[Antibiotic therapy in the outpatient setting: update 2009].
Rational outpatient therapy restricts antibiotics to infections where they are beneficial and selects substances based on local resistance patterns. Respiratory tract infections typically caused by viruses should not be treated with antibiotics (e.g., rhinitis, bronchitis, sinusitis). Many respiratory infections likely caused by bacteria can be treated with aminopenicillin, sometimes combined with a beta-lactamase inhibitor. Quinolones should be used only as exception for respiratory tract infections, since resistance is rising. For this reason uncomplicated urinary tract infections (cystitis) should be treated with trimethoprim-sulfa-methoxazole (TMP-SMX) instead of quinolones, even though approximately 20% of Escherichia coli are resistant to TMP-SMX. Skin and soft tissue infections are best treated with beta-lactam antibiotics, as long as the community acquired methicillin-resistant strains of S. aureus frequently seen in certain countries remain uncommon here.
Täuber
M G
MG
Institut für Infektionskrankheiten, Universität Bern und Universitätsklinik für Infektiologie, Friedbühlstrasse 51, Inselspital, Bern. martin.taeuber@ifik.unibe.ch
Mühlemann
K
K
D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D003937:Diagnosis, Differential; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents