Antibiotics and human behavior

Last week I blogged about stubbornly irrational use of antibiotics for acute bronchitis. Then this arrived in my inbox from a TIE reader:

I know anecdotes are not data, but a number of years ago, I was diagnosed with acute bronchitis and given antibiotics which worked wonders.  I’d had a cold, which I had started to recover from, then I got worse, to the point where sitting up for a few hours seemed too exhausting. The doctor explained that I’d probably had a viral infection which had been the cold.  That allowed a bacterial infection to set in.  Within an hour of the first antibiotic, I was feeling much better, no longer lying on the couch, too tired to read.  After two doses, I was back on my feet.

I’m perfectly willing to believe that antibiotics are over-prescribed, but that the prescription rate should be zero? Nope.

In the JAMA article, the second sentence was:

For more than 40 years, trials have shown that antibiotics are not effective for acute bronchitis.1

Endnote 1 is to a 2014 Cochrane Review by Smith, Fahey, Smucny and Becker. Go read it and see if you think the evidence supports antibiotic use for acute bronchitis.

Which brings me back to the comment from the TIE reader. By definition, they are interested in evidence-based health policy. I assume lots of education and relevant experience. And yet –

So here’s my question: how do we close this gap between clear research and human behavior with antibiotics?

Since we don’t accept comments, please discuss on Twitter #saveABX



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