Consider benefits versus harms of antimicrobial therapy
All antimicrobials can cause adverse effects, so consider the benefit–harm profile when deciding whether to prescribe an antimicrobial. Adverse effects are usually minor or self-limiting but serious adverse effects, including death, do occur rarely. Adverse effects of antimicrobials can be classified as direct and indirect.
When prescribing, discuss the benefits and harms of antimicrobial therapy with the patient. The benefits vary depending on the infection; for guidance on explaining the harms, see Explaining the harms of antimicrobial therapy.
Antimicrobials disrupt the balance of bacteria in the body (the microbiome). While the consequences of this are not fully understood, it can cause problems ranging from mild yeast infections (eg thrush) through to more serious infections (eg Clostridioides difficile).
Antimicrobials can also cause bacteria to become resistant to treatment so that future infections are harder to treat. Multidrug-resistant bacteria (known as ‘superbugs’) can spread between people, affecting other family members and the community.