Letters

Choosing the right antibiotic

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7214.919a (Published 02 October 1999) Cite this as: BMJ 1999;319:919

Right drug at right time in right dose saves lives

  1. David Bihari, associate professor (dbihari@enternet.com.au)
  1. Intensive Care Unit, St George Hospital, Sydney NSW 2217
  2. Department of Microbiology, General Infirmary and University of Leeds, Leeds LS1 3EX

    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 …

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