Duration Health — Field Guide: Infection

Infection

Introduction

Minor infections will often go away on their own without antibiotics. When the body isn't able to clear an infection on its own, or if a serious bacterial infection is suspected, antibiotics are sometimes used to treat the infection. There are also some viral infections like influenza that are treated with antiviral agents.

The choice of whether to use an antibiotic, and which antibiotic to use, is complex, and you should always seek the advice of a physician before initiating an antibiotic. Antibiotics treat only bacterial infections, but many infections are caused by viruses, not bacteria.

Each antibiotic is effective against certain groups of bacteria, but often it is not known which bacteria are responsible for a given infection. Practitioners will therefore often choose an antibiotic based on the part of the body in which the infection occurs, since certain classes of bacteria are most often responsible for infections in a particular organ system.

Do not take multiple antibiotics at once. A better strategy is to choose one antibiotic, take a full course, and contact a physician to discuss next steps if symptoms have not resolved after the full course is completed. There are cases where a physician may recommend that certain antibiotics be taken together, as a pair, for specific types of infections.

Infections that occur with fever, a change in someone’s behavior, lethargy, weakness, decreased urination, or rapid or shallow breathing, may indicate sepsis and are always a medical emergency. Seek help immediately.

If most infections are viral, why do I get better when I take an antibiotic when I'm sick?

Antibiotics are drugs specifically design to kill bacteria. Each class of antibiotics kills bacteria by interfering with a particular component of the bacterial cell that the bacteria needs to survive. Viruses don't have these components, so they simply aren't affected by antibiotics.

It's not uncommon, however, for people to report that they feel better after taking an antibiotic during a viral infection. Why?

One explanation is the placebo effect, a well-known and extensively studied phenomenon whereby people feel better after taking a pill, no matter what the pill contains. This effect is so strong that when new drugs are developed, they are compared to a pill containing an inactive ingredient, because test subjects will report or experience an effect just by taking a pill, whether the new drug is working or not.

Another explanation is that during the time a patient is taking an antibiotic, the body is fighting the viral infection on its own. By the time the antibiotic is finished, the body has cleared the infection, and the person feels better. But this would have happened without the antibiotic.

Yet another explanation is that some antibiotics have anti-inflammatory effects on the body as a whole, as a side effect of the antibiotic. This reduction in inflammation makes a person feel better, but it's not because the antibiotic is treating the infection. A regular anti-inflammatory drug, such as ibuprofen, may have the same effect without the potential side effects of the antibiotic.

If an antibiotic might help, why not just try it?

The decision to give an antibiotic is a balancing act between the antibiotic's benefits (potentially treating a bacterial infection) and risks (side effects). These side effects can be serious. While you may have never personally experienced side effects from an antibiotic, experienced practitioners know that these side effects are in fact very common.

Side effects from antibiotics include diarrhea (the most common), allergic reaction (ranging from mild rash to life-threatening anaphylaxis), and, paradoxically, infection with a different microorganism. Because antibiotics are designed to kill bacteria, they also kill "good" bacteria in the body. (See: Human Microbiome) The loss of "good" bacteria gives "bad" bacteria (and fungi) an opportunity to grow and make you sick. A number of antibiotics also may have harmful drug interactions with commonly used medications that a person may already be taking for other conditions.

The bottom line is that the decision to start an antibiotic is synonymous with deciding that the benefits outweigh the risks. If the benefits are in doubt, it would be unwise to assume the risks.

Reference

ciprofloxacin

Ciprofloxacin (generic for Cipro) is a fluoroquinolone antibiotic. It can be used to treat infections in the abdomen. Consider ciprofloxacin for diarrhea with blood or mucous. Ciprofloxacin can be taken with ondansetron, if nausea and/or vomiting accompany abdominal pain or diarrhea. Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. Ciprofloxacin is also used to treat other infections, for example, skin infections, sinus infections, urinary tract infections, and infections with some bioterrorism agents including anthrax.

