If you had to pick one antibiotic...

[greenbeetle]

Liff,

No, I don't need to look up the definition of broad spectrum. I can tell you. Broad spectrum means an antibiotic is active against a wide variety of bacterial organisms. The term "wide variety" is not strictly defined. Also note that just because an antibiotic kills something in vitro does not mean it will do so in vivo or if it does it may not penetrate all the types of tissues infected well enough to treat the infections typically caused by that organism. So functionally, all antibiotics listed are narrow spectrum by definition and by limited clinical usefulness due to factors such tissue penetrance, the need for dual antibiotic therapy in some infections (meaning they are not effective by themselves in vivo even if they are in vitro), and so on.

Antibiotics do not get more narrow spectrum than penicillin, amoxicillin, zithromax, vancomycin, clindamycin, erythromycin... Just because keflex is good for 2 gram negative organisms doesn't make it broad spectrum. No matter what you read on the internet. Taking keflex as your choice for one-drug-do-it-all is inadequate. Same with amoxicillin, no matter what you read on wikipedia, in practice this is a narrow spectrum antibiotic that is seldom used outside of sinus infections (for which it is over-prescribed) tooth aches and strep throat and is not employed empirically as a broad spectrum antibiotic (unless it is combined with clavulinic acid "Augmentin"). Flagyl may have a wide range of coverage but not of clinical uses making it effectively a narrow spectrum antibiotic. Using it for anything other than a limited number GI or protazoal infections is not undertaken, and even then it is not often used empirically as monotherapy. Well, it cures trich by itself...

EDIT: Add that the spectrum for 1 gen cephalosporins and penicillins is shrinking rapidly (not that they were ever broad spectrum). The most common cause of skin infections is staph aureus which is a very common reason to prescribe those two classes of antibiotics. MRSA has emerged as the predominate form of staph aureus over the past 20 years making the vast majority of hospital staph infections and a narrow majority of community staph infections resistant to those two classes of antibiotics. Strep which was thought to be universally sensitive to beta lactams 10 years ago now shows signs of emerging penicillin resistance. The few gram negative organisms typically covered by some of those antibiotics have developed beta lactamases. H. Flu, a common cause of pneumonia and ear infections, that used to be readily treated with beta-lactams is now up to 30% isolate resistant. Same with e. coli which until recently was readily treated with early generation cephalosporins. In other words, the spectrum for these antibiotics is shrinking / has shrunk (ie nearly cut in half) from when the dated material some guy threw up on wikipedia was put out.

I might retract 2nd generation cephalosporins as being narrow spectrum. I just never use them because of reasons above.

I know plenty about the indications for levoquin and penicillin and will not be looking anything up.

Cephalosporins are beta lactams but retain more of their activity in the presence of beta lactamases than penicillins do, specifically against pencillinases. That is not my call, it is widely known in the field of medicine starting with the second generation and moving forward that cephalosporins are more resistant to beta lactamases than penicillin. There are many types of beta lactamases, some of which inhibit cephalosporins, some monobactams, there are ESBLs now, etc.

MRSA. Look it up.

My post is accurate.

It's what I'd do, if you don't like it then don't read it anymore.

[Liff]

So you are going to redefine terms to mean whatever you personally want the term to mean, and not post references? Something tells me that if I continue to discuss this topic with you I will only leave very, very frustrated. No thanks.



For everyone else; I would just like to leave this one indicator of inaccuracies in the above post.

Antibiotics do not get more narrow spectrum than penicillin, amoxicillin, zithromax, vancomycin, clindamycin, erythromycin... <Snip>.

http://www.nlm.nih.gov/medlineplus/drug ... 97037.html (Zithromax is the brand name in the US for azithromycin.)

Azithromycin is used to treat certain infections caused by bacteria, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, skin, and throat.

Azithromycin is also used sometimes to treat H. pylori infection, early Lyme disease, and other infections. It is also used sometimes to prevent heart infection in patients having dental or other procedures and to prevent STD in victims of sexual assault.

