Antibiotics: What they are and How to use them. Lesson from Book "Where there is no doctor"

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&7/%, (Bivet Fleer) Si. Marks nooe, .
oe aenqalora - 6609 001,

CHAPTER

| ANTIBIOTICS: WHAT THEY ARE
", AND How To USE THEM

te teeeneenrereten <usnues veneer oe

This is a reprint from

Where There Is No Doctor

(Indian adaptation)

published by the

Voluntary Health Association of India
C-14 Community Centre
Safdarjung Development Area
New Delhi 110016

Si

Pale

‘COMMUNITY HEALTH CELL

CHAPTER

ANTIBIOTICS: WHAT THEY ARE
AND HowW TO USE THEM

When used correctly, antibiotics are extremely useful and important medicines.
They fight certain infections and diseases caused by bacteria. Well-known
antibiotics are penicillin, tetracycline, streptomycin, and chloramphenicol. In this
book the sulfa drugs, or sulfonamides, are also considered as antibiotics.

The different antibiotics work in different ways against specific infections. All
antibiotics have dangers in their use, but some are far more dangerous than others.
Great care must be taken in the choice and use of antibiotics.

There are many kinds of antibiotics, and each kind is sold under several ‘brand
names’. This can be confusing. However, the most important antibiotics fall into
a few major groups:

antibiotic group examples of. brand names see
(generic name) brand names in your area page
(write in)
PENICILLINS Ee Pahidure ea ne
TETRACYCLINES Terramycin Boies GS Ei 400
SULFONAMIDES Gantrisin eee SS 402
CHLORAMPHENICOL Chloromycetin 401
ERYTHROMYCIN _— Erythrovin 400
AMPICILLINS* Ampiltin Sein 399
STREPTOMYCIN Ambastrim en 403

“Note: Ampicillin is a type of penicillin that kills more kinds of bacteria than do
ordinary penicillins.

If you have a brand-name antibiotic and do not know to which group it belongs,
- read the fine print on the bottle or box. For example, if you have some Paraxin ’S’
but do not know what is in it, read the fine print. It says ‘chloramphenicol’.

SS Look up chloramphenicol in the GREEN
4 = PAGES (p.401). You will find it must be
ae used only for a’ few very serious illnesses, like
Each capsule contains ; typhoid, and is especially dangerous when

Chioramphenicol ... 250 ma.

given to the newborn.

Never use an antibiotic unless you know to what group it belongs, what
diseases it fights, the correct dose for that disease and the precautions you must
take to use it safely.

eo Fd

68

information on the uses, dosage, risks, and precautions for the antibiotics
recommended in this book can be found in’the GREEN PAGES. Look for the
name of the medicine in the alphabetical list at the beginning of those pages.

GUIDELINES FOR THE USE OF ALL ANTIBIOTICS

1. lf you do not know exactly how to use the antibiotic and what infections it
can be used for, do not use it.

2. Use only an antibiotic that is recommended for the infection you wish to
treat. (Look for the illness in this book.) | :

3. Know the risks in using the antibiotic and take all the recommended
precautions (see the GREEN PAGES). ,

4. Use the antibiotic only in the recommended dose—no more, no less. The
dose depends on the illness and the age or weight of the sick person.

5. Never use injections of antibiotics if taking them by mouth is likely to work
as well. Inject only when absolutely necessary.

6. Keep using the antibiotics until the illness is completely cured, or for at least
2 days after the fever and other signs of infection have gone. (Some illnesses, like
tuberculosis and leprosy, need to be treated for rnmany months or years after the
person feels better. Follow the instructions for each illness.) 7

7. \f the antibiotic causes a skin rash, itching, difficult breathing, or any serious
reactions, the person must stop using it and never use it again (see p. 82).

8. Only use antibiotics when the need is great. When antibiotics are used too
much they begin not to work as well. : |

9. Always give vitamin B tablets along with any antibiotic taken by the mouth

GUIDELINES FOR THE USE OF CERTA/N ANTIBIOTICS

1. Before you inject penicillin, ampicillin, always have ampules of adrenalin
(epinephrine) ready to control an allergic reaction if one occurs (p81) Keep
adrenalin ready both before and after doing a sensitivity test (p. 91)

2. For persons who are allergic to penicillin, use another antibiotic such as
erythromycin or a sulfa (see p.400 and 402) |

3. Do not use tetracycline, or another broad-spectrum antibiotic, for an illness
that can probably be controlled with penicillin or another narrow-spectrum
antibiotic (see p. 70)

4. Asa rule, use chloramphenicol only for typhoid fever. It isa dangerous drug.
Never use it for mild illness. And never give it to newborn children

©. Never inject tetracycline or chloramphenicol. They are safer, less painful
and do as much or more good when taken by mouth.. : |

6. Do not give tetracycline to Pregnant women after the fourth month or to
children under 6 years old (see p. 401). | ) |

7.Use streptomycin and products that contain it only for tuberculosis.-- and

always together with another anti-tuberculosis medicine (see P. 403).

