Antibiotics

qas: question: What is one disease that has been nearly eradicated thanks to vaccines and antibiotics?
answers: text: tuberculosis
is_impossible: no

question: What is one issue that can arise from overuse of antibiotics?
answers: text: overuse, especially in livestock raising, prompting bacteria to develop resistance
is_impossible: no

question: In which century were antibiotics first introduced?
answers: text: 20th century
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question: What organization called antimicrobial resistance a 'serious threat?'
answers: text: World Health Organization
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question: What can be affected by issues resulting from overuse of antibiotics?
answers: text: anyone, of any age, in any country
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question: In what century did antibiotics revolutionized medicine?
answers: text: 20th
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question: What other medicine worked along antibiotics to eradicate diseases like tuberculosis?
answers: text: vaccination
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question: What does there medicines do for livestock?
answers: text: develop resistance
is_impossible: no

question: What organization classifies this as a current serious threat in the whole world??
answers: text: World Health Organization
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question: Besides antimicrobial, what did the overused medicine cause? 
answers: text: antibiotic resistance
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question: When did antibiotics revolutinzed medicine?
answers: text: 20th century
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question: What happened when antibiotics was over used in livestock?
answers: text: develop resistance
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question: What organization stated that the world has this serious problem?
answers: text: World Health Organization
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question: What regions in the world does this apply in?
answers: text: every region of the world
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question: When were antibiotics created?
answers: text: 20th century
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question: What disease did antibiotics help eliminate?
answers: text: tuberculosis
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question: Who else uses antibiotics besides the medical industry?
answers: text: livestock raising
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question: What is a common problem in antibiotic use?
answers: text: antimicrobial and antibiotic resistance
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question: What is one disease that has been widespread thanks to vaccines and antibiotics?
is_impossible: yes

question: What is one issue that can arise from overuse of predictions?
is_impossible: yes

question: In which century was tuberculosis first introduced?
is_impossible: yes

question: What organization called bacteria a 'serious threat?'
is_impossible: yes

question: What other medicine worked along antibiotics to classify diseases like tuberculosis?
is_impossible: yes

question: What is another word for interfere?
is_impossible: yes

question: Do antibiotics mess with birth control pills?
is_impossible: yes

question: What type of organism has been reported to have worked on infections?
is_impossible: yes
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: 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: empirical therapy
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question: Where do doctors perform microorganism identification testing?
answers: text: laboratory
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question: What kinds of antibiotics are most commonly used for empirical therapy?
answers: text: broad spectrum antibiotic
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question: At what stage does a doctor begin empirical therapy?
answers: text: While the microorgainsim is being identified
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question: How long does the identification process take?
answers: text: several days
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question: What happens when a doctor doesn't know the microorganism yet?
answers: text: broad spectrum antibiotic
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question: What happens in empirical therapy?
answers: text: a patient has proven or suspected infection, but the responsible microorganism is not yet unidentified
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question: When is empirical started?
answers: text: before the doctor knows the exact identification of microorgansim
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question: What is one kind of microorganism that may be used when a patient has an infection but it has not yet been identified?
is_impossible: yes

question: Where do doctors perform empirical therapy testing?
is_impossible: yes

question: What kinds of infections are most commonly used for empirical therapy?
is_impossible: yes

question: At what age does a microorganism begin empirical therapy?
is_impossible: yes

question: How long does the infection process take?
is_impossible: yes

question: What is penicillins produced by?
is_impossible: yes

question: What are organizations who are lobbying to other US agencies concerned with?
is_impossible: yes

