“The Whole Picture”

For the clinical microbiologists and ID physicians….

It might be the most susceptible antibiotic on the report but the child will only take syrup and not tablets.

It might be the most susceptible antibiotic on the report but there is little chance that this patient will take antibiotics four times a day.

It might be the most susceptible antibiotic on the report but it tastes horrible. Is this patient likely to stomach it?

It might be the most susceptible antibiotic on the report but it causes diarrhoea in a good proportion of patients. Will this patient “run” with it?

It might be the most susceptible antibiotic on the report but this patient swears by another antibiotic.

These are only a few of the things that should be considered when individualising treatment. Advising on the best antibiotic is not just about looking at the report and looking for the most susceptible antibiotic available. It is about “What antibiotic is most likely to work best in this particular patient?”. Getting good at this sort of decision making takes time and experience and a good deal of background knowledge, not all of which can be learned from textbooks. We certainly don’t always get these decisions right.

Michael

 

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