Verskil tussen weergawes van "Antibiotikum"

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[[Beeld:Staphylococcus aureus (AB Test).jpg|thumbduimnael|''Staphylococcus aureus'' se vatbaarheid vir antiobiotikum word getoets deur die Kirby Bauer-metode: die antiobiotikum versprei oor die skyf en beperk die groei van ''S. aureus'', wat lei tot remsones.]]
 
'n '''Antibiotikum''' is 'n [[medisyne|geneesmiddel]] wat [[bakterie|bakterieë]] doodmaak of die groei daarvan vertraag. Antibiotika is 'n klas van [[antimikrobe]]s wat 'n groter groep is wat antivirus-, antiswam- en antiparasitiese geneesmiddels insluit. Hulle is relatief skadeloos vir die gasheer en kan daarom gebruik word om besmetting (infeksies) te behandel. Die begrip wat deur [[Selman Waksman]] verwoord is, het oorspronklik slegs na preparate verwys wat afgelei is vanaf lewende organismes, in teenstelling met "chemoterapeutiese middels" wat suiwer sintetiese produkte is. Deesdae verwys die begrip "antibiotika" ook na die [[Chemiese sintese|sintetiese]] antimikrobes soos onder andere die [[sulfa geneesmiddel]]s. Antibiotika is klein [[molekule]]s met 'n [[molekulêre massa]] van minder as 2000. Hulle is nie [[ensiem]]e nie. Sommige antibiotika word vanaf [[muf]] verkry.
 
 
== Geskiedenis ==
Baie antieke kulture, insluitend die [[Griekeland|antieke Grieke]] en die [[Sjina|antieke Sjinese]], het [[muf]] en ander plante gebruik om [[besmetting]]s te behandel. Dit het gewerk omdat sommige mufsoorte antibiotiese stowwe afskei. Hulle kon egter nie die aktiewe bestandelebestanddele uitken of onttrek nie.
 
Moderne navorsing op antibiotika het begin met die ontdekking van [[Penisilien]] in 1928 deur [[Alexander Fleming]].
 
 
 
<!-- Vir verdere vertaling
 
== Classes of antibiotics ==
{| width="100%" cellspacing="0" cellpadding="2" frame="none" rules="none" border="0"
|+'''Antibiotics<ref>The Merck Manual of Medical Information - Home Edition, Robert Berkow (Ed.), Pocket (September, 1999), ISBN 0-671-02727-1.</ref>'''
 
|-
!style="text-align:left; background:aqua" | Class !!style="background:silver;" | Generic&nbsp;Name !!Brand&nbsp;Names !!style="background:silver" | Common&nbsp;Uses !!style="text-align:left" | Side&nbsp;Effects
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Aminoglycosides]]
|-
| || style="text-align:left; background:silver;" | [[Amikacin]] || ||rowspan="7" style="text-align:left; vertical-align:top; background:silver;" | Infections caused by [[Gram-negative bacteria]], such as [[Escherichia coli]] and [[Klebsiella]] || rowspan="7" style="text-align:left; vertical-align:top;" | Hearing loss<br />[[Vertigo (medical)|Vertigo]]<br />Kidney damage
|-
| || style="text-align:left; background:silver;" | [[Gentamicin]] || Garamycin
|-
| || style="text-align:left; background:silver;" | [[Kanamycin]]
|-
| || style="text-align:left; background:silver;" | [[Neomycin]]
|-
| || style="text-align:left; background:silver;" | [[Netilmicin]]
|-
| || style="text-align:left; background:silver;" | [[Streptomycin]]
|-
| || style="text-align:left; background:silver;" | [[Tobramycin]] || Nebcin
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Carbacephem]]
|-
| || style="text-align:left; background:silver;" | [[Loracarbef]] || Lorabid || rowspan="1" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="1" style="text-align:left; vertical-align:top;" |
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Carbapenems]]
|-
| || style="text-align:left; background:silver;" | [[Ertapenem]] || || rowspan="3" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="3" style="text-align:left; vertical-align:top;" |
|-
| || style="text-align:left; background:silver;" | [[Imipenem]]/[[Cilastatin]]
|-
| || style="text-align:left; background:silver;" | [[Meropenem]]
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Cephalosporins]] ([[Cephalosporins#First Generation Cephalosporins|First generation]])
|-
| || style="text-align:left; background:silver;" | [[Cefadroxil]] || || rowspan="3" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="3" style="text-align:left; vertical-align:top;" | Gastrointestinal upset and diarrhea<br />Nausea (if alcohol taken concurrently)<br />Allergic reactions
|-
| || style="text-align:left; background:silver;" | [[Cefazolin]] ||
|-
| || style="text-align:left; background:silver;" | [[Cephalexin]]
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Cephalosporins]] ([[Cephalosporins#Second Generation Cephems|Second generation]])
|-
| || style="text-align:left; background:silver;" | [[Cefaclor]] || || rowspan="5" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="5" style="text-align:left; vertical-align:top;" | Gastrointestinal upset and diarrhea<br />Nausea (if alcohol taken concurrently)<br />Allergic reactions
|-
| || style="text-align:left; background:silver;" | [[Cefamandole]] || Mandole
|-
| || style="text-align:left; background:silver;" | [[Cefoxitin]]
|-
| || style="text-align:left; background:silver;" | [[Cefprozil]] || Cefzil
|-
| || style="text-align:left; background:silver;" | [[Cefuroxime]] || Ceftin
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Cephalosporins]] ([[Cephalosporins#Third Generation Cephalosporins|Third generation]])
 
