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Antibiotics are used to treat or prevent common infections, and sometimes viral infections, as well. Antibiotics have been used for over 500 years, but the earliest known usage was used in the 1600s and 1700s. The first documented "antibiotic for diarrhea" occurred in 1555 and was described by the Dutch medical doctor, Samuel Ahema, and its use has been described by many physicians over the centuries.1

Antibiotics are usually administered orally as capsules or powders or by injection after a thorough thorough culture of the patient's stool. Antibiotics are not used to treat or prevent infection with any organism due to their non-specific activity. For example, antibiotic-sensitive organisms can cause infections, particularly if antibiotics are applied too soon followed by excessive administration or if they are administered in conjunction with drug-resistant organisms that cause significant or irreversible damage.2

Treatment is typically started with a 1-3 day course of antibiotics that are repeated for at least 3 days and may be continued with a second 1-3 day course. The antibiotic used should be clinically indicated. All individuals are at risk for adverse reactions to antibiotics and any of the following are serious concerns:1

• Sores or ulcers (especially in children);

• Increased susceptibility to infection;

• Hypersensitivity reactions including:

• Increased susceptibility to infection;

• Decreased immune function.

The development of any of these allergic reactions may be considered a medical emergency by the medical community and can be treated aggressively using a combination of appropriate antimicrobial therapy, which includes an antihistamine, oral steroids and corticosteroids.

When antibiotics are used for the treatment of diarrhea associated with the ingestion of a certain foodstuff, the specific foodstuff may be included as a reference. However, this is not the case with some products, and no foodstuff has been identified as responsible for the occurrence of diarrhea in patients infected with norovirus, rotavirus, campylobacter, salmonella and E. coli.

To minimize or eliminate the risk, many people who have been exposed to a particularly common food, drink, or food item must be carefully watched and carefully examined for signs and symptoms of infection. An outbreak of intestinal dysmotility has occurred in several countries where food was contaminated by food borne illness.

A special dietary protocol has been developed for preventing diarrhea associated with the ingestion of certain foods. Allergy to one or more of the ingredients in these foods is the most common cause of diarrhea in children. Antibiotics should only be used in very small doses to prevent the development of disease. In the event that diarrhea presents to hospital, the child should be admitted for observation until they show signs of improvement. As soon as signs of improvement develop, a patient may be discharged at the earliest opportunity.

Once the pathogen is identified, a different, more potent empiric, is used in parallel. The use of antibiotics in this situation is sometimes called the "antibiotic-resistant" syndrome. The concept of the antibiotic-resistant syndrome was developed by Séralini in the late 70s, and was widely discussed in the medical profession.

A number of antibiotics have been approved as medicines in most or all parts of the world for a number of different infections, including the common cold. The main drugs used in the treatment of the common cold are the streptomycin penicillins and other products, including tetracycline, ampicillin, erythromycin, and tetracycline. Antibiotic-resistant conditions include bronchiolitis externa, which is associated with an increased risk of serious infections; tuberculosis; cholera; typhoid fever, which is an acute illness caused by the bacterium Bacillus anthracis; and, less common illnesses such as acute respiratory tract infections (ARTI), which can cause life-threatening respiratory distress.

Acute bronchiolitis externa is the most common cause of sudden death, and is an infection caused by a bacterium, including B. anthracis (the organism that causes seasonal influenza), and includes streptomycin. Bronchiolitis externa is caused by bacteria that produce a toxin that attacks the airways. The primary symptoms include a cough that worsens when air is exhausted. Other symptoms might include difficulty breathing, chest pain, shortness of breath, and fever. The bacterium that causes bronchiolitis externa is B. anthracis. Treatment involves the administration of a variety of antibiotic medications, starting with the standard antibiotic. The duration of the patient's illness and whether antibiotic therapy is completed also need to consider. Bronchiolitis externa usually resolves on its own. Sometimes it will go into an acute respiratory decline as a result of decreased bronchial oxygen tension, with exacerbation of symptoms, and more bronchial fluid in the lungs (pulmonary edema). Other antibiotics used to treat bronchiolitis externa are doxycycline and levofloxacin. A more potent antibiotic is also sometimes prescribed (amoxicillin) for this situation.

In other words, a positive patient culture and specific antibiotic targets of treatment can be established. If the clinical diagnosis is confirmed, a drug is prescribed based on the appropriate clinical indication.

An alternative is to initiate a culture and select a targeted and specific antibiotic using a specific panel of clinical laboratory tests, the majority of which will be positive for both bacteria and protozoa, before initiating therapy. Since the antibiotics are administered as a single dose, many patients feel better when the first line therapy begins.

If resistance to a particular antibiotic was anticipated based on a prior infection experience, the same organism that might have developed resistance to that particular antibiotic in that patient could develop resistance to others. For example, if antibiotic used in treatment of a patient with tuberculosis develops resistance to several different antibacterial agents, a patient might develop a second infection, a second resistant strain, and then eventually a third resistant strain. In reality, resistance does not always occur.

In clinical practice, resistance rarely develops in the first 24 hours after administration of therapy because most commonly antibiotic resistant organisms are present several weeks before the therapy is administered to the patient. However, resistance can develop within 24 to 72 hours of the initiation of therapy, especially if the antibiotics are administered in the setting of a secondary infection. Treatment with a broad-spectrum antibiotic is often preferable to an empiric regimen that is based on a laboratory analysis alone, because the standard is much lower. This higher standard makes it much less likely that a resistance will develop in the event that an antibiotic has been previously administered to a patient. It is important to note that this risk is especially acute for empiric therapy to which a person has received at least a week's time of treatment.

An important advantage of the empiric form of antibiotic therapy is that it can provide an early and precise diagnosis in about three out of every four cases in which resistance develops.

Treatment Alternatives

The next option for the physician to consider is to use a variety of antibiotics.