E-DRUG: Use of ceftriaxone in poor countries (14)
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Hi all,
I do not see a problem using ceftriaxone in poor countries or developing world. Reasons being that
-most patients have tried some form of self medication with antibiotics when they present to you.
In most developing countries, patients are able to buy these oral antibiotics (amoxicillin, tetracycline, cotrimoxazole, ampicillin etc) over the counter without prescription. And in most cases, they do not buy a complete course enough for 5 to 10 days of therapy.
We must also bear in mind that there are some WHO notifiable diseases that you must start on emperic therapy as you wait for your lab results eg bacterial menengitis.
-Use of ceftriaxone improves compliance. It can be given as a once a day dosing or twice daily.
-Daily or twice a day dosing ensures that patients can take parenteral therapy from the comfort of their homes.
-Use of ceftriaxone also reduces sick days; patients are able to return to work ASAP, hence keeps our economy running in such hard times
-We should worry less about resistance, especially if we use this drug appropriately as recommended.
-I also do believe that if a patient can afford it, then give it to him/her. Why subject them to suffering while you are trying out the "cheaper" oral antibiotics! It ends up being expensive to the patient and employers anyway, since they will miss so many days of work due to sickness!!
-The goal should be quick recovery, and return to work soon
-Like someone already mentioned, with ceftriaxone, you do not have to worry about renal dose adjustments; you do not have to worry about drug levels as is with gentamicin, amikacin, vancomycin etc; steady-state levels achieved around the 3rd dose.
[The moderator finds that some discussants are not differentiating between substituting oral narrov-spectrum antibiotics for minor infections with ceftriaxone and serious infections needing admittance to hospital.]
Dr. Otieno A.A
otienoaduma@hotmail.com