question: What is an example of bad treatment causing infections?
is_impossible: yes
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: question: What are two examples of minor side effects caused by some antibiotics?
answers: text: fever and nausea
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question: What causes diarrhea?
answers: text: disruption of the species composition in the intestinal flora
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question: What negative effects can antibiotics have on the vaginal area?
answers: text: yeast
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question: What is one example of antibiotics that may have a possible side effect of tendon damage?
answers: text: a quinolone antibiotic with a systemic corticosteroid
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question: What is one possible serious side effect of over-using antibiotics?
answers: text: alter the host microbiota
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question: What are antibiotics screened for on mammals and humans?
answers: text: negative effects
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question: What do antibiotics need approval for?
answers: text: clinical use
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question: What besides the individual patient is targeted when antibiotics is being used?
answers: text: microbial organisms
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question: Photodermatitis, nausea, allergic reactions and anaphylaxis are all what type of side effect?
answers: text: Adverse effects
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question: What was altered during the hypothesis of indiscriminate use of antibiotics?
answers: text: host microbiota
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question: Why are antibiotics checked before use?
answers: text: negative effects on humans or other mammals
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question: Name some adverse effects?
answers: text: fever and nausea to major allergic reactions, including photodermatitis and anaphylaxis
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question: Name some side-effects?
answers: text: diarrhea
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question: What can happen to vaginal flora?
answers: text: overgrowth of yeast
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question: What can happen when antibiotics are used with other drugs?
answers: text: Additional side-effects
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question: What are two examples of anitbacterials caused by some antibiotics?
is_impossible: yes

question: What causes anaphylaxis?
is_impossible: yes

question: What is one possible side effect of antibiotics that do not have a side effect of tendon damage?
is_impossible: yes

question: What are antibiotics screened for on microbiota and chronic disease?
is_impossible: yes

question: What type of organism has been reported to have worked on penicillin?
is_impossible: yes

question: whats another word for cell membrane?
is_impossible: yes

question: When was Gramicidin created?
is_impossible: yes
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: question: What is one common result of using antibiotics from a young age?
answers: text: increased body mass
is_impossible: no

question: What does STAT stand for?
answers: text: subtherapeutic antibiotic treatment
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question: What are some antibiotics can be used for STAT?
answers: text: penicillin, vancomycin, penicillin and vancomycin, or chlortetracycline
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question: Do antibiotics cause obesity in humans?
answers: text: unclear
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question: Why do physicians use antibiotics on infants when the relationship has been proven? 
answers: text: weighed against the beneficial effects
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question: What can happen if people are exposed to antibiotics at a young age?
answers: text: increased body mass
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question: When do intestinal microbiota develop?
answers: text: Early life
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question: Do antibiotics increase the chance of getting fat for humans?
answers: text: unclear
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question: What is one common result of using genes from a young age?
is_impossible: yes

question: What are some microbiota that can be used for STAT?
is_impossible: yes

question: Do antibiotics cause fasting in humans?
is_impossible: yes

question: Why do physicians use antibiotics on mice when the relationship has been proven?
is_impossible: yes

question: When do models develop?
is_impossible: yes

question: What does the infection activity of antibacterials depends on?
is_impossible: yes

question: What should women do if they are using antibiotics and birth control pills?
is_impossible: yes

question: What was a once almost controlled antibiotic that is coming back to do resistance?
is_impossible: yes
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: question: Do antibiotics interact with birth control pills?
answers: text: The majority of studies indicate antibiotics do interfere with contraceptive pills
is_impossible: no

question: What percentage of birth control pill failure is attributed to antibiotics?
answers: text: about 1%
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question: What are the potential effects on intestinal flora?
answers: text: reduced absorption of estrogens in the colon
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question: Have these potential effects been proven through testing?
answers: text: inconclusive and controversial
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question: What do physicians recommend to counteract this potential issue?
answers: text: extra contraceptive measures
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question: What do antibiotics interfere with?
answers: text: contraceptive pills
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question: What percent is the  failure rate of contraceptive pills?
answers: text: about 1%
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question: Whhat does intestinal flora reduce?
answers: text: absorption of estrogens
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question: In therapy, what does the antibacterial interact with?
answers: text: oral contraceptives
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question: Do antibiotics mess with birth control pills?
answers: text: antibiotics do interfere
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question: What is birth control failure rate due to antibiotics?
answers: text: about 1%
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question: What should women do if they are using antibiotics and birth control pills?
answers: text: extra contraceptive measures
is_impossible: no

