What were the most commonly prescribed antibiotics in 2022. How do antibiotic prescription rates vary by age, sex, and region in the United States. Which antibiotic classes and agents are most frequently prescribed. How does antibiotic prescribing differ among healthcare provider specialties. What factors influence regional variations in antibiotic prescription rates.

Overview of Outpatient Antibiotic Prescriptions in the United States

In 2015, healthcare providers in the United States prescribed a staggering 269.4 million antibiotic prescriptions for outpatient use. This translates to approximately 838 antibiotic prescriptions per 1,000 persons. While this data is from 2015, it provides valuable insights into antibiotic prescription patterns and trends that likely influence current practices.

The Centers for Disease Control and Prevention (CDC) collected this data from the QuintilesIMS Xponent database, which captured an estimated 88% of outpatient prescriptions nationwide. The data was then projected to 100% coverage, providing a comprehensive view of antibiotic prescribing practices across the country.

Key Findings on Antibiotic Prescriptions

• Total prescriptions: 269.4 million
• Prescriptions per 1,000 persons: 838
• Data source: QuintilesIMS Xponent database
• Coverage: 88% of outpatient prescriptions, projected to 100%
• Exclusions: Federal facilities

Antibiotic Prescription Patterns by Age, Sex, and Region

Antibiotic prescription rates vary significantly across different demographic groups and geographical regions. Understanding these patterns is crucial for identifying potential areas of overuse or misuse and developing targeted interventions to promote appropriate antibiotic prescribing.

Age-Related Prescription Patterns

How do antibiotic prescription rates differ between age groups? The data reveals interesting patterns:

• Under 20 years: 64.7 million prescriptions (778 per 1,000 persons)
• 20 years and older: 203.3 million prescriptions (850 per 1,000 persons)

These figures indicate that adults aged 20 and older receive slightly more antibiotic prescriptions per capita compared to younger individuals. This trend may be attributed to factors such as increased prevalence of chronic conditions, weakened immune systems, or higher rates of healthcare utilization among older adults.

Gender Differences in Antibiotic Prescriptions

Is there a notable difference in antibiotic prescriptions between males and females? The data shows a significant disparity:

• Females: 164.0 million prescriptions (1,005 per 1,000 persons)
• Males: 104.9 million prescriptions (663 per 1,000 persons)

Females receive substantially more antibiotic prescriptions than males, with a difference of 342 prescriptions per 1,000 persons. This disparity may be due to various factors, including higher rates of urinary tract infections in women, more frequent healthcare visits, or potential differences in prescribing practices based on gender.

Regional Variations in Antibiotic Prescribing

Do antibiotic prescription rates vary across different regions of the United States? The data reveals significant regional disparities:

• Northeast: 48.8 million prescriptions (867 per 1,000 persons)
• Midwest: 61.0 million prescriptions (898 per 1,000 persons)
• South: 111.5 million prescriptions (920 per 1,000 persons)
• West: 48.1 million prescriptions (632 per 1,000 persons)

The South has the highest rate of antibiotic prescriptions, while the West has the lowest. These regional variations may be influenced by factors such as differences in population demographics, healthcare access, cultural attitudes towards antibiotics, and local prescribing practices.

Top Antibiotic Classes and Agents: Analyzing Prescription Trends

Understanding which antibiotic classes and specific agents are most frequently prescribed can provide valuable insights into current treatment practices and potential areas for improvement in antimicrobial stewardship.

Most Prescribed Antibiotic Classes

Which antibiotic classes are most commonly prescribed in the United States? The top five classes are:

1. Penicillins: 61.6 million prescriptions (192 per 1,000 persons)
2. Macrolides: 49.4 million prescriptions (154 per 1,000 persons)
3. Cephalosporins: 36.3 million prescriptions (113 per 1,000 persons)
4. Fluoroquinolones: 32.5 million prescriptions (101 per 1,000 persons)
5. Beta-lactams with increased activity: 25.3 million prescriptions (79 per 1,000 persons)

Penicillins remain the most frequently prescribed class of antibiotics, followed by macrolides. This pattern reflects their broad-spectrum activity and effectiveness against common bacterial infections.

Leading Individual Antibiotic Agents

Which specific antibiotic agents are most commonly prescribed? The top five agents are:

1. Amoxicillin: 54.8 million prescriptions (171 per 1,000 persons)
2. Azithromycin: 46.2 million prescriptions (144 per 1,000 persons)
3. Amoxicillin/clavulanic acid: 25.3 million prescriptions (79 per 1,000 persons)
4. Cephalexin: 21.4 million prescriptions (67 per 1,000 persons)
5. Ciprofloxacin: 20.3 million prescriptions (63 per 1,000 persons)

Amoxicillin, a penicillin-class antibiotic, leads the list, followed closely by azithromycin, a macrolide. These agents are commonly used for respiratory tract infections, urinary tract infections, and other common bacterial infections.

Antibiotic Prescribing Patterns Among Healthcare Provider Specialties

Different healthcare provider specialties have varying rates of antibiotic prescribing, reflecting their patient populations and the types of conditions they typically treat.

Top Prescribing Specialties

Which medical specialties prescribe the most antibiotics? The data reveals the following patterns:

1. Primary Care Physicians: 110.8 million prescriptions (466 per provider)
2. Physician Assistants and Nurse Practitioners: 62.9 million prescriptions (363 per provider)
3. Dentistry: 25.1 million prescriptions (205 per provider)
4. Surgical Specialties: 19.5 million prescriptions (219 per provider)
5. Emergency Medicine: 14.8 million prescriptions (457 per provider)

Primary care physicians prescribe the highest number of antibiotics, which is expected given their role in managing a wide range of common infections. Interestingly, dentistry ranks third in total prescriptions, highlighting the significant role of dental infections in overall antibiotic use.

Specialties with Highest Per-Provider Prescription Rates

Which specialties have the highest rates of antibiotic prescribing per provider? The top specialties are:

1. Dermatology: 628 prescriptions per provider
2. Emergency Medicine: 457 prescriptions per provider
3. Primary Care Physicians: 466 prescriptions per provider

Dermatologists have the highest rate of antibiotic prescribing per provider, which may be attributed to the treatment of skin infections and acne. Emergency medicine physicians also have a high prescribing rate, likely due to the acute nature of many conditions they treat.

