Antibiotic Case No 8. Antibiotic Use in Ent,Rti,uti,Urti.

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Antibiotic Case No 8. Antibiotic Use in Ent,Rti,uti,Urti.

গ্রাম পজিটিভ ব্যাকটেরিয়া গুলি সাধারণত ডায়াফ্রামের উপরের অংশে ইনফেকশন করে, স্কিন ইনফেকশন, ENT Infection এ সাধারণত গ্রাম পজিটিভ ব্যাকটেরিয়া predominant থাকে, আর ডায়াফ্রাম এর নিছের অংশে সাধারণত gram negative bacteria দিয়ে ইনফেকশন হয়,

গ্রাম পজিটিভ এবং নেগেটিভ ব্যাকটেরিয়া গুলি নরমাল ফ্লোরা হিসাবে শরীরে থাকে, এন্টিবায়োটিক এর বেসিক জানতে হলে কোন নরমলা ফ্লোরা কোথায় থাকে, কোন টা দিয়ে কোন রোগ হয় , তা জানা অপরিহার্য

স্কিন ইনফেকশন সাধারণত গ্রাম পজিটিভ ব্যাকটেরিয়া দিয়ে হয়, এখানে গ্রাম নেগেটিভ ব্যাকটেরিয়া থাকেনা,

আবার ENT Infection সমূহ, RTI Respiratory tract infection (RTI) is defined as any infectious disease of the upper or lower respiratory tract., sinusitis, etc ইনফেকশনে গ্রাম পজিটিভ ব্যাকটেরিয়া ও গ্রাম নেগেটিভ ব্যাকটেরিয়া দুইটাই থাকে,

তাই স্কিনের ইনফেকশনে শধু মাত্র গ্রাম পজিটিভ ব্যাকটেরিয়া মারার ঔষধ দিলেই চলে,

In that case Gram Positive bacteria kill korar jonnho Penicillinase-resistant penicillins Dile e better performance pawa jai so we can use

Capsule 1.Fluclox 500 (AS A Flucloxacilline Sodium AS A Penicillinase-resistant penicillins).

Flucloxacillin is active against Gram-positive organisms including penicillinase producing strains. It has little activity against Gram-negative bacilli. Flucloxacillin acts by inhibiting the formation of cell wall of bacteria. Flucloxacillin kills bacterial cellwall, thus interfering with peptidoglycan synthesis.

Indications of Capsule 1.Fluclox 500 (AS A Flucloxacilline Sodium AS A Penicillinase-resistant penicillins)

Fluclox is indicated for the treatment of infections due to Gram-positive organisms, including infections caused by penicillinase producing staphylococci. These indications include:

Skin and soft tissue infections: Boils, abscess, carbuncles, infected skin conditions (e.g. ulcer, eczema, acne, furunculosis, cellulitis, infected wounds, infected burns, otitis media and externa, impetigo).
Respiratory tract infections: Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy.
It is also used for the treatment of other infections i.e. osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia caused by Fluclox-sensitive organisms.
As a prophylactic agent, it is used during major surgical procedures where appropriate; for example, cardiothoracic and orthopedic surgery.

তবে ENT, RTI,Sinusitis ইত্যাদিতে Broad spectrum antibiotics দিতে হয়, কারণ ওইসব জায়গায় গ্রাম নেগেটিভ ব্যাকটেরিয়াও থাকে, most commonly above diaphragm যে দুইটা গ্রাম নেগেটিভ ব্যাকটেরিয়া থাকে তা হচ্ছে Moraxella, and Hemophilus influenza, তাই স্কিন ব্যতীত ডায়াফ্রামের উপরের অন্যান্য অংশের ইনফেকশনের জন্য broad spectrum antibiotics Orthat Broad spectrum penicillins লাগবে, যাতে গ্রাম পজিটিভ ও নেগেটিভ দুইটাই ধ্বংস হয়,Sei Jonnho amra broad spectrum antibiotics hisebe amra Amoxicilline use korte pari jeta sobcheye Valo Parformence dei in that case we can use

Tablet 3:Moxaclav 500 mg (AS A Amoxicilline+Clavulanic Acid ) AS A Broad spectrum penicillins)

Co-amoxiclav is an antibacterial combination consisting of the antibiotic Amoxicillin and the (3-lactamase inhibitor Clavulanic Acid. Amoxicillin has a broad spectrum of bactericidal activity against many Gram-positive & Gram-negative microorganisms.

