Smart Medicine

A smart, snappy reader wrote to me asking if I was planning on discussing the preponderance of “prescribing unnecessary medications” given my recent entry on drug reactions. Not ever being one to shy away from opening the proverbial can of worms, LET’S DO IT.

When we talk about the dispensing of antibiotic medicines responsibly we use the phrase “antibiotic stewardship.” Isn’t that a fantastic term? I kind of love it. And I love its meaning even more.

I know I can appeal to universal reason when I make the blanket statement that not every illness needs a prescription medication to cure it. Intellectually, we all buy this. Emotionally however, when it’s your own kid who doesn’t feel well in the middle of the night, it’s a little tougher. I’ve been that parent who just wants ANYTHING to help her child when they are sick.

Earlier this week I wrote about different kinds of drug reactions and a few problems that can result from them. The thought of these are reason enough to make me pause whenever I prescribe a medication. Medicines are wonders for sure and do indeed fix many things, but they are not without risk and every prescription should be considered carefully.

Superbugs. They are real and they are mean.

And then there’s the whole other Pandora’s box of drug resistant germs, generally thought to have come about in large part from the over prescribing of antibiotics. That’s where stewardship comes in. It’s our responsibility as healthcare providers to be smart about making sure we are treating a disease with the right medication by checking lab tests and cultures when necessary—like with strep throat and bladder infections. It’s also our responsibility as patients to be reasonable and accept the fact that not every illness warrants a prescription to fix it—like when we have an annoying, but uncomplicated viral-type infection.

Antibiotic stewardship involves awareness of current germ patterns—types circulating, sensitivity and resistance to certain medications, education about all this, and good old fashioned RESTRAINT. It’s natural that when you take your child to the doctor you want to leave feeling like you’ve got SOMETHING to make them feel better faster. But keep antibiotic stewardship in mind. You don’t want “added to the strength and resistance of superbugs” on your conscience, do you? And my doctor colleagues, let’s stay firm in our conviction to treat our patients with medications only when they need it, not as an easy out of any sort.

Responsible prescribing + antibiotic stewardship = fewer drug reactions + easier to fight infections

I like that math equation. Don’t you?

Go to previous article: A Tale of Two Immune Reactions