The team led by Dr. Qijing Zhang has found Mfd, a protein involved in DNA transcription and repair that plays an important role in the development of fluoroquinolone antibiotic resistance in Campylobacter, a bacterial pathogen associated with food poisoning in humans.

Previous studies have revealed that Campylobacter is highly mutable to antibiotic treatment and the number of fluoroquinolone-resistant Campylobacter is greatly increased in many regions of the world.

But it has not been clear why Campylobacter is able to mutate at such a high frequency.

With the help of various molecular tools, the research team from the College of Veterinary Medicine found that Campylobacter increases the production of Mfd in the presence of a fluoroquinolone antibiotic.

Elimination of Mfd from Campylobacter resulted in 100-fold reduction in the rate of emergence of mutants resistant to fluoroquinolones.

Without Mfd, the development of fluoroquinolone-resistant Campylobacter under antibiotic treatment was significantly reduced.

The study is published in June 6th open-access journal PLoS Pathogens

source : topnewshealth

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DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Though antibiotics have many benefits, it may destroy normal bacteria living in the gut that can help ‘bad’ bacteria to develop.

According to the report, between 5 to 30 per cent of patients being treated in hospitals with antibiotic develop antibiotic- associated diarrhoeal infections such as Clostridium difficile, (C difficile).

C difficile, a common side- effect of broad-spectrum antibiotics, can lead to ulceration of the colon.

“There is a growing bank of evidence to support the positive effects that probiotics have on antibiotic- associated diarrhoea,” the Scotsman quoted Ian Rowland, a professor of human nutrition research at the University of Reading, as saying.

“By studying this evidence as well as various patient case studies, the expert group were led to conclude that patients should take probiotics during and after their hospital stay to reduce the risk of acquiring antibiotic-associated diarrhoea, or if required, to limit its severity and duration,” he added

source : topnewshealth

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JL Taman Bendungan Asahan 5 Jakarta Indonesia 102010

phone : 62(021) 70081995 – 5703646

http://childrenclinic.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

The agency said that a step to over-the-counter antibiotics could make the problem worse, for doctors are running out of medications for potentially deadly infections.

And rising resistance levels mean that some bugs are treatable only with antibiotics previously used as a ‘last defence’, the agency added.

The number of potentially fatal E. coli blood poisoning cases, which are resistant to a ‘last’ antibiotic have tripled in the last six years, and now make up 12 per cent of all cases.

In these cases, doctors are left able to use only less effective antibiotics, which can be toxic, and raises the prospect that a strain could become entirely resistant to antibiotics.

Dr David Livermore, the agency”s top scientist, warned that the problem posed a major public health threat.

He suggested that patients should not request antibiotics from their GPs when they are simply suffering from a cough or a cold, for which the drugs are useless.

“Most common cough and colds are caused by viruses and therefore patients should not be asking their doctor for an antibiotic,” the Telegraph quoted him, as saying.

“The doctor should also know that they are not necessary and the patient should know that they are not appropriate,” he added.

Livermore also said that there was a concern that providing an antibiotic over the counter could increase resistance.

He also called for action to increase the amount of research into new antibiotics.

SOURCE : TOPNEWSHEALTH

Supported  by
CLINIC FOR CHILDREN 

Yudhasmara Foundation 

JL Taman Bendungan Asahan 5 Jakarta Indonesia 102010

phone : 62(021) 70081995 – 5703646

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Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

According to new research, published in The Lancet, doctors should cut down on antibiotic prescriptions for sinus because the drugs do not work.

An analysis of nine trials shows the drugs make no difference even if the patient has been ill for more than seven days.

Sinusitis is very common – often occurring after colds or flu.

The infection of the sinuses – small air pockets inside the cheekbones and forehead – causes a high temperature, pain and tenderness in the face and forehead, and a blocked or runny nose.

In the research, which looked at how long 2,600 patients were ill before they received treatment, found time of illness is not a good indicator of whether antibiotics will be effective.

Because of side-effects, costs, and the risk of resistance, antibiotics are not justified even if patients have been ill for longer than a week, the researchers concluded.

The figures showed 15 patients would need to be treated before one would be cured with antibiotics.

