Harold C. Neu ANTIMICROBIAL PRESCRIBING Princeton, NJ.: Antimicrobial Prescribing, 1979, 111 pp., $19.95.
So many new antimicrobial agents have been marketed in recent years that it is impossible even for infectious-disease specialists to remember their individual properties, routes of excretion, antimicrobial spectra, dosages, etc. For example, 13 separate cephalosporins have been or soon will be marketed; similarly, there are nine aminoglycosides and 14 penicillins. In many instances, closely related drugs have considerably different uses and thus cannot be employed interchangeably. While a number of recent textbooks cover the area of antimicrobial therapy thoroughly, the physician needs a vade mecum that he can carry easily with him and refer to as the need arises. Several of these already exist: for example, the Medical Letter has produced a Handbook of Antimicrobial Therapy and Dr. John Nelson's Pocketbook of Antimicrobial Therapy in Children has achieved a wide circulation. To these admirable and useful little books is now added Dr. Harold Neu's Antimicrobial Prescribing.
Dr. Neu has approached the problem of presenting detailed information in a clear and informative manner. Like the Medical Letter's booklet, he not only discusses the use of antimicrobials in adult medical and surgical patients but lists the pediatric dosages for agents that might be useful in the latter age group. In order that the maximum amount of data might be packed into approximately a hundred pages, there is little text; rather, most information is presented in tabular form.
The first part of the book is devoted to infections of specific organ systems - for example, the ear. Infections in this site are divided into the various types of otitis externa, otitis media, and mastoiditis. For each disorder, the drug of choice is listed and, often, alternative agents, if these are available. There is additional comment on the proper duration for therapy and on other measures that might prove useful in treatment. Some brief diagnostic advice also appears that lists the most common symptoms and signs to be expected for each disease.
Other sections of the book describe in tabular form the various antimicrobial, antifungal, and antiparasitic agents available; their uses, toxicity, dosage in adults and children, side effects, incompatibilities, dosage adjustment in renal disease, and situations where antimicrobial prophylaxis has been shown to be useful; and, finally, various immunizing and vaccine agents.
My description of the content of the book really does not do it justice. Even minor points are covered, such as the most likely bacterial cause of infective endocarditis in drug addicts; the drug of choice in the treatment of Yersinia enterolytica (it is ampicillin), eubacteriae (penicillin), and Aeromonas hydrophila (aminoglycoside); and the most likely causes of postpartum or postabortion septic thrombophlebitis.
The book can be recommended to all physicians who see patients with infections. It seems more immediately useful than the Handbook of Antimicrobial Therapy by the Medical Letter because of the manner in which data are presented. For the pediatrician, however, Dr. Nelson's booklet must head the list: it covers much of the same material as is contained in Dr. Neu's admirable effort but by limiting itself to infants and children is able to provide more detail about the specific needs of these age groups.