Abstract and Introduction
"Tell me what you know about antibiotics."
That's the discussion I start with hospitalized patients all the time, right after they ask me to prescribe antibiotics for their simple cough or other viral-like illness.
And, from their perspective, asking for antibiotics makes sense. After all, antibiotics have been the physician's knee-jerk reaction to a number of patient symptoms for decades, especially for a cough or upper respiratory infection. We have inadvertently trained our patients that there is an easy solution to almost any common medical problem.
But patients often answer my question with something like "not much," coupled with a little surprise that I haven't already started ordering the prescription.
That's when I talk about the potential harms of antibiotics. And that's also when their eyebrows go up. I start with the easy harms, like the fact that many antibiotics can cause diarrhea, a symptom nobody wants to deal with along with their runny nose. Then I move on to the big ones: Use of antibiotics today could make the patient resistant to antibiotics later in life, when they might really need them, and using antibiotics can lead to other painful and even fatal conditions, like Clostridium difficile .
After that, every patient agrees with my recommendations that we hold off on antibiotics for certain, particularly viral-like, ailments.
The Hospitalist. 2015;19(8) © 2015 John Wiley & Sons, Inc.