“If a patient comes to the GP and says they have had the complaint for seven to 10 days that’s not a good enough reason for giving them the antibiotic,” BBC quoted Study leader, Dr Jim Young, from the Basel Institute for Clinical Epidemiology in Switzerland, as saying.

source : topnewshealth

Supported  by
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Yudhasmara Foundation 

JL Taman Bendungan Asahan 5 Jakarta Indonesia 102010

phone : 62(021) 70081995 – 5703646

http://childrenclinic.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Rekomendasi dan kampanye penyuluhan ke orangtua dan dokter  yang telah dilakukan oleh kerjasama CDC (Centers for Disease Control and Prevention) dan AAP (American Academy of Pediatrics) memberikan pengertian yang benar tentang penggunaan antibiotika.

1. Pilek, panas dan batuk adalah gejala dari Infeksi Pernapasan Atas yang disebabkan virus.
2. Perubahan warna dahak dan ingus berubah menjadi kental kuning, berlendir dan kehijauan adalah merupakan perjalanan klinis Infeksi Saluran Napas Atas karena virus, bukan merupaklan indikasi antibiotika.
3. Pemberian antibiotika tidak akan memperpendek perjalanan penyakit dan mencegah infeksi tumpangan bakteri  

Upaya ini seharusnya menjadi contoh yang baik terhadap intitusi yang berwenang di Indonesia dalam mengatasi permasalahan penggunaan antibiotika ini. Melihat rumitnya permasalahan pemberian  antibiotika yang irasinol di Indonesia tampaknya sangat sulit dipecahkan. Tetapi kita harus yakin dengan kemauan keras, niat yang tulus dan keterlibatan semua pihak maka  permasalahan ini akan dapat terpecahkan. Jangan sampai terjadi, kita semua baru tersadar saat masalah sudah  dalam keadaan yang sangat serus.

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phone : 62(021) 70081995 – 5703646

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

For reactions that are presumed to be mediated by IgE, drug desensitization may be performed if the implicated agent is required for treatment.Desensitization is performed by a person with appropriate training, typically in a hospital setting. It involves the administration of increasing amounts of the antibiotic slowly over a period of hours until a therapeutic dose is reached. The typical starting dose is in micrograms; the route of administration may be oral or intravenous, but the oral route appears to be associated with fewer reactions. Doses are doubled every 15 to 30 minutes; therapeutic levels can be obtained in most cases within 4 to 5 hours. The patient is monitored closely throughout the procedure, and antihistamines and inhaled -agonists are given for urticarial reactions and bronchospasm, respectively. If a mild reaction (e.g., flushing or urticaria) occurs, the procedure may resume at the last tolerated dose; if a reaction is severe (hypotension or severe bronchospasm), the procedure should be aborted and an alternative antibiotic selected.

The mechanism by which clinical tolerance is achieved is unclear, but it is thought to involve antigen-specific mast-cell desensitization. Since maintenance of a desensitized state requires the continuous presence of the drug, desensitization must be repeated if the antibiotic is required again later.

In a recent retrospective report, desensitization for IgE-mediated drug allergy was successful in 43 of 57 cases (75 percent). Eleven desensitizations (19 percent) were complicated by severe allergic reactions, either during the procedure (anaphylaxis) or days after its completion (serum sickness); three were terminated for reasons other than allergic reactions. In most cases of failed desensitization, the drug reaction did not appear to be solely mediated by IgE. Desensitization appears more likely to fail in patients with cystic fibrosis.

            Graded Challenge

For reactions that are not considered to be mediated by IgE, management depends on the clinical manifestations of the previous reaction. For maculopapular eruptions, the specialist may consider a graded drug challenge, which is equivalent to provocation testing. Initial starting doses are generally higher than those used for desensitization (milligrams vs. micrograms), and the interval between doses varies, ranging from hours to days or even weeks. The patient is monitored for adverse reactions, which are most commonly cutaneous. The decision whether to discontinue an antibiotic if a reaction occurs depends on the nature of the reaction; bullous lesions or those involving mucous membranes warrant withdrawal of the drug, whereas it may be reasonable to treat through milder reactions, such as maculopapular eruptions, with the use of antihistamines, corticosteroids, or both as needed.

During drug readministration, repeated hypersensitivity reactions (morbilliform eruptions, fever, or both) have been noted in 58 percent of patients with the acquired immunodeficiency syndrome who have had previous reactions to sulfamethoxazole  Several graded-challenge procedures have been used successfully in such patients. An analysis of several studies showed that readministration of sulfamethoxazole with the use of an incremental-dosing regimen permitted the use of the drug in more than 75 percent of treated patients. Repeated administration is contraindicated, however, after any life-threatening reaction that is not mediated by IgE (e.g., drug-induced hemolytic anemia, immune-complex reactions, the Stevens–Johnson syndrome, and toxic epidermal necrolysis).

