H49 antibiotics

Bismuth quadruple therapy . This therapy contains two antibiotics, tetracycline and metronidazole, plus bismuth and PPI for 14 days (Harb et al. 2015).This therapy is preferred as a first-line treatment option for areas with a high incidence of clarithromycin resistance and also as second-line therapy when first treatment with the classical triple therapy against H. pylori was failed ...

H49 antibiotics. Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic.

Sulfamethoxazole for Dogs. One of the most common and potent antibiotics that is used in canine medicine is sulfamethoxazole. Routinely combined with the drug called trimethoprim, this antibiotic is able to stop bacteria that are the cause of a number of different types of infections. Together, these two drugs are quite a bit more potent than ...

Antibiotics: An overview. Antibiotics are a type of medicine which are used to treat bacterial infections. Every day we come into contact with thousands of bacterial cells. We are colonized with lots of different types of bacteria which live on us, and inside of us; everywhere from the grooves of your fingerprint, to the nooks and crannies of ...Qty. SMZ-TMP DS 960 mg, 500 Tablets is an antibiotic that treats a variety of urinary tract, respiratory, gastrointestinal, ear, and skin infections in pets. These pet medications are commonly prescribed by veterinarians. The usual dose for dogs is 13 mg/pound by mouth every 24 hours or 6.5 mg/pound by mouth every 12 hours.Sulfamethoxazole / trimethoprim is an antibiotic combination used to prevent and treat infections. Learn more and get expert advice at VCA.Suggested antibiotic treatment for necrotizing soft tissue infection (NSTI) and future perspectives. The mainstem of empiric treatment is a broad-spectrum beta-lactam (e.g., piperacillin-tazobactam) with additional aminoglycosides in case of septic shock.How do we stay safe from the growing epidemic of antibiotic resistant bacteria? NIAID is researching ways to keep us safe. Trusted Health Information from the National Institutes o...Side Effects. Hypersensitivity reactions and hematologic effects, including anemias, thrombocytopenia, or leukopenias may occur. The most common side effect is diarrhea.redness, swelling, or soreness of the tongue. seizures. soreness of the muscles. stiff neck or back. stomach tenderness. swelling of the face, hands, legs, and …

According to a 2001 review on Clostridium difficile associated diarrhea published in the Archives of Internal Medicine, the most common antibiotic culprits are clindamycin, ampicillin, amoxicillin ...The use of antibiotic alternatives to promote health and reduce disease will decrease antibiotic use, thereby decreasing selective pressure for the emergence and transmission of antibiotic-resistance genes. Antibiotics are used for disease treatment and prevention in both humans and animals. Historically, antibiotics have also been used for ...Macrolides are a class of drugs used to manage and treat various bacterial infections. Azithromycin, clarithromycin, and erythromycin are commonly used to treat infections like pneumonia, sinusitis, pharyngitis, and tonsillitis. They are also used in uncomplicated skin infections and otitis media in pediatric patients. Clarithromycin is used to treat Helicobacter pylori infections in standard ...Antibiotics by definition fight bacteria infections such as UTIs, strep throat, pneumonia, sinus, ear, and tooth infections. Antibiotic classification types include penicillin, cephalosporin, macrolide, tetracycline, sulfonamide, carbapenem, and fluoroquinolone. Antibiotic class chart, mnemonic, ppt, and table included on drug names, gram ...Brand names: Bactrim, Bactrim DS, Septra, Co-trimoxazole, SMZ-TMP DS, …show all brand names. Sulfamethoxazole / trimethoprim has an average rating of 5.2 out of 10 from a total of 68 reviews for the treatment of Sinusitis. 40% of reviewers reported a positive experience, while 44% reported a negative experience. Filter by condition.Asymptomatic bacteriuria does not require antibiotic therapy for most patients. Antibiotics are only indicated for: Pregnancy: cystitis treatment; Urological procedure: 1 dose prior to procedure and 1 to 2 doses after; Catheter associated UTIs (CAUTI) require change in catheter and then may be treated based on site of infection

