Sharon Reid, General Practitioner, Wentworthville, NSW. Lecturer, Department of General Practice, University of Sydney at Westmead Hospital, and Continuing Education Program Manager, Western Sydney Division of General Practice
Therapeutic Guidelines: Antibiotic was first published in 1978. Since the early 1990s a reasonably up-to-date version of this book has been one of my most used sources of reference when consulting. While my usage of this book was previously limited to a few favourite chapters, the opportunity to review this book has provided the impetus to read it in much more detail. As I expected, given the expertise that has contributed to this book, it appears to be a very useful book for busy clinicians.
I have mainly considered the book from the general practitioner viewpoint and have structured my review to address its presentation, organisation and content.
Presentation
The book is presented in its familiar pink cover and has a wonderful historical `discovery of antibiotics' graphic on the front. The book seems to be getting a little thicker and the font a little smaller over the years, but in the current version I do not find either feature a major problem. I did wonder if the smaller font size might be problematic for readers with a degree of visual impairment.
Organisation
The slightly different colours of the various sections of the book facilitate quick access to the content. Future editions would benefit from variation in the colour of the appendices, too.
One other aspect for comment is the listing of drug alternatives. The `Key information†' section of the book contains the statement `several drugs are given as alternatives in a list, they are listed alphabetically or in order of preference'. This is confusing, and one or the other scheme should be used throughout.
Content
Aspects of the book I found particularly useful were:
– the inclusion of statements about the strength of evidence for drug and non-drug therapies
– the introductory chapter `Principles of antimicrobial use', provides a valuable overview of the basic good practice that will minimise emerging drug resistance
– `Getting to know your drugs' is a very useful refresher and overview of antimicrobial categories, mechanisms of action, effectiveness and risks
– in the chapters particularly relevant to general practice: (eye, gastrointestinal, genital tract, intra-abdominal, oral and dental, respiratory and skin infections) the topic coverage extends from common minor to more complicated, yet still not uncommon, infections
– the chapter `Prophylaxis: medical' has a number of useful recommendations including post needle-stick injury prophylaxis
– `Antimicrobials and food' answers questions patients often ask about
– the appendices `Pregnancy and breastfeeding' and `Paediatric doses' are both useful quick references.
While a few of the chapters and appendices are less useful for day-to-day general practice, they are helpful for keeping up to date with inpatient treatments and as a source of information for general practitioners caring for patients in hospital.
Overall I found Version 11 to be a practical, concise and informative book. Despite a few minor imperfections in the organisation and presentation of the book I would recommend it highly to the busy general practitioner. In addition, because of its breadth of cover and summarised format, it is likely to be of value to specialist clinicians outside their area of expertise, clinicians in training and medical students.