question: Do antibiotics interact with intestinal flora?
is_impossible: yes

question: What percentage of birth control pill failure is attributed to estrogens?
is_impossible: yes

question: What are the potential effects on antibacterials?
is_impossible: yes

question: What do control pills recommend to counteract this potential issue?
is_impossible: yes

question: What do oral contraceptives reduce?
is_impossible: yes

question: What causes diarrhea?
is_impossible: yes

question: What is one issue that can arise from overuse of predictions?
is_impossible: yes

question: What is the acronym used to describe enzymes?
is_impossible: yes
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: question: What is one potential issue with drinking alcohol while taking antibiotics?
answers: text: decreased effectiveness
is_impossible: no

question: Do all antibiotics interact dangerously with alcohol?
answers: text: moderate alcohol consumption is unlikely to interfere with many common antibiotics
is_impossible: no

question: Is it OK to drink alcohol while taking any antibiotic?
answers: text: there are specific types of antibiotics with which alcohol consumption may cause serious side-effects
is_impossible: no

question: How common is the belief that alcohol and antibiotics should never be mixed?
answers: text: widespread
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question: What can alcohol and certain antibiotics cause?
answers: text: decreased effectiveness of antibiotic therapy
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question: What is unlikely to interfere with  with many common antibiotics?
answers: text: alcohol consumption
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question: What belief should bever be mixed widespread?
answers: text: alcohol and antibiotics
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question: What common drug can reduce antibiotic effectiveness?
answers: text: alcohol
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question: What type of antibiotic is most likely to be a problem with alcohol?
answers: text: specific types of antibiotics with which alcohol consumption may cause serious side-effects
is_impossible: no

question: Should alcohol be used while on antibiotics?
answers: text: alcohol and antibiotics should never be mixed
is_impossible: no

question: What is one potential issue with drinking alcohols while in therapy?
is_impossible: yes

question: Do all antibiotics interact dangerously with conterindication?
is_impossible: yes

question: Is it OK to drink alcohol while taking any risks?
is_impossible: yes

question: What is unlikely to interfere with many common side-effects?
is_impossible: yes

question: What common drug can reduce interactions?
is_impossible: yes

question: Who discovered tyrothricin?
is_impossible: yes

question: What type of vaccines have saved millions of lives?
is_impossible: yes

question: What are strains that are resistant to antibiotics called sometimes?
is_impossible: yes
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: question: What does the bactericidal activitty of antibacterials depend on what?
answers: text: bacterial growth phase
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question: What does this eliminate?
answers: text: bacterial infection
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question: What besides ongoing metabolic activity is required in bactericidal activity?
answers: text: division of bacterial cells
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question: What does the activity of antibacterials depends on?
answers: text: concentration
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question: What does a successful treatment using antibiotics entail?
answers: text: host defense mechanisms, the location of infection, and the pharmacokinetic and pharmacodynamic properties of the antibacterial
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question: What does the potency of antibacterials depend upon?
answers: text: concentration
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question: How do you predict the clinical result?
answers: text: several pharmacological parameters are used as markers of drug efficacy
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question: What does the infection activity of antibacterials depends on?
is_impossible: yes

question: What besides ongoing metabolic activity is required in drug efficacy?
is_impossible: yes

question: What does the activity of defense mechanisms depend on?
is_impossible: yes

question: What does a successful treatment using pharmacological parameters entail?
is_impossible: yes

question: How do you predict the cell division?
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question: What is the molecular weight loss of antibacterial compounds?
is_impossible: yes

question: What do antibiotics need approval for?
is_impossible: yes

question: How many new infections of resistant TB are reported per year?
is_impossible: yes
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: question: Besides sprectrum of activity and chemical structure, how can antibacterial antibiotics classified?
answers: text: mechanism of action
is_impossible: no