|-
| || style="text-align:left; background:silver;" | [[Cefixime]] || || rowspan="10" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="10" style="text-align:left; vertical-align:top;" | Gastrointestinal upset and diarrhea<br />Nausea (if alcohol taken concurrently)<br />Allergic reactions
|-
| || style="text-align:left; background:silver;" | [[Cefdinir]] || Omnicef
|-
| || style="text-align:left; background:silver;" | [[Cefditoren]]
|-
| || style="text-align:left; background:silver;" | [[Cefoperazone]] || Cefobid
|-
| || style="text-align:left; background:silver;" | [[Cefotaxime]] || Claforan
|-
| || style="text-align:left; background:silver;" | [[Cefpodoxime]]
|-
| || style="text-align:left; background:silver;" | [[Ceftazidime]] || Fortum
|-
| || style="text-align:left; background:silver;" | [[Ceftibuten]]
|-
| || style="text-align:left; background:silver;" | [[Ceftizoxime]]
|-
| || style="text-align:left; background:silver;" | [[Ceftriaxone]] || Rocephin
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Cephalosporins]] ([[Cephalosporins#Fourth Generation Cephalosporins|Fourth generation]])
 
|-
| || style="text-align:left; background:silver;" | [[Cefepime]] || Maxipime || rowspan="1" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="1" style="text-align:left; vertical-align:top;" | Gastrointestinal upset and diarrhea<br />Nausea (if alcohol taken concurrently)<br />Allergic reactions
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Glycopeptide antibiotics|Glycopeptides]]
|-
| || style="text-align:left; background:silver;" | [[Teicoplanin]] || || rowspan="2" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="2" style="text-align:left; vertical-align:top;" |
|-
| || style="text-align:left; background:silver;" | [[Vancomycin]]
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Macrolides]]
|-
| || style="text-align:left; background:silver;" | [[Azithromycin]] || [http://www.pfizer.com/pfizer/do/medicines/mn_zithromax.jsp Zithromax&reg;]&nbsp;([[Pfizer]])<br />[http://www.sumamed.com.hr/disclaim.htm Sumamed&reg;]&nbsp;([[Pliva]]) || rowspan="5" style="text-align:left; vertical-align:top; background:silver;" | [[Streptococcal infection]]s, [[syphilis]], [[respiratory infection]]s, [[mycoplasmal infection]]s, [[Lyme disease]] || rowspan="5" style="text-align:left; vertical-align:top;" | Nausea, vomiting, and diarrhea (especially at higher doses)<br />Jaundice
|-
| || style="text-align:left; background:silver;" | [[Clarithromycin]]
|-
| || style="text-align:left; background:silver;" | [[Dirithromycin]]
|-
| || style="text-align:left; background:silver;" | [[Erythromycin]]
|-
| || style="text-align:left; background:silver;" | [[Troleandomycin]]
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Monobactam]]
|-
| || style="text-align:left; background:silver;" | [[Aztreonam]] || || rowspan="1" style="text-align:left; vertical-align:top; background:silver;" | || rowspan="1" style="text-align:left; vertical-align:top;" |
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Penicillins]]
|-
| || style="text-align:left; background:silver;" | [[Amoxicillin]] || style="text-align:left" | [http://cipla.com/admin.php?mode=prod&action=disp&id=196 Novamox&trade;]&nbsp;([[Cipla]])|| rowspan="12" style="text-align:left; vertical-align:top; background:silver;" | Wide range of infections; penicillin used for [[streptococcal infection]]s, [[syphilis]], and [[Lyme disease]] || rowspan="12" style="text-align:left; vertical-align:top;" | Gastrointestinal upset and diarrhea<br />Allergy with serious [[anaphylactic reaction]]s<br />Brain and kidney damage (rare)
|-
| || style="text-align:left; background:silver;" | [[Ampicillin]]
|-
| || style="text-align:left; background:silver;" | [[Azlocillin]]
|-
| || style="text-align:left; background:silver;" | [[Carbenicillin]]
|-
| || style="text-align:left; background:silver;" | [[Cloxacillin]]
|-
| || style="text-align:left; background:silver;" | [[Dicloxacillin]]
|-
| || style="text-align:left; background:silver;" | [[Flucloxacillin]]
|-
| || style="text-align:left; background:silver;" | [[Mezlocillin]]
|-
| || style="text-align:left; background:silver;" | [[Nafcillin]]
|-
| || style="text-align:left; background:silver;" | [[Penicillin]]
|-
| || style="text-align:left; background:silver;" | [[Piperacillin]]
|-
| || style="text-align:left; background:silver;" | [[Ticarcillin]]
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Polypeptide antibiotics|Polypeptides]]
|-
| || style="text-align:left; background:silver;" | [[Bacitracin]] || || rowspan="3" style="text-align:left; vertical-align:top; background:silver;" | Eye, ear or bladder infections; usually applied directly to the eye or inhaled into the lungs; rarely given by injection|| rowspan="3" style="text-align:left; vertical-align:top;" | Kidney and nerve damage (when given by injection)
|-
| || style="text-align:left; background:silver;" | [[Colistin]]
|-
| || style="text-align:left; background:silver;" | [[Polymyxin B]]
|-
 
