What are the consequences of refusing or reducing the amount of antibacterial agents?

[ China Pharmaceutical Network Health and Health ] In recent years, the state has been strictly controlling the abuse of antibacterial drugs, and has issued a series of laws and regulations to regulate the use of antibacterial drugs in medical institutions. Larger publicity education, scientific popularization, and introduction of the serious consequences of antimicrobial abuse, such education science has gradually formed a positive impact on the public.

(What are the consequences of refusing or reducing the amount of antibacterial agents? Image Source: Baidu Pictures)

An antibacterial agent generally refers to a drug having bactericidal or bacteriostatic activity, certain products obtained by culturing microorganisms such as bacteria, actinomycetes, fungi, or the like, or the same or similar substances obtained by chemical semi-synthesis and total synthesis. Antiviral drugs are not antibacterial drugs.

In 1928, the Englishman Fleming stumbled upon penicillin in the experiment. This is a very important event in the history of human medicine and even in the history of science. It once made people think that they can completely overcome various infectious diseases. In fact, everyone was very clear about the "double-edged sword" effect of antibacterial drugs. If used well, it can cure diseases. If it is not used well, it will cause illness.

In China, for a long time, people generally think that "anti-inflammatory drugs" are very easy to use, from small infections to multiple infections of various complex bacteria, and they all use antibacterial drugs. (In fact, the term "antibacterial drugs" is called "anti-inflammatory drugs", which is very unprofessional. Anti-inflammatory drugs are "commonly known", a drug that allows the body to lift the alarm and let the immune system reduce or stop the attack. Generally refers to the drug. Non-steroidal anti-inflammatory drugs or glucocorticoids, such as aspirin, acetaminophen, prednisone, etc., but not antibacterial drugs.)

In response to this abuse of antibacterial drugs, the state has been strictly controlling in recent years, and has introduced a series of laws and regulations to regulate the use of antibacterial drugs in medical institutions. Larger publicity education, scientific popularization, and introduction of the serious consequences of antimicrobial abuse, such education science has gradually formed a positive impact on the public.

At present, most people already know that some diseases without bacterial infections such as colds, headaches, fever, etc. should not use antibiotics. It is also clear that most antibacterial drugs need to be used under the guidance of doctors and pharmacists to hoard antibacterial drugs at home. The phenomenon is also gradually decreasing.

However, another "extreme" situation has emerged. Some people think that since antibacterial drugs are "poisons", they will be rejected when the disease that requires the use of antibiotics occurs, or the dosage can be reduced and the course of treatment shortened. Rejection, use less, and the disease has not been cured, it will not be used, and it will not achieve the purpose of treating diseases, but it may lead to a situation similar to "double infection" and even induce bacterial resistance. Relative to "abuse", "rejection" and "less use" of antibacterial drugs are equally harmful, which is an overkill. So, how should antibacterial drugs be used safely, reasonably, effectively and economically?

Which diseases must use antibiotics

Antibacterial drugs are mainly used for the treatment of various infectious diseases such as bacteria, mycoplasma, chlamydia, spirochetes, fungi, etc. In principle, the above infections are not suitable for antibacterial drugs. Antibacterial drugs are not effective against various viral infections (typically influenza or varicella), and antiviral drugs should not be used for viral diseases.

In addition, antibacterial drugs can also be used for the prevention of post-operative infections, although some clinical trials do not advocate the use of antibacterial drugs to prevent infection. Some patients do not understand the doctor's antibiotics after surgery. In fact, infection is one of the most common postoperative complications. Therefore, for some infections that may cause infection, especially open surgery, antibiotics should be used after surgery. Infected pointer. These include: the gastrointestinal tract (starting from the oropharynx), the respiratory tract, the female genital tract surgery and cardiac prosthetic valve replacement, artificial joint replacement, and craniotomy, heart and large vascular surgery, intraocular surgery, etc. .

How long is the routine use of antibacterial drugs?

