An antibiotic is a class of antimicrobial medication used in prevention and treatment of a bacterial infection by either killing or inhibiting the growth of that bacteria. Antibiotics are less effective against viral infections like influenza or the common cold. They can be administered in a broad spectrum depending on symptoms and signs presented or in a narrow spectrum. Antibiotics can be given orally, intravenously or applied topically to easily accessible infection sites. Most antibiotics are considered safe although depending on the antibiotic type used, targeted microbes and the patient, they may be associated with unfavorable side effects that range from minor to severe effects. Amoxicillin as a type of an antibiotic, it is widely used in treating infections caused by bacteria such as urinary tract infection, chest infection such as pneumonia and dental abscesses. Also used in treating ear and chest infection in children. This paper is an education tool for the patient about amoxicillin as used in pediatrics ear infection and evidence-based practice on the effectiveness of its use.
Ear infection, also otitis media is a common problem among pediatric patients that occurs when Eustachian tube gets filled with mucus and fluid due to viral or bacterial infection leading to middle ear being inflamed. Children are often prone to otitis media since their Eustachian tube is narrow, making it hard to drain the fluids. It can present with otalgia, holding, rubbing, tugging of the ear, irritability, fever with indicators of upper respiratory tract infections like a cough.
Amoxicillin, which is a penicillin antibiotic is used for sinusitis or an ear infection since it performs well in fighting bacteria causing ear and sinus infection like beta- and alpha-hemolytic streptococcus strains, streptococcus pneumonia, Haemophilus influenza and some staphylococcus strains.
Amoxicillin comes in oral suspensions of 250mg or 125mg in 5mL, pediatric drops, regular and chewable tablets in 500mg and 250mg.
Dose. For infections that range from mild to moderate, a child requires 25mg/kg/day divided into two doses, and or 20mg/kg/day administered in three doses equal in proportion for over 24 hour period. For infections that are severe, the recommended dosage for children is 45mg/kg/day given in two doses or three doses as 40mg/kg/day.
Contraindications. It is not prescribed in cases where the infection is suspected to be viral. Since it is a penicillin based drug, it can trigger anaphylaxis which is an allergic reaction that is life-threatening. Emergency medical attention should be obtained for facial swelling, difficulty in swallowing, severe itching, hives or respiratory problems that may occur during antibiotic treatment of otitis media.
Administration of medicine is a basic function of a health facility, and it involves multiple disciplines (Long & Prober, 2012). Delivering the medicine to the patient requires precision, attention, and communication in details by the hospital staff. Advancement in safety of patient comes from understanding in-depth how system failure can lead to errors in the administration of medication (Acton, 2012).
Patient medicine education tool enables caregivers to understand the risk that may accompany the administration of antibiotics and what should be done to promote safety and quality outcome. Some of the things to look out for during amoxicillin administration include;
Side effects that include stomach pains, severe and bloody diarrhea, nausea discoloration of the skin, yellowing of skin and eyes, dark pee, skin rashes with blisters, fever, and flushing. These can cause dehydration with other associated problems (Long & Prober, 2012). Most of the time health caregivers provide adequate information about this and ways to go about it if it happens. Inform the doctor about any side effect to ensure safety and quality outcome.
Allergic reactions can also occur characterized by itching, rashes, and dyspnea in the advent of amoxicillin administration. This can be taken care of by reporting any allergic reactions the child may have experienced in the past Long & Prober, 2012).
Antibiotics resistance is also another harmful effect of antibiotic administration. It results when using antibiotics often or inappropriate use of viral infection (Acton, 2012). When it develops, the antibiotics are unable to eradicate the germs that cause a particular infection making your infection to last longer. Taking an antibiotic when you don’t require it increases chances of developing resistance to antibiotics to illnesses (Bluestone & Rosenfeld, 2003).
Misuse of amoxicillin which includes prescribing them unnecessarily is also a risk. Using evidence-based prescription prevents incorrect usage and administration of this medicine in either very high or low doses in either narrow or broad spectrum administration (Acton, 2012). This also helps to reduce selection and emergence of antibiotics that are resistant to bacteria. Evidence also shows that most prescriptions of antibiotics are not much helpful in healthy patients having common infections since they will not get better any quicker.
Following a treatment regime for children is a widespread problem for physicians since the extent of adherence to the medical regime is the crucial determinant of clinical achievement (Acton, 2012). Approaches to improve children adherence are; use of pleasant tasting drugs, use of simple drug rules like once daily dose, using liquid formulations, individual management plans and consistent phone contact among physicians and parents amongst other regimes (Bluestone & Rosenfeld, 2003). Observance can be encouraged by provision of a clear written description and patient information sheet that shows brand and generic name, schedule, dosage, common side effects and useful means of handling them and duration. Parents, children, and physicians should come up with a mutually established treatment plan. This is because involving the child in creating the plan leads to improvement of adherence (Acton, 2012). Parents should also remember that regular utensils like spoons differ in volume hence giving inaccurate dosage. Therefore, there should be the provision of a dispenser which is a measuring spoon or drug syringe by the prescribing nurse or pharmacist (Long & Prober, 2012). Mixing drugs with a minimal amount of juice or food, use of rewards and any other strategy may aid the rise of compliance in young kids (Bluestone & Rosenfeld, 2003).
In conclusion, medical adherence is a difficult subject involving family members, children and caregivers because the process depends on family cultural belief, the perception of the severity of disease and their appreciation of treatment benefits (Acton, 2012). Patients usually have their forms of adherence depending on their view of the world and social setting. Hindrances to medical adherence include low health literacy and language barriers (Long & Prober, 2012). Helpful gears to finish this includes; multi-lingual staff, interpreters, medicine administration technique training like the use of inhalers and instruction reinforcement by nurses or pharmacists (Bluestone & Rosenfeld, 2003). Patient training pamphlets have also greatly reduced adverse events of drugs related to noncompliance.
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Long, S. S., Pickering, L. K., & Prober, C. G. (2012). Principles and practice of pediatric infectious diseases. Edinburgh: Elsevier/Saunders. Bottom of Form
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Bluestone, C. D., & Rosenfeld, R. M. (2003). Evidence-based otitis media. Hamilton, ON B.C. Decker.
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In Acton, A. Q. (2012). Otitis media: New insights for the healthcare professional.
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