Does this sound like a "narrow spectrum" antibiotic to anyone?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC175832/

The macrolide antibiotic azithromycin (CP-62,993; 9-deoxo-9a-methyl-9a-aza-9a-homoerythromycin A; also designated XZ-450 [Pliva Pharmaceuticals, Zagreb, Yugoslavia]) showed a significant improvement in potency against gram-negative organisms compared with erythromycin while retaining the classic erythromycin spectrum. It was up to four times more potent than erythromycin against Haemophilus influenzae and Neisseria gonorrhoeae and twofold more potent against Branhamella catarrhalis, Campylobacter species, and Legionella species. It had activity similar to that of erythromycin against Chlamydia spp. Azithromycin was significantly more potent versus many genera of the family Enterobacteriaceae; its MIC for 90% of strains of Escherichia, Salmonella, Shigella, and Yersinia was less than or equal to 4 micrograms/ml, compared with 16 to 128 micrograms/ml for erythromycin. Azithromycin inhibited the majority of gram-positive organisms at less than or equal to 1 micrograms/ml. It displayed cross-resistance to erythromycin-resistant Staphylococcus and Streptococcus isolates. It had moderate activity against Bacteroides fragilis and was comparable to erythromycin against other anaerobic species. Azithromycin also demonstrated improved bactericidal activity in comparison with erythromycin. The mechanism of action of azithromycin was similar to that of erythromycin since azithromycin competed effectively for [14C]erythromycin ribosomebinding sites.

I am starting to think it is more so a broad spectrum antibiotic based on the multiple sites of infection and the multiple bacterial species covered. Maybe one more....

http://www.ncbi.nlm.nih.gov/pubmed/1280567

Azithromycin is an acid stable orally administered macrolide antimicrobial drug, structurally related to erythromycin, with a similar spectrum of antimicrobial activity. Azithromycin is marginally less active than erythromycin in vitro against Gram-positive organisms, although this is of doubtful clinical significance as susceptibility concentrations fall within the range of achievable tissue azithromycin concentrations. In contrast, azithromycin appears to be more active than erythromycin against many Gram-negative pathogens and several other pathogens, notably Haemophilus influenzae, H. parainfluenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, Urea-plasma urealyticum and Borrelia burgdorferi. Like erythromycin and other macrolides, the activity of azithromycin is unaffected by the production of beta-lactamase. However, erythromycin-resistant organisms are also resistant to azithromycin. Following oral administration, serum concentrations of azithromycin are lower than those of erythromycin, but this reflects the rapid and extensive movement of the drug from the circulation into intracellular compartments resulting in tissue concentrations exceeding those commonly seen with erythromycin. Azithromycin is subsequently slowly released, reflecting its long terminal phase elimination half-life relative to that of erythromycin. These factors allow for a single dose or single daily dose regimen in most infections, with the potential for increased compliance among outpatients where a more frequent antimicrobial regimen might traditionally be indicated. The potential disadvantage of low azithromycin serum concentrations, however, is that breakthrough bacteraemia may occur in patients who are severely ill; nevertheless, animal studies suggest that tissue concentrations of azithromycin are more important than those in serum when treating respiratory and other infections. The clinical efficacy of azithromycin has been confirmed in the treatment of infections of the lower and upper respiratory tracts (the latter including paediatric patients), skin and soft tissues (again including paediatric patients), in uncomplicated urethritis/cervicitis associated with N. gonorrhoeae, Chlamydia trachomatis or U. urealyticum and in the treatment of early Lyme disease. Azithromycin was as effective as erythromycin and other commonly used drugs including clarithromycin, beta-lactams (penicillins and cephalosporins), and quinolone and tetracycline antibiotics in some of the above infections. Some patients with acute exacerbations of chronic bronchitis due to H. influenzae may be refractory to therapy with azithromycin (as is the case with erythromycin) indicating the need for physician vigilance, although it should be noted that azithromycin is of equivalent efficacy to amoxicillin in the treatment of such patients. In the therapy of urethritis/cervicitis associated with C. trachomatis, N. gonorrhoea or U. urealyticum, a single dose azithromycin regimen offers a distinct advantage over currently available pharmacological options, while providing effective therapy.(ABSTRACT TRUNCATED AT 400 WORDS)

Seems broad spectrum to me again....

