Stop giving antibiotics for the common cold. (Stand Your Ground, Expert Says).(Brief Article)

ORLANDO, FLA. -- Pediatricians face numerous pressures to simply write out yet another antibiotic prescription, rather than stand their ground.

But if enough pediatricians stand their ground enough of the time, they could make dramatic reductions in unnecessary antibiotic use, Dr. Richard Jacobs said at a pediatric conference sponsored by Orlando Regional Healthcare.

"We could stop up to 22 million antibiotic prescriptions if we just stopped giving antibiotics for the common cold," said Dr. Jacobs, Horace C. Cabe Professor of Pediatrics and chief of pediatric infectious diseases at the University of Arkansas, Little Rock.

He acknowledged that there are many pressures to prescribe unnecessary antibiotics, ranging from anxious parents to day care policies to time restraints.

"I know we are all strapped for time, and it's quicker to write out a prescription. But if I spend an extra minute--60 seconds is all it takes--to explain why I am not giving an antibiotic, it works," he said. This often lays the groundwork for a much easier rapport the next time the patient returns with the same request.

But in addition to sidestepping the outside pressures to prescribe, physicians must also negotiate their own internal dilemmas about when antibiotics are called for and when they are not, Dr. Jacobs noted.

"It's not always dear to the physician when the patient has, for example, acute otitis media, compared with otitis media with effusion. And even if you determine that it is a bacterial infection you are dealing with, it's not always that dear how much an antibiotic will help," he said.