What rhinologists and allergists should know about the medico-legal implications of antibiotic use: A review of the literature

Background: Antibiotics are commonly used in the management of both acute rhinosinusitis and acute exacerbations of chronic rhinosinusitis. With their common use, they have become the leading medication for litigation. It is crucial for the provider to be familiar with potential complications and the medico-legal ramifications of their use. The objectives of this review were to outline the existing data of the medico-legal implications of prescribing oral antibiotics. Methods: An OVID search of the following terms was performed: antibiotics or antibacterial agents AND medico-legal, malpractice, jurisprudence, or informed consent. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance. Results: An OVID search identified 272 articles. This search was then narrowed, resulting in 13 articles that were relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Antibiotics were the most common medication associated with litigation. Allergic reaction was the single most common reason for litigation. Conclusion: Lawsuits associated with medications are disproportionately costly and antibiotics are the most common type of medication to result in litigation. Although the use of electronic medical records (EMRs) may decrease the frequency of these lawsuits, it is up to the physician to be familiar with the agents prescribed, their risks, and be vigilant regarding possible reactions.