A Better Medicine

“My doctor gives me Bactrim to take whenever I get another infection, and I need more.”

Antibiotic requests are good news to some hotel doctors who know that, provided they go along, the guest will happily hand over the fee. An easy visit.

When I see these patients and do my best and don’t prescribe an antibiotic if they don’t need one (usually the case), most are grateful, but a minority aren’t. It’s not a small minority, and I hate driving off to what might be an unpleasant encounter.

Hearing this request I go into “no-housecall” mode, perhaps mentioning that the illness is self-limited and doesn’t require medical attention or directing the guest to an urgent-care clinic. I don’t want to see them.

But I gave this lady her Bactrim.

There is a single exception to the rule that healthy patients are wrong when they decide that they need an antibiotic: the common, uncomplicated urinary tract infection. In fact, it’s OK to prescribe over the phone. Scientific studies show that this works as well as an office visit.