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Old 07-17-2019, 07:04 PM
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How did the general public widely come to believe antibiotics cure viruses?


As I sat in urgent care this morning, waiting to have a tick bite looked at, I read a poster that among other things stated that antibiotics are only effective against bacteria, not viruses.

I've heard this caution scores of times over the course of my life, so obviously there are a lot people who apparently believe otherwise. These people, along with their push-over doctors who give into their demands for antibiotics to treat viral illnesses, are cited as one of the reasons that we've now plagued drug resistant bacteria types (well, that and giving antibiotics to food animals). If this is even a partial cause, that's a whole lot of people demanding drugs that won't do anything for their illness.

But where did the idea that things like the common cold or viral bronchitis could be cured with antibiotics even come from? Is there a single initial source of this misinformation decades ago?
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Old 07-17-2019, 07:11 PM
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Very likely just that the "general public" doesn't really know the difference between the two - germs are germs, after all, and just thinks of "antibiotic" as "anti-germ".
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Old 07-17-2019, 07:11 PM
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Originally Posted by elfkin477 View Post

But where did the idea that things like the common cold or viral bronchitis could be cured with antibiotics even come from? Is there a single initial source of this misinformation decades ago?
Antibiotics were a miracle when they were introduced. Diseases like TB that were previously incurable could now be cured in days and wounds that previously led to fatal infections could now be dusted with a little sulfa and a man headed for amputation or death would live to walk again. It's no wonder that people came to believe that there was nothing they could not treat (particularly since viruses were little-known to the public when antibiotics were introduced).

Last edited by Andy L; 07-17-2019 at 07:13 PM.
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Old 07-17-2019, 07:20 PM
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And it was once common practice for doctors to just automatically prescribe antibiotics "just in case" whenever you came in with pretty much any illness whatsoever, without testing whether your infection was bacterial or viral. I know that was the case when I was a kid in the 1980s -- any time I was sick and my mom took me to the doctor, I pretty much always came home with a prescription for antibiotics. This probably helped reinforce the misconception antibiotics are anti-germ. This has fallen out of practice now that antibiotic resistant bacteria have become an issue.
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Old 07-17-2019, 07:27 PM
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Originally Posted by WildaBeast View Post
And it was once common practice for doctors to just automatically prescribe antibiotics "just in case" whenever you came in with pretty much any illness whatsoever, without testing whether your infection was bacterial or viral. I know that was the case when I was a kid in the 1980s -- any time I was sick and my mom took me to the doctor, I pretty much always came home with a prescription for antibiotics. This probably helped reinforce the misconception antibiotics are anti-germ. This has fallen out of practice now that antibiotic resistant bacteria have become an issue.
I think thatís it. And because viruses are inherently self-limiting, the patients always started getting better as they were taking the antibiotics. They presumed the antibiotics worked.
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Old 07-17-2019, 07:34 PM
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Diseases like TB that were previously incurable could now be cured in days
Untrue, it took months of antibiotic treatment to put TB disease in remission and cure wasn't guaranteed. It all depended on the extent/severity/location of the infection. TB forms lots of deep abscesses where oxygen and blood just don't get to, so antibiotics often can't reach it.

Granted, antibiotics were a boon for TB sufferers, as they had a chance at a cure, and if not that, at least prolonged remission with partial or even complete functional recovery. But there were few instant miracles.

Last edited by Qadgop the Mercotan; 07-17-2019 at 07:35 PM.
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Old 07-17-2019, 08:20 PM
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Untrue, it took months of antibiotic treatment to put TB disease in remission and cure wasn't guaranteed. It all depended on the extent/severity/location of the infection. TB forms lots of deep abscesses where oxygen and blood just don't get to, so antibiotics often can't reach it.

Granted, antibiotics were a boon for TB sufferers, as they had a chance at a cure, and if not that, at least prolonged remission with partial or even complete functional recovery. But there were few instant miracles.
Thank you. Sorry about the error.
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Old 07-17-2019, 08:30 PM
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All the general public thinks is, "Antibiotics kill the bad things in our bodies that cause disease." Whether the bad thing is a germ or a virus is already beyond their hair-splitting. Antibiotics are the stuff you inject in your body to stop bad diseases, period, in their view.
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Old 07-18-2019, 03:38 AM
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And it was once common practice for doctors to just automatically prescribe antibiotics "just in case" whenever you came in with pretty much any illness whatsoever, without testing whether your infection was bacterial or viral.
Is this completely nonsense though?

