{"id":1186,"date":"2010-11-17T09:30:39","date_gmt":"2010-11-17T14:30:39","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=1186"},"modified":"2015-06-04T15:24:24","modified_gmt":"2015-06-04T19:24:24","slug":"ferlater-antibiotics","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/ferlater-antibiotics\/2010\/11\/17\/","title":{"rendered":"Ferlater Antibiotics"},"content":{"rendered":"

\"danish\"In this absolutely hysterical, laugh-out-loud comedy routine<\/a>, Mal Z. Lawrence describes a woman at a Catskill hotel, piling danish into her handbag.<\/p>\n

She calls them “ferlater danish” — as opposed to the ones she’s eating at breakfast, those are “fernow.”<\/p>\n

Did you ever have one of your patients request “ferlater” antibiotics? \u00a0That is, ask that you write a prescription for an antibiotic even though they’re not sick now, just in case they become <\/em>sick?<\/p>\n

Over at the “The Ethicist”<\/a> column this week in the Sunday\u00a0New York Times<\/em>, Randy Cohen<\/a> fields a question from a woman whose husband has just developed pneumonia on a trip to Peru, even though he’d requested (and had been refused) antibiotics from his doctor before he left. \u00a0“Was the doctor overly rigid?” asks the woman. \u00a0Responds Cohen:<\/p>\n

This doctor does seem disturbingly conservative… \u00a0So, yes, I\u2019m with you, and so is Dr. Jane O\u2019Shaughnessy, an expert in emergency medicine, who e-mailed me to say, \u201cPrescribing antibiotics and other medications tailored to the trip destination is usual practice among doctors who specialize in travel medicine.\u201d<\/p><\/blockquote>\n

On first glance, this seems right, especially since the man had a history of recurrent respiratory tract infections.<\/p>\n

But Mr. Cohen and Dr. O’Shaughnessy should know it’s not always quite so simple. \u00a0First, travel medicine and ID \u00a0specialists — and I wonder why Cohen asked an ER doc rather than go right to the source — recommend providing antibiotics before trips to developing countries in case diarrhea develops, but not in general for respiratory tract infections, most of which are viral anyway.<\/p>\n

Second, let’s say he did get the antibiotics — would this have necessarily prevented the pneumonia? \u00a0Who’s to say?<\/p>\n

Third, it’s important that Times<\/em> readers know just how often clinicians get asked for “ferlater” antibiotics, usually with far less justification than in the anecdote presented in the Times.<\/em><\/p>\n

And rather than displaying excess rigidity, doctors and nurses who say no to this request are generally acting with very sound judgment.<\/p>\n

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In this absolutely hysterical, laugh-out-loud comedy routine, Mal Z. Lawrence describes a woman at a Catskill hotel, piling danish into her handbag. She calls them “ferlater danish” — as opposed to the ones she’s eating at breakfast, those are “fernow.” Did you ever have one of your patients request “ferlater” antibiotics? \u00a0That is, ask that […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[72,942],"class_list":["post-1186","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","tag-antibiotics","tag-travel-medicine"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1186","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=1186"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1186\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=1186"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=1186"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=1186"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}