Antibiotics


Antibiotics are drugs used to treat bacterial infections.   

 

The discovery of antibiotics in the second decade of the previous century has lead to an overall improvement of human health. The World Health Organization states that antibiotics have increased human life expectancy by 10 years.   


Causes of infection 

Bacteria are microorganisms living in air, water, soil, but also in humans, animals and plants.   

 

Bacteria have a role in the natural chain, for example, bacteria in our intestines help digest food and normal peristaltic of theintestines. However, if they get into an environment which is not their natural habitat, they can cause infections (inflammations) and lead to serious diseases, such as: sore throat, ear infection, pneumonia, meningitis, urinary infections and wound infections. When a bacterial infection occurs, antibiotics are applied to destroy the bacteria and lead to the healing of the infection.   

 

Viruses are micro organisms smaller than bacteria. They live in air, water, and soil. They are not natural inhabitants of human body; once they get into organisms, they settle in the host cells and lead to viral infections. They can cause diseases such as cold, the flu, sore throat, ear infection, contagious diseases such as: measles, rubella but also some difficult diseases such as viralhepatitis or AIDS. Antibiotics are ineffective in viral infections.   


Principles of correct use of antibiotics 

 

In order for an antibiotics therapy to be successful and rational, the first step is to choose the right antibiotic. In an ideal situation, every doctor should first do an antibiogram when suspecting a bacterial infection . Antibiogramis performed by placing a biological material from the infection spot (throat, ear, wound, urine, blood or liquor swab) for an analysis, thereby identifying which antibiotic will lead to healing. In many cases however, the severity of the disease makes it impossible to wait for antibiogram results, and doctors prescribe antibiotics relying on the sate of patient and their knowledge of the most common causes of diseases and their sensitivity.   The right choice of an antibiotic means:

  • Choosing the antibiotic that the cause is the most sensitive to.
  • Identification of an efficient drug dose
  • Application route: oral, intravenous, intramuscular, local
  • Therapy duration


Resistance to antibiotics 

 

Bacteria are living beings that have the ability to adjust to the environment they live in, and develop resistance to external factors. In the presence of antibiotics, they develop defense mechanisms to counteract antibiotics. This ability of bacteria to counteract antibiotics is called resistance. Bacterial resistance to action of antibiotics poses a huge problem to medical practice, and it is the reason why some antibiotics have become useless. Resistance to antibiotics, and their tremendous importance are the reasons why the World Health Organization keeps recommending rational use of antibiotics.   

 

Rational use of antibiotics 

 

Rational use of antibiotics refers to their use in practice only in the cases when its is:

  • medically justified
  • the use of antibiotics that the causeof infection  is sensitive to
  • in a dose and length of therapy that will result in healing

 

Adverse effects of antibiotics


Antibiotics are drugs with relatively few adverse effects.

  • Antibiotic allergy is the most prominent adverse effect. Allergies most commonly occur with the use of penicillin and trimethoprim. They can be mild, such as a skin rash, or very severe (anaphylactic shock) even with a deadly outcome. Fortunately, they are very rare. Allergy to one antibiotic can cause a cross-allergy to other drugs from the same group, and the doctor should therefore be forewarned about the existence of the allergy.
  • Gastrointestinal problems: the use of some antibiotics can cause nausea, feeling of stomach heaviness, vomiting and diarrhea. The doctor and the pharmacist will always inform the patient about thepossibility of these adverse effects.

 

Advice for correct use of antibiotics:

 

  1. Antibiotics should only be used when the doctor says so
  2. The dose regime and the therapy duration must be observed. Antibiotics are drugs which must be taken at specific intervals, for example: every 8 hours, every 6 hours or every 12 hours, and long enough (5,7, 10 days) to result in the healing of an infection. The dosing regime and the length of therapy are decided by the doctor, and the pharmacist in the pharmacy will repeat the doctor's instruction when handing over the drug. Antibiotic related complications usually occur when the patient does not observe the time intervals for taking the drug, or ceases using it after 2 or 3 days on account of feeling better. In such cases, the patient may not be healed completely but only temporarily, and the disease my recur a few days later, in a heavier form, and with complications. The doctor then encounters a disease that is more difficult to recognize and more difficult to be prescribed an adequate antibiotic for.
  3. Should an allergy reaction occur, the use of the drug should be ceased, and the patient should go to see the doctor.
  4. In the cases of mild adverse effect occurrence (nausea, feeling of stomach heaviness, diarrhea) the doctor and the pharmacist should be consulted about the continuation of the therapy.

B. Sc. ph Sanja Bućan, Centralna apoteka Pharmacy manager


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