Y. Khabir. Coastal Carolina University.
It is estimated that 35– 50% of women with gonococcal cervicitis also have Complications in men infected rectal mucosa buy generic accutane 5mg on line. Rectal gonorrhoea in • Epididymitis accutane 40 mg on-line, a unilateral testicular pain and women is usually asymptomatic buy generic accutane 10 mg line. Male urethral swab • 15–19 year olds at particularly high risk • Low socioeconomic status • Past history of gonorrhoe • Early onset of sexual activity Prognosis Gonorrhoea generally remains localised to the initial sites of infection order genuine accutane. The complications of gonorrhoea leading to serious morbidity are commoner in areas where access to diagnosis and treatment is more difficult. Diagnosis Diagnosis is made by identification of the organism Neisseria gonorrhoea at the site of infection Diagram 6. Female urethral swab through: • Microscopy; direct visualization of Gram stained specimens allows diagnosis of gonorrhoea when Gram negative diplococci are seen within polymorphonuclear leucocytes. Rectal gonorrhoea is more likely to be diagnosed through microscopy if a proctoscope has been used to collect the sample. Speculum examination and tests Worldwide, resistant strains have developed to penicillins and quinolones. Antibiotics for Swab Cervix Cervical swab being taken gonorrhoea should be selected to clear over 95% of infection in the local area. Ceftriaxone has been used worldwide effectively as a single dose with as yet no noted resistance. Speculum Co-infection with chlamydia trachomatis Up to 40% of adults with genital gonorrhoea infection also have chlamydia. Treating for both infections simultaneously after a diagnosis of Cervical swab gonorrhoea is made is recommended. Cervical smear Screening Thesting for gonorrhoea should be offered to the following groups: Methods of treatment • patients with signs or symptoms attributable to Uncomplicated genital infection gonorrhoea; Ceftriaxone 250 mg intramuscularly as a single • individuals attending sexual health clinics; dose; Ciprofloxacin 500 mg as a single oral dose; • anyone diagnosed with another sexually Ampicillin 2 g or 3 g plus Probenecid 1 g orally as transmitted infection; and a single dose in regions where penicillin resistance • sexual partners of patients with gonorrhoea. Ceftriaxone 250 mg intra- urethral infection muscularly as a single dose; Cefotaxime 500 mg See Appendix 2 for partner management. Other Eastern European countries including Module 7, Part I Page 209 Contact tracing of men and women with asymptomatic infection and infection at other sites Trace all sexual partners in the three months preceding the diagnosis. Follow-up Patients diagnosed with gonorrhoea should be seen again after treatment has been completed in order to assess efficacy of treatment. In some sources, retesting is only recommended if an unusual treatment regime has been used. Nursing care and the role of the primary health care team, and of the hospital/community setting, see Appendices 4 and 5. Page 210 Module 7, Part I Syphilis Definition the Slovak Republic and Finland have reported a Syphilis is caused by the infectious organism rise in cases since the early 1990s as well as parts of Treponema pallidum. Modes of transmission Manifestations of syphilis Sexual transmission These vary depending upon the stage of infection. Early Syphilis Vertical transmission Includes primary, secondary and early latent Untreated early syphilis in pregnant women will syphilis. One third of untreated Primary Syphilis vertically-transmitted episodes will result in • Incubation period between 9–90 days (usually stillbirth. Treatment for congenital sites: penis, anal canal, labia, fourchette, cervix, (less syphilis is with procaine penicillin. Less common routes of transmission include kissing a person with active lesions, inoculation via Secondary syphilis a needlestick injury, or through infected blood Treponema pallidum disseminates through the transfusion. The rash is non- million new cases among adults, with most ulcerative and generally, not itchy (on dark skin, it occurring in South and Southeast Asia, followed may appear grey in colour). The • At the same time large, raised, fleshy white/grey incidence of syphilis has fallen in Western lesions (condylomata lata) appear on moist areas industrialized countries since the second world war, including the perineum, axilla and groin – these and apart from a rise in the early eighties, there are highly infectious. Relapses may occur during which transmission • Individuals who are most sexually active of syphilis is possible. Features of late latent syphilis are: One third of patients with untreated late latent • no relapses; syphilis have no recurrence of illness and remain • immunity to new infections of primary syphilis; symptomless for the rest of their lives and syphilis • no risk of horizontal sexual transmission; can only be detected through standard serological • vertical and blood borne transmission can still tests. A further third of patients with late latent