Choosing the right antibiotic

BACKGROUND: With the increasing complexity of the antibiotic armamentarium and the increasing prevalence of resistance, the choice of an appropriate antibiotic is more difficult than ever before. There is also increasing concern that overuse of broad spectrum antibiotics may help reduce their effectiveness in the future. In attempting to make rational antibiotic choices, competing interests must be balanced in order to preserve one of our most powerful medical tools. OBJECTIVE: The aim of this paper is to discuss some of the factors that should be considered when selecting an antibiotic and to provide general principles for use in day to day decision making. DISCUSSION: A knowledge of the patient combined with a working knowledge of the likely target organism and its predicted susceptibility profile is the basis of antibiotic selection.