Wells Shoemaker is a pediatrician in a small California town. Not too long ago he saw a patient new to the area, a little boy with a runny nose. "It's the same story every time," his mother complained. "He starts out with a cold, and then his nose starts running green stuff, and then he gets an ear infection. He's only two years old, and he's already had four ear infections."
Shoemaker examined the child. He had a cold, all right, but his nasal fluid was clear, and he had no fever or bulging eardrums. No hint of an ear infection or any other bacterial attack. As Shoemaker offered his diagnosis, the mother interrupted: "The only thing that keeps him from getting an ear infection is antibiotics. My previous doctor used to give him antibiotics at the beginning of a cold. They worked great!"
"Antibiotics fight bacteria," Shoemaker explained. "Your son's cold is caused by a virus. He doesn't have an ear infection. But let's keep close tabs, and if he does begin to develop an infection, then we can turn to an antibiotic."
"But sometimes the doctor just prescribed them over the phone."
"Well, an antibiotic might prevent an infection, but it might not. It could even make way for a more aggressive germ that might cause an ear infection from hell. Then we'd have to resort to very, very powerful drugs with unpleasant side effects that have to be given by injection."
