CHAPTER 14: Indications for whether oral or injection drugs should be used

Abstract

Indications for whether oral or injection drugs should be used: Oral drugs are easy to use, which is the greatest benefit. However, high concentrations cannot generally be obtained after oral administration, with a great difference in bioavailability after oral and intravenous administration. Also, some patients cannot take drugs orally. Meanwhile, definite concentrations can be achieved at an early stage after administration of injection drugs (generally, via intravenous drip infusion), although the use of injection drugs involves cumbersome procedures. The indications for whether oral or injection drugs should be used are presented below. It goes without saying that, the best option is determined based on patient’s demographic information, and finally left to the judgment of the physician giving treatment. Indications for the use of oral drugs: Mild or moderate pneumonia with meal consumption possible Indications for the use of injection drugs: Severe or extremely severe pneumonia, or moderate pneumonia with meal consumption impossible An intradermal reaction test was a previous requirement before the use of antimicrobial agents for injection; however, this has now been abolished. Instead, physicians are required to interview patients sufficiently regarding their medical history before drug administration and record this information in their medical chart. Therefore, when an antimicrobial agent is administered, comprehensive drug use and allergy histories should be taken. The special committee on intradermal reactions of the Japanese Society of Chemotherapy released “Measures for anaphylactic shock occurring with administration of antimicrobial agents.” The contents consist of 1. Important precautions when antimicrobial agents are administered intravenously, 2. Measures to be taken to prevent the occurrence of anaphylactic shock, 3. Monitoring during administration, 4. Examples of drug required in the event of anaphylactic shock occurring, 5. Symptoms and level of shock, and 6. Specific measures for first-aid treatment. These guidelines provide the details of the above number 3. Monitoring during administration below. Carefully monitor the patient after the start of administration (particularly, immediately after the start of administration). If any of the following symptoms appear, administration should be discontinued immediately, and appropriate action taken. Symptoms associated with suspected immediate allergic reaction