Regardless, this is the internet. Be careful of what information you take away. Reference the stuff I say with your own research and learning. Reference the stuff others say against quality resources. Think for yourself.

[greenbeetle]

Azithromycin covers about what a first generation cephalosporin does. Let me put it this way, if you get diagnosed with a pneumonia and sent home from the ER you will probably get zmax. If you get diagnosed with a pneumonia and sent from the ER to the ICU you will be required by JCAHO to receive zmax and one other antibiotic because zmax by itself just isn't good enough... If you get sick with penumonia in a nursing home, while on dialysis, while receiving home health, while receiving chronic wound care or within weeks of taking any other antibiotic it may be malpractice to give you zithromax whether or not it is combined with a second drug because its spectrum and effectiveness are not adequate.


This is a waste of my time...

You win!

(EDIT: One last attempt to help. Look up some broad spectrum antibiotics, it will help you understand: zosyn, timentin, augmentin, ceftazidime, merrem, gentamycin, cefepime, doripemen, avelox, doxycycline)

[abelru]

Without stirring the pot beyond how agitated it already is...

I'm going to have to side with Liff on the issue of the meaning of "broad spectrum" (irrespective of his credentials), especially with regard to drugs such as vanco. "Broad spectrum" by anyone's definition does not mean "kills all"
As best as I can think, I would use it to describe drugs which have activity against the most common organisms given a specific type of infection (either causative organism, and or tissue type). Vanco certainly falls within this category. As do clinda and azith, and a number of others that were named.

On another note, this is a great illustration of the complexity of the issue at hand, which is that even among professionals (giving greenbeetle the benefit of the doubt credentials wise on this as I do not 'know' the individual), there can be great debate as to what/when/delivery vehicle/etc.

In other words, 5 pages of struggling for an answer to a question for which there is no answer...

Sounds like a fools errand, no?

[greenbeetle]

I am an ICU physician boarded in two specialties and practicing for 7 years. Liff's credentials mean little to me.

And btw, there may literally not be a more narrow spectrum antibiotic than vancomycin. There may not be a drug that is effective with fewer organisms than vanc. Orally it kill's c. dif, that is all, one bug. It is the narrowest of the narrow. Definitely illustrates what I'm up against here.

[abelru]

I am an ICU physician boarded in two specialties and practicing for 7 years. Liff's credentials mean little to me.

And btw, there may literally not be a more narrow spectrum antibiotic than vancomycin. There may not be a drug that is effective with fewer organisms than vanc. Orally it kill's c. dif, that is all, one bug. It is the narrowest of the narrow. Definitely illustrates what I'm up against here.

Do you speak of vanc in terms of oral administration only? If so, this is very common knowledge...
Parenteral? Well...

[greenbeetle]

Vanc is narrow spectrum by IV too. Primarily used only for GPC or c. dif but even then often requires combination therapy with another drug to be curative, especially for enterococcus and endocarditis infections. Can be used IV for C. Dif. Has some effect against limited number of anaerobes though it is not employed clinically often for that (have never seen it for that, personally. There are better, less toxic drugs for those infections).

Vancomycin is universally recognized as narrow spectrum. Please don't site a wikipedia article. There is no debate.

From the nature of responses I don't think this is going to be productive at this point. Anyways I'm full of poo, now let's carry on to another thread!

[Liff]

I am an ICU physician boarded in two specialties and practicing for 7 years. Liff's credentials mean little to me.

Generally, I got to agree with greenbeetle here, credentials don't mean everything. And I know greenbeetle's credentials mean a lot to me. Why? If he was specialized in infectious diseases he would have said so. And he works in the ICU department. This means he does not think in terms of oral antibiotics. Notice how few IV only antibiotics were mentioned in this thread prior to greenbeetle posting? And the ICU thing, which means he works in a hospital. This means he prescribes off of a formulary, and all of the anti-infectives were chosen by infectious disease physicians. So he has a limited amount of decisions and has to request permission to use something off of the formulary. And the ICU thing again, he deals with a limited type of patient. By his own admission he has a very limited knowledge base, limited experience base, and few clinical options to choose from. Thank you greenbeetle for showing your credentials, I appreciate knowing your background.

