Ever since med school I’ve been struck by how much medicine is more art than science. Dosing and treatment durations have always seemed so surprisingly variable and squishy between doctors… even within doctors (me in particular).
When I work in ERs I typically dose high and long when it comes to antibiotics, because I know I’m unlikely to get follow up for every sore throat or UTI. I also know that patients often struggle to get appointments for follow up if symptoms return. And we all hate “bounce backs.” So there is some logic to the madness.
On the other hand, with Pre-R I’m empowered to use smaller hammers. I get follow up until patients say they’re better. And I advise patients to take antibiotics for only 2-3 more days beyond their symptoms.
Browbeating patients to take their antibiotics for the “full course” no matter what has always felt flakey to me, especially for folks who get better after day one of a 10 day Rx. The following article “The antibiotic course has had its day” confirms a hunch.
To those of you like me with unused antibiotics on your shelves, you are forgiven.