E-DRUG: Cloxacillin, dicloxacillin or flucloxacillin? (3)
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Dear Brenda,
Thank you for your discussion of antibiotics on an EML. Can you tell me
what consideration is given to antibiotic resistance? First, resistance
can vary greatly across regions, and within regions by institutional
settings (clinic v. ICU). Even within a class, resistance is not
(necessarily) uniform. These resistance factors might lead to the
conclusion that the injectible form used in an ICU might need to be a
different drug from the community & clinic tablets, or that the drug of
choice in one region is different from another region.
Second, prevention of resistance is a major WHO goal. For many
antibiotics, monotherapy may speed resistance. Cycling, FDCs and other
techniques should be considered in order to avoid the premature
exhaustion of the drug. (These techniques generally include multiple
classes). Again, this has implications for an EML.
Your thoughts? (or input from the list?)
Kevin Outterson
Associate Professor of Law
West Virginia University
304 293 8282
kevin.outterson@mail.wvu.edu
LL.M. (Cantab.)
J.D. (Northwestern)