You have posted a lot of things that make very, very good sense (even if for the wrong reasons) for someone working the the ICU. So stretch your legs a bit, join the discussion, and think in terms of of antibiotics that you may want to have in the paw. I really like the doripemem idea, but IV infusion over 60 minutes seems beyond the layperson. And it appears that Imipenem/cilastatin has more approved indications. And Primaxin isn't on your hospital's formulary, so you don't use it much.

So, going forward, use references and don't post stupid shit like,

With regards to infants and young children. Their antibiotics come formulated differently, often in liquids and are dosed on a per kg basis. Meaning if you could only choose one antibiotic for adults and kids, it would have to come in a liquid.

Because I can't tell you how many hundreds of times I have turned tablets or capsules into oral liquids for children or adults who couldn't swallow the oral tablet/capsule. Or how amoxicillin 'liquid' for children is sent as a powder for reconstitution. But how often is liquid oral amoxicillin prescribed in the ICU? Or other mis-informed things like;

Azithromycin covers about what a first generation cephalosporin does.

Because you know or should know that isn't true.

[greenbeetle]

I've worked in clinics, the hospital floor, ERs and a rehab facility. I used dorepenem as an example of a broad spectrum antibiotic not as an oral antibiotic. We have primaxen at the hospital where I work. I can't follow all of what you're saying about that to be honest. One of my board certifications is pediatrics but thank you for your input. I never said my knowledge was admittedly limited - what I did was make an effort at self-deprication to diffuse the tension created by your confrontational posts.

My point is one antibiotic can't do it all. There's the problem of spectrum, allergies, drug interactions and children's forumulations. If you have a "BOB compounding kit" and want to smash up an adult pill to measure out for a 1 year old child and are comfortable dosing in mg/kg for the indication and antibiotic you've chosen then that 1 year old is in luck. Or, we'll have to acknowledge a single antibiotic to do-it-all isn't really possible.

You say "don't post stupid #$*!"

Number one, cursing is not welcome, sir. Number two, no worries this is clearly not the place for informed opinions so next time I see a 4 page thread in an area I spent 12 years training and 7 years working I will definitely not try to help, because help is obviously not welcome here.

What a strange reception. I won't be back to this thread. Bash and flame all you want, Liff.

[Liff]

I really hope everyone can see the difference in pointing out a personal attack and making a personal attack.

What a strange reception. I won't be back to this thread. Bash and flame all you want, Liff.

Personal attack right there. If you do come back, please show where I "bash and flame" you as a person vs disagree with your opinions while citing references.

what I did was make an effort at self-deprication (sic) to diffuse the tension created by your confrontational posts.

Compare and contrast "self-deprecation":

I disagree that people should not try to educate themselves about any subject. I do think that people should not try to learn how to diagnose and treat over the internet. I spent years getting my PharmD., and I have been out of school for 8 years now. I consider my current knowledge lacking. First I am human, second, I know how bad I am at diagnosing, and third, my pharmacist education is 8 years old. And I practice nuclear pharmacy, so this is not my specific area of specialty. (Nuclear pharmacists still deal with infection, radiolabeling white blood cells and labeling antifungals and antibacterials to visualize bio-distribution.) There are wonderful guides out there for empiric antibiotic therapy like The Sandford guide to antimicrobial therapy, but the diagnosis must be made first. Guess what pharmacist's don't do.

(Page 4.)

Liff, No, I don't need to look up the definition of broad spectrum. I can tell you.

Liff,<Snip> no matter what you read on wikipedia, ....

I know plenty about the indications for levoquin and penicillin and will not be looking anything up.

MRSA. Look it up.

My post is accurate. [No references given.]

It's what I'd do, if you don't like it then don't read it anymore.

This is a waste of my time...

I am an ICU physician boarded in two specialties and practicing for 7 years. Liff's credentials mean little to me.

Please don't site a wikipedia article. There is no debate.

From the nature of responses I don't think this is going to be productive at this point.

