Research in the application of antibiotics for special population groups in emergency care

Summary: This paper focuses on the use of antibiotics for specific groups of the population in emergency medical care, including children, the elderly, pregnant women and those with low immunization capacity. In-depth examination of the physiological and pathological peculiarities of these special groups, analysis of their infection characteristics and pathogen distribution patterns, and elaboration of the principles of special consideration and application in the fields of antibiotics selection, dosage determination and treatment process setting. The aim is to provide a comprehensive guide to the appropriate application of antibiotics to specific populations by emergency internal health care providers in order to improve the effectiveness of treatment, reduce adverse effects and ensure the health and safety of special populations.IntroductionEmergency medical units are often approached by special groups of people who, because of their particular physical or pathological state, cannot be treated in the same way as antibiotics. Children are at the stage of growth and development and are not yet mature in their organs; older persons suffer from a decline in their physical functioning, often associated with a variety of underlying diseases; the biological environment of pregnant women is changed, and the health of the foetus needs to be balanced; and people with low immune capacity are susceptible to infection and have complex infections. It is therefore of the utmost clinical importance to study in depth the application of antibiotics to specific population groups in emergency medical care.II. Children ‘ s antibiotic applications(i) Child biological characteristics and infectionsChildren, especially infants, are developing their liver and kidney functions, the immune system, blood and brain barriers, etc. For example, the drug metabolic enzyme system for the liver of newborns is underdeveloped and has a weak metabolic capacity for some antibiotics, which can easily lead to drug accumulation in the body. Children ‘ s immune systems are relatively weak, they are vulnerable to infections in the respiratory, digestive and other areas, and their conditions change rapidly. Common infectious pathogens include pneumocococcus, haemophilus influenzae, yellow grapes, etc.(ii) Antibiotic selection principles1. Security priorityThe use of antibiotics with significant adverse effects on the growth and development of children should be avoided, such as tetracyclics, which can lead to yellowness of the teeth, bad development of the tooth, amino sugar, which can cause ear and kidney toxicity, and chloroacin, which can cause grey baby syndrome, etc. For mild infections, the choice of β-neamide antibiotics, such as Amosicillin, Hautcló and others, is relatively high.Effectiveness considerationsActive antibiotics are selected according to the area of infection and possible pathogens. For example, in the case of acute ear disease, most of which is caused by pneumococcus, influenza haemophilus influenzae, etc., the choice is to use potassium amosicillin-Clavic acid; in the case of skin soft tissue infections, the choice is to be made for enzymes such as phenolin.(iii) Dose and procedureAntibiotic doses for children are calculated on the basis of weight and age. Weight-based drugs, such as a dose of antibiotics per kilogram of body weight, are commonly used. At the same time, individual differences among children should be taken into account, such as those who are obese or wasting can be appropriately adjusted. With regard to the treatment process, for acute infections, the use of the drug continues for three to five days, usually after the symptoms have abated and the body temperature is normal, in order to ensure the complete elimination of the pathogens, but also to avoid problems such as the strain caused by the long treatment.III. Antibiotic applications for the elderly(i) Physical change and risk of infection in older personsOlder persons experience a gradual decline in the function of organs in their bodies, a decline in liver and kidney function leading to a decrease in drug metabolism and excretion and an increase in the half-life of the drug in their bodies. At the same time, older persons are often associated with a wide range of underlying diseases, such as diabetes, cardiovascular diseases and chronic lung diseases, which make them more vulnerable to infection and, often, to multiple organ function disorders. Common infections include lung infections, urologist system infections, skin soft tissue infections, and pathogenesis are more common in the form of eclacteria, e.g. coli, pneumocococcal infections, and have a high rate of drug-resistant infections.(ii) Points for application of antibioticsCareful choice of medicinesTaking into account the liver and kidney function of the elderly, the use of antibiotics, such as amino-cyanide antibiotics, which have significant damage to the liver and kidney function, should be avoided as little or as much as possible. In the case of mild to moderate infections, priority is given to β-nimamine-type antibiotics, such as head sepsis. In cases of severe infections, the use of powerful antibiotics such as carbon pyroacne can be carefully selected when the liver and kidney function are closely monitored.Dose adjustmentsAntibiotic doses usually need to be properly reduced as a result of a slow down in drug metabolism. The dose may generally be adjusted to the age-old acetic anhydride removal rate, for example, for antibiotics that are mainly excreted through kidneys, when the acetic anhydride removal rate is reduced, the dose should be reduced or the interval between the drugs should be extended to prevent toxic effects from accumulation.