How do Antibiotics Work?

Part 1

A brief history of antibiotics- or what do bread mold, arsenic, and soil all have in common?

Throughout history populations used plants, soils and foods to treat infections. Many of our modern-day antibiotics originated from these. Only recently- the past 100 years or so has the active compounds been isolated and purified for commercial use, saving millions of lives globally. We know antibiotics work, but how do they do their job? 

 In this 4-part series we will explore:

Part 1

  • A brief history of antibiotics
  • How antibiotics work- what mechanisms are at play when we take them

Part 2

  • The role of biofilms in bacteria and why these present a challenge to our modern-day arsenal of antibiotics
  • Antibiotic resistance challenges

Part 3

  • When antibiotics are needed and when they aren’t appropriate
  • Distinguish between an allergic reaction to an antibiotic and the symptoms the infection is treating

Part 4

  • A review of each of the antibiotics found in the Jase Case and their use.

A brief history of antibiotics

  • As far back as 350 A.D., tetracycline, a widely used antibiotic were found in bone fragments in ancient Sudanese Nubia. It is believed that stored contaminated grains back then helped cultivate a strain of tetracycline from Streptomycetes. By the late 40s tetracycline was purified and marketed commercially. This antibiotic covers a wide variety of infections, from acne to certain types of pneumonia, and some infections spread by mice and ticks.
  • In ancient Egypt, China, Serbia, Greece and Rome moldy bread was used topically to treat infections. This was documented by John Parkison in his book “Theatrum Botanicum” which was published in 1640.
  • Heavy metals, such as arsenic, bismuth and mercury were used to treat syphilis and gonorrhea with some success.  Salvarsan, an arsenic based chemical was discovered in 1909 by Paul Ehrlich. who is considered the father of microbial therapy. 
  • In 1928 Alexander Fleming discovered mold growing on a petri dish that had staphylococcus bacteria in it. The mold prohibited the growth of the staph. He described the mold as a type of self-defense chemical that killed bacteria. He named it penicillin. It wasn’t until 1940 that penicillin was first used- to treat streptococcal meningitis. 
  • Early 1930s- sulfa based drugs were discovered and produced by the Massengill Company in pill and tablet form. However, the company decided to mass produce an elixir without animal testing made from diethylene glycol (known today as antifreeze) which resulted in what was called the Sulfanilamide Disaster of 1937. More than 100 people died after ingesting this poison. This led to the Food Drug and Cosmetic Act in 1938 and the Drugs and Cosmetics Act of India, where controls are now in place on the manufacture and sale of drugs. 
  • In the mid-1950s synthetic antibiotics were introduced (such as quinolones)

How antibiotics work- what mechanisms are at play when we take them

Before we dive into how antibiotics work it must be stated that they do not work on viruses such as colds, flu, covid, viral pneumonia, RSV, measles, etc. Sometimes there is confusion when an antibiotic is given when the patient has a virus. The virus can lower the bodys immune defenses, in turn making it susceptible to opportunistic bacteria. At that point an antibiotic may be indicated. 

Many antibiotics work by attacking the cell wall of bacteria. Specifically, the drugs prevent the bacteria from synthesizing a molecule in the cell wall called peptidoglycan, which provides the wall with the strength it needs to survive in the human body,

Examples are penicillin, Ceftin,vancomycin

Protein synthesis is a multistep process where DNA is first transcribed into a molecule of single-stranded messenger RNA (mRNA). Then, ribosomes translate it with the help of transfer RNA (tRNA) into long strings of amino acids, which become proteins. Protein synthesis inhibitors prevent proteins from being made by acting as inhibitors of translation or transcription. By blocking either of these processes, many types of antibiotics kill or impair the growth of bacteria by preventing them from making proteins.

Examples: tetracycline, erythromycin, streptomycin, gentamycin

Antimicrobial drugs that can target the microbial cell membrane to alter its functionality. Membrane lysis, or rupture, is a cell death pathway in bacteria frequently caused by cell wall-targeting antibiotics.

Examples are polymyxin and gramicidin

  • Antibiotics that interfere with the development of DNA or break DNA strands through enzyme inhibitors 

Examples: rifamycins and fluoroquinolones, metronidazole

Antimetabolites are medications that interfere with the synthesis of DNA. Some antimetabolites are used in chemotherapy to kill cancer cells, while others are used as antibiotics since they inhibit bacterial folate synthesis

Examples: levofloxacin, norfloxacin, and ciprofloxacin

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Practice Gratitude – Improve Health

“I awoke this morning with devout thanksgiving for my friends, the old and the new.”

