Oral antibiotic treatment of infectious diseases.

The use of antimicrobial agents (i.e., penicillins, cephalosporins, macrolides, aminoglycosides, tetracyclines, quinolones) have continued to grow at an astounding rate. Centers for Disease Control and Prevention estimates are of some 150 million prescriptions annually in the United States, amounting to some 50 millions pounds of antibiotics annually being used in the United States with some 15 to 17 million pounds being used in livestock and agriculture alone. These large numbers serve as indicators for caution and concern. Most oral antibiotics are prescribed for respiratory tract infections, more than half of which are probably viral, for which antimicrobials are not necessary. This overprescribing is noted at a time when increasing antimicrobial resistance is being recognized in hospital settings as well as in the community. The dilemma for the practitioner is to be able to use antibiotics efficaciously and prevent overusage and overprescribing.