Antibiotic prophylaxis: reasoned choice and not casual use.

Editorial Medical and dental practitioners are going through difficult years in which litigation is frequent, because of complications related to treatment vs non treatment decision as well as to each treatment option vs any others possible. This is also true as far as antibiotic prophylaxis is concerned, so litigation may arise due to surgical or distant site infections subsequent to interventions carried out without preventive antibiotic treatment as well as from any kind of adverse reactions against the prescribed antibiotic. However, law is inclined to ascribe professional guilt to antibiotic treatment failure without evaluating the overtreatment risks whose consequences will occur most likely un-indicated in the future. Therefore , no legal problems arise from the two most important negative effects of the not ruled and excessive use or abuse of antibiotics, that is microbial resistance firstly and allergy secondly. Some observations have to be made in this regard. People are used to self-prescription and they often do not stick to the physician's and dentist's prescriptions as far as antibiotic type, dosage and timing are concerned. Household medicine chests are full of many, and often expired, drugs among which and above all antibiotics. As soon as a mild in-flammatory symptom appears (slight fever, cough) people take antibiotics often without any indications and in a non-effective way. This is a wrong approach in health care due to disinformation, bad habits, disease phobia, lack of time and money for medical and dental consultations, unavailability of medical and dental practitioners, possibility to buy such drugs without specialist's prescription and availability of drugs at home. The latter is often due to the fact that pharmaceutical companies do not manufacture and sell antibiotic packaging for prophylactic use, therefore patients are forced to buy the usual antibiotic packaging, which is for therapeutic use, and contains more tablets than those necessary for prophylactic use. Physicians and dentists are also responsible for this situation since they do not update their specific knowledge on prophylactic antibiotic treatment and thus their approach is due to force of habit, they use an excess of zeal and they usually apply the concept that " melius abunda-re quam deficere " or " a little bit of antibiotics cannot harm anyone ". In the light of the above-mentioned considerations, an effective antibiotic policy is therefore necessary to avoid inappropriate use or abuse of antibiotics. In recent years an attempt to regulate prophylactic antibiotic use has …