Ralph Waldo Emerson

Gratitude- The state of being grateful. Thankfulness Thanksgiving. Embracing and being grateful for what we have (the gift) and for the source (the giver) of it. The gift can come from another, a higher power or nature. 

The world is in upheaval. There are challenges facing all of us as we bid 2022 goodbye and welcome 2023 with a little trepidation. We are entering uncharted territory in world history. The good news is that we are not alone. How we enter this new year depends a lot on our attitude and ability to remain flexible to our changing landscape. In other words, our attitude can make or break us. Let’s take the higher road and focus on solutions.

Robert Emmons, professor of psychology at the University of California, Davis, is one of the world’s leading experts on the science of gratitude, conducted a series of tests to determine if acknowledging and expressing gratitude had any lasting health effects. After conducting several studies ranging from weekly to daily gratitude journaling, he concluded that daily expressions of gratitude had lasting positive outcomes physically, emotionally, and mentally. In other words, daily expressions of gratitude set the stage for continued habits of positive emotions and resilience. 

Practicing gratitude, either in written or spoken form activates the parasympathetic nervous system, which is known as the calming part of the nervous system. This in turn lowers cortisol levels and promotes feelings of wellbeing. 

Health benefits of practicing gratitude

  • Reduces stress- Stress hormones such as cortisol 23% lower
  • Lowers inflammation with reduced stress comes reduced inflammation
  • Improved heart health- lower blood pressure
  • Alleviates anxiety
  • Promotes social wellness
  • More likely to choose healthy habits such as diet and exercise
  • Better sleep quality
  • Higher sense of self worth
  • Improved immune function

Is gratefulness a personality trait or can it be learned?

While there are certain personalities that are naturally geared to be more grateful, gratitude can be developed into lifelong habits. Dr. Emmons believes you can cultivate gratitude. In this excellent video, he explains how to become more grateful.  (He has a whole series on gratitude on You Tube worth watching)  

How to practice gratitude

Practicing gratitude not only elevates another person but also elevates you. Dr Emmons work revealed daily and consistent focus on gratitude and being thankful had lasting benefits

The following are a few tips to get started:

    • Journal- Keep a daily journal of 5 things you are grateful for, commit to doing this daily for one month
  • Write letters to loved ones and those you appreciate. Let them know how you feel. It always feels good to get something in the mail that isn’t an advertisement or bill! This could be in combination with other forms of gratitude.
  • Tell 5 people something about them you are grateful for 
  • Text 5 people something positive. Let them know you are thinking about them
  • Start a couple’s journal. Leave it out on coffee table. Write something positive in it daily to each other. 
  • Take time out each day to meditate or pray. Focus on what is good in your life, and work towards solutions to challenges in your life.

Gratitude Quotes- to inspire you!

  1. “This is a wonderful day. I have never seen this one before.” Maya Angelou
  2. “When we focus on our gratitude, the tide of disappointment goes out and the tide of love rushes in.” Kristin Armstrong
  3. “When eating fruit, remember the one who planted the tree.” Vietnamese proverb
  4. “When I started counting my blessings, my whole life turned around.” Willie Nelson
  5. “Enjoy the little things, for one day you may look back and realize they were the big things.” Roert Brault
  6. “‘Enough’ is a feast.” Buddhist Proverb
  7. “He is a wise man who does not grieve for the things which he has not, but rejoices for those which he has.” Epictetus
  8. “Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude.” A.A. Milne
  9. “We must find time to stop and thank the people who make a difference in our lives.” John F. Kennedy
  10. “Gratitude is the ability to experience life as a gift. It liberates us from the prison of self-preoccupation.” John Ortberg
  11. “O Lord that lends me life, lend me a heart replete with thankfulness.” William Shakespeare
  12. “We can only be said to be alive in those moments when our hearts are conscious of our treasures.” Thornton Wilder



- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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A Dementia Diagnosis Can Be Challenging

Rule out other causes of decline first

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common type of dementia. It takes a toll on families and especially caregivers. Holidays and get togethers can be challenging for both families and the patient.

Some symptoms of early onset of dementia are:

  • Confusion
  • Loss of coordination-tripping, unable to hold items
  • Memory loss especially short term
  • Inability to reason complex situations
  • Emotional lability- anger, sadness, depression.

