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Front Microbiol. 2011 Nov 24;2:230. doi: 10.3389/fmicb.2011.00230. eCollection 2011.

"Ten Commandments" for the Appropriate use of Antibiotics by the Practicing Physician in an Outpatient Setting.

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Division of Infectious Diseases, Hospital Carlos Durand, University of Buenos Aires Buenos Aires, Argentina.


A multi-national working group on antibiotic stewardship, from the International Society of Chemotherapy, put together ten recommendations to physicians prescribing antibiotics to outpatients. These recommendations are: (1) use antibiotics only when needed; teach the patient how to manage symptoms of non-bacterial infections; (2) select the adequate ATB; precise targeting is better than shotgun therapy; (3) consider pharmacokinetics and pharmacodynamics when selecting an ATB; use the shortest ATB course that has proven clinical efficacy; (4) encourage patients' compliance; (5) use antibiotic combinations only in specific situations; (6) avoid low quality and sub-standard drugs; prevent prescription changes at the drugstore; (7) discourage self-prescription; (8) follow only evidence-based guidelines; beware those sponsored by drug companies; (9) rely (rationally) upon the clinical microbiology lab; and (10) prescribe ATB empirically - but intelligently; know local susceptibility trends, and also surveillance limitations.


antibiotic resistance; antibiotic stewardship; generic antibiotics; guidelines; self-prescription; treatment compliance

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