!colspan="5" style="text-align:left; background:aqua;"| [[Quinolones]]
|-
| || style="text-align:left; background:silver;" | [[Ciprofloxacin]] || style="text-align:left" | [http://cipla.com/admin.php?mode=prod&action=disp&id=161 Ciplox&trade;]&nbsp;([[Cipla]])|| rowspan="9" style="text-align:left; vertical-align:top; background:silver;" | Urinary tract infections, [[bacterial postatitis]], [[bacterial diarrhea]], [[gonorrhea]]|| rowspan="9" style="text-align:left; vertical-align:top;" | Nausea (rare)
|-
| || style="text-align:left; background:silver;" | [[Enoxacin]]
|-
| || style="text-align:left; background:silver;" | [[Gatifloxacin]]
|-
| || style="text-align:left; background:silver;" | [[Levofloxacin]]
|-
| || style="text-align:left; background:silver;" | [[Lomefloxacin]]
|-
| || style="text-align:left; background:silver;" | [[Moxifloxacin]]
|-
| || style="text-align:left; background:silver;" | [[Norfloxacin]]
|-
| || style="text-align:left; background:silver;" | [[Ofloxacin]]
|-
| || style="text-align:left; background:silver;" | [[Trovafloxacin]]
 
|-
!colspan="5" style="text-align:left; background:aqua;"| [[Sulfonamides]]
|-
| || style="text-align:left; background:silver;" | [[Mafenide]] || || rowspan="9" style="text-align:left; vertical-align:top; background:silver;" | [[Urinary tract infection]]s (except sulfacetamide and mafenide); mafenide is used topically for burns|| rowspan="9" style="text-align:left; vertical-align:top;" | Nausea, vomiting, and diarrhea<br />[[Allergy]] (including skin rashes)<br />Crystals in urine<br />Kidney failure<br />Decrease in [[white blood cell]] count<br />Sensitivity to sunlight
|-
| || style="text-align:left; background:silver;" | [[Prontosil]] (archaic)
|-
| || style="text-align:left; background:silver;" | [[Sulfacetamide]]
|-
| || style="text-align:left; background:silver;" | [[Sulfamethizole]]
|-
| || style="text-align:left; background:silver;" | [[Sulfanilimide]] (archaic)
|-
| || style="text-align:left; background:silver;" | [[Sulfasalazine]]
|-
| || style="text-align:left; background:silver;" | [[Sulfisoxazole]]
|-
| || style="text-align:left; background:silver;" | [[Trimethoprim]]
|-
| || style="text-align:left; background:silver;" | [[Trimethoprim]]-[[Sulfamethoxazole]] ([[Co-trimoxazole]]) ([[TMP-SMX]])
|-
 
