Drugs are a double-edged sword, reasonable use can cure diseases and save lives, while abuse can be fatal, and antibiotics are no exception. Therefore, we also need to understand how to use antibacterial drugs reasonably. For the treatment of infectious diseases, anti-infective drugs have been widely used, especially antibiotics and chemically synthesized antibacterial drugs among antibacterial drugs are used at a very high rate. There are many different types of these drugs and different mechanisms of action, so it is not easy for us ordinary people to understand them comprehensively and thoroughly, so how to use antibacterial drugs reasonably, we can only grasp some of the necessary principles of use and understand the general knowledge. Pharmacist tips* antibacterial drugs are prescription drugs, so it is not recommended to stock up as a family medicine! Even if you buy them in pharmacies you still need a prescription from a physician to buy them. *If you suspect that you may have an infectious disease, you should seek prompt medical attention to determine if you need an anti-infective medication. *If your physician deems that you need to use antibacterial drugs after the visit, please follow the doctor’s prescription strictly, paying particular attention to the dosage and duration of use. *Pay attention to possible adverse drug reactions. If you have any questions about the antibacterial drug you are using, please consult your physician and pharmacist promptly to ensure the safety of the drug!
Principles of clinical use of antimicrobial drugs There are strict rules for the clinical use of antimicrobial drugs. Physicians must make a preliminary diagnosis of bacterial infection as well as those diagnosed by pathogenic examination as bacterial infection, or pathogenic infections caused by fungi, Mycobacterium tuberculosis, non-tuberculous mycobacteria, mycoplasma, chlamydia, spirochetes, rickettsia and some protozoa, based on the patient’s symptoms, signs and laboratory test results such as routine blood and urine Only infections caused by microorganisms can be applied antibacterial drugs. In principle, the selection of antimicrobial drugs should be based on the type of pathogenic bacteria and their sensitivity or resistance to antimicrobial drugs, i.e. the results of bacterial drug sensitivity tests. The pharmacodynamics (antibacterial spectrum and antibacterial activity) and pharmacokinetics (absorption, distribution, metabolism and excretion process) of various antibacterial drugs are different, so each has different clinical indications. According to the characteristics of various antibacterial drugs, such as the pathogenic bacteria, the site of infection, the severity of infection and the physiological and pathological conditions of the patient, clinicians will develop antibacterial drug treatment plans, including the selection of antibacterial drug species, dose, the number of times of administration, route of administration, course of treatment and combination drugs. The route of administration of mild infections can receive oral administration, oral absorption of antimicrobial drugs should be used, without the use of intravenous or intramuscular injection of drugs.
In patients with severe infections and systemic infections, the initial treatment should be given intravenously to ensure the efficacy of the drug; when the condition improves and can be given orally, the drug should be switched to oral administration as early as possible. Try to avoid local application of antibacterial drugs. In order to ensure the maximum efficacy of the drug in the body and to kill the pathogenic bacteria at the site of infection, the physician will administer the drug according to the principle of combining pharmacokinetics and pharmacodynamics. Penicillins, cephalosporins and other beta-lactams, erythromycin, and clindamycin with short elimination half-lives should be administered multiple times a day. Fluoroquinolones, aminoglycosides, etc. can be given once a day (with the exception of severe infections). The combination of antibacterial drugs should be clearly indicated. Infections that can be effectively treated with a single drug do not require a combination of drugs. Expert tip: Some patients with hepatic or renal insufficiency, elderly or children, pregnant or breastfeeding women, physicians will also adjust the drugs used, the dose and the course of treatment according to the patient’s specific situation. The prophylactic use of antimicrobials at home is extremely unsafe and should be administered according to medical advice. Different antibacterial drugs have different pharmacological and pharmacodynamic properties; different antibacterial drugs have different absorption, distribution and metabolism; and different antibacterial drugs have different adverse reactions and allergy potential. So you should learn as much as possible about which type of antibacterial drugs you are using.