Regional Variations in Antibiotic Prescribing: A State-by-State Analysis

Antibiotic prescription rates vary significantly across different states in the U.S., reflecting regional differences in healthcare practices, population demographics, and potentially, antibiotic resistance patterns.

States with Highest Prescription Rates

Which states have the highest rates of antibiotic prescriptions? The top five states are:

1. Kentucky: 1,256 prescriptions per 1,000 persons
2. Mississippi: 1,254 prescriptions per 1,000 persons
3. Louisiana: 1,174 prescriptions per 1,000 persons
4. Tennessee: 1,165 prescriptions per 1,000 persons
5. Arkansas: 1,154 prescriptions per 1,000 persons

These Southern states have prescription rates significantly higher than the national average of 838 per 1,000 persons. This regional trend aligns with the earlier observation of higher prescription rates in the South.

States with Lowest Prescription Rates

Which states have the lowest rates of antibiotic prescriptions? The five states with the lowest rates are:

1. Alaska: 511 prescriptions per 1,000 persons
2. Oregon: 582 prescriptions per 1,000 persons
3. California: 590 prescriptions per 1,000 persons
4. Colorado: 624 prescriptions per 1,000 persons
5. Hawaii: 640 prescriptions per 1,000 persons

These states, predominantly in the Western region, have prescription rates well below the national average. This pattern suggests potential differences in prescribing practices, healthcare access, or population health in these areas.

Implications of Antibiotic Prescribing Patterns for Public Health

The extensive use of antibiotics in outpatient settings has significant implications for public health, particularly in the context of antimicrobial resistance and healthcare-associated infections.

Antimicrobial Resistance Concerns

Does the high rate of antibiotic prescriptions contribute to antimicrobial resistance? The widespread use of antibiotics can indeed accelerate the development of resistant bacteria. This is particularly concerning for commonly prescribed antibiotics like amoxicillin and azithromycin, as resistance to these drugs could significantly impact treatment options for common infections.

The regional variations in prescribing patterns may also lead to different patterns of antimicrobial resistance across the country. States with higher prescription rates may be at greater risk of developing resistant strains of bacteria.

Potential for Overuse and Misuse

Are antibiotics being overprescribed in certain contexts? The high prescription rates, particularly in some regions and among certain specialties, suggest potential overuse. For example, the high rate of prescriptions in dermatology may indicate overuse of antibiotics for acne treatment, where alternative therapies might be equally effective.

Similarly, the significant gender disparity in prescription rates raises questions about whether antibiotics are being appropriately prescribed based on clinical need rather than other factors.

Strategies for Improving Antibiotic Stewardship

Given the concerns raised by these prescribing patterns, what strategies can be employed to promote more judicious use of antibiotics?

Education and Guidelines

Implementing comprehensive education programs for healthcare providers and the public can improve understanding of appropriate antibiotic use. This could include:

• Updated clinical guidelines for antibiotic prescribing
• Continuing education programs for healthcare providers
• Public awareness campaigns about antibiotic resistance

Prescription Monitoring and Feedback

Establishing systems to monitor antibiotic prescribing patterns and provide feedback to healthcare providers can encourage more judicious use. This might involve:

• Regular audits of prescribing practices
• Benchmarking against peers and national standards
• Implementing electronic health record systems with decision support tools

Policy Interventions

Policy-level interventions can also play a crucial role in promoting appropriate antibiotic use:

• Implementing restrictions on certain antibiotic prescriptions
• Requiring justification for prescribing broad-spectrum antibiotics
• Incentivizing appropriate prescribing practices through reimbursement mechanisms

By implementing these strategies, it may be possible to reduce unnecessary antibiotic use, slow the development of antimicrobial resistance, and improve overall public health outcomes.

Future Directions in Antibiotic Prescribing Research

While the data from 2015 provides valuable insights, ongoing research is crucial to understand current trends and develop effective interventions. What areas should future research focus on?

Longitudinal Studies

Conducting longitudinal studies to track changes in prescribing patterns over time can help identify trends and evaluate the impact of interventions. These studies could explore:

• Changes in overall prescription rates
• Shifts in the types of antibiotics prescribed
• The impact of antibiotic stewardship programs

Detailed Analysis of Prescribing Indications

More detailed research into the specific conditions for which antibiotics are prescribed could provide valuable insights. This might include:

• Analyzing the appropriateness of prescriptions for specific conditions
• Identifying conditions where antibiotics are frequently overprescribed
• Exploring variations in prescribing practices for similar conditions across different specialties or regions

Impact of Telehealth on Antibiotic Prescribing

With the recent surge in telehealth services, understanding how this shift affects antibiotic prescribing is crucial. Research in this area could explore:

• Differences in prescribing patterns between in-person and telehealth consultations
• The impact of telehealth on overall antibiotic prescription rates
• Potential benefits and risks of telehealth for antibiotic stewardship

By focusing on these areas, future research can provide a more comprehensive understanding of antibiotic prescribing practices and guide the development of effective interventions to promote appropriate use.

Outpatient Antibiotic Prescriptions — United States, 2015 | Antibiotic Use

Healthcare providers prescribed 269.4 million antibiotic prescriptions—equivalent to 838 antibiotic prescriptions per 1000 persons.

Print only version: Outpatient Antibiotic Prescriptions — United States, 2015  pdf icon[PDF – 366 KB]

Citation: Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions — United States, 2015.

Systemic oral antibiotics were extracted from the QuintilesIMS Xponent database. QuintilesIMS captured an estimated 88% of outpatient prescriptions for any medication nationally, reconciled them to wholesale deliveries, and projected to 100% coverage. These data represent all outpatient antibiotic prescriptions from community pharmacies from all payers, but exclude federal facilities. Provider specialties are taken from the American Medical Association (AMA) self-designated practice specialties and categorized into one of 17 groups.  Population data were obtained from the U.S. Census bridging files.

References

Hicks, L.A., et al., US Outpatient Antibiotic Prescribing Variation According to Geography, Patient Population, and Provider Specialty in 2011. Clin Infect Dis, 2015. 60(9): p. 1308-16.

Table 1b. Oral antibiotic prescriptions by age, sex and region—United States, 2015

Sex	NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS)	ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Femalea	164. 0	1,005
Malea	104.9	663

^aTotals may not add to all oral prescriptions (269.4 million) due to missing data
^bTotals may not add to all oral prescriptions (269.4 million) due to rounding.