Sulfamethoxazole/trimethoprim is an antibiotic that's a combination of two medications, sulfamethoxazole and trimethoprim. They work together to stop bacteria from being able to make a chemical ( folic acid ) that's needed for them to grow and survive.Does hydrocodone pills have H49 imprinted on them? No, it's sulfamethoxazole a antibiotic. What doesH49 oval white pill for bacterial infections treat?The 2024 edition of ICD-10-CM H49.00 became effective on October 1, 2023. This is the American ICD-10-CM version of H49.00 - other international versions of ICD-10 H49.00 may differ. Convert H49.00 to ICD-9-CM. Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.Sulfamethoxazole / trimethoprim is an antibiotic combination used to prevent and treat infections. Learn more and get expert advice at VCA.Official answer. by Drugs.com. Sulfamethoxazole/TPM would be ineffective against gonorrhoea and chlamydia. Chlamydia is caused by the bacteria Chlamydia trachomatis. Chlamydia can be treated with a variety of antibiotics, including azithromycin, tetracyclines, quinolones, and erythromycin. Gonorrhea is caused by the bacteria …

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amoxicillin. penicillin. cephalexin. clindamycin. azithromycin. The best antibiotics for tooth infection are known to fight the bacteria most commonly found in your mouth. When your dentist prescribes one of these antibiotics, the choice will depend on whether you are allergic to penicillin or have other issues.Feeding the beneficial bacteria before and after taking antibiotics can help to bring balance back to the gut. Some foods contain low levels of prebiotics, such as: onions. garlic. bananas ...Bactrim is the brand name of a combination medicine that contains the antibiotics sulfamethoxazole and trimethoprim. It’s used to treat certain bacterial infections, including ear infections ...Sulfamethoxazole and trimethoprim is a combination of two synthetic (man-made) antibiotics, sulfamethoxazole, and trimethoprim. Both drugs reduce the ability of some bacteria to utilize folic acid for growing. Sulfamethoxazole is an anti-bacterial sulfonamide, a "sulfa" drug.

Probiotics and Other Bacterial Infections. Two meta-analyses have found that taking probiotics and antibiotics together was 20–23% more effective than taking antibiotics alone for curing bacterial vaginosis (an overgrowth of bacteria in the vagina) [ 9, 10 ]. In addition, probiotics taken alone were 12–30% more effective at curing bacterial ...Bactericidal antibiotics are represented by the aminoglycosides, the fluoroquinolones, the penicillins, and the cephalosporins. Conversely, bacteriostatic drugs are sodium sulfacetamide, trimethoprim, and to some degree, erythromycin. Concentration-dependent and time-dependent. Concentrationdependent drugs are aminoglycosides and fluoroquinolones.You'll want to eat raw garlic for best effects. If eating whole, raw garlic cloves doesn't sound appealing, try adding chopped, raw garlic to salad dressing or guacamole. You can also rub cut garlic cloves on toast. If pungent foods are your thing, raw onions and leeks are also great prebiotics to add to your diet. 4.Interactions. Antibiotic resistance. Antibiotics can sometimes interact with other medicines or substances. This means it can have an effect that is different to what you expected. If you want to check that your medicines are safe to take with your antibiotics, ask your GP or local pharmacist. Some antibiotics need to be taken with food, while ...BACTRIM belongs to a group of medicines called antibiotics. There are many different types of medicines used to treat bacterial infections. Sulfamethoxazole ... You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment. This medication is a combination of two antibiotics: sulfamethoxazole and trimethoprim. It is used to treat a wide variety of bacterial infections (su. Antibiotic resistance is a global health challenge, involving the transfer of bacteria and genes between humans, animals and the environment. Although multiple barriers restrict the flow of both ...Diarrhea is common with antibiotics. Rarely, a severe form called C diff-associated diarrhea (CDAD) may happen. Sometimes, this has led to a deadly bowel problem. CDAD may happen during or a few months after taking antibiotics. Call your child's doctor right away if your child has stomach pain, cramps, or very loose, watery, or bloody stools.

