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January 7, 2020

Medications for Treating Infection

Author Affiliations
  • 1Rush University Medical Center, Chicago, Illinois
JAMA. 2020;323(1):100. doi:10.1001/jama.2019.17387

Drugs that treat infections in humans include antibacterial, antiviral, antifungal, and antiparasitic medications.

Infections in humans are caused by microorganisms (microbes), and include bacteria, viruses, fungi, and parasites. There are more than a trillion species of microbes, but only a small number cause infection in humans. These are called pathogens.

Types of Antibiotics

The term antibiotic usually refers to medications that treat bacterial infections like strep throat, ear infection, or urinary tract infection. But it can be a more general term for medications that kill any type of microbe. Antimicrobial or anti-infective are other general terms. More specific terms include antibacterial medications, which treat infections caused by bacteria; antiviral medications, which treat infections like influenza, HIV, or hepatitis C; antifungal medications, which treat infections like yeast infections, toenail infections, or valley fever; and antiparasitic medications, which treat infections like malaria or tapeworms.

Antibiotic Resistance

Pathogenic microbes can develop ways to evade antibiotics, increasing the risk of infections that are difficult to treat. Antibiotic resistance is increasing and is a top global public health threat.

One response to this threat is reintroduction of older antibiotics that previously had fallen out of use. However, many older antibiotics are no longer used because of significant side effects. New antibiotics are being developed, but the process is slow. Government agencies and professional organizations are involved in efforts to promote development of new antibiotics, and several new antibiotics have been approved in the last few years.

Another response is that a different way to treat bacterial infection, called phage therapy, is under research. Bacteriophages are viruses that infect and kill specific bacteria and can be used to treat bacterial infection because bacteriophages do not infect humans. Phage therapy was first recognized in the beginning of the 20th century but was overshadowed by discovery of antibiotics. In addition to treating antibiotic-resistant bacteria, phage therapy targets specific bacteria, whereas antibiotics affect a large range of bacteria, even the normal, beneficial ones in the digestive tract. Phage therapy is still experimental and is not yet approved by the US Food and Drug Administration.

Viruses, fungi, and parasites can develop resistance to antibiotics too. HIV develops resistance easily, so patients with HIV always take more than 1 type of antiviral medication to reduce development of resistance. Candida auris is a new pathogenic fungus that can be resistant to all antifungal medications. Malaria is an example of a parasite that has developed resistance to many antiparasitic medications, limiting public health efforts to control it globally.

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Article Information

Conflict of Interest Disclosures: Dr Moore reported receipt of grants and personal fees from Cepheid and grants from bioMérieux and Curetis. No other disclosures were reported.

Source: Hooper DC, Shenoy ES, Varughese CA. Treatment and prophylaxis of bacterial infections. In: Jameson J, Fauci AS, Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 20th ed. New York, NY: McGraw-Hill; 2018.