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Samaniego ,Improper use of antibiotics may lead to evolution of infectious superbugs, Philippine Daily Inquirer, December 2011 Inappropriate and improper use of antibiotics has long been a major problem. According to Dr. Samaniego there are four common practices of antibiotic misuse in the Philippines that promote the emergence of superbugs. It includes self-medication. This happens when a patient buys antibiotics on his or her own without prior consultation with a doctor. Some of these patients borrow a used prescription, or follow the advice of relatives and friends in buying antibiotics. Also skipping a dose of antibiotic. Patients who miss a dose or several doses of antibiotic are allowing bacteria to recover from, and develop a resistance, to the antibiotics effects. Theres also a risk of infection resurgence. There are some patients dont finish the prescribed treatment course of the antibiotics prescribed to them. They stop taking the antibiotics once they feel better. Others are unable to buy all the antibiotics prescribed because they dont have enough money. As well as using antibiotics like over-the-counter drugs. Antibiotics are powerful medications that must be used only under a doc tors supervision. Unfortunately, some patients mistakenly believe that antibiotics are used to relieve symptoms like fever, body pain, coughs and colds.

LOCAL STUDIES Emmanuel Edwin R. Dy, M.D, Inappropriate Antibiotic Use in the Philippines , http://www.psmid.org.ph/vol26/vol26num2topic6.pdf, November 2011

Inappropriate antibiotic use refers to improper administration with respect to drug dose, interval duration (whether singly or collectively) in the light of proper clinical situations and/or financial considerations. The recognized effects of inappropriate use (whether overuse or underuse) of antibiotics are multiple among them are rapid emergence of resistance, selection pressure on resistant microorganisms, adverse reactions, treatment failures, occurrence of preventable morbidity and mortality and waste of resources. In his study Dr. Dy summarized several thoughts on the Inappropriate Antibiotic Use in the Philippines. Clinically and economically inappropriate use of antibiotics is a major problem in thePhilippines and internationally as well. There is both overuse and underuse. The problem is more acute in developing countries because of limited resources. The consequences of antibiotic misuse include increased selection pressure of resistant microorganisms, preventable morbidity and mortality from treatment failures, adverse drug reactions and wastage of limited health care resources. The problem of inappropriate use of antib iotics is complex, multi-factorial and involves numerous stakeholders. There is no simple solution but the first step is to get all stakeholders to acknowledge that a major problem exists and that cooperation is essential if national and global solutions are to be achieved. Angeles BL, Book DR, Go KG, Lim DJ, Uy HG. A bacterial sensitivity test to determine the effectiveness of minocycline HCI (Minocin), erythromycin (Erythrocin) and ampicillin (Ampicin) on the predominant microorganisms present in a diseased periodontium. J Philipp Dent Assoc. 1994 Jun-Aug;46(1):4-12. The authors, Angeles BL, Book DR, Go KG, Lim DJ, Uy HG, determined the effectiveness of the three antimicrobials--Minocycline HCI, Erythromycin and Ampicillin

based on the percentage reduction of bacteria present in subgingival microflora and in vitro assessment of antibiotic susceptibility of cultured strains of predominant microorganisms present in a diseased periodontium. Twelve volunteers 18 to 65 years of age, with moderate to severe periodontal disease, were randomly divided into Group A and Group B of 6 members each. Oral lavage procedure was performed to Group A and Group B received systemic administration of antibiotic for five days. As a result Bacterial sensitivity testing showed 60% of samples with positive growth of microorganisms (S. viridans) were also equally sensitive to Minocycline HCI, Erythromycin and Ampicillin. Oral lavage proved to be ineffective in reducing the number of bacteria. However, systemic drug administration revealed that there was a reduction in bacterial count after taking such antibiotics for five days which is more favorable to Minocycline HCI. Zelda May, Gum Disease, http://www.dentalinsurancecare.com/gum -

disease.html, November 2011 According to Dr. Zelda May There are several ways dentists treat gum disease Antibiotics or antibacterial mouthwash will be recommended to lessen the swelling before any dental treatment is made. In worst cases, a periodontist or a dentist who specializes in gum disease will handle the series of treatments which may include the following procedures: Scaling and scraping of the plaque and tartar. Advanced cases of gum disease may require surgery, where antibiotic treatment has to reach inside the gum pocket. However, there are instances when surgery is not possible because the gums are too distressed to allow being sewn back together. Gum grafting known as gingival grafting is also another of the remedies for gum disease. Healthy gum tissues

will be taken from the mouth and will be used to replace the badly deteriorated and diseased gum tissues.