It's all about the Rational use of Antibiotics. It will help medical students and health personnel to work out.

1. Presented By-
Raihan Hossain
Date of Presentation: 05/07/2018
Rational Use Of Antibiotics

2. Objectives
• Define the term ‘antibiotic’ and ‘antimicrobials’
• List the names of commonly used antibiotics
• Identify key risks associated with antibiotic use
• Describe the role of different antibiotic in
several diseases
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3. What are antibiotics?
• Any substance that inhibits the growth and replication of a bacterium or
kills it outright can be called an antibiotic.
• Antibiotics are used to treat bacterial infections. Some are highly
specialized and are only effective against certain bacteria. Others, known
as broad-spectrum antibiotics, attack a wide range of bacteria, including
ones that are beneficial to us.
• The term antimicrobials is accepted as a broader definition, and includes
medicines used for:
bacterial
viral
fungal
parasitic
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infections

4. Examples of antimicrobials
Antimicrobial
Group
Class Examples
Antibacterials
(antibiotics)
Penicillins • Flucloxacillin (Flopen, Flucil)
• Amoxycillin + clavulanate (Augmentin, Clamoxyl)
• Piperacillin + tazobactam (Tazocin)
Cephalosporins • Cephalexin (Keflex, Ibilex)
• Cephazolin (Kefzol)
• Ceftriaxone (Rocephin)
Macrolides • Azithromycin (Zithromax)
• Roxithromycin (Rulide)
Antifungals Azoles • Fluconazole (Diflucan)
• Voriconazole (Vfend)
Antivirals Guanine
analogues
• Aciclovir (Zovirax)
• Valaciclovir (Valtrex)
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5. How many hospital patients are on
antibiotics at any one time?
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Frequency of antibiotic use
35 to 50%
(i.e. These are very common medications!)

6. Why is it important to use
antibiotics with care?
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1. Antibiotics are life-saving medicines
2. Only effective if the antibiotic works against
the organism causing infection
3. Risk of side effects and harm
4. Use of antibiotics can contribute to the
problem of antimicrobial resistance

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8. Chemotherapy of bacterial meningitis when the cause is
known
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9. Antibiotic treatment for CAP*
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10. Enteric Fever
• A number of different antibiotics are used to treat
typhoid fever. In most parts of the world,
fluoroquinolones (usually or ) are the drug of choice
for empiric treatment of typhoid fever. However, in
recent years, there has been increasing
fluorquinolone-resistant and multidrug-resistant
strains (resistant to , amoxacilline, chloramphenicol,
and -sulfamethoxazole) of Salmonella typhi.
Recently, some physicians have started using , but
azithromycin-resistant strains have already been
identified. There are other alternative antibiotics
when resistance is suspected. Most commonly used
antibiotics in multidrug-resistant strains are the
injectable third-generation cephalosporins.10

11. Antibiotic regimen for urinary tract infection in adults
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12. Australian Medicines Handbook, 2014
Adverse effects of antibiotics
• Common side effects: rash, nausea or diarrhoea
• More serious reactions include immediate
hypersensitivity (severe allergy) or angioedema
• The risk of Clostridium difficile infection is
significantly raised in patients on broad-spectrum or
multiple antibiotics, particularly when used for
prolonged periods
• This condition can be a very serious complication for patients
who are already unwell or frail, and can be very difficult to treat
• Some antibiotics are higher risk (e.g. cephalosporins, co-
amoxiclav, clindamycin and ciprofloxacin – known as “the 4 C’s”)
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13. Impact on current and future patients
• Antibiotic use contributes to the
development of antibiotic resistance
– For most medicines, side effects are limited to the
individual patient
– Resistance developed from exposure to an
antibiotic may affect the patient, but also affects
future patients and the wider community
– This reduces the number of effective antibiotics
available to treat infections
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14. CDC Antibiotic resistance threats in the United States, 2013
Antibiotic resistance
• When bacteria develop new ways to defend
against antibiotics, this is called ‘antibiotic
resistance’
• Resistance to an antibiotic means the drug is no
longer effective against the infecting bacteria
• Examples:
– Methicillin-resistant Staphylococcus aureus (MRSA) cannot
be treated with flucloxacillin
– Vancomycin-resistant enterococci (VRE) cannot be treated
with vancomycin
– Carbapenem-resistant Enterobacteriaceae (CRE) cannot be
treated with meropenem or other carbapenems
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15. Image courtesy of CDC / Melissa Brower
Centers for Disease Control and Prevention Public Health Image Library
http://phil.cdc.gov/phil/home.asp
Development of Antibiotic Resistance

16. • Selective advantage
– Bacteria that contain resistance mechanisms can
survive and multiply when exposed to antibiotics
• Gene transfer
– Allows bacteria to share genes that cause antibiotic
resistance
• Cross-resistance
– Changes in bacteria which create resistance to one
antibiotic may cause resistance to other antibiotics
as well
Development of Antibiotic Resistance

17. Image courtesy of CDC /
Melissa Brower
Centers for Disease Control
and Prevention Public Health
Image Library
http://phil.cdc.gov/phil/home.
asp
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18. Key messages
• Antibiotics are essential medicines in healthcare
and are used to treat bacterial infections
• There are many types of antibiotics used in
hospital patients
• Using the most suitable antibiotic in a patient
minimises the risk of harm to the patient
• Antibiotic resistance is a global problem, and
responsible antibiotic use is needed
• Discussing antibiotic therapy with patients during
their hospital stay can help to ensure antibiotics
are used properly
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19. Thank you
Any Questions?
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