E-drug: Re: No Free Lunch (cont'd)
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Dear Peter
Thank you for providing us with the benefit of your doubt! Our
typical (brief) answer to your query follows:
In the Western Cape we do see resistance to amoxycillin. 14.6% of
H.influenzae and 5.4% of S. pneumoniae are resistant to penicillin.
A further 11.9% of isolates of S. pneumoniae show moderate
resistance. Therefore, plain amoxycillin is still the drug of choice
(cheap, effective and minimum side effects) and is recommended if
follow-up cannot be guaranteed. If there is no initial response, then
amoxycillin-clavulanic acid may be effective. Importantly,
amoxy-clav is more toxic and much more costly which may lead to
problems with compliance.
References:
1. Gibbon CJ ed. South African Medicines Formulary (SAMF). 4th
Edition. The South African Medical Association 1997:462
2. Lisby-Sutch SM et al. Therapy of Otitis Media. Clinical Pharmacy;
American Society of Hospital Pharmacists 1990;9:15-34.
3. Oliver S, Roditi D, Maartens G. Groote Schuur Hospital
Antibiotic Recommendations 1999.
4. Groote Schuur Hospital ENT Department.
5. Consultants, Department Pharmacology, University of Cape Town.
Tanya Boyce
Director
Medicines Information Centre
Department of Pharmacology
University of Cape Town
OBSERVATORY 7925
Tel: (021) 406 6586
Fax: (021) 448 0503
E-mail: tboyce@uctgsh1.uct.ac.za
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