Can Bactrim treat a staph infection

Antibiotics - "How can I protect myself against resistant germs?"

Chat log

Good day. I recently had to take the antibiotic penicillin for angina. About a week after the last antibiotic I had a red rash on my body, especially on my arms, which itched extremely. Could this already be an allergic reaction from penicillin or would more symptoms have to be added to define an allergic reaction? Many Thanks :)

Andreas Widmer: It may actually be the case that there is a delayed form of penicillin allergy. More likely, however, the cause is the infection that triggered the rash. I recommend that you see a skin specialist for clarification after the infection has subsided. Penicillins are among the best antibiotics, and alternatives are sometimes less effective. If you ever suspect you have allergies to penicillin in your medical history, hardly anyone dares to prescribe this important effective antibiotic for you

In the past, the iron rule that AB should never be used too briefly applied, but this knowledge now seems to have been put into perspective. Not too short, but too long administration of AB could promote resistance. For what kind of illnesses is it advisable to take AB compared to previous recommendations?

Andreas Kronenberg: According to current knowledge, taking it too short does not lead to increased resistance, but it can lead to a relapse (flare-up) of the infection. Which infections have to be treated for how long depends not only on the infection, but also on the pathogen and the response, which is why I cannot answer your answer in general. You must discuss the duration of therapy with the attending physician every time you prescribe.

What is this constant scaremongering about? Antibiotics have been used in medicine for less than 70 years. One wonders how humanity even survived before ...

Urs Karrer: It's not about scaremongering. Humanity will survive even without antibiotics. But certain treatments and operations that are now 'routine' would be life-threatening in the future if we no longer have effective antibiotics.

Hello, How is it with the flu vaccination, If I do this, and then got a runny nose through the whole winter, What should I do about it or also vaccinate for the next few years? I am around 50 years old. Had such a case (had an experience) so I don't dare to vaccinate myself anymore. Then I registered at, most of the doctors I know refuse to make the entries, I don't understand that.

Chat-Admin: Antibiotics are not used for the flu vaccination, as they work against bacteria and do nothing in the case of flu viruses.

Good evening. I would like to ask how long you can use antibiotics and when the body has broken them down. Also how it behaves with children. From what age can you give antibiotics? Thank you and best regards.

Andreas Kronenberg: The duration of antibiotic therapy depends on the infection. While a single dose can be sufficient for a bladder infection, tuberculosis requires 6 months of antibiotic therapy. Children of all ages can also be treated with antibiotics. Most antibiotics are broken down quickly by the body, but again there are differences depending on the antibiotic.

How does it make sense to take antibiotics with yoghurt or something because of the intestinal flora

Andreas Widmer: in Switzerland - in contrast to some other countries, Switzerland yogurts have millions of living yogurt bacteria. Our yogurts are not pasteurized. A documented benefit for preventing diarrhea does not yet exist, but the intestinal flora is disturbed depending on the antibiotic. The type of antibiotic is important, as some e.g. quinolones (brand name: Ciproxin, Ciprofloxacin) make the absorption of the antibiotic more difficult through dairy products, but especially through calcium and magnesium intake. Ask your doctor, yogurt is not prohibited with penicillin, and it may also be useful.

The bacterium "Whipple" caused polyarthritis in me. After a 14-day course of intravenous antibiotics, I have to take the drug Bactrim forte for a year. What consequences can the long use of this drug have regarding "my resistance?"

Urs Karrer: Your intestinal flora will become resistant to the active ingredient in Bactrim (cotrimoxazole). If you need treatment for another infection (e.g. cystitis) you will need to use a different antibiotic for treatment.

+++ This morning the doctor used the term "antibiotic / -a" correctly, the moderator steadfastly repeated the term incorrectly. This is not good. - Would it be possible for you to inform and instruct the radio presenters that they will use the term "antibiotic" correctly in the future, including adapted verb forms? "Antibiotics" only stands for the plural (plural) of the word. The radio contributes to the education of the listeners and therefore has a great responsibility. +++

I have an erisipelas for the third time this year, I take antibiotics every time I am afraid that I will become resistant, I have lymphoma.

Andreas Widmer: Fortunately, the most common pathogens of erysipelas are so-called beta-hemolytic streptococci. For reasons that are not entirely clear, there is NO development of resistance in these pathogens. I recommend using lifoscrub soap to cleanse your body (substance: chlorhexidine), this could help reduce the frequency of recurrences

Good day! Myself and my daughter hardly ever had antibiotics in our lives. Does that mean that we respond even better if we ever need it or do we absorb so much from the environment that the resistances could have the same effect? Thank you and best regards

Andreas Kronenberg: Antibiotics are an important trigger for developing resistance, but not the only one. Resistant germs can also be transmitted from other people or "brought in" from stays abroad. Nevertheless, it is of course an advantage if you and your daughter have hardly used antibiotics so far, and the risk of them carrying resistant germs is smaller.

Good evening. Wound infection found 3 months after emergency Dacron prosthesis in aorta carotis. During 10 1/2 weeks of antibiotic therapy in the hospital and b. General Practitioner (Cubicin). Now prescribed for 2 months: 3 x 600 mg clindamycin and 2 x 750 mg ciprofloxacin daily. I have concerns about the effectiveness of the therapy and the resistance that may develop after long-term therapy with strong antibiotics. (Age 70)

Urs Karrer: This is a difficult situation that I cannot reliably assess without knowing all the medical information. In most clinics, such an infection and its treatment are discussed in detail with an infectiologist. Ask your family doctor or the doctor who operated on you where the recommendation for this treatment came from.

