H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
Assignment 12C: Understand how infectious diseases
can be treated and managed
Treatment and management of infectious diseases
Different methods are available to treat infectious diseases like influenza and
chickenpox, which help to manage these diseases.
Treatments include antibiotics, antivirals, antiretrovirals, antifungals,
antiprotozoals, antimalarials, anthelmintics, immunoglobulins and rehydration
therapy. These will be researched in depth for this assignment for a specific
named infectious disease.
This assignment will describe and analyse treatments for infectious diseases in
terms of how they work, availability, relevance, suitability, deliverance, and cost.
These treatments will also be evaluated, and research will be undertaken to
determine whether there are social, cultural, and religious beliefs that are
contraindications in addition to the consideration of any side effects of
treatments.
Treatments
Antibiotics
Antibiotics are a method of treating infectious diseases caused by bacteria such
as bacterial meningitis and work in several ways:
- Disruption of the reproductive process
- Disruption of the energy process
- Cell wall/lysis
- Specificity
- Resistance
They are substances that inhibit the growth and replication of bacteria, classed
as antimicrobials: an umbrella term for anything that inhibits/kills microbial cells
(2). They come in several forms which include capsules, tablets, liquids, creams,
and ointments, and only target the pathogen, bacteria (3). Antibiotics help to
prevent moderate infections from becoming severe infections by disrupting their
processes and by attacking the wall surrounding bacteria (3).
Antibiotics work by disrupting reproductive processes that occur in bacteria,
known as DNA replication, through blockage of the enzyme, DNA polymerase,
which is used to join nucleotides of new strands to form copies of DNA (7). The
blockage of this enzyme prevents DNA replication from occurring, leading to the
death of bacterial cells as they are unable to replicate their DNA (7). Another way
that antibiotics work is by disrupting energy processes that occur in bacteria by
inhibiting the enzyme ATP synthase, which is involved with the production of
ATP- an immediate source of energy for cells (7). This inhibition works by
interfering with the use of the hydrogen ion gradient for ATP synthesis,
preventing the production of ATP (7). The bacteria are unable to carry out these
energy processes, losing energy and leading to death. Alternatively, antibiotics
1
, H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
work by preventing the mechanism in bacteria for building cell walls- discussed
further in the next paragraph (2). This occurs as the formation of peptidoglycan;
a major component of bacterial cell walls is inhibited as antibiotics block the
cross-linking of peptide chains during the formation of peptidoglycan (7). If
peptidoglycan is not formed then bacterial cell walls cannot be made, causing
bacteria to die (8). Another way antibiotics work is by destroying the membranes
of bacterial cells, also known as cell lysis. Antibiotics do this by disrupting the
outer membrane, consisting of a lipopolysaccharide layer, breaking it down then
killing the bacterial cell once the membrane has been ruptured (7). Moreover,
antibiotics are highly specific and can only be effective for use against specific
bacteria- discussed further in the next paragraph (2). However, some antibiotics
can be used to target a variety of bacteria, known as broad-spectrum antibiotics
(2). Resistance to antibiotics refers to bacteria that cannot be controlled/killed by
specific antibiotics (3). Annually, more than 2.8 million cases of bacterial
infections are resistant to antibiotics, resulting in around 35,000 deaths (3). This
resistance can occur when an unsuitable antibiotic is taken and when an
antibiotic is taken to treat anything other than bacterial infections, e.g., viruses
(4).
In terms of bacterial meningitis, the pathogen responsible for causing bacterial
meningitis is the Gram-negative bacterium, Neisseria meningitidis
(meningococcus) (1). Bacterial meningitis is an infection of the brain and spinal
cord membranes (4). This infection can be life-threatening and around 80% of all
cases are acute bacterial meningitis (4). The symptoms include a high fever,
headache, and stiffness in the neck (4). The symptoms can occur within 24 hours
of contracting bacterial meningitis and the progress of these symptoms can
eventually lead to death (4). The specific treatment for bacterial meningitis is a
course of antibiotics and the type of antibiotics depends on factors including age
and pre-existing health conditions (5). Generally, the antibiotics Claforan
(cefotaxime) and Rocephin (ceftriaxone) are given to treat bacterial meningitis
(6). These antibiotics may be taken in combination or by themselves. They work
to kill the bacteria causing bacterial meningitis by preventing bacteria from
building cell walls (8). Firstly, they bind to and block enzymes that are involved
with forming peptidoglycan, a crucial constituent of bacterial cell walls (8). This
means that the bacteria no longer have the strength of cell walls to survive in
the body (10). Therefore, this prevents bacteria from causing damage to the
body as they are unable to attack cells in the body, eventually leading to the
death of bacteria (9). Claforan and Rocephin are highly specific as they only
target bacteria that cause bacterial meningitis. Furthermore, Claforan and
Rocephin are referred to as bactericidal as they directly kill bacteria causing
bacterial meningitis (9). These antibiotics used to treat bacterial meningitis are
delivered intravenously, through a tube/needle into the body (5).
