August 27, 2022

1400H - 1500H
Via Zoom

Empowerment
Health Issue objective - for
Course – laypeople to have an
ANTIBIOTICS – understanding of
USE & MISUSE ANTIBIOTIC USE &
MISUSE in their
health management.
 ROJoson PEP Talk
Empowerment
objective - for I have a Patient
Health Issue Empowerment
Course – laypeople to have an
Program in which I
ANTIBIOTICS – understanding of like to empower the
USE & MISUSE ANTIBIOTIC USE & lay people or
MISUSE in their patients to take
health management. control in the
management of
their health.
 There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
 My PEP TALK today
is entitled:
Empowerment
Health Issue objective - for ANTIBIOTICS –
Course – laypeople to have an USE & MISUSE.
ANTIBIOTICS – understanding of
USE & MISUSE ANTIBIOTIC USE &
This is part of the
MISUSE in their Health Issue Course.
health management.
 Contents of ANTIBIOTICS – USE & MISUSE
• What are antibiotics?
Health Issue • What is MISUSE and USE of antibiotics?
• What are germs? What are bacteria?
Course – • What are examples of bacterial infections? How to recognize bacterial infections?
ANTIBIOTICS – • What are the different classes of antibiotics?
USE & MISUSE • How do antibiotics control bacterial infections?
• What are the general objectives in prescribing antibiotics?
• How physicians decide on what antibiotics to prescribe for bacterial infections?
• How long do you take the antibiotics?
• What are the potential side-effects of antibiotics?
• What is antibiotic resistance and its usual causes?
• What are ROJoson’s advocating statements and advice on ANTIBIOTICS USE &
MISUSE?
 • What are antibiotics?
Health Issue Antibiotics are medicines.
Course –
Antibiotics are medicines that help stop infections
ANTIBIOTICS – caused by harmful BACTERIA.
USE & MISUSE
 • What is “MISUSE” of antibiotics?
Health Issue MISUSE of antibiotics means using them for the
Course – wrong purpose and/or in the wrong way which
ANTIBIOTICS – pose greater risk than benefit to the health of the
USE & MISUSE patients as well as in contributing to development
of antibiotic resistance (and eventual
ineffectiveness).
 • What is “USE” of antibiotics?
Health Issue USE of antibiotics means using them for the right
Course – purpose and/or in the right way which justifiably
ANTIBIOTICS – balance the benefit and risk of treatment in the
USE & MISUSE patients as well as in avoiding the development of
antibiotic resistance (and eventual
ineffectiveness).
 What are bacteria?
• What are “germs”? What are “bacteria”?
Microscopic single-celled
Health Issue As mentioned, antibiotics are medicines that help organisms lacking a
distinct nucleus are known
Course – stop infections caused by harmful BACTERIA. as bacteria.
ANTIBIOTICS – Bacteria is a kind of a germ. They may be shaped like
spheres, rods, or spirals.
USE & MISUSE
The word “germ” is a catch-all term that describes
very small microorganisms like bacteria, viruses,
fungi, and protozoa.
Germs are everywhere. Most are harmless or
even helpful. But some may cause disease, an
infection or an infectious disease.
 • What are “germs”? What are “bacteria”? Remember these
statements on
Health Issue Our bodies are home to an estimated 100 trillion “good” bacteria in
Course – “good” bacteria, many of which reside in our gut. our body when we
ANTIBIOTICS – Not only do we live in harmony with these talk of risk of taking
USE & MISUSE beneficial bacteria, but they are actually essential antibiotics, especially
to our survival. They contribute to digestion, in misusing them.
produce vitamin K, promote development of the
immune system, and detoxify harmful chemicals. Antibiotics can affect
To help you remember that germs are not all the normal bacteria
harmful, think of the microbes that contribute to in our body when
making many foods we enjoy, such as bread, misused.
cheese, and wine.
 • Use and Misuse of Antibiotics So, antibiotics are
used for bacterial