How often do fluoroquinolones cause severe complications (nerve damage)? In your opinion, is the special hazard warning in the instruction leaflet that the FDA stipulates (highlighted black box) justified? According to Wolfgang Becker Büser, head of the German "Arznei-Telegram", the relevant complications have been known for 30 years without the warnings having received enough attention.

Andreas Widmer: We at the University Hospital Basel have been treating many patients with fluoroquinolones for months for 20 years, and the frequency from the FDA does not correspond to my observation. However, we virtually never use fluoroquinolones to treat upper respiratory infections, which appears to be a common practice in the United States. We therefore continue to prescribe fluoroquinolones; they are still excellent for infections of the lower urinary tract and prostate, even if increased resistance is observed as a result of the abuse.

How long do you think antibiotics should be used after erythema has occurred? My treatment lasted 10 days (200mg doxocycline, completed a week ago). Is this enough? Do I have to make sure afterwards that the therapy was successful? The disappearance of the erythema is no proof of this. Many thanks and kind regards

Andreas Widmer: I assume that it was a "wandering" erythema of 5-10 cm (so-called erythma migrans), then your therapy would be correct and you are cured. However, it may be that the "dead" Borrelia still trigger an immune reaction with rheumatic-like symptoms that are not an expression of inadequate therapy. The therapy guidelines can be found on the homepage of our specialist society (

In the case of an infection of unknown origin 3 weeks after the operation, I took Dalacin C for 1 week. 10 days after ingestion, I had diarrhea with intestinal cramps. Clostridia difficile was found after 1 week. Therapy: 1 week of Flagyl. Diarrhea again after 4 symptom-free days. Again Clostridia difficile. After 14 days Vancocin 4x125mg daily. Diarrhea again after 4 days. What kind of treatment if clostridia again? How can you rebuild the intestinal flora?

Urs Karrer: If the problem is clostridia again, your doctor treating you should discuss it with a specialist (infectious disease or gastroenterology). You can either treat you again with vancomycin and then slowly reduce the dose over weeks, or you can try treating you with a new antibiotic (fidaxomycin) for 14 days. Sometimes only a so-called fecal transplant can help in this situation, which is currently only offered at a few centers in Switzerland. This is the most effective way to restore the normal intestinal flora.

Is Sudeck, I have an infectious disease on my right foot. Why not curable, if so with what. Since Dec. 14, 2015 after a broken fibula.

Urs Karrer: Sudeck is not an infectious disease and does not need antibiotics. Unfortunately, we don't really understand the cause of the Sudeck and the symptoms can be extremely persistent. Your general practitioner will know better than we infectiologists.

I have rosacea on my face. Can I take the antibiotic ROSACEA 40 mg for a long time?

Chat-Admin: Unfortunately there is no drug with this name in the compendium. In order to be able to answer the question, the correct name of the antibiotic would have to be known.

I (male, early 40s) have had urethritis for almost 2 years. Antibiotics did not help although the germs found are not considered resistant to my knowledge. So far, acupuncture and drops from the Chinese doctor have helped most. Even so, the pain keeps coming and going. What do you advise me? Thank you very much.

Urs Karrer: Inflammation is by no means always caused by an infectious agent, so antibiotics are of no use. In the case of chronic urethritis, there is, for example, the so-called Reiter syndrome, which is not caused by viruses or bacteria, but presumably represents a malfunction of the immune system. Ask your doctor if you have any other signs of the disease. He will be able to advise you correctly.

Since about 20-y. I suffer from cystitis again and again. Today I am over 50. I received a lot of + often 2-week antibiotics because of this. Then 2 bladder reflections were carried out by the specialist + since then it has been clear that I always have Antib. on reserve at home + with you during the holidays. Also that I have the Antib. immediately but most. Should take 5 days. During the last infection about 1 year ago, the 1st antib took effect. no longer = 2nd antib. What help if no Antib. helps?

Urs Karrer: No antibiotic treatment without prior urine examination (urine culture). Antibiotics only if the symptoms of a recurring urinary tract infection are clear and severe.

I've been to India a few times, where seemingly resistant bacteria are picked up. have you traveled permanently after such visits to India?

Andreas Widmer: Our own studies of Basel citizens show that 80% of people who have traveled to India will carry ESBL-type resistance home with these pathogens. This has also been confirmed by Holland. As long as there is no infection, nothing happens, but I advise you to inform your doctor about the India trips in the event of an infection. He / she will search for resistant pathogens in a more targeted manner and you will then receive better, more effective therapy

How can I protect myself against resistant germs?

Andreas Kronenberg: Antibiotics should only be taken if necessary and in the exact dose and duration prescribed by the doctor. Excess antibiotics should be returned to the pharmacy for disposal after therapy. If you suffer from an infectious disease after staying abroad, you should inform the doctor treating you about your stay abroad so that he can choose the right therapy. In addition, chicken products in particular should be well cooked before consumption.

How useful are single ABs intraoperatively?

Urs Karrer: It makes sense for clearly defined interventions, there are medical guidelines for this.

Today I am 51 years old and fortunately I have only taken antibiotics once in adolescence. Does that mean that the likelihood of developing antibiotic resistance is low in my case?

Andreas Kronenberg: Yes, the probability is definitely lower. However, antibiotics are not the only reason you can get infected with resistant antibiotics.

If you have staphylococcus aureus, does an antibiotic work?

