Lege Artis Medicinae

[Principles of antibiotic use in clinical practice]

SZALKA András

MAY 20, 2003

Lege Artis Medicinae - 2003;13(04)

[There has been a very significant reduction in morbidity and mortality associated with the use of antibiotics since they were first introduced, but, there has also been a concomitant rise in resistance among pathogens over the past 50 years. Moreover, antibiotics are sometimes associated with adverse events and their use can account for a significant proportion of the cost of treatment of some conditions. To ensure the optimal use of antibiotics doctors should use the most appropriate antibiotics to stop the spread of infection. In choosing the appropriate antimicrobial agent for the therapy of a certain infection several key factors must be considered: the most likely identity of the infecting organism, the potential antimicrobial susceptibility of the infecting organism and the host factors that influence the response to therapy. This publication is designed to introduce the concept of appropriate antibiotic therapy and how it can minimise the emergence of antimicrobial resistance while ensuring optimal patient management.]

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[Human adult-onset lactase decline, characterised by a decrease in intestinal lactase enzyme activity is a biologic feature characteristic of the maturing intestine in the majority of the world's population. It demonstrates an autosomal recessive pattern of inheritance and it is regulated primarily by the rate of lactase gene transcription. Ingestion of high quantities of lactose-containing foods by patients with adultonset lactase decline results in intestinal symptoms, including bloating, distension, cramps, flatulence and diarrhoea. Due to the differences in the rates of gastric emptying and intestinal transit as well as the abundance of lactosemetabolising bacteria in the colon, the symptoms of lactose intolerance are often quite variable from persons to person. Lactose intolerance usually leads to self-imposed dietary restriction of dairy products, the main source of calcium intake, therefore it appears to be a risk factor for development of osteoporosis. Consumption of milk with solid foods can reduce symptoms in many individuals. Yoghurt containing active cultures are useful substitute for whole milk. Prehydrolized milk and lactase enzyme containing tablets are also available in the treatment.]

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