Appropriate prescribing of oral beta-lactam antibiotics.

Abstract

Beta-lactam antibiotics include penicillins, cephalosporins and related compounds. As a group, these drugs are active against many gram-positive, gram-negative and anaerobic organisms. Information based on "expert opinion" and antimicrobial susceptibility testing supports certain antibiotic choices for the treatment of common infections, but less evidence-based literature is available to guide treatment decisions. Evidence in the literature supports the selection of amoxicillin as first-line antibiotic therapy for acute otitis media. Alternative drugs, such as amoxicillin-clavulanate, trimethoprim-sulfamethoxazole and cefuroxime axetil, can be used to treat resistant infections. Penicillin V remains the drug of choice for the treatment of pharyngitis caused by group A streptococci. Inexpensive narrow-spectrum drugs such as amoxicillin or trimethoprim-sulfamethoxazole are first-line therapy for sinusitis. Animal and human bites can be treated most effectively with amoxicillin-clavulanate. For most outpatient procedures, amoxicillin is the preferred agent for bacterial endocarditis prophylaxis. Beta-lactam antibiotics are usually not the first choice for empiric outpatient treatment of community-acquired pneumonia. Based on the literature, the role of beta-lactam antibiotics in the treatment of bronchitis, skin infections and urinary tract infections remains unclear.

• Authors: K B Holten, E M Onusko
• Journal: American family physician (Am Fam Physician) Vol. 62 Issue 3 Pg. 611-20 (Aug 01 2000) ISSN: 0002-838X [Print] United States
• PMID: 10950216 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Bacterial Agents
• beta-Lactams

Topics

• Administration, Oral
• Adult
• Anti-Bacterial Agents (administration & dosage, adverse effects, classification, therapeutic use)
• Bacterial Infections (drug therapy)
• Drug Prescriptions
• Humans
• beta-Lactams