Prescription only

InfectionMedication

Urine test strips

Urine test strips are used to test for urinary tract infection (UTI). We offer urine test strips that check for the presence of leukocytes (white blood cells) and nitrites. A urine test showing positive leukocytes or nitrites may indicate a urinary tract infection. Brand, color, or style may vary based on available inventory.

GeneralDisposable

ofloxacin

Ofloxacin is an antibiotic eye drop. It is used to treat bacterial conjunctivitis (pink eye). It also used to prevent infection in cases of corneal abrasion (a scratch on the eyeball). While ofloxacin is formulated to be used in the eye, it can also be used in the outer ear to treat an outer ear infection (otitis externa) if no other alternative is available. Ofloxacin can be used to treat eye infections in people who normally wear contact lenses, but should never be used at the same time as wearing contact lenses.

Prescription only

InfectionMedication

oseltamivir

Oseltamivir (generic for Tamiflu) treats influenza, the virus that causes the flu. Oseltamivir should be started within 48 hours of influenza symptoms. In some cases, people who do not have flu symptoms are given oseltamivir to help stop them from getting the flu because they are exposed to or come into close contact with someone who has the flu.

Prescription only

InfectionMedication

doxycycline hyclate

Doxycycline is an antibiotic, and belongs to a class of medications called tetracyclines. Doxycycline can be used to treat multiple types of infections, including respiratory tract infections, tick-borne illness, E. coli, Cholera, Lyme disease, Yersinia (bubonic plague), Tularemia, and more. This medication should be taken with food.

Prescription only

InfectionMedication

atovaquone-proguanil

Atovaquone-proguanil (generic for Malarone) is used for malaria prophylaxis in areas with chloroquine-resistant Plasmodium falciparum, and can be used in most parts of the world where malaria occurs. Take it daily for 1-2 days before possible exposure to malaria, and continue daily for 7 days after leaving an exposed area.

Prescription only

TravelMedication

trimethoprim-sulfamethoxazole

Trimethoprim-sulfamethoxazole (TMP-SMX, generic for Bactrim, and also abbreviated SMZ-TMP) is an antibiotic. It can be used to treat urinary tract infections and skin infections, and can be used to treat infections caused by MRSA (Methicillin-resistant S. aureus) bacteria.

Prescription only

InfectionMedication

metroNIDAZOLE

Metronidazole (generic for Flagyl) is an antiprotozoal and antibiotic, which means it fights bacteria as well as other organisms that cause disease. Metronidazole can be used to treat infections in the abdomen.

Prescription only

InfectionMedication

ivermectin

Ivermectin is used to treat parasite infections. It is FDA-approved to treat two parasitic infections, strongyloidiasis and onchocerciasis, which are relatively rare in the United States. It is also often used in an off-label manner to treat scabies and lice. This medication should be taken on an empty stomach.

Prescription only

WildernessMedication

azithromycin

Azithromycin is an antibiotic. Azithromycin can be used to treat respiratory infections like pneumonia, abdominal infections, ear infections, throat infections, and other infections. It is often used in place of penicillin drugs in people with a penicillin allergy. It has a longer duration of action than other antibiotics, so it is usually given for a shorter course of therapy.

Prescription only

InfectionMedication

azithromycin pediatric

Azithromycin is an antibiotic. Azithromycin can be used to treat respiratory infections like pneumonia, abdominal infections, ear infections, throat infections, and other infections. It is often used in place of penicillin drugs in people with a penicillin allergy. It has a longer duration of action than other antibiotics, so it is usually given for a shorter course of therapy.

Prescription only

InfectionMedication

azithromycin suspension

Azithromycin is an antibiotic. Azithromycin can be used to treat respiratory infections like pneumonia, abdominal infections, ear infections, throat infections, and other infections. It is often used in place of penicillin drugs in people with a penicillin allergy. It has a longer duration of action than other antibiotics, so it is usually given for a shorter course of therapy.

Prescription only

InfectionMedication

mupirocin

Mupirocin (generic for Bactroban) is an antibiotic ointment. Mupirocin can be used to treat a localized skin infection, including infections caused by methicillin-resistant S. aureus bacteria (MRSA).

