Brief: When should you use anti-infective drugs?
This Summary is an adaptation of the Clinical Info on Medical Emergencies provided by the Canadian Pharmacists Association (CPhA)
Consider the following when prescribing antibiotics:
- Use only when there is an indication.
- Use only when the risk-benefit ratio is favourable.
- They are not a substitute for establishing adequate drainage.
- Choose an effective agent with the narrowest spectrum of activity.
- Prescribe a therapeutic dose and consider a loading dose.
- Prescribe at an appropriate frequency and for an appropriate duration.
- Choose the drug with the fewest side effects.
- Consider laboratory culture and sensitivity tests to target specific bacteria with antibiotics identified as effective.
- Recognize that antibiotics encourage development of resistance, if used for a long duration and/or at suboptimal doses.
- In superficial infections, consider alternatives to antibiotics, such as topical debridement and application of topical antiseptics when appropriate.
- Consider individual patient factors, such as age, allergies and drug interactions, especially with azole antifungals (fluconazole, itraconazole, ketoconazole), clarithromycin, erythromycin, metronidazole, tetracyclines; consult individual product monographs and drug interaction references.
- Consider cost.
Antibacterial Dosages for Orofacial Infections.
Antifungals for the Treatment of Oral Candidiasis
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Clarithromycin, Doxycycline and Erythromycine are not a good choice for the treatment of infections of dental origin. Likewise Cephalosporins are a poor choice. I suggest that readers take a look at the book “Bugs and Drugs” page 503. I believe this book has been distributed free of charge by the respective governments to dentists in BC and Alberta.
I an sending a copy of this page by fax to CDA.