Principles of antibiotic use

In our country, there is a situation of blindly using antibiotics when treating diseases. Whether it is a cold, fever or a red and swollen throat, antibiotics are always used. Some people don’t even know which drugs are antibiotics and buy them at the pharmacy on their own. Antibiotics have serious side effects. Improper use can easily lead to drug resistance, affect the human gastrointestinal flora, and cause adverse consequences. So what are the principles for the use of antibiotics?

The following basic principles must be considered when using antibiotics clinically:

(I) Strictly follow the indications and avoid using antibiotics if possible. In addition to considering the specificity of the antibiotic's antibacterial effect, it is also necessary to understand the adverse reactions of the drug and the relationship between the in vivo process and the efficacy.

(II) Antibiotics should not be used for patients with fever of unknown cause. Except for patients with critical conditions and highly suspected bacterial infection, antibiotics should not be used for patients with fever of unknown cause, because the use of antibiotics often makes it difficult to detect the pathogenic microorganisms and makes the clinical manifestations atypical, which affects clinical diagnosis and delays treatment.

(III) Antibiotics are not used for diseases that are viral or presumably viral infections. Antibiotics are ineffective against various viral infections. It is harmless to give antibiotics to patients with measles, mumps, colds, influenza, etc. More than 90% of pharyngitis and upper respiratory tract infections are caused by viruses. Therefore, antibiotics are generally not used unless it can be confirmed that the infection is bacterial.

(IV) Avoid using antibiotics locally on the skin or mucous membranes as they can easily cause allergic reactions and lead to the production of drug-resistant bacteria. Therefore, except for antibiotics mainly for local use, the use of other antibiotics should be avoided as much as possible. When using antibiotics for burns of the ocular mucosa and skin, it is important to choose the appropriate period and dosage.

(V) Strictly control the scope of preventive antibiotics. Preventive treatment can be used in the following situations:

1. Patients with rheumatic fever should use antibiotics regularly to eliminate pharyngeal hemolytic streptococci and prevent recurrence of rheumatic fever.

2. Use antibiotics before and after surgery for rheumatic or congenital heart disease to prevent the occurrence of subacute bacterial endocarditis.

3. When removing the infection focus, choose appropriate antibiotics according to the sensitivity of the bacteria.

4. After combat injuries or combined trauma, antibiotics are used to prevent gas gangrene.

5. Antibiotics are used for intestinal preparation before colon surgery.

6. After severe burns, antibiotics should be used to eliminate hemolytic streptococcal infection in the wound before skin grafting. Or use appropriate antibiotics according to the wound bacteria and drug sensitivity results to prevent the occurrence of sepsis.

7. Patients with chronic bronchitis and bronchiectasis can use antibiotics preventively in winter.

8. Taking antibiotics one day before cranial surgery can prevent infection.

(VI) Emphasize the importance of comprehensive treatment. In the process of using antibiotics to treat infectious diseases, the importance of the human body's defense mechanism should be fully recognized.

Do not rely too much on the efficacy of antibiotics and ignore the internal factors of the human body. When the quality and quantity of human immunoglobulins are insufficient, cellular immune function is low, or the performance and quality of phagocytes are insufficient, antibiotic treatment will be difficult to be effective.

Tips:

While applying antibiotics, every effort should be made to improve the patient's general condition; various comprehensive measures should be taken to enhance the body's resistance, such as lowering the patient's excessively high body temperature; paying attention to diet and rest; correcting water, electrolyte and alkali imbalances; improving microcirculation; replenishing blood volume; and treating primary diseases and local lesions.