Filled 83 prescriptions the other day. 9 of them were for Zithromax (either a Zpak or Zithromax oral suspension). That means 10.3% of my presription volume was an azalide antibiotic.
What about doxycyline, amoxicillin, sulfamethoxazole/trimethoprim? What about fluoroquinolones (except ciprofloxacin, which has little activity against Streptococcus pneumoniae)?
What about delaying or avoiding antimicrobial therapy, as most cases of respiratory infections are viral in nature?
CDC guidelines for adults suggest that only 10% of pharyngitis cases are caused by group A beta hemolytic strep. If the infection is determined to be caused by strep, treatment of choice is PENICILLIN (or erythromycin for penicillin allergic patients).
Rhinosinusitis infections are caused primarily by viruses. If symptoms last longer than 7 days, infection with the bacteria Streptococcus pneumoniae or Haemophilis influenzae may be considered, and should treated with antibiotics that cover both bacteria (amoxicillin, Augmentin, Ceftin, or Bactrim would work, as well as Zithromax and Levaquin).
Bronchitis can be treated with a Zpak, but prescribers can also use Bactrim, doxycycline, Augmentin, Ceftin, Cipro, or Levaquin.
Overuse of a single antibiotic increases bacterial resistance to that product. Maybe spread the love around a little, guys.
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