Antibiogram: what is it used for?

Not all bacteria are sensitive to the same antibiotics, and also, within the same type of infectious agents, not all require the same medications. The antibiogram helps the doctor to know which drug to prescribe .

But why can’t all microorganisms be fought with the same antibiotic? This is a very recurring question and it has its answer in the concept of evolution. Microorganisms have generated mechanisms to avoid substances that prevent them from surviving.

These resistances must be known in advance in order to apply the appropriate treatment to the infected person. To do this, the antibiogram reveals the sensitivity of a certain bacterium to antibiotics.

Antimicrobial resistance

Bacteria become resistant over time, based on their need to survive. Drug resistance, which can be seen on antibiograms, is classified in two ways:

  • Innate: they are mechanisms that a family of bacteria have written in their genetic code in a natural way, that is, they already had this resistance long before the application of antibiotics.
  • Acquired: certain bacteria created methods to resist or fight antibiotics. They went from being sensitive to these drugs to being resistant.
the antibiogram
The antibiogram reveals bacterial resistance, both innate and acquired

Continue reading:  Bacterial resistance: what you can do to combat it

An example of acquired resistance

An example of acquired resistance is that which occurred after the discovery of penicillin by Alexander Fleming. In the 1940s, the main antimicrobial used was penicillin, but a bacterium called Staphylococcus aureus quickly developed resistance .

The penicillin is an antibiotic that binds to an enzyme that generates the wall of the bacteria. In other words, penicillin inhibits the synthesis of the bacterial wall, leaving the microorganism unprotected and leading to death. However, Staphylococcus aureus generated enzymes called penicillinases to break down the penicillin molecule.

Dangers of antimicrobial resistance

The Centers for Disease Control and Prevention (CDC) wrote the 2019 report on the threat to antibiotic resistance in the United States, stating that the number of resistance remains high. Currently, there are 2.8 million antibiotic-resistant infections.

Looking at all this data, the threat posed by antibiotic resistance is worrying and frightening. According to the World Health Organization ( WHO ), in recent years the use and abuse of antimicrobials has increased the number and types of resistant microorganisms.

What is the antibiogram?

The antibiogram helps us determine the most appropriate antibiotic to specifically treat the bacteria that have infected us. When we have an infection, the doctor removes a sample from the source of the infection to isolate the causative organism.

The microorganism grows in a controlled medium, called a culture, to determine what type of bacteria it is and what family it belongs to. Once this step is completed, it is cultivated in another medium with tablets that release antibiotics.

Bacteria grow in this new culture, but if they are sensitive to antibiotics they leave a halo around the pill . This halo indicates that the bacteria has not been able to reproduce because the antibiotic has prevented it.

The indiscriminate use of antibiotics increased the resistance of bacteria, and today the antibiogram is more valuable than decades ago

You may be interested:  What is resistance to antibiotics?

Treatment according to the antibiogram

When an infection is very serious there is no time to wait for the results of the antibiogram . Based on the characteristics of the patient, the focus of the infection, and whether it has been contracted outside or inside the hospital, the patient is treated with broad-spectrum antibiotics.

These broad-spectrum drugs cannot be deliberately applied to everyone who has an infection, because their indication involves the risk of resistance. If they become resistant, we have a problem, since in serious infections we will not be able to apply the same antibiotic.

On the other hand, targeted treatment is one that is tailored to the bacteria in question . It is determined by the antibiogram, which tells us which antibiotic to use.

Avoid bacterial resistance

Avoiding and preventing bacterial resistance is necessary and vital for humanity. If the microorganisms become very resistant, the therapy will be ineffective and the consequences serious.

The number one advice is to take the appropriate dose of antibiotic prescribed during the days that the doctor has told us. We cannot stop the medication even if we feel good, nor can we change the milligrams ingested based on our personal taste.

If despite the precautions we come across a resistant bacterium, the use of the antibiogram will be the norm. It is a powerful biochemical tool for treating severe infectious cases.


Relationship between metformin and weight loss

Metformin and weight loss have a long-standing link. First of all, it was noted that users who took the drug to control their blood glucose also lost kilograms of weight. At first it was not known if this decrease in fat was due to diet or medication; however, it was a starting point for hypotheses.

One of the theories suggests that this drug has the ability to reduce appetite. Therefore, the calorie balance is in favor of weight loss. Anyway, it should be clear that it is not a strategy of choice to lose weight. For what reason? Here we explain it in detail.

