The Best Antibiotics for Ear Infections

The 2004 American Academy of Pediatrics guidelines for the treatment of ear infections includes specific recommendation for which antibiotics should be used in different situations. Most ear infections do not need antibiotics at all. If antibiotics are used, high-dose amoxil is the best choice for most children - along with treatment for their ear pain. If the child is allergic to Amoxil (amoxicillin), then Ceftin, Omnicef, or Vantin are the preferred choices. If the child is also allergic to all four of these, then Zithromax or Biaxin are the recommended alternatives. If the child with the ear infection has a fever over 102.2 F or is severely ill, then the best starting antibiotic is usually Augmentin. If the child is allergic to Augmentin, then 1 to 3 injections of Rocephin is usually the best choice. Whatever the initial antibiotic, it should be changed if there is not clear improvement within 48 to 72 hours. High-dose Augmentin is usually the best follow-up choice. If the fever is still over 102.2, the child is severely ill, or allergic to Augmentin, then three days of Rocephin injections are recommended. If the child is allergic to Rocephin, then clindamycin is the antibiotic of choice. These guidelines can help many children avoid unnecessary rounds of ineffective antibiotics

Urinary Tract Infection (UTI) - Symptoms , Causes,and Treatmen

Urinary tract infection (UTI) is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract. Women are most at risk of developing a UTI. In fact, half of all women will develop a UTI during their lifetimes, and many will experience more than one. Some women seem are more prone to repeated infections than others and for them it can be a frustrating battle.

Causes

The most common cause of UTI is bacteria from the bowel that live on the skin near the rectum or in the vagina which can spread and enter the urinary tract through the urethra. Certain people are more likely to get UTIs. Women tend to get them more often because their urethra is shorter and closer to the anus. Elderly people (especially those in nursing homes) and people with diabetes also get more UTIs.

Other bacteria that cause urinary tract infections include Staphylococcus saprophyticus in most of the 5 to 15% of cases, Chlamydia trachomatis, and Mycoplasma hominis. Men and women infected with chlamydia trachomatis or mycoplasma hominis can transmit the bacteria to their partner during sexual intercourse, causing Urinary tract infection (UTI).

Symptoms

Symptoms of Urinary tract infection (UTI) or bladder infection are not easy to miss and include a strong urge to urinate that cannot be delayed which is followed by a sharp pain or burning sensation in the urethra when the urine is released. Mostly very little urine is released and the urine that is released may be bloody. The urge to urinate recurs quickly and soreness may occur in the lower abdomen, back, or sides. Common symptoms of lower urinary tract infections : -

Painful urination
Increased urinary frequency/urgency
Awakening at night to urinate
Tenderness or heaviness in the lower abdomen
Blood in the urine
Foul smelling urine
Urine appears cloudy

Treatment

Urethritis in men and women can be caused by the same bacteria as sexually transmitted diseases (STDs). Therefore, people with symptoms of STDs (vaginal or penile discharge, for example) should be treated with appropriate antibiotics. Drugs most commonly recommended for simple UTIs include amoxicillin (Amoxil, Trimox), nitrofurantoin (Furadantin, Macrodantin), trimethoprim (Proloprim) and the antibiotic combination of trimethoprim and sulfamethoxazole (Bactrim, Septra).

In children, cystitis should be treated promptly with antibiotics to protect their developing kidneys. In the elderly, prompt treatment is recommended due to the greater chances of fatal complications.
Adult females with potential for or early involvement of the kidneys, urinary tract abnormalities, or diabetes are usually given a 5 to 7 day course of antibiotics.

Peripheral Neuropathy Associated With Cipro

dverse effects associated with the use of ciprofloxacin (Cipro) and other fluoroquinolone antibiotics are not always benign. Not infrequently, they can be severe and permanently disabling, and they may occur following just one or a few doses, according to a study posted on the Annals of Pharmacotherapy Web site. Scheduled for publication in December 2001, this article was released early online because of the threat of anthrax and subsequent heightened interest in Cipro.

Jay S. Cohen, MD, an associate professor of family and preventive medicine at the University of California, San Diego, analyzed 45 cases in which fluoroquinolone antibiotics (including 11 cases involving ciprofloxacin) were associated with adverse effects involving the peripheral nervous system such as tingling, numbness, burning pain, twitching, or spasms. Of those 45 cases, 42 (93%) of these patients also sustained adverse effects involving other systems. Seventy-eight percent experienced central nervous system (CNS) symptoms such as dizziness, agitation, impaired cognitive function, or hallucinations, and 73% reported musculoskeletal symptoms such as joint or muscle pain or tendon rupture. Adverse events also involved the cardiovascular and gastrointestinal systems, skin, and special senses in 18%-42% of cases.

Assessments of severity revealed 2 cases that were mild (4%), 7 moderate (16%), and 36 severe (80%) with chronic pain and/or significantly limited normal function. Symptoms were typically long-term, with 91% exceeding 1 month in duration, 71% exceeding 3 months, and 58% exceeding 1 year. Twelve cases (27%) lasted longer than 2 years. These severe, long-term reactions occurred in a generally young and healthy population. The average patient age was 42 years (range, 11-68 years). Sixty-two percent had no other medical disorder except the infection (mainly sinusitis, prostatitis, urinary infections) that prompted fluoroquinolone therapy.

Because of the current anthrax threat and the hoarding of ciprofloxacin by thousands of people, it is imperative that physicians and the public understand the benefits and potential risks of using ciprofloxacin or other fluoroquinolone antibiotics indiscriminately. The media have, generally, presented only a few fluoroquinolone adverse effects, which are usually described as mild and brief. There are anecdotal reports of people already taking ciprofloxacin prophylactically.

The cases presented in this article, as well as previously published articles about the adverse effects of fluoroquinolones, should give physicians pause before using fluoroquinolones unnecessarily, especially because other, safer antibiotics (eg, penicillin, doxycycline) can often be used instead. Moreover, not all serious reactions associated with fluoroquinolones are listed in package inserts or the Physicians' Desk Reference.

Patients must be informed that with the development of any musculoskeletal, or peripheral or central nervous system symptoms, fluoroquinolone treatment should be discontinued immediately unless medical circumstances (eg, severe infection and no alternative treatment) warrant otherwise. Patients sustaining these reactions should not receive fluoroquinolone antibiotics in the future.