Handbook of Antibiotics

American Family Physician,  Nov 1, 1994  by Richard W. Sloan

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This book is an updated version of the antibiotic chapter from the third edition of A Practical Approach to Infectious Diseases by the same authors. The book's 23 chapters and numerous tables contain a wealth of practical, concise and relevant information concerning all aspects of antibiotic use.

The authors outline a core of information with bolded print to emphasize key points. The well-referenced text is similar to the Medical Letter on Drugs and Therapeutics in its brevity, clinical usefulness, comparisons, place in therapy, unbiased viewpoint, useful tables and cost-effectiveness. Many references are followed by key summary statements that help the user identify references of interest for further study.

The first chapter on principles of antibiotic use, with its associated 12 tables, contains a 10-question antibiotic checklist to help physicians select the proper antibiotic, with the appropriate route, dose and duration. The tables on common pathogens in focal infections, antibiotics of choice for common pathogens, costs of oral antibiotics, placental transfer of antibiotics, antibiotics in breast milk, major pathways of antibiotic excretion, duration of antibiotic therapy for common infections and allergic reactions to penicillins and semisynthetic penicillins will be of particular interest to family physicians.

Chapter two is an excellent review of the proper prophylactic use of antibiotics. The section on surgical prophylaxis contains an excellent discussion of indications based on types of surgery and organisms involved, timing of dose and duration of therapy. Nonsurgical prophylaxis includes discussion of prevention of rheumatic fever, prevention of serious infections after splenectomy and prevention of bacterial endocarditis. The latter discussion contains several useful tables.

The bulk of the book is devoted to a concise and focused outline of 18 classes of commonly used antibiotics. Each section reviews pharmacokinetics, spectrum of activity, clinical uses, preparations available, toxicity and commonly used antibiotics. A summary statement follows the review of many drugs that highlight recommendations for use and place in therapy. The chapter on cephalosporins contains an excellent review of oral agents with unbiased recommendations for use. The review of aminoglycosides contains a practice review of serum drug levels, dosing in obese patients, once-daily dosing regimens and a method for reducing maintenance doses in renal failure. Inappropriate and excessive use of fluoroquinolones is nicely summarized in a well-written chapter on this important and growing group of antibiotics.

Separate chapters cover antiviral agents and antipneumocystis therapy. These sections will be particularly useful for family physicians who care for patients with human immunodeficiency virus. A brief introduction to antiviral therapy is followed by a discussion of acyclovir, ganciclovir, foscarnet, zidovudine, didanosine, dideoxycytidine, amantadine, ribavirin and interferon alpha.

Antifungal chemotherapy, antituberculous drugs (including rifabutin) and malaria chemoprophylaxis agents are discussed in a chapter on miscellaneous agents. An appendix contains nine useful tables for ready reference on such topics as empiric regimens in suspected bacteremias or treatment regimens for bacterial meningitis and Lyme disease.

The usefulness of this handbook for family physicians could be improved by including a separate section on topical antibiotics (e.g., opthalmic, otic, dermatologic and vaginal agents). The index could also be improved by including more detailed referencing.

This handbook, which family physicians will find as invaluable as a reference as the Physicians' Desk Reference and Drug Facts and Comparisons, is an important, inexpensive addition to the working library of family physicians.

COPYRIGHT 1994 American Academy of Family Physicians
COPYRIGHT 2008 Gale, Cengage Learning