What is metformin?

Metformin is an oral antidiabetic drug, that is, it is indicated as the first choice in people with type 2 diabetes . This form of the pathology is one in which the use of injectable insulin is not yet required.

Its form of action focuses on preventing the amount of circulating glucose in the blood from rising. This is achieved by blocking the absorption of sugars in the intestine, which in the end results in less availability of the nutrient.

In addition, metformin also works in the liver, where it helps stop glucose production. It forces you to make glycogen, which is a storage form of sugar. Finally, another important point of action is in the muscle, where the sensitivity of this tissue to insulin improves .

Ultimately, the drug does not lower a person’s blood glucose, but rather prevents it from rising after meals. For this reason, their administration schedules are in relation to the big meals of the day. 500 to 800 milligrams are usually prescribed with lunch and dinner.

The most severe cases reach up to 1000 milligrams, twice a day, although at that point it is preferred to combine it with another oral hypoglycemic agent, such as glimepiride, glibenclamide , among others. The choice is very particular for each clinical picture.

Patient measuring blood glucose
Metformin is a drug that is indicated for patients with type 2 diabetes. It serves to keep glucose at stable levels.

Keep reading: Treatment of diabetes mellitus

The side effects of metformin

Metformin can cause weight loss as a side effect. This does not always mean an adverse reaction , but, in this as in other drugs, there are issues that occur in parallel to what is intended when indicated by the doctor.

First of all, we will talk about adverse effects, which are those that happen in a negative sense. They are not always present, but when they are, they could explain weight loss in some patients, since most are gastrointestinal.

Regular users of the drug suffer from nausea, diarrhea and abdominal pain . Increased peristalsis leading to flatulence and a feeling of bloating is also common .

Given this combination of signs and symptoms, the patient may reduce their intake due to discomfort. Metformin may not be discontinued, as the medical indication is usually precise and strong. Diabetes leaves no room for interpretation on how to deal with it. The priority is to lower blood glucose.

On the other hand, there is a serious adverse effect of the drug that, although rare, is life-threatening. It is lactic acidosis . In this situation, the blood fills with lactic acid, the product of a deviation in cellular metabolism due to the drug . Thus, the person may suffer symptoms such as the following:

  • Confusion.
  • Dizziness
  • Extreme weakness
  • Heart and lung rhythm disturbances.

The side effect of weight loss

The association between weight loss and metformin is not fully understood . Various investigations have been carried out to know the reason for the effect, but none has been conclusive.

One of the strongest hypotheses is about the alteration of appetite. It is suspected that it reduces the hunger of those who consume it, which favors the energy balance. If to this we add the carbohydrate restriction diet that is usually indicated, the combination is favorable.

In any case, the effect on body weight is not immediate. The studies available have found that the benefit appears after a year of continuous use, and are consistent between 6-15 years later.

Therefore, the effect is considered long-term weight loss (LTWL or long-term weight loss , for its meaning in English). It is not a magic pill nor was it created with the aim of supporting a low calorie diet. It should be clear that this situation was seen as collateral .

The side effect of weight loss
Metformin was not created to support weight loss diets. Therefore, it should not be considered a weight loss supplement.

Find out more: How diabetes affects the digestive system

Can Metformin Be Prescribed For Weight Loss?

How to be prescribed, it is possible. In any case, it is a drug for type 2 diabetes, designed and marketed to lower blood glucose levels in patients with metabolic disorders.

What happens many times is that diabetic patients with insulin resistance are obese or overweight . In these particular cases, metformin appears as a first-line option, since it would reduce not only circulating sugar, but also body fat. With all this, the insulin response would improve.

The same criteria apply to metabolic syndrome or polycystic ovary syndrome , in which the lack of action of insulin is combined with a high weight. Again, metformin appears as the logical therapeutic strategy.

However, if a professional prescribes it for the sole purpose of helping you lose weight without diabetes, you are using it “off-label.” This expression names the prescription for a utility that is not endorsed. It can be done, but there is no scientific evidence to back it up.

Metformin for diabetic patients

A type 2 diabetic person will most likely receive a prescription for metformin. It is the drug of choice to initiate glycemic regulation . It may be prescribed in combination with another, and in aid of dietary and lifestyle changes.

The scientific evidence is sufficient to rely on this substance to changes in glucose levels. In fact, all over the world it is part of the formula used by endocrinologists.

