The choice of antimicrobial chemotherapy is initially dependent on the clinical diagnosis. In some circumstances the clinical diagnosis implies a microbiological diagnosis which may dictate specific therapy.
CLINICAL USE
The choice of antimicrobial
chemotherapy is initially dependent on the clinical diagnosis. In some
circumstances the clinical diagnosis implies a microbiological diagnosis which
may dictate specific therapy. For example, typhoid fever is caused by Salmonella enterica serovar Typhi, which is
generally sensitive to cotrimoxazole, ceftriaxone and ciprofloxacin. However,
for many infections, establishing a clinical diagnosis implies a range of
possible microbiological causes and requires laboratory confirmation from
samples collected, preferably before antibiotic therapy is begun. Laboratory
isolation and susceptibility testing of the causative agent establish the
diagnosis with certainty and make drug selection more rational. However, in
many circumstances, especially in general practice, microbiological
documentation of an infection is not possible. Hence knowledge of the usual
microbiological cause of a particular infection and its susceptibility to
antimicrobial agents is essential for effective drug prescribing. The following
section explores a selection of the problems associated with antimicrobial drug
prescribing for a range of clinical conditions.
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