As dementia progresses symptoms become more pronounced, and leads to physical inability to take care of self independently

Risk factors for dementia

  • Genetics
  • Age- older adults are more at risk for a dementia diagnosis
  • Alcohol abuse
  • Smoking
  • Social isolation

Types of dementia

Alzheimer’s dementia

  • Twice as many women as men are diagnosed with Alzheimer’s dementia
  • Most are over 65 years.

Alzheimer’s disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions.

Symptoms are mild to start and progress over time. Early symptoms are forgetfulness- of names or items such as keys are, unable to recall family or friends names along with forgetting special dates or appointments

As disease progresses changes in mood, depth perception and inability to organize thoughts and cognition are apparent. In later stages of Alzheimer’s the person experiences hallucinations, delusions and is physically incapable of performing basic hygiene.


Frontotemporal dementia (FTD), also called Picks disease is one of the less common types of dementia. It covers a range of different conditions that can affect personality, behavior, and language. FTD is mostly diagnosed in people under 65. Average onset is between 40 and 60 years, however it can occur as early as 20 years old.

Dementia with Lewy bodies

Dementia with Lewy bodies (DLB) is caused by Lewy body disease. In this disease, tiny

clumps of proteins – known as Lewy bodies – appear in the nerve cells of the brain, and progresses to decline in reasoning, independent function. and cognition. It can be hard to diagnose because it presents similar to many psychiatric symptoms

Vascular Dementia

 This type of dementia- which is sometimes called “Post Stroke Dementia” is different from Alzheimer’s or Lewy Body Dementia. Vascular Dementia is brain damage caused by bleeding or harm in the brain-such as a stroke. Symptoms that identify Vascular Dementia are observed immediately following a stroke and can include:

  • Changes in personality,
  • Depending on the area of the brain that has been affected- thinking short attention span
  • Difficulty reasoning organizing and analyzing thoughts

Correct diagnosis of dementia can be challenging

Many medical conditions, physical and emotional factors, along with medications can mimic dementia.

Medical conditions that can present as dementia like symptoms:

  • Liver and kidney disease– accumulation of toxic metabolic waste products in the blood can cause confusion and inability to form cohesive thoughts.
  • Infections– notably urinary tract infections can cause confusion and personality changes.This is more common in older population, symptoms of urinary tract infection sometimes present with different symptoms than younger population. Other infections should also be ruled out, such as syphilis or Lyme disease.
  • Cancer-especially brain cancer- by tumor pressing on the brain- or an immune response in which antibodies against the brain are formed, producing a “paraneoplastic syndrome”.
  • Endocrine dysregulation– such as thyroid gland (hypo or hyperthyroid) or diabetes- both of these conditions can alter mood, ability to coordinate and concentrate.
  • Head trauma– concussion
  • Depression– which can alter and slow thought processes and cause inability to make decisions along with irritability and mood changes.

Physical conditions that can present as dementia like symptoms

  • Poor vision– resulting in tripping, falling and bumping into furniture, walls, stairs, etc
  • Hearing lossA Lancet Commission report on hearing loss showed a link between hearing loss and cognitive decline, leading to a diagnosis of dementia.
  • Lack of sleep– inability to concentrate or pay attention can mimic dementia, however research points to altered sleep patterns , even one nights sleep disruption has been shown to increase the beta amyloid plaque – the protein that causes dementia in the brain.

Medications that can mimic dementia

Some medications can take a long time before symptoms set in, so if you notice any cognitive changes even without a change in medication- either over the counter or prescription review with your care provider your concerns.

  • Anticholinergic medications-such as tolterodine or oxybutynin, often used to treat urinary incontinence, Benadryl used for allergies and for sleep,
  • Tricyclic antidepressants such as amitriptyline for example
  • Antipsychotics such as Seroquil
  • Benzodiazepines such as Valium, Xanax, and Librium
  • Sleep aids such as Sonata and Ambien
  • Corticosteroids such as Prednisone
  • Narcotic pain relievers- such as morphine
  • Anti-Parkinson drugs such as trihexyphenidyl (Artrane)

It is important to make sure all other causes of confusion, memory loss, poor coordination, mood changes and other dementia mimicking signs have been considered before a diagnosis of dementia is made. Many medical conditions, physical conditions and drugs mimic the symptoms of dementia, take the time to review them and discuss with your care provider.