Prescription only

InfectionMedication

nitrofurantoin

Nitrofurantoin (generic for Macrobid) is an antibiotic used specifically to treat urinary tract infections. While nitrofurantoin does not treat many types of infections, it tends to work exceptionally well for simple urinary tract infections, and is often used for this purpose.

Prescription only

InfectionMedication

amoxicillin-clavulanate

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin-clavulanate pediatric

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin-clavulanate suspension

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin capsule

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

InfectionMedication

amoxicillin pediatric

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

PediatricsMedication

amoxicillin

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

PediatricsMedication

trimethoprim-sulfamethoxazole pediatric

Trimethoprim-sulfamethoxazole (TMP-SMX, generic for Bactrim, and also abbreviated SMZ-TMP) is an antibiotic. It may be used to treat urinary tract or ear infections in pediatric patients. Other antibiotics are usually preferred as first-line treatment options. The suspension form of this medication contains sulfamethoxazole (SMX) 200 mg and trimethoprim (TMP) 40 mg together in each 5 mL liquid. Dosing is based on the trimethoprim (TMP) component.

Prescription only

PediatricsMedication

levoFLOXacin

Levofloxacin (generic for Levaquin) is an antibiotic. It is used to treat pneumonia, urinary tract infections, prostatitis, anthrax, and bubonic plague. It is in the fluoroquinolone category of antibiotics.

Prescription only

InfectionMedication

cephalexin

Cephalexin (generic for Keflex) is an antibiotic. It is used to treat respiratory infections, ear infections, skin infections, and urinary tract infections. It is in the cephalosporin category of antibiotics.

Prescription only

InfectionMedication

cephalexin pediatric

Cephalexin (generic for Keflex) is an antibiotic. It is used to treat respiratory infections, ear infections, skin infections, and urinary tract infections. It is in the cephalosporin category of antibiotics.

Prescription only

InfectionMedication

clindamycin

Clindamycin is an antibiotic. Is is used to treat serious respiratory tract, skin, and soft tissue infections. Clindamycin is used to treat infections cause by a class of bacteria called anaerobic bacteria. Clindamycin is sometimes used in place of penicillin-family antibiotics in people allergic to penicillin.

Prescription only

InfectionMedication

clindamycin pediatric

Clindamycin is an antibiotic. Is is used to treat serious respiratory tract, skin, and soft tissue infections. Clindamycin is used to treat infections cause by a class of bacteria called anaerobic bacteria. Clindamycin is sometimes used in place of penicillin-family antibiotics in people allergic to penicillin.

Prescription only

InfectionMedication

clotrimazole

Clotrimazole is an antifungal cream. It is used to treat fungal infections of the skin. Clinical improvement, with relief of itching, usually occurs within the first week of treatment.

InfectionMedication

polymyxin B-trimethoprim

Polymyxin B-trimethoprim (generic for Polytrim) is an antibiotic eye drop.

Prescription only

InfectionMedication

erythromycin

Erythromycin is an antibiotic eye ointment. It is used to treat bacterial conjunctivitis (pink eye). It also used to prevent infection in cases of corneal abrasion (a scratch on the eyeball).

Prescription only

InfectionMedication

polymyxin B-neomycin-hydrocortisone otic

Polymyxin B-neomycin-hydrocortisone otic is an antibiotic ear drop. It is used to treat otitis externa, an infection of the ear canal. Otitis externa, also called swimmer's ear, presents with ear pain, swelling of the ear canal, pain with movement of the outer ear, and occasionally decreased hearing. Do not use this medication if a ruptured ear drum (ruptured tympanic membrane) is suspected. This medication should not be relied upon to treat ear pain and a fever. Presence of a fever suggests an infection of the middle ear (otitis media) or a more serious infection, which may require oral antibiotics or other treatment.

Prescription only

InfectionMedication

valacyclovir

Valacyclovir (generic for Valtrex) is an antiviral used to treat viral illnesses including shingles and chickenpox, primarily in those with compromised immune systems. Valacyclovir can also be used to treat cold sores of the mouth and genitals caused by the herpes virus.

