The relative safety of antibiotics is a critical issue to consider- it is apparent that chloramphenicol which most of the world has stopped using systemically owing to the risk of idiosyncratic and fatal aplastic anaemia may in fact be safer than some agents that are used very widely for relatively minor indications! Food for thought!
Much time is spent discussing the development of antimicrobial resistance and changes to the microbiome but perhaps should we should also focus on the potential for patient mortality. Based on best current estimates, trimethoprim, macrolides and quinolones may be less safe than chloramphenicol in certain patient populations.
A future posting will provide a practical approach to the prolonged QT issue that may arise with macrolides and quinolones.
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