Table 2. Top oral antibiotic classes and agents prescribed—United States, 2015

Table 2a. Top oral antibiotic classes and agents prescribed—United States, 2015

ANTIBIOTIC CLASS	NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS)	ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Penicillins	61.6	192
Macrolides	49.4	154
Cephalosporins	36.3	113
Fluoroquinolones	32.5	101
Beta-lactams, increased activity	25.3	79

Table 2b. Top oral antibiotic classes and agents prescribed—United States, 2015

ANTIBIOTIC AGENT	NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS)	ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Amoxicillin	54.8	171
Azithromycin	46.2	144
Amoxicillin/clavulanic acid	25. 3	79
Cephalexin	21.4	67
Ciprofloxacin	20.3	63

Table 3. Oral antibiotic prescribing by provider specialty — United States, 2015

Table 3. Oral antibiotic prescribing by provider specialty — United States, 2015

PROVIDER SPECIALTY	NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS)	ANTIBIOTIC PRESCRIPTIONS PER PROVIDER, RATE
Primary Care Physicians	110.8	466
Physician Assistants and Nurse Practitioners	62.9	363
Surgical Specialties	19.5	219
Dentistry	25.1	205
Emergency Medicine	14.8	457
Dermatology	7. 1	628
Obstetrics/Gynecology	6.3	167
Other	22.9	110
All Providers	269.4	295

Figure 1. Antibiotic prescriptions per 1000 persons by state (sextiles) for all ages — United States, 2015.

This project was made possible through a partnership with the CDC Foundation. Support for this project was provided by The Pew Charitable Trusts.

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Amoxicillin – StatPearls – NCBI Bookshelf

Continuing Education Activity

Amoxicillin is one of the most commonly used antibiotics in the primary care setting. It is an amino-penicillin, created by adding an extra amino group to penicillin to battle antibiotic resistance. Amoxicillin covers a wide variety of gram-positive bacteria, with some added gram-negative coverage compared to penicillin. Like penicillin, it covers most Streptococcus species and has improved coverage of Listeria monocytogenes and Enterococcus spp. It also has coverage over Haemophilus influenzae, some Escherichia coli, Actinomyces spp., Clostridium species, Salmonella spp., Shigella spp., and Corynebacteria species. This activity covers amoxicillin, a beta-lactam antimicrobial that interprofessional team members need to review its indications, coverage, contraindications, and adverse event profile to manage patients with infectious disease optimally.

Objectives:

• Outline the indications for initiating amoxicillin as an anti-infective strategy for patient care.

• Identify the mechanism of action of amoxicillin and its target coverage.

• Summarize the adverse effects of amoxicillin.

• Explain the importance of antimicrobial stewardship and how it affects antimicrobial selection to improve care coordination among the interprofessional team when initiating amoxicillin antimicrobial therapy.

Access free multiple choice questions on this topic.

Indications

Amoxicillin is one of the most commonly used antibiotics in the primary care setting. It is an amino-penicillin, created by adding an extra amino group to penicillin to battle antimicrobial resistance. Amoxicillin covers a wide variety of gram-positive bacteria, with some added gram-negative coverage compared to penicillin. Like penicillin, it covers most Streptococcus species and is also effective against Listeria monocytogenes and Enterococcus species. It also covers Haemophilus influenza, some Escherichia coli, Actinomyces species, Clostridium species, Salmonella species, Shigella species, and Corynebacteria species.

FDA-approved Indications

• Amoxicillin is indicated in treating infections due to susceptible (only beta-lactamase–negative) isolates of the selected bacteria in the conditions listed below.

• Ear, nose, and throat infections: Treatment of tonsillitis, pharyngitis, and otitis media in adults and pediatric patients ≥12 years of age. The microbiological spectrum is infections due to beta-lactamase-negative Streptococcus species (alpha- and beta-hemolytic isolates only), Streptococcus pneumoniae, Staphylococcus species, or Haemophilus influenza.[1]

• Helicobacter pylori eradication: Triple therapy for Helicobacter pylori with clarithromycin, amoxicillin, and lansoprazole to eradicate Helicobacter pylori reduces the risk of duodenal ulcer recurrence. Dual treatment with amoxicillin and lansoprazole is also FDA approved to eradicate Helicobacter pylori infection.[2]

• Lower respiratory tract infections: Treatment of lower respiratory tract infection due to beta-lactamase-negative Streptococcus species (alpha- and beta-hemolytic strains only), pneumococcus, Staphylococcus species, or Haemophilus influenzae. For community-acquired pneumonia, IDSA recommends a combination of amoxicillin and macrolide.[3]

• Acute Bacterial Sinusitis: Treating infections due to beta-lactamase-negative Streptococcus species (alpha- and beta-hemolytic isolates only), Streptococcus pneumoniae, Staphylococcus species, or Haemophilus influenzae.[4]

• Skin and skin structure infections: Immediate release: Treatment of skin and skin structure infections due to beta-lactamase-negative Streptococcus species (alpha and beta-hemolytic strains only), Staphylococcus species, or Escherichia coli.[5]

• Urinary tract infection: Treatment of the genitourinary tract infections. Organisms include beta-lactamase-negative Escherichia coli, Proteus mirabilis, or Enterococcus faecalis.[6]

• The Centers for Disease Control and Prevention (CDC) recommends using amoxicillin for post-exposure prophylaxis for anthrax(second-line agent). [7]      

Off-label Clinical Uses

• Infectious endocarditis prophylaxis(cardiac conditions associated with the high risk such as the presence of prosthetic cardiac valve or congenital heart disease)[9]

• Actinomycosis[11]

Mechanism of Action

Amoxicillin is in the class of beta-lactam antimicrobials. Beta-lactams act by binding to penicillin-binding proteins that inhibit a process called transpeptidation (the cross-linking process in cell wall synthesis), leading to activation of autolytic enzymes in the bacterial cell wall. This process leads to lysis of the cell wall, thus destroying the bacterial cell. This type of activity is referred to as bactericidal killing.[12]

Amoxicillin administration can also be in combination with a beta-lactamase inhibitor. Some examples of these are clavulanic acid and sulbactam. These beta-lactamase inhibitors work by binding irreversibly to the catalytic site of an organism’s beta-lactamase enzyme, which causes resistance to the original beta-lactam ring of amoxicillin. These drugs do not have inherent bactericidal activity; however, they may broaden amoxicillin’s spectrum to organisms that produce the beta-lactamase enzyme when combined with amoxicillin.[13]

