By Dr. med. Sabine Enenkel, Professor Dr. Wolfgang Stille (auth.)

International textbooks on infectious ailments and antibacterial chemotherapy tend to be written for readers in North the US and Europe. in lots of methods, they aren't acceptable for the prob­ lems encountered in constructing nations. This booklet, against this, intends to outline the foundations of antibacterial chemotherapy practised less than stipulations of restricted assets. it truly is intended for everybody con­ cerned with using antibiotics in constructing nations, includ­ ing medical professionals, scientific assistants, pharmacists, officers in overall healthiness mio­ isteries, and scientific scholars. through the booklet, remedy thoughts are made for 1 antibiotics from the WHO checklist of crucial medications. for instance, em­ phasis has as a result been placed upon chloramphenicol as a sturdy, unexpensive and commonly on hand oral agent appropriate for the deal with­ ment of serious bacterial infections like septicemia and meningitis. So-called "international chemotherapy" with modem cephalospor­ ins and acylaminopenicillins has been defined for comparability. because it is the purpose of the ebook to base therapy recommenda­ tions on info from constructing international locations, many facts at the etiology of universal bacterial infections in constructing international locations have additionally been incorporated. many of the facts are from African, English-speak­ ing constructing nations, yet references were made to the lit­ erature on South East Asia, India or Papua New Guinea, the place applicable. nevertheless, pertinent information weren't to be had in each example, in order that a number of statements and proposals needed to be made as "best guess". The authors are conscious of those imperfections and should welcome reviews from the readers.

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Cumulation of an antibiotic due to decreased elimination may result in toxic side effects. 1. ;< 1;j ++ ++ ++ ++ ++ ± ± ± ± ± + ++ ++ Contraindicated (except in lifethreatening disease) ± ± ± ± ± + + + + ± + ee ± ± ± ± +8 + ± + + ± ± ee ee + ee .. "Q 0 ~>. 11 i ± o 5 ~ s a (,,) 'c Q ... m. c. injection; 2, venous irritation with i. v. injection; 3, gastrointestinal intolerance; 4, histamine release; 5, development of secondary resistance; 6, pneumonia or pulmonary fibrosis; 7, bleeding tendency; 8, damage of growing cartilage; 9, alcohol intolerance; x, contraindicated.

The mode of action of the antibiotic, its pharmacokinetic properties, the site and severity of the infections, and the patient's age and hepatic and renal function influence the choice. Other important factors are the ease of administration and the therapeutic range of the antibiotic. Nonmedical factors are the availability and the price of the antibiotic. The selection of the appropriate antibiotic thus depends on sensitivity, pharmacokinetic parameters, clinical efficacy, and side effects. 3.

N Eng) J Med 299: 735-740 15. Koopman JS, Fighetti de Olave A (1980) An extensive outbreak of Klebsiella pneumoniae bacteremias from in-use contamination of i. v. bottles. Bull Pan Am Health Organ 14: 185-192 16. Menard M (1982) Resultats des 5691 antibiogrammes pratiques en 1979, 1980 et 1981 a l'Hopital Principal de Dakar. Dakar Med 27: 595-602 17. Mhalu FS, Mtango FDE, Msengi AE (1984) Hospital outbreaks of cholera transmitted through close person-to-person contact. Lancet II: 82-84 18. Murray BE, Alvarado T, Kim K-H, Vorachit M, Jayanetra P, Levine M, Prenzel I, Fling M, Elwell L, McCracken GH, Madrigal G, Odio C, Trabulsi LR (1985) Increasing resistance to trimethoprim-sulfamethoxazole among isolates of Escherichia coli in developing countries.

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