Indications of Tablet 3:Moxaclav 500 mg (AS A Amoxicilline+Clavulanic Acid ) AS A Broad spectrum penicillins)

Co-amoxiclav is indicated for short-term treatment of bacterial infections at the following sites:

Upper respiratory tract infections (including ENT) e.g.tonsillitis,sinusitis,otitis media.
Lower respiratory tract infections e.g.acute and chronic bronchitis, lobar and bronchopneumonia.
Genito-urinary tract infections e.g.cystitis,urethritis,pyelonephritis.
Skin and soft tissue infections.
Bone and joint infections e.g.osteomyelitis.
Other infections e.g.septic abortion,puerperal sepsis,intra-abdominal sepsis etc.

এই ক্ষেত্রে Extended spectrum penicillin দেওয়া যেতে পারে, 2nd generation cephalosporin দেওয়া যেতে পারে, কিংবা টেট্রাসাইক্লিন দেওয়া যেতে পারে,

In that case we can use 2nd generation cephalosporin hisebe amra best medicine use kori ta holo Cefuroxime

(Cefuroxime Axetil +Clavulanic Acid ).

Tablet 2:-Cefotil Plus (500mg+125mg) AS A (Cefuroxime Axetil +Clavulanic Acid ).AS A Second generation Cephalosporins, Vaccines, Anti-sera & Immunoglobulin).

IndicationsCefuroxime is a bactericidal second generation cephalosporin antibiotic which is active against a wide range of Gram-positive and Gram-negative susceptible organisms including many beta-lactamase producing strains. Cefuroxime inhibits bacterial cell wall synthesis by interfering with the transpeptidation process.

Cefotil Plus is indicated for the treatment of infections caused by sensitive bacteria.

Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.
Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.
Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)
Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli.
Acute bacterial exacerbation of chronic bronchitis and secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).
Uncomplicated skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.
Uncomplicated urinary tract infections caused by E.coli or Klebsiella pneumoniae.
Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).
Uncomplicated Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.
Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.
Septicemia caused by Staphylococcus aureus, Streptococcus pneumoniae, E.coli, Haemophilus influenzae (including ampicillin-resistant strains) & Klebsiella spp.
Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin-resistant strains), Neisseria meningitidis & Staphylococcus aureus (penicillinase and non-penicillinase producing strains)
Switch therapy (Injectable to oral)

above diaphragm infection এ গ্রাম পজিটিভ ব্যাকটেরিয়া প্রিডমিনেন্ট থাকলেও মেনিনজাইটিস এর ক্ষেত্রে তা ব্যতিক্রম, মেনিনজাইটিস এ গ্রাম নেগেটিভ ব্যাকটেরিয়া predominant… সাথে কিছু গ্রাম পজিটিভ ব্যাকটেরিয়া ও থাকে, তাই মেনিনজাইটিস এর ক্ষেত্রে এমন এন্টিবায়োটিক লাগবে, যার গ্রাম নেগেটিভ কাভারেজ সর্বোচ্চ,

Below diaphragm infection —

Below diaphragm বলতে appendicitis, cholecystitis, pancreatitis, Cystitis, UTI, Pelvic inflammatory didisease ইত্যাদি বুঝায়, এইসব ক্ষেত্রে infection এর খুব কমন অর্গানিজম হচ্ছে Enterobacteriacae, তথা E-coli, klebshilla, proteus ইত্যাদি, এক কথায় ডায়াফ্রামের নিছের অংশে ইনফেকশন এর জন্য দায়ী হচ্ছে গ্রাম নেগেটিভ ব্যাকটেরিয়া, তাই এইসব ইনফেকশনে এমন এন্টিবায়োটিক চয়েজ করতে হবে,orthat amra 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs use korte pari as ciprofloxacin যার গ্রাম নেগেটিভ কাভারেজ সবচেয়ে বেশি, উদাহরণস্বরূপ Ciprofloxacin, Cefixime, Ceftriaxone, etc, in that we can use

Tablet 4.Beuflox 500mg (AS A Ciprofloxacin AS A 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs).

Ciprofloxacin is a synthetic quinolone anti-infective agent. Ciprofloxacion has broad spectrum of activity. It is active against most gram negative aerobic bacteria

Indications of Tablet 4.Beuflox 500mg (AS A Ciprofloxacin AS A 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs).

Beuflox is indicated for the treatment of single infection or mixed infections caused by two or more susceptible organisms. It can also be used for infections caused by organisms resistant to other antibiotics including Aminoglycosides, Penicillins and Cephalosporins.