Health Issue Again, antibiotics are medicines that help stop infections only,
Course – infections caused by harmful BACTERIA.
ANTIBIOTICS – There are “right” medicines for the different types not for infections
USE & MISUSE of germ infections: caused by viruses,
fungi and protozoa.
• Bacteria – antibiotics
• Viruses – anti-virus drugs
• Fungi – anti-fungal drugs
• Protozoa – anti-protozoal drugs (some of these
may be used to treat bacterial infection – ex.
metronidazole)
 Examples of Viral
• What are examples of bacterial infections?
Infections:
Health Issue Examples of bacterial infections: • COVID19
Course – • Pneumonia - Klebsiella pneumoniae
• FLU
ANTIBIOTICS – •• Tuberculosis – Mycobacterium tuberculosis Examples of Fungal
Tetanus – Clostridium tetani
USE & MISUSE • Cholera - Vibrio cholerae Infections:
• Dysentery - genus Shigella • RINGWORMS
• Pseudomonas Infection - Pseudomonas aeruginosa
• Gonorrhea - Neisseria gonorrhoeae
ATHLETE’S FOOT
• Syphilis - Treponema pallidum
• Meningitis - Neisseria meningitidis, E.coli, Listeria Examples of
monocytogenes, and Streptococcus pneumonia Protozoal Infections:
• Leptospirosis - Leptospira sp. • MALARIA
• AMEBIASIS
 Examples of Viral
• What are examples of bacterial infections?
Infections:
Health Issue Examples of bacterial infections: • COVID19
Course – • Pneumonia - Klebsiella pneumoniae
• FLU
ANTIBIOTICS – •• Tuberculosis – Mycobacterium tuberculosis
Tetanus –How to recognize
Clostridium tetani and diagnose and Examples of Fungal
USE & MISUSE • Cholera - Vibrio cholerae
differentiate? Infections:
• Dysentery - genus
Using Shigella
pattern recognition (symptoms • RINGWORMS
• Pseudomonas Infection - Pseudomonas aeruginosa
and signs) and prevalence processes ATHLETE’S FOOT
• Gonorrhea - Neisseria gonorrhoeae
• (frequency)
Syphilis - Treponema pallidum
• Meningitis - Neisseria meningitidis, E.coli, Listeria Examples of
By physician
monocytogenes, and Streptococcus pneumonia Protozoal Infections:
• Leptospirosis - Leptospira sp.
By diagnostic tests • MALARIA
• AMEBIASIS
 • Use and Misuse of Antibiotics So, antibiotics are
used for bacterial
Health Issue Again, antibiotics are medicines that help stop infections only,
Course – infections caused by harmful bacteria.
ANTIBIOTICS – There are “right” medicines for the different types not for infections
USE & MISUSE of germ infections: caused by viruses,
fungi and protozoa.
• Bacteria – antibiotics
• Viruses – anti-virus drugs
• Fungi – anti-fungal drugs
• Protozoa – anti-protozoal drugs (some of these
may be used to treat bacterial infection – ex.
metronidazole)
 • What are different classes of antibiotics?
Health Issue Classes:
Course – • penicillins
• macrolides
ANTIBIOTICS –
• cephalosporins
USE & MISUSE • fluoroquinolones
• beta-lactams with increased activity
• tetracyclines
• trimethoprim-sulfamethoxazole
• lincosamides
• urinary anti-infectives
• others
 • How do antibiotics control bacterial infection?
Health Issue Some antibiotic classes work by killing bacteria
Course – and others work by preventing the ability of
ANTIBIOTICS – bacteria to multiply through the following means:
USE & MISUSE  attacking the wall or coating surrounding
bacteria
 interfering with bacteria reproduction
 blocking protein production in bacteria
 • What are the different spectrum of activities of Types of bacteria
antibiotics? based on:
Health Issue
Course – Antibiotics can be categorized by their spectrum
Staining:
ANTIBIOTICS – of activity—namely, • Gram (+)
USE & MISUSE • Whether they are narrow-, broad-, or • Gram (-)
extended-spectrum agents.
• Whether they are best against Gram(+) or Requiring oxygen:
• Aerobes
Gram(-) or both.
• Anaerobes
• Whether they are effective against aerobes,
anaerobes or both.
 • What are the different spectrum of activities of
antibiotics?
Health Issue
Course – Narrow-spectrum antibiotic can only kill or inhibit
ANTIBIOTICS – limited species of bacteria.
USE & MISUSE Eg. penicillin G affects primarily gram-positive
bacteria.

