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Dr. Paul Smolen has been practicing pediatrics for 32 years as an attending physician at Carolinas Medical Center, an Adjunct Associate Professor at the University of North Carolina School of Medicine-Chapel Hill, and a private practitioner. To learn more about Dr. Smolen, click here


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Cutting Down Antibiotic Use (Article)



Overuse of antibiotics has been a source of worry for both health care professionals and patients for some time. Antibiotics, such as penicillin, help a child’s body destroy or slow down the growth of disease causing bacteria. When you or your child has an infection, whether through ingestion of contaminated food or an infection of an open wound, an antibiotic can be lifesaving. Have you ever wondered why you cannot buy antibiotics over the counter, without a prescription? The answer to that question is simple. Even if you were smart enough to know which one to buy, this practice would undoubtedly lead to even greater overuse of antibiotics with all of it’s attendant consequences;  gastrointestinal problems, such as diarrhea from C. Diff,  drug to drug interactions in which antibiotics interfere with other treatments, and dangerous antibiotic resistance, such as we are seeing around the globe.


Fortunately, a recent study has demonstrated a simple way to prevent some antibiotic overuse. Previously, patients or parents bought and used antibiotic beyond the date when antibiotic use is to end because they simply overlooked the stop order. With the new intervention, your doctor will not only place an “x” on the stop date but also draw a line through the remainder of the month so that you will follow the doctor’s prescription protocol form. This simple method has had significant reductions in number of days when antibiotic was taken..


By flagging a stop date on a patient’s prescription, doctors have discovered another method of safely reducing antibiotic use.  Longtime followers of my blog will remember articles about the so called “Wait and see” approach to treating ear infections that have previously been shown to significantly reduce antibiotic use in children.  (http://www.docsmo.com/doc-smo-bugs-or-drugs-whos-winning/). When it comes to antibiotics and children, that old saying, “Less is more”, just may be true.  Hopefully, the “ Stop now” approach to writing prescriptions will help keep antibiotic use to a minimum.


Your comments are welcome at www.docsmo.com.  Until next time.


Smo Notes:







Written collaboratively by John Eun and Paul Smolen M.D.



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