Antibiotic Use-Changing Paradigms

摘要

Most antibiotics consumed in the United States are prescribed for respiratory tract infections (RTIs), including pneumonia, bronchitis, acute exacerbations of chronic bronchitis, sinusitis, and otitis media. This finding suggests that review of antibiotic use in these arenas is an appropriate starting place for identifying ways in which to maximize the cost-benefit ratio of these medications.It has long been acknowledged that when it conies to common infections, physicians may have a tendency to use an antibiotic even when there is a very low likelihood of bacterial infection. A number of factors contribute to this phenomenon, including limitations on time, the costs of a full diagnostic workup, and patient expectations. It is clear, however, that in some instances the etiology of common infections is not bacterial (Fig. 1). The remainder of this article examines issues surrounding the optimal use of antibiotics in infections frequently treated in primary care settings.