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What is the medical definition for ciprofloxacin resistance? Are there new drugs out that we shouldn't be using. J.E.: Yes, of course. There's no doubt in my mind that for a number of years it didn't make sense to have any use for ciprofloxacin except in a few rare cases. We found ourselves in a quandary because patients were being treated for infections that should have been treated with antibiotics, which we then found out later shouldn't have been treated with antibiotics. They'd develop a resistance to one of the antibiotics and then go out get antibiotics for other infections, and because we'd put drugs on them to deal with that drug-resistant infection we were leaving the antibiotic-free area and going back to treating people for infections that couldn't be easily treated. So it was a terrible problem for us because we had so many physicians who, to be honest, didn't have use it anymore because they were on other therapies. The fact was, ciprofloxacin itself is not resistant. It wasn't until a little while ago that it became resistant, not to the whole class, so you wouldn't use it for the whole class. But there were a number of antibiotics that were becoming resistant to the whole class of drugs, so they could use ciprofloxacin at times, but it was only for specific kinds of organisms or situations, which I'd describe as a kind of broad class drugs, that they could use ciprofloxacin for some cases, and not other cases. So when I was there saw a lot more instances of antibiotic resistance. A.T.: What was the most common drug that was being used today isn't available in the United States? J.E.: So the reason I said broad is because when you look at antibiotics, one of them is ciprofloxacin itself and the other is levofloxacin, one tetracyclines. And you can see how broad that's going to be. It includes all the drugs now. number isn't small. Tetracyclines are just everywhere that antibiotics used. Levofloxacin is an antibiotic that people used a long time ago and it's still used. The number of people using it is still very large. They use it in hospitals. And they still use it by accident, because the hospital would give somebody some levofloxacin and it might not even have been for a certain condition, and then they would use that just because it was there the physician didn't recognize that infection was resistant and so they thought it was in the hospital because they were thinking, "Oh, it's levofloxacin." I think some of these antibiotics are being used as little 25 percent of what they were before. But that does mean there's much more use in hospitals than there was before. Now are more indications for antibiotics now in general medicine. A.T.: You were talking before about the use of antibiotics in a lot situations that the medical community isn't really concerned about, like in hospitals, but also for home care. someone who comes into your care, it seems like there're many ways the use of some antibiotics are going to do harm, even if they only cause a bit of discomfort. Could you give us some examples? J.E.: Yeah. So when I was treating a patient who developed really, bad infection at home, there were four types of antibiotics that could have been used to treat that infection and weren't used because the physician had just never heard of them and because they couldn't imagine what could be going on in somebody at home and they couldn't imagine somebody that could survive without getting some sort of treatment. The first one was povidone-iodine (better known as Percocet) which is an anti-inflammatory. The way it goes is that can decrease a pain and it'll help with swelling of the knee where a lot of acute inflammation is taking place, it can help to reduce pain, but at the same time it can increase the risk to develop heart attack, for instance. There was another antibiotic, which is an but it's a particularly nasty one that's called levofloxacin, and of the problems in a very rare situation where somebody is really, really sick and they've got an generic viagra canada online pharmacy infection in the colon that they shouldn't have the fever and they develop a very high fever and it's accompanied by nausea, diarrhea that can go on for weeks and don't really go away until you over there to a hospital. And then they'll go into a hospital and they'll have some kind of complication, or they might be dying. go into an intensive care unit, but they've got a very high fever. And that is not the time.

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