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- W69008034 abstract "Editor—Leibovici et al make a fundamental point about the prescription of antimicrobial drugs—the right antibiotic at the right time saves lives1—and we should not forget it. Yet as the various commentators point out, it is not always easy to choose the right antimicrobial since we know that all drugs have side effects, some are expensive, and some are more poisonous than others.In intensive care, many patients present with septic shock, and we usually only get “one bite” at the cherry. I try to teach our residents a few of the “see-saw” principles of antimicrobial prescribing that I have learnt along the way.Firstly, the right drug in the right dose (big) at the right time does save lives. Surprisingly to some, antibiotics do work and you need to get it right from the start. Secondly, there is not much point in saving your “best” antibiotic for the postmortem room. Next, we treat patients, not fevers, white cell counts, chest radiographs, or cultures. But on the other hand, just because the laboratory cannot grow something does not mean that there are no germs there causing trouble. And it does not mean that you should not consult them. You should. Finally, try to avoid poisoning the patient but always remember (and keep telling the managers) that saving lives costs money. There is nothing cheaper than a quick death." @default.
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- W69008034 date "1999-10-02" @default.
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- W69008034 title "Choosing the right antibiotic" @default.
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- W69008034 doi "https://doi.org/10.1136/bmj.319.7214.919a" @default.
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