When it comes to the issue of prescribing antibiotics in the various clinical scenarios we discuss on the course, I bring a fairly non-interventional approach. My rationale for this is not however based on the reasons that I was taught when I was a medical student or even a GP trainee. My avoidance of antibiotics comes from the simple realisation that they cause so many problems and are very rarely the solution to the presenting scenario.
This week I was asked to provide a guest blog for Johnathan Laird who has a site which gives practical advice about therapeutics in general. Without hesitation I submitted my 10 reasons to avoid antibiotics in children. None of the ten reasons are to do with resistance or oral thrush. Here are two of the reasons:
Although it is probably my most strongly worded piece, I would like to add that I have without a doubt prescribed antibiotics that were not needed and that caused many of the problems listed. All that I am trying to do is to be clear about why we should avoid antibiotics. I do realise that a 100% appropriate prescribing rate is a nonsense.
So in answer to my student, I do prescribe antibiotics about three times every month. Once for a pneumonia where the child is well enough to be treated at home, once for a urinary tract infection and once for a soft indication such as a throat or ear infection. For the pneumonia and UTI the denominator is one, whereas for ears and throats the denominator is about fifty. So do I just never prescribe antibiotics? Not never but certainly with a high threshold and that threshold exists for ten good reasons.
Winner of the Connecticut State Science Fair
Disclaimer: If my children so much as sneeze I give them broad spectrum antibiotics. Any self respecting doctor does the same for their children.