Dear TSW Nation,
This month (meaning next month, but it already feels like December around here), we are donating this space to Quizzify, where we are reposting Quizzify’s Greatest Hits of their Six Things Employees Need to Know series. One a weekday for the next month, interrupted only by our annual awards.
As an alphabetical coincidence, we’ll be starting with Six Things Employees Need to Know about Antibiotics.
Antibiotics are America’s most overused prescription non-opioid. Here’s what your employees should know about them. [SPOILER ALERT: They don’t.]
(1) Do not demand an antibiotic if one is not offered
Americans get enough antibiotics without asking for more. Official statistics show that half of all antibiotics are the wrong dose, wrong duration, or wrong drug – including a quarter that should not have been prescribed at all.
My personal tally is probably 75% wrong, in one way or another, as in this harrowing example, one of the highlights of which is a dentist asking me; “So, what’s your favorite antibiotic?
There is nothing, nothing in Quizzify, that suggests the correct way to prescribe an antibiotic is to ask your patient what their “favorite” is. Quite the opposite, taking the same antibiotic multiple times is a good way to create antibiotic resistance.
Alexander Fleming himself predicted the rise of antibiotic resistance by using the same antibiotic repeatedly.
(2) Some specialties are worse offenders than others
Pediatricians often immediately prescribe these for earaches, when the best evidence clearly says this choice should be far from automatic.
Urgent care is the worst, with almost 50% overuse for respiratory issues. ERs, for all their faults in the billing department, seem to be much more responsible in this respect, with “only” 25% inappropriate.
Dentists, with Exhibit A being my former one as noted above, are major overprescribers. With a few exceptions, of course.
And if a telemedicine doctor prescribes one, consider this: how can they possibly be sure you have a bacterial infection? There’s no in-person exam and no culture. You guessed it – they are also major overprescribers.
(3) If an antibiotic is proposed, ask some questions
“Are you sure this is a bacterial infection?” is the best. If you get an answer like: “This is just to be safe,” or something similar, your best bet may be to get the prescription, but maybe only fill it once the culture is completed and is positive for bacteria. Or maybe whatever you have will go away on its own. Or ask (and call back if needed) what new symptoms might lead the doctor to think this is bacterial, and start taking the antibiotic then.
There is also a decent chance that whatever antibiotic the doctor guesses at before the culture is completed is the wrong one. Or is an overly powerful “broad spectrum” antibiotic when the culture reveals a specific organism that should be targeted.
(4) “Finish your entire course even if you are feeling better” is an urban legend
The one thing drilled into us when we are prescribed an antibiotic is that stopping early gives the hardier bacteria a chance to rebound.