Broad-spectrum antibiotics are antibiotics which are designed to work against a broad spectrum of bacteria, rather than narrow-spectrum antibiotics, which are only effective against a smaller range of bacteria. These medications are classically used in cases in which a doctor is not sure about the identity of a disease-causing organism and wants to provide a patient with medication which will rapidly attack the infection, rather than waiting for culture results and prescribing a narrow-spectrum antibiotic which is more targeted in effect.
Some examples of broad-spectrum antibiotics include penicillin, cephalosporin, tetracycline, ciprofloxacin, and levofloxacin. These drugs work on both gram-negative and gram-positive organisms. When a patient appears to have a bacterial infection, a broad-spectrum antibiotic is the most likely to provide effective treatment without knowing which organism is behind the infection. For example, when a patient comes to a doctor with bronchitis, the doctor may prescribe a general antibiotic medication to treat the infection without taking a culture.
If an infection persists or it appears unusual in nature, cultures will be done. In a culture, a sample of the bacteria is collected and grown to find out which organism is responsible for the infection. Furthermore, a culture can also be used to test antibiotics in case an organism is antibiotic-resistant. In this case, the culture is used to find the drug which will be most effective so that the patient does not have to try several unsuccessful antibiotics before finding one which works.
One problem with broad-spectrum antibiotics which began to grow in the late 20th century was the emergence of antibiotic resistance in bacteria. Almost as soon as humans started developing antibiotics, bacteria started swapping genes which they could use to survive antibiotic therapy. In some cases, organisms developed resistance to multiple antibiotics, making treatment of infections involving these organisms very challenging. More advanced classes of antibiotics were developed in response, but bacteria also adapted to address these. A broad-spectrum antibiotic is only useful as long as it kills most bacteria and organisms which can quickly adapt to resist antibiotics present a significant challenge.
Concerns about resistance to antibiotics have led to some recommendations that doctors change the way they use and prescribe these medications. Doctors are encouraged to only prescribe a broad-spectrum antibiotic when a patient cannot fight an infection off on his or her own, for example. In addition, patients are instructed in the importance of completing a course of antibiotics fully in order to avoid promoting the development of antibiotic resistance.