occur; and syphilis not only remain symptomless as in the first • detectable through serological tests for syphilis. The final third develop Thertiary syphilis is noninfectious and can be treated, tertiary syphilis. It may take the form of: Diagnosis of early syphilis • neurological syphilis: asymptomatic infection, • Microscopic examination of serum from a diagnosed by abnormal cerebrospinal fluid findings primary lesion on lumbar puncture. Note: If serological tests are positive for syphilis Risk factors for contracting syphilis and there is an inadequate history of previous Page 212 Module 7, Part I treatment, the patient should be treated. Methods of treatment Contact tracing of primary syphilis Early syphilis Trace all sexual partners within 3 months preceding Bicillin 800 000 units intramuscularly daily for 10- the diagnosis or onset of symptoms, whichever is 14 days (contains Procaine Penicillin G) or earlier. Doxycycline 200mg daily for 14 days if allergic to Penicillin or Benzathine Penicillin 2. Treatment in pregnancy Contact tracing of late syphilis Bicillin 800 000 units intramuscularly daily for 10– Sexual transmission at this stage does not occur, 14 days or Erythromycin 500 mg four times daily and vertical transmission is unusual after 2 years. Treatment in late syphilis or early syphilis with Follow-up neurological involvement. All patients should be reviewed after treatment in order to: Treatment involves increased doses of antibiotics • assess efficacy of treatment and to detect relapse over a longer period of time. Specifically, sexual partners of • reinforce health education including ensuring patients with syphilis should be tested at the first patients are aware that specific treponemal tests will visit, then at 6 weeks and 3 months. Pregnant women should be • provide ongoing medical assessment for those offered serological testing for syphilis at their first with late syphilis. Chancroid is an acute genital ulcerative condition, Specifically: caused by the bacterial organism Haemophilus • Continuous therapy: the patient should be assisted ducreyi. If the patient is unlikely to be compliant, Mode of transmission Nursing careconsider the weekly regime. Resuscitation • vertical transmission has not been reported facilities should be available in treatment areas. In pregnancy can cause foetal distress facilities and poor understanding of the and premature labour. Estimates based there can be a risk of severe clinical deterioration on syphilis prevalence for 1995 suggest around 7 and the patient should be cared for in hospital. Management • Incubation period between 3 and 10 days includes reassurance and Diazepam 10mg • Single or several ulcers usually on the fourchette, intramuscularly/rectally/intravenously if fits occur. Risk factors Infection in pregnancy and during breastfeeding • Young, sexually active adults Erythromycin 500 mg orally four times a day for 7 days. Azithromycin has an unestablished safety Prognosis profile in pregnancy and lactation. If healthy skin, repeated after two to three days as untreated, persistent ulcers and abscesses can remain required, avoiding the risk of ulceration from unhealed for years. Diagnosis • Isolation of the organism Haemophilus ducreyi Prevention of spread in culture of scrapings from ulcers See Appendix 1. Trichomoniasis is caused by Trichomonas vaginalis, a flagellated protozoan, found in the genitourinary Contact tracing tract of both men and women. Maternal oestrogens cause the neonatal • assess whether fluctuant buboes require aspiration; vaginal epithelium to resemble adult vaginal • ascertain there has been no risk of reinfection; epithelium, allowing trichomonas to grow. After • check that contact tracing has taken place; and 3–4 weeks of life, the infant vagina becomes • reinforce health education (see Appendix 2). For nursing care, the role of the primary health Symptoms of discharge usually spontaneously care team, and the role of the hospital/community resolve at this stage. Global trichomoniasis was estimated at 170 Definition million new adult cases for 1995. Manifestations of trichomoniasis In women: • Vaginal discharge of a variable consistency, from thin and light to thick, frothy and yellow-green • Vulval itch • Dysuria Page 216 Module 7, Part I • Offensive odour 30% of cases in men. In men: • 60% have urethral discharge Treatment without diagnosis • Rarely, balanoposthisis If facilities for laboratory culture are not available, Note: 15–50% have no symptoms treating male partners of women with trichomonas will reduce reinfection of the female partner and Complications onward transmission to new partners. Risk factors Infection in pregnancy • Young adult First trimester: symptomatic relief with co- • Sexually active trimazole pessaries 100 mg daily for 7 days. Specifically, avoid alcohol during Trichomoniasis is curable with antibiotic therapy.
