Why antibacterial agents might be prescribed for an infection




















Helping healthcare professionals improve the way they prescribe antibiotics, and improving the way we take antibiotics, helps keep us healthy now, helps fight antibiotic resistance, and ensures that these life-saving drugs will be available for future generations. Antibiotics are only needed for treating certain infections caused by bacteria.

Effective antibiotics are also needed for people who are at high risk for developing infections. Some of those at high risk for infections include patients undergoing surgery, patients with end-stage kidney disease, or patients receiving cancer therapy chemotherapy. Antibiotics do not work on viruses, such as those that cause colds, flu, bronchitis, or runny noses, even if the mucus is thick, yellow, or green. Antibiotics are only needed for treating certain infections caused by bacteria, but even some bacterial infections get better without antibiotics.

Most cases of sore throat are caused by viruses. One kind, strep throat, diagnosed by a lab test, needs antibiotics. Common viral infections, like coughs or a cold, can sometimes become complicated and a bacterial infection can develop. However, treating viral infections with antibiotics in order to prevent bacterial infections is not recommended because of the risk of causing bacterial resistance:. Remember that antibiotics do not work against viral colds and the flu, and that unnecessary antibiotics can be harmful.

Talk with your healthcare provider about antibiotics and find out about the differences between viruses and bacteria, and when antibiotics should and should not be used. If your child receives an antibiotic, be sure to give it exactly as prescribed to decrease the development of resistant bacteria. Have your child finish the entire prescription.

Don't stop when the symptoms of infection go away. Never save the left over antibiotics to use "just in case. Do not share your antibiotics with someone else or take an antibiotic that was prescribed for someone else. Sometimes, a child who has been bitten by a dog, another animal, or even another person will be given medicines to prevent an infection from developing.

When youngsters are hospitalized for a surgical procedure, they may be given medicines before their operation to prevent an infection from developing at the site of the surgical incision.

Typically, these drugs are given to children no more than 30 minutes before the operation. If your pediatrician believes that your child can benefit from taking medicines as a preventive measure, your pediatrician will choose them carefully and prescribe them for the shortest possible period.

This strategy will reduce the chances that use of these drugs will contribute to the problem of antimicrobial resistance. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Turn on more accessible mode. Turn off more accessible mode. Skip Ribbon Commands. Skip to main content. Turn off Animations.

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The second step is to decide if antibiotics are warranted for that particular infection. Antibiotics are almost never necessary for treatment of the common cold or acute bronchitis in otherwise healthy persons. Table 2 10 lists the indications for appropriate antimicrobial treatment in common infections. Treat only proven acute OM. Although antibiotics are indicated for treatment of acute OM, diagnosis requires the following:. Documented middle-ear infection.

Signs or symptoms of acute local or systemic illness. Do not prescribe antibiotics for initial treatment of OM with effusion. Treatment may be indicated if bilateral effusions persist for three months or more. Mucopurulent rhinitis thick, opaque or discolored nasal discharge frequently accompanies viral rhinosinusitis.

It is not an indication for antibiotic treatment unless it persists without improvement for more than 10 to 14 days.

Prolonged nonspecific upper respiratory signs and symptoms e. More severe upper respiratory tract signs and symptoms e. Initial antibiotic treatment of acute sinusitis should use the narrowest-spectrum agent that is active against the active pathogens. Diagnose as group A streptococcal pharyngitis using a laboratory test in conjunction with clinical and epidemiologic findings. Antibiotics should not be given to a child with pharyngitis in the absence of diagnosed group A streptococcal infection.

A penicillin remains the drug of choice for treating group A streptococcal pharyngitis. Antibiotic treatment for prolonged cough more than 10 days may occasionally be warranted. Pertussis should be treated according to established recommendations. Mycoplasma pneumoniae infection may cause pneumonia and prolonged cough usually in children older than five years ; a macrolide agent or tetracycline in children eight years or older may be used for treatment.

Children with underlying chronic pulmonary disease not including asthma may occasionally benefit from antibiotic therapy for acute exacerbations. Information from Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics ; suppl — In the third step, the physician should evaluate the potential for side effects or drug-drug interactions. Finally, with all else being equal, the physician should choose the least expensive alternative among equally effective and safe drugs.

The physician should also address the social aspects of the illness and explain to the patient that antibacterial drugs are not effective in viral infections and emphasize that unnecessary antibiotics can be harmful in several ways Table 3. Several studies show that recent antibiotic use is a risk factor for colonization and infection with resistant organisms.

Many antimicrobial agents are costly. Perhaps most important to patients, an antibacterial agent will not shorten the duration of bothersome symptoms.

The physician should not dismiss the importance of a patient's illness and the impact of those symptoms on the daily routine. Instead, the physician should explain the natural course of the illness and what the patient can expect in terms of time to symptom resolution. Realistic patient expectations may help decrease future office visits for a resolving illness.

Explain to patients the probable viral nature of common respiratory infections and that antibiotics have no effect on duration of symptoms of viral infections. Explain to patients that antibiotics are potentially harmful in the following ways:. Increased colonization and infection with resistant pathogens in patients with prior antibiotic therapy. Increased antimicrobial resistance in the community.

Unwanted allergic reactions and adverse effects of antibiotics. Cost of unnecessary therapy. Finally, the physician should actively manage symptoms with analgesics, antipyretics and decongestants, where appropriate.

Therapy with beta agonists often is effective in shortening the duration of cough in acute bronchitis when clinical evidence of bronchial hyperresponsiveness such as wheezing or bothersome cough is present. Physicians may take a preemptive approach to educating patients about appropriate use of antibiotics. The American Academy of Pediatrics recommends discussing antibiotic use as part of well-child care visits. Educational materials in the office waiting room also may help disseminate the principles of judicious antibiotic use to patients.

Several sites on the Internet offer posters, pamphlets, videotapes and other materials for office use. Already a member or subscriber? Log in. Interested in AAFP membership?

Learn more. JOHN H. Powers completed subspecialty training in infectious diseases at the University of Virginia School of Medicine, Charlottesville. Address correspondence to Richard Colgan, M. Paca St.



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