Administration

Bactericidal antimicrobials, such as amoxicillin, often are most effective in a “time-dependent” manner rather than a “concentration-dependent” manner. Time-dependent refers to the time that serum concentrations exceed the minimum-inhibitor-concentration (MIC) for the microorganism. Therefore, they are often dosed more frequently, rather than the concentration-dependent drugs, which can be dosed, for example, daily. The more “around-the-clock” dosing provides minor variation in peak and trough serum concentrations.[14]

Amoxicillin is an oral antimicrobial; whereas, ampicillin (which is structurally similar) can be given orally, intravenously, or intramuscularly. Amoxicillin comes in immediate-release or extended-release tablets. It also comes in a chewable tablet or a suspension. It may be mixed (after thoroughly shaking) and administered with formula, milk, water, fruit juice, ginger ale, or other cold drinks if given in suspension. The administration should take place immediately after mixing. Patients should not crush Extended-release tablets, and the administration should be within 1 hour after finishing a meal. Amoxicillin is sometimes preferred over penicillin in children because of its taste.

Dosing

• In adults, 750-1750 mg/day in divided doses every 8-12 hours.

• In Pediatric Patients > 3 Months of Age, 20-45 mg/kg/day in divided doses every 8-12 hours.

• Dosing for H. pylori Infection: Triple therapy: 1 gram amoxicillin, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (every 12 hours) for 14 days.

• Dual therapy: 1 gram amoxicillin and 30 mg lansoprazole, each given three times daily.

Dosing in Renal Impairment

• Patients with impaired renal function do not generally require a reduction in dose unless the impairment is severe.

• Severely impaired patients with a glomerular filtration rate of < 30 mL/min should not receive an 875-mg dose.

• Patients with a glomerular filtration rate of 10 to 30 mL/min should receive 500 mg or 250 mg every 12 hours, depending on the severity of the infection.

• Patients with a glomerular filtration rate less than 10 mL/min should receive 500 mg or 250 mg every 24 hours, depending on the severity of the infection.

• Hemodialysis patients should receive 500 mg or 250 mg every 24 hours, depending on the severity of the infection. They should receive an additional dose both during and at the end of dialysis.

Geriatric Consideration

• It is important to note that it is excreted in most people by the kidney, and some renal adjustment and extra caution may be necessary for renal insufficiency. Because elderly patients are more likely to have decreased renal function, the clinician should adjust the dose. It is reported to be partially dialyzable, and therefore, immediate-release tablets can be an option for dosing after hemodialysis.[15]

Pregnancy

• Amoxicillin is a pregnancy category B drug under the old FDA classification system, which means there have been no studies demonstrating clear risk. Amoxicillin is widely used in pregnant women. Based on available data, amoxicillin is usually considered compatible for use during pregnancy. The dose and duration of amoxicillin therapy in pregnant and postpartum women are the same as in nonpregnant adults.[16]

Breastfeeding

• An exclusively breastfed infant would be expected to receive a maximum daily dosage of about 0.1 mg/kg of amoxicillin with a maternal dose of 500 mg three times daily. This amounts to 0.25 to 0.5% of a typical infant amoxicillin dosage. As discussed above, amoxicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally, rash and disruption of the infant’s gastrointestinal flora, resulting in diarrhea or thrush, have been reported. Consequently, amoxicillin is acceptable in nursing mothers.[17]

Adverse Effects

Common Adverse Drug Reactions: Amoxicillin is well-tolerated, but some common complaints can be gastrointestinal (GI) symptoms, such as nausea, vomiting, and diarrhea.

Superinfections: Mucocutaneous candidiasis, clostridium difficile associated diarrhea. Of note, patients who take amoxicillin may have less diarrhea than those who take ampicillin because of better absorption in the gut.[18]

Nephrotoxicity: Crystalluria, interstitial nephritis[19][20]

Hypersensitivity
Reactions: Amoxicillin can lead to type-I, II, III, or IV reactions. It is essential to differentiate between a type-I and type-IV hypersensitivity reaction because one may be more dangerous than the other. A type-I hypersensitivity reaction is an IgE-mediated response to a sensitized patient that triggers widespread histamine release leading to an urticarial-like pruritic rash or severe anaphylaxis. A type-IV hypersensitivity reaction is not mediated by histamine release and is more papular or morbilliform and often not itchy. Professionals suggest that almost all patients that receive amoxicillin inadvertently for infectious mononucleosis develop a maculopapular rash caused by a type IV-mediated hypersensitivity reaction. These types of reactions are not known to cause anaphylaxis.[21]

Hepatotoxicity: instances of idiosyncratic liver injury have been reported in persons receiving amoxicillin.  The serum enzyme pattern associated with the liver injury is the hepatocellular pattern with marked elevations in AST and ALT. There are minimal elevations in alkaline phosphatase. Most patients recover rapidly after withdrawal of amoxicillin and rapid recovery after withdrawal. The cause of the liver injury associated with amoxicillin use is hypersensitivity. Rare cases of acute liver failure and vanishing bile duct syndrome have been reported. Corticosteroids have often been used to treat the allergic manifestations of penicillin-related immunoallergic hepatitis. Likelihood score: B (highly likely but rare cause of clinically apparent liver injury).[22]

Postmarketing Adverse Drug Reactions

Gastrointestinal: black hairy tongue, pseudomembranous colitis, hemorrhagic colitis[23]

Neurological: reversible hyperactivity, agitation, anxiety, insomnia, confusion, convulsions, aseptic meningitis[24]

Hematological: hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and neutropenia[25]

Dermatological: serum sickness-like reactions, erythematous maculopapular rashes, exfoliative dermatitis, toxic epidermal necrolysis, hypersensitivity vasculitis[26]

Contraindications

• Any previous anaphylactic or serious skin reaction (for example, Stevens-Johnson syndrome) to amoxicillin or any other beta-lactam is a contraindication to amoxicillin. These reactions may have crossover sensitivity with cephalosporins or carbapenems. However, it is important to note that newer data has suggested a much lower cross-reactivity with cephalosporins and carbapenems than once suspected.