question: What is another name used for bacterial cell wall?
answers: text: penicillins and cephalosporins
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question: whats another word for cell membrane?
answers: text: polymyxins
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question: How many new classes of antibacterial antibiotics was introduced in the late 2000's/
answers: text: four
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question: What three ways are antibiotics classified?
answers: text: mechanism of action, chemical structure, or spectrum of activity
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question: What do anitibiotics mostly target?
answers: text: bacterial functions or growth processes
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question: Which two types of antibiotics target the cell wall?
answers: text: penicillins and cephalosporins
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question: Which type of antibiotic goes after the cell membrane?
answers: text: polymyxins
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question: What 3 types go after protein synthesis?
answers: text: (macrolides, lincosamides and tetracyclines
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question: Besides spectrum of activity and chemical structure, how can protein synthesis be classified?
is_impossible: yes

question: What is another name used for target specificity?
is_impossible: yes

question: What is another word for interfere?
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question: How many new classes of glycylcyclines was introduced in the late 2000's?
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question: What three ways are bacteria classified?
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question: What is an example of bad treatment causing infections?
is_impossible: yes

question: Whhat does intestinal flora reduce?
is_impossible: yes

question: What is a worry of using phages?
is_impossible: yes
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: question: Besides semisytetic modifications, what advances in medicinal chemistry regarding antibacterials?
answers: text: various natural compounds
is_impossible: no

question: What is the molecular weight loss of antibacterial compounds?
answers: text: 2000 atomic mass units
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question: What is included in the beta-lactam antibiotics?
answers: text: penicillins
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question: What is penicillins produced by?
answers: text: fungi
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question: What are antibiotics in chemical terms?
answers: text: semisynthetic modifications
is_impossible: no

question: What type of antibiotics include penicilin?
answers: text: beta-lactam antibiotics
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question: What are the type of antibiotics which are taken from still living things?
answers: text: aminoglycosides
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question: How are the slufonamides,quinolones, and oxazolidinones created?
answers: text: synthesis
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question: What is the molecular weight loss of chemical synthesis?
is_impossible: yes

question: What is included in the natural compounds?
is_impossible: yes

question: What are cephalosporins produced by?
is_impossible: yes

question: What are compounds in chemical terms?
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question: What type of antibiotics include sulfonamides?
is_impossible: yes

question: What should women do if they are using antibiotics and birth control pills?
is_impossible: yes

question: What is an example of bad treatment causing infections?
is_impossible: yes

question: When does the spread of antibacterial resistance frequently occurs/
is_impossible: yes
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: question: What does emergence of resistance reflect?
answers: text: evolutionary processes
is_impossible: no

question: What is the purpose of antibiotic treatment?
answers: text: survive high doses of antibiotics
is_impossible: no

question: When was antibacterial-resistance demonstrated?
answers: text: 1943
is_impossible: no

question: Who made the demonstration in 1943?
answers: text: Luria–Delbrück
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question: What is a modern common occurence with antibiotics?
answers: text: resistance of bacteria
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question: What is resistance to antibiotics a cause of?
answers: text: evolution
is_impossible: no

question: When was the Luria-Delbruck experiment?
answers: text: 1943
is_impossible: no

question: Which two antibiotics that have high efficacy are much less useful now?
answers: text: penicillin and erythromycin
is_impossible: no

question: What does emergence of bacteria reflect?
is_impossible: yes

question: What is the purpose of bacterial strains?
is_impossible: yes

question: When were bacterial species and strains invented?
is_impossible: yes

question: What is a modern occurrence with high doeses?
is_impossible: yes

question: What is resistance to genes a cause of?
is_impossible: yes

question: What are cephalosporins produced by?
is_impossible: yes

question: What is one kind of therapy that may be used when a patience has an infection, but it has not been identified?
is_impossible: yes

question: What is an example of bad treatment causing infections?
is_impossible: yes
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: question: What is part of hje the make up of bacterial strains?
answers: text: Intrinsic antibacterial resistance
is_impossible: no