Generally speaking, antibacterial drugs are divided into antibiotics and chemically synthesized antibacterial drugs. Common antibiotics such as penicillins, cephalosporins, macrolides, aminoglycosides, glycopeptides, polymyxins, carbapenems, tetracyclines and so on. Chemically synthesized antimicrobials include quinolones, sulfonamides, nitrofurans and nitroimidazoles, etc. Pay attention to the dose and course of drugs used The dose and course of drugs are directly related to the treatment effect. Due to the extent of the disease, individual differences in the patient, the dose and course of medication should be determined on a case-by-case basis. Generally, it is advisable to use until 3-4 days after the body temperature is normal and the symptoms have subsided. However, sepsis, infective endocarditis, septic meningitis, typhoid fever, osteomyelitis, hemolytic streptococcal pharyngitis and tonsillitis, deep fungal disease, tuberculosis, etc. require a longer course of treatment to completely cure and to prevent recurrence. Due to the special physical condition of the elderly and children, the dosage and course of medication need to be closely monitored. Since the determination of drug dosage and course of treatment is directly related to the occurrence of adverse drug reactions, they should also be of concern to us. Understanding the adverse reactions and precautions of the drugs used Understanding the adverse reactions and precautions is more helpful to the safe and rational use of antimicrobial drugs effectively. Adverse drug reactions are any harmful reactions that occur in the course of prevention, diagnosis, treatment of diseases or regulation of physiological functions, when taking normal doses of drugs, and the purpose of the drug is not relevant.
Including side effects, toxic reactions, allergic reactions, after-effects, withdrawal reactions, carcinogenic, teratogenic, mutagenic, idiosyncratic reactions, drug dependence, excessive effects, the first dose effect (refers to some patients in the first dose of a drug, because the body has not yet adapted to the role of drugs and cause intolerable strong reactions) and so on. These reactions may occur during the course of drug administration and lead to other physical damage and discomfort. Patients should pay attention to the following questions before applying antibacterial drugs: what factors may affect the efficacy of the drug in the process of use, and how to respond to adverse reactions according to their specific situation Before using any prescribed drug, you should provide a detailed medical history and allergy history to the prescribing physician for his or her reference, especially for antibacterial drugs, so that prevention is better than cure. Attention should be paid to drug cross-allergy for patients with a history of allergy. After a patient becomes unwell from oral or topical anti-infective medication, please seek prompt consultation for the physician to determine if the drug caused the adverse reaction; and follow the physician pharmacist’s guidance to determine a safer treatment plan. If a patient has a reaction to an injection or infusion, such as palpitation, chest tightness, dyspnea, chills, pallor, rash, fever, etc., call the nurse for emergency treatment to prevent the patient from going into shock. Then ask the physician to determine whether it is an infusion reaction or an adverse drug reaction, and develop a safe dosing plan to continue treatment.
The use of anti-infective drugs need to pay attention to 12 issues Ministry of Health China-Japan Friendship Hospital Pharmacy Department Pharmacist Deng Ang 1, antibacterial drugs, antibiotics are not anti-cold medicine, not all infections need to use antibacterial drugs. Antibacterial drugs are not effective for viral infections, and the use of antibiotics for prevention of viral influenza is ineffective.
2, antibacterial drugs are not the more expensive, the newer the better. There is no difference between high grade and low grade antimicrobial drugs, only the use of the right, wrong and safe, unsafe problem.
3, any kind of antibacterial drugs have their specific antibacterial spectrum, not broad-spectrum is better than narrow-spectrum.
4, the use of antimicrobial drugs must ensure that there is a sufficient dose (including the amount of medication and the number of days of medication), so that the drug in the blood has a sufficient concentration of bactericidal or antibacterial.
5, the use of penicillin class (including oral) drugs must be done before the skin test. Cephalosporins and penicillins have cross-allergenicity, and patients with penicillin allergy should use cephalosporins with caution and do skin test when necessary.
6.When oral antibacterial drugs are taken, drug absorption may be affected by food, and the time of taking should be considered according to the requirements of specific drugs.
7.Pregnant women and nursing mothers should pay special attention to the use of antibacterial drugs, and should take them strictly in accordance with medical advice. Some drugs should be used on balance, and the fetus and infant should be considered as potential recipients of the drug.
8, the use of anti-infective drugs for the elderly and children should take into account the body’s metabolic situation, and the physician should determine the appropriate dose and course of treatment.
9, antibacterial drugs can not be used for a long time, high dose, to prevent the occurrence of dysbiosis resulting in secondary infection.
10, some quinolones anti-infective drugs, minors under 18 years of age is prohibited.
11, intravenous drip antimicrobial drugs, can quickly achieve effective blood concentration, but not all cases of infection require infusion.
12, should pay attention to the antibacterial drugs used and certain drugs, food interactions, such as the prohibition of alcohol, certain fruits, etc..