I am not sure there is any self-deprecation on one side of the debate by the standard definition of self-deprecation. Or by this definition of the term; http://en.wikipedia.org/wiki/Self-deprecation.

The one question I would have for you, if you were to come back to this thread, would be: In your experience, (4 years of pre-medical education, 4 years of medical education, 4 years of supervised practice, and 7 years of practice), your knowledge has never been questioned? No one has ever asked you for a reference? Is this really this first time?

My point is one antibiotic can't do it all.

I have re-read your posts carefully, please forgive me if I missed it, but you never said that or made that point before your last post. And that idea has been posted over and over by multiple people though out this thread, starting on page one. For example:

Seriously though:
1) Water filter.
2) Soap.
3) Worry about something else.
4) Some antibiotics just don't work against some microbiota, or don't work depending on the site of infection, or don't work because the duration was too short, or don't work due to lack of patient compliance, and so on. Sometimes regular penicilllin is the best choice, sometimes it is the worst choice. It all depends. And what about when there is an adverse reaction to the antibiotic and you need the ER?


Asking this question is just like asking, "What one tool do would I need to rebuild an engine?" You could answer a crescent wrench, but what are you going to do when you need a screwdriver?

This is the place for informed opinions, and un-informed opinions, and completely wrong opinions, and baseless opinions. This is the internet. Everyone here is 6'4", 212 pounds, did international modeling, was a SEAL and Delta Force. Everyone holds multiple doctorates, vast amounts of certifications, and has had more encounters than Gene Simmons and Wilt Chamberlain combined. And most of us are able to count to infinity. I personally counted to infinity twice and I can make a donkey laugh then cry.

If you can't cite references and you are not able to cope with people questioning your opinion, then maybe you shouldn't play on the internet.

[PotatoMuncher]

We'll, this topic has gone out the window...

[Liff]

You're right. But if the two ideas that regular people take away is that one singular antibiotic isn't going to be adequate and that there is a great many facets to the topic then the thread served its purpose I hope.

[Jamie]

Some topics should just go 1 page and then stop...

Jamie

[kbilly84]

Some topics should just go 1 page and then stop...

Jamie

Especially since the main points - Only one antibiotic will not cover all things (probably not even most things) & trying to dose and administer without a pharmacist or doc close by could be dangerous/deadly - were covered pretty early on.

Then someone comes in trying to stir up shit. Lulz.

Cut this last page and lock it? Sounds good to me.

[Liff]

Cut this last page and lock it? Sounds good to me.

That is an outstanding idea. All the BS on the last page that I contributed to (sorry) really does not add to anything. Who should we petition for assistance in that idea?

[Jamie]

I'd love to, but am no longer a mod...

Jamie

[kbilly84]

That is an outstanding idea. All the BS on the last page that I contributed to (sorry) really does not add to anything. Who should we petition for assistance in that idea?

Liff, far as I'm concerned, you have zero need to apologize. Your info was very well presented and very well cited (not to mention spot-on). And that's all I'm gonna say about.

As far as who to petition... Good question. How would one go about it?

[Liff]

I sent a PM to raptor, I have discussed other topics with him in the past. We'll see where it goes from there.

[whisk.e.rebellion]

Liff, don't feed the trolls.

greenbeetle, don't be a jerk.

Locked pending review.

ETA: Not locking. Put your e-penises away and we'll see if we can salvage what was once a useful thread.

[crypto]

This thread has illustrated one of my pet peeves about the ZS forums, and the First Aid forum in particular:

Here is what happens in a nutshelll, all the time:

Person one: "Hey I'm preparing for disasters that might mean my doctor and walgreens/CVS are unavailable what should I do to learn about and stock (insert medical thing here)"

Persons two, three, four: "OH NO SEE IM A TRAINED PROFESSIONAL AND THAT SHIT IS SIMPLY TOO HARD FOR YOU TO COMPREHEND YOU HAVE TO DO THE TRAINING LIKE I DID TO UNDERSTAND IT".



I think that is pure B.S., and counter to the spirit of trying to get people to prepare. Whether its a layman wanting to know how to run an IV or insert an OPA/NPA, or someone wanting to know what antibiotics to have on hand (hint: they're all in the fish supplies aisle at the petco/petsmart), or what-have-you.