question: What can be absent from the bacterial genome?
answers: text: antibiotic target
is_impossible: no

question: When does the spread of antibacterial resistance frequently occurs/
answers: text: vertical transmission
is_impossible: no

question: What is exchanged between between bacterial strains or species via plasmids that have this resistance?
answers: text: antibacterial resistance genes
is_impossible: no

question: What does some resistance come from?
answers: text: mutation
is_impossible: no

question: What method of spread can occur in antibacterial resistance?
answers: text: vertical transmission of mutations
is_impossible: no

question: What do plasmids do in resistance?
answers: text: carry several different resistance genes
is_impossible: no

question: What is part of the makeup of bacterial strains?
is_impossible: yes

question: What can be absent from the resistance genes?
is_impossible: yes

question: When does the spread of DNA frequently occur?
is_impossible: yes

question: What is exchanged between bacterial stains of species via mutations that have this resistance? 
is_impossible: yes

question: What do plasmids do in bacterial chromosomes?
is_impossible: yes

question: Who discovered the chemical structure of penicillin?
is_impossible: yes

question: What has been talked about to treat resistant bacteria?
is_impossible: yes

question: When was the Nobel Prize first Purified?
is_impossible: yes
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: question: What are strains that are resistant to antibiotics called sometimes?
answers: text: superbugs
is_impossible: no

question: What was a once almost controlled disease that is coming back do to resistance?
answers: text: tuberculosis
is_impossible: no

question: How many new infections of resistant TB are reported per year?
answers: text: half a million
is_impossible: no

question: What is the acronym used to describe resistant TB?
answers: text: MDR-TB
is_impossible: no

question: What are strains that are resistant to tuberculosis called sometimes?
is_impossible: yes

question: What was a once almost controlled antibiotic that is coming back to do resistance?
is_impossible: yes

question: How many new infections of bacteria are reported per year?
is_impossible: yes

question: What is the acronym used to describe enzymes?
is_impossible: yes

question: What is a newly identified enzyme conveying bacterial resistance to a broad range of strains and species? 
is_impossible: yes

question: Who is a director at the Pew Charitable Trusts?
is_impossible: yes

question: How do you predict the clinical result?
is_impossible: yes

question: When did the EU ban antibiotics for speeding up growth?
is_impossible: yes
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: question: What are the two biggest reasons for resistance?
answers: text: Inappropriate antibiotic treatment and overuse
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question: What is a common method of misuse?
answers: text: Self prescription
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question: What is an example of bad treatment causing resistance?
answers: text: overuse of antibiotics
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question: What are the two biggest reasons for antibiotics?
is_impossible: yes

question: What is a common method of hospitals?
is_impossible: yes

question: What is an example of bad treatment causing infections?
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question: What as been associated with increases in suboptimal antibiotics?
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question: Since when have symptoms and diseases been associated with emerging antibiotic resistance?
is_impossible: yes

question: Who led the team that came up with Bayer Laboratories?
is_impossible: yes

question: What is resistance to genes a cause of?
is_impossible: yes

question: What do antibiotics need approval for?
is_impossible: yes
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: question: What is a way of improperly using antibiotics for those traveling?
answers: text: prophylactic antibiotics
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question: What can happen if a doctor doesn't prescribe to a person's weight and prior use?
answers: text: failure of medical professionals to prescribe the correct dosage
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question: What are 3 other common forms of bad antibiotic practices?
answers: text: failure to take the entire prescribed course of the antibiotic, incorrect dosage and administration, or failure to rest for sufficient recovery
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question: What happens when a cold is treated with antibiotics?
answers: text: Inappropriate antibiotic treatment
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question: What do doctors usually do when a patient seems to want antibiotics even though they may not be right?
answers: text: prescribe antibiotics
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question: What is a way of improperly using rest for those traveling?
is_impossible: yes