Establishment of identity of living persons – Definition of Corpus Delicti discount accutane line,Race purchase accutane 5 mg with visa, sex purchase accutane american express, religion best 40 mg accutane, complexion, stature, age determination using morphology, teeth-eruption,decay, bite marks, bones- ossification centres, medicolegal aspects of age. Foetal age determination, Identification of criminals,unknown persons, dead bodies from the remains-hairs,fibers,teeth,anthropometry, dactylography, foot prints,scars,tattoos,poroscopy and Superimposition. Abrasion, bruise, laceration, stab wound, incised wound,chop wound, defence wound, self inflicted/fabricated wounds and their medicolegal aspects. Description of regional injuries to head (Scalp wounds, fracture skull, Intracranial haemorrhages, Coup and contrecoup injuries), Neck,Chest,Abdomen,Limbs,Genital organs, Spinal cord and skeleton, Vehicular injuries – Primary and Secondary impact, Secondary injuries, crush syndrome, railway spine, reconstruction of scene of crime. Factors influencing, Infliction of Injuries and Healing, Different legal questions, examination and certification of wounds, Wound as a cause of death: Primary and Secondary. Structure and components of various firearms,description of ammunition propellant charge and mechanism of fire-arms, Various terminology in relation of firearm – calibre, range,choking. Preservation and despath of trace evidences in cases of firearm and blast injuries. Adultery, Unnatural Sexual offences Sodomy, Examination of accused and victim, preparation of report and framing of opinion, preservation and despath of trace evidences in cases of sodomy, incest, lesbianism, buccal coitus, bestiality, indecent assault. Fetichism, transvestism, voyeurism, sadism necrophagia, masochism, exhibitionism, frotteurism, necrophillia. Definitions of Impotence, Sterility, Frigidity, Sexual Dysfunction, Premature Ejaculation, Causes of Forensic Medicine & Toxicology 31 Impotence and sterility in male and female, Sterilization, Artificial Insemination, Surrogate mother, Delhi Artificial Insemination act 1995. Definition of Virginity and defloration, anatomy of male and female genitalia, Hymen and its types, Medicolegal importance of hymen, Medicolegal importance of pregnancy, diagnosis of pregnancy, Superfoetation, superfecundation, Definition of Legitimacy and its medicolegal importance, Diputed paternity and maternity, Medicolegal aspects of delievery, Signs of delievery, Signs of recent and remote delievery in living and dead. Medical council of India, state medical councils- Their functions and disciplinary control. Laws in relation to medical practice, duties of medical practitioner towards the patients and society. Indian Medical Register, rights priviliges of medical practitioner, penal erasure, infamous conduct, disciplinary committee, warning notice & euthanasia. Definition, Various types of mental disorder, Lucid interval, Classification of mental disorder, mental subnormality, Diagnosis of Insanity and Feigned insanity, Restraint, admission and discharge of Insane in accordance to Mental Health act 1994, Mental disorder and responsibility-Civil and Criminal responsibility, Thestamentary Capacity, Mc Naughten‘s rule. Locard’s exchange principle, Examination, preservation, despatch and identification of blood, Seminal stains (Physical,microscopic,chemical and serological test, blood grouping) and its medicolegal aspects, Saliva, vaginal fluid, faecal and urinary stain, examination of skin, nail tooth pulp and other body fluids group specific substances, hazards of blood transfusion. Corrosive poisons – sulphuric acid, phenol ,oxalic acid, nitric acid, hydrochloric acid, organic acids and alkalies. Irritant non metallic poisons- Phosphorus, Halogens, Organophosphorus, chlorinated hydrocarbons, miscellaneous preparation & mechanical irritatants. Classification and description of common insecticides and pesticides used in India 4. Animal poisons – snake bite, scorpion bite , wasp, bee, cantherides & toxic fishes. Somniferous poisons – opium & its derivatives, synthetic preparations, pethidine & codeine. Spinal & peripheral nerve poisons – strychnine, curare & domestic poisons – kerosene, cleansing agents, disinfectants, household medicines. Vegetable poisons – abrus, ricinus, croton, ergot, capsicum, camphor, argemone, lathyrus & calotropis. Describe and examine Alcohol poisoning (ethyl & methyl alcohol) and drunkenness, its medico- legal aspects & benzodiazepine poisoning. Asphyxiant poisons – carbon monoxide, , carbon dioxide, hydrogen sulphide, phosgene and phosphine. Names of common adulterants and general methods of detection for food adulterants, Common food poisonings- Botulism, Chemical Poisoning, Poisonous Mushrooms and epidemic dropsy. Description of toxic pollution of environment, its medico-legal aspects & toxic hazards of occupation and industry. General principles of analytical toxicology and its application in management , prevention and control Forensic Medicine & Toxicology 33 of poisoning. Basic principles of functioning of Gas Liquid Chromatography, Thin Layer Chromatography, Atomic Absorption Spectrophotometer, Spectrophotometer, Neutron Activation Analysis, Mass