Antibiotics, Sensible Use; Injudicious Overuse

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It's easier to prescribe antibiotics in a cold, sinsitis or bronchitis than to explain why not. (It takes less time, it's expected, it's someone else's money and diagnostic confusion from partial or inappropriate treatment will likely be someone else's problem.)

Advisory

"If you're suffering from a cold, the flu, or another virus, there are things you can do to help relieve the symptoms, but taking antibiotics will not help. Antibiotics only treat bacterial infections, such as strep throat.

Antibiotic resistance is a serious public health problem that is primarily being caused by the repeated and improper use of antibiotics.

You can help prevent antibiotic resistance by taking these actions:

Don't take antibiotics for viral infections, such as colds or the flu.
If you are prescribed antibiotics for a bacterial infection, take the full course of treatment even if you begin to feel better after a few days.
If you need to stop taking a course of antibiotics for some reason, discard leftover medication--do not save it for a future illness.
Do not take antibiotics prescribed for someone else.
If your healthcare provider determines that you do not have a bacterial infection, ask about ways to relieve your symptoms. Don't pressure your provider to prescribe antibiotics."

Source: USA.gov.

What's wrong with giving antibiotics, 'just in case,' or because the patient will go elsewhere until they get them? Antibiotic resistance; it may be the number one problem facing the medical community, according to several major medical organizations or associations. "Since 2000, two new classes of antibiotics have been approved for use, compared with none between 1970 and 2000, and 10 between 1930 and 1960." Practitioners may not have "effective antibiotics to treat all patients in the future.

According to Ron Dagan, MD, director of the pediatric infectious disease unit at Soroka Medical Center in Beer-Sheva, Israel “Pediatricians are still using antibiotics much beyond what is needed, and they must remember that some are worse than others at driving resistance." Among the worst is Azithromycin, which is a "very popular drug because it is long acting. It can be given in three doses, sometimes maybe even one dose, to get rid of the susceptible organism, so a lot of pediatricians use it for almost everything. Cephalosporins are another offender, while amoxicillin and amoxicillin clavulanate have much less of an effect on antibiotic pressure.

The “ESKAPE” pathogens (per the Infectious Diseases Society of America) cause the most U.S. hospital-associated infections and are resistant to many antibacterial drugs:

Enterococcus faecium.
Staphylococcus aureus.
Klebsiella pneumoniae.
Acinetobacter baumannii.
Pseudomonas aeruginosa.
Enterobacter species.

Of these. MRSA - Methicillin Resistant Staphylococcus Aureus and S. pneumoniae remain the most problematic.

Unfortunately, we are seeing fewer and less effective efforts that promote judicious antibiotic use, in part because the infectious disease specialists, [today] are spending more time on grant writing and lab research with less teaching of junior physicians and minimal patient care.”