Cephalosporin in Patients with Penicillin Allergy

Penicillins and cephalosporins share a -lactam ring structure, making cross-reactivity a concern. Although a rate of cross-reactivity of more than 10 percent has been reported, this figure must be interpreted with caution since it is based on retrospective studies in which penicillin allergy was not routinely confirmed by skin testing, and at least some of the reactions were probably not immune-mediated.Available data, although based on small numbers, suggest an increased risk of cephalosporin reactions among patients with positive results on penicillin skin tests. In a review combining data from 11 studies of cephalosporin administration in patients with a history of penicillin allergy,⁴⁵ cephalosporin reactions were found to have occurred in 6 of 135 patients with positive skin-test results for penicillin allergy (4.4 percent), as compared with only 2 of 351 with negative skin tests (0.6 percent).

Whereas most patients who have a history of penicillin allergy will tolerate cephalosporins, indiscriminate administration cannot be recommended, especially for patients who have had life-threatening reactions.  Among 12 cases of fatal anaphylaxis caused by antibiotics in the United Kingdom from 1992 to 1997, 6 cases occurred after the first dose of a cephalosporin, and 3 of the 6 patients were known to have penicillin allergy.

For patients with a history of penicillin allergy who require a cephalosporin, treatment depends on whether the previous reaction was mediated by IgE.  Skin testing is warranted if the reaction was consistent with an IgE-mediated mechanism or if the history is unclear. In one study, one third of patients with positive results on skin tests had unclear or vague histories of penicillin allergy.If testing is positive and a cephalosporin is considered necessary, then desensitization should be performed with the use of the particular cephalosporin chosen for treatment. A possible alternative is to perform a graded challenge with the cephalosporin, but the risk of anaphylaxis, although low, must be recognized. If the history is inconsistent with an IgE-mediated mechanism, it is considered safe to initiate a graded challenge without previous skin testing.

Sulfonamide Allergy

For patients who have a history of allergy to sulfonamide antibiotics, concern has been raised about the use of other sulfonamide-containing drugs (diuretics, sulfonylureas, and celecoxib). However, sulfonamide antimicrobial agents (sulfamethoxazole, sulfadiazine, sulfisoxazole, and sulfacetamide) differ from other sulfonamide-containing medications by having an aromatic amine group at the N4 position and a substituted ring at the N1 position; these groups are not found in nonantibiotic sulfonamide-containing drugs. Thus, despite product-labeling warnings, cross-reactivity between these two groups of sulfonamides is believed to be unlikely.

In a large observational study, patients with a history of allergy to sulfonamide antibiotics had an increased risk of an allergic reaction to nonantibiotic sulfonamides, as compared with patients without such a history (adjusted odds ratio, 2.8; 95 percent confidence interval, 2.1 to 3.7), and were even more likely to have a reaction to penicillin (adjusted odds ratio, 3.9; 95 percent confidence interval, 3.5 to 4.3). These results suggest that the association between an allergy to sulfonamide antibiotics and subsequent reactions to nonantibiotic sulfonamide drugs is probably attributable to a predisposition to allergic reactions in general, as opposed to cross-reactivity between sulfonamide-containing antibiotics and nonantibiotic drugs.  However, the results must be interpreted with caution, given the retrospective design and the use of diagnosis codes to categorize reactions, which probably resulted in some misclassification of nonallergic reactions as allergic reactions.

Areas of Uncertainty

The mechanisms underlying antibiotic allergy have not been clearly elucidated. This understanding is needed to facilitate the development of better diagnostic tools and drugs that are less immunogenic. Better understanding is needed of factors mediating individual susceptibility to allergic reactions to antibiotics. A few studies have evaluated the role of major-histocompatibility-complex polymorphisms in the predisposition of patients to drug reactions, but these findings need to be confirmed and expanded.

Some patients have reported adverse reactions to many chemically unrelated antibiotics. The existence of the so-called multiple drug allergy syndrome is controversial,  and accepted diagnostic tests are needed to document drug allergy in these patients.

Guidelines

The American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology, and the Joint Task Force on Practice Parameters for Allergy and Immunology have developed practice guidelines for the management of drug allergy on the basis of evidence and expert opinion. The recommendations in the present review are consistent with these guidelines.

