Monday, June 27, 2011

Inappropriate use of antibiotics

A good friend of mine has just come back form overseas, and like a lot of international travelers, she has brought home more than just her luggage and some duty free! She has had a terrible time since she got back with a chest infection, and told me over the phone that she was "just finishing her third course of strong antibiotics".

As a doctor, I hate to hear things like that: and I'm not just talking about my compassion for a dear friend who is suffering, but more so for that fact that three different "strong" antibiotics have been used to no effect and probably for the wrong reason. Just as many chest infections are caused by viral infections as bacterial infections, and antibiotics have absolutely no effect on viruses!! In fact, giving antibiotics for the wrong reason can have completely the opposite intended effect - by that I mean that the effect of the unnecessary antibiotic is to wipe out all the bacteria sensitive to it, and leave behind all those that are resistant to it.

If you have a chest infection and are coughing up sputum, the first thing to do is to collect a sample of that sputum in a sterile container, so that it can be sent off to the Lab for analysis and to determine the sensitivity of any bacteria present to potential antibiotic treatment. These days this is a relatively quick process, but even if it takes a couple of days, your treating Doc can start you on a treatment that is likely to be successful, and once the "sensitivities" have come back, can then continue, or change medications, depending on the laboratory findings.

Trying three antibiotics in a row to see if they work is not smart medicine, and will often do more harm than good.

I sent my friend round a jar of Vicks (as a joke because laughter gets the lungs moving vigorously and helps shift sticky mucous) and suggested she try a gentle walk down the street. Today I hear that she is starting to recover, not, I am sure because it's anything to do with my suggestions, more that her own body is finally coping with the infection and almost certainly not because of any benefit from those "strong antibiotics."
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1 comment:

Lauren D :) said...

Just found your blog and am back tracking through it - so interesting! I completely agree with this one though. Sometimes I feel that doctors simply want to seem as though they are doing something to help their patients - no patient likes to pay $66 to be told to "wait it out" and no doctor has the time to feel that wrath. On the other hand, patients need to be educated about anitbiotics and need to not expect them every time they present with a runny nose.