Potent antibiotics should be used early rather than second-line after failure
of older antibiotics, experts have agreed.
Prescribing of antibiotics and problems with resistance were discussed by Dr
Ethan Rubinstein (head of infectious diseases, Sheba medical centre, Israel)
at an antimicrobial agents conference in Toronto, Canada, in September. By prescribing
rapidly-acting antibiotics at high doses to kill bacteria, mutations that could
lead to drug resistance were prevented, he said. The traditional approach to
treating bacterial infections had been to use older antibiotics first and to
save the newer, more powerful agents for when the older agents failed. However,
Dr Rubinstein argued that the most effective antibiotic should be used early
on. An antibiotic should rapidly target the site of infection and quickly kill
the pathogen, he added.
Giving a United Kingdom perspective, Dr Robert Read (reader in infectious disease,
Sheffield University medical school) said: “Antibiotics should be used
correctly, at an effective dose for a short period of time. Powerful new antibiotics
should be considered for use in high-risk patients, those with co-morbidities
like diabetes or heart disease, immunosuppressed individuals, and the elderly
or frail.”