question: What can happen if a doctor doesn't prescribe to a person's traveling?
is_impossible: yes

question: What are 3 other common forms of bad viral infections?
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question: What happens when a physician is treated with antibiotics?
is_impossible: yes

question: What do doctors usually do when a patient seems to want the common cold even though they may not be right?
is_impossible: yes

question: Who regulates antibiotic approval?
is_impossible: yes

question: When did penicillin G become available as a therapeudic drug?
is_impossible: yes

question: What 3 US organizations have called for the banning of antibiotics in the production of food animals?
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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: question: What is the name of a US government agency tasked with trying to stop improper use of antibiotics?
answers: text: US Interagency Task Force on Antimicrobial Resistance
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question: Which agencies control this task force?
answers: text: US Centers for Disease Control and Prevention, the Food and Drug Administration (FDA), and the National Institutes of Health (NIH)
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question: When did the French start going after overuse of antibiotics?
answers: text: 2002
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question: What is the name of a US government agency tasked with trying to stop the FDA?
is_impossible: yes

question: Which agencies control France?
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question: When did the French start going after children?
is_impossible: yes

question: What has been adressed by an NGO campaign group?
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question: What are organizations who are lobbying to other US agencies concerned with?
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question: What is unlikely to interfere with many common side-effects?
is_impossible: yes

question: What happens in empirical therapy?
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question: How many new infections of resistant TB are reported per year?
is_impossible: yes
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: question: When did the EU ban antibiotics for speeding up growth?
answers: text: 2003
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question: What report caused the UK to worry about resistance?
answers: text: Swann report 1969
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question: What 3 US organizations have called for the banning of antibiotics in the production of food animals?
answers: text: American Society for Microbiology (ASM), American Public Health Association (APHA) and the American Medical Association (AMA)
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question: Name two US bills that want to ban antibiotics in food production?
answers: text: S.742 and H.R. 2562
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question: What 3 medical associations supported the bills?
answers: text: American Holistic Nurses' Association, the American Medical Association, and the American Public Health Association (APHA)
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question: When did the EU ban bills for speeding up growth?
is_impossible: yes

question: What report caused the UK to worry about industries?
is_impossible: yes

question: What 3 US organizations have called for the banning of medical organizations and the production of food animals?
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question: Name two AMA bills that want to ban antibiotics in food production.
is_impossible: yes

question: What 3 medical associations supported antibiotics?
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question: What do anitibiotics mostly target?
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question: What are strains that are resistant to tuberculosis called sometimes?
is_impossible: yes

question: When was the Nobel Prize first Purified?
is_impossible: yes
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: question: What besides sick people are antibiotics used for?
answers: text: animal husbandry
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question: When was resistance first discussed as a problem in the raising of farm animals?
answers: text: 1977
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question: When did a district court order the FDA to stop approving antibiotics in animals?
answers: text: March 2012
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question: What besides sick people are bacterial strains used for?
is_impossible: yes

question: When was resistance first discussed as a problem in the raising of the United States?
is_impossible: yes

question: When did a district court order the FDA to stop approving animals?
is_impossible: yes

question: What violated Natural Resources Defense Council regulations?
is_impossible: yes

question: Who ordered the FDA to use antibiotics?
is_impossible: yes

question: What happens in empirical therapy?
is_impossible: yes

question: What has been talked about to treat bateriophages?
is_impossible: yes

question: What disease did antibiotics help eliminate?
is_impossible: yes
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: question: What methods did people use before antibiotics to treat infections?
answers: text: medicinal folklore
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question: When were some kinds of antimicrobials first used?
answers: text: over 2000 years ago
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question: What type of things did Egyptians and Greeks use?
answers: text: mold and plant materials and extracts
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question: What does antibiosis mean?
answers: text: against life
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question: Who came up with the term antibiosis?
answers: text: Jean Paul Vuillemin
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question: What methods did people use before Robert Koch to treat infections?
is_impossible: yes

