Antibiotic Prescribing 101

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“Quite astounding. They did a remarkable job.” Two years before these remarks could be uttered the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America issued antibiotic guidelines for treating children who developed pneumonia outside of a hospital.

These guidelines called for the drug “ampicillin” to be used in these cases because it is a “narrow spectrum” antibiotic and concern was that the developing practice of using “broad spectrum” antibiotics was contributing to antibiotic resistance. According to the study, “doctors were rarely in line with the national guidelines.”
Even though a similar study at Children’s Mercy Hospital in Kansas City did not show that using broad-spectrum antibiotics increased antibiotic resistance, the lead author of this study implemented the “ampicillin only” program at her workplace, Cincinnati’s Children’s Hospital. Within 2 years they have adhered to it 100%. The goal of their program is to now see whether their results differ from the already completed Kansas City study. For taking this step her peers are overjoyed.

MY TAKE:
“Quite astounding? They did a remarkable job?” Correct me if I’m wrong, but why didn’t medical schools teach proper antibiotic prescribing to students who are now standing at my child’s hospital bedside? I agree that it is “astounding,” but not for the reasons they do! What is astounding to me is that many, if not most doctors continue to miss prescribe and then pat themselves on the back when they think that a research paper might be pointing them in the right direction. Given that “national guidelines” are developed with loyalty to drug companies, it is the guidelines even more than the prescribing doctors that concerns me. The foxes continue to guard the hen houses in medicine and will until we the people express outrage. 65 years after the introduction of antibiotics, this should be an exact science, not the guesswork that it remains today.
If you have ever had a child in the hospital, you know that more than anything else, you want knowledgeable and competent care. Indulging themselves for “maybe” figuring out how to use antibiotics for pneumonia should leave every American concerned.


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