Broad-spectrum antibiotics can kill or inhibit a

wide range of microorganisms.
Eg. azithromycin and clarithromycin 
 • What are the different spectrum of activities of
antibiotics?
Health Issue
Course – Extended-spectrum antibiotic can kill or inhibit
ANTIBIOTICS – Gram positive bacteria and some Gram negative
USE & MISUSE bacteria.
Eg. carbenicilllin, mezlocillin, piperacillin and
ticarcillin 
 • What are the general objectives in prescribing
antibiotics?
Health Issue
Course – Therapeutic – to treat when bacterial infection
ANTIBIOTICS – has already set in
USE & MISUSE
Prophylactic – to prevent the onset of bacterial
infection in situations where risk is high
• Surgical prophylaxis – antibiotics to prevent
wound infections after surgery
• Leptospirosis prophylaxis – doxycycline
 • How physicians decide on what antibiotics to
prescribe for bacterial infections?
Health Issue
Course – Start with: diagnosis of a bacterial infection.
ANTIBIOTICS – Then: from experience and/or lab tests, determine the
usual bacteria that are causing the infection.
USE & MISUSE
Answer: Is the infection mild, moderate or severe?
Then DECIDE:
• Narrow / broad / extended-broad spectrum
• Benefit – risk – cost – availability analysis of
different antibiotic options
*Oral – parenteral - topical // inpatient /
outpatient
 Health Issue • Narrow vs Broad Spectrum Antibiotics
Course – General Recommendations: Examples of narrow-
CANCER • As much as possible, narrow-spectrum spectrum antibiotics:
• Penicillin
INCURABILITY antibiotics are used when the specific
causative bacterial agents are known to be the • Amoxycillin
& HOSPICE
usual culprit (or determined by lab tests).
CARE
Narrow-spectrum antibiotics kill or inhibit only
those bacteria species that are unwanted (i.e.
causing disease). As such, they leave most of the
beneficial bacteria unaffected, hence minimizing
the collateral damage on the microbiota and
there is low propensity for bacterial resistance
development.
 Health Issue • Narrow vs Broad Spectrum Antibiotics
Course – General Recommendations: Examples of broad-
CANCER • Use a broader-spectrum antibiotics only when spectrum antibiotics:
• Co-amoxiclav
INCURABILITY needed such as when the harmful bacteria are
multiple such as combination of Gram(+) and • Azithromycin
& HOSPICE
Gram(-).
CARE
• Using a broader-spectrum antibiotics when
only narrow-spectrum antibiotics are needed
– otherwise, may cause damage to normal
bacteria flora and antibiotic resistance.
 Health Issue • Topical vs Oral Antibiotics for Skin Lesions
Course –
General Recommendations:
CANCER • NO need for topical antibiotics for minor skin
INCURABILITY and soft tissue wounds and infections
& HOSPICE (commonly done in the community). Usually
CARE antibiotics are NOT needed – just cleaning
with soap and water will do.
• For moderate to severe wounds and
infections, oral or at times, parenteral
antibiotics are preferred.
• Using topical antibiotics commonly lead to
antibiotic resistance and allergy.
 Health Issue • Selection of an antibiotic for a patient
Course – There are usually many options in the selection of
CANCER antibiotics. A physician has to use the BRCA in
INCURABILITY the selection of the most cost-effective
& HOSPICE antibiotics.
CARE Antibiotics Benefit Risk Cost Availability
(effective) (side-effects)
Antibiotic1        

Antibiotic2        

Antibiotic3

Antibiotic4
 • How long should be a course of antibiotic Recommendations:
treatment? 1. Take for at least 3 days
Health Issue initially and observe.
The traditional recommendation is at least 7 days 2. If infection is
Course – subsiding, add 2 to 3
ANTIBIOTICS – (and some 14 days) for all antibiotics to avoid more days and
USE & MISUSE antibiotic resistance. observe. After
complete subsidence,
However, nowadays, the recommendations on
add 2 to 3 more days.
duration may be shorter, may be as short as 3 to 5 If no recurrence, stop.
days. But it all depends on the type and severity 3. If after 3 days NO
of bacterial infections. The duration can still response, change
antibiotics.
reach 7 to 14 days.
 • What are the potential side effects of
antibiotics?
Health Issue
Course – Common side effects:
ANTIBIOTICS – • Nausea / Vomiting
USE & MISUSE • Abdominal discomfort
• Diarrhea

Some may develop ALLERGY and TOXIC EFFECT.