The course of use of antibacterial drugs varies depending on the degree of infection, and is generally suitable for 72 to 96 hours after the body temperature returns to normal and the inflammatory symptoms subsides. However, severe infections such as sepsis, infective endocarditis, purulent meningitis, typhoid fever, brucellosis, osteomyelitis, hemolytic streptococcal pharyngitis, tonsillitis, deep mycosis, tuberculosis, etc. require longer medications. In order to completely cure and prevent recurrence.

Taking common pneumonia as an example, for infections caused by common bacteria such as Streptococcus pneumoniae, antibacterial drugs can be applied to 72 hours after antipyretic; for Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella or erythema Oxygen bacteria and other infections that are easily caused by pathogenic bacteria that cause necrosis of lung tissue. The course of general antibacterial drugs should be about 2 weeks. For atypical pathogens such as M. pneumoniae or chlamydia, the course of treatment is usually 10~. 14 days; treatment of infection caused by Legionella, usually 10 to 21 days. In fact, in the treatment of diseases, the main purpose of using antibacterial drugs in the past few days is to relieve symptoms, and in the next few days, it is essential to completely kill pathogens and prevent resurgence.

What is the general dose of antibacterial drugs?

Treatment of severe infections (such as: sepsis, infective endocarditis, etc.) and antibiotics are not easy to reach the site of infection (such as central nervous system infections, meningitis, etc.), the dose should be larger (generally take the high limit of the therapeutic dose) In patients with severe systemic infection, intravenous administration should be preferred, and the patient should be switched to oral therapy as soon as the condition improves.

For the treatment of mild or single infections, such as simple urinary tract infections, small doses (usually the lower limit of the therapeutic dose) can be applied. For those with mild infection, oral administration is preferred, intramuscular injection is selected, and veins are avoided as much as possible. Instillation, in fact, the risk of intravenous administration is comparable to a "small surgery."

What are the consequences of refusing or arbitrarily reducing the dose?

The refusal to use antibacterial drugs is definitely a mistake of "disposing of food." Infections change from light to heavy, disease prolongs, impairs function, and even life-threatening. In fact, the adverse reactions of antibacterial drugs are not terrible. The terrible thing is that they are overly worried and delay the best time to use them. As long as it is used under a reasonable and safe track, antibacterial drugs must be a weapon against infection.

The use of antibacterial drugs, the infection is alleviated, the symptoms are relieved, and at this time, it is even more difficult to reduce or discontinue the drug at will. Because blindly reducing the dose of antibacterial drugs and shortening the course of use, it is not only not conducive to exerting its bactericidal and bacteriostatic effects, but is also likely to cause a large number of mutant strains to mutate while killing some sensitive strains. Relief, but with the proliferation of resistant strains, the infection will come back again. At this time, the original antibacterial drugs will be used, and the anti-infection effect will be greatly reduced or even invalidated. The "screening" process of this "distorted" mutant strain leads to a situation similar to "double infection", and bacterial resistance also occurs, with very serious consequences.

Antibacterial drugs are "double-edged swords". Abuse can induce bacterial resistance and cause flora disorder. Rejection and seldom use can also lead to serious consequences. Clinical examples are shocking. What diseases need to use antibacterial drugs, what problems need to be paid attention to when using antibacterial drugs, how to face up to the adverse reactions of antibacterial drugs, how to truly use safe and reasonable use of antibacterial drugs is not only a matter of doctors and pharmacists, but also should be the concern of all sectors of society. The focus, overkill, must not be done.

Please remember: 1. Antibacterial drugs are only used for bacterial infections and partial surgical prevention, and are not used for viral infections. 2. The course of antibiotics varies depending on the degree of infection. It is generally recommended to use 72 to 96 hours after normal temperature and symptoms have subsided. 3. Mild infection should be taken orally, and severe infection can be considered for intravenous administration. 4. Rejection is dangerous. Reducing the dose or stopping the drug without authorization may also cause bacterial resistance and recurrent episodes of infection, which is also undesirable.

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