It’s Still Hard to Know When Kids Need Antibiotics

This is largely a philosophical issue, complicated by the tendency of doctors to lie about the reasons underlying their recommendations. It is in society's best interests to limit antibiotic usage. There is little evidence that the traditional practice of giving a child an antibiotic "just in case" ever is counter to the child's best interests, as opposed to the interests of society as a whole and perhaps the insurance company paying for the drug. I would guess that working adults who will miss days on their job if they don't get better quickly are far more likely to get antibiotics right away than a similarly situated stay at home mom, retiree, or child. Usually, in my experience, when the doctor wants to withhold antibiotics, he comes into the examining room and announces that the problem is viral not bacterial. Not once did said doctor have the lab data or a believable clinical rationale for that announcement.

Most parents I know routinely swap stories of how to lie to the doctor to get antibiotics. It is simple self defense against the doctors that are too immature to tell the truth when they withhold them, namely: "Mrs. Smith, I am not giving little Amanda antibiotics today because I would rather see her suffer for a couple of days extra because the needs of society are more important than her little needs, and anyway she's too little to challenge me, and you're too wimpy to tell me I'm violating my medical oath by failing to put patient needs first, so who cares."

Jeff of CA 5:15PM August 26, 2009