 • What are the potential side effects of Why do antibiotics cause
antibiotics? Clostridium difficile?
Health Issue
Course – Antibiotic-associated diarrhoea is among the Taking antibiotics can kill
most common adverse events related to the "good" bacteria,
ANTIBIOTICS – allowing C. difficile to
antibiotic use.
USE & MISUSE multiply and release
Most cases are mild, but Clostridium difficile toxins that damage the
cells lining the intestinal
infection causes a spectrum of disease, ranging
wall, causing diarrhea,
from occasional diarrhoea to colitis, toxic abdominal pain, and fever
megacolon, and potentially death. as well as other
symptoms.
 • What is antibiotic resistance? When you take an
antibiotic, the sensitive
Health Issue Before the advent of high frequency of antibiotic bacteria are eliminated.
Course – resistance, antibiotics are powerful medications The bacteria that survive
that work very well for control of bacterial during antibiotic
ANTIBIOTICS – treatment are often
infections.
USE & MISUSE resistant to that
antibiotic. These bacteria
However, some antibiotics are now less useful typically have unique
characteristics that
than they once were due to an increase in
prevent antibiotics from
antibiotic resistance. Antibiotic resistance occurs working on them.
when bacteria can no longer be controlled or
killed by certain antibiotics. In some cases, this
can mean there are no effective treatments for
certain conditions.
 • What are the causes of antibiotic resistance?
Health Issue
Course – Antibiotic resistance is commonly
ANTIBIOTICS – due to misuse of antibiotics by
USE & MISUSE physicians and patients.
 • ROJoson advocating statements and advice on
ANTIBIOTICS – USE & MISUSE
Health Issue
Course – Promote correct use of antibiotics on yourself and
ANTIBIOTICS – on other people.
USE & MISUSE • To maximize their benefits (prevention and
treatment of bacterial infections).
• To prevent unneeded side-effects and toxic
effects of antibiotics.
• To prevent antibiotic resistance.
 • ROJoson advocating statements and advice on
ANTIBIOTICS – USE & MISUSE
Health Issue
Course – Avoid misuse of antibiotics on yourself and on
ANTIBIOTICS – other people.
USE & MISUSE • Avoid wrong use particularly on using them for
viral infections.
• Avoid topical antibiotics if not indicated.
• Avoid too short or too long a time of antibiotics
intake which is a common cause of antibiotic
resistance.
 Contents of ANTIBIOTICS – USE & MISUSE Summary
• What are antibiotics?
Health Issue • What is MISUSE and USE of antibiotics? Take Away
• What are germs? What are bacteria?
Course – • What are examples of bacterial infections? How to recognize bacterial infections?
ANTIBIOTICS – • What are the different classes of antibiotics?
USE & MISUSE • How do antibiotics control bacterial infections?
• What are the general objectives in prescribing antibiotics?
• How physicians decide on what antibiotics to prescribe for bacterial infections?
• How long do you take the antibiotics?
• What are the potential side-effects of antibiotics?
• What is antibiotic resistance and its usual causes?
• What are ROJoson’s advocating statements and advice on ANTIBIOTICS USE &
MISUSE?
 Be always in touch with reliable medical Take Away in
information on ANTIBIOTICS – USE & MISUSE. relation to
Health Issue
Course – Patient
Knowledge is power; it gives power.
ANTIBIOTICS – Use the 4Ks of Patient Empowerment: Empowerment
USE & MISUSE Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of oneself by
knowing the basic principles and processes
of USE & MISUSE of ANTIBIOTICS in their
health management.
 Empowerment
Health Issue objective - for
Course – laypeople to have an
ANTIBIOTICS – understanding of
USE & MISUSE ANTIBIOTIC USE &
MISUSE in their
health management.