Doctors must be careful about giving antibiotics

The call for the medical community to be cautious about prescribing antibiotics is a timely message. And it’s a difficult one.

There is no doubt that this is a good cause. The overuse of antibiotics breeds drug-resistant germs that can turn routine medical conditions into life-threatening situations. Far too many people are dying as a result of encountering resistant bacteria. For individuals and society alike, more caution will result in long-term benefits.

The front line in the fight will be when patients visit doctors expecting an automatic prescription of antibiotics. Both doctors and patients will have to listen more carefully to one another than in the past. The listening process will go best if the communication begins before a patient arrives at the office. Most of us can think a little harder before calling the doctor’s office. And medical offices must be clearer about patients’ options for treatment and self-care that don’t involve a visit with the doctor.

The health care community must not forget that working parents, for instance, will be frustrated if, after arranging a doctor’s appointment and handing over a co-pay, they are told that they should just give Jane some Tylenol for an earache. Physicians’ sympathy and clear directions about when to call back may be helpful. Unnecessary visits can also be minimized by the public education campaign on the issue. Even so, work places will be affected by parents who may have to spend more time nursing sick kids.

It is also important to realize that patients must be told clearly how to be effective advocates for themselves and their families in the changing environment. Doctors can help by being clear about follow-up procedures and what circumstances might cause an antibiotic to be prescribed.

Outside of medical offices, policymakers and the drug industry have responsibilities to support physicians and patients alike. Too little effort has gone into developing new antibiotics. Pharmaceutical companies can put more attention into this vital need. Government could probably encourage their efforts with some judicious use of research funds.

With winter coming, many of us will be hit by viruses, which don’t respond to antibiotics. We should think twice before asking for a prescription. And doctors do have to be more judicious. The apparent run on Cipro (the anti-anthrax drug of choice) would be a great place for them to practice their say-no skills. As with the war on terrorism, though, the effort to reduce our reliance on antibiotics will require patience and flexibility.

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