Three common reasons for prescribing antibiotics are fever, sore throat and diarrhea. Drugs are most
often prescribed unnecessarily. Viruses are more abundant, and these conditions are also most often
due to the viral infections and antibacterials have no role to play in their management. Use of
antibacterials in non-bacterial illness results only in the destruction of susceptible bacteria and
selective proliferation of resistant bacteria, thus aiding the propagation of bacterial drug resistance.
Fever:
It is a manifestation of hundreds of diseases, infective and non-infective. Antibiotics do not have any
beneficial effects in cases of fever due to non-bacterial causes. Self-limiting viral infections are the
commonest infectious causes for fever and antibacterials have no role to play in their management,
neither do they shorten the duration of the illness nor do they "prevent secondary infections".
Premature, presumptive and indiscriminate use of antibiotics in all cases of fever adds to the cost of
therapy, adverse effects (ampicillin rash in infectious mononucleosis being a classic example!), development
of drug resistance and may mask the signs of bacterial infection, making a proper diagnosis difficult. The
urge to prescribe antibiotics in all cases of fever should be reconsidered. Attempts should be made to
localize the site and type of the infection. Empirical antibacterial therapy should be reserved only for emergencies.
|
