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Antibiotic Resistance: Expert Q&A With the CDC

What is a more judicious use of antibiotics?

Srinivasan: From a public health perspective, the definition of judicious is ensuring the antibiotic is used in the right circumstance, is being used at the right dose, and is given for the right duration. Broadly, that's how we would define the most judicious use of antibiotics.

What are potential side effects of taking an antibiotic?

Hicks: Adverse drug events can range from minor stomach ailments, like nausea and vomiting, to more serious consequences that may be life-threatening and require hospitalization. In children, antibiotics are the most common cause of emergency department visits for adverse drug events. Using antibiotics responsibly is the best way to avoid an adverse drug event.

What should a health care provider do if a patient or a parent insists on antibiotics, even if the illness isn't treatable with antibiotics?

Hicks: It falls on the health care provider to prescribe only when needed. The health care provider does have to take all the factors into consideration: how sick the patient is, what the likeliest diagnosis is, what their findings are on physical exam. If it's an upper respiratory infection, it's not always obvious whether (the illness) is viral or bacterial, but the vast majority of time it's viral.

If the patient still wants an antibiotic, the most important approach for a health care provider is to validate the patient's concerns, discuss why they don't need an antibiotic, tell them that just because they don't need an antibiotic doesn't mean they aren't sick. They can suggest an over-the-counter product or other medicine to treat symptoms.

What are some steps the public can take to push back at antibiotic resistance?

Hicks: Be informed when an antibiotic is needed. Don't insist on an antibiotic when going to your health care provider. If you have a nasty cold, it's important to drink plenty of fluids, get plenty of rest, maybe use over-the-counter products. It's very important for patients and health care providers to work as a team to develop alternatives when an antibiotic isn't needed. Don't be afraid to ask questions of your health care provider. It's reasonable to ask why an antibiotic wasn't prescribed.

Patients can also play a role by staying up to date on vaccines and taking care of themselves. Hand washing can prevent the spread of infections.

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Reviewed on November 23, 2010

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