German doctors careful with antibiotics

Project seeks to suppress resistance / antibiotic prescribing for respiratory tract infections in Europe differs

STOCKHOLM (grue). The prescription of antibiotics is different in the different European countries. Sun Hungarian GP to prescribe some medications for these respiratory infections more often than colleagues in Scandinavia or Germany. And most Britons choose amoxicillin, doxycycline prefer the Dutch, the Italians fluoroquinolones.


Whether patients with respiratory infections take antibiotics or not - on the course has the most influence.

Such differences in antibiotic prescribing examines the network GRACE ×, which is funded by the EU with 11.5 million euros. "Because there is no guidance on the use of antibiotics, the doctors proceed differently," said Professor Herman Goossens GRACE coordinator of Antwerp. "Because it is easier at high antibiotic use leads to resistance, which is now submitted inventory make the delicate points clear," he said at the congress in Stockholm pulmonologists. Altogether more than 600 family physicians from twelve countries participating in the project. They reported in the winter season 2006/2007 a total of 3402 patients with acute bronchitis, mild fever and cough symptom. More than 70 percent also had typical symptoms such as sputum, rhinitis, malaise and disturbed sleep.

Sore throat antibiotics often fail

Antibiotics such as penicillin or amoxicillin achieve classic for a quarter of the patients hardly the desired effect against angina.

They were for a long time as a real miracle weapon against infections of all kinds, but now the traditional antibiotics like penicillin and amoxicillin seem to leave the forces, you can achieve for many patients no longer have the desired effect.

Among the findings of a study by the University of Rochester has come. The local researchers analyzed data from nearly 11 500 children who suffered from a common throat infection. About 25 percent of patients who had received penicillin, amoxicillin, and 18 percent of recipients required within a few weeks, another treatment for their streptococcal infection.

Newer agents are expensive
The researchers therefore called for an international conference in Washington that the doctors should use more often newer antibiotics such as cephalosporins, are the much more expensive than the older agents. The British expert Robert George, director of the Respiratory and Systemic Infection Laboratory, said in the context that WHO continue to recommend the use of penicillin for strep throat.

Pneumonia: enzyme and antibiotic

Researchers at Berlin's Charité Hospital have successfully together with colleagues at the Rockefeller University in New York, a new  amoxicillin treatment for pneumonia tested. The team led by Dr. Martin Witzenrath and Professor Dr. Norbert Suttorp reported in the journal "Critical Care Medicine" (Volume 37 (2), pp. 642-649) that it had succeeded in mice for the first time, one caused by pneumococcal pneumonia by enzyme to heal cpl-1. The enzyme is produced by so-called bacteriophages (viruses infecting bacteria).

amoxicillin most common antibiotic medicine

The antibiotic prescribing should be standardized across Europe to help device resistance

There were also significant differences between networks in the choice of antibiotic. Amoxicillin was the most common antibiotic prescribed overall, but this ranged from 3% of prescriptions in Norway to 83% in England. These differences may lie in the different correction lines and habits in different countries, say the authors.

This is the largest study of its kind, and the results suggest that close management of acute cough, a point that is appropriate for the international standardized care paths that promote conservative antibiotic prescribing, the author is.

amoxicillin treatment of streptococcal tonsillopharyngitis

Short-term treatment of streptococcal tonsillopharyngitis

Dtsch Arztebl 2001; 98 (48): A-3216 / B-2708 / C-2400 Scholz, Horst

rer to the post of lecturer Dr. Horst Scholz Prof. Dr. Dr. med. nat. Dr. hc. mult. Dieter Adam Helmer King Manfred in issue 21/2001
In the numerous letters to various aspects of antibiotic therapy with 
for streptococcal tonsillopharyngitis (such as selection of antibiotics, treatment costs and rates of penicillin dosage, resistance) critical comments. This illustrates how current discussion on the treatment of streptococcal tonsillopharyngitis after 50 years use of penicillin V is still.
First, be mentioned that the incidence of streptococcal sequelae in Germany before the start of the study was not known. In the case estimate was assumed that a frequency of three cases per 1000 children under the age of penicillin therapy, and an increase to more than eight children per 1 000 was a five-day regimen taken as significant difference. This hypothesis was tested whether complications occur in a short course of five days, significantly more than for a treatment period of ten days of penicillin V.
For the ten-day group (1530 patients) of amoxicillin penicillin V was chosen in the internationally usual dosage of 50 000 IU / kg / day. For the five-day group (3180 patients), six different antibiotics were used, was its effectiveness in earlier comparative studies, however, with lower numbers of cases detected. The DGPI could and would be aware of this large clinical trial is not set on an antibiotic for the five-day therapy, as there is for five-day treatment, no single substance that could be evaluated on behalf of all antibiotics.
The choice of  amoxicillin antibiotics according to the level of costs and many other criteria is still in the hands of the treating physician. The said in a letter costs per kg body weight / day, however, does not meet the specifications of the Red List. For instance, the price quoted for a daily dose of cefuroxime per kg DM, but not 4.09 0.75 DM