• An important consideration is determining if the patient’s allergic rash is a type-I or a type-IV hypersensitivity reaction. Occasionally patients will report a childhood allergy to amoxicillin, which is, in fact, a type-IV-mediated hypersensitivity reaction, often in the setting of infectious mononucleosis; this is not a contraindication to giving repeat amoxicillin. However, a type-1 mediated hypersensitivity reaction is a contraindication given that a repeat exposure puts the patient at risk for anaphylaxis.

• Skin testing has been approved to help assist in hypersensitivity to penicillins. Reports are that the risk of an allergic reaction in a patient with a positive skin test is roughly four percent. In contrast, a negative skin test has a relatively high sensitivity in ruling out a type-I hypersensitivity reaction.[27]

Monitoring

• It is essential to be aware of hypersensitivity reactions, and the patient should understand to notify their physician of any rashes. [27]

• In a patient on a short-term course of amoxicillin, no specific laboratory monitoring parameters are suggested. However, during prolonged administration, such as for osteomyelitis, it is essential to monitor renal and hepatic function and hematologic function periodically throughout treatment.[22]

• Mild diarrhea is often tolerable. However, prolonged diarrhea with fever and abdominal pain should prompt evaluation by a clinician for CDAD.[28]

• Penicillins in high doses can cause seizures which is a concern, especially in patients with renal failure.[29]

Toxicity

A prospective study of 51 pediatric patients at a poison-control center proposed that less than 250 mg/kg of amoxicillin overdosages are not associated with significant clinical symptoms(Product labeling FDA).

Clinical Features

• Interstitial nephritis resulting in oliguric renal failure has been reported in a small number of patients after overdosage with amoxicillin. [19][20]

• Crystalluria leading to renal failure has been reported after amoxicillin overdosage in adult and pediatric patients.[30]

Management

• In case of overdose, discontinue medication, treat symptomatically.

• Maintain airway, breathing, and circulation.

• For updated information about the overdose of amoxicillin, call a poison control center (1-800-222-1222)

Enhancing Healthcare Team Outcomes

Amoxicillin is a common antimicrobial often prescribed by nurse practitioners, primary care providers, and internists. The drug is safe, but it is essential always to get a good history of allergy before prescribing the medication. Due to the widespread use of amoxicillin, all healthcare providers should understand the mechanism, resistance patterns, adverse drug reactions, and toxicity management.[27][32]

The clinician usually initiates amoxicillin therapy for appropriate indication. However, a pharmacist should verify the dosing and duration are correct for the infection being treated and confirm that no drug interactions could impede treatment. Nursing staff can counsel on administration, verify adherence. Additionally, nurses should educate the patient not to discontinue amoxicillin when they start to feel better. If the nurse or pharmacist encounters any issues, they should address them with the prescriber immediately.

In case of significant overdose, triage nurses should admit the patient. Emergency physicians need to evaluate and manage nephrotoxicity. Nephrologist consultation is necessary for hemodialysis. Consult a medical toxicologist or poison control center for the latest information.[33] Infectious disease specialists should ensure proper management of pseudomembranous colitis resulting from irrational amoxicillin use. Additionally, infectious disease specialists should emphasize the importance of antimicrobial stewardship. Antimicrobial stewardship is a coordinated program that encourages the proper use of antimicrobials, enhances patient outcomes, decreases microbial resistance, and reduces the spread of infections caused by multidrug-resistant organisms. [34]

As depicted above, clinicians(MDs, DOs, NPs, PAs), specialists, pharmacists, nurses, and other healthcare providers should collaborate to maximize efficacy and minimize adverse drug reactions related to amoxicillin therapy. This type of interprofessional team approach and antimicrobial stewardship will improve the likelihood of more favorable patient outcomes.[35] [Level 2]

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

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Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA, Pankey GA, Seleznick M, Volturo G, Wald ER, File TM., Infectious Diseases Society of America. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012 Apr;54(8):e72-e112. [PubMed: 22438350]

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Disclosure: Bobak Akhavan declares no relevant financial relationships with ineligible companies.

Disclosure: Niloufar Khanna declares no relevant financial relationships with ineligible companies.

Disclosure: Praveen Vijhani declares no relevant financial relationships with ineligible companies.

What are antibiotics? – article on the website Aptechestvo, Nizhny Novgorod

Antibiotics are a group of drugs that are used in the treatment of bacterial infections. Bacteria are living microorganisms that, having penetrated into the human body, begin active life and reproduction. The effect of antibiotic therapy is the direct destruction of the pathogen, as well as slowing down the reproduction of pathogens. In connection with these antibacterial drugs are divided into 2 large groups: bactericidal – destroying the bacterium itself, as well as bacteriostatic, inhibiting their growth. In addition, antibiotics have a narrow and broad spectrum of action. Narrow-spectrum drugs destroy the infection selectively, while broad-spectrum drugs destroy most of the microorganisms, including those that benefit humans. What antibiotics to take for the treatment of various diseases should be decided by the doctor after the diagnosis. Taking such drugs at your own discretion is fraught with complications.

Fluoroquinolones

They suppress the activity of enzymes involved in the formation of bacterial DNA, as a result of which the infection dies. The drugs are available in the form of tablets, injections, ophthalmic drops. Indications for appointment:

This group of drugs:

• Ciprofloxacin;

• Ofloxacin;

• Pefloxacin;

• Norfloxacin.

Aminoglycosides

Broad-spectrum agents that kill most types of Gram-negative aerobic and facultative bacteria. The active substance disrupts the process of protein synthesis, as a result of which the pathogen is destroyed and dies.

Aminoglycosides are poorly absorbed when taken orally, so, as a rule, they are prescribed as intravenous or intramuscular injections. Members of this group:

• Amikacin;

• Gentamicin;

• Kanamycin;

• Neomycin;

• Plazomycin;

• Streptomycin.

As a rule, these drugs are used in combination with other antibiotics to treat such infectious diseases:

Tetracyclines

Bacteriostatic antibiotics that retard the growth of pathogenic microorganisms, but do not completely destroy them. As a result, the reproduction of the infection stops, and it gradually dies.

Tetracyclines have a wide spectrum of activity, with pronounced activity against aerobic gram-positive and gram-negative bacteria. Tetracyclines are not prescribed for children under 8 years of age, since long-term use causes a number of serious complications.

The drugs of this group can be prescribed in tablet forms and in the form of injections. For the treatment of ophthalmic infections, ointments are produced, the active substance of which is tetracycline.