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DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Skin testing may be used to detect allergen-specific IgE antibodies. However, with the exception of penicillin, the relevant immunogens (which may be derived from an unidentified drug metabolite or degradation product) are not known for most drugs. Thus, there are no valid in vivo or in vitro diagnostic reagents available for identifying most antibiotic-specific IgE antibodies. Although the parent antibiotic compound may be used in testing by allergy specialists, a negative response on a skin test cannot be interpreted to mean that IgE antibodies are absent. Rather, a negative result may simply indicate insufficient sensitivity of the assay technique or, more likely, that the appropriate drug immunogen was not used in testing.

Skin testing is highly accurate for the identification of penicillin allergy, however. The clinically relevant antigenic determinants for penicillin are well characterized and include the important penicillin determinant penicilloyl polylysine and multiple minor determinants. Skin testing is performed with penicilloyl polylysine and either penicillin G diluted to 10,000 U per milliliter or a mixture of minor determinants that usually includes a 10^–2 M mixture of benzyl penicilloate, benzyl penilloate, and benzyl-n-propylamine. Skin-prick testing with full-strength materials is done first, and if these tests are negative at 15 minutes, they are followed by intracutaneous testing. An increase in the wheal diameter of at least 3 mm (as compared with the negative control) in the presence of erythema constitutes a positive test. Less than 20 percent of patients who report a history of penicillin allergy have detectable penicillin-specific IgE antibodies at the time of testing. Negative skin testing indicates that the previous reaction was not IgE-mediated or that the antibodies are no longer present; in either case, penicillin can be administered again with minimal risk of an immediate reaction (no more than 4 percent, an incidence similar to that in the general population³). Although penicilloyl polylysine has recently become unavailable commercially owing to manufacturing issues related to the production of a low-volume product, production is expected to resume in the future.

Other Testing

Skin testing is not predictive for drug reactions that are not mediated by IgE. In such cases, other tests may be useful but must be performed during or soon after the reaction. A positive Coombs’ test indicates cell-bound antibodies (e.g., penicillin-induced hemolytic anemia), and low complement levels may indicate the involvement of the complement cascade (e.g., minocycline-induced serum-sickness–like reaction). Levels of serum tryptase, a mast-cell–specific neutral protease that indicates systemic mast-cell activation, have been shown to be elevated for several hours after anaphylactic drug reactions.

Drug-specific T cells, which are involved in some hypersensitivity reactions, may be detected with the use of in vitro lymphocyte transformation tests, which are widely used in Europe but not approved for use in the United States. This test involves mixing lymphocytes from the patient with the drug that elicited the reaction. If drug-specific T cells are present, a proliferative response may result; proliferation, as measured by the incorporation of tritiated thymidine in the presence of the drug, is compared with that in the absence of the drug. A positive test result indicates that the patient has been sensitized to the drug. However, sensitization may be present even in the absence of any clinical manifestations, and positive test results have been demonstrated in both immediate and delayed antibiotic-induced reactions caused by -lactam drugs, sulfonamides, and quinolones. Until this test is further validated, it is best considered a research tool.

Provocation testing, which involves the administration of approximately three to six increasing doses of a drug up to the usual daily dose, may be used to confirm drug hypersensitivity.  However, provocation testing carries a clear risk of a reaction similar to the previous immediate hypersensivity reaction, although subsequent reactions are generally milder and briefer than the original reaction. In one study, the overall rate of such reactions during provocation testing was 17.6 percent. Thus, such testing should be performed only by experienced personnel in a setting in which equipment for cardiopulmonary resuscitation is available.

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CLINIC FOR CHILDREN

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JL Taman Bendungan Asahan 5 Jakarta Indonesia 102010

phone : 62(021) 70081995 – 5703646

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Supported  by
CLINIC FOR CHILDREN

Yudhasmara Foundation

JL Taman Bendungan Asahan 5 Jakarta Indonesia 102010

phone : 62(021) 70081995 – 5703646

http://childrenclinic.wordpress.com/

Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Indikasi yang tepat dan benar dalam penggunaan antibiotika pada anak adalah bila penyebab infeksi tersebut adalah bakteri. Menurut CDC (Centers for Disease Control and Prevention) indikasi pemberian antibiotika adalah

• bila batuk dan pilek berkelanjutan selama lebih 10 – 14 hari.yang terjadi sepanjang hari (bukan hanya pada malam hari dan pagi hari).
• Indikasi lain bila terdapat gejala infeksi sinusitis akut yang berat seperti  panas > 39 C dengan cairan hidung purulen, nyeri, pembengkakan sekitar mata dan wajah.
• Pilihan pertama pengobatan antibiotika untuk kasus ini cukup dengan pemberian Amoxicillin, Amoxicillinm atau Clavulanate. Bila dalam 2 – 3 hari membaik pengobatan dapat dilanjutkan selama 7 hari setelah keluhan membaik atau biasanya selama 10 – 14 hari.

