I am sure patients will be thinking -how does a doctor decide treatment?
Is it a standard protocol for everyone or its doctor's favourite drug .....so on.
Actually things have changed for the past few decades.
When I was training to become a doctor the choice of antibiotics was limited or shall i say the bugs were limited.Now the bacteria are changing ,the lifestyle is changing & the way we treat is changing.
The practice is more evidence based now.For example ,there is a X & Y drug which should be First line prescription for sinusitis.We should keep in mind the duration of taking it & NOT to stop half way-this leads to resistance.
If a particular patient does not respond to this X or Y drug,it is important for the doctor to look into complaince & associated factors -like treating allergies in a case of sinusitis.
If still symptoms persist -instead of blindly changing antibiotic-your doctor may consider a local swab from the nostrils or back of oral cavity[pus from sinus drips in throat].This swab may grow some bug & it will be worthwhile to treat accordingly.Of course if this exercise fails -we go to Second line drugs.
Its a step by step approach.This needs good communication & understanding between patient & doctor.The doctor has to keep him/herself uptodate with latest evidence based medicine.
Experience definitely counts for the rare cases.Most of the routine work requires evidence based approach.
Is it a standard protocol for everyone or its doctor's favourite drug .....so on.
Actually things have changed for the past few decades.
When I was training to become a doctor the choice of antibiotics was limited or shall i say the bugs were limited.Now the bacteria are changing ,the lifestyle is changing & the way we treat is changing.
The practice is more evidence based now.For example ,there is a X & Y drug which should be First line prescription for sinusitis.We should keep in mind the duration of taking it & NOT to stop half way-this leads to resistance.
If a particular patient does not respond to this X or Y drug,it is important for the doctor to look into complaince & associated factors -like treating allergies in a case of sinusitis.
If still symptoms persist -instead of blindly changing antibiotic-your doctor may consider a local swab from the nostrils or back of oral cavity[pus from sinus drips in throat].This swab may grow some bug & it will be worthwhile to treat accordingly.Of course if this exercise fails -we go to Second line drugs.
Its a step by step approach.This needs good communication & understanding between patient & doctor.The doctor has to keep him/herself uptodate with latest evidence based medicine.
Experience definitely counts for the rare cases.Most of the routine work requires evidence based approach.
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