If a definite diagnosis of dementia has been made there are many resources available. One is the online support group and help with finding local resources to help with caring for your loved one.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Join Our Newsletter

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Avian Influenza Adds to Skyrocketing Thanksgiving Meal

Turkey jumps 73% in price over last year

Thanksgiving is a time for families and loved ones to get together and share a meal and give thanks- a longstanding tradition in many households across the U.S. The centerpiece for many of these meals is the turkey. Recent outbreaks of avian influenza has put a dent in available turkeys, sending the price to skyrocket. Over the past year over 6 million turkeys had to be culled due to highly pathogenic avian influenza(HPAI). This resulted in 2.5 percent reduction in turkeys going to market, however the USDA projects the numbers should rebound to pre cull (kill) numbers within a short time.  The CDC has an interactive map reveals where outbreaks are occurring in real time in both commercial and home flocks for each state and county.

Wholesale prices for frozen whole turkey hens: 

  • 2019 average: $0.89 per pound
  • 2020 average: $1.07 per pound
  • 2021 average: $1.23 per pound
  • 2022 average: $1.69 per pound (73% increase over 2021)

Avian flu not the only reason Thanksgiving will be more expensive. Exploding feed prices and energy prices are also contributing to a much more expensive thanksgiving meal. Aceoss the board food prices have risen  Farm Bureau projects that  Thanksgiving dinner will be 14% higher than 2021.

Domestic pets at risk

Bird flu is spread primarily through migratory waterfowl as they travel to their destinations. Bird droppings and sick or dead birds infected with the bird flu can infect pets if consumed or have prolonged contact with an infected bird. It is highly unlikely (but not impossible) for humans to come down with bird flu if you follow these precautions:

Watch for signs of illness in your pet

If your pet shows signs of illness that are indicative of bird flu:

  • Sudden death with no prior signs
  • Low energy or appetite
  • Purple discoloration or swelling of various body parts
  • Reduced egg production, or soft-shelled/misshapen eggs
  • Nasal discharge, coughing, or sneezing
  • Lack of coordination
  • Diarrhea

Don’t touch sick or dead birds, their feces or litter, or any surface or water source (ponds, waterers, buckets, pans, troughs) that might be contaminated with their saliva, feces, or any other bodily fluids without wearing personal protective equipment (PPE).

What to do if you find a dead or sick bird

If you find a dead bird, don’t touch it with your bare hands. Use a plastic bag or gloved hands and place it in garbage can and dispose of it in your garbage. To report unusual signs in birds you have seen in the wild, call 1-866-536-7593.

Can you get avian flu from eating infected turkey?

Bird flu virus can be passed through bird droppings and saliva on surfaces such as cages, tractors, and other farm equipment. Most people don’t need to worry about getting sick with bird flu virus. You cannot get bird flu from eating fully cooked chicken, turkey, or duck, because heat kills the virus.

Avian flu food safety

Proper food handling will prevent not only avian flu but foodborne illnesses such as E coli and Salmonella (The Jase case contains antibiotics that can handle Salmonella if the need arises) from contaminating you and your cooked food.

USDA Questions and Answers: Food Safety and Avian Influenza

(Excerpts from USDA pdf on avian flu and food safety)

  1. Can I get avian influenza from eating poultry or eggs?
  2. No. Poultry and eggs that are properly prepared and cooked are safe to eat. Proper food

safety practices are important every day. In addition to proper processing, proper handling and

cooking of poultry provides protection from viruses and bacteria, including avian influenza. As

we remind consumers each and everyday, there are four basic food safety steps to follow:


  1. Does proper food handling prevent avian influenza?
  2. Avian influenza is not transmissible by eating properly prepared poultry, so properly

prepared and cooked poultry and eggs are safe to eat. The chance of infected poultry or eggs

entering the food chain is extremely low because of the rapid onset of symptoms in poultry as

well as the safeguards USDA has in place, which include testing of flocks, and Federal

inspection programs.

  1. What does proper food handling mean?
  2. Proper handling and cooking of poultry provides protection against all avian influenza

viruses, as it does against other viruses and bacteria, including Salmonella and E.coli. Safe food

handling and preparation are important at all times. USDA continually reminds consumers to

practice safe food handling and preparation every day.

Cooking poultry, eggs, and other poultry products to the proper temperature and preventing

cross-contamination between raw and cooked food is the key to safety. You should:

  • Wash hands with warm water and soap for at least 20 seconds before and after handling raw

poultry and eggs;

  • Prevent cross-contamination by keeping raw poultry and eggs away from other foods;
  • After cutting raw meat, wash cutting board, knife, and countertops with hot, soapy water;
  • Use a food thermometer to ensure poultry has reached the safe internal temperature of at least

165 °F to kill foodborne germs that might be present, including the avian influenza viruses. Sanitize cutting boards by using a solution of 1 tablespoon chlorine bleach in 1 gallon of water.

