romikgosai/squad_modified_2 huggingface dataset:
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".

Q1: What is one disease that has been nearly eradicated thanks to vaccines and antibiotics?
A1: tuberculosis
Q2: What is one issue that can arise from overuse of antibiotics?
A2: overuse, especially in livestock raising, prompting bacteria to develop resistance
Q3: What organization called antimicrobial resistance a 'serious threat?'
A3: World Health Organization
Q4: In which century were antibiotics first introduced?
A4: 20th century
Q5: What can be affected by issues resulting from overuse of antibiotics?
A5: anyone, of any age, in any country
Q6: What does there medicines do for livestock?
A6: develop resistance
Q7: What organization classifies this as a current serious threat in the whole world??
A7: World Health Organization
Q8: In what century did antibiotics revolutionized medicine?
A8: 20th
Q9: Besides antimicrobial, what did the overused medicine cause?
A9: antibiotic resistance
Q10: What other medicine worked along antibiotics to eradicate diseases like tuberculosis?
A10: vaccination
Q11: When did antibiotics revolutinzed medicine?
A11: 20th century
Q12: What happened when antibiotics was over used in livestock?
A12: develop resistance
Q13: What organization stated that the world has this serious problem?
A13: World Health Organization
Q14: What regions in the world does this apply in?
A14: every region of the world
Q15: When were antibiotics created?
A15: 20th century
Q16: What is a common problem in antibiotic use?
A16: antimicrobial and antibiotic resistance
Q17: Who else uses antibiotics besides the medical industry?
A17: livestock raising
Q18: What disease did antibiotics help eliminate?
A18: tuberculosis
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.

Q1: What is one kind of therapy that may be used when a patience has an infection, but it has not been identified?
A1: empirical therapy
Q2: Where do doctors perform microorganism identification testing?
A2: laboratory
Q3: What kinds of antibiotics are most commonly used for empirical therapy?
A3: broad spectrum antibiotic
Q4: At what stage does a doctor begin empirical therapy?
A4: While the microorgainsim is being identified
Q5: How long does the identification process take?
A5: several days
Q6: What happens when a doctor doesn't know the microorganism yet?
A6: broad spectrum antibiotic
Q7: What happens in empirical therapy?
A7: a patient has proven or suspected infection, but the responsible microorganism is not yet unidentified
Q8: When is empirical started?
A8: before the doctor knows the exact identification of microorgansim
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.

Q1: What are two examples of minor side effects caused by some antibiotics?
A1: fever and nausea
Q2: What causes diarrhea?
A2: disruption of the species composition in the intestinal flora
Q3: What negative effects can antibiotics have on the vaginal area?
A3: yeast
Q4: What is one example of antibiotics that may have a possible side effect of tendon damage?
A4: a quinolone antibiotic with a systemic corticosteroid
Q5: What is one possible serious side effect of over-using antibiotics?
A5: alter the host microbiota
Q6: What are antibiotics screened for on mammals and humans?
A6: negative effects
Q7: What do antibiotics need approval for?
A7: clinical use
Q8: What besides the individual patient is targeted when antibiotics is being used?
A8: microbial organisms
Q9: Photodermatitis, nausea, allergic reactions and anaphylaxis are all what type of side effect?
A9: Adverse effects
Q10: What was altered during the hypothesis of indiscriminate use of antibiotics?
A10: host microbiota
Q11: Why are antibiotics checked before use?
A11: negative effects on humans or other mammals
Q12: Name some adverse effects?
A12: fever and nausea to major allergic reactions, including photodermatitis and anaphylaxis
Q13: Name some side-effects?
A13: diarrhea
Q14: What can happen to vaginal flora?
A14: overgrowth of yeast
Q15: What can happen when antibiotics are used with other drugs?
A15: Additional side-effects
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.

Q1: What is one common result of using antibiotics from a young age?
A1: increased body mass
Q2: What does STAT stand for?
A2: subtherapeutic antibiotic treatment
Q3: What are some antibiotics can be used for STAT?
A3: penicillin, vancomycin, penicillin and vancomycin, or chlortetracycline
Q4: Do antibiotics cause obesity in humans?
A4: unclear
Q5: Why do physicians use antibiotics on infants when the relationship has been proven?
A5: weighed against the beneficial effects
Q6: What can happen if people are exposed to antibiotics at a young age?
A6: increased body mass
Q7: When do intestinal microbiota develop?
A7: Early life
Q8: Do antibiotics increase the chance of getting fat for humans?
A8: unclear
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.

Q1: Do antibiotics interact with birth control pills?
A1: The majority of studies indicate antibiotics do interfere with contraceptive pills
Q2: What percentage of birth control pill failure is attributed to antibiotics?
A2: about 1%
Q3: What are the potential effects on intestinal flora?
A3: reduced absorption of estrogens in the colon
Q4: Have these potential effects been proven through testing?
A4: inconclusive and controversial
Q5: What do physicians recommend to counteract this potential issue?
A5: extra contraceptive measures
Q6: What do antibiotics interfere with?
A6: contraceptive pills
Q7: What percent is the  failure rate of contraceptive pills?
A7: about 1%
Q8: Whhat does intestinal flora reduce?
A8: absorption of estrogens
Q9: In therapy, what does the antibacterial interact with?
A9: oral contraceptives
Q10: Do antibiotics mess with birth control pills?
A10: antibiotics do interfere
Q11: What should women do if they are using antibiotics and birth control pills?
A11: extra contraceptive measures
Q12: What is birth control failure rate due to antibiotics?
A12: about 1%
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.