We are preparing for a time when we cannot get to you, and cannot benefit from your specialized training, and need to do something on our own other than curl up and die. Sorry if it offends you that we'd want to do that, but stop acting like a secret guild. "Do no harm" doesn't count if you just tell someone how they might hurt themselves.

[Jamie]

This thread has illustrated one of my pet peeves about the ZS forums, and the First Aid forum in particular:

Here is what happens in a nutshelll, all the time:

Person one: "Hey I'm preparing for disasters that might mean my doctor and walgreens/CVS are unavailable what should I do to learn about and stock (insert medical thing here)"

Persons two, three, four: "OH NO SEE IM A TRAINED PROFESSIONAL AND THAT SHIT IS SIMPLY TOO HARD FOR YOU TO COMPREHEND YOU HAVE TO DO THE TRAINING LIKE I DID TO UNDERSTAND IT".



I think that is pure B.S., and counter to the spirit of trying to get people to prepare. Whether its a layman wanting to know how to run an IV or insert an OPA/NPA, or someone wanting to know what antibiotics to have on hand (hint: they're all in the fish supplies aisle at the petco/petsmart), or what-have-you.

We are preparing for a time when we cannot get to you, and cannot benefit from your specialized training, and need to do something on our own other than curl up and die. Sorry if it offends you that we'd want to do that, but stop acting like a secret guild. "Do no harm" doesn't count if you just tell someone how they might hurt themselves.

+47!

I get bored with the hubris of the medical profession in general, but to have to wade through it on ZS as well is tiresome...

We get it...you went to school...so did I, but despite my two Masters degrees, I don't presume to tell people that they can't teach their kids...

Jamie

[emtmark]

Fish isle ABX! Had no idea! Off to research........

[ironsheik7]

First off, I rate this thread as good. Among people who deal with antibacterials or antibiotics as part of their normal job there is consensus that there is not a "The One" antibiotic, and no one should be looking for something like that. Anytime a good question is asked and there is that much consensus, it clearly represents the current thought in the state of whatever topic is being discussed.

There are good romper stomper combinations that fail in a different infection, and the better point is that the reverse is also true. And we have not even started to discuss why an E Coli infection of the prostate needs cipro for 28 days while the same E Coli bacteria causing a UTI needs therapy for 3 days. (Guidelines vary.) Or how different areas in this country have different rates of antibacterial resistance. What works well in Texas may be a poor choice in North Dakota.

Lots and lots goes into this topic. A little knowledge can be (not "is", but "can be") a dangerous thing.

Either way, stock up of fish antibiotics. (Just in case: blue text means sarcasm on this board.)

I can answer your question as I have battled with bladder infections, prostate infections for 5 years now and have also studied some urology and microbiology..

(((And we have not even started to discuss why an E Coli infection of the prostate needs cipro for 28 days while the same E Coli bacteria causing a UTI needs therapy for 3 days. ))))

Number 1 when a person first gets an infection the bacteria is plankton bacteria which is free floating micro organisms. In the planktonic state bacteria are killed very easily. But if the infection survives an antibiotic because the antibiotic was not taken long enough and only killed a few of the bacteria and left a remaining amount. The plankton then have 2 choices either die the next go around of antibiotics or come together, latch down on a surface, and form a gelatin like substance called biofilm which makes the bacteria up to 1,000 x resistant to antibiotics. This is what happens when people have chronic infections that antibiotics aren't putting a dent in. And it takes such a huge huge concentration of antibiotics to knock out a biofilm , that many people are stuck to live a chronic infection out the rest of their life. This is very common in our current society.

But to answer the above question, a UTI is very basic to cure because a big concentration of antibiotics can reach the bladder very easily. depending on the antibiotic a 500 milligram pill could mean anywhere from 1,000 -5,000 micrograms per pill, also keep in mind that it takes 1,000 micrograms to equal one milligram. so you would basically be getting 1 - 5 milligrams of that 500 mg cephalexin pill or that 500 mg ciprofloxacin pill into that bladder infection.