This medication is a combination of two antibiotics: sulfamethoxazole and trimethoprim. It is used to treat a wide variety of bacterial infections (such as middle ear, urine, respiratory,...

Side effects that you should report to your care team as soon as possible: Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat. Aplastic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising, fever, chills, cough, or sore throat.Antibiotics begin to work right after you start taking them. However, you might not feel better for 2 to 3 days. How quickly you get better after antibiotic treatment varies. It also depends on ...Introduction. Clostridium difficile (C. difficile) is one of the major causes of diarrhea transmitted by the fecal-oral route.C. difficile type BI/NAP1/027 is responsible for the most severe C. difficile infection (CDI). It is a major cause of antibiotic-associated diarrhea followed by Clostridium perfringens, Staphylococcus aureus,and Klebsiella oxytoca.Main page; Contents; Current events; Random article; About Wikipedia; Contact us; DonateSide effects that you should report to your care team as soon as possible: Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat. Aplastic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising, fever, chills, cough, or sore throat.Acute pharyngitis is one of the most common complaints that a physician encounters in the ambulatory care setting, accounting for approximately 12 million visits annually or 1 to 2% of all ambulatory care visits annually.[1] Typically, the incidence peaks during childhood and adolescents and accounts for 50% of all visits annually.[2] Although there are a large number of visits each year for ...Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. Individual patient circumstances and local resistance patterns may alter treatment choices.Introduction. Clostridium difficile (C. difficile) is one of the major causes of diarrhea transmitted by the fecal-oral route.C. difficile type BI/NAP1/027 is responsible for the most severe C. difficile infection (CDI). It is a major cause of antibiotic-associated diarrhea followed by Clostridium perfringens, Staphylococcus aureus,and Klebsiella oxytoca.antibiotic and is available as a single drug or in combination with sulfamethoxazole (a sulfonamide antibiotic). Trimethoprim and the combination of trimethoprim and sulfamethoxazole (TMP/SMX) are effective against many gram-positive bacteria and gram-negative bacteria, including susceptible bacteria that are resistant to other antibiotics ...

