Antimicrobial Usage & Spread of Resistance

Alan Junkins JunkinsA at SMTPGW2.MUSC.EDU
Mon Jan 20 15:53:49 EST 1997


Just thought I'd ask a question of any pharmacy
types out there.  We've all heard about how one
of the main causes for the spread of
antimicrobial resistance among bacteria is
improper usage, including taking an
antimicrobial for two days until you feel better,
then neglecting to take the final eight days of
the regimen.  If that's the case, then which is
better in this scenario -  Patient goes to the
physician with a possible infection.  The
physician prescribes an antimicrobial, most
likely a fairly broad spectrum drug, and sends a
specimen to the laboratory for culture.  The next
day culture results come back negative. 
Obviously at this point the best thing for the
patient's microbial health is to stop taking the
antimicrobial.  But which is better for
minimizing spread of antimicrobial resistance
in the population - stop taking the drug, or
continue through the full ten day course?  In
other words, is it better to fully treat a
non-existent infection and completely obliterate
susceptible members of the normal flora, or
expose the normal flora to an incomplete
course of the drug?



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