This treatment, however, may not always work to effectively treat diseases
caused by bacteria as resistance against antibiotics can occur, usually because
of overuse of antibiotics (75). Resistance to an antibiotic refers to the ability to
not be affected by an antibiotic. For example, overusing the antibiotic, Claforan
for bacterial meningitis could cause the bacterium, Neisseria meningitidis, to
become resistant to Claforan. This is the reason why antibiotics may be taken in
combination so that the likelihood of the bacteria becoming resistant to an
antibiotic is reduced, e.g., the use of Claforan and Rocephin to treat bacterial
meningitis. Another example is MRSA (Methicillin-Resistant Staphylococcus
2
, H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
Aureus), a type of bacteria that is resistant to a range of common antibiotics
(76). The overuse of antibiotics for colds, flu and other viral infections has led to
this resistance to antibiotics as they should only be used to treat bacterial
infections and not for viral infections. MRSA is challenging to treat because of
antibiotic resistance and so antibiotics generally do not work effectively to treat
MRSA.
The antibiotics, Claforan and Rocephin (discussed above) for bacterial meningitis
are both effective in treating bacterial meningitis however Rocephin is more
widely used. This is because Rocephin comes in a generic form whereas Claforan
only comes in the form of an injection, therefore, can only be delivered in a
hospital (77). This also means that Rocephin is more suitable and accessible for
all people as people can administer the antibiotic themselves whereas in the
case of Claforan you would need to go to the hospital to get it administered. In
addition to this, Rocephin is less expensive and cost-effective (can get it on a
prescription) in comparison to Claforan which makes it a better treatment to use
to treat bacterial meningitis.
There is a vaccination that is also used for bacterial meningitis and is part of the
MenACWY (Meningococcal ACWY) vaccination programme, introduced by the UK
government. The vaccine in this programme provides protection against the 4
types of bacteria that can cause meningitis and is highly effective against
bacterial meningitis (78). This vaccine contains only the sugar coating found on
the surface of the 4 bacteria that cause meningitis and works by stimulating the
immune system to produce antibodies against these sugar coatings without
causing meningitis (78). Furthermore, another vaccination programme called
MenC (Meningococcal C) was also introduced by the UK government which
increases the protection against meningitis. It works by containing parts of the
bacteria that causes meningitis, stimulating the body again to produce
antibodies without causing meningitis (79). In addition to this, there is a MenB
(Meningococcal B) vaccination programme which further increases the protection
against meningitis specifically against meningococcal group B bacteria (80). This
vaccine consists of 3 major proteins found on the surface of most meningococcal
bacteria and the outer membrane of 1 MenB strain (81). It works by again,
stimulating the immune system to produce antibodies for future exposures to
meningococcal bacteria (81). These vaccines discussed are all delivered as an
injection and must be carried out by a trained professional.
Evaluation
There are barriers to antibiotics as a treatment which prevent people from
accessing and accepting treatment:
- Social barriers, the stigma associated with meningitis
- Cultural barriers
- Religious barriers
- Treatment regime, in terms of length of treatment
- Side effects
- Contraindications
Firstly, to evaluate, there are social barriers to antibiotics as a treatment that
may prevent people from accessing antibiotics and so accepting antibiotics.
3
, H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
Social barriers refer to inequalities that exist between different individuals in a
society, created by a specific culture based on behaviour and beliefs (82) (83).
An example of a social barrier surrounding antibiotics is if an individual has
bacterial meningitis despite being vaccinated against meningitis and is hesitant
on speaking to their GP about their illness in fear of the information getting
passed on to their friends, family and/or employer. The social fear of being
treated unequally as a possibility of being diagnosed with meningitis can lead to
many individuals within a population being unable to access and/or accept
treatment. This is a social barrier to antibiotics as a treatment as these specific
individuals that have meningitis will be separated from the society that has
formed a belief that those with the disease must be avoided at all costs. They
are unable to be treated with antibiotics therefore will remain to have meningitis,
increasing the risk of other potential infections arising.
