Clinical choices of antibiotics: judging judicious use.

Scientific literature widely documents the current overuse of antibiotics but often does not address the issue of the judicious use of antibiotics. Multiple analyses of prescribing patterns consistently reveal inappropriate prescribing of antibiotics, even when the clinician is aware of appropriate antibiotic use. In addition to overprescribing antibiotics, providers frequently address therapy failures by switching to same-class antibiotic agents. Additional investigations report that prescribing of antibiotics at the first office visit tends to increase, rather than decrease, costs and has marginal impact on patient outcomes. Patient education interventions, delivered prior to illness, can significantly reduce inappropriate use of antibiotics and reverse resistance trends. A variety of developments in antimicrobial use and resistance and newer antibiotic and respiratory infection management strategies are discussed.