Rational Antibiotic Use

For rational use of antibiotics; it’s primarily essential to decrease unnecessary use of antibiotics and to minimize its use in every field (human, veterinary, agriculture, livestock breeding, textile etc.) to control existence of antibiotics in the nature. Among them in the short term, the realization of the rational implementation of antibiotics for therapeutic use in humans is particularly important in terms of a greater effect can be achieved from the control of other uses of antibiotics.

Rational implementation of antibiotics necessitates that: the antibiotic therapy should consider the individual characteristics of patients with the right dose of appropriate antibiotics, by the correct route of administration in the right treatment duration. The first point to be noted here, correct evaluation of the necessity of the use of antibiotics and  to inform the patient about this.

To plan a rational drug therapy for a patient, the drug’s efficacy,  safety, cost and the clinical condition of the patient (age, allergy history, kidney and liver function, special situations such as pregnancy, other diseases, lifestyle, drugs being used, etc. ) should be evaluated. Proper information should be given to patients and patients compliance should be followed.

Therefore rational drug use is not just right prescribing it also includes right diagnosis with proper physical examinations and tests, an effective communication with the patient, cooperation with other health personnel and a good follow up of treatment process and patients compliance.

As well as rational antibiotic administration requires all of the general requirements of the above-mentioned rational drug use it also requires  further evaluation in terms of antibiotic resistance.  As an example new drugs  should reserved for the treatment of resistant infections .

As a general principle drugs for treatment of patients with infectious diseases should be choosen between the drugs that  provide the necessary criteria for rational drug selection, with narrower spectrum and older ones (primarily monotherapy).

 However in the cases when the underlying pathogen is unknown and empiric theraphy needed  as soon as possible,  broad-spectrum agents are preferred.  Similarly in some cases combination antibiotic  therapy İs needed to prevent the development of antibiotic resistance. Physician should regularly  follow the national and international  guidelines to make rational decisions and  prescribe in compliance with these guidelines.

When to use antibiotics ?

Infectious diseases are caused by a variety of microorganisms such as bacteria, viruses, fungi and parasites. Like all other diseases treatment of infectious diseases can be divided as drug treatment and non-drug treatment. Non-drug treatment can be used alone or with drug treatment. The idea of non-drug treatment includes to make body defence mechanisms more effective against microorganisms, to  prevent factors that faciliate pathogen microorganisms survival and proliferation  and transmission to other humans. Thus, the treatment of infections can be provided by its own immune system and the effectiveness of antimicrobial may be increased.

Drug treatment of infectious diseases vary according to the causing microorganism. For example,  widely used antibiotic drugs is only effective in the treatment of bacterial infections. Therefore, the use of antibiotics for the treatment of a disease necessitates the  diagnosis of bacterial infections by clinical and / or laboratory tests.

One of the most  common cause of antibiotic use in community is upper respiratory tract infections which majority of these infections are viral. These diseases  are usually self limiting and have a clinical picture of full recovery within 7-10 days  without causing any complications. Antibiotic  use for treatment of viral infections , will not accelerate the healing process and can cause in the selection of antibiotic-resistant bacteria and may lead to the development of antibiotic-resistant bacterial infectious diseases in the patient and community.

As the symptoms of viral infections showed extensive homology to bacterial infections it is important that diagnosis must be set only  by the physician. Physicians diagnosis should compliance with the national and international diagnostic and treatment guidelines.


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