What are the basic medicines, including antibiotics, eyedrops, ointments, antiallergics, and cold/cough medications, that a clinic should stock to manage everyday infections and medical problems?

Essential Medicines for a Clinic to Stock for Everyday Infections and Medical Problems

Every clinic should stock amoxicillin, azithromycin, ciprofloxacin, diphenhydramine, albuterol inhaler, hydrocortisone cream, antibiotic eye drops, acetaminophen, ibuprofen, and oral rehydration solution as the basic medicines to manage common infections and medical problems. Based on the most recent guidelines, these medications address the most frequent clinical needs while ensuring optimal patient outcomes in terms of morbidity, mortality, and quality of life.

Antibiotics

• Amoxicillin: First-line antibiotic for many common infections including streptococcal pharyngitis, otitis media, and community-acquired pneumonia; preferred over broader-spectrum antibiotics due to its narrow spectrum and low cost 1

• Azithromycin: Essential for treating atypical pneumonia, mycoplasma infections, and as an alternative for patients with penicillin allergy; recommended dosing is 10 mg/kg on day 1, followed by 5 mg/kg once daily for days 2-5 for pediatric patients 2, 3

• Ciprofloxacin: Necessary for urinary tract infections and certain gastrointestinal infections; helps reduce inappropriate use of broader-spectrum antibiotics that increase risk for antimicrobial resistance 1

Antiallergics and Anti-inflammatory Medications

• Diphenhydramine: Critical for managing mild allergic reactions including urticaria and pruritus; can be used as first-line treatment before escalating to more aggressive management for significant allergic reactions 4

• Hydrocortisone cream (1%): Essential for treating inflammatory skin conditions, contact dermatitis, and mild allergic skin reactions; reduces the need for systemic steroids 1

• Oral antihistamine (e.g., loratadine or cetirizine): Important for managing allergic rhinitis and other non-urgent allergic reactions without the sedating effects of diphenhydramine 1

Respiratory Medications

• Albuterol inhaler: Critical for immediate management of bronchospasm and acute asthma exacerbations; listed as an essential bronchodilator in emergency settings 1

• Ipratropium bromide inhaler: Important adjunct to albuterol for managing COPD exacerbations and severe asthma attacks; recommended as part of essential respiratory medications 1

Eye Medications

• Antibiotic eye drops (e.g., erythromycin or polymyxin B-trimethoprim): Essential for treating bacterial conjunctivitis and preventing corneal infections; reduces risk of vision-threatening complications 1

• Lubricating eye drops: Important for symptomatic relief of dry eyes and as a vehicle for diluting medicated drops when needed 1

Pain and Fever Medications

• Acetaminophen (tablets and liquid): First-line antipyretic and analgesic with excellent safety profile; essential for managing fever and mild to moderate pain in both adults and children 1

• Ibuprofen (tablets and liquid): Important non-steroidal anti-inflammatory drug for managing pain, inflammation, and fever; provides an alternative mechanism of action to acetaminophen 1

Other Essential Items

• Oral rehydration solution: Critical for preventing and treating dehydration, especially in pediatric patients with gastroenteritis; reduces morbidity and mortality from diarrheal illnesses 1

• Topical antibiotic ointment (e.g., bacitracin or mupirocin): Essential for treating minor skin infections and preventing infection in minor wounds 1

Implementation Considerations

• Medications should be clearly labeled with name, date, and concentration to prevent confusion and medication errors 5

• Proper storage conditions must be maintained for all medications to ensure stability and efficacy 5

• Regular inventory checks should be conducted to ensure medications are not expired and are available in sufficient quantities 1

• Consider local resistance patterns when selecting antibiotics, as resistance of common pathogens varies geographically 1, 3

Common Pitfalls to Avoid

• Overuse of broad-spectrum antibiotics: This increases the risk of antimicrobial resistance, including MRSA and VRE, as well as C. difficile infections 6, 7

• Assuming "sulfa allergy" applies to all sulfur-containing drugs: A "sulfa allergy" specifically refers to sulfonamide antibiotics and does not mean the patient is allergic to drugs containing sulfur, sulfites, or sulfates 4

• Inadequate stocking of emergency medications: Essential medications should be immediately available for time-sensitive conditions to prevent increased morbidity and mortality 1

• Failure to consider pediatric formulations: Liquid formulations of key medications are essential for accurate dosing in pediatric patients 2, 3