spectrometry, alcometer. Preparation of a Medico-legal report of an injured person due to mechanical violence. Conduct & prepare postmortem examination report in a case of suspected poisoning and to preserve & dispatch viscera for chemical analysis. Conduct & prepare postmortem report in a case of death due to violence of any nature - road accident, fall from height, assault, factory accident, electrocution, burns & accident due to any other cause, fire arm injury, asphyxia, natural death & medical negligence. Demonstration, interpretation and medico-legal aspects from examination of hair (human &animal)fibre, semen & other biological fluids. Demonstration & identification of a particular stain is a blood and identification of its species origin. Identification & drawing medico-legal inference from various specimen of injuries e. Identification & description of weapons of of medicolegal importance commonly used e. Description of the contents and structure of bullet & cartridges used & medico-legal interpretation drawn. Examination & preparation of report of an alleged accused in a rape/unnatural sexual offence. Examination & preparation medico-legal report of a victim of sexual offence/unnatural sexual offence. Dhatura, castor, cannabis, opium, aconite copper sulphate, pesticides compounds, marking nut, oleander, Nux vomica, abrus seeds, snakes, capsium, calotropis, lead compounds & tobacco. Apurba Nandy- Principles of Forensic Medicine, 3rd Edition 2000, New Central Book Agency (P) ltd. Total Theory Practical 75 38 37 Theory paper consists of two parts - a) Forensic Medicine 19 marks b) Toxicology 19 marks Both above two papers have to be answered on separate sheets. Introduction to Bacteriology – The nature of bacteria – Morphological differences – Growth requirement – Nomenclature and classification – Enumeration of bacteria responsible for certain primary diseases. Bacterial Staining and Cultivation – Microscopy : types and principles – Staining : principles – Media for growth / bacterial colony – Familiarization with materials used 4. Introduction to parasitology – Biology of protozoa – Protozoan parasites causing human infection – Medically important helminths – Ectoparasites 6. Introduction to Mycology – Nature of fungi : basic structures and classification – Superficial mycoses – Subcutaneous mycosis – Systemic fungal infections with opportunistic mycosis 9. Collection of Transport of Samples – Collection of clinical samples – Transport of various appropriate clinical samples. Host-Parasite relationship – Presence of normal flora – Enumeration and explanation of various host-parasite interaction – Mechanism of pathogenesis adhesion/ colonisation/ virulence and toxigenicity – Host response – Koch’s postulates 12. Immunity to infection – Normal immune system – Innate Immunity – Antigens – presentation and association in immunity – Immunoglobulins and their role in immunity – Cell mediated immunity and their role – Hypersensitivity – Immunodeficiency – Tolerance 14. Immunodiagnosis – Antigen-antibody reactions in infectious diseases and diagnostic tests based on these 15. Microscopy and micrometry – Introduction to microscopes – Focussing slides under low/ high power and oil immersion – Principles and demonstration of various types of microscopes 2. Direct demonstration of bacteria by staining – Gram staining – Albert’s staining – Acid fast staining 3. Motility tests and biochemical tests for bacterial identification – Hanging drop method for motility testing – Important biochemical tests : principles and interpretation 4. Intestinal nematodes (Clinical features and lab diagnosis) (Micro, Gastro) Intestinal cestodes (Focus: only those seen in india; and trematodes incl. Intestinal cestodes (Epidemiology, clinical features, (Micro, Gastro, Neuro) microbiological aspects, diagnosis) 4. Enterobacteriaceae (Introduction, common features, classification, infections caused - enumeration only) 5. Cholera (Clinical Features, Epidemiology, (Micro, Med, lab diagnosis, vaccines) Paeds, Comm. Streptococcal infections (Group A, B, B: bacteriology, pathogenesis, infections, lab diagnosis), and, introduction to viridans group and pneumococcus 18.
Respondents then determine themselves if they wish to participate accutane 5mg generic, considering the subject matter buy accutane 20 mg with mastercard, duration and level of incentive accutane 40 mg discount. In countries where internet penetration is not widespread enough to recruit a nationally- representative sample using an online methodology purchase accutane 5mg on-line, face-to-face surveys were used, and in these cases the interviewers in each country recruited and screened participants. Recruitment was conducted via street-intercepts, with interviewers working in specified locations, based on the agreed quota spread. Interviewers targeted respondents based upon their outstanding quota requirements. Once an interview had been achieved the quota sheet was updated and then next respondent was targeted to fill remaining quotas. To help minimize methodological bias across