Andreas Kronenberg: There are many antibiotics that work against the pathogen Staphylococcus aureus. In the laboratory, tests can be carried out to determine which antibiotics are effective; this can vary from case to case.

I tested positive for ESBL after a stay in India (as part of a study). 6 Installation after this stay, no more ESBL could be detected. Does this mean that ESBL can recur or is it over?

Andreas Widmer: we assume that after 3 negative smears you can assume that the ESBL is gone. Unfortunately, you are not entirely sure, but an infection is then very, very unlikely. Do you know whether it is an ESBL E.coli or another type. In Switzerland, chickens are up to 90% contaminated with ESBL, so you can rest assured when it comes to E.coli.

Good evening. Can I personally protect myself from the resistant bacteria if I avoid antibiotics as often as possible or does that have no effect because the germs are transmitted to me by other people and therefore end up resistant to me? Thank you for your reponse.

Andreas Widmer: You certainly help to be able to prove that you have little resistance if you take few antibiotics. Not easy to implement, but very effective, the travel destinations India and Pakistan should be avoided. There you have an 80% risk of carrying a resistant pathogen in your intestines home as a souvenir. With no history of antibiotic therapy and no past trip to these countries, our ancient antibiotics will help you with an infection.

Why are phages not used in Switzerland as they are in the east?

Chat admin: «Puls» has dedicated its own special program to this topic:

India trip. Risk? Prevention?

Urs Karrer: The fewer antibiotics you take and the fewer antibiotics that are used in the production of the food you eat, the better. In addition, traveling to certain countries carries the risk of being colonized with resistant bacteria.

Can antibiotic drugs that are used externally develop resistance like those that are swallowed? I have already received eye drops or skin ointments (fucidin) containing antibiotics for my children several times. I don't want to give my children any antibiotics if it's not really necessary.

Andreas Widmer: External antibiotics should be avoided as far as possible due to the possible risk of allergies, with the exception of eye drops. Fucidin is rarely used as tablets, so it can also be used locally. However, I recommend a good disinfectant that does not burn and is very effective: It is called Polihexanid (brand name: e.g. Prontosan), so there is CERTAINLY no development of resistance

Two years ago I was diagnosed with ESBL after perforating my intestine. Will I now always carry this germ in me and thus be at risk in the event of any infections?

Urs Karrer: It is possible that these resistant bacteria persist in your intestinal flora for several years. The more you are exposed to antibiotics, the more likely it is that this colonization will persist. In pneumonia, this type of bacteria usually does not play a role. On the other hand, in the case of bladder or intestinal inflammation, you have to use an absolute reserve antibiotic because of this ESBL colonization.

Hello, the resistances only arise in the body, or residual substances (or antibiotics) get into the environment through excretions after use, where further germs then become resistant.

Andreas Kronenberg: Resistance does not only arise in the body, it can also arise in the environment, for example through antibiotic residues. However, antibiotic resistance also existed before the development of the first antibiotics and certain bacteria are used to displace other bacteria or fungi.

I am 70 years old. Have COPD.Had pneumonia once 4 years ago. Received very few antibiotics in my life. Am i at risk?

Andreas Kronenberg: Even if you have never received an antibiotic, that does not rule out an infection with a resistant pathogen, but the probability is lower.

I am 48 years old and already have the 4th type of knee prosthesis (due to incorrect size / incorrect inclination, etc.). Now I had cefuroxime for 5.5 weeks and still the inflammation levels in the blood increased. Bacteria that are resistant to a large number of antibiotics were detected in the puncture. Further diagnostics follow. If the suspicion of a prosthesis infection is confirmed, the "thing" must be removed or installed in two stages. are there alternatives

Andreas Widmer: After 5 weeks of antibiotic therapy there is a suspicion of an infection. a 4th knee prosthesis is a very rare case, and reoperations are associated with a higher risk than a 1st operation. I would advise you to get the opinion of an infectious disease specialist with extensive experience in this field before undergoing another operation. The Universities of Basel and Bern have published most of the studies on this subject in German-speaking Switzerland

Why is phage therapy not used as an alternative to antibiotics?

Andreas Widmer: It is not registered in Switzerland and is mainly used in Russia. If there is a high level of resistance and there is no possible antibiotic therapy, phage therapy may be a good alternative in the future. However, the scientific data are still sparse compared to antibiotics and, as already mentioned, they are not available in Switzerland, so we have no personal experience

When I was 7 months old, I had festering meningococcal meningitis. I was given the drug Cibazol in 1943, but I was resistant to it. Fortunately, during this time the penicillin was used completely new and I got well again. Here is my question: is Cibazol still in use today or a similar active ingredient that I would be resistant to in an emergency?

Andreas Widmer: The so-called sulfonamides are practically no longer in use today, so there is no danger, they will not receive this therapy in Switzerland

I had sepsis in 2014, a kidney infection, I was then diagnosed with resistant bacteria ESBL I then had all sorts of side effects Do these bacteria stay with me in the intestine? What can I do, they are no longer effective?

Andreas Kronenberg: A difficult question. Today we know that the ESBL intestinal bacteria can remain in the intestine for months. There is no way today to definitely get rid of these bacteria. Many patients lose these bacteria spontaneously over time, but unfortunately the duration of the carrier cannot be predicted. Further antibiotic therapies promote the survival of these resistant germs and prolong the carrier life. It is important that you tell all doctors treating you about this infection.