!colspan="5" style="text-align:left; background:aqua;"| [[Tetracyclines]]
|-
| || style="text-align:left; background:silver;" | [[Demeclocycline]] || || rowspan="5" style="text-align:left; vertical-align:top; background:silver;" | [[Syphilis]], [[chlamydia]]l infections, [[Lyme disease]], [[mycoplasmal infection]]s, [[rickettsia]]l infections|| rowspan="5" style="text-align:left; vertical-align:top;" | Gastroitestinal upset<br />Sensitivity to sunlight<br />Staining of teeth<br />Potential toxicity to mother and fetus during pregnancy
|-
| || style="text-align:left; background:silver;" | [[Doxycycline]] || Vibramycin
|-
| || style="text-align:left; background:silver;" | [[Minocycline]]
|-
| || style="text-align:left; background:silver;" | [[Oxytetracycline]]
|-
| || style="text-align:left; background:silver;" | [[Tetracycline]]
 
|-
!colspan="5" style="text-align:left; background:aqua;"| Others
|-
| || style="text-align:left; background:silver;" | [[Chloramphenicol]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Clindamycin]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Ethambutol]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Fosfomycin]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Furazolidone]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Isoniazid]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Linezolid]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Metronidazole]] || style="text-align:left;"| Flagyl || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Nitrofurantoin]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Pyrazinamide]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Quinupristin/Dalfopristin]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Rifampin]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
| || style="text-align:left; background:silver;" | [[Spectinomycin]] || style="text-align:left;"| || style="text-align:left; background:silver;" | || ||
|-
!style="text-align:left; background:aqua" | Class !!style="background:silver;" | Generic&nbsp;Name !!Brand&nbsp;Names !!style="background:silver" | Common&nbsp;Uses !!style="text-align:left" | Side&nbsp;Effects
|}
 
== Production ==
:''Main article: [[Production of antibiotics]]''
 
Since the first pioneering efforts of [[Howard Walter Florey|Florey]] and [[Ernst Boris Chain|Chain]] in 1939, the importance of antibiotics to [[medicine]] has led to much research into discovering and producing them. The process of production usually involves screening of wide ranges of microorganisms, testing and modification. Production is carried out using [[fermentation]].
 
== Side effects ==
Possible side effects are varied, and range from fever and nausea to major allergic reactions. One of the more common side effects is [[diarrhea]], which results from the antibiotic disrupting the normal balance of intestinal flora. Other side effects can result from interaction with other drugs, such as elevated risk of [[tendon]] damage from administration of a [[Quinolones|quinolone]] antibiotic with a systemic [[corticosteroid]].
 
Some antibiotics can interfere with the efficacy of birth control pills. Such effects were found to be unusual, and have been studied only for a limited number of antibiotics.
 
== Antibiotic misuse ==
Common forms of antibiotic misuse include taking them in inappropriate situations. Common examples of this would be the use of antibacterials for viral infections such as the [[common cold]], and failure to take the entire prescribed course of the antibiotic, usually because the patient feels better before the infecting organism is completely eradicated. In addition to treatment failure, these practices can result in [[antibiotic resistance]] in the bacteria that survive the abbreviated treatment.
 
In the United States, vast quantities of certain antibiotics are routinely included as low doses in the diet of some kinds of healthy farm animals, where this practice has been shown to make animals grow faster. Opponents of this practice, however, point out the likelihood that it also leads to an environment conductive to the evolution of antibiotic resistance, frequently in bacteria that are known to also infect humans. There has been no convincing evidence as yet that the evolution of antibiotic resistance in such bacteria is actually occurring. As the majority of bacteria is killed in the pasteurization process applied to the milk, and the cooking of the meat of such animals, any possible resistance may go unnoticed until the bacteria survives it. Theoretically, though, there is a significant possibility that such resistances could be transferred through bacterial [[plasmids]], and the aforementioned conditions of continous, low-dose antibiotics are ideal for the development of antibiotic resistance. Excessive use of [[prophylaxis|prophylactic]] antibiotics in travelers may also be classified as misuse.
 
== Antibiotic resistance ==
:''Main article: [[Antibiotic resistance]]''
 
Use or misuse of antibiotics may result in the development of ''antibiotic resistance'' by the infecting organisms, similar to the development of [[pesticide resistance]] in insects. [[Evolutionary theory]] of [[selection|genetic selection]] requires that as close as possible to 100% of the infecting organisms be killed off to avoid selection of resistance; if a small subset of the population survives the treatment and is allowed to multiply, the average susceptibility of this new population to the compound will be much less than that of the original population, since they have descended from those few organisms which survived the original treatment. This survival often results from an inheritable resistance to the compound which was infrequent in the original population but is now much more frequent in the descendants thus selected entirely from those originally infrequent resistant organisms.
 
