Prudent Use of Antibiotics: Are Our Expectations Justified?

Abstract

Prudent use of antibiotics has 3 components, rational use, adherence to local guidelines and policies, and avoidance or reversal of upward demographic trends in antibiotic resistance. Although rational use is mandatory, it must be recognized that adherence to policies will reduce clinical freedom, for good or ill. Expectations that prudent use will deliver reversals in resistance trends should be accepted with caution. Sound, pertinent data are lacking, and our ability to detect change, if it does occur, and to attribute its cause correctly, is questionable.

Prescription Patterns of Antibiotics in Five Dermatologic Outpatient Clinics: A Cross Sectional Study from Yemen

“…Concomitant use of oral and topical antibiotics in acne should be avoided because it may increase the risk of multidrug-resistant bacterial strains and provides no additive benefit; our result is rationally similar to other studies. [3][4][5][6][7][8][9][10][11]12] Eczematous skin often harbors staphylococcus aureus, the density of organisms is greater in exudative lesions than in erythematous or lichenified ones, so antibiotics are indicated when infection is clearly present, but proper therapy must include medication that reduce inflammation such as corticosteroids [3][4][5][6][7][8][9][10][11][12][13] In our study, Macrolides mostly prescribed (39.5%), this may be due to the fact that Macrolides have fewer side effects than penicillin, and in public health centers in Yemen this medicine is distributed to patients for free. Beta-lactam drugs (penicillin, cephalosporin) and Macrolides are the most frequently prescribed antimicrobial agents for skin and soft tissue infections; the present study is in agreement with previous reports.…”

“…The monitoring efficacy, adherence to local guidelines and policies is also other phase. [7,8] There are no studies that examined the rational use and prescription patterns of antibiotics in Aden and this knowledge gap hinders our understanding of the prevailing practices of prescribing antibiotics by dermatologists, where overwhelming number of skin infection cases are being treated. The aim of this study is to describe the prescription patterns and rational use of antibiotics by dermatologists in five main dermatologic clinics in Aden, Yemen.…”

Antimicrobial Stewardship Programs in Health Care Systems

“…Microbiologic outcomes include the percentage of organisms resistant to a certain antimicrobial, percentage of multidrug-resistant organisms, or number of infections due to specified organisms. In spite of the known association between antimicrobial use and resistance, inferring improvement in microbiological outcomes from studies that only demonstrate a reduction in antimicrobial usage is hazardous (124). Differences in potential for selection of resistance between antimicrobials, impact of duration of therapy and dosage changes, and secular trends in resistance may impact resistance rates to a greater extent than changes in absolute quantities of antimicrobial drug use.…”

A multidisciplinary approach to antimicrobial stewardship: evolution into the 21st century

“…It is also assumed that this will be accompanied by improvement in survival. Data to support this second notion are sparse, particularly as there are numerous confounders that can muddy the results [28,60].…”