Antimicrobial Usage & Spread of Resistance

Gary Lum glum at ozemail.com.au
Tue Jan 21 06:17:11 EST 1997


Alan Junkins wrote:
> 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?

Alan,

I'd like to take the liberty of answering your question with two
distinct answers.

1. the best answer is for local medical officers not to prescribe
antimicrobials for frivilous (potential) bacterial infections.  When the
likelihood of a viral aetiology is high, a culture may be collected and
if a pathogenic typical bacterium is isolated then maybe antimicrobials
are warranted.

2. to answer your question specifically, I usually tell patients or
medical officers who refer work to me, that the antimicrobials should be
ceased.  Better to stop the antimicrobials rather than take an agent
with potential side effects (like selection of yeasts, drug fever, rash
etc.).

Hope this helps.

Gary

--
******************************************************** 
Dr Gary Lum
Director of Microbiology
Royal Darwin Hospital

Microbiologists do it with culture and sensitivity 
Meet me at http://www.ozemail.com.au/~glum/index.html
E-mail me at glum at ozemail.com.au or gary.lum at nt.gov.au



More information about the Microbio mailing list