Antibiotic policy

Abstract

Antibiotics are often effective in curing a patient of his infection even when used in a suboptimal manner. In this situation it is often difficult for the prescriber to accept that he/she is using antibiotics "badly" when he can point to the majority of his infections responding well--either to the antibiotic or the patient's own immune response. Many attempts have been made to limit antibiotic use by selective laboratory reporting, by restricting the antibiotics available, by producing guidelines for initial therapy of infection or prophylaxis, by involvement of infectious disease specialists in all antibiotic use and by several other systems. It appears, however, that antibiotic use is still heavily criticised and is a continuing source of conflict in medicine. Consensus on antibiotic indications is still difficult to obtain and is likely to be achieved very slowly. It is clear that polemic is not sufficient and that consensus practices can only be based upon firm scientifically acquired data and detailed discussion of the options by those most intimately involved.