Antibiotics: What They Are and How To Use Them: Bacteria. Well-Known Antibiotics

55
7
Antibiotics: What They Are
CHAPTER
and How 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, chloramphenicol, and the sulfa drugs, or
sulfonamides.
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. Take great care in choosing and using 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 Pen-V-K 350

AMPICILLINS* Penbritin 352
TETRACYCLINES Terramycin 355
SULFAS (SULFONAMIDES) Gantrisin 356
COTRIMOXAZOLE Bactrim 357
STREPTOMYCIN, etc. Ambistryn 353, 361
CHLORAMPHENICOL Chloromycetin 356
ERYTHROMYCIN Erythrocin 354
CEPHALOSPORINS Keflex 358
*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’.
Look up chloramphenicol in the GREEN PAGES

(p. 356). You will find it must be used only for a few
very serious illnesses, like typhoid, and is especially
dangerous when given to the newborn.
Never use an antibiotic unless you know to what group it belongs, what
diseases it fights, and the precautions you must take to use it safely.
56 Where There Is No Doctor 2011
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
medicine in the alphabetical list at the beginning of those pages.
GUIDELINES FOR THE USE OF ALL ANTIBIOTICS
1. If 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 does—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 many months or years after the person
feels better. Follow the instructions for each illness.)
7. If 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. 70).
8. Only use antibiotics when the need is great. When antibiotics are used too
much they begin not to work as well.
GUIDELINES FOR THE USE OF CERTAIN ANTIBIOTICS
1. Before you inject penicillin or ampicillin, always have ready ampules of Adrenalin
(epinephrine) to control an allergic reaction if one occurs (p. 70).
2. For persons who are allergic to penicillin, use another antibiotic such as
erythromycin or a sulfa (see p. 354 and 356).
3. Do not use tetracycline, ampicillin, or another broad-spectrum antibiotic for an

illness that can probably be controlled with penicillin or another narrow-spectrum
antibiotic (see p. 58). Broad-spectrum antibiotics attack many more kinds of bacteria
than narrow-spectrum antibiotics.
4. As a rule, use chloramphenicol only for certain severe or life-threatening illnesses

like typhoid. It is a dangerous drug. Never use it for mild illness. And never give it to
newborn children (except perhaps for whooping cough, p. 313).
5. 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 or to children under 8 years old. It

can damage new teeth and bones (see p. 355).
Where There Is No Doctor 2011 57
7. As a general rule, use streptomycin, and products that contain it, only for
tuberculosis—and always together with other anti–tuberculosis medicines (see
p. 361). Streptomycin in combination with penicillin can be used for deep wounds to
the gut, appendicitis, and other specific infections when ampicillin is not available
(or is too costly). but should never be used for colds, flu, and common respiratory
infections.
8. All medicines in the streptomycin group (including kanamycin and gentamicin)

are quite toxic (poisonous). Too often they are prescribed for mild infections where
they may do more harm than good. Use only for certain very serious infections for
which these medicines are recommended.
9. Eating yogurt or curdled milk helps to replace necessary bacteria killed by

antibiotics like ampicillin and to return the body’s natural balance to normal (see
next page).
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 seem to help, it is possible that:
1. 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 this antibiotic (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.
These three children had a cold...
What was What took Why did this child
the villain? the toll? get well again?
He got no
Penicillin! Chloramphenicol! risky medicine—
(see Allergic (see risks and precautions just fruit juice,
Shock, p. 70) for this drug, p. 356) good food, and rest.
Antibiotics do no good for the common cold.

Use antibiotics only for infections they are known to help.
58 Where There Is No Doctor 2011
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 or yeast infections of the mouth (thrush, p. 232) or skin (moniliasis, p. 242). 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 much 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 mild soap and water, or
hot soaks, and perhaps painting them with gentian violet (p. 370). 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. 155), 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.
For more information on learning to use antibiotics sensibly, see Helping Health
Workers Learn, Chapter 19.

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55

and How to Use Them

The different antibiotics work in different ways against specific infections.

antibiotic group examples of brand names see

PENICILLINS Pen-V-K 350

Look up chloramphenicol in the GREEN PAGES

GUIDELINES FOR THE USE OF ALL ANTIBIOTICS

5. Never use injections of antibiotics if taking them by mouth is likely to work as

GUIDELINES FOR THE USE OF CERTAIN ANTIBIOTICS

3. Do not use tetracycline, ampicillin, or another broad-spectrum antibiotic for an

4. As a rule, use chloramphenicol only for certain severe or life-threatening illnesses

6. Do not give tetracycline to pregnant women or to children under 8 years old. It

8. All medicines in the streptomycin group (including kanamycin and gentamicin)

9. Eating yogurt or curdled milk helps to replace necessary bacteria killed by

WHAT TO DO IF AN ANTIBIOTIC DOES NOT SEEM TO HELP

2. The dose of the antibiotic is not correct. Check it.

Antibiotics do no good for the common cold.

IMPORTANCE OF LIMITED USE OF ANTIBIOTICS

In some places typhoid has become resistant to chloramphenicol, normally the

Throughout the world important diseases are becoming resistant to antibiotics—

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