I suffer from rheumatoid arthris (psoriatic arthritis?) I am treated with Methofix 15 mg once a week, Orencia injections subcutaneously once a week, Imurek 50 mg 2x1 / day, Felden lingual 20 mg 1-2 / day, 5 mg prednisone. In addition, 3 x / week Bactrim forte. My concerns are, aren't these interruptions actually promoting resistance? Thanks for your opinion

Urs Karrer: This treatment with Bactrim can effectively protect you against a special type of pneumonia that only occurs if you have a weakened immune system (caused by arthritis medication). Your intestinal flora is therefore resistant to Bactrim, regardless of whether you take it daily or only 3 times a week. Continue to take Bactrim as directed.

Good evening. My age is 66. 6 weeks ago I developed an acute intestinal inflammation as a result of diagnosed diverticula. Treatment with 2 combined antibiotics after the first antibiotic (Amoxi mepha) did not work. The attending surgeon would like to operate on the bowel as soon as possible. How can I tell if I have intestinal-resistant bacteria? Is there an increased risk of surgery in my case? Thank you for your opinion.

Andreas Widmer: I can reassure you: Amoxicillin-resistant ones are common and normal in the intestine. You will be given an effective antibiotic if you should get an infection after the operation.

I have bladder inflammation for the second time and have 500 white blood cells. I have to reckon with antipotics

Andreas Kronenberg: Until now, it was assumed that cystitis had to be treated with antibiotics. There are now some studies that show that spontaneous healing can also occur with pain reliever medication and a lot of drinking. The symptoms last on average about 2 days longer, and at most the risk of suffering from kidney inflammation is slightly increased. On the other hand, we also know that many patients with mild symptoms do not go to the doctor at all and can get the incipient infection under control with sufficient amounts of water.

My husband (80) had a pancreatic infection about 1 year ago, for which he was treated with "multiple antibiotic therapy". Since then he has been extremely emaciated. In addition, he had an infection on his toe after the BSD infection due to a cut that was ignored. That means: renewed treatment with antibiotics. After a while the already healed wound opened again and everything started all over again. He is epileptic due to a brain tumor. Possibly resistant?

Urs Karrer: I suspect that it is more a result of malnutrition than a problem with resistant bacteria. Since I do not know the exact medical history of your husband, a more precise assessment is not possible.

I have severe COPD with emphisema. If I have a cold, my family doctor will measure the inflammation level in my blood and, if necessary, take an X-ray. If the inflammation is high, he will prescribe antibiotics to prevent bronchitis or even pneumonia. The pulmonologist even recommended that I take antibiotics with me when traveling abroad. How do you rate this approach? Thank you for your reply.

Andreas Widmer: In the case of severe COPD, it is very difficult to differentiate between a so-called exarcerbation, an infection with bacteria or viruses. Today there is a comparably quick and reliable way of detecting viruses as the cause and thus avoiding antibiotic therapy. But viruses are like the plow in the field, weeds - that is, bacteria - can easily establish themselves, and then antibiotics bring something back to life. When traveling abroad, it is not always possible to see a doctor quickly, so if you have a new fever and shortness of breath, it can make sense to take an antibiotic with you, and you can enjoy the trip. In this case, "misuse" of an antibiotic is acceptable in exceptional cases, instead of taking a cure in the hotel or even breaking off the trip. But in individual cases, a visit to the doctor is safer and better for your health

Good evening, I went to the doctor today. Diagnosis of frontal sinusitis. Body temperature 37.9 CRP value below 5, tough phlegm. She wanted to prescribe an antibiotic for me, but since I don't like taking antibiotics, I decided not to take them. Was that a good decision? Thank you for your reponse

Andreas Kronenberg: It is difficult to answer specific medical questions in chat form. Frontal sinus infections often heal without antibiotics, in addition to the general condition and the inflammation values ​​in the blood, the decision also depends, for example, on the duration of the complaint and any accompanying ailments.

+++ Why aren't the farmers checked instead of the doctors? The problem of antibiotic resistance lies there. Every day we consume meat from animals that have been given antibiotics as a preventative measure. +++

If someone has picked up a resistant germ in India, does he endanger his fellow human beings after his return and, if so, how?

Andreas Kronenberg: Yes, resistant germs can be transmitted. After a trip to India there is a particular risk of having picked up resistant intestinal bacteria. However, this risk can be minimized through banal basic hygienic rules (such as hand washing after using the toilet).

What about the antibiotics that we take in with food, e.g. in meat?

Andreas Widmer: that's not a problem, if you roast the meat, the antibiotics are inactivated by the heat. There is danger from the chicken meat, where you can contaminate your hands while preparing raw chicken, it also affects that. So no danger when eating, but when preparing. Wash your hands here, work cleanly

I have been suffering from vaginal infections (Strepto B and fungus) for about three months. I've taken three different antibiotics with additional medication in the meantime. There was no improvement. I'm a little desperate and worry because nothing works. Does it even make sense to have additional antibiotics prescribed?

Urs Karrer: Are you a diabetic? If not recently done, your blood sugar should be checked occasionally. Group B streptococci do not need treatment outside of pregnancy. More antibiotics are more likely to promote the fungal infection. If you have already passed the menopause (amendment), local estrogens may help.

Since the spring I had blood poisoning on the path of eb e coli three times (did not feel any cystitis, suddenly chills and fever). Was treated as a substitute. 2 times a week each, 1 time three weeks. Since then again 2 times cystitis with antibiotic treatment. Repeats about every 6/7 weeks. Take urivaxom, femannose, oestrogens and cream as a preventive measure. What should I do?