Still, if we only want to use it for weight loss, we should be careful. Given the lack of evidence, it is not known whether it can cause adverse effects in healthy adults in the long term. It is best to avoid its consumption in these cases and look for other strategies to achieve a healthy weight.


Metformin: is it really good for weight loss?

Will Metformin Work For Weight Loss? It is a question that science has asked on several occasions after verifying that diabetic patients under a regimen with this drug also lose kilograms after months of use.

The diabetes management protocols propose to indicate metformin to people with altered blood glucose levels who, in addition, have a body mass index greater than 25, that is, who are obese. But what if we want to use it only as weight loss therapy?

What is metformin?

Metformin is a medicine used for type 2 diabetes. It was specially formulated to reduce the sugar that the intestine absorbs from food, thereby helping to keep blood sugar levels in check.

Type 2 diabetes is the form of the disease in which insulin is still circulating , so the patient does not need to inject it, as in type 1 . There is a large battery of oral antidiabetic drugs that are prescribed to these people, although metformin is the current therapeutic star.

The basic functions in the body are the following:

  • Reduces the entry of glucose through the intestinal mucosa when eating.
  • It stimulates the liver to make glycogen to store sugar and not dump it into the bloodstream.
  • Accelerates the entry of glucose into muscle tissue by improving the insulin sensitivity of muscle receptors .

The general use guideline is with meals. Doses of 500, 800, 850 or 1000 milligrams are usually indicated with lunch and dinner. Some commercial presentations are combined with another oral antidiabetic.

What is metformin?
Metformin is a medicine that is used regularly in patients with type 2 diabetes.

Keep reading: Diet in type 2 diabetes: how should it be?

Is metformin useful for weight loss?

We know that the drug is an antidiabetic, but science has also determined that it causes weight loss. So can it be used in this regard? Is it valid to prescribe it for a person without diabetes who wants to lose weight?

The question is complex. The use of metformin to lose weight is an off-label or off-label use , this means that the professional indicates it for a utility that is not approved by the government associations that regulate drugs.

Prescription is not illegal, although it cannot be said to have sufficient evidence . What is known so far is that the effect is long-term, in the context of an LTWL, short for long-term weight loss . These are the treatments that have proven effective for weight loss after months or years of use.

The available studies on metformin indicate that the greatest benefit on body mass indices recorded after a year of continuous use . However, consistency is reached about 10 years after starting it.

The side effects that contribute to weight loss

Metformin, like any drug, is not without adverse effects. During its consumption it is common for gastrointestinal signs to occur which, although not of intolerance, are associated with its effect on the intestine.

These reactions have been speculated to contribute to weight loss. Nausea, vomiting, diarrhea , abdominal swelling and flatulence are some of the problems that occur. Some diabetic patients reduce their food intake because of this digestive discomfort.

On the other hand, the drug is an appetite reducer . The mechanism by which this decrease in cravings for food is produced is not clear. It could be a hormonal change linked to the effect on the distribution of body fat. In any case, in some series of case studies an increase in hunger was registered at the beginning of the treatments, in the opposite direction to that expected.

The side effect of weight loss
To date, there is not enough evidence on the relationship between metformin and weight loss. For this reason, one is afraid of the appearance of possible unwanted effects.

Find out more: Hyporexia or lack of appetite

Alternatives to Metformin for Weight Loss

Metformin may not be the first choice for weight loss . Its use in weight loss is not endorsed as an initial indication nor can it be used as the only way to approach a diet plan .

On the contrary, the recommendation is to exhaust the traditional and proven ways of weight loss first. Both low-calorie diets and physical exercise are the logical ways to deal with overweight and obesity.

Like any drug, even the diuretics that popularized its use in nutritional terms, the adverse effects must not be forgotten. One of the most complicated of metformin is lactic acidosis , which can be life-threatening . Therefore, strict medical control is required and never proceed to self-medication.

If it is a diabetic patient with extra kilograms, then the drug will be of choice, since a possible loss of weight will contribute to the improvement of glycemic values. Even so, the need for a specific diet and appropriate physical exercise also applies.

There is insufficient scientific evidence to support the sole use of metformin for weight loss . It would be unwise for the drug to be prescribed without exhausting the previous instances, especially since there is relevant information to develop dietary and sports plans that help in weight loss.


What medications change the color of urine?

