Author Affiliations: Center for Patient Safety Research and Practice, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (Dr Schiff); Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago (Dr Galanter); and Department of Pharmacy Administration, University of Illinois at Chicago College of Pharmacy, Chicago (Dr Lambert).
We agree with Wlodaver and May that prescribing antimicrobials vividly illustrates the need for conservative prescribing practices. Whether we will have effective antimicrobials in the future depends on avoiding their overuse today. Nearly all of our 24 principles apply to antibiotic prescribing, particularly those recommending treating underlying causes rather than reflexively responding to symptoms, considering drug effects as the cause of symptoms (such as fever), discontinuing drugs when no longer needed or working, recognizing that that not all patients desire or expect drug (antibiotic) prescriptions (rather than reassurance and close follow-up), and considering longer-term risks (including antibiotic resistance).
Schiff GD, Galanter BL, Lambert BL. Conservative Prescribing and the Importance of Psychotherapy—Reply. Arch Intern Med. 2012;172(3):294-295. doi:10.1001/archinternmed.2011.1564