Anti-antibiotics

In their excellent Review Article on the principles of conservative prescribing, Schiff et al¹ make only infrequent specific reference to antibiotics. Yet herein lies great opportunity for more judicious prescribing, the importance of which is punctuated by the multiple-drug–resistant organism and Clostridium difficile epidemics, the “collateral damage” of antibiotics. Because antibiotics are relatively so efficacious, safe, and inexpensive, they are prone to overuse. Inconsiderable attention has been given to when to withhold antibiotics and when to discontinue them once in use. Antibiotic stewardship programs address judicious use,² and we recently reviewed specific guidelines for limiting antibiotic use.³