Because antibiotics can be used to treat various infectious diseases, some people regard antibiotics as a panacea and treat them no matter what diseases they have. You know, the abuse of antibiotics will cause many adverse consequences. Therefore, it is necessary to emphasize the rational use of antibiotics and attach importance to the side effects of antibiotics. So, how to use antibiotics reasonably?
(1) Viral diseases should not be treated with antibiotics. Upper respiratory tract infection, sore throat and angina are mostly caused by virus infection, so these diseases should be treated with antiviral drugs such as virus spirit, virus cup and Chinese herbal medicine without antibiotics.
(2) Antibiotics should be selected according to the results of bacterial culture and drug sensitivity test. However, if the condition is limited or the condition is critical, it can also be selected according to the infection site and experience, but the reliability is poor. Generally speaking, Gram-positive cocci are the most common respiratory infections. Gram-negative bacteria are common in urinary tract and biliary tract infections. Staphylococcus aureus is the most common infection in skin wounds.
(3) Antibiotics can cure diseases, but they also have side effects. No antibiotic is absolutely safe without side effects. Such as streptomycin, gentamicin, kanamycin, etc., can damage the eighth cranial nerve and cause deafness. Penicillin can cause anaphylactic shock, rash and drug fever. The application of broad-spectrum antibiotics, such as tetracycline, will lead to a large number of drug-resistant bacteria in the body, thus causing new and more serious infections. Therefore, the use of antibiotics should be targeted and not abused.
(4) Newborns, the elderly and people with hepatic and renal insufficiency should avoid or use more toxic antibiotics, which are mainly excreted by liver metabolism and kidney.
(5) Preventive use of antibiotics should be strictly controlled, and the use of antibiotics in skin, mucosa and other parts should be avoided as far as possible, because it is easy to cause allergic reactions and drug-resistant strains.
Adverse reactions of antibacterial drugs and their prevention and treatment
After the clinical application of antibacterial drugs, especially antibiotics, the mortality of many infectious diseases has been greatly reduced, and the prognosis of some diseases that were previously considered incurable, such as infective endocarditis and tuberculous meningitis, has also been greatly improved. But at the same time, it also brings adverse reactions, which can lead to disability or death in severe cases. When people actually use antibacterial drugs, they often only pay attention to their therapeutic effects and pay insufficient attention to adverse reactions, which leads to treatment failure.
Adverse reactions of antibacterial drugs are mainly manifested in the following aspects:
Toxic reactions refer to physiological and biochemical abnormalities and pathological changes of tissues and organs caused by antibacterial drugs, and their severity generally increases with the increase of dose and the extension of treatment course, and most of them are reversible reactions. Toxic reaction is one of the most common adverse reactions, mainly in kidney, nervous system, liver, blood, gastrointestinal tract, local administration and so on. Generally speaking, aminoglycosides, polymyxin, vancomycin, penicillin and cephalosporins are prone to produce multi-system toxic reactions.
Allergy Almost every antibiotic will cause some allergic reactions, the most serious of which is anaphylactic shock, which is mostly caused by penicillin. The most common is rash, which can be caused by various antibiotics; Seropathy-like reactions characterized by fever, joint pain and urticaria are more common in penicillin and cephalosporins. Vancomycin can cause red man syndrome. In addition, there are drug fever, photosensitive reaction and so on.
Double infection refers to the new infection during the use of antibacterial drugs. It is because after a long period of extensive use of broad-spectrum antibiotics, the sensitive flora is inhibited, and the uninhibited flora takes the opportunity to reproduce. The pathogens of double infection are often resistant to a variety of antibacterial drugs, and the human body's resistance is obviously reduced due to the primary disease and/or primary infection. Double infection is often difficult to control and the mortality rate is high.
Rational use of antibiotics
Recently, some medical experts wrote to this newspaper to remind consumers to get out of the misunderstanding of using antibiotics.
Myth 1: expensive is good. Antibiotics are definitely not as expensive as possible. Only antibiotics for infected bacteria are effective.
Myth 2: New drugs are better than old ones. In fact, the advantages and disadvantages of each antibiotic are different, depending on the disease. Some old drugs have stable curative effect and low price, and the curative effect may be better if they are not used frequently.
Myth 3: Antibiotics are hidden at home. The doctor's advice is that it is best not to store antibiotics at home, avoid indiscriminate use of drugs, and avoid taking expired, deteriorated and ineffective antibiotics by mistake.
Myth 4: It is a good thing to get quick results. In fact, for acute infections, antibiotics usually take 3 to 5 days to take effect. Remember, the principle of using antibiotics is to use low-level antibiotics, not high-level, and use one to solve the problem without two.
