With the improvement of people's living standards, people's requirements for health are getting higher and higher. When choosing antibiotics, people often go into a misunderstanding that the more expensive the drug, the better, and the newer the better. However, incorrect use has accelerated the rapid growth of drug-resistant bacteria. On the other hand, due to the large dosage of antibiotics in clinic, many varieties, rapid update, complex relationship between various drugs, increasing combination drugs, and more and more preventive drugs. Therefore, the incidence of adverse reactions and drug resistance of antibacterial drugs are still increasing year by year. In this social environment, the rational use of antibiotics is particularly important.

1, the basic principles of rational use of antibiotics

The clinical pharmacological concept of rational use of antibiotics is to use antibiotics safely and effectively, that is, to ensure effectiveness under the premise of safety, which is the basic principle of rational use of antibiotics.

2. How to use antibiotics rationally

2. 1 Identification of pathogenic bacteria

As soon as possible, the pathogenic bacteria were isolated from the infected site and blood of patients, and drug sensitivity tests were carried out to select antibiotics.

2.2 Selection of antibiotics

The rational use of antibiotics is related to the success or failure of treatment. The following points must be considered when selecting drugs.

2.2. 1 First of all, we must master the antibacterial spectrum of antibiotics. The action characteristics of various antibiotics are different, so the antibacterial spectrum of the selected drugs must be adapted to the infected microorganisms, otherwise it will waste money and delay the illness.

2.2.2 Balance between antibiotic efficacy and adverse reactions: Most antibiotics have some side effects or other adverse reactions unrelated to the therapeutic purpose. Generally speaking, try to choose drugs that are beneficial to patients or do more harm than good, so we must strictly control the indications of drugs when using drugs to prevent drug abuse. For example, renal insufficiency should avoid using antibacterial drugs that are mainly excreted by the kidneys and harmful to the kidneys; In the case of hepatic insufficiency, antibacterial drugs which are mainly metabolized by the liver and harmful to the liver should be avoided; Special groups such as newborns, children, pregnant women and lactating women should use safe antibacterial drugs.

2.2.3 Combination of drugs Combination of drugs may increase the effect of the original drug, which is called synergy; It may also weaken the effect of the original drug, which is called antagonism. The purpose of combined medication is to improve the therapeutic effect and reduce the side effects. On the contrary, it reduces the therapeutic effect, increases the toxic and side effects, and will have adverse reactions to patients. At present, antibiotics are generally divided into four categories. The first category is bactericide (ⅰ) in breeding period, such as? -lactam antibiotics, and the second category is static bactericidal drugs (category II), such as aminoglycosides and polymyxin antibiotics. The third category is fast bacteriostatic drugs (III), such as tetracycline and macrolide, and the fourth category is slow bacteriostatic drugs (IV), such as sulfonamides. When the above antibiotics are used together, they can produce four effects: synergistic (Ⅰ+Ⅱ), antagonistic (Ⅰ+Ⅲ), additive (Ⅲ+Ⅳ), irrelevant and additive (Ⅰ+Ⅳ). In order to achieve the purpose of combined medication, appropriate compatibility should be carried out according to the nature of antibacterial drugs.

Generally speaking, when using antibiotics, we should strictly grasp the indications and try to use them with or without them. In addition to considering the pertinence of antibacterial effect of antibiotics, we should also master the relationship between adverse drug reactions, internal processes and curative effects. Antibiotics should not be used in patients with unknown fever; Virus infection does not require antibiotics; Try to avoid external use of antibiotics (such as skin). Strictly controlling the scope of preventive antibiotics can prevent rheumatic fever patients, and penicillin G should be used regularly to eliminate hemolytic streptococcus in pharynx and prevent rheumatism from recurring. Use penicillin G or other suitable antibiotics before and after rheumatic or congenital heart disease surgery to prevent subacute bacterial endocarditis; Appropriate antibiotics should be selected according to the sensitivity of bacteria when removing infected lesions; After war injury or compound injury, use penicillin G or tetracycline to prevent gas gangrene. Neomycin is used for intestinal preparation before colon surgery. After severe burns, penicillin G was used to eliminate the infection of hemolytic streptococcus on the wound surface before skin grafting.

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