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Enter the imprint code that appears on the pill. Example: L484 Select the the pill color (optional). Select the shape (optional). Alternatively, search by drug name or NDC code using the fields above.; Tip: Search for the imprint first, then refine by color and/or shape if you have too many results.Single-dose 1 g tablet taken in conjunction with a single dose of ceftriaxone. Diarrhea, vomiting, headache. Vibramycin ( doxycycline) Tetracycline antibiotics. Oral tablet. 100 mg oral tablet taken twice daily for 7 days in conjunction with a single dose of ceftriaxone. Nausea, vomiting, diarrhea.Antibiotics by definition fight bacteria infections such as UTIs, strep throat, pneumonia, sinus, ear, and tooth infections. Antibiotic classification types include penicillin, cephalosporin, macrolide, tetracycline, sulfonamide, carbapenem, and fluoroquinolone. Antibiotic class chart, mnemonic, ppt, and table included on drug names, gram ...Nov 26, 2004 ... ... H49N7O9·½H2O. The compound is highly active against various gram-positive bacteria but less active against gram-negative organisms ...Antibiotics work in different ways to kill bacteria or stop them from growing. "All classes" of antibiotics group together all types of antibiotic use. In this portal, antibiotics are classified into one of the following classes: penicillins, fluoroquinolones, cephalosporins, macrolides, beta-lactams with increased activity (e.g. amoxicillin ...Antibiotics were prescribed for a 10-day course of treatment. In both the intention-to-treat and evaluable populations, SXT and clindamycin had similar efficacies. Cure was achieved in 80% and 78% at 10–14 days after completion of therapy for SXT and clindamycin, respectively ( P = .52) [ 22 ].You and your healthcare provider need to work together to decide if and when you need to take antibiotics. For example, when you have a serious bacterial infection (illness caused by a specific bacteria), you will need antibiotics. Some examples include bacterial pneumonia, bacterial meningitis, and bacterial urinary tract infections (UTIs).There are several antibiotics that kill the common mouth bacteria that cause tooth infections. The best (first-line) antibiotics for tooth infection include: Amoxicillin, Penicillin, Cephalexin, Clindamycin, Azithromycin. Amoxicillin is often the first choice because it is widely effective and has the fewest gastrointestinal side effects.Antibiotics are powerful, lifesaving medications that treat bacterial infections like strep throat and urinary tract infections. But they're not for every sickness, and they can cause side effects like diarrhea. Learning when you need antibiotics and how to take them properly can help you benefit from these medications with the least risk. Antibiotics may decrease hormonal contraceptive efficacy. sulfamethoxazole will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive ... May 24, 2023 · Antibiotics are powerful, lifesaving medications that treat bacterial infections like strep throat and urinary tract infections. But they’re not for every sickness, and they can cause side effects like diarrhea. Learning when you need antibiotics and how to take them properly can help you benefit from these medications with the least risk. Total outpatient oral antibiotic prescriptions in 2022. Healthcare professionals prescribed 236.4 million antibiotic prescriptions—equivalent to 709 antibiotic prescriptions per 1000 persons. Table 1. Oral antibiotic prescriptions by age, sex, and region a,b —United States, 2022. For each age group, number of prescriptions and rate per 1,000. ….

