The Curbsiders Internal Medicine Podcast

#284 An Antibiotics Primer with @IDdocAdi

Jul 12, 2021
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ADVICE

Five Questions Before Starting Antibiotics

  • Ask five questions before starting antibiotics: is it infectious, do I have time, are tests needed, what's the site, and is source control required.
  • Use those answers to avoid reflexive broad-spectrum starts and guide targeted therapy.
ADVICE

Use Broad Antibiotic Buckets

  • Group antibiotics mentally: beta-lactams, anti-MRSA agents, tetracyclines, fluoroquinolones, and others to simplify choices.
  • Use the group properties (e.g., beta-lactams for many typicals, doxy for atypicals) when selecting empiric therapy.
ADVICE

Don't Forget Old Penicillin Uses

  • Use plain penicillin for streptococcal infections like strep throat and for syphilis when appropriate.
  • Don't assume older agents are obsolete; match drug to organism and syndrome.
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