Part of the allure of infectious diseases, in addition to the pleasurably long hours, is the dynamic nature of the specialty. The infectious diseases literature is replete with new revelations and paradigm shifts in diagnosis and management.Here is an excellent update from the American College of Physicians on clinical infectious diseases.
The topics include, sinusitis, azithromycin drug toxicity, and the management of asymptomatic bacteriuria in women with recurrent urinary tract infections.
The underlying theme: stop prescribing so many antibiotics as outcomes are not improved (sinusitis and asymptomatic bacteriuria) and as there is a risk of harm (increased risk of cardiac death with azithromycin for patients with underlying cardiac disease).
For the conditions above, changing clinical practice may be tough. For many, the urge to reach for the prescription pad is strong and difficult to contain. Patients expect an antibiotic for many common, non-life threatening infections, despite the absence of proven benefit. This is a dangerous mix.
Less is more. Exciting times!