In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, "In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.". According to the ADA Chairside Guide ...CONTENTS commonly used antibiotics Aminoglycosides Ampicillin & Ampicillin-Sulbactam Aztreonam Carbapenems (meropenem & ertapenem) Cephalosporins Cephalosporin G1: cefazolin Cephalosporin G3: ceftriaxone Cephalosporin G3: ceftazidime Cephalosporin G4: cefepime Cephalosporin G5: ceftaroline Clindamycin Daptomycin Doxycycline Fluoroquinolones Linezolid Macrolides (Azithromycin, Clarithromycin ...A step forward? McDonald’s is asking chicken suppliers to its US locations to phase out the use of antibiotics important to human medicine, addressing concerns that current practic...The nucleus of cephalexin, USP is related to that of other cephalosporin antibiotics. The compound is a zwitterion; i.e., the molecule contains both a basic and an acidic group. The isoelectric point of cephalexin, USP in water is approximately 4.5 to 5. The crystalline form of cephalexin, USP which is available is a monohydrate.A 2023 study notes that clove essential oil may possess a strong inhibitory effect against Staphylococcus aureus. Similarly, a 2020 article notes that clove extract may have potential as a new ...Sulfamethoxazole and trimethoprim is a combination of two synthetic (man-made) antibiotics, sulfamethoxazole, and trimethoprim. Both drugs reduce the ability of some bacteria to utilize folic acid for growing. Sulfamethoxazole is an anti-bacterial sulfonamide, a "sulfa" drug. It disrupts the production of dihydrofolic acid while … Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Pill with imprint H 48 is White, Round and has been identified as Sulfamethoxazole and Trimethoprim 400 mg / 80 mg. It is supplied by Aurobindo Pharma. Top 10 List of Common Infections Treated with Antibiotics. Acne. Bronchitis. Conjunctivitis (Pink Eye) Otitis Media (Ear Infection) Sexually Transmitted Diseases (STD’s) Skin or Soft Tissue Infection. Streptococcal Pharyngitis (Strep Throat) Traveler’s diarrhea.Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic. H49 antibiotics, antibiotic, chemical substance produced by a living organism, generally a microorganism, that is detrimental to other microorganisms. Antibiotics commonly are produced by soil microorganisms and probably represent a means by which organisms in a complex environment, such as soil, control the growth of competing microorganisms., Sulfamethoxazole (SMZ or SMX) is an antibiotic.It is used for bacterial infections such as urinary tract infections, bronchitis, and prostatitis and is effective against both gram negative and positive bacteria such as Escherichia coli and Listeria monocytogenes.. Common side effects include nausea, vomiting, loss of appetite, and skin rashes.It is a sulfonamide and bacteriostatic., In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, "In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.". According to the ADA Chairside Guide ..., Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Pill with imprint H 48 is White, Round and has been identified as Sulfamethoxazole and Trimethoprim 400 mg / 80 mg. It is supplied by Aurobindo Pharma., HMS H 49 (Lt. P.R. Ward, RN) shifted from Portsmouth to Portland where she was to participate in A/S exercises. [As there are no logs available of HMS H49 from Februaury to MAy 1940 no details regarding these A/S exercises can be given.] (8) 10 May 1940 For the daily positions of HMS H 49 during her 1st war patrol see them map below., Mechanism of Action. Sulfamethoxazole interferes with bacterial folic acid synthesis and growth via inhibition of dihydrofolic acid formation from para-aminobenzoic acid; trimethoprim inhibits dihydrofolic acid reduction to tetrahydrofolate resulting in sequential inhibition of enzymes of the folic acid pathway., Using any antibiotic when it is not needed can cause it to not work for future infections. How to use amoxicillin-potassium clavulanate oral Take this medication by mouth with a meal or snack as ..., Sulfamethoxazole and trimethoprim are are both antibiotics that treat different types of infection caused by bacteria. Bactrim is a prescription medicine used to …, See how to make your own 100% natural sore throat spray (with essential oils, herbs, and honey!) 3. Goldenseal. Best For - upper respiratory infections, digestive infections, UTI. Goldenseal is one of the five top-selling herbal products in the United States and is one of the most powerful antibiotic herbs., Antibiotics for boils. The majority of boils are caused by the bacteria Staphylococcus aureus, also known as staph. To fight this infection, your doctor might prescribe oral, topical, or ..., Antibiotic resistance is one of the world's most urgent health problems. The overuse and misuse of antibiotics are key factors leading to antibiotic resistance. The general public, health care providers and hospitals all can help ensure correct use of the drugs. This can lessen the growth of antibiotic resistance., Currently, the only FDA-approved drug for the treatment of active RSV infection is ribavirin. This medication is used only for people hospitalized with severe lower respiratory RSV infections ..., Oct 24, 2023 · Official answer. by Drugs.com. Sulfamethoxazole/TPM would be ineffective against gonorrhoea and chlamydia. Chlamydia is caused by the bacteria Chlamydia trachomatis. Chlamydia can be treated with a variety of antibiotics, including azithromycin, tetracyclines, quinolones, and erythromycin. Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. , The most important antibiotics in H. pylori treatment are clarithromycin, metronidazole, and amoxicillin. Figure. . 1 illustrates recently reported clarithromycin and metronidazole resistance rates worldwide. Resistance to these antibiotics is thought to be the main cause of eradication failure [ 27 - 29 ]., BACTRIM belongs to a group of medicines called antibiotics. There are many different types of medicines used to treat bacterial infections. Sulfamethoxazole ..., Can you take expired antibiotics? 90% of the potency and efficacy of antibiotics can be retained 5 years from the expiration date if stored correctly. But like other medications, antibiotics do expire. Potency can remain for solid forms of antibiotics. However, taking expired antibiotics, unless for an emergency, is not safe and may be toxic., 2. Linezolid (Brand Names: Zyvox, Zyvoxid or Zyvoxam) Folliculitis is a common type of MRSA skin infection often treated with oral antibiotics. Approved for use in the year 2000, Linezolid is FDA approved for treating soft tissue and skin infections, including those caused by MRSA. It is often prescribed for CA-MRSA pneumonia and in particular ..., Currently, the only FDA-approved drug for the treatment of active RSV infection is ribavirin. This medication is used only for people hospitalized with severe lower respiratory RSV infections ..., 2. Antibiotic Drugs. Antibiotics always existed in our environment, but we did not know how to isolate and produce them. The first potentially healthy use of beer containing tetracycline was found in ancient Nubia about 350-550 years BC [].The modern era of antibiotics began with Alexander Fleming (1881-1955), the great antibiotic explorer., CONTENTS commonly used antibiotics Aminoglycosides Ampicillin & Ampicillin-Sulbactam Aztreonam Carbapenems (meropenem & ertapenem) Cephalosporins Cephalosporin G1: cefazolin Cephalosporin G3: ceftriaxone Cephalosporin G3: ceftazidime Cephalosporin G4: cefepime Cephalosporin G5: ceftaroline Clindamycin Daptomycin Doxycycline Fluoroquinolones Linezolid Macrolides (Azithromycin, Clarithromycin ..., Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Pill with imprint H 48 is White, Round and has been identified as Sulfamethoxazole and Trimethoprim 400 mg / 80 mg. It is supplied by Aurobindo Pharma. , Painkillers can be taken with antibiotics, according to Dr. Meng K. Syn. In depth dental procedures, such as a root canal treatment, usually results in having an antibiotic and a p..., You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment. This medication is a combination of two antibiotics: sulfamethoxazole and trimethoprim. It is used to treat a wide variety of bacterial infections (su. , For most people, antibiotic-associated diarrhea causes mild signs and symptoms, such as: Loose stools. More-frequent bowel movements. Antibiotic-associated diarrhea is likely to begin about a week after you start taking an antibiotic. Sometimes, however, diarrhea and other symptoms don't appear until days or even weeks after …, 3 days ago · Sulfamethoxazole and trimethoprim combination is used to treat infections including urinary tract infections, middle ear infections (otitis media), bronchitis, traveler's diarrhea, and shigellosis (bacillary dysentery). , Treats a myriad of infections naturally without upsetting your body's natural gut flora or contributing to the world epidemic of superbugs! Take these All-Natural Antibiotics at the first sign of infection (eyes, ears, nose, throat), cold, flu, for a week or two, amazing results, no side effects. HSV-1 and HSV-2., What is a H49 pill? a pill that treats uti"s. What doesH49 oval white pill for bacterial infections treat? ... bronchitis and belongs to the drug classes miscellaneous antibiotics, ..., The American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) recently updated their recommendations on the diagnosis and treatment of community-acquired pneumonia (CAP ..., The development of antibiotics was one of the greatest discoveries in modern medicine. They fight bacteria and can cure life-threatening infectious diseases such as pneumonia, for which there was previously no effective treatment. But the widespread and improper use of antibiotics means that more and more bacteria are becoming …, Bactrim is rapidly absorbed when taken by mouth with maximum concentrations occurring 1-4 hours after taking a dose. If you want to avoid consuming alcohol while concentrations are at their highest, 4 hours seems to be that upper limit. Therefore alcohol should be avoided at least 4 hours after taking Bactrim., Some common antibiotics, such as penicillin (e.g., amoxicillin) or ciprofloxacin, can stay in your body for up to 12 to 24 hours after your last dose. Amoxicillin, for example, is excreted through the kidneys and urine. Most of it is expected to pass through the urine within eight hours of the last dose and should be completely gone by 12 hours., Bactrim Pill Images. Note: Multiple pictures are displayed for those medicines available in different strengths, marketed under different brand names and for medicines manufactured by different pharmaceutical companies. Multi-ingredient medications may also be listed when applicable. What does Bactrim look like?, Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. Individual patient circumstances and local resistance patterns may alter treatment choices.