Prostate is very different, if you get a prostate infection it can be almost impossible to cure because of the biofilm factor, and also because of the simple fact the concentration of antibiotics into the prostate is minimal. Norfloxacin concentration into the prostate for two 400 milligram pills is 1 microgram and this is considered one of the best agents for prostatitis. link below

http://www.ncbi.nlm.nih.gov/pubmed/2452139

Many times men will come into urologists with prostate infections. high amounts of pus cells located in urine, urine cultured for bacteria, bacteria found, antibiotic sensitivity conducted for bacteria. correct antibiotic prescribed. one example a guy was given ofloxacin for ecoli prostatitis. It knocks bacteria infection out of urine, but it doesn't kill the infection in the prostate even though it was taken for 90 days. Then you are screwed. Because a urologist will only let you take so many antibiotics till he tells you you are taking to many antibiotics and you will just have to find a away to live with this infection sir.

I have seen men who have failed 90 - 120 days of levaquin for prostatitis. And who end up at a urologist in California named Dr Bahn. Who can take these same men who have prostatitis who have failed 3 - 4 months of levaquin and do a direct injection of levaquin into the prostate gland and cure men of the disease. which goes back to my earlier statement, BIOFILM. Biofilm has caused a real problem keeping antibiotics from killing the bacteria. Many people die every year from biofilm infections. Such as bacteria growing on a heart valve, and not being able to get a high enough antibiotic concentration into the heart valve to kill the bacteria.

The main problem is general practitioners (family doctors) who hand antibiotics out like it is candy for a headache or stopped up nose. Another problem is when someone has a real infection they under treat it by only giving the patient 10 days of antibiotics. And if the antibiotic is working and you have a very bad infection meaning a lot of planktonic bacteria and 10 day course of antibiotic pills isn't enough to kill it and maybe you actually needed 20 days of the antibiotic pill instead. But he prescribes you 10 days of that pill and it kills some of the planktonic bacteria guess what happens, when the 10 days of antibiotics is gone ? Bacteria comes together latches down on a surface forms the biofilm and becomes 1,000 times resistant to antibiotics good luck killing it then.

In my opinion, if you have an infection it is better to over treat it than under treat it. because if that bacteria manages to survive, if just one of those e coli bacteria or pseudomonas bacteria or enterococci bacteria survive, your body could be in for a world or extreme trouble. I remember reading a story about a girl who was at a museum and cut her hand on a fish tank and died. Because doctors couldn't stop the infection, it spread to her blood and the antibiotics could not kill it. Not only that, but, gonorrhea is one of the weakest bacteria of all time. usually a gonorrhea infection can be killed with a just a few days of doxcycline or ciprofloxacin can kill.... But now there is a super strain of gonorrhea that can not be killed by any antibiotic and people are having to live with gonorrhea there entire life. And if that super gonorrhea manages to get into an infected persons kidneys then they are dead, because antibiotics can't kill it.

[abelru]

First off, I rate this thread as good. Among people who deal with antibacterials or antibiotics as part of their normal job there is consensus that there is not a "The One" antibiotic, and no one should be looking for something like that. Anytime a good question is asked and there is that much consensus, it clearly represents the current thought in the state of whatever topic is being discussed.

There are good romper stomper combinations that fail in a different infection, and the better point is that the reverse is also true. And we have not even started to discuss why an E Coli infection of the prostate needs cipro for 28 days while the same E Coli bacteria causing a UTI needs therapy for 3 days. (Guidelines vary.) Or how different areas in this country have different rates of antibacterial resistance. What works well in Texas may be a poor choice in North Dakota.

Lots and lots goes into this topic. A little knowledge can be (not "is", but "can be") a dangerous thing.

Either way, stock up of fish antibiotics. (Just in case: blue text means sarcasm on this board.)

I can answer your question as I have battled with bladder infections, prostate infections for 5 years now and have also studied some urology and microbiology..

