To aid in choosing the most cost-effective therapy for common infections, the properties of five of the most widely used older antibiotics are discussed in comparison to newer alternatives. Dr. Joshi is Assistant Professor, Department of General Internal Medicine, Pennsylvania State University, Hershey.
Antibiotics are among the most frequently used medications in ambulatory care.
Many of those introduced in the last few years have replaced older, more familiar drugs. Although some may provide a broader spectrum of activity or less toxicity than older agents, there have been few studies carefully comparing their relative efficacy in treating common ambulatory infections. The strong economic incentives for marketing new drugs often means that they are preferentially used. Given the increasing threat of drug resistance and the pressures to limit health care costs, it is time to ask whether the old are still gold. The oral antibiotics chosen for discussion are those most frequently used to treat common infections in an ambulatory setting.