The Responsible Use of Antibiotics

I write often about irresponsible antibiotic use. But I want to make one thing clear: antibiotics are critical, life-saving and health-improving drugs. In the U.S., every year roughly two million people contract hospital-acquired infections (this ignores infections contracted outside the hospital). Roughly 96% don't die. Antibiotics are a major reason, if not the major reason, for why the mortality rate is so low. I'm pointing out the obvious because of an email I received (I've 'de-identified' all of the personal information):

hi, mike. i've been reading your blog on triclosan and products containing triclosan. i had extensive surgery for necrotizing fasciitis in [date removed]. the doctors did a fascitectomy from my [side] hip down into the [same side] groin area to remove the diseased tissue. my surgeon told me to use an antibacterial shower/bath soap all the time after that. from what i've read, i guess i shouldn't be using any antibacterial soaps. makes sense to me now why lever quit making their brand of antibacterial shower soap.

will be checking in on your blog again.

[name removed]

First, I'm glad this person emailed me (I really do read the comments and your emails, even if I can't respond). I've discussed the misuse of triclosan before. But there is a proper use, which I've always stated: in clinical settings (e.g., hospitals), and among those at high risk for infection. That's why we shouldn't misuse triclosan.

Do doctors make mistakes? Sure. Are some not up to date regarding antibiotic use. Yep. But for every Lorenzo's Oil, there are a lot more tragedies where someone tries to 'outthink' a trained, medical professional (several of the doctors--and others--around here write about this often). If you have had major surgery as a result of an infection, and your doctor tells you to take antibiotics or to use triclosan in order to prevent another infection, please do it. You definitely fall into a high risk group. If you want to stop, speak to your doctor first. Your doctor may not always know best, but he or she probably knows better than you do.

A related point: Always take the full recommended course: by failing to do so, you increase the probability that resistant bacteria will evolve.