Medicines:

• doxycycline;

• minocycline;

• Tetracycline;

• Oxytetracycline.

Diseases for which tetracyclines are prescribed:

Macrolides

They suppress vital activity and prevent the reproduction of anaerobic and aerobic gram-positive bacteria. Preparations of this group are used in the treatment of bronchopulmonary infections, tonsillitis, otitis, scarlet fever, intestinal infections. Medicines that are included in this group:

• Erythromycin;

• Azithromycin;

• Clarithromycin;

• Spiramycin.

Penicilli

A group of antibiotics produced by the fungus Penicillium. Penicilli are active against most Gram-positive and some Gram-negative bacteria. This group of drugs:

• Amoxicillin;

• Augumetin;

• Amoxiclav;

• Flemoxin Slutab.

Cephalosporins

These are bactericidal beta-beta-lactam antibiotics that interfere with cell protein synthesis. There are 5 generations of cephalosporins. The active substance penetrates well into most body fluids, having a pronounced bactericidal effect. Cephalosporins are used for uncomplicated skin and soft tissue infections caused by staphylococcal and streptococcal bacteria. This group of drugs:

• Ceftriaxone;

• Cefodox;

• Cefix;

• Tsepefim.

Bacteria are organisms that do not live long, but in order to restore their population, they multiply rapidly, and, accordingly, quickly mutate, adapting to new living conditions. Microorganisms that survive after taking antibiotics become resistant to them. Their offspring also become immune to a particular drug.

Antibiotic resistance is a common problem of modern man, which causes serious complications. A person who has tried many antibiotics, that is, self-medicated, is at risk for patients with antibiotic resistance. Very often they die before a specialist can pick up a drug that works against a specific pathogen. Therefore, it is important to follow the recommendations of the doctor and take antibacterial agents strictly according to an individual scheme.

Which antibiotic should be chosen for effective treatment?

If you need an antibiotic for treatment, read our article. We will talk about the different types of antibiotics, their side effects and the correct dosage. Find an effective remedy to eliminate the disease.

Antibiotics are medicines used to treat infectious diseases. They are able to kill or stop the growth of bacteria. However, choosing the right antibiotic can be difficult because not all drugs may be effective for certain types of infections. In addition, many patients face the problem of choosing an antibiotic that will not cause side effects or allergic reactions.

There are many factors to consider when choosing an antibiotic, such as the age and general condition of the patient, type of infection, bacterial susceptibility to the drug, and possible side effects. Some patients may develop resistance to antibiotics, so it is important to take the drug correctly and follow your doctor’s instructions to avoid consequences.

In this article, we will review the main classes of antibiotics and their use in the treatment of various infections. We will also discuss important points to consider when choosing an antibiotic and give advice on how to minimize the risk of side effects and allergic reactions.

When is an antibiotic needed?

Antibiotics are used to fight bacterial infections. Their intake is not recommended in the treatment of viral diseases such as influenza, colds, herpes and others. This is because viruses are not killed by antibiotics, and their use can adversely affect health and cause side effects.

Antibiotics may be required for the following bacterial infections:

• sore throat;
• pneumonia;
• urethritis;
• sinusitis;
• bronchitis;

Antibiotics may also be prescribed for certain urinary tract infections, skin infections, and other bacterial infections.

But do not forget that each case is individual, and the decision to take antibiotics should only be made by a doctor after appropriate examinations and diagnosis.

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Types of antibiotics

There are many types of antibiotics, which are divided into several classes depending on the mechanism of action and the spectrum of action on bacteria.

The first class of antibiotics are penicillins, which kill bacteria that cause infections in the body. They are the main class of antibiotics used for moderate to severe infections.

The second class are cephalosporins, which are also used to treat moderate to severe infections. These antibiotics continue to work even after the penicillins have worn off.

The third class are macrolides, which are widely used to treat respiratory and skin infections. They are usually used only in cases where penicillins and cephalosporins do not work.

Another class of antibiotics, the aminoglycosides, are sometimes used and are often used in intensive care for severe infections. However, they may be toxic to some patients and their use should be limited.

Combination antibiotics are also available, which contain two or more classes of antibiotics in the same formulation and may be effective for infections caused by more than one bacterial species.

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How to take antibiotics correctly?

Antibiotics are powerful drugs used to fight infectious diseases. Antibiotics must be taken correctly in order to maximize the effectiveness of treatment and reduce the risk of side effects.

First, be sure to follow your doctor’s recommendations for antibiotic choice and dosage. Do not interrupt the course of treatment ahead of time, even if you already feel better. A full course of antibiotics is needed to kill all the bacteria that caused the disease.

Second, take your antibiotics exactly on schedule and at the same time. This will help maintain a constant blood level of the drug and improve its effectiveness. If you miss a dose, don’t try to catch up, just keep taking your next dose at the usual time.

Third, don’t take antibiotics unnecessarily. If you are healthy and do not have indications for taking them, do not use antibiotics. This will only exacerbate the problem as bacteria can become resistant to the drug.

Fourth, do not combine antibiotics with other medicines without your doctor’s advice. Some drugs can interact, which can lead to serious side effects.

By following these guidelines, you will be able to take your antibiotics correctly and get the most out of your treatment. Remember that self-medication is always a risky practice, and in case of unexpected symptoms, you should immediately consult a doctor.

Why is a course of treatment necessary?

After getting a prescription for antibiotics, many patients tend to start taking them right away. However, a full course of treatment is required to achieve maximum effectiveness.

A course of treatment is a period during which a patient takes prescribed medications on a scheduled basis for a specified amount of time, usually from a few days to a few weeks. Unlike short-term use of antibiotics, a course of treatment ensures that all bacteria that caused the infection are killed.

Why is the full course of treatment so important?

• Failure to follow medication recommendations may result in recurrence of symptoms or complications.
• If antibiotics are stopped prematurely, not all bacteria will be killed, which may lead to the development of drug resistance.
• Failure to comply with treatment may lead to the emergence of a new antibiotic-resistant infection that will be difficult to treat.

Meanwhile, if the drug is taken throughout the course, the appearance of resistance to it and the likelihood of complications is reduced. Therefore, it is important not to interrupt the course of treatment even if the symptoms of the disease have already passed.

What can happen if an antibiotic is chosen incorrectly?