question: When were some kinds of dyes first used?
is_impossible: yes

question: What type of things did American microbiologists use?
is_impossible: yes

question: Who came up with the term salvarsan?
is_impossible: yes

question: Who renamed drugs therapudics?
is_impossible: yes

question: What causes diarrhea?
is_impossible: yes

question: When was resistance first discussed as a problem in the raising of the United States?
is_impossible: yes

question: What can happen if a doctor doesn't prescribe to a person's traveling?
is_impossible: yes
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: question: What type of organism has been reported to have worked on infections?
answers: text: mold
is_impossible: no

question: Who noticed in a lab the antibacterial characteristics of mold?
answers: text: Alexander Fleming
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question: What mold did Fleming notice had antibacterial properties?
answers: text: penicillin
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question: What did Fleming initially think a good use would be for it?
answers: text: chemotherapy
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question: What type of organism has been reported to have worked on penicillin?
is_impossible: yes

question: Who noticed in a lab the development of chemists?
is_impossible: yes

question: What mold did Fleming notice had chemotherapy?
is_impossible: yes

question: What did Fleming initially think a good use for chemists would be?
is_impossible: yes

question: What did Fleming use to treat a Petri dish?
is_impossible: yes

question: What are two examples of anitbacterials caused by some antibiotics?
is_impossible: yes

question: Name two US bills that want to ban antibiotics in food production?
is_impossible: yes

question: What is unlikely to interfere with many common side-effects?
is_impossible: yes
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: question: What was the first available antibiotic?
answers: text: Prontosil
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question: What company developed Prontosil?
answers: text: IG Farben
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question: Who led the team that came up with Prontosil?
answers: text: Gerhard Domagk
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question: What prize did Domagk get for his work?
answers: text: 1939 Nobel Prize for Medicine
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question: What was the first available cocci?
is_impossible: yes

question: What company developed enterobacteria?
is_impossible: yes

question: Who led the team that came up with Bayer Laboratories?
is_impossible: yes

question: What prize did Prontosil get for its work?
is_impossible: yes

question: What opened the era of Germany?
is_impossible: yes

question: What percent is the  failure rate of contraceptive pills?
is_impossible: yes

question: What was the first antibiotic developed from wounds?
is_impossible: yes

question: When did a district court order the FDA to stop approving antibiotics in animals?
is_impossible: yes
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: question: What was the first antibiotic developed from nature?
answers: text: tyrothricin
is_impossible: no

question: When was tyrothricin created?
answers: text: 1939
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question: What also happened in 1939 besides tyrothricin?
answers: text: start of World War II,
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question: Who discovered tyrothricin?
answers: text: Rene Dubos
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question: What was tyrothricin used for during the war?
answers: text: wounds and ulcers
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question: What was the first antibiotic developed from wounds?
is_impossible: yes

question: When was Gramicidin created?
is_impossible: yes

question: Who discovered systematic usage?
is_impossible: yes

question: What was tyrothricin used for during toxicity?
is_impossible: yes

question: Rene Dubos was not shared between who?
is_impossible: yes

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

question: What is an example of bad treatment causing infections?
is_impossible: yes

question: What year did the Infectious Disease Society of America say that production of new antibiotics does not keep up with resistance?
is_impossible: yes
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: question: When was penicillin G first purified?
answers: text: 1942
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question: When did penicillin G become available outside of military use?
answers: text: 1945
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question: Who came up with a way to quickly produce penicillin?
answers: text: Norman Heatley
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question: When was the chemical make-up of penicillin discovered?
answers: text: 1945
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question: Who discovered the chemical structure of penicillin?
answers: text: Dorothy Crowfoot Hodgkin
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question: When was the Nobel Prize first Purified?
is_impossible: yes

question: When did penicillin G become available as a therapeudic drug?
is_impossible: yes

question: Who came up with a way to quickly produce pus?
is_impossible: yes

question: When was the chemical make-up of bacteria discovered?
is_impossible: yes

