Bacterial infections are a leading cause of morbidity and mortality. Accurate diagnosis and appropriate, cost-effective treatment are essential. Incorrect and overuse of antibiotics facilitates the development and growth of drug resistant bacteria, which are in turn difficult to treat. Specific treatments for the various infections are discussed under their respective heading. Generally, the following should be taken into account:
The organisms responsible for infections depend on the age of the victims.
The management of infections depends on their severity.
Underlying conditions like immune depression determines the bacterial infections involved and type of treatment required.
The organisms and the treatment for community acquired infections differ from hospital acquired ones.
Antibiotic dosage and the side-effects vary with age.
Drug sensitivity to antibiotics is constantly changing.
Treatments should be given using correct doses for the various conditions and compliance with drug administration should be encouraged for complete treatment.
Leftover drugs should be discarded to avoid poisoning.
In some conditions you may need to start with what is labeled as the second line or switch very quickly to the second line if the patient is deteriorating fast. These patients should be managed in the hospital.
Penicillin refers to narrow spectrum penicillin such as benzyl penicillin, procaine penicillin, and phenyxymethyl penicillin. Benzylpenicillin is used in moderate to severe infections where high blood levels are required, and because of its short half-life is given 4-6 hourly. Procaine penicillin is given by intramuscular route and is used in uncomplicated pneumonia.
Gentamicin doses should be adjusted according to renal function.
Chloramphenicol’s oral absorption is excellent and peak plasma levels are reached at the same time whether given intravenously or orally. Fatal toxicities include aplastic anaemia (not dose related) and grey baby syndrome (dose related)
