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Dr Shapiro completed his undergraduate education at UC San Diego earning a B S in Biochemistry and Cell Biology and a B A in Political Science He furthered his education at UCLA where he earned a Masters Degree in Public…
FAST FACTS
Before I begin my brief rant on the importance of not over-prescribing nor over-using antibiotics, I would like to thank everyone for their responses in my recent blogs. I realize some very strong viewpoints will often emerge, but always appreciative when things stay civil...which for the most part they have been. Granted, this new topic may not generate as much discussion as the recent blogs and certainly one of the more enjoyable parts of sharing my thoughts is hearing yours in response, but the importance of not overusing antibiotics needs to be stressed these days...particularly in the pediatric population.
Why bring this up now? Well, why not. I must admit a recent medical article initially sparked my thoughts in writing this but since we're also moving (although the 100 degree days around here would make it seem so far away) toward the Fall/Winter seasons here in the northern hemisphere where typically more illnesses are to be found, now seemed to be a perfect time to remind you all of the simple fact that antibiotic resistance is a growing concern.
And at least in the pediatric population, there are not many, if any, antibiotics coming down the pipeline in the near future (conspiracy discussion for another time). So it should become clear antibiotic use should only occur when determined to be medically necessarily. Because when we use an antibiotic (meant for treating bacterial infections only) for a simple viral infection (i.e. a simple head cold) and not let the body allow its own immune system ward off the infection or always treat with broad-spectrum antibiotics (meaning it will take care of more than just the bacteria we are concerned with), we are contributing to the development of resistance. And with more resistance, we become more limited with what we can treat with and, well, it should be clear what that means...just look at our current plight with MRSA infections in both the immunocompromised and immunocompetent populations.
So please keep in mind the next time you are in the office of your child's physician or caregiver and an antibiotic is not automatically prescribed, it may be the best thing for your child...both for the short and long-term.
Dr. Jeremy
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EasyM is right, a huge part of the problem is the feedlot and the giving huge amounts of antibiotics to the animals. Not only don’t bacteria know the difference, most people are also eating those animals with the huge amounts of antibiotics in them. Hundreds of tons of antibiotics are given to animals each year just so they aren’t “downer” animals and can be sold for food.
Congress was supposed to act on this, they have something called Preservation of Antibiotics for Medical Treatment Act of 2009 – HR 1549. But like everything else, I haven’t heard of them doing anything about it.
Someone asked about taking antibiotics for the swine flu. NO, flu is a virus and antibiotics only work for bacteria. But sometimes people will get antibiotics when they have the flu if the flu can turn into pneumonia.
Of course, serious illnesses deserve serious solutions, but the prevalence of MRSA and similarly AB-resistant bacteria should be a caution against reliance on antibiotics as the "magic bullets" of medicine. Here in Sydney, there's a proliferation of MRSA in the public health system, which has scared many patients away given the highly negative media coverage of the issue. Hopefully more practitioners will come to realise that the quick-fix isn't always the best one.
I couldn't agree more. My daughter's doctor, as well as mine, (They're in the same practice, but I really like mine, so don't feel inclined to make a change to hers, who is trained in pediatrics, but practicing as a GP.) don't give antibiotics unless they're absolutely necessary. What they do is give you a script and then tell you not to fill it unless things deteriorate or don’t improve.
A couple of times DD has been complaining about her ears and I've taken her to the doctor. He has checked her ears and said that while they were red he felt it was a viral thing and would improve over the next few days, but to use the script for antibiotics if she was still complaining in about 4 days or if she spiked a temp. The same happened to me recently about my sinuses with my doc. I think this is the way to go, at least with people who're informed enough to decide what the words "getting worse" or "not improving" mean. It means you don’t have to make a return trip to the doctor.
BTW, both times my daughter got better without the antibiotics and I have too. So 3 times now doctors from our practice have been spot on in their diagnoses.
Thanks again for your great articles,
C.
Many adults hear the "Doctors Over Prescribe Antibiotics" mantra and then proceed to go to the other end of the spectrum. They do not go to the doctor even though the flu symptoms persist for more than 7 days (one patient had it for three weeks). Then all of a sudden a whole bunch of new symptoms occur and they do go to the doctor.
The only problem, those new symptoms are of a dead heart valve, killed when what started as the flu migrated to the heart.
I have seen similar instances where family insisted on pain meds being given and then once the patient starts having depressed respiration's, they had to be reversed.
Somehow there has to be a balance. It starts with education such as your postings here.
Many countries, practically all of the Central American countries sell antibiotics OTC. Even some of the most used like Cipro, Augmentin, and Zithromax. Of course some of the older ones like pennicilin, the tetracyclines like Vibramycin and the cephalosporins are available. The only ones I haven't seen in my travels are the aminoglycosides for obvious reasons.
The scariest thing about them, horrible side effects not withstanding, is the desensitization of the 'bugs' to the abx's. It makes me very nervous now to have any sort of invasive test done. I've seen too many "trained" lab techs, etc. NOT wash their hands OR wear gloves. When I confronted one, she had the nerve to say it didn't hurt the patient - that it was more for her protection. I got her name and reported her, but I doubt it did any good.
We have to be our own advocates and that's hard a lot of the time because drs (I'm sure not you Dr. J) have a god complex and don't like their patient's input. I give it anyway and if they don't listen, I find a new dr.
Something worth repeating is HAND WASHING - Wash your hands after EVERYTHING! And use REGULAR soap. The abx soaps are a major contributor to the abx-resistant bugs.
Thank you Dr. J for bringing this to the forefront.
When I was a child I fortunately had a good pediatrician who never prescribed antibiotics without serious reason but in the rare occasions I visited other doctors they would prescribe a pack or bottle with the advice to take the whole package even if you feel better.
I recently went to a pharmacist's store while on vacation, recovering from a viral infection. The pharmacist's husband was a doctor and he was in the store at the moment. I asked him to give me something to give me something to sooth my coughing. His immediate response was "antibiotics"!!! He didn't know anything about me, he certainly couldn't examine me, and he certainly didn't care to examine me... I said "No, thank you." and bought some strepsiles instead....
Last year I had a muscular pain on my wrist. No clinical evidence of something serious. I was prescribed 2 non-steroid anti-inflammatory drugs, 1 muscle relaxer, and a couple of muscle relaxer gels... The doctor was so convincing that I decided to take them... While on this medication and on vacation again, I had a tooth ache, I called my dentists and told him the symptoms and mentioned all the medication I was taking. He said I should take 2 antibiotics, one of aerobic bacteria and one for un-aerobic.... "But, I am already taking all these..." I said. "No problem", he said... Of course you will wonder if I am so stupid. I don't know... but when the doctor says you should take this, I thought he knows better, I should trust him... The result was I had a shock including swelling, confusion, diarrhea, tachycardia, shaking, shortness of breath, pain in gastrointestinal area, pain in my lever and an esophagitis I suffered for many months after....