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The antibiotic treatment may select for bacterial strains with physiologically or genetically enhanced capacity to survive high doses of antibiotics. Under certain conditions, it may result in preferential growth of resistant bacteria, while growth of susceptible bacteria is inhibited by the drug. [ 84 ]
Narrow-spectrum antibiotics have low propensity to induce bacterial resistance and are less likely to disrupt the microbiome (normal microflora). [3] On the other hand, indiscriminate use of broad-spectrum antibiotics may not only induce the development of bacterial resistance and promote the emergency of multidrug-resistant organisms, but also cause off-target effects due to dysbiosis.
A major teaching hospital has developed a program on rational drug use, developing a hospital formulary, guidelines for rational diagnosis and treatment guidelines for the rational use of antibiotics. Generic drugs have been available at affordable costs to low-income groups.
Since 2000, IDSA has recommended against long-term antibiotic treatment for Lyme disease, finding that it is ineffective and potentially harmful. [18] [19] The American Academy of Neurology, Centers for Disease Control and Prevention, National Institutes of Health, and medical groups around the world similarly recommend against such treatment.
Antibiotic treatment leading to disruption of the physiological microbiome, thus allowing some microorganisms to outcompete others and become pathogenic (e.g. disruption of intestinal microbiota may lead to Clostridium difficile infection) Medical procedures; Pregnancy
In clinical medicine, antibiotics are most frequently prescribed on the basis of a person's symptoms and medical guidelines.This method of antibiotic selection is called empiric therapy, [1] and it is based on knowledge about what bacteria cause an infection, and to what antibiotics bacteria may be sensitive or resistant. [1]
β-Lactam antibiotics are indicated for the prevention and treatment of bacterial infections caused by susceptible organisms. At first, β-lactam antibiotics were mainly active only against gram-positive bacteria, yet the recent development of broad-spectrum β-lactam antibiotics active against various gram-negative organisms has increased their usefulness.
Uncomplicated bacteremia is defined as having positive blood cultures for MRSA, but having no evidence of endocarditis, no implanted prostheses, negative blood cultures after 2–4 days of treatment, and signs of clinical improvement after 72 hrs. [44] The antibiotic treatment of choice for streptococcal and enteroccal infections differs by ...