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9 points to learning how antibiotics work and how resistance occurs

5/2/2014

 
Many medical students I teach are desperate to know how
antibiotics work and how resistance to these antibiotics occurs. I try to reassure them that this knowledge is not really necessary for being a good doctor, unless you want to become a Microbiologist; I can only assume this question is asked a lot in medical school exams.

First, a quick reminder of the anatomy of bacteria. The flagella and plasmid have no role in antibiotic mechanisms of action or how bacteria mount resistance.
anatomy of a bacteria
Click for larger image
The following two diagrams group mechanisms of action and resistance into common themes and are how I found it best to learn and remember them.

Essentially there are only 5 basic mechanism of action or sites within the bacteria where antibiotics work and 4 basic mechanisms of resistance or how the bacteria launches a survival response. Learn these first and then start to slot your knowledge of individual classes of antibiotics into these groups.

Mechanisms of Action
Antibiotics either work in the bacteria’s cytoplasm, on its chromosome, at its cell membrane, on its ribosome or at its cell wall.
how antibiotics work
Click for larger image
Mechanisms of Resistance
Bacteria develop resistance in 4 ways; in effect it is the bacteria’s survival response to the action of the antibiotic, which is trying to kill it.
how resistance occurs
Click for larger image
Using this method hopefully allows you to remember enough to get  a framework for an essay. Use the individual antbiotic sections in the book "Microbiology Nuts and Bolts" to get more detailed explanations about each antibiotic. Give this method a go and let me know if it works for you.

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    Blog Author:

    David Garner
    Consultant Microbiologist
    Surrey, UK

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