What to say when antibiotics are unnecessary

Deciding when an antibiotic prescription is unnecessary is often easier than the conversation that follows. Lianne Holloway, MD, of Salem, Ore., has developed an effective way of explaining these decisions to even her most persistent patients. She writes, “If I am absolutely certain they do not need an antibiotic, I first reassure them that their own body is going to be able to take care of this illness and that they will be fine by next week. I even offer medication to relieve their symptoms. For patients who are still determined to receive an antibiotic, I then explain that, by avoiding an unnecessary antibiotic, they do not have to worry about getting antibiotic-associated diarrhea or developing antibiotic-resistant organisms that can hurt them later. If they continue to protest, I emphasize that, based on my medical knowledge, I truly believe they don't need an antibiotic, and I say, ‘If I give a patient medicine to treat a condition I don't think he or she has, that is kind of like malpractice, isn't it? Neither of us wants me to do that.’ They usually give me a funny look and stop asking.”

What are your tips for talking with patients about antibiotics? Share them in the Comments section below, or read Practice Pearls on other topics in FPM.