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Clinician’s Corner: Antibiotics

Let’s begin our discussion about antibiotics.  Since Alexander Fleming discovered penicillin in the 1930’s resistance has always been a problem. Protecting those antibiotics from unnecessary use is best for all of us!

Anti-infective stewardship is a must!

  • Antibiotics are the only drug where use in one patient can impact the effectiveness in another.
  • If everyone does not use antibiotics well, we will all suffer the consequences.
  • Antibiotics are a shared resource, (and becoming a scarce resource).
  • Using antibiotics properly is similar to developing and maintaining good roads.
  • Available data demonstrate that we are not doing a good job of using antibiotics in in-patient settings.
  • Several studies show that a substantial percentage (up to 50%) of in-patient antibiotic use is either unnecessary or inappropriate. 

Definitions

  • anti-infective: applies to any drug that is effective against pathogens.
  • antibiotic: technically refers to natural substances produced by a micro-organism that can kill other micro-organisms. However, most of us use antibiotic, anti-infective and antimicrobial interchangeably.
  • bacteriostatic: do not actually kill the bacteria but slow the growth of the organism. The body’s immune system can then dispose of the bacteria.  Most bacteriostatic antibiotics disrupt protein synthesis.
  • bactericidal: kill the bacteria outright, usually by interruption of cell wall synthesis
  • superinfection: secondary infections caused when microorganisms normally present in the body are killed by the antibiotic. These normal organisms called host flora (or normal flora) inhabit the skin, upper respiratory, GU, and GI tract.
    • Examples: candida vulvovaginitis after amoxicillin therapy
    • difficile: after clindamycin therapy (or any broad-spectrum antibiotic)

COMMMENTARY:

We must also be prudent in prescribing antibiotic therapy for our patients because they can create resistance to bacteria.  Increasing bacterial resistance through reckless prescribing can cause an increase in resistant organisms in which current antibiotics can be futile.  We have to look no further than the infamous “Z-pak” (Azithromycin) which in our area has a 48% resistance rate for Strep pneumo, a very common pneumonia causing bacteria.  It is a “flip of the coin” as to whether the “Z-pak” will cure your next community acquired pneumonia.

When your physician chooses not to prescribe an antibiotic follow his recommendations and come to Thompson Pharmacy for medications to manage those bothersome symptoms.  Whether cough, cold or allergies your Thompson Pharmacist is a great resource to help you feel better without antibiotics!

Go Ahead and ASK… at Thompson Pharmacy it’s ALL for YOU!