What antibiotics are recommended for common bacterial infections?

From the Guidelines

The most effective antibiotics for common bacterial infections are those that target the specific type of bacteria causing the infection, with considerations for patient allergies, local resistance patterns, and infection severity. When considering the treatment of common bacterial infections, the choice of antibiotic depends on the type of infection, suspected bacteria, and patient factors.

• For urinary tract infections (UTIs), nitrofurantoin for 5 days, trimethoprim-sulfamethoxazole for 3 days, or fosfomycin as a single dose are recommended for uncomplicated cystitis 1.
• For skin and soft tissue infections, guidelines suggest amoxicillin-clavulanate, cefalexin, or clindamycin as first-line treatments 1.
• In cases of community-acquired pneumonia, amoxicillin, doxycycline, or a macrolide (such as azithromycin) may be prescribed 1. It's essential to note that antibiotic resistance is a growing concern, and the choice of antibiotic should be guided by local resistance patterns and patient-specific factors, such as allergies and comorbidities.
• The use of probiotics during and after antibiotic treatment can help maintain gut health, as antibiotics can disrupt beneficial gut bacteria.
• Completing the full course of antibiotics, even if symptoms improve before finishing treatment, is crucial to ensure the infection is fully cleared and to reduce the risk of antibiotic resistance.
• In some cases, culture testing may be necessary to identify the exact bacteria and its antibiotic sensitivities, guiding the choice of antibiotic therapy.

From the FDA Drug Label

To reduce the development of drug-resistant bacteria and maintain the effectiveness of doxycycline tablets and other antibacterial drugs, doxycycline tablets should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria Doxycycline is indicated for the treatment of the following infections: Rocky mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections: Gram-Positive Bacteria Staphylococcus aureus Streptococcus agalactiae Streptococcus pneumoniae Streptococcus pyogenes Gram-Negative Bacteria Haemophilus ducreyi Haemophilus influenzae Moraxella catarrhalis Neisseria gonorrhoeae Other Bacteria Chlamydophila pneumoniae Chlamydia trachomatis Mycoplasma pneumoniae

Recommended Antibiotics for Common Bacterial Infections:

• Doxycycline is recommended for the treatment of infections such as Rocky mountain spotted fever, typhus fever, Q fever, and respiratory tract infections caused by Mycoplasma pneumoniae.
• Azithromycin is recommended for the treatment of infections caused by Gram-Positive Bacteria (Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes), Gram-Negative Bacteria (Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae), and Other Bacteria (Chlamydophila pneumoniae, Chlamydia trachomatis, Mycoplasma pneumoniae) 2 3. Key Points:
• The choice of antibiotic should be based on the suspected or confirmed causative bacteria and its susceptibility to the antibiotic.
• It is essential to use antibiotics only when necessary and to follow the recommended dosage and treatment duration to minimize the development of antibiotic-resistant bacteria.

From the Research

Antibiotic Recommendations for Common Bacterial Infections

• For urinary tract infections (UTIs), fluoroquinolones such as norfloxacin and ciprofloxacin are recommended, as the agents of uncomplicated UTIs are least resistant to these antibiotics 4.
• The duration of antibiotic therapy for acute cystitis is determined by risk factors, with a 7-day course recommended for cases with risk factors and a 3-day course for cases without risk factors 4.
• For acute pyelonephritis, antibiotic therapy should be longer, typically 10-14 days 4.
• Azithromycin is a safe and effective antibiotic for the treatment of adult patients with acute skin and skin-structure infections, with a once-daily dose of 500 mg for three days 5.
• For anthrax infection, ciprofloxacin or doxycycline is recommended for antimicrobial prophylaxis and treatment, while amoxicillin is an option for children and pregnant women 6.
• The efficacy of antibiotics against uropathogenic Escherichia coli and Pseudomonas aeruginosa strains is greatly suppressed when treatment is delayed, highlighting the importance of immediate antibiotic administration 7.

Specific Antibiotic Treatments

• Ciprofloxacin and nitrofurantoin are effective against uropathogenic Escherichia coli strains when administered immediately, but their effectiveness is reduced when treatment is delayed 7.
• Azithromycin and dicloxacillin are effective against Staphylococcus aureus, Streptococcus spp., and coagulase-negative staphylococci in the treatment of adult skin and skin-structure infections 5.
• Amoxicillin is an option for antimicrobial prophylaxis for children and pregnant women, and to complete treatment of cutaneous anthrax disease when B. anthracis is susceptible to penicillin 6.