What
Consumers Need
To Know About Antibiotics
(Part 1)
Yolanda
R. Robles, PhD
Antibiotics are
one of the most commonly prescribed groups of drugs, both for the
treatment and prevention of infectious diseases. They may be indicated
for diagnosed infections of the human body and may also be used
as prophylaxis for certain conditions or procedures. While these
drugs are to be taken by patients only when prescribed by a doctor,
it has become commonplace for Filipinos to self-medicate on suspected
infections. The usual reason is financial, in that they have to
skip paying for a consultation with the doctor. Sometimes, patients
self-medicate for convenience's sake. But unknown to many patients,
this practice is contributing to the inappropriate use of these
powerful drugs which may result to additional or more serious health
problems. It is therefore important for any person to know the following
facts about antibiotics before deciding on their use.
FACT
1: AN ANTIBIOTIC CANNOT BE USED
FOR ANY INFECTION
Antibiotics can
be classified into two groups: broad- and narrow-spectrum antibiotics.
Broad-spectrum antibiotics are effective against a wide range of
infectious microorganisms while the narrow-spectrum antibiotics
are specific for certain types of microorganisms. As such, you cannot
expect any antibiotic to be effective for all types of infection.
For example, some antibiotics are good only for upper respiratory
tract infections caused by Gram-positive microorganisms. In that
case, they may not be effective against Gram-negative bacteria causing
urinary tract infections. You have to know the medical indication
of an antibiotic.
FACT
2: AN ANTIBIOTIC THAT WORKS FOR ANOTHER PERSON DOES NOT NECESSARILY
WORK FOR YOU
An antibiotic that
is effective for another person does not necessarily work for you
even when both of you experienced similar symptoms. For example,
there are various microorganisms that cause sore throat and they
respond variably to different drugs. Unless a culture sensitivity
test is done, a chosen antibiotic may or may not provide the cure.
Ideally, a physician has to depend not only on the observed symptoms,
he has to rely also on some diagnostic or laboratory tests and has
to consider patient, disease and drug factors before making a decision
on a patient's treatment. That is one reason why a patient has to
depend on a health professional to decide on medical problems.
FACT
3: THE DOSE AND DURATION OF AN ANTIBIOTIC AFFECT THE OUTCOMES OF
TREATMENT
Before drugs are
made into dosage forms like tablets, capsules and injection, their
effective dose range has to be determined first. For antibiotics,
their minimum and maximum inhibitory concentrations are first determined
experimentally and clinically before the dosage regimen is set.
Once the dosage regimen is established, a patient who takes less
than the therapeutic dose or a person who stops taking the drug
before the prescribed period of time will not get optimum benefit
from the drug. A number of antibiotic users do stop taking the medicine
once symptoms subsided, little did they know that microorganism
though reduced in number are still capable of multiplying and that
they can transform into strains resistant to the drugs used.
FACT
4: IMPROPER ANTIBIOTIC USE MAY LEAD TO MORE SERIOUS HEALTH PROBLEMS
When a person takes
an antibiotic without proper medical guidance, there is greater
chance of misusing it. I remember a time in the 1970s when mothers
use chloromycetin for any diarrhea in children, that is, even without
prescription. Little is known of the adverse effects of the drug
at that time among the laymen. However, with the advent of more
information about the drug's adverse effects on children, it became
clear that Gray's syndrome toxicity might occur especially for those
with undeveloped liver or those with liver impairment. In adults,
improper use may lead to bone marrow depression. These additional
medical problems would require more medicines, may affect quality
of life and may bring about unnecessary expenditure for the family.
The World Health
Organization reported that antibiotics for tuberculosis and malaria
are no longer effective against some strains of the microorganisms
causing these diseases. Why? People have used antimalarial drugs
indiscriminately, even for very common symptoms like headache and
muscular pain. The practice gave rise to highly resistant strains
of the microorganisms which do not respond to the standard antibiotic
treatment.
(To
be continued in Part 2)
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