Q1: What is one potential issue with drinking alcohol while taking antibiotics?
A1: decreased effectiveness
Q2: Do all antibiotics interact dangerously with alcohol?
A2: moderate alcohol consumption is unlikely to interfere with many common antibiotics
Q3: Is it OK to drink alcohol while taking any antibiotic?
A3: there are specific types of antibiotics with which alcohol consumption may cause serious side-effects
Q4: How common is the belief that alcohol and antibiotics should never be mixed?
A4: widespread
Q5: What can alcohol and certain antibiotics cause?
A5: decreased effectiveness of antibiotic therapy
Q6: What is unlikely to interfere with  with many common antibiotics?
A6: alcohol consumption
Q7: What belief should bever be mixed widespread?
A7: alcohol and antibiotics
Q8: What common drug can reduce antibiotic effectiveness?
A8: alcohol
Q9: What type of antibiotic is most likely to be a problem with alcohol?
A9: specific types of antibiotics with which alcohol consumption may cause serious side-effects
Q10: Should alcohol be used while on antibiotics?
A10: alcohol and antibiotics should never be mixed
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.

Q1: What is part of hje the make up of bacterial strains?
A1: Intrinsic antibacterial resistance
Q2: What is exchanged between between bacterial strains or species via plasmids that have this resistance?
A2: antibacterial resistance genes
Q3: What can be absent from the bacterial genome?
A3: antibiotic target
Q4: When does the spread of antibacterial resistance frequently occurs/
A4: vertical transmission
Q5: What does some resistance come from?
A5: mutation
Q6: What method of spread can occur in antibacterial resistance?
A6: vertical transmission of mutations
Q7: What do plasmids do in resistance?
A7: carry several different resistance genes
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."

Q1: What are strains that are resistant to antibiotics called sometimes?
A1: superbugs
Q2: What was a once almost controlled disease that is coming back do to resistance?
A2: tuberculosis
Q3: How many new infections of resistant TB are reported per year?
A3: half a million
Q4: What is the acronym used to describe resistant TB?
A4: MDR-TB
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.

Q1: What are the two biggest reasons for resistance?
A1: Inappropriate antibiotic treatment and overuse
Q2: What is a common method of misuse?
A2: Self prescription
Q3: What is an example of bad treatment causing resistance?
A3: overuse of antibiotics
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.

Q1: What is a way of improperly using antibiotics for those traveling?
A1: prophylactic antibiotics
Q2: What can happen if a doctor doesn't prescribe to a person's weight and prior use?
A2: failure of medical professionals to prescribe the correct dosage
Q3: What are 3 other common forms of bad antibiotic practices?
A3: failure to take the entire prescribed course of the antibiotic, incorrect dosage and administration, or failure to rest for sufficient recovery
Q4: What happens when a cold is treated with antibiotics?
A4: Inappropriate antibiotic treatment
Q5: What do doctors usually do when a patient seems to want antibiotics even though they may not be right?
A5: prescribe antibiotics
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.

Q1: What is the name of a US government agency tasked with trying to stop improper use of antibiotics?
A1: US Interagency Task Force on Antimicrobial Resistance
Q2: Which agencies control this task force?
A2: US Centers for Disease Control and Prevention, the Food and Drug Administration (FDA), and the National Institutes of Health (NIH)
Q3: When did the French start going after overuse of antibiotics?
A3: 2002
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).

Q1: When did the EU ban antibiotics for speeding up growth?
A1: 2003
Q2: What report caused the UK to worry about resistance?
A2: Swann report 1969
Q3: What 3 US organizations have called for the banning of antibiotics in the production of food animals?
A3: American Society for Microbiology (ASM), American Public Health Association (APHA) and the American Medical Association (AMA)
Q4: Name two US bills that want to ban antibiotics in food production?
A4: S.742 and H.R. 2562
Q5: What 3 medical associations supported the bills?
A5: American Holistic Nurses' Association, the American Medical Association, and the American Public Health Association (APHA)
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.

Q1: What besides sick people are antibiotics used for?
A1: animal husbandry
Q2: When was resistance first discussed as a problem in the raising of farm animals?
A2: 1977
Q3: When did a district court order the FDA to stop approving antibiotics in animals?
A3: March 2012
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.

Q1: What methods did people use before antibiotics to treat infections?
A1: medicinal folklore
Q2: When were some kinds of antimicrobials first used?
A2: over 2000 years ago
Q3: What type of things did Egyptians and Greeks use?
A3: mold and plant materials and extracts
Q4: What does antibiosis mean?
A4: against life
Q5: Who came up with the term antibiosis?
A5: Jean Paul Vuillemin