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Antibiotic Overuse

While we have been focused on Covid, there are other changes in medical care that can't be overlooked. One of them is the serious issue of antimicrobial (antibiotics) overuse that contributes to antibiotic resistance. We physicians are guided by evidence-based science and there are some changes in how we use antibiotics to treat infection. The Annals of Internal Medicine have issued new guidelines for the use of antibiotics.

Remember when your doctor would give you a 10 or 14 day course of antibiotics and tell you to take all of them? That has now changed for the majority of common infections. Infections like out-patient acquired pneumonia are to be treated with 5 days of antibiotics. If fever is gone and the patient is eating normally, that is enough!

What about common urinary tract infections? Escherichia coli (eColi) makes up 75% of all UTIs. So we target this infection if we don't have a urine culture. Some antibiotics are a single dose, some 3 days and some 5 days and all are as effective as a longer ten day course. Longer treatment is not necessary and can cause resistance.

Another common condition is cellulitis, a skin infection. The recommendation is 5-6 days only. Many minor skin infections can be cured with hot compresses. Remember, antibiotics only work with your own blood flow to the area. Our natural immunity is often enough if blood flow is increased and that is why hot compresses for infection work.

For us Physicians, we aim for the right antibiotic at the right dose for the right duration for a specific condition. We don't treat bronchitis or sinus congestion with antibiotics. We don't treat viruses like colds or Covid-19 with antibiotics because they are not effective.

The next time your doctor tells you an antibiotic will not be effective, believe her. And if antibiotics are used, a short course may be the right choice.


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