Cultural barriers are also present to antibiotics as different cultures have
different beliefs about antibiotics being used as a treatment. Cultural barriers
refer to expectations within a culture that prevents people from being included in
a culture (84). An example of a cultural barrier to antibiotics is traditional
Chinese culture which believes that medications such as antibiotics are aversive
and should be avoided at all costs since traditional remedial practices should be
used as a treatment instead (85). Those that are part of this traditional Chinese
culture may be prevented from accessing and accepting antibiotics as their
culture is against the use of antibiotics. Therefore, cultural barriers such as
traditional Chinese culture are present and play a significant factor when
deciding on treatment for meningitis.
In addition to these barriers discussed, religious barriers are also present to
antibiotics as there are religious beliefs surrounding antibiotics that prevent
religious people from accessing and accepting antibiotics as a treatment.
Religious barriers refer to principles within a religion that are followed to be
included within a religion. An example of a religious barrier is Christianity which
have a belief that the only treatment is prayer, so antibiotics are not accepted.
Some denominations of Christianity may not hold this strong religious belief and
may accept antibiotics however some may avoid taking antibiotics because of
this belief. Another religious barrier is Islam as religious believers of Islam do not
accept antibiotics that may contain pork gelatine or other animal fats/derivatives
(86). This prevents religious people from accepting antibiotics as a treatment as
it can against their religious beliefs. Moreover, Judaism has a religious festival
called Passover that does not permit the consumption of wheat starch which can
be present in some antibiotics (86). For this reason, if a religious believer of
Judaism has meningitis during Passover, they may not accept antibiotics that
contain wheat starch and would be against using this treatment.
In terms of treatment regime, the antibiotics used to treat meningitis generally
are given 3 times a day for 7 to 21 days (6). This can prevent individuals from
accepting antibiotics as a treatment for meningitis as it requires them to
complete a full course of antibiotics for around 1-3 weeks. Also, this means that
they must remember to take their antibiotics 3 times a day which can cause
interference in their day-to-day lives so people may be against taking antibiotics
as a treatment for meningitis. Therefore, this can lead to many individuals not
accepting antibiotics, especially in the case of Claforan which would require
individuals to be hospitalised as it must be delivered intravenously.
4
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
Assignment 12C: Understand how infectious diseases
can be treated and managed
Treatment and management of infectious diseases
Different methods are available to treat infectious diseases like influenza and
chickenpox, which help to manage these diseases.
Treatments include antibiotics, antivirals, antiretrovirals, antifungals,
antiprotozoals, antimalarials, anthelmintics, immunoglobulins and rehydration
therapy. These will be researched in depth for this assignment for a specific
named infectious disease.
This assignment will describe and analyse treatments for infectious diseases in
terms of how they work, availability, relevance, suitability, deliverance, and cost.
These treatments will also be evaluated, and research will be undertaken to
determine whether there are social, cultural, and religious beliefs that are
contraindications in addition to the consideration of any side effects of
treatments.
Treatments
Antibiotics
Antibiotics are a method of treating infectious diseases caused by bacteria such
as bacterial meningitis and work in several ways:
- Disruption of the reproductive process
- Disruption of the energy process
- Cell wall/lysis
- Specificity
- Resistance
They are substances that inhibit the growth and replication of bacteria, classed
as antimicrobials: an umbrella term for anything that inhibits/kills microbial cells
(2). They come in several forms which include capsules, tablets, liquids, creams,
and ointments, and only target the pathogen, bacteria (3). Antibiotics help to
prevent moderate infections from becoming severe infections by disrupting their
processes and by attacking the wall surrounding bacteria (3).
