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Misuse of Antibiotics

Antibiotics Misuse Case 1

Debbie is a 40-year-old white female who was seen in a physician's office in the month of December (during "flu" season) for presenting symptoms of a cough and fever.  She insisted the physician give her something for this cough and suggested an antibiotic.  The physician prescribed the antibiotic Amoxicillin and told her to return if she didn't get better.  She returned to the physician's office the next day and presented with a rash that was diagnosed as a drug-induced rash related to the antibiotic.  She was still coughing and had a slight fever.  He switched the antibiotic to an oral Cephalosporin.  After a few days, she called and said that she was not much better.  The antibiotic was again changed.  The physician prescribed Erythromycin.

Approximately two weeks later, she presented to the hospital with signs and symptoms of enterocolitis and was diagnosed with Clostridium difficile pseudomembranous colitis.  Clostridium difficile is often found in the intestine, but does not usually cause disease because other organisms in the bowel keep it in check.  However, if one reduces the normal flora, it overgrows and causes a severe enterocolitis.

This patient died from these complications.  All she had in the beginning was a mild case of influenza!