countries, participants were asked to self- complete much of the survey. A closed question methodology was also adopted to ensure consistency and allow for comparability across countries and methodologies. Regarding sample size, because this survey seeks to capture information for the general population rather than boosting for any specific groups, a sample size of 1000 per country was used where an online methodology was adopted and a sample of 500 per country where it was necessary to use face-to-face (Table 1 below). This sample size was selected to ensure that resulting data is as robust as possible, while also managing resource effectiveness. Number of respondents in each country and method of survey, by region Region Country Methodology Sample size Nigeria Face-to-face 664 African South Africa Online 1002 Barbados Face-to-face 507 Americas Mexico Online 1001 India Online 1023 South-East Asia Indonesia Online 1027 Russian Federation Online 1007 European Serbia Face-to-face 510 Egypt Face-to-face 511 Eastern Mediterranean Sudan Face-to-face 518 China Online 1002 Western Pacific Viet Nam Online 1000 A nationally-representative sample of adults aged 16+ in each country completed the survey. For all countries, a quota sampling methodology was employed to ensure that the sample was broadly nationally representative, with hard quotas set for age and gender and soft quotas for region and household income. Other demographic data, such as education level and urbanization, was collected for the purpose of profiling. This document presents the multi-country average alongside some country-specific data, drawing out differences in findings between countries and socioeconomic differences. Since the data set does not include wide-ranging numeric responses, the mean rather than the median has been used for the overall average. The demographic factors considered in the analysis are: Gender: Male or female Age: 16-24, 25-34, 45-54, 55-64, 65+ Education: None, basic, further, higher Household composition: With children under 16, without children, other Urbanization: Urban (within a densely populated city or town), suburban (in a suburb or a city or town), rural (outside of a city or town) 2 Income classification (World Bank classifications) : - Lower income countries (Egypt, India, Indonesia, Nigeria, Sudan and Viet Nam) - Higher income countries (Barbados, China, Mexico, Russian Federation, Serbia and South Africa) 2 The World Bank classifies economies based on gross national income per capita (http://data. These include, though are not limited to: sample size; length of sampling and fieldwork time; the duration of the interview and expectations of the participant; the need to minimize the potential for methodological bias across countries, and the pros and cons of the different research methodologies. Balancing these different considerations, and managing overall budget and cost, result in survey limitation, and for this reason it is important to emphasize that the results reported are a snapshot, and should be considered as estimations, rather than accurate results. Therefore, the data cannot be considered to be representative of each Region, nor of the global situation. When people last took antibiotics The majority of respondents surveyed report having taken antibiotics within the past six months (65%), including more than one third having taken them within the past month (35%) (Figure 1). Percentages of responses from all respondents to "When did you last take antibiotics? More than half of respondents in Egypt reported having taken antibiotics within the past month (54%), and more than three quarters (76%) of respondents in Egypt, Sudan and India took them in the past six months. In contrast, respondents in Barbados and Serbia are noticeably less likely to have taken antibiotics recently, with only 19% reporting having taken them within the past month in both cases. Respondents in Barbados are also the most likely to have never taken antibiotics at 13% (Figure 2). Percentages of responses from all respondents to “When did you last take antibiotics? Percentages of responses from all respondents to “When did you last take antibiotics? There are also some notable differences between countries of different income levels across the 12 countries surveyed. Percentages of responses from all respondents to “When did you last take antibiotics? Percentages of responses from all respondents to “When did you last take antibiotics? How people obtained antibiotics Respondents who reported having taken antibiotics were then asked if they had obtained them (or a prescription for them) from a doctor or nurse on the occasion when they last received them. Overall, the vast majority of respondents (81%) report that they got their antibiotics (or a prescription for them) from a doctor or nurse. This was relatively consistent across the countries surveyed ( Figure 6), though the findings from the Russian Federation were particularly low on this measure, with only 56% of respondents reporting that they got their antibiotics in