Myth 5: Take it irregularly. The efficacy of antibiotics depends on their reaching a certain concentration in the body. If it can't be achieved, it can't be completely sterilized, but it will make bacteria resistant. And in order to restore health as soon as possible and increase the dose of behavior, the consequences are the same.
Myth 6: Preventive use. When people around you have a cold, fever or illness, some people take antibiotics, thinking that this can prevent infection. However, in most cases, this not only can not effectively prevent the occurrence of infection, but also may bring adverse reactions and increase the chance of drug resistance. (Heilongjiang Daily)
Abuse of antibiotics can lead to serious consequences. On the contrary, as long as antibiotics are used reasonably, life-saving effects can be achieved. Rational use of antibiotics should pay attention to the following points:
1. Choosing effective drugs should master the antibacterial spectrum of different antibacterial drugs, so that the antibacterial spectrum of the selected drugs can adapt to the infected microorganisms. For example, the antibacterial spectrum of penicillin mainly includes some cocci and some gram-positive bacilli. Streptococcus is an important pathogen causing upper respiratory tract infection, and it is sensitive to penicillin, so penicillin should be selected. When penicillin cannot be used, erythromycin or cephalosporin can be considered. Gentamicin is not suitable for streptococcal infection, because most streptococci are not sensitive to aminoglycoside antibiotics, and often fail to achieve the desired curative effect after application.
When choosing antibiotics, we should also consider their absorption and distribution characteristics. For the treatment of intracranial infection, drugs with good blood-brain barrier performance should be selected, such as chloramphenicol, sulfanilamide, penicillin and ampicillin. However, aminoglycosides and macrolides are not easy to penetrate the blood-brain barrier and should not be used.
2. Application Methods After rational drug selection, the dosage regimen should be determined according to its pharmacokinetic properties. For example, the intermediate sulfanilamide should be given twice a day according to the interval of t 1/2. Too little can't maintain the effective blood concentration, and too much can cause cumulative poisoning. Antibacterials often need to reach a certain blood concentration in body fluids to maintain their pharmacological effects. However, sterilization drugs (penicillin and cephalosporin) in the reproductive period need to enter the body quickly in a short time and reach a high blood concentration (intermittent shock therapy) in order to play a better bactericidal role.
3. Indications for combined use of antibiotics The purpose of combined use of antibiotics is to improve the curative effect, reduce the dosage, obtain the synergistic effect of drug efficacy, expand the antibacterial scope, and prevent or delay the emergence of bacterial drug resistance. However, its disadvantage is that the incidence of adverse reactions increases, which can cause double infection and lead to drug resistance of bacteria to various antibacterial drugs. Therefore, it needs to be strictly controlled in clinic, and the following situations often occur in combination medication:
The clinical application of antibiotics must consider the following basic principles:
(1) Strictly grasp the indications of whether it can be used or not, and try not to use it. In addition to considering the pertinence of antibacterial effect of antibiotics, we should also grasp the relationship between adverse reactions of drugs and internal processes and curative effects.
(2) People with fever of unknown cause should not use antibiotics, except those who are critically ill and highly suspected of being infected with bacteria. People with fever of unknown cause should not use antibiotics, because the use of antibiotics often makes it difficult to detect pathogenic microorganisms, and makes clinical manifestations atypical, affecting clinical diagnosis and delaying treatment.
(3) Viral diseases or diseases estimated to be viral infections have no curative effect on various viral infections without antibiotics, and it is also harmless and useless to treat patients with measles, mumps, colds and influenza with antibiotics. More than 90% of patients with angina pectoris and upper respiratory tract infection are caused by viruses, so antibiotics are generally not used except those who are infected by bacteria.
(4) Try to avoid the reaction of skin and mucous membrane. After using antibiotics, allergic reactions and drug-resistant bacteria are easy to occur. Therefore, in addition to the main local antibiotics such as neomycin and bacitracin, the local application of other antibiotics, especially penicillin G, should be avoided. When using antibiotics in ocular mucosal and skin burns, the appropriate period and dosage should be selected.
(VI) Emphasize the importance of comprehensive treatment In the process of using antibiotics to treat infectious diseases, we should fully realize the importance of the human defense mechanism, and we should 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 immunoglobulin are insufficient, the cellular immune function is low, or the performance and quality of phagocytes are insufficient, antibiotic treatment is difficult to be effective. Therefore, when using antibiotics, we should try our best to improve the general condition of patients; Take various comprehensive measures to improve the body's low resistance, such as reducing the patient's excessive body temperature; Pay attention to diet and rest; Correct the imbalance of water, electrolyte and alkali; Improve microcirculation; Replenish blood volume; And the treatment of local diseases.