(((And we have not even started to discuss why an E Coli infection of the prostate needs cipro for 28 days while the same E Coli bacteria causing a UTI needs therapy for 3 days. ))))

Number 1 when a person first gets an infection the bacteria is plankton bacteria which is free floating micro organisms. In the planktonic state bacteria are killed very easily. But if the infection survives an antibiotic because the antibiotic was not taken long enough and only killed a few of the bacteria and left a remaining amount. The plankton then have 2 choices either die the next go around of antibiotics or come together, latch down on a surface, and form a gelatin like substance called biofilm which makes the bacteria up to 1,000 x resistant to antibiotics. This is what happens when people have chronic infections that antibiotics aren't putting a dent in. And it takes such a huge huge concentration of antibiotics to knock out a biofilm , that many people are stuck to live a chronic infection out the rest of their life. This is very common in our current society.

But to answer the above question, a UTI is very basic to cure because a big concentration of antibiotics can reach the bladder very easily. depending on the antibiotic a 500 milligram pill could mean anywhere from 1,000 -5,000 micrograms per pill, also keep in mind that it takes 1,000 micrograms to equal one milligram. so you would basically be getting 1 - 5 milligrams of that 500 mg cephalexin pill or that 500 mg ciprofloxacin pill into that bladder infection.

Prostate is very different, if you get a prostate infection it can be almost impossible to cure because of the biofilm factor, and also because of the simple fact the concentration of antibiotics into the prostate is minimal. Norfloxacin concentration into the prostate for two 400 milligram pills is 1 microgram and this is considered one of the best agents for prostatitis. link below

http://www.ncbi.nlm.nih.gov/pubmed/2452139

Many times men will come into urologists with prostate infections. high amounts of pus cells located in urine, urine cultured for bacteria, bacteria found, antibiotic sensitivity conducted for bacteria. correct antibiotic prescribed. one example a guy was given ofloxacin for ecoli prostatitis. It knocks bacteria infection out of urine, but it doesn't kill the infection in the prostate even though it was taken for 90 days. Then you are screwed. Because a urologist will only let you take so many antibiotics till he tells you you are taking to many antibiotics and you will just have to find a away to live with this infection sir.

I have seen men who have failed 90 - 120 days of levaquin for prostatitis. And who end up at a urologist in California named Dr Bahn. Who can take these same men who have prostatitis who have failed 3 - 4 months of levaquin and do a direct injection of levaquin into the prostate gland and cure men of the disease. which goes back to my earlier statement, BIOFILM. Biofilm has caused a real problem keeping antibiotics from killing the bacteria. Many people die every year from biofilm infections. Such as bacteria growing on a heart valve, and not being able to get a high enough antibiotic concentration into the heart valve to kill the bacteria.

The main problem is general practitioners (family doctors) who hand antibiotics out like it is candy for a headache or stopped up nose. Another problem is when someone has a real infection they under treat it by only giving the patient 10 days of antibiotics. And if the antibiotic is working and you have a very bad infection meaning a lot of planktonic bacteria and 10 day course of antibiotic pills isn't enough to kill it and maybe you actually needed 20 days of the antibiotic pill instead. But he prescribes you 10 days of that pill and it kills some of the planktonic bacteria guess what happens, when the 10 days of antibiotics is gone ? Bacteria comes together latches down on a surface forms the biofilm and becomes 1,000 times resistant to antibiotics good luck killing it then.

In my opinion, if you have an infection it is better to over treat it than under treat it. because if that bacteria manages to survive, if just one of those e coli bacteria or pseudomonas bacteria or enterococci bacteria survive, your body could be in for a world or extreme trouble. I remember reading a story about a girl who was at a museum and cut her hand on a fish tank and died. Because doctors couldn't stop the infection, it spread to her blood and the antibiotics could not kill it. Not only that, but, gonorrhea is one of the weakest bacteria of all time. usually a gonorrhea infection can be killed with a just a few days of doxcycline or ciprofloxacin can kill.... But now there is a super strain of gonorrhea that can not be killed by any antibiotic and people are having to live with gonorrhea there entire life. And if that super gonorrhea manages to get into an infected persons kidneys then they are dead, because antibiotics can't kill it.

1,000,000,000,000,000,000,000 Times, No...


Whatever it is that is being stated, asked, or otherwise asserted.

The answer is no.

BTW, go Kings!