The color of urine is a great indicator of certain processes that take place in our body. Normally, urine varies between different shades of yellow , depending on how much water is drunk and the level of hydration.

However, some medicines cause the color of this liquid to change. It is not that it becomes darker or lighter, but it can acquire very vivid tones, such as red, yellow or even blue.

The normal thing is that, when this data is unknown, the person to whom it happens is scared. Therefore, in this article we explain which are the medications that can cause the color of urine to change and what result is obtained from the modification.

Medicines that turn the color of urine red

When urine turns pink or reddish, it makes sense to startle and think that something is wrong. The truth is that, on many occasions, this is caused by the presence of blood in this liquid . It is a consequence of the use of anticoagulants such as warfarin and heparin.

However, many other medications also cause this problem because of their metabolism. First, the drug most often associated with this, because it is used in many patients, is rifampicin . Rifampicin is an antibiotic used to treat tuberculosis.

On the other hand, certain laxatives that contain senna (an herbal component) change the color of urine to red. The same occurs with phenazopyridine, which is a drug that acts as an analgesic in the urinary tract for colic in the region or urinary infections that cause pain.

Yellow urine
Urine is yellow as a normal color, and variations on that hue are alterations.

Green or blue colored urine

Incredibly, this liquid can turn bluish-green with certain medications. First, it may be due to amitriptyline. It is an antidepressant that is used not only for this purpose, but it is also indicated in fibromyalgia and neuropathic pain, among other conditions.

On the other hand, this tone can be a consequence of indomethacin . It is a drug that is used very frequently in people with rheumatoid arthritis , acute gout, and other musculoskeletal disorders.

Propofol , which is used as part of general anesthesia and for sedation, has also been registered as an adverse effect generator. It can make the urine greenish.

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Medications that turn urine orange

Sometimes the orange and reddish color of urine are confused. Therefore, in this category we can also include drugs such as rifampicin and phenazopyridine, since some people consider that the tone that is acquired is more orange than red.

Another medicine that can cause urine to turn orange is sulfasalazine. It is an anti-inflammatory that is often prescribed to treat ulcerative colitis or Crohn’s disease . Nitrofurantoin, an antibiotic indicated in urinary infections, and vitamin B, have also been linked to this situation.

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Other urine color changes

Sometimes urine may darken to a dark yellow or even brownish color. First of all, it may be due to the use of metronidazole. It is an antibiotic that is used frequently, since it is indicated in Trichomonas vaginitis and urethritis .

Similarly, it works for intestinal amebiasis and Clostridium perfringens infection On the other hand, antimalarials (antimalarial drugs) also make urine brown . Within this group we find chloroquine and primaquine.

Yellow urine sample
Drug package inserts usually report when one of the adverse effects is a change in the color of the urine.

To remind

The color of urine is usually yellow and varies in intensity according to the degree of hydration that the person presents. However, many medications can cause this liquid to turn very different colors, such as red, blue, or even purple.

What we must bear in mind is that, given these changes, the ideal is to always consult with the doctor . Although it is true that it can be a benign side effect, it is also indicative that something is not right in the body when it is sustained over time.

If you are taking a specific drug for a pathology you suffer from, your doctor will inform you of the possible adverse effects of it, among which can be counted the chromatic alterations of the urine. Similarly, drug package inserts often describe the possibility.


9 most common side effects of birth control

Contraceptive side effects are not unusual. Although they are used to prevent unwanted pregnancies, they are still drugs, in some cases, or instruments in others. Thanks to scientific advances, different types have been developed that adapt to the conditions of each woman.

However, most are based on the administration of hormones. Therefore, they usually have adverse reactions that vary depending on the person. In this article we explain why they occur and which are the most frequent.

Why can side effects occur with contraceptives?

Hormonal contraceptives are, today, the most effective method of controlling fertility. In addition, they are the most used by women, along with condoms. Within the group we find the following:

  • Contraceptive pills.
  • Vaginal ring
  • Hormonal IUD: The copper intrauterine device is also an effective method that does not contain hormones. Therefore, its possible side effects are different.
  • Transdermal patches.
  • Subdermal implants .
  • Morning-after pill.

The fact that side effects occur from contraceptives must be attributed to the administration of exogenous hormones . In general, the menstrual cycle and everything related to female fertility is regulated by estrogens and progesterone.

