Editing Antibiotic (section)

==Usage==
===Medical uses===
Antibiotics are used to treat or prevent bacterial infections,<ref name=Antibiotic>{{cite book|title=Antibiotics Simplified.|date=2011|publisher=Jones & Bartlett Publishers|isbn=978-1-4496-1459-1|pages=15–17|url=https://books.google.com/books?id=vIRgA57q414C&q=Antibiotics|access-date=28 April 2024|archive-date=2 January 2024|archive-url=https://web.archive.org/web/20240102114230/https://books.google.com/books?id=vIRgA57q414C&q=Antibiotics#v=snippet&q=Antibiotics&f=false|url-status=live}}</ref> and sometimes [[protozoan infection]]s. ([[Metronidazole]] is effective against a number of [[parasitic disease]]s). When an infection is suspected of being responsible for an illness but the responsible pathogen has not been identified, an [[empiric therapy]] is adopted.<ref name="General principles">{{cite journal | vauthors = Leekha S, Terrell CL, Edson RS | title = General principles of antimicrobial therapy | journal = Mayo Clinic Proceedings | volume = 86 | issue = 2 | pages = 156–67 | date = February 2011 | pmid = 21282489 | pmc = 3031442 | doi = 10.4065/mcp.2010.0639 }}</ref> This involves the administration of a [[broad-spectrum antibiotic]] based on the signs and symptoms presented and is initiated pending laboratory results that can take several days.<ref name="Antibiotic"/><ref name="General principles"/>

When the responsible pathogenic microorganism is already known or has been identified, [[therapy#Definitive therapy|definitive therapy]] can be started. This will usually involve the use of a narrow-spectrum antibiotic. The choice of antibiotic given will also be based on its cost. Identification is critically important as it can reduce the cost and toxicity of the antibiotic therapy and also reduce the possibility of the emergence of antimicrobial resistance.<ref name="General principles"/> To avoid surgery, antibiotics may be given for non-complicated acute [[appendicitis]].<ref>{{cite journal | vauthors = Rollins KE, Varadhan KK, Neal KR, Lobo DN | title = Antibiotics Versus Appendicectomy for the Treatment of Uncomplicated Acute Appendicitis: An Updated Meta-Analysis of Randomised Controlled Trials | journal = World Journal of Surgery | volume = 40 | issue = 10 | pages = 2305–18 | date = October 2016 | pmid = 27199000 | doi = 10.1007/s00268-016-3561-7 | s2cid = 4802473 }}</ref>

Antibiotics may be given as a [[preventive healthcare|preventive measure]] and this is usually limited to at-risk populations such as those with a [[immunodeficiency|weakened immune system]] (particularly in [[HIV]] cases to prevent [[pneumonia]]), those taking [[immunosuppressive drug]]s, [[cancer]] patients, and those having [[surgery]].<ref name=Antibiotic/> Their use in surgical procedures is to help prevent infection of [[surgical incision|incisions]]. They have an important role in [[dental antibiotic prophylaxis]] where their use may prevent [[bacteremia]] and consequent [[infective endocarditis]]. Antibiotics are also used to prevent infection in cases of [[neutropenia]] particularly cancer-related.<ref>{{cite journal | vauthors = Flowers CR, Seidenfeld J, Bow EJ, Karten C, Gleason C, Hawley DK, Kuderer NM, Langston AA, Marr KA, Rolston KV, Ramsey SD | title = Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline | journal = Journal of Clinical Oncology | volume = 31 | issue = 6 | pages = 794–810 | date = February 2013 | pmid = 23319691 | doi = 10.1200/JCO.2012.45.8661 }}</ref><ref>{{cite journal | vauthors = Bow EJ | title = Infection in neutropenic patients with cancer | journal = Critical Care Clinics | volume = 29 | issue = 3 | pages = 411–41 | date = July 2013 | pmid = 23830647 | doi = 10.1016/j.ccc.2013.03.002 }}</ref>

The use of antibiotics for secondary prevention of coronary heart disease is not supported by current scientific evidence, and may actually increase cardiovascular mortality, all-cause mortality and the occurrence of stroke.<ref name=":4">{{cite journal | vauthors = Sethi NJ, Safi S, Korang SK, Hróbjartsson A, Skoog M, Gluud C, Jakobsen JC | title = Antibiotics for secondary prevention of coronary heart disease | journal = The Cochrane Database of Systematic Reviews | volume = 2 | issue = 5 | pages = CD003610 | date = February 2021 | pmid = 33704780 | pmc = 8094925 | doi = 10.1002/14651858.CD003610.pub4 | collaboration = Cochrane Heart Group }}</ref>