Prescription only

InfectionMedication

cefdinir

Cefdinir is a broad-spectrum antibiotic that treats many types of infections including urinary tract infections, respiratory infections, and ear/nose/throat infections. It is in the cephalosporin family of antibiotics.

Prescription only

InfectionMedication

cefdinir suspension

Cefdinir is a broad-spectrum antibiotic that treats many types of infections including urinary tract infections, respiratory infections, and ear/nose/throat infections. It is in the cephalosporin family of antibiotics.

Prescription only

InfectionMedication

cefpodoxime

Cefpodoxime is a broad-spectrum antibiotic that treats many types of infections including urinary tract infections, respiratory infections, and ear/nose/throat infections. It is in the cephalosporin family of antibiotics.

Prescription only

InfectionMedication

cefuroxime

Cefuroxime is a broad-spectrum antibiotic that treats many types of infections including urinary tract infections, respiratory infections, and ear/nose/throat infections. It is also sometimes used to treat the STD gonorrhea. It is in the cephalosporin family of antibiotics.

Prescription only

InfectionMedication

mefloquine

Mefloquine is used for malaria prophylaxis in areas with Plasmodium falciparum or Plasmodium vivax and can be used in most parts of the world where malaria occurs. Take it weekly for 2 weeks before possible exposure to malaria, and continue weekly for 4 weeks after leaving an exposed area. If you plan to travel to malaria-endemic areas, discuss with your Duration Health provider or consult CDC guidelines to determine which prophylaxis is appropriate for you.

Prescription only

TravelMedication

rifaximin

Rifaximin is an antibiotic used to treat E. coli associated traveler's diarrhea.

Prescription only

TravelMedication

tinidazole

Tinidazole is an antiparasitic used to treat infections caused by amoebas, giardia and trichomonas.

Prescription only

TravelMedication

acyclovir

Acyclovir is an antiviral used to treat shingles. Acyclovir can also be used to treat cold sores of the mouth and genitals caused by the herpes virus.

Prescription only

GeneralMedication

albendazole

Albendazole is an antiparasitic used to treat infections caused by tapeworms, hookworms, pinworms and longworms. It works by killing the worms present in the gastrointestinal tract.

Prescription only

TravelMedication

artemether-lumefantrine

Artemether-lumefantrine is used to treat malaria infection. It works by stopping the synthesis of the malaria parasite's genetic material.

Prescription only

TravelMedication

artemether-lumefantrine pediatric

Artemether-lumefantrine is used to treat malaria infection. It works by stopping the synthesis of the malaria parasite's genetic material.

Prescription only

PediatricsMedication

atovaquone-proguanil pediatric

Atovaquone-proguanil (generic for Malarone) is used for malaria prophylaxis in areas with chloroquine-resistant Plasmodium falciparum, and can be used in most parts of the world where malaria occurs. Take it daily for 1-2 days before possible exposure to malaria, and continue daily for 7 days after leaving an exposed area.

Prescription only

PediatricsMedication

ciprofloxacin ophthalmic

Ciprofloxacin ophthalmic is an antibiotic eye drop. It is used to treat bacterial conjunctivitis (pink eye). It also used to prevent infection in cases of corneal abrasion (a scratch on the eyeball). While ciprofloxacin is formulated to be used in the eye, it can also be used in the outer ear to treat an outer ear infection (otitis externa) if no other alternative is available. Ciprofloxacin drops can be used to treat eye infections in people who normally wear contact lenses, but should never be used at the same time as wearing contact lenses.

Prescription only

InfectionMedication

Abbott BinaxNOW Malaria Test

Malaria tests (Abbott BinaxNOW point-of-care malaria test) can be used to diagnose malaria in resource-limited settings.

Prescription only

GeneralEquipment

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How to approach Infection Only your Duration Health provider can decide, based on your medical history and other factors, whether it is medically appropriate for you to receive prescriptions. We do not sell prefabricated bags of pharmaceuticals. Each Duration Health Med Kit that contains prescription medications is custom assembled, tailored to each individual patient's needs.

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