Antibiotics work by disrupting reproductive processes that occur in bacteria,
known as DNA replication, through blockage of the enzyme, DNA polymerase,
which is used to join nucleotides of new strands to form copies of DNA (7). The
blockage of this enzyme prevents DNA replication from occurring, leading to the
death of bacterial cells as they are unable to replicate their DNA (7). Another way
that antibiotics work is by disrupting energy processes that occur in bacteria by
inhibiting the enzyme ATP synthase, which is involved with the production of
ATP- an immediate source of energy for cells (7). This inhibition works by
interfering with the use of the hydrogen ion gradient for ATP synthesis,
preventing the production of ATP (7). The bacteria are unable to carry out these
energy processes, losing energy and leading to death. Alternatively, antibiotics
1
, H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
work by preventing the mechanism in bacteria for building cell walls- discussed
further in the next paragraph (2). This occurs as the formation of peptidoglycan;
a major component of bacterial cell walls is inhibited as antibiotics block the
cross-linking of peptide chains during the formation of peptidoglycan (7). If
peptidoglycan is not formed then bacterial cell walls cannot be made, causing
bacteria to die (8). Another way antibiotics work is by destroying the membranes
of bacterial cells, also known as cell lysis. Antibiotics do this by disrupting the
outer membrane, consisting of a lipopolysaccharide layer, breaking it down then
killing the bacterial cell once the membrane has been ruptured (7). Moreover,
antibiotics are highly specific and can only be effective for use against specific
bacteria- discussed further in the next paragraph (2). However, some antibiotics
can be used to target a variety of bacteria, known as broad-spectrum antibiotics
(2). Resistance to antibiotics refers to bacteria that cannot be controlled/killed by
specific antibiotics (3). Annually, more than 2.8 million cases of bacterial
infections are resistant to antibiotics, resulting in around 35,000 deaths (3). This
resistance can occur when an unsuitable antibiotic is taken and when an
antibiotic is taken to treat anything other than bacterial infections, e.g., viruses
(4).
In terms of bacterial meningitis, the pathogen responsible for causing bacterial
meningitis is the Gram-negative bacterium, Neisseria meningitidis
(meningococcus) (1). Bacterial meningitis is an infection of the brain and spinal
cord membranes (4). This infection can be life-threatening and around 80% of all
cases are acute bacterial meningitis (4). The symptoms include a high fever,
headache, and stiffness in the neck (4). The symptoms can occur within 24 hours
of contracting bacterial meningitis and the progress of these symptoms can
eventually lead to death (4). The specific treatment for bacterial meningitis is a
course of antibiotics and the type of antibiotics depends on factors including age
and pre-existing health conditions (5). Generally, the antibiotics Claforan
(cefotaxime) and Rocephin (ceftriaxone) are given to treat bacterial meningitis
(6). These antibiotics may be taken in combination or by themselves. They work
to kill the bacteria causing bacterial meningitis by preventing bacteria from
building cell walls (8). Firstly, they bind to and block enzymes that are involved
with forming peptidoglycan, a crucial constituent of bacterial cell walls (8). This
means that the bacteria no longer have the strength of cell walls to survive in
the body (10). Therefore, this prevents bacteria from causing damage to the
body as they are unable to attack cells in the body, eventually leading to the
death of bacteria (9). Claforan and Rocephin are highly specific as they only
target bacteria that cause bacterial meningitis. Furthermore, Claforan and
Rocephin are referred to as bactericidal as they directly kill bacteria causing
bacterial meningitis (9). These antibiotics used to treat bacterial meningitis are
delivered intravenously, through a tube/needle into the body (5).
This treatment, however, may not always work to effectively treat diseases
caused by bacteria as resistance against antibiotics can occur, usually because
of overuse of antibiotics (75). Resistance to an antibiotic refers to the ability to
not be affected by an antibiotic. For example, overusing the antibiotic, Claforan
for bacterial meningitis could cause the bacterium, Neisseria meningitidis, to
become resistant to Claforan. This is the reason why antibiotics may be taken in
combination so that the likelihood of the bacteria becoming resistant to an
antibiotic is reduced, e.g., the use of Claforan and Rocephin to treat bacterial
meningitis. Another example is MRSA (Methicillin-Resistant Staphylococcus
2
, H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
Aureus), a type of bacteria that is resistant to a range of common antibiotics
(76). The overuse of antibiotics for colds, flu and other viral infections has led to
this resistance to antibiotics as they should only be used to treat bacterial
infections and not for viral infections. MRSA is challenging to treat because of
antibiotic resistance and so antibiotics generally do not work effectively to treat
MRSA.
The antibiotics, Claforan and Rocephin (discussed above) for bacterial meningitis
are both effective in treating bacterial meningitis however Rocephin is more
widely used. This is because Rocephin comes in a generic form whereas Claforan
only comes in the form of an injection, therefore, can only be delivered in a
hospital (77). This also means that Rocephin is more suitable and accessible for
all people as people can administer the antibiotic themselves whereas in the
case of Claforan you would need to go to the hospital to get it administered. In
addition to this, Rocephin is less expensive and cost-effective (can get it on a
prescription) in comparison to Claforan which makes it a better treatment to use
to treat bacterial meningitis.