Andreas Kronenberg: Unfortunately, many women suffer from recurrent (repeated) bladder infections. The main concern here is to look for possible beneficial factors and, if necessary, to treat them (e.g. infected kidney stones, kidney cysts, subsidence of the bladder, etc.). Some of these measures (e.g. estrogen suppositories to care for the vaginal mucosa) have apparently already been initiated. I cannot read from your question what other clarifications and measures have been taken. I recommend that you discuss this question directly with your treating doctor.

I'm 60 and 7 years ago I had endocartitis with subsequent heart valve surgery. The cause of the endocartitis was never found, but I still have to take antibiotics with every DH cleaning and dental procedure. Is that right?

Andreas Widmer: The new guidelines have simplified the indication for antibiotic prophylaxis, and only major interventions require prophylaxis. Ask your doctor whether antibiotics are really necessary for the upcoming procedure. But the most important thing is good dental hygiene with a visit to the dentist every 6 months, dental floss and electr. / sono toothbrush. This is more important than antibiotic prophylaxis. Ask your dentist for the best dental hygiene, he knows better than I do

I had multiple operations on my back and right hip last year. Several SKN were found in biosculptures. I was treated with vancomycin and cefepime as well as rimactan for about 7 weeks. HOW long does it take the body to use these drugs and to rebuild its natural defenses? Thank you

Urs Karrer: Depending on the active ingredient, the antibiotics are eliminated from the body within a few days. The body's own defense (= immune system) is not weakened by these antibiotics. However, it takes weeks to months until your normal bacterial flora in the intestines, skin or mouth is completely restored.

I have frequent bladder infections and my body stops responding to many antibiotics. What can I do

Andreas Kronenberg: This question is formulated too generally to be able to give a concrete answer here. I recommend that you discuss this question with your gynecologist.

I have to undergo tear duct surgery. Can I make a contribution against blood poisoning or antibiotic resistance?

Andreas Widmer: The risk is extremely low, you don't have to do anything. All the best for the procedure: a well-draining tear duct is the most important thing against eye infections.

Good evening, how can I protect myself against resistant bacteria?

Andreas Widmer: Avoid traveling to India or Pakistan and follow your doctor's instructions for any antibiotic therapy

How can I best protect myself?

Andreas Widmer: no trips to India and Pakistan, washing hands and being careful when preparing raw chicken, then putting the kitchen board in the dishwasher or washing it with hot water, no messing with beef and chicken in meat fondue.

I have had a titanium aortic valve for 13 years. Do I have to / should I take 2.1g ampicillin for an appointment with the dental hygienist? Does that still make sense today, is it still of any use with all the resistances?

Urs Karrer: Such prophylaxis is still recommended in your situation during dental interventions. What is more important, however, is good, regular dental hygiene with appropriate dental and dental hygienic controls.

My grandfather caught the MRSA germ in the hospital. He was able to go to an old people's home in Riehen with some rectal germs. We do not know his current state regarding MRSA. He received no further treatment and did not take another test. We had a child 6 weeks ago and have not visited my grandfather since then for fear of infecting our child. Is our fear well founded? When would a visit be relatively unproblematic? Many Thanks!

Andreas Widmer: A visit is not problematic, it requires very intensive contact. for a transfer You could - in order to rule out all risks - clean your baby's hands with a wet wipe after the visit.

Good evening. Now I'm confused. I shouldn't stop taking antibiotics at my own discretion. I see that. But I also cannot understand the statement about the duration of the doctor! Pharmaceutical companies have to prove their effectiveness. The cycle is defined on the basis of this data. What is the basis of data available to the doctor to adjust the duration of therapy?

Andreas Kronenberg: The duration of the therapy depends on the type of infection (brief cystitis, pneumonia longer), the type of pathogen / bacterium (short pneumococci, legionella longer), the possible resistance of the bacterium (here you sometimes have to resort to other antibiotics that must be given longer), the antibiotic itself (there are antibiotics that are relatively slowly excreted and therefore can only be administered for a short time and still have a longer effect) and the speed of the patient's response. In short, the duration of the therapy can be determined individually.

I often suffer from frontal sinus or sinus infections and in this context I receive an antibiotic in each case. Are there alternatives?

Andreas Widmer: It is difficult to answer in general. Sea salt inhalation can help, and you can get it in pharmacies. Good ventilation of the maxillary sinuses is important; if there is a narrowing, an operation might be tedious, but in the long term the better option.

Hello, antibiotics can cause migraines, thank you

Andreas Widmer: No, that's not a typical side effect

Good evening - is this problem only with antibiotics or can this also be the case if you take painkillers or antidepressants for a long time? What exactly can you do to prevent you from getting such germs?

Andreas Widmer: I can reassure you that resistance cannot arise like this.

I received an artificial knee joint at the end of May. Now I should take 1 tablet of Co-Amoxicillin 1000 mg at the dental hygienist and the dentist's 1 hour beforehand. Every time. Why?

Urs Karrer: In my opinion, this recommendation is wrong. Tell your doctor / dentist that recommendations on this question were recently published in the Swiss Medical Journal ('yellow booklet') that he / she can consult.

Good evening, I receive the drug flagyl 500mg vagnialtabletten several times a year because of bacterial infections in the vagina. Can i develop resistance? Or should my doctor examine this better? Only one smear is examined briefly under the microscope and the medication is prescribed based on my symptoms. Thank you very much for your answer

Andreas Widmer: Resistance is extremely rare at Flagyl, and there is hardly any resistance. The causative agent of your vaginal infection is missing from your question, so I cannot answer it conclusively. But no laboratory routinely does resistance tests to Flagyl, as it can be present in significantly less than 1%. So do not worry.

