"I’ve seen resistance patterns change, such that
antibiotics that were effective only years ago are
no longer good choices."
Peter Currie, MD
Emergency Physician, Emergency Physicians Professional Association
How does your work involve antibiotic use?
As an Emergency Physician, I prescribe antibiotics on a daily basis for routine and complex infections.
From your perspective, what is most challenging about antibiotic prescribing and stewardship?
The most challenging thing is balancing many competing interests. In the Emergency Department, we need to make decisions often based on limited information and in a timely manner. Additionally, educating patients about antibiotics, and the issues around their use, is time-consuming; many patients start with preconceived notions based on how they’ve been treated in the past which may not reflect current realities or practices.
What is your professional experience with antibiotic resistance?
Even in my career, I’ve seen resistance patterns change, such that antibiotics that were effective only years ago are no longer good choices. It’s incredible, and a bit disconcerting, to actually “see” it happening.
How has antibiotic resistance or antibiotic use affected your work?
It has made antibiotic selection for our most complex patients, those with serious infections, and many other medical illnesses, more challenging. Even for patients with simple, common infections, other factors like pregnancy, allergies, and side effects, compound the complexity of antibiotic selection. We work closely with a clinical pharmacist for help with the difficult cases.
What worries you most about antibiotic resistance as a clinician and person?
Of course, the worst case scenario is a common infection that causes significant harm and for which we might no longer have an effective antibiotic. This has seemed far-fetched, but as the development of resistance seems to be out-pacing the development of new antibiotics, it seems more and more realistic.
What would you like to know more about in regard to antimicrobial resistance and/or antibiotic use?
My sense is that even with greater scrutiny and care, we still prescribe antibiotics too often. So a greater understanding of which conditions benefit from antibiotics, and specifics like how much and how long and how often, could really help us focus our antibiotic use on those patients and conditions that truly benefit, while limiting harm to those who don’t.
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