(iii) Treatment managementThe recovery of older persons after infection is relatively slow and the course of antibiotic treatment may need to be extended, but drug adverse response and infection control should also be closely monitored. In the course of treatment, indicators such as liver and kidney function, blood routines should be periodically reviewed to determine, on the basis of the results of the examination and the patient ‘ s clinical symptoms, whether the drug can be stopped, and to avoid a premature withdrawal that results in re-emergence of the infection or late withdrawal of the drug causing resistance and an increase in the adverse effects of the drug.IV. Antibiotic applications for pregnant women(i) Physical change during pregnancy and infectionChanges in hormonal levels in pregnant women, increased blood capacity and some changes in the immune system. These changes make pregnant women vulnerable to urinological infections, respiratory infections, etc. Infections during pregnancy not only affect the health of the pregnant woman herself but may also have adverse effects on the foetus, such as premature birth, abnormal foetal development, etc. Common pathogens are similar to non-pregnancy periods, but the pathogenicity of certain pathogens may increase.(ii) Specificity of Antibiotic Selection1. Drug safety classificationAntibiotics are classified at different levels according to the United States Food and Drug Administration (FDA). Antibiotics A and B are relatively safe and can be used with caution when there is a clear indication during pregnancy, such as penicillin, sepsis, etc., and no significant adverse effects on the foetus, such as teratogenicity, have been identified in a number of clinical studies. In contrast, antibiotics of C, D and X need to be carefully weighed, for example, tetracyclic (category D) can cause abnormal foetal and skeletal development and should be banned; quinone (category C) may have an impact on foetal cartilage development and is generally not used during pregnancy.2. Comprehensive considerationsIn the selection of antibiotics, the treatment of pregnant women ‘ s infection must be balanced with consideration of the safety of the drug in the foetus. For example, in cases of urinological infections during pregnancy, safe antibiotics, such as Amosicillin, may be preferred if the condition is less serious, and certain relatively safe second-line antibiotics may be used with careful monitoring after the risk to pregnant women and their families has been fully informed and consent obtained.(iii) Drug monitoringThe use of antibiotics during pregnancy needs to be monitored more closely. In addition to observing the improvement of the symptoms of pregnant women and the adverse effects of the drug, the development of the foetus should be monitored by means of tests such as ultrasound. In the event that abnormal foetal behaviour or a serious adverse reaction of the pregnant woman is detected, the treatment programme should be adjusted or the drug stopped and treated accordingly.V. Antibiotic applications for the immunologically impaired(i) Classification and characteristics of infections among populations with low immunization capacityImmunologically impaired persons include persons with AIDS, oncological patients receiving chemotherapy or treatment, organ transplants with chronic immunosuppressants, etc. Their immune systems are inhibited, they are highly susceptible to a variety of infections, which are often severe and complex, with a wide variety of pathogens, including bacteria, fungi, viruses, parasites, etc., and a high percentage of drug-resistant bacteria. For example, people living with AIDS are vulnerable to pneumococcal pneumonia, tuberculosis estreptocosis, etc.; organ transplant recipients often suffer from megacellvirus infections, invasive fungi infections, etc.(ii) Antibiotic application strategies1. Integration of empirical drugs with precision treatmentBecause of the urgency and complexity of the infection among these groups, it is often necessary to use experiential drugs based on the patient ‘ s immune status, infection location, local epidemiological data, etc., and to select broad spectrum, high-impact antibiotics before the results of specific pathogen tests are available. For patients with moderate particle cells reducing co-heating, the use of carbon pyroacne is empirical. At the same time, various pathogen tests are carried out as soon as possible, and once the pathogens are identified, they are adjusted in time for precise target treatment.2. Joint application of antifouls and antiviralsIn response to the characteristics of co-production of fungi and viral infections among people with immunological impairments, close attention should be paid to whether there are signs of fungi or viral infection, while treatment for bacterial infections is provided. For example, in cases of chronic use of broad-spectral antibiotics with signs of fever, cough, etc., people should be warned about fungal infections, and anti-facter drugs, such as Vulcanium, can be used jointly; in cases of respiratory symptoms of persons with AIDS, both antiretroviral treatment (e.g. use of antiretroviral drugs) and anti-infection treatment for possible pathogens such as bacteria, fungi, viruses, etc.(iii) Treatment and preparationTreatment for those with low immunological capacity is usually long, requiring continuous medication to be fully controlled, and still needs to be consolidated for some time after the symptoms have disappeared in order to prevent a relapse. Because of the difficulty of short-term recovery of immune functions and the relatively poor lead times, long-term follow-up and monitoring, including periodic reviews of infection indicators, immunization function indicators, etc., are needed to detect the recurrence of new or pre-existing infections in a timely manner and to adjust treatment programmes in a timely manner.ConclusionsAntibiotic applications for special population groups in emergency care are a complex and critical clinical issue. Medical personnel must be fully aware of the physical and pathological characteristics of children, the elderly, pregnant women and those with low immune capacity, be familiar with their infection characteristics and pathogen distribution patterns, and strictly follow the antibiotic selection principles, dose determination methods and treatment process management strategies for specific population groups. (b) To improve the effectiveness of the treatment of infectious diseases among specific population groups through the application of accurate and reasonable antibiotics, to reduce the incidence of adverse medical effects and to guarantee the health and safety of special population groups, and to lay a solid foundation for the improvement of the quality of medical care in emergency medical care.