===Routes of administration===
There are many different [[routes of administration]] for antibiotic treatment. Antibiotics are usually [[oral administration|taken by mouth]]. In more severe cases, particularly deep-seated [[systemic disease|systemic infections]], antibiotics can be given [[intravenous therapy|intravenously]] or by injection.<ref name="NHSB"/><ref name="General principles"/> Where the site of infection is easily accessed, antibiotics may be given [[routes of administration#Topical|topically]] in the form of [[eye drop]]s onto the [[conjunctiva]] for [[conjunctivitis]] or [[ear drop]]s for ear infections and acute cases of [[otitis externa|swimmer's ear]]. Topical use is also one of the treatment options for some skin conditions including [[acne vulgaris|acne]] and [[cellulitis]].<ref>{{cite journal | vauthors = Pangilinan R, Tice A, Tillotson G | title = Topical antibiotic treatment for uncomplicated skin and skin structure infections: review of the literature | journal = Expert Review of Anti-Infective Therapy | volume = 7 | issue = 8 | pages = 957–65 | date = October 2009 | pmid = 19803705 | doi = 10.1586/eri.09.74 | s2cid = 207217730 }}</ref> Advantages of topical application include achieving high and sustained concentration of antibiotic at the site of infection; reducing the potential for systemic absorption and toxicity, and total volumes of antibiotic required are reduced, thereby also reducing the risk of antibiotic misuse.<ref name="Treating chronic wounds">{{cite journal | vauthors = Lipsky BA, Hoey C | title = Topical antimicrobial therapy for treating chronic wounds | journal = Clinical Infectious Diseases | volume = 49 | issue = 10 | pages = 1541–9 | date = November 2009 | pmid = 19842981 | doi = 10.1086/644732 | doi-access = free | title-link = doi }}</ref> Topical antibiotics applied over certain types of surgical wounds have been reported to reduce the risk of surgical site infections.<ref>{{cite journal | vauthors = Heal CF, Banks JL, Lepper PD, Kontopantelis E, van Driel ML | title = Topical antibiotics for preventing surgical site infection in wounds healing by primary intention | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 11 | pages = CD011426 | date = November 2016 | pmid = 27819748 | pmc = 6465080 | doi = 10.1002/14651858.CD011426.pub2 }}</ref> However, there are certain general causes for concern with topical administration of antibiotics. Some systemic absorption of the antibiotic may occur; the quantity of antibiotic applied is difficult to accurately dose, and there is also the possibility of local [[hypersensitivity]] reactions or [[contact dermatitis]] occurring.<ref name="Treating chronic wounds"/> It is recommended to administer antibiotics as soon as possible, especially in life-threatening infections. Many emergency departments stock antibiotics for this purpose.<ref>{{cite journal | vauthors = Hung KK, Lam RP, Lo RS, Tenney JW, Yang ML, Tai MC, Graham CA | title = Cross-sectional study on emergency department management of sepsis | journal = Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi | volume = 24 | issue = 6 | pages = 571–578 | date = December 2018 | pmid = 30429360 | doi = 10.12809/hkmj177149 | doi-access = free | title-link = doi }}</ref>

===Global consumption===
Antibiotic consumption varies widely between countries. The [[WHO]] report on surveillance of antibiotic consumption published in 2018 analysed 2015 data from 65 countries. As measured in defined daily doses per 1,000 inhabitants per day. Mongolia had the highest consumption with a rate of 64.4. Burundi had the lowest at 4.4. [[Amoxicillin]] and [[amoxicillin/clavulanic acid]] were the most frequently consumed.<ref>{{cite news |title=UK antibiotic consumption twice that of the Netherlands, WHO report finds |url=https://www.pharmaceutical-journal.com/20205732.article |access-date=22 December 2018 |publisher=Pharmaceutical Journal |date=14 November 2018 |archive-date=22 December 2018 |archive-url=https://web.archive.org/web/20181222221210/https://www.pharmaceutical-journal.com/20205732.article |url-status=dead }}</ref>