Founder & Medical Director at New York Cosmetic Skin & Laser Surgery Center
Answered 3 months ago
I prescribe antibiotics when they are truly needed, like cellulitis, infected cysts, or select surgical cases. I also see the downside up close. Patients often feel fine until the rash, diarrhea, yeast infection, or severe allergy hits. I found a study of 600 patients where 17.3 percent had potential antibiotic related complications within 90 days. New resistant infection or colonization showed up in 8.0 percent. Control starts with better decisions, not guilt. Confirm bacteria when you can. Use the narrowest drug. Stop at the shortest effective duration. Avoid antibiotics for viral colds and uncomplicated bronchitis. Explain risks in plain language before the first pill. Simple follow up helps too. Many people only learn after harm is done.
One of the biggest problems with antimicrobial resistance is that patients don't see the consequences until it's too late. In practice, I regularly see patients who expect antibiotics for conditions that don't need them, believing they're harmless. I've treated patients who had taken multiple courses of antibiotics over the years "just in case," only to later develop infections that responded poorly to standard medications. When that happens, treatment becomes more complicated, more expensive, and carries higher risk. The side effects people worry about—stomach upset or allergies—are minor compared to the real danger: bacteria that no longer respond to first-line antibiotics. By the time resistance becomes obvious, options are already limited. Responsible antibiotic use isn't about withholding care—it's about protecting patients now and in the future. Every unnecessary prescription increases resistance, and once it develops, we can't undo it.