question: Who discovered the chemical structure of bacteria?
is_impossible: yes

question: What are the two biggest reasons for antibiotics?
is_impossible: yes

question: What are cephalosporins produced by?
is_impossible: yes

question: What is a worry of using DNA?
is_impossible: yes
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: question: What do vaccines need to work?
answers: text: immune modulation or augmentation
is_impossible: no

question: What type of vaccines have saved millions of lives?
answers: text: Antibacterial vaccines
is_impossible: no

question: What types of vaccines have been phased out?
answers: text: Vaccines made from attenuated whole cells or lysates
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question: What do polysaccharides need to work?
is_impossible: yes

question: What type of polysaccharides have saved millions of lives?
is_impossible: yes

question: What types of polysaccharides have been phased out?
is_impossible: yes

question: Vaccines made from what have been replaced by less protein carriers?
is_impossible: yes

question: What happens when a host includes polysaccharides?
is_impossible: yes

question: When was the Luria-Delbruck experiment?
is_impossible: yes

question: When does the spread of antibacterial resistance frequently occurs/
is_impossible: yes

question: What happens when a doctor doesn't know the microorganism yet?
is_impossible: yes
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: question: What has been talked about to treat resistant bacteria?
answers: text: Phage therapy
is_impossible: no

question: How have researchers been doing this?
answers: text: infecting pathogenic bacteria
is_impossible: no

question: What is a worry of using phages?
answers: text: phages will infect "good" bacteria
is_impossible: no

question: What has been talked about to treat bateriophages?
is_impossible: yes

question: How have bacterium been doing this?
is_impossible: yes

question: What is a worry of using DNA?
is_impossible: yes

question: What makes researchers confident that phages fight pathogens?
is_impossible: yes

question: By what method do phages destroy antibiotics?
is_impossible: yes

question: What type of things did American microbiologists use?
is_impossible: yes

question: Who ordered the FDA to use antibiotics?
is_impossible: yes

question: What happens when a cold is treated with antibiotics?
is_impossible: yes
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: question: How many antibiotics have been created in the last 7 years?
answers: text: 2
is_impossible: no

question: How many are in the pipelin to fight GNB?
answers: text: seven
is_impossible: no

question: What year did the Infectious Disease Society of America say that production of new antibiotics does not keep up with resistance?
answers: text: 2013
is_impossible: no

question: How many bacilli have been created in the last 7 years?
is_impossible: yes

question: How many are in the pipeline to fight IDSA?
is_impossible: yes

question: What year did the Infectious Diseases of America say that production of GNB does not keep up with resistance?
is_impossible: yes

question: What happens to the umber of new resistance?
is_impossible: yes

question: What drugs address teh entire spectrum of resistance of GNB?
is_impossible: yes

question: What is a common method of misuse?
is_impossible: yes

question: What is one issue that can arise from overuse of predictions?
is_impossible: yes

question: What could help to spur pharmaceuticals to make new infections?
is_impossible: yes
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: question: Who regulates antibiotic approval?
answers: text: FDA
is_impossible: no

question: What could help to spur pharmaceuticals to make new antibiotics?
answers: text: economic incentives
is_impossible: no

question: What are resistant bacteria called in the media?
answers: text: superbugs
is_impossible: no

question: Who is a director at the Pew Charitable Trusts?
answers: text: Allan Coukell,
is_impossible: no

question: Who regulates infection approval?
is_impossible: yes

question: What could help to spur pharmaceuticals to make new infections?
is_impossible: yes

question: Who is a director at the FDA?
is_impossible: yes

question: Who will monitor the use of economic incentives?
is_impossible: yes

question: Who aims to fast track healthcare professionals?
is_impossible: yes

question: Rene Dubos was not shared between who?
is_impossible: yes

question: Do antibiotics increase the chance of getting fat for humans?
is_impossible: yes

question: What 3 US organizations have called for the banning of antibiotics in the production of food animals?
is_impossible: yes
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."