Contact USDA Meat & Poultry Hotline with questions

Consumers with questions about the safe storage, handling, or preparation of meat,

poultry, and egg products, can call the USDA Meat & Poultry Hotline at: 1-888-MPHotline,

that’s 1-888-674-6854. The hotline is available in English and Spanish and can be reached from

10 a.m. to 4 p.m. (Eastern Time) Monday through Friday. Also, “Ask Karen” is the FSIS virtual

representative available 24 hours a day to answer your questions at




- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Keeping you informed and safe.

Join Our Newsletter

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Pulse Oximeters – Helpful or Harmful?

Over the counter pulse oximeters saw a surge in use during the pandemic. They are widely available, inexpensive, and easy to use. A panacea- or too good to be true?

What is a pulse oximeter and how does it work?

Pulse oximeters come as either a small unit with a built-in finger/toe clip, or as a small handheld device that has a wire probe with adhesive pads that can be applied to your finger, toe or earlobe.

“The pulse oximeter uses a cold light source that shines a light through the fingertip, making the tip appear to be red. By analyzing the light from the light source that passes through the finger, the device is able to determine the percentage of oxygen in the red blood cell.” Excerpt from the American Lung Association.

There are two categories of pulse oximeters: prescription use and over the counter (OTC).

According to the FDA “Prescription oximeters are reviewed by the FDA, receive 510(k) clearance, and are available only with a prescription. The FDA requires that these pulse oximeters undergo clinical testing to confirm their accuracy. They are most often used in hospitals and doctors’ offices, although they may sometimes be prescribed for home use.

Over-the-counter (OTC) oximeters are sold directly to consumers in stores or online and include smart phone apps developed for the purpose of estimating oxygen saturation. Use of OTC oximeters has increased as a result of the COVID-19 pandemic. These products are sold as either general wellness or sporting/aviation products that are not intended for medical purposes, so they do not undergo FDA review. OTC oximeters are not cleared by the FDA and should not be used for medical purposes.”

Limitations of OTC pulse oximeters

  • A study done in November 2021 comparing white, black and Hispanic patients revealed the limitations of over the counter (OTC) pulse oximeters. Skin pigmentation plays a role in how accurate the pulse oximeters are. These devices work by absorbing light in hemoglobin, where oxygen is carried. However, darker pigmented individuals repeatedly had false high oxygen levels (3 times more than white individuals) because the light source from the oximeter can’t tell the difference between the hemoglobin and skin pigmentation. The darker the skin, the less accurate the reading. This prompted the FDA to review and issue a warning to the public on the use of these OTC devices.
  • A program launched March 2020 by Penn University called “Covid Watch” to remotely monitor patients with COVID-19 who were well enough to stay home to recover found that questioning the patients on symptoms, such as shortness of breath or use of pulse oximeters did not change outcomes of patients’ recovery from Covid 19.
  • Smokers read artificially high levels of oxygen -Instead of carrying oxygen on the red blood cells, which the pulse oximeter reads, carbon monoxide- from smoking, cooking over a grill or other forms of smoke- may be attached to the red blood cell receptors. The pulse oximeter cannot tell the difference between oxygen and carbon monoxide. This can produce a false high reading.
  • Other factors can affect accuracy of OTC pulse oximeter such as poor circulation, nail polish on the finger being tested and even skin thickness.

The FDA advises the following:

  • Do not rely only on a pulse oximeter to assess your health condition or oxygen level.
  • If monitoring oxygen levels at home, pay attention to other signs or symptoms of low oxygen levels, such as:
  • Bluish coloring in the face, lips, or nails;
  • Shortness of breath, difficulty breathing, or a cough that gets worse;
  • Restlessness and discomfort.
  • Chest pain or tightness; and
  • Fast or racing pulse rate.
  • Be aware that some patients with low oxygen levels may not show any or all of these symptoms. Only a health care provider can diagnose a medical condition such as hypoxia (low oxygen levels).

Sometimes we rely too heavily on technology to assess and make healthcare decisions. This may be one of those cases. Use these OTC devices only under the supervision and care of your primary care provider. As stated above, physical assessment can tell just as much if not more than the popular OTC pulse oximeters. If you need to use one of these devices, ask for a prescription level device and receive proper instruction in its use.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

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