How do we know that doctors prescribe the most appropriate antibiotics to treat infectious diseases?

February 20, 2020 / BIOON / -- before the use of antibiotics, it is very common to die of bacterial infection Seemingly minor diseases may also escalate into serious diseases, which will kill people in a few hours or days Now antibiotics Can help save disease, in the community, it can usually be used to treat bacterial infection including lung, urethra, skin and other tissues But not all bacterial infections need antibiotics, and many don't need treatment to heal themselves Of course, antibiotics can't treat viral and fungal infections, such as influenza and thrush Even if antibiotics are needed, they are not a universal method, and not all antibiotics can kill all types of bacteria Photo source: iviewfinder / shutterstock what type of bacteria can cause infection? If your doctor suspects that you have a serious bacterial infection, an individual will have a urine or blood test, or a swab sample will be taken to a pathologist for testing; in the laboratory, these tests can help diagnose Some methods only need to detect the DNA of bacteria, which is called "genotype method", which is fast and sensitive Other methods try to culture and isolate bacteria from samples, but this usually takes 1-4 days Which antibiotics can resist infection? If antibiotic therapy is needed, the isolated bacteria can be used in a second series of tests to help determine the right antibiotics for infection, a test known as antibiotic sensitivity tests Just like the first test to detect bacteria that cause infection, it can use DNA based methods or by culturing bacteria in the presence of multiple antibiotics and assessing their growth Genotyping is often more likely to determine which antibiotics don't work, so it's possible to exclude them as a therapeutic option, that is, to exclude those that don't work, leaving only those that should In phenotypic tests, bacteria grow again in the presence of a series of antibiotics, so researchers can see which antibiotics can organize their growth, and the concentration of each antibiotic is usually used in these tests Why do you sometimes get a "script" without testing? No matter what kind of test is carried out, the results may not come out in a few days At the same time, the doctor may let you start using the most effective antibiotic, which is called experience therapy, which is the "best guess" treatment when they wait for the test results The selection of experienced antibiotics is usually based on the doctor's previous experience of the type of infection, as well as evidence-based clinical guidelines, which are usually related to the type of infection Once available, the test results will confirm the initial choice, or affect the doctor's decision to prescribe different antibiotics Take urinary tract infection as an example, most of them are caused by E.coli, and some antibiotics can reliably treat these infections The data of thousands of pathological tests on E It's like a clinical guideline Therefore, when waiting for the test results of urine samples, the doctor can safely prescribe antibiotics; you will either get better without further intervention or return to the doctor, and your test results should be used to fine tune the choice of antibiotics Why is it important to choose the right antibiotics? Under normal circumstances, we all want to get an antibiotic that can effectively treat infection, but if the effect of antibiotic treatment is effective or ineffective, it will have different effects If the effect of antibiotic is too strong, it will not only clear the body of infection, but also kill the body of beneficial bacteria, interfere with the microbiome and cause other chain reactions On the other hand, an invalid antibiotic can not only not effectively treat the infection, but also cause side effects and infect the health of the body A broader consideration about the wise use of antibiotics is that overuse or ineffective use of antibiotics will lead to unnecessary antibiotic resistance, and the use of all antibiotics will promote the resistance of the body to other bacteria in contact with them, so it is particularly important to reduce and optimize the use of antibiotics The right choice of antibiotics for infection is a very complicated decision, which must be made before the key additional evidence supports the decision With the release of the test results, therapeutic antibiotics may be improved or even stopped Reference materials: [1] be antibiotics aware: smart use, best care [2] current and emerging methods of antibiotic sustainability testing [3] antibiotic alter the guide microorganism and host health [4] defining and combining antibiotic resistance from one health and global health perspectives [5] how do you know you've been prescribed the right antibiotics？
by Christine Carson， The Conversation