The wrong choice of antibiotic can lead to serious consequences, which may include:

• Failure to achieve the goal of treatment: The wrong choice of antibiotic may not eliminate the microorganism causing the infection and lead to recovery.
• Increased symptoms: Some antibiotics may worsen the symptoms of the infection, causing it to progress.
• Development of allergic reactions: Choosing the wrong antibiotic may cause an allergic reaction that can be hazardous to health. Symptoms may include swelling of the lips, face, and tongue, difficulty breathing, rash, and burning.
• Development of superinfections: Incorrect prescription of an antibiotic can also lead to the development of superinfections because some antibiotics can destroy not only pathogenic bacteria, but also beneficial bacteria inside the body that protect against the growth of harmful microorganisms.

Moreover, the misuse of antibiotics can lead to an increase in bacterial resistance to these drugs, making it more difficult to treat more serious infections in the future.

Therefore, in order to effectively treat an infection, it is necessary to choose an appropriate antibiotic and follow the indicated dosages and periods of administration, and consult a doctor before using antibiotics.

How to choose an antibiotic?

The choice of antibiotic must be approached responsibly and competently. An incorrectly selected drug can not only not lead to the expected result, but also be harmful to health. To choose the right antibiotic, several important factors must be considered.

• Diagnosis. First of all, it is necessary to correctly establish the diagnosis and, on the basis of this, select the antibiotic that is most effective in a particular case. For example, when treating influenza, you need to choose drugs that can fight the virus, not bacteria.
• Microbiological analysis. If possible, a microbiological test should be performed to determine which microorganism has caused the disease and to determine antibiotic susceptibility. This will allow you to choose the most effective drug.
• Patient’s condition. It is necessary to take into account the patient’s condition, the presence of concomitant diseases and other factors that may affect the choice of drug. For example, when treating a pregnant woman, you need to consider which antibiotic will be safe for the child.

It is also worth paying special attention to the instructions for use of the antibiotic, dosage and method of application. It is necessary to strictly follow the recommendations of the doctor and not change the dosage or the period of treatment on your own.

The choice of antibiotic is an important step in treatment and should be left to professionals. Try not to treat yourself, but trust an experienced doctor who will select the most effective and safe drug for you.

Factors affecting the choice of antibiotic

Type of bacteria: The choice of antibiotic depends on the type of bacteria causing the infection. Some antibiotics only work against specific types of bacteria, while others are more general.

Antibiotic susceptibility: Laboratory tests determine the susceptibility of bacteria to a particular antibiotic. This allows you to prescribe the most effective drug.

Side effects: Each antibiotic may cause different side effects such as diarrhea or allergic reactions. The attending physician should take into account the possible risks and side effects when choosing a drug.

Dosage: The dosage of the antibiotic depends on the patient’s weight, age and severity of the infection. Before prescribing the drug, it is necessary to conduct an appropriate assessment.

Patients with chronic disease: Patients with chronic disease or other conditions may need to choose antibiotics that do not interact with other drugs they are taking.

Duration of treatment: In many cases it is necessary to choose drugs that can be taken for a certain period of time, for example, for 7-14 days.

Pregnancy and breastfeeding: Some antibiotics may be dangerous for women who are pregnant or breastfeeding. When choosing a drug, possible risks and side effects should be taken into account.

Price: The price of an antibiotic can be an important factor when choosing a drug. Some drugs may be more expensive than others, but may be more effective.

Basic Rules for Antibiotic Selection

Antibiotics are powerful medicines for fighting infectious diseases. However, in order to achieve maximum effectiveness of treatment, it is necessary to take into account the basic rules for choosing an antibiotic:

1. Determine the sensitivity of microorganisms to antibiotics. An incorrectly selected drug can harm the body without having the desired effect. Antibiotic sensitivity can be determined using laboratory tests.
2. Choose an antibiotic based on the type of infection and the patient. In the treatment of upper respiratory tract infections, for example, broad-spectrum drugs are primarily used. However, in the case of more serious diseases, more specific treatment may be required.
3. Monitor the patient during treatment. While taking medications, the patient’s condition should be monitored and treatment adjusted if necessary. It is undesirable to cancel the drug on your own without consulting your doctor.
4. Follow the regimen of the drug. Violation of the antibiotic regimen may reduce its effectiveness and lead to the development of microorganism resistance to the drug.
5. Avoid self-medication. Improper use of antibiotics can lead to complications and reduce the effectiveness of treatment in the future.

How not to harm?

The choice of an antibiotic for the treatment of diseases is a responsible and important point, because an incorrectly selected drug can harm health. Therefore, a number of factors should be taken into account in order to minimize the risks:

• Diagnostics. Before prescribing antibiotics, it is necessary to conduct tests and studies, a detailed examination of the patient in order to determine the causative agent of the disease and sensitivity to antibiotics. This will help you choose the most effective remedy and avoid prescribing ineffective drugs.
• Compliance with dosage and regimen. Insufficient or overdose may lead to side effects and deterioration of well-being. You should strictly adhere to the doctor’s recommendations for taking antibiotics in order to achieve maximum effectiveness of treatment.
• Healthy lifestyle. Maintain a healthy lifestyle while taking antibiotics. It is not recommended to drink alcohol, smoke, you should avoid overloading the advanced modes of work and rest, listen to your body and not neglect rest and sleep.

In general, choosing the right antibiotic, along with the above factors, can help avoid side effects and achieve a speedy recovery.

Compatibility of antibiotics with other drugs

In the treatment of infections, several drugs are often prescribed, including antibiotics. It is important to consider the compatibility of antibiotics with other drugs in order to avoid negative consequences and to carry out the treatment as efficiently as possible.

Some drugs can interact with antibiotics, reducing their effectiveness or, conversely, increasing unwanted side effects. Therefore, before starting treatment, it is important to tell your doctor about all medications you take, including vitamins, dietary supplements, and herbal preparations.

Unwanted interactions include, for example, antibiotics and anticonvulsants. This is because some antibiotics can reduce the effectiveness of anticonvulsants. Also, some antibiotics interfere with the metabolism of other drugs and may cause unwanted effects.

When taking several medications together, it is important to monitor the dosage and follow the doctor’s recommendations. Sometimes it is necessary to change the dosage or replace one of the drugs with another to avoid negative interactions. Therefore, self-medication and changing the dosage of antibiotics and other drugs without consulting a doctor is not recommended.

