"The trouble with being a hypochondriac these days is that the antibiotics have cured all the good diseases."
- Caskie Stinnet
Prescribing antibiotics is one of the most basic things a physician does... which is why it's so embarrassing when I am often unsure what to give for certain infections. Now I can memorize a few protocols for acute devastating infections or throw a Z-pack at every respiratory complaint I see, but it wouldn't be good medicine. We need to focus our antibiotic treatment to the narrowest effective coverage.
However, doing this is not an easy task. There's a lot to think about:
- What bacteria are common for this infection?
- Do we need to cover for the uncommon causes?
- What antibiotics cover the bacteria we're targeting?
- Does the patient have any allergies to medicines? Sulfa?
- Any renal problems? Side effects? Etc?
Luckily, after doing a rotation in the Infectious Disease department at our hospital I feel a lot more confident on my recommendations. Not necessarily because I inherently know what to prescribe, but rather because of this handy chart. Our attending helped us workout a simple cheat-sheet that I now keep on my phone for easy access. It has undergone a few revisions, and some re-formatting, but I think that it can be a useful aid throughout your rotations/intern year. Here is the full chart:
Check out our other posts in the medical mnemonic series like Atrial Fibrillation and even Laxatives!
How do you decide which antibiotics to use? Let us know in the comments below!