We have a problem of antibiotics overuse in PNG. The same can be said for antibiotic or antiseptic creams for treating minor cuts and scratches. While working in the bush for an oil exploration company I decided to write a guideline for my field medics on the use of antibiotic and antiseptic cream in treating skin sores.
It is now widely accepted worldwide that microorganisms are increasingly becoming resistant to commonly prescribed antibiotics. This has been attributed to several factors including:
- Widespread use of antibiotic/anti-septic creams for minor cuts and scratches.
- Widespread prescribing of antibiotics for localized infections. E.g Amoxycillin for small skin sores.
- Prescribing of antibiotics where its use is not indicated. E.g. Amoxycillin for viral infections of the upper respiratory tract.
- Addition of antibiotics in animal feeds.
In contrast, the development of new generation of antibiotics has been slow.No new antibiotic has come into the market for the long time now. Therefore, to help reduce antibiotic resistance in microorganism, guidelines for the rationale prescribing of antibiotics have been developed. I therefore felt we needed to develop a set of guidelines for our field medics.
The guidelines stated below are for my field medics but anyone can use or adopt it depending on your environment and resources.
Use of antibiotic/antiseptic cream guideline:
- Antibiotic cream: No antibiotic cream is to be used when dressing sores, cuts and bruises.
- Antiseptic cream: No anti-septic cream is to be used when dressing sores, cuts and bruises.
- Antibiotic powder: No antibiotic powder is to be used when dressing sores, cuts and bruises. Application of amoxicillin or any other antibiotic powder to sores, cuts and bruises is strongly prohibited.
- Antiseptic solution: These are to be used for cleaning sores, cuts, bruises and wounds ONLY.
- Iodine based solutions: These are to be used for cleaning dirty and infected wounds, cuts, sores and scratches. They can also be used for dressing dirty and infected wounds, cuts, sores and scratches using soaked sterile gauze.
ALL CLEAN, NON-INFECTED SORES ARE TO BE CLEANED WITH AN ANTISEPTIC SOLUTION AND DRESSED WITH STERILE DRESSING.
NO STAT ANTIBIOTICS FOR SORES, CUTS AND BRUISES ARE TO BE PRESCRIBED.
IF A WOUND OR SORE IS INFECTED, EVIDENCED BY:
- ENLARGED ASSOCIATED LYMPH NODES
- PRESENCE OF PUS
- OFFENSIVE SMELL
THEN AMOXYCILLIN 500MG ORALLY EVERY 8 HOURS CAN BE GIVEN FOR 7 DAYS. IF THERE IS NO AMOXYCILLIN, GIVE FLUCLOXACILLIN 5OOMG ORALLY EVERY 6 HOURS FOR 7 DAYS.
DISCLAIMER: Always consult your family physician if you are in any doubt. This is only a guide for general information only and should not be followed without consulting a physician first.