Bila batuk dan pilek yang berkelanjutan yang terjadi hanya pada malam hari dan pagi hari (bukan sepanjang hari) biasanya berkaitan dengan alergi atau bukan lagi dalam fase infeksi dan tidak perlu antibiotika  Indikasi lain bila terdapat gejala infeksi sinusitis akut yang berat seperti  panas > 39 C dengan cairan hidung purulen, nyeri, bengkak di sekitar mata dan wajah. Pilihan pertama pengobatan antibiotika untuk kasus ini cukup dengan pemberian Amoxicillin, Amoxicillinm atau Clavulanate. Bila dalam 2 – 3 hari membaik pengobatan dapat dilanjutkan selama 7 hari setelah keluhan membaik atau biasanya selama 10 – 14 hari. Indikasi lainnya adalah radang tenggorokan karena infeksi kuman streptokokus. Penyakit ini pada umumnya menyerang anak berusia 7 tahun atau lebih. Pada anak usia 4 tahun hanya 15%  yang mengalami radang tenggorokan karena kuman ini.  Bila sakit batuk dan pilek timbul sepanjang hari (bukan hanya malam dan pagi hari) lebih dari 10-14 hari disertai cairan hidung mukopurulen (kuning atau hijau). Untuk mengetahui apakah ada infeksi bakteri biasanya dengan melakukan kultur yang membutuhkan beberapa hari untuk observasi. Apabila dicurigai adanya infeksi saluran kemih, dilakukan pemeriksaan sample urin dan kemudian di lakukan pemeriksaan kultur di rumah sakit.  Setelah beberapa hari akan ketahuan bila ada infeksi bakteri berikut jenisnya dan sensitivitas terhadap jenis obatnya.

Penyakit yang lain yang harus mendapatkan antibiotika adalah infeksi saluran kemih dan penyakit tifus Untuk mengetahui apakah ada infeksi bakteri biasanya dengan melakukan kultur darah atau urine. Apabila dicurigai adanya infeksi saluran kemih, dilakukan pemeriksaan kulut urine.  Setelah beberapa hari akan diketahui bila ada infeksi bakteri berikut jenis dan sensitivitas terhadap antibiotika. Untuk mengetahui penyakit tifus harus dilakukan pemeriksaan darah Widal dan kultur darah gal.  Anak usia di bawah 5 tahun yang mengalami infeksi virus sering mengalami overdiagnosis penyakit Tifus. Sering terjadi kesalahan persepsi dalam pembacaan hasil laboratorium. Infeksi virus dengan peningkatan sedkit pemeriksaan nilai widal sudah divonis gejala tifus dan dihantam dengan antibiotika.

Sebagian besar kasus penyakit infeksi pada anak penyebabnya adalah virus. Dengan kata lain seharusnya kemungkinan penggunaan antibiotika yang benar tidak besar atau mungkin hanya sekitar 10 – 15% penderita anak. Penyakit virus adalah penyakit yang termasuk “self limiting disease” atau penyakit yang sembuh sendiri dalam waktu 5 – 7 hari. Sebagian besar penyakit infeksi diare, batuk, pilek dan panas penyebabnya adalah virus. Secara umum setiap anak akan mengalami 2 hingga 9 kali penyakit saluran napas karena virus. Sebaiknya jangan terlalu mudah mendiagnosis (overdiagnosis) sinusitis pada anak. Bila tidak terdapat komplikasi lainnya secara alamiah pilek, batuk dan pengeluaran cairan hidung akan menetap paling lama sampai 14 hari setelah gejala lainnya membaik. Sebuah penelitian terhadap gejala pada 139 anak penderita pilek(flu) karena virus didapatkan bahwa pemberian antibiotik pada kelompok kontrol tidak memperbaiki cairan  mucopurulent   dari hidung. Antibiotika tidak efektif mengobati Infeksi saluran napas Atas dan tidak mencegah infeksi bakteri tumpangan. Sebagian besar infeksi Saluran napas Atas termasuk sinus paranasalis sangat jarana sekali terjadi komplikasi bakteri.