Is there a variant in front of multires. To protect germs? Why are ABs often prescribed prophylactically as well?

Andreas Widmer: Antibiotic prophylaxis before surgical interventions is the most important prevention for avoiding postoperative wound infections, and there is also no resistance if you only receive 1 dose immediately before surgery (so-called single shot). Traveling to India and Pakistan is a big risk, as is the processing of raw chicken meat, risk factors for picking up resistance. Wash hands after chicken contact and wash the kitchen board

What influence do the antibiotics that are used prophylactically in animal fattening and the antibacterial household cleaners that get into the drinking water have on the spread of resistant none?

Andreas Kronenberg: The prophylactic use of antibiotics as growth promoters in animal fattening has been banned in Switzerland for years. But antibiotics prescribed therapeutically also promote the development of resistance. I am not aware of any data on antibacterial household cleaners, nor do I know too little which products are used here. From my point of view, however, these products make no sense in the "normal household", a germ-free environment does not exist and is also not necessary.

I have a new organic heart valve and have to swallow 4 Amoxi-Mepha 500 tablets before each dental treatment.

Andreas Widmer: Ask your dentist; Newer Swiss guidelines only show e.g. implant placement as an indication for prophylaxis. but there is no development of resistance with prophylaxis

My father (95) was infected with Klebsellia pneumoniae during a heart operation in a German hospital. How dangerous is this germ? Only now - after a good 2 months - is he gradually feeling a little better. Why shouldn't my father consume sugar or sweetener?

Andreas Widmer: It's probably pneumonia, which is very common in elderly patients after such a major operation. Most Klebsiella are easy to treat, only the so-called KPC type is dangerous. Heart surgery at the age of 95 is a high risk, despite all precautionary measures. Get well

Dear doctors, Was at Hausatzt today, had an inflammation of the intestine, received Arilin 500 mg and Ciprofloxacin 500 mg, had to take both tablets in the morning and in the evening. Had the same problem in April and is taking the same medication. Asked if there is another option, i.e. not taking antibiotics, there is no! Is it really like that ?? Thanks for the answer !

Andreas Kronenberg: Ciprofloxacin and Arilin is a classic combination for intestinal infections. However, I do not know which intestinal infection you were diagnosed with, which is why I cannot make a definitive statement here.

Good evening, because of very frequent cystitis, my gynecologist advised me to take 1 Furadantin capsules prophylactically after each sexual intercourse. In fact, I have never had cystitis since. Do I promote resistance with this intake?

Urs Karrer: Every antibiotic intake can promote resistance. Nitrofurantoin (= furadantin) is real in this regard. harmless. If the repeated bladder infections cannot be prevented without antibiotics, this prophylaxis is probably justified. You can, however, arrange to try an elimination with your doctor.

Good evening, - I had to take two-pronged antibiotics in the summer - since then I've no longer had an appetite - an aversion to certain foods and drinks - eggs, red wine don't work at all ... - stupid: I have a wine pickle ... ... this stops again at some point .... stabilizes this .... ???

Andreas Kronenberg: I ​​don't know what you mean by "two-pronged antibiotic". I should already know the name here. The fact that you still have symptoms several months after completing the antibiotic therapy can hardly be attributed to the antibiotic therapy.

Good evening, I am 71 years old and this year I had urinary tract infections which were treated with various antibiotics after a urine test was always made and it was determined what is still effective in the respective bacteria. At the moment I have an inflammation again which I now try to treat only with tea and natural products. What do you advise me? Thank you for your reponse

Andreas Widmer: You can like with a lot of fluids. E.g. tea can also trigger a natural healing. Bacteria in the urine with no symptoms do not need antibiotics. Unfortunately, the scientific studies of the cranberry juice have not produced the desired results, and the juice is extremely high in calories. Therefore, I cannot recommend the extract. Are there any indications of so-called reflux or do you suffer from drip incontinence? This can be improved or even remedied through pelvic floor exercises, electrostimulation and, in the worst case, surgery.

Have multiple dental implants. Had to take antibiotics preventively every time. Is that ok?

Andreas Widmer: Prophylaxis - only 1 day - does not lead to resistance and can help prevent infection, but I would have to know more precisely in order to be able to answer the question properly. Ask if it is really necessary with your type of implants

What do you think of the still common endocarditis prophylaxis, where antibiotics must be taken before every dental hygiene treatment and before every bloody dental treatment or other small interventions such as excisions or biopsies? Is this measure really useful and evidence based. Doesn't this also contribute to the development of resistance?

Andreas Kronenberg: Endocarditis prophylaxis is still useful in certain situations. However, the Swiss recommendations as to when endocarditis prophylaxis makes sense have been revised and significantly restricted in recent years. Ask your doctor for what is known as an "endocarditis passport".

Good evening, are there any reliable studies on grapefruit seed extract as a substitute for antibiotics? - Thanks!

Andreas Widmer: Grapefruit is well known that there are considerable dangers with various drugs (so-called interactions). Unfortunately, it is not suitable as an antibiotic, but if you take this, tell your doctor.

After amputation of the forefoot, I have had to take Co-Amoxi 625 mg twice a day for a good 1.5 years, as the wound does not heal well .. can my cells be resistant then .. and can the antibiotics cause dizziness?

Urs Karrer: This is an unusually long antibiotic treatment for a wound that does not heal well. I doubt this is still justified. Ask your doctor whether an elimination attempt can be made. Dizziness is not a common side effect of CoAmoxicillin.

