Use and Abuse of Antibiotics


Dr Pramod jog    20 January 2017

Here is a mnemonic RATIONALE to fit in some aspects of rational prescribing practices.R: Reasoning behind prescription. This is a 3 step process: Is the fever because of infection or not because of infection? If because of infection, is it viral or bacterial? If bacterial, what is the likely organism? Right dose, route, durationA: Academically updated decisions T: Training of mind (3 Os-Organ, Organism, Option) Training of subordinates (Resident doctors, etc.) Training parents (not to pressurize the doctor) Training chemists (to refrain from selling without valid prescription)I: Instructions to parents (reconstitution, administration, completing the course, not to self-medicate)O: Organism (finding out the causative organism by culture, etc.)N: Noting down the diagnosis (if you clinically diagnose and write provisional diagnosis as viral, your hands should shake while writing an antibiotic) A: Avoiding double standards (writing one in private OPD, using a different one in a general hospital and speaking totally different in conferences) Avoiding irrational combinations Antibiotic PolicyL: Local sensitivity pattern (includes our active efforts and research in office practice)E: Ethical considerations Economic condition of the patientI sincerely hope that this will guide the pediatrician in rational antimicrobial practice and translate into each one of us applying in our day-to-day practice.

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