There is a vaccination that is also used for bacterial meningitis and is part of the
MenACWY (Meningococcal ACWY) vaccination programme, introduced by the UK
government. The vaccine in this programme provides protection against the 4
types of bacteria that can cause meningitis and is highly effective against
bacterial meningitis (78). This vaccine contains only the sugar coating found on
the surface of the 4 bacteria that cause meningitis and works by stimulating the
immune system to produce antibodies against these sugar coatings without
causing meningitis (78). Furthermore, another vaccination programme called
MenC (Meningococcal C) was also introduced by the UK government which
increases the protection against meningitis. It works by containing parts of the
bacteria that causes meningitis, stimulating the body again to produce
antibodies without causing meningitis (79). In addition to this, there is a MenB
(Meningococcal B) vaccination programme which further increases the protection
against meningitis specifically against meningococcal group B bacteria (80). This
vaccine consists of 3 major proteins found on the surface of most meningococcal
bacteria and the outer membrane of 1 MenB strain (81). It works by again,
stimulating the immune system to produce antibodies for future exposures to
meningococcal bacteria (81). These vaccines discussed are all delivered as an
injection and must be carried out by a trained professional.
Evaluation
There are barriers to antibiotics as a treatment which prevent people from
accessing and accepting treatment:
- Social barriers, the stigma associated with meningitis
- Cultural barriers
- Religious barriers
- Treatment regime, in terms of length of treatment
- Side effects
- Contraindications
Firstly, to evaluate, there are social barriers to antibiotics as a treatment that
may prevent people from accessing antibiotics and so accepting antibiotics.
3
, H.
BTEC L3 EXTENDED DIPLOMA IN APPLIED SCIENCE
Unit 12: Diseases and Infection
Social barriers refer to inequalities that exist between different individuals in a
society, created by a specific culture based on behaviour and beliefs (82) (83).
An example of a social barrier surrounding antibiotics is if an individual has
bacterial meningitis despite being vaccinated against meningitis and is hesitant
on speaking to their GP about their illness in fear of the information getting
passed on to their friends, family and/or employer. The social fear of being
treated unequally as a possibility of being diagnosed with meningitis can lead to
many individuals within a population being unable to access and/or accept
treatment. This is a social barrier to antibiotics as a treatment as these specific
individuals that have meningitis will be separated from the society that has
formed a belief that those with the disease must be avoided at all costs. They
are unable to be treated with antibiotics therefore will remain to have meningitis,
increasing the risk of other potential infections arising.
Cultural barriers are also present to antibiotics as different cultures have
different beliefs about antibiotics being used as a treatment. Cultural barriers
refer to expectations within a culture that prevents people from being included in
a culture (84). An example of a cultural barrier to antibiotics is traditional
Chinese culture which believes that medications such as antibiotics are aversive
and should be avoided at all costs since traditional remedial practices should be
used as a treatment instead (85). Those that are part of this traditional Chinese
culture may be prevented from accessing and accepting antibiotics as their
culture is against the use of antibiotics. Therefore, cultural barriers such as
traditional Chinese culture are present and play a significant factor when
deciding on treatment for meningitis.
In addition to these barriers discussed, religious barriers are also present to
antibiotics as there are religious beliefs surrounding antibiotics that prevent
religious people from accessing and accepting antibiotics as a treatment.
Religious barriers refer to principles within a religion that are followed to be
included within a religion. An example of a religious barrier is Christianity which
have a belief that the only treatment is prayer, so antibiotics are not accepted.
Some denominations of Christianity may not hold this strong religious belief and
may accept antibiotics however some may avoid taking antibiotics because of
this belief. Another religious barrier is Islam as religious believers of Islam do not
accept antibiotics that may contain pork gelatine or other animal fats/derivatives
(86). This prevents religious people from accepting antibiotics as a treatment as
it can against their religious beliefs. Moreover, Judaism has a religious festival
called Passover that does not permit the consumption of wheat starch which can
be present in some antibiotics (86). For this reason, if a religious believer of
Judaism has meningitis during Passover, they may not accept antibiotics that
contain wheat starch and would be against using this treatment.
In terms of treatment regime, the antibiotics used to treat meningitis generally
are given 3 times a day for 7 to 21 days (6). This can prevent individuals from
accepting antibiotics as a treatment for meningitis as it requires them to
complete a full course of antibiotics for around 1-3 weeks. Also, this means that
they must remember to take their antibiotics 3 times a day which can cause
interference in their day-to-day lives so people may be against taking antibiotics
as a treatment for meningitis. Therefore, this can lead to many individuals not
accepting antibiotics, especially in the case of Claforan which would require
individuals to be hospitalised as it must be delivered intravenously.
4