As antibacterial concentrations of Beuflox are obtained in serum and body tissues as well as in the urine following administration by mouth, Beuflox has been suggested for use in the treatment of a wide range of infections caused by susceptible organisms including infections of the urinary, respiratory and gastrointestinal tracts, gonorrhoea and septicaemia. The extensive tissue penetration of Beuflox combined with its enhanced antibacterial activity (including antipseudomonal activity), enables Beuflox to be used alone (pending sensitivity results) or in combination with an Aminoglycoside or with beta lactam antibiotics for instance when severe neutropenia is present or with an antibiotic active against anaerobes where the presence of bacteroides fragilis is suspected. Beuflox is indicated for the treatment of the following infections caused by sensitive bacteria:

Severe systemic infections: e.g. septicaemia, bacteraemia, peritionitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.
Respiratory tract infections: Lobar and bronchopneumonia, acute and chronic bronchitis, acute exacerbation of cystic fibrosis, bronchiectasis, empyema.
Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis, epididymitis.
Skin and soft tissue infections: e.g. infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas, infected burns.
Gastro-intestinal infections: e.g. enteric fever, infective diarrhea.
Infection of the biliary tract: e.g. cholangitis, cholecystitis, empyema of the gall bladder.
Intra abdominal infections: e.g. peritonitis, intra abdominal abscesses.
Bone and joint infection: Osteomyelitis, septic arthritis.
Pelvic infections: e.g. salpingitis, endometritis, pelvic inflammatory diseases.
Eye, ear, nose and throat infections: e.g. otitis media, sinusitis, mastoiditis, tonsillitis.
Gonorrhoea: Including urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organisms or organisms moderately sensitive to penicillin.

Othoba amra Third generation Cephalosporins Use korte Pari AS Cefixime

Tablet 5:Cef 3-DS 400mg (AS A Cefixime Trihydrate AS A Third generation Cephalosporins).

Cefixime is a third generation semisynthetic cephalosporin antibiotic for oral administration. It is bactericidal against a broad spectrum of gram positive and gram negative bacteria at easily achievable plasma concentrations. It kills bacteria by interfering in the synthesis of bacterial cell wall.

Indications of Tablet 5:Cef 3-DS 400mg (AS A Cefixime Trihydrate AS A Third generation Cephalosporins).

Cef-3 DS is an orally active cephalosporin antibiotic which has marked in-vitro bactericidal activity against a wide variety of Gram-positive and Gram-negative organism. It is indicated for the treatment of the following acute infections when caused by susceptible microorganisms.

Upper Respiratory Tract Infections (URTI): e.g. otitis media; and other URTI where the causative organism is known or suspected to be resistant to other commonly used antibiotics, or where treatment failure may carry significant risk. Lower Respiratory Tract Infections-e.g. bronchitis.

Urinary Tract Infections: e.g. cystitis, cystourethritis, pyelonephritis. Clinical efficacy has been demonstrated in infections caused by commonly occurring pathogens including Streptococcus pneumonia, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella species, Haemophilus influenzae (beta-lactamase positive and negative), Moraxella catarrhalis (beta-lactamase positive and negative) and Enterobacter species. Cef-3 DS is highly stable in the presence of beta-lactamase enzymes.

OR amra Ceftriaxone AS A 3rd Generation Cephalosporins Use korte pari Mone rakhte hobe Ceftriaxone sob gula antibiotic e hosse Injection i mean Intervenous IV/IM othoba Inter mascular hisebe pawa jai

Injection 7:Ceftron 1gm /vial AS A Ceftriaxone Sodium AS A 3rd Generation Cephalosporins .

Ceftriaxone is a 3rd generation broad-spectrum parenteral cephalosporin antibiotic. It has potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms. Ceftriaxone kills bacteria by interfering with the synthesis of the bacterial cell wall.

Indications

Ceftron injection is indicated for the treatment of the following major infections:

Lower respiratory tract infections
Acute Bacterial Otitis Media
Skin and skin structure infections
Urinary tract infections
Gonorrhea
Bacterial Septicemia
Bone and joint infections
Meningitis
Prevention of postoperative infections
Perioperative prophylaxis of infections associated with surgery

আবার intestine এ Anaerobic organism গুলি নরমাল ফ্লোরা হিসাবে থাকে, তাই abdominal যে কোনো ইনফেকশনে Anaerobic normal flora গুলি flare-up করে ইনফেকশন বাড়াতে পারে, তাই Anaerobic organism coverage antibiotics দিয়ে দেওয়া হয়….. Metronidazole is most common antibiotics For anaerobic coverage… Amoebicides, Anti-diarrhoeal Antiprotozoal hisebe amra Metronidazole use korbo

In that case we can use AS Metronidazole:

Tablet 6.Amodis 400mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Indications of Tablet 6.Amodis 400mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Amodis is indicated in the treatment of following diseases:

The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci).
The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes.
In the treatment of urogenital trichomoniasis.
Bacterial vaginosis (also known as non-specific vaginitis).
All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers).
Giardiasis.
Acute ulcerative gingivitis.
Anaerobically infected leg ulcers and pressure sores.
Acute dental infections due to anaerobic organisms.
Antibiotic associated pseudomembranus colitis.

Raiyyan Tahsan Date:-26-01-2025 Sunday Time:-2-57-30 PM

Raiyyan Tahsan

Raiyyan Tahsan