this way. The proportions of survey participants reporting that they got their antibiotics from a doctor or nurse in South Africa (93%), Mexico (92%), Barbados (91%), Sudan (91%) and India (90%) were all above the overall average, with at least nine out of ten. Percentages of responses from all respondents to “On that occasion, did you get the antibiotics (or a prescription for them) from a doctor or nurse? From a socio-demographic perspective, the survey finds relatively little variation around how respondents reported getting their antibiotics. Suburban respondents are slightly more likely than those in urban or rural areas to report having gotten antibiotics from a doctor or nurse, with 85% of suburban respondents obtaining antibiotics in this way compared with 80% of those in urban areas and 79% of rural respondents. Whether people received advice from a medical professional on how to take them The vast majority of respondents in all countries surveyed said they had received advice from a medical professional on how to take the antibiotics they last took (86%) (Figure 7. Percentages of responses from all respondents “On that occasion, did you get advice from a doctor, nurse or pharmacist on how to take them? Where people obtained the antibiotics Almost all respondents across the 12 countries surveyed report having obtained the antibiotics they last took from a medical stall or pharmacy (93%) (Figure 8. China and India are the only countries in which any respondents report having gotten antibiotics online, with 5% and 2% of respondents respectively saying that they got their antibiotics in this way. China is also the country with the highest number of respondents reporting that they got their antibiotics from a friend or family member, though this response was still low, at 4%. Nigeria is the country with the highest number of respondents who report getting antibiotics from a stall or hawker, though this response is low too, at 5%. Percentages of responses from all respondents “On that occasion, where did you get the antibiotics? From a socio-demographic group perspective, the data show relatively few significant differences, though Figure 9 shows that respondents in rural areas are more likely than those in urban or suburban areas to report having received antibiotics from somewhere other than a medical store or pharmacy, at 14% and 6% respectively. Percentages of responses from all respondents to “On that occasion, where did you get the antibiotics? How and when to take antibiotics Respondents were first asked whether they thought the following statement was true or false: “It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness” Overall, 25% of the survey respondents think this is true, whereas it is in fact a false statement. However, the findings show noticeable differences between the countries surveyed (Figure 10. In comparison, more than one third of respondents in Nigeria (37%) and Egypt (34%) think that this statement is "true". Percentage of responses from all respondents to “It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness” by country surveyed. Percentage of responses from all respondents to “It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness” by education level. Survey respondents were then shown a second statement and again asked whether they thought it was true or false: “It’s okay to buy the same antibiotics, or request these from a doctor, if you’re sick and they helped you get better when you had the same symptoms before” Across the countries surveyed, 43% of respondents think this is true, whereas it is in fact a false statement. The findings again show some notable differences between countries surveyed on this statement (Figure 12). Respondents in Mexico and Barbados are most likely to agree that this statement is false, with 67% and 66% respectively selecting this response. In contrast, more than half of respondents in Nigeria (56%), India (52%), Egypt (51%) and Indonesia (51%) think this incorrect statement is true. Percentage of responses from all respondents to “It’s okay to buy the same antibiotics, or request these from a doctor, if you’re sick and they helped you get better when you had the same symptoms before” by country surveyed. The survey findings show a few notable socio-demographic differences in relation to this question. Percentage of responses from all respondents to “It’s okay to buy the same antibiotics, or request these from a doctor, if you’re sick and they helped you get better when you had the same symptoms before” by income classification. When to stop taking antibiotics Survey respondents were then asked when they thought they should stop taking antibiotics once they had begun treatment: when they feel better, or when they have taken all the antibiotics as directed. The majority of respondents across the countries surveyed answered that the full course of antibiotics should be taken as directed (64%). Respondents in South Africa are most likely to choose this option, with 87% saying that the full course should be taken as directed.