If you have any questions about the compatibility of antibiotics with other medicines, ask your doctor or pharmacist for advice.

Main side effects of antibiotics

When using antibiotics, be aware of possible side effects that may adversely affect the health of the patient. Some of them can be very serious.

One of the most common side effects of antibiotics is an allergic reaction, which manifests itself in the form of a skin rash, dermatitis, and even anaphylactic shock. If these symptoms occur, stop using the antibiotic and seek medical attention.

Another side effect can be dysbacteriosis, when antibiotics destroy not only harmful but also beneficial bacteria in the intestines, which leads to indigestion and diarrhea. To prevent dysbacteriosis, it is recommended to take probiotics during antibiotic treatment.

Some antibiotics can cause sensitivity to sunlight, which can lead to burns. Therefore, during treatment, it is necessary to avoid prolonged exposure to the sun and use sunscreen.

There are also possible side effects related to the function of the genitourinary system, such as candidiasis, cystitis and even high blood pressure.

If you experience any side effects, you should consult a doctor to correct treatment or change the drug.

When should I see a doctor?

Symptoms that require a mandatory visit to a doctor:

• High body temperature (more than 38 degrees).
• Severe pain in the head, abdomen, chest or other parts of the body.
• Discoloration of the skin (appearance of a rash, spots, signs of burns).
• Changes in urination (pain, burning, blood in urine).
• Sick, prolonged cough with sputum.

Situations in which you need to call an ambulance immediately:

• Stop breathing or heartbeat.
• Bleeding, unable to stop on its own.
• Rapid deterioration after injury or other exposure.
• Urinary or fecal incontinence with significant pain.
• Signs of myocardial infarction, stroke or other dangerous conditions.

If you feel sick, don’t delay going to the doctor – it could save your life.

How to properly store antibiotics?

Antibiotics are used to treat infections and diseases. They can become useless if not properly stored. The following are general guidelines for storing antibiotics.

• Store antibiotics in a dry place . Humidity can degrade the quality of the antibiotic and make it less effective. Therefore, it is best to store antibiotics in a dry place, perhaps even in a block of dry bags.
• Store antibiotics in a cool place . High temperatures can damage antibiotics and make them less effective. Store antibiotics in a cool place, such as a refrigerator, if directed to do so.
• Store antibiotics in the original container . The original packaging contains information about the action, use, expiration date and warnings. This information is very important when using an antibiotic, so keep it in its original packaging.
• Keep antibiotics out of the reach of children and animals . Any drug, even if it is safe for humans, can be dangerous for animals. Keep antibiotics out of the reach of children and animals.

Following these recommendations can help maintain the effectiveness of antibiotics and prevent potential storage problems.

New trends in the development of antibiotics

The development of new antibiotics is a necessary task in the fight against infectious diseases. Existing drugs lose their effectiveness due to misuse and the development of resistance in bacteria.

One of the new directions in the development of antibiotics is the use of peptides. These molecules have unique properties to fight infections and are also more resistant to bacterial resistance mechanisms.

Another trend is the development of completely new classes of antibiotics, despite the difficulty of finding targets to kill microorganisms. Such drugs will have novel mechanisms of action and potentially high efficacy in fighting infections.

Another important area is to improve the effectiveness of existing antibiotics. This is facilitated by various studies, including the study of the possibility of combination therapy and the use of technologies to enhance the effect of drugs at the cellular level.

New trends in the development of antibiotics offer hope for better treatment of infectious diseases and the fight against bacterial resistance. However, more research and testing of new drugs is needed for their further use.

Alternative Therapies

Today, many people are looking for alternative therapies because they can be more pleasant and less dangerous to health than antibiotics. One such method is the use of herbs and herbal preparations.

Medical research shows that many herbs and plants contain substances that can help treat infections. For example, garlic is a natural antibiotic that can kill bacteria and fungi. The effectiveness of garlic for treating infections has long been known.

In addition, there are many other herbs and herbal preparations that can be used as alternative treatments. For example, propolis, echinacea, golden root and many others.

For example, some studies show that the use of propolis can help treat respiratory infections such as bronchitis and sinusitis. In addition, some herbal preparations can help boost the immune system, which can help prevent infections.

In any case, before using alternative treatments, you should consult a specialist, as some plants and herbs can be hazardous to health, especially when used in large doses or in combination with other medicines.

Conclusions

The study of the microbiological characteristics of the bacterial agent is the basis for the correct choice of antibiotic for treatment. The use of antibiotics for the treatment of infections is possible only after determining the type of pathogen and its sensitivity to a particular drug.

Given the pharmacokinetic properties of antibiotics, it is important to correctly determine the frequency and dosage of administration. Some antibiotics may not be effective if the patient does not take them as recommended by the doctor.

It is important to remember that the use of antibiotics can lead to the development of resistance in bacterial pathogens. Therefore, antibiotics should be used only when they are really needed and under the supervision of a doctor.

In general, the correct choice of antibiotic for the treatment of infections is a key factor in the effectiveness of treatment. It is necessary to take into account the individual characteristics of the patient, his state of health and the sensitivity of the bacterial agent to the drug in order to achieve the best treatment result.

Q&A:

How do you know which antibiotic is right for a specific disease?

It is best to see a doctor who can diagnose and prescribe the appropriate treatment. Microbiological studies can also be performed to help determine which bacteria caused the infection and which antibiotics will be most effective on them.

What are the side effects of using antibiotics?

Side effects may vary depending on the specific antibiotic, but in general, some of them may be: allergic reactions, intestinal problems, less often – damage to the liver or kidneys. It is also important to understand that the use of antibiotics can lead to the development of bacterial resistance to them, which can make future treatment more difficult.

How often should antibiotics be taken?

The dosage and regimen of antibiotics depends on the specific drug and disease, so you should follow your doctor’s instructions. Often antibiotics are taken 1 to 3 times a day, depending on the type of medication and dosage.

How quickly do antibiotics take effect?

The rate of onset of effect may vary depending on the type of disease and the specific antibiotic, but in general, improvement may begin within a few days of starting treatment. However, it is important to continue taking antibiotics until the end of the course, regardless of improvement, to prevent recurrence of the disease and the development of bacterial resistance to the drug.

How to choose the right antibiotic dosage?

Antibiotic dosage depends on the specific drug and disease, so you should consult your doctor who will prescribe the optimal dosage according to your condition and medical history.