Antibiotics: less is more

Well, in the context of writing not one but TWO prescriptions for antibiotics in the last 24 hours (long-time readers will recall that I am a fanatic about the overuse of antibiotics and I write for them very rarely)

This time, I had a reason.

Our local version of the pertussis outbreak has become signifiant.  With 21 confirmed cases in a high school about 4 miles from our office, I treated a coughing student from that school this morning after consultation with the health department.   But last night's customer was a textbook case.  The PCR's will be back in a few days. We'll see.

In realted news …

This study in JAMA confirms that a shorter duration of antibiotics may be better in the ICU:

  • CONTEXT: The optimal duration of antimicrobial treatment for ventilator-associated pneumonia (VAP) is unknown.
  • Shortening the length of treatment may help to contain the emergence of multiresistant bacteria in the intensive care unit (ICU).
  • RESULTS: Compared with patients treated for 15 days, those treated for 8 days had neither excess mortality (18.8% vs 17.2%; difference, 1.6%; 90% confidence interval [CI], -3.7% to 6