Blog | Friday, December 16, 2016

Antibiotics and principles for best use

As physicians we worry about antibiotic resistance. Slowly, we understand that we can help slow down the development of more resistance through excellent antibiotic stewardship. Even Time has highlighted this problem.

I was discussant in a PCORI sponsored workshop for this topic:

Smarter, More Appropriate Use of Antibiotics

Moderator: Kara Walker, MD, MPH

Speakers: Carey Bickford, Jeffrey Gerber, MD, PhD, Kathy Goggin, PhD, Dan Merenstein, MD

Discussant: Robert Centor, MD, MACP

How can we use antibiotics more intelligently? I hope some of you will watch and listen to the discussion.

Antibiotic resistance is a growing public health concern in the US. My online panel on this topic was on Nov. 18 at

I discussed 4 issues:
1. Giving antibiotics when we have no evidence that they will help
2. Using narrow spectrum antibiotics when indicated
3. Using shorter durations when indicated
4. De-escalating antibiotics after culture or PCR results become available

I believe this was a useful discussion. We have a responsibility to become smarter in our antibiotic prescribing.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.