Good evening, I have to do a gastroscopy and I recently read that this test can introduce resistant bacteria into the body. thanks

Urs Karrer: No, that is not a relevant risk of a gastroscopy.

My husband died of staphylococcus aureus within 2 days of a high fever while on a trip to India. According to Zurich forensic medicine, antibiotics would not have helped. What do you mean?

Andreas Kronenberg: A Staphylococcus aureus infection (especially blood poisoning) is an extremely severe infection with a high mortality rate, even if the germ is not resistant to antibiotics. I cannot answer whether the germ was resistant in your husband or not.

I (born 1965) had endocarditis in 2007. As a result, heart surgery with 2 artificial valves. Antibiotics are now prescribed very often. Even when visiting the dentist and cleaning your teeth. Still up to date? Many Thanks. With kind regards.

Andreas Widmer: Ask about: Switzerland. "Endocarditis prophylaxis" guidelines have simplified the indication and no longer provided for many interventions

In March I had to remove my gallbladder as an emergency. Since this stay in hospital I have had cystitis four times and each time I had to be treated with antibiotics. Am I at risk of resistance? Since I will have to have an operation again soon, I am afraid that I will be infected with bacteria again! How should I behave? Can i protect myself? If yes how?

Andreas Kronenberg: It is relatively easy to determine whether the bacteria that caused your bladder infection are resistant with an appropriate laboratory test. However, I cannot answer why you keep getting bladder infections.

I am 69, had to consult the emergency service at the hospital in the past SA because of acute and very painful swelling in the left ankle, walking is practically impossible. At the same time, 37.8 temp. And slight chills. The young doctor on duty believed (was not sure) about WUNDROSE .CRP increased (52) and he gave me an antibiotic with Mepha 1000 mg 6 days 2 tablets per day fever gone, pain subsided, swelling almost halved, just tired .. Do I have to go through the 6 days? Thanks!

Urs Karrer: Yes, this treatment is correct for erysipelas.

I survived an inflammation of the bladder and prostate with multi-resistant coli bacteria with a 5-day hospital stay and a 4-week course of antibiotics. Is there still arousal in my body after this treatment? And how long? The urologist advised me not to go on vacation far away for 1 year. Thank you for your reponse.

Andreas Widmer: Prosat infections over the age of 65 are very difficult to treat, and sometimes there are small stones in the prostate that make effective antibiotic therapy almost impossible. A trip to countries with low med. Care may be indicated in your case, but especially in northern countries the med. Supply with our comparable. It would be IMPORTANT, however, that you take the doctor's reports of these infections with you, then the doctor can quickly find out more, and then m.Erachtens can also travel to neighboring countries

Good evening I am 54 years old and have received penicilin and antibiotics 4-5 times a year since my childhood because of bladder infections and colds. With the colds, one box usually didn't help and I had to take a second one. I think over the years I had taken at least 150 antibiotics. What damage do I have to expect as a result?

Andreas Kronenberg: The risk that your intestinal germs are resistant to certain antibiotics is increased, but you do not have to expect any damage yourself. Colds are viral diseases against which antibiotics are of no use. Antibiotics should therefore not be taken with colds.

Good evening, my 22 month old daughter has a CRP of 83, the leukemia is high and the pediatrician diagnosed a throat infection. I doubt whether it is the right thing to give antibiotics to such a small child. Can you help me?

Urs Karrer: If the angina is caused by certain bacteria (so-called group A streptococci), antibiotic therapy is justified, this also applies to a small child.

As a result of ulcerative colitis, I have had to take the antibiotic ciproxin for 20 years (approx. 3 times a year) with severe bacterial overgrowth (diarrhea) in the intestine. Even after such a long time, it works already 24 hours after ingestion and stops the diarrhea immediately. Now I've read that the fluoroquinolones can have strong side effects. Do I still have to expect such side effects after such a long period of use. To this day I can tolerate the antibiotic without any problems. thanks

Andreas Widmer: In the USA, Ciproxin was often used for upper airway infections, and then these side effects are unacceptable. But with you the indication is given: we have treated over 800 patients with 3-6 months of ciproxin therapy - that is, for a really long time - and have not observed these side effects. If you notice problems with the Achilles tendon, report to your doctor, otherwise you don't have to worry, it has been on the market for 30 years and has been used millions of times.

Subject MRSA: Is it true that some of the patients bring the germ with them to the hospital, i.e. do not get it first in the hospital? Can it be that in such cases MRSA is only diagnosed when complications arise?

Andreas Kronenberg: Yes, MRSA can indeed be transmitted outside of the hospital. In general, you usually do not feel when you are colonized with resistant germs (be it the skin or the intestinal tract). Only when these pathogens cause an infection and further investigations are initiated do you become aware of this situation.

I've had Lyme disease since 1981. Detected after 11 years. This was followed by several Rocephin and Claphoran therapies. Now on Friday 15 screws 2 plates + 1 wire will be removed from my forearm. Do I need more antibiotics prophylactically during the operation than a healthy person? Thank you for your reponse.

Urs Karrer: No, the previous Lyme disease has no influence on whether you need antibiotics for an operation.

I often suffer from bacterial angina. The doctor then prescribes an antibiotic for me. Can the angina subside / heal without antibiotics, or is an antibiotic absolutely necessary? What do you recommend? Are There Natural Remedies For Angina? Many thanks & MfG

Andreas Widmer: If it is an angina with streptococci and the doctor prescribes antibiotics for you, take it. With a quick test, they can prove in practice within a few minutes whether antibiotic therapy is necessary or whether a virus is responsible for the symptoms

Which AB active ingredients are contained in meat such as chicken?