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phone : 62(021) 70081995 – 5703646

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Sebenarnya penggunaan antibiotika secara benar dan sesuai indikasi memang harus diberikan. Meskipun terdapat pertimbangan bahaya efek samping dan mahalnya biaya. Tetapi menjadi masalah yang mengkawatirkan, bila penggunaannnya berlebihan. Banyak kerugian yang terjadi bila pemberian antibiotika berlebihan tersebut tidak dikendalikan secara cepat dan tuntas.  Kerugian yang dihadapi adalah meningkatnya resistensi terhadap bakteri. Belum lagi perilaku tersebut berpotensi untuk meningkatkan biaya berobat. Seperti diketahui bahwa harga obat antibiotika merupakan bagian terbesar dari biaya pengobatan. 

Efek samping yang sering terjadi pada penggunaan antibiotika adalah gangguan beberapa organ tubuh. Apalagi bila diberikan kepada bayi dan anak-anak, karena sistem tubuh dan fungsi organ pada bayi dan anak-anak masih belum tumbuh sempurna. Apalagi anak beresiko paling sering mendapatkan antibiotika, karena lebih sering sakit akibat daya tahan tubuh lebih rentan. Bila dalam setahun anak mengalami 9 kali sakit, maka 9 kali 7 hari atau 64 hari anak mendapatkan antibiotika. Gangguan organ tubuh yang bisa terjadi adalah gangguan saluran cerna, gangguan ginjal, gangguan fungsi hati, gangguan sumsum tulang, gangguan darah dan sebagainya. Akibat lainnya adalah reaksi alergi karena obat. Gangguan tersebut mulai dari yang ringan seperti ruam, gatal sampai dengan yang berat seperti pembengkakan bibir atau kelopak mata, sesak, hingga dapat mengancam jiwa (reaksi anafilaksis).

Pemakaian antibiotika berlebihan atau irasional juga dapat membunuh kuman yang baik dan berguna yang ada didalam tubuh kita. Sehingga tempat yang semula ditempati oleh bakteri baik ini akan diisi oleh bakteri jahat atau oleh Namur atau disebut “superinfection”. Pemberian antibiotika yang berlebihan akan menyebabkan bakteri-bakteri yang tidak terbunuh mengalami mutasi dan menjadi kuman yang resisten atau disebut “superbugs”.

Jadi jenis bakteri yang awalnya dapat diobati dengan mudah dengan Antibiotika yang ringan, apabila antibiotikanya digunakan dengan irasional, maka bakteri tersebut mutasi dan menjadi kebal, sehingga memerlukan jenis antibiotika yang lebih kuat. Bila bakteri ini menyebar ke lingkungan sekitar, lama kelamaan, apabila pemakaian antibiotika yang irasional ini terus berlanjut, maka suatu saat akan tercipta kondisi dimana tidak ada lagi jenis antibiotika yang dapat membunuh bakteri yang terus menerus bermutasi ini. Hal ini akan membuat kembali ke zaman sebelum antibiótica ditemukan. Pada zaman tersebut infeksi yang diakibatkan oleh bakteri tidak dapat diobati sehingga angka kematian akan drastis melonjak naik. Hal lain yang mungkin terjadi nantinya kebutuhan pemberian antibiotika dengan generasi lebih berat, dan menjadikan biaya pengobatan semakin meningkat karena harganya mahal.

Peneliti dari the University of Washington School of Medicine di Seattle seperti yang dikutip pada New England Journal of Medicine menunjukkan bahwa resiko terjadinya gangguan Hemolitic uremic Syndrome lebih sering pada penderita infeksi E.Coli yang diberikan antibiótica dibandingkan pada kelompok yang tidak diberi antibiótika.

Dahulu Tetraclin dianggap sebagai biang keladi gangguan perubahan warna pada gigi. Tetapi dalam penelitian terakhir yang dilakukan oleh peneliti dari Universitas Iowa didapatkan efek samping pada pembentukan enamel gigi pada gigi permanent akibat pemberian amoksisilin pada usia bayi. Sedangkan penelitian yang dilakukan di kanada terhadap 12,082 anak menunjukkkan pemberian antibiotika pada usia bayi beresiko meningkatkan terjadinya asma pada anak. 

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