The Secret of Great Health Care

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Antibiotic - Summary

Summary

     Antibiotics are powerful weapons in the fight against infectious disease.  Unfortunately, they are overused and this overuse may eventually result in them not working in the future.  The role of the patient is to have a basic understanding about when antibiotics are needed and when they are not. 

     Many health care conditions can be managed without antibiotics, but with time, home remedies and some over the counter medications.

     It is the responsibility of the patient to have a basic understanding when antibiotics are needed and when they are not.  The patient needs to partner with their doctor in order to get the best health care experience possible. 

     The goal of this book was to help the reader understand basic antibiotics prescribed in the doctor’s office.  As a summary to the book, below is a list of common diseases and which antibiotics should be considered.  Many factors need to be considered when an antibiotic is prescribed, but this chart will help the reader understand antibiotics that are appropriate in the management of common diseases. 

    The chart lists a disease and then a primary and secondary antibiotic. This chart is used for the management of common diseases that present typically in the average person.  There are times that a doctor will need to stray from the recommendations. 

     It describes first-line treatment.  This means that a disease is being treated for the first time.  When antibiotics fail the first time a second-line treatment is often needed.  This chart does not dive into that. 

      The primary antibiotic is the recommended antibiotic for most cases of the infection.  The secondary antibiotic is another consideration if there is an allergy or another problem with the primary choice. 

     These conditions will, at times, be treated with other antibiotics.  There are many reasons for this.  For example, the first antibiotic did not work, the patient had an  allergy, the patient had another underlying condition that may alter the course of treatment, and sometimes the doctor does not know the guidelines. 


Table
6: Common health care problems and antibiotics used to treat them

Disease

Primary antibiotic

Secondary antibiotic

Strep throat

Penicillin

Amoxicillin is OK in kids who need the liquid form

Cephalosporins – if mild allergy

Macrolide if severe allergy

Sore throat that is not strep or another bacterial infection

None

 

Sinus Infection

Amoxicillin

Cephalosporins – if mild allergy

Macrolide if severe allergy (increased resistance). 

Cold (Nasal congestion of less than 7 days)

None

None

Inner ear infection

Amoxicillin

Amoxicillin-Clavulanate

Sometimes no antibiotic is needed - only pain control

Cephalosporins – if mild allergy

Macrolide if severe allergy

Outer ear infection

Hydrocortisone/polymyxin/neomycin, Ciprofloxacin/hydrocortisone (Cipro HC otic), Ciprofloxacin/dexamethasone

Another choice from:

Hydrocortisone/polymyxin/neomycin, Ciprofloxacin/hydrocortisone (Cipro HC otic), Ciprofloxacin/dexamethasone

Acute Bronchitis

Most cases are viral and do not need an antibiotic

Amoxicillin, sulfa drug, macrolide if a bacterium is suspected

Pneumonia (that does not need to be treated in the hospital)

Macrolide or quinolone

Doxycycline

Urinary tract infection

Sulfamethoxazole-trimethoprim, nitrofurantoin and ciprofloxacin

Antibiotic based on the culture and sensitivity report

Bacterial conjunctivitis

Multiple eye drops or ointments (see chart)

Another option from the eye drop/ointment chart

Skin infections (Not caused by MRSA)

Cephalexin (Keflex), Dicloxacillin

Clindamycin

Macrolide

 


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