Andreas Widmer: no antibiotic residues must be detectable, otherwise the meat must not go on sale

Is it possible to develop more AB? What is the next goal of research at btrf. this big problem?

Andreas Kronenberg: Yes, there are indeed various possible candidates. However, this research has been neglected for years and it will now take several years until, hopefully, new antibiotics will become available to us.

I have been taking antibiotics for 2 years, is there any use? I was diagnosed with leukemia 3 years ago.

Urs Karrer: If you have a relevant immune deficiency due to leukemia or its treatment, this antibiotic prophylaxis can be justified and continue to be effective. But I don't have the medical details for a conclusive answer.

How sensible is it to take antibiotics on the evening before the operation; for dental implants with bone augmentation?

Andreas Widmer: Antibiotics as prophylaxis must be used a maximum of 120 minutes before the procedure (WHO guideline 2016, I work there as an expert on this guideline), never the evening before. if there is an infection, therapy should be started earlier.

I have had secondary progressive MS for about 38 years. For about 14 years I have not been able to dissolve water myself and have to catheterize. As a result, I had bladder infections very often. That's why I often had to take antibiotics. Now I am resistant to most antibiotics. Only 1 preparation is still effective. I now also have the "ESBL hospital beetle". Can I ever get rid of this "beetle" or will it remain my "companion" all my life?

Andreas Widmer: Unfortunately, ESBL is not a hospital beetle, but more often in the ambulance. 90% of the chicken can be contaminated with ESBL in Switzerland. Ask about fosfomycin (brand: Monuril) sometimes it works. About half of the patients lose ESLB within 1-2 years, half remain "colonized" longer. The most important thing is a clean, single-use catheterization, take it locally prontosan for disinfection before catheterization?

For years I have had cystitis very often (sometimes with no kidney infections). The germ: echerichia coli. , resistant to tetracycline, co-trimaxazole and norfloxacin. Meanwhile, the cystitis is chronic - the germs are always there, I try not to take antibiotics anymore, because after 2 months at the latest after antibiotics they are back. How dangerous is it to live with these germs in the bladder? Thanks and Greetings

Andreas Widmer: I would advise you to go to an infectious clinic so that you can be given the best possible advice. Chronic cystitis can reduce the quality of life, and here one should exhaust all the possibilities of conventional medicine, and the specialists may be able to contribute something. Get well

Good evening. Years ago I learned that taking sulfonamides does not favor the development of antibiotic-resistant bacteria. Is this statement still valid today? Are Sulfonamides "Less Bad"? Thank you for your reply.

Andreas Kronenberg: In fact, not all antibiotics promote the development of resistance to the same extent. Above all, quinolones and 3rd generation cephalosporins strongly promote the development of resistance. According to current knowledge, sulfonamides are less likely to promote the development of resistance, but I would not think that they do not at all.

Is the prescription of 2 grams of amoxicilin after valve replacement with annual dental hygienic treatment still necessary and up-to-date from today's perspective?

Andreas Widmer: Please note the earlier answers on the topic. thanks

Two months ago I had to have a cyst removed from under a tooth. A material was used to build up bones. Before and after the operation, I had to swallow antibiotics. In a few months, an implant will be placed on the site of the removed tooth. Is the implant operation justifiable even without antibiotics?

Andreas Widmer: Ask your dentist, I need more specific information in order to be able to advise you correctly

Good evening My son had chronic ostem myelitis metatarsal III & IV with abscess with various operations and had to take antibiotics in various therapies (intravenous and oral) for more than a year. Is there a risk that he will be resistant to antibiotics if he has to depend on antibiotics again in his life? Is there an investigation that can determine resistance?

Urs Karrer: During and immediately after this long antibiotic treatment, it must be assumed that the bacteria that normally occur in your son's intestines, on the skin or elsewhere are resistant to the antibiotics used. Over time (months to years) these resistant bacteria are mostly replaced by 'normal' bacteria. A test (so-called.Resistance testing) only makes sense if your son has an infection that requires antibiotic treatment.

Dear Doctors, My husband, who died of cancer in February, was wearing a urinary catheter six months earlier. He was hospitalized three times for relapse of cancer and isolated because of a resistant germ. In between my husband was released back home and I was at the mercy of this resistant germ. I'm afraid I got infected. What are the consequences for me? Do I have to bring this up to the general practitioner, have me examined?

Andreas Widmer: You would have to tell me the pathogen, so I can't help you

I have mitral valve prolapse. I have cranked amoxicillins axapharm I should take it every time I have a fever or go to the dentist. !! Do I have to?

Urs Karrer: No, according to the new guidelines, that is not justified. Discuss it with your family doctor.

Why is there no smear taken during treatment in hospital in order to limit the spread, since resistant germs can also be transmitted?

Andreas Kronenberg: In risky situations (e.g. after a stay abroad), a smear is definitely taken in the hospital. However, it is not possible (and also not useful) to make smears in all patients.

Good evening - I had 6 bladder infections within a year after stopping the pill. I was given the antibiotic Monuril 4 times, which also worked. But do I have to worry about that? How can I bypass the antibiotic? Alternatives? Thank you for your reponse.

Andreas Widmer: There are some measures, such as B. watering after intercourse, cotton underwear, drinking a lot, otherwise you don't need to worry, unfortunately it is a common ailment.

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