:

G, | Es

8. Donotapply penicillin ointment or powder locally onthe skin or anopen wound. -

This may make the person allergic to penicillin. The person may also develop
resistance to penicillin and will need stronger ana more expensive medicines to
cure a simple disease (p. 397).

WHAT TO DO IF AN ANTIBIOTIC DOES NOT SEEM TO HELP

For most common infections antibiotics begin to bring improvement in a day

or two. If the antibiotic you are using does not bring any improvement, it is

possible that: SS ,
rT. The illness is not what you think. You may be using the wrong medicine.
Try to find. out more exactly what the illness is—and use the right medicine.
2. The dose of the antibiotic is not correct. Check it.
3. The bacteria have become resistant to the antibiotic being used (they no

longer are harmed by it). Try another one of the antibiotics recommended for

that illness.

4. You may not know enough to cure the illness. Get medical help, especially
if the-condition is serious or getting worse. ? Be | |

These three children had a cold...

What was _ eh hac What took. Why did this child.
the villain? bie fo the toll? is 3 igpeen again?

eo)

Penicillin! : Chloramphenicol! He got no
| _risky medicine—
(see Allergic (see risks and precautions - just fruit juice,
Shock, p.83) for this drug, p. 401) good food, and rest.

Antibiotics do no good for the common cold.
Use antibiotics only for infections they are known to help.

69

70

IMPORTANCE OF LIMITED USE OF ANTIBIOTICS

The use of all medicines should be limited. But this is especially true of
antibiotics. for the following reasons:

1. Poisoning and reactions. Antibiotics not only kill bacteria, they can also
harm the body, either by poisoning it or by causing allergic reactions. Many
people die each year because they take antibiotics they do not need.

2. Upsetting the natural balance. Not all bacteria in the body are harmful.
Some are necessary for the body to function normally. Antibiotics often kill the
good bacteria along with the harmful ones. Babies who are given antibiotics
sometimes develop fungus infections of the mouth (thrush, p: 276) or skin
(moniliasis, p.286): This is because the antibiotics kill the bacteria that help keep
fungus under control.

For similar reasons, persons who take ampicillin and other broad-spectrum
antibiotics for several days may develop diarrhea. Antibiotics may kill some kinds
of bacteria necessary for digestion, upsetting the natural balance of bacteria in the
gut.

3. Resistance to treatment. In the long run, the most important reason the use
of antibiotics should be limited, is that WHEN ANTIBIOTICS ARE USED TOO
MUCH, THEY BECOME LESS EFFECTIVE.

When attacked many times by the same antibiotic, bacteria become stronger
and are no longer killed by it. They become resistant to the antibiotic. For this
reason, certain dangerous diseases like typhoid are becoming more difficult to
treat than they were a few years ago.

In some places typhoid has become resistant to chloramphenicol, normally the
best medicine for treating it. Chloramphenicol has been used far too much for
minor infections, infections for which other antibiotics would be safer and work
as well, or for which no antibiotic at all is needed.

Throughout the world important diseases are becoming resistant to antibiotics
—largely because antibiotics are used too much for minor infections. If antibiotics
are to continue to save lives, their use must be far more limited than it is at
present. This will depend on their wise use by doctors, health workers, and the
people themselves.

For most minor infections antibiotics are not needed and should not be used.
Minor skin infections can usually be successfully treated with soap and water, hot
soaks, and perhaps painting them with gentian violet (p.409). Minor respiratory
infections are best treated by drinking lots of liquids, eating good food, and
getting plenty of rest. For most diarrheas, antibiotics are not necessary and may
even be harmful. What is most important is to drink lots of liquids (p..186) and
provide enough food as soon as the child will eat.

Do not use antibiotics for infections the body can fight successfully
by itself. Save them for when they are most needed.

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Summary: COMMUNITY HEA - . aCe 5 ae,  &7/%, (Bivet Fleer) Si. Marks nooe, .  oe aenqalora - 6609 001,    CHAPTER    | ANTIBIOTICS: WHAT THEY ARE  ", AND How To USE THEM    te teeeneenrereten <usnues veneer oe    This is a reprint from    Where There Is No Doctor    (Indian adaptation)    published by the    Voluntary Health Association of India  C-14 Community Centre  Safdarjung Development Area  New Delhi 110016    Si    Pale    ‘COMMUNITY HEALTH CELL    CHAPTER    ANTIBIOTICS: WHAT THEY ARE  AND HowW…