Single dose antibiotic ensures patient compliance

Cold and influenza viruses are especially prevalent at this time of year and such viruses are the most common cause of respiratory infections. However, in many cases, if there is inadequate treatment, secondary infection by a bacterium occurs, most commonly streptococcus.

When this happens, colds and influenza can progress to sinusitis, acute bronchitis and ultimately pneumonia, which is a very serious illness. Forty percent of pneumonia cases are fatal. Early, adequate treatment is therefore critical to minimise the likelihood of pneumonia developing.

This is according to Dr Nivesh Sewlall, a pulmonologist and criti-care specialist at Morningside Medi-Clinic.

“Antibiotics don't work against viruses, so correct diagnosis is crucial,” says Dr. Sewlall. “We need to make sure that the infection is indeed of bacterial origin and identify the causative organism. We then need to choose the most appropriate antibiotic in a high enough dose to kill the bug (bacteria) and ensure that the patient actually takes it as prescribed.”

This is easier said than done. “Most patients fail to finish their course of antibiotics, and this has several consequences. The infection is not eradicated properly and over and the above that, there is a higher chance of the bugs becoming resistant to the antibiotic in question.”

“Use or misuse of antibiotics may result in the development of antibiotic resistance. Antibiotic resistance has become a serious problem in both developed and developing nations. In certain settings, such as hospitals and some childcare locations, the rate of antibiotic resistance is so high that the usual, low cost antibiotics are virtually useless for treatment of frequently seen infections. This leads to more frequent use of newer and more expensive compounds, which in turn leads to the rise of resistance to those drugs. “A struggle to develop new antibiotics ensues to prevent losing future battles against infection,” says Dr Khanyi Mzolo, product physician at Pfizer South Africa.

Dr Sewlall also notes that traditionally, long courses of low-dose antibiotics were preferred, but pointed out that this mindset has been replaced by a newer understanding that shorter courses and higher doses are more likely to achieve the required goals.

“There are two main reasons why patients discontinue taking their medication - either they start to feel better, or else they experience unpleasant side-effects that discourage them from completing a long course of treatment. With this in mind, the ‘ideal antibiotic' is one that comes in a once-off dose. This guarantees both eradication of the infection and patient compliance,” continues Dr. Sewlall

Dr. Sewlall says the good news is that one such antibiotic is being launched in the market. As a result of a new microsphere technology - Azithromycin can now be given as a once off dose. This means that you can take the antibiotic once and its effects persist in your system for up to 10 days.

“This makes it the first of its kind,” says Dr. Sewlall. “Treatment needs to be directed to ensure adequate bacterial cover, with minimal side effects and the least chance of causing bacterial resistance. The most important thing is that the patients get better. Something they can tolerate, in a simple single dose that guarantees 100% compliance is therefore the ideal.”

Dr. Sewlall cautions, however, that antibiotics must only be given when they are warranted. Often, patients are inappropriately given antibiotics for viral infections. Not only does this do no good in respect of treating the virus, it also increases the likelihood of greater resistance in future when antibiotic treatment really is required.

“Diagnosis is key, and it must be established beyond doubt that an initial viral infection has indeed progressed to a point where a bacterium is implicated. Often this can take as long as 5-7 days. Only when there is no longer any doubt should an antibiotic be introduced,” Dr. Sewlall concluded.

Pfizer South Africa
Solly Mabotha
Pfizer Public Relations Manager
www.pfizer.com