When exogenous hormones are introduced into the body, the synthesis of natural ones is disrupted. In this way, the menstrual cycle and ovulation stop following their normal course, which is why a pregnancy is prevented.

The problem is that hormones not only act on the reproductive system. They also exert their action on other parts of the body, such as the breasts and adipose tissue. Hence, they may have more effects, apart from interfering with fertility.

Subdermic implant.
The subdermal implant is a form of contraception that slowly delivers hormones.

1. Breakthrough bleeding

Intermenstrual bleeding as an adverse effect of contraceptives is one that appears unexpectedly between two periods . According to research , this secondary reaction is frequent when starting to take the pill and, in addition, it is a cause of detachment from the method, so it causes its abandonment in many opportunities.

It is likely to appear during adaptation to hormonal imbalance. However, if the bleeding becomes very heavy or lasts for more than five days, the ideal is to consult your doctor to rule out other causes.

2. Dizziness, nausea and vomiting as adverse effects of contraceptives

Dizziness, nausea, and vomiting are very unspecific symptoms . They can appear for many reasons, but it has been described that there are women who also suffer from them when starting the hormonal method.

However, it is important to bear in mind that, in the event that the contraceptive is taken orally, vomiting can interfere with its absorption. Therefore, it is essential to be well informed about whether to repeat the dose. As a general rule, when the episode occurs before 12 hours after ingestion, it should be repeated.

3. Tender breasts

As we mentioned at the beginning, hormones also act on breast tissue. Hence, they can cause the breasts to be more swollen or sensitive . Many women even claim to feel pain to the touch, as explained in the Revista de gynecología y obstetricia de México.

4. Headache and migraine

This is one of the most relevant side effects for some female users. In the event that a person suffers from migraine, it is usually recommended to avoid hormonal contraceptives and look for alternatives, since there is some evidence that denotes the link.

The reason, as the Mayo Clinic describes , is that fluctuating estrogen levels alter certain chemicals related to this symptom. Therefore, the ideal is to prevent pain in some phases of the cycle or, if they are very disabling, avoid this type of method.

You may be interested in: Signs and symptoms of high estrogen levels

5. Weight gain

Weight gain is one of the most controversial side effects. It seems that there is no increase in body mass as such . That is, it would not be the fat tissue the culprit.

Most likely , fluids will be retained , especially at the beginning of use, which is why it is considered an adverse effect of initial contraceptives. Over time, the internal electrolyte balance stabilizes and there is no longer retention.

6. Mood swings between contraceptive side effects

As explained in the package inserts for birth control pills, some women experience changes in mood. That is, they tend to be more unstable in their emotions or have a higher risk of depression.

However, the relationship between the two events is still being studied . The investigations that we have agree that the effect is not very measurable and, when it could be verified, it appeared after more than 10 years of use of the pills.

You might like: What are the contraceptive methods for men?

7. Amenorrhea

Amenorrhea, like breakthrough bleeding, is a common symptom. This is the name given to the lack of menstruation at the time it would be expected to happen. In the case of hormonal contraceptives, it is a secondary form, since it is related to the imbalance of the cycle.

The truth is that many factors can influence and not just the pills. Stress or diet itself, as well as physical exercise, are determining factors. However, it is important that, if this happens, a pregnancy test is carried out to make sure.

8. Decreased sexual desire

Sexual desire is a sensation on which many conditions intervene. Hormones play a fundamental role, but they are not the only determining factor. However, it is possible that with contraceptives there is a decrease in libido.

According to an article in the Medical Journal of the Mexican Institute of Social Security , the reduction in sexual desire is more evident in the patch and implant methods than in the others. In any case, it is difficult to separate the other factors that could intervene to have a final opinion.

Birth control pills in the hands.
Hormonal side effects are not always present and vary among female users.

9. Vaginal discharge

When it comes to hormones, one of the side effects of contraception will be the change in vaginal discharge. This fluid responds to internal variations and the conformation of the flora of the vagina.

This change is almost never a sign of pathology. It is even expected that the change will happen and that it will be maintained during the use of pills or injectables.

Contraceptives are safe, despite adverse effects

Hormonal contraceptives are a safe and effective method of preventing pregnancy . However, this does not mean that they are exempt from possible unwanted effects.

Therefore, you should always consult with the doctor all the doubts. The professionals will help you choose the most suitable one for you and will advise you based on your situation. Each woman has the power to choose what best suits her lifestyle and the least complications associated with it.