% gramicidin and 80% tyrocidine, from B. brevis. It was one of the first commercially manufactured antibiotics universally and was very effective in treating wounds and ulcers during World War II. Gramicidin, however, could not be used systemically because of toxicity. Tyrocidine also proved too toxic for systemic usage. Research results obtained during that period were not shared between the Axis and the Allied powers during the war.
qas: answers: text: tyrothricin
question: What was the first antibiotic developed from nature?

answers: text: 1939
question: When was tyrothricin created?

answers: text: start of World War II,
question: What also happened in 1939 besides tyrothricin?

answers: text: Rene Dubos
question: Who discovered tyrothricin?

answers: text: wounds and ulcers
question: What was tyrothricin used for during the war?

context: Florey and Chain succeeded in purifying the first penicillin, penicillin G, in 1942, but it did not become widely available outside the Allied military before 1945. Later, Norman Heatley developed the back extraction technique for efficiently purifying penicillin in bulk. The chemical structure of penicillin was determined by Dorothy Crowfoot Hodgkin in 1945. Purified penicillin displayed potent antibacterial activity against a wide range of bacteria and had low toxicity in humans. Furthermore, its activity was not inhibited by biological constituents such as pus, unlike the synthetic sulfonamides. The discovery of such a powerful antibiotic was unprecedented, and the development of penicillin led to renewed interest in the search for antibiotic compounds with similar efficacy and safety. For their successful development of penicillin, which Fleming had accidentally discovered but could not develop himself, as a therapeutic drug, Ernst Chain and Howard Florey shared the 1945 Nobel Prize in Medicine with Fleming. Florey credited Dubos with pioneering the approach of deliberately and systematically searching for antibacterial compounds, which had led to the discovery of gramicidin and had revived Florey's research in penicillin.
qas: answers: text: 1942
question: When was penicillin G first purified?

answers: text: 1945
question: When did penicillin G become available outside of military use?

answers: text: Norman Heatley
question: Who came up with a way to quickly produce penicillin?

answers: text: 1945
question: When was the chemical make-up of penicillin discovered?

answers: text: Dorothy Crowfoot Hodgkin
question: Who discovered the chemical structure of penicillin?

context: Vaccines rely on immune modulation or augmentation. Vaccination either excites or reinforces the immune competence of a host to ward off infection, leading to the activation of macrophages, the production of antibodies, inflammation, and other classic immune reactions. Antibacterial vaccines have been responsible for a drastic reduction in global bacterial diseases. Vaccines made from attenuated whole cells or lysates have been replaced largely by less reactogenic, cell-free vaccines consisting of purified components, including capsular polysaccharides and their conjugates, to protein carriers, as well as inactivated toxins (toxoids) and proteins.
qas: answers: text: immune modulation or augmentation
question: What do vaccines need to work?

answers: text: Antibacterial vaccines
question: What type of vaccines have saved millions of lives?

answers: text: Vaccines made from attenuated whole cells or lysates
question: What types of vaccines have been phased out?

context: Phage therapy is another option that is being looked into for treating resistant strains of bacteria. The way that researchers are doing this is by infecting pathogenic bacteria with their own viruses, more specifically, bacteriophages. Bacteriophages, also known simply as phages, are precisely bacterial viruses that infect bacteria by disrupting pathogenic bacterium lytic cycles. By disrupting the lytic cycles of bacterium, phages destroy their metabolism, which eventually results in the cell's death. Phages will insert their DNA into the bacterium, allowing their DNA to be transcribed. Once their DNA is transcribed the cell will proceed to make new phages and as soon as they are ready to be released, the cell will lyse. One of the worries about using phages to fight pathogens is that the phages will infect "good" bacteria, or the bacteria that are important in the everyday function of human beings. However, studies have proven that phages are very specific when they target bacteria, which makes researchers confident that bacteriophage therapy is the definite route to defeating antibiotic resistant bacteria.
qas: answers: text: Phage therapy
question: What has been talked about to treat resistant bacteria?

answers: text: infecting pathogenic bacteria
question: How have researchers been doing this?

answers: text: phages will infect "good" bacteria
question: What is a worry of using phages?

context: In April 2013, the Infectious Disease Society of America (IDSA) reported that the weak antibiotic pipeline does not match bacteria's increasing ability to develop resistance. Since 2009, only 2 new antibiotics were approved in the United States. The number of new antibiotics approved for marketing per year declines continuously. The report identified seven antibiotics against the Gram-negative bacilli (GNB) currently in phase 2 or phase 3 clinical trials. However, these drugs do not address the entire spectrum of resistance of GNB. Some of these antibiotics are combination of existent treatments:
qas: answers: text: 2
question: How many antibiotics have been created in the last 7 years?

answers: text: seven
question: How many are in the pipelin to fight GNB?

answers: text: 2013
question: What year did the Infectious Disease Society of America say that production of new antibiotics does not keep up with resistance?

context: Possible improvements include clarification of clinical trial regulations by FDA. Furthermore, appropriate economic incentives could persuade pharmaceutical companies to invest in this endeavor. Antibiotic Development to Advance Patient Treatment (ADAPT) Act aims to fast track the drug development to combat the growing threat of 'superbugs'. Under this Act, FDA can approve antibiotics and antifungals treating life-threatening infections based on smaller clinical trials. The CDC will monitor the use of antibiotics and the emerging resistance, and publish the data. The FDA antibiotics labeling process, 'Susceptibility Test Interpretive Criteria for Microbial Organisms' or 'breakpoints', will provide accurate data to healthcare professionals. According to Allan Coukell, senior director for health programs at The Pew Charitable Trusts, "By allowing drug developers to rely on smaller datasets, and clarifying FDA's authority to tolerate a higher level of uncertainty for these drugs when making a risk/benefit calculation, ADAPT would make the clinical trials more feasible."
qas: answers: text: FDA
question: Who regulates antibiotic approval?

answers: text: economic incentives
question: What could help to spur pharmaceuticals to make new antibiotics?

answers: text: superbugs
question: What are resistant bacteria called in the media?

answers: text: Allan Coukell,
question: Who is a director at the Pew Charitable Trusts?