Antibiotic resistance has become a serious problem in both the developed and underdeveloped nations. By 1984 half of the people with active [[tuberculosis]] in the [[United States]] had a strain that resisted at least one antibiotic. In certain settings, such as hospitals and some child-care locations, the rate of [[antibiotic resistance]] is so high that the normal, low cost antibiotics are virtually useless for treatment of frequently seen infections. This leads to more frequent use of newer and more expensive compounds, which in turn leads inexorably to the rise of resistance to those drugs, and a never-ending ever-spiraling race to discover new and different antibiotics ensues, just to keep us from losing ground in the battle against infection. The fear is that we will eventually fail to keep up in this race, and the time when people did not fear life-threatening bacterial infections will be just a memory of a golden era.
 
Another example of selection is ''[[Staphylococcus aureus]]'', which could be treated successfully with penicillin in the 1940s and 1950s. At present, nearly all strains are resistant to [[penicillin]], and many are resistant to [[nafcillin]], leaving only a narrow selection of drugs such as [[vancomycin]] useful for treatment. The situation is worsened by the fact that genes coding for antibiotic resistance can be transferred between bacteria, making it possible for bacteria never exposed to an antibiotic to acquire resistance from those which have. The problem of antibiotic resistance is worsened when antibiotics are used to treat disorders in which they have no efficacy, such as the common cold or other viral complaints, and when they are used widely as prophylaxis rather than treatment (as in, for example, animal feeds), because this exposes more bacteria to selection for resistance.
 
== Beyond antibiotics ==
Unfortunately, the comparative ease of finding compounds which safely cured bacterial infections proved much harder to duplicate with respect to fungal and viral infections. Antibiotic research led to great strides in our knowledge of basic biochemistry and to the current biological revolution; but in the process it was discovered that the susceptibility of bacteria to many compounds which are safe to humans is based upon significant differences between the cellular and molecular physiology of the bacterial cell and that of the mammalian cell. In contrast, despite the seemingly huge differences between fungi and humans, the basic biochemistries of the fungal cell and the mammalian cell are much more similar; so much so that there are few therapeutic opportunities for compounds to attack a fungal cell which will not harm a human cell. Similarly, we know now that viruses represent an incredibly minimal intracellular parasite, being stripped down to a few genes worth of [[DNA]] or [[RNA]] and the minimal
molecular equipment needed to enter a cell and actually take over the machinery of the cell to produce new viruses. Thus, the great bulk of viral metabolic biochemistry is not merely similar to human biochemistry, it actually is human biochemistry, and the possible targets of antiviral compounds are restricted to the relatively very few components of the actual virus itself.
 
Research into [[bacteriophage]]s is ongoing at the moment. Bacteriophages are a specific type of virus that only targets bacteria. Research suggests that nature has evolved several types of bacteriophage for each type of bacteria. While research into bacteriophages is only in its infancy the results are promising and have already lead to major advances in microscopic imaging<ref>Purdue University "Biologists build better software, beat path to viral knowledge", see Imaging of Epsilon 15, a virus that infects the bacterium Salmonella [http://news.uns.purdue.edu/UNS/html4ever/2006/060201.Jiang.salmonella.html News report]</ref>. While bacteriophages provide a possible solution to the problem of antibacterial resistance there is as of yet no proof that we will actually be able to deploy these microscopic killers in humans, we can only continue the research and see where it leads.
 
Phage therapy has been used in the past on humans in the US and Europe during the 1920's and 1930's, however due to not fully understanding the mechanism by which phage therapy worked, these treatments had mixed results. With the discovery of penicillin in the 1940s, Europe and the US changed to using antibiotics. However, in the former Soviet Union phage therapies continued to be studied. In the Republic of Georgia, the Eliava Institute of Bacteriophage, Microbiology & Virology continues to research the use of phage therapy. Various companies and foundations in North America and Europe are currently researching phage therapies.
 
== References ==
<references />
 
== External links ==
* [http://www.genomenewsnetwork.org/categories/index/drugs/resist.php Antibiotic News from Genome News Network (GNN)]
* [http://www.eff.org/Misc/Publications/Bruce_Sterling/FSF_columns/fsf.15 Bruce Sterling's Bitter Resistance]
* [http://www.jaapa.com/issues/j20040601/articles/antibiotics0604.html JAAPA: New antibiotics useful in primary care]
* [http://www.isracast.com/tech_news/090605_tech.htm A new method for controlling bacterial activity without antibiotics] - Research conducted at the Hebrew University
 
=== Resources ===
* [http://www.apua.org Alliance for the Prudent Use of Antibiotics]
 
[[Kategorie:Antibiotics|*]]
[[Kategorie:Pharmacologic agents]]
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[[Kategorie:Geneesmiddels]]