I'm not for a moment suggesting that this should be standard practice, but back in the day you used to hear the phrase "opportunistic infection" quite a lot - as I recollect the idea was that you might have something viral, but by giving antibiotics prophylactically you could prevent things from getting worse as a result of a secondary, bacterial, infection. Is there a germ (heh heh) of sense in the idea?

I know, for example, that opportunistic infections can (could?) be a very serious thing in HIV. Is this also more broadly true of other viral infections - can they "weaken the immune system"?

Paging Qadgop.....

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Old 07-18-2019, 04:11 AM
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I know, for example, that opportunistic infections can (could?) be a very serious thing in HIV. Is this also more broadly true of other viral infections - can they "weaken the immune system"?

Paging Qadgop.....

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That is also my recollection for why doctors prescribed antibiotics for respiratory conditions.

I know that this was true for the influenza pandemic of 1918. Nearly all the deaths were caused by secondary infections.
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Old 07-18-2019, 07:30 AM
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Thank you. Sorry about the error.
No apology needed, I'm sorry if that came across as snarky, it wasn't meant that way.
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Old 07-18-2019, 07:33 AM
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I know, for example, that opportunistic infections can (could?) be a very serious thing in HIV. Is this also more broadly true of other viral infections - can they "weaken the immune system"?

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It's standard practice to put certain patients on prophylactic antibiotics, particularly HIV patients who have a low CD4 count or who have had certain manifestations of AIDS in their past. The same is true for other diseases (as noted by don't ask). So there is certainly a role for using antibiotics preventively.
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Old 07-18-2019, 08:25 AM
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And of course, it's not always easy to tell what the cause of a disease is. Sometimes doctors will diagnose by means of treatment. Did the antibiotic work? If yes, then I guess that it was bacterial. If no, then we'll have to try something else.
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Old 07-18-2019, 09:24 AM
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It's standard practice to put certain patients on prophylactic antibiotics, particularly HIV patients who have a low CD4 count or who have had certain manifestations of AIDS in their past. The same is true for other diseases (as noted by don't ask). So there is certainly a role for using antibiotics preventively.
Malaria is one of them. My wife and I took doxycycline daily for three years in Africa.
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Old 07-18-2019, 09:37 AM
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I believe the general public is uninformed and or willfully ignorant.

Look at what people think gives you a cold or pneumonia. The real info is out there and yet my neighbors tell me I'll get a cold from walkin barefoot in 50 degree temps (arctic weather in FL).
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Old 07-18-2019, 10:04 AM
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Antibiotics were a miracle when they were introduced. Diseases like TB that were previously incurable could now be cured in days and wounds that previously led to fatal infections could now be dusted with a little sulfa and a man headed for amputation or death would live to walk again. It's no wonder that people came to believe that there was nothing they could not treat (particularly since viruses were little-known to the public when antibiotics were introduced).
TB could not (and cannot) be cured in days. It's one of the reasons there are resistant forms. The bacillus has a long reproductive cycle, so the drug has to be in one's system a long time to prevent every generation of bacillus from having a shot at reproducing. Stop taking the meds and you've allowed all the stronger or longer repro-cycled bacilli to survive and multiply, making it even harder to clear them from the body.
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Old 07-18-2019, 10:34 AM
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Many doctors, faced with a patient demanding treatment for their cold/hepatitis/measles infection used to prescribe antibiotics even though they knew that they would have no effect. It happened here in the UK where the consultation was free and the prescription free or low cost, and I suspect that it was even more prevalent in countries where the patient was paying directly.
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Old 07-18-2019, 11:01 AM
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TB could not (and cannot) be cured in days. It's one of the reasons there are resistant forms. The bacillus has a long reproductive cycle, so the drug has to be in one's system a long time to prevent every generation of bacillus from having a shot at reproducing. Stop taking the meds and you've allowed all the stronger or longer repro-cycled bacilli to survive and multiply, making it even harder to clear them from the body.
Yep. I messed up. Antibiotics produced a cure for a disease that was previously incurable (and often led to years as an invalid before death), but did not provide an instant cure.
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Old 07-18-2019, 01:53 PM
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I believe the general public is uninformed and or willfully ignorant.

Look at what people think gives you a cold or pneumonia. The real info is out there and yet my neighbors tell me I'll get a cold from walkin barefoot in 50 degree temps (arctic weather in FL).
Yes. Before wondering about the general population distinguishing bacterial from viral infections, Iíd like to see how well understood the germ theory of infection is.
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Old 07-18-2019, 02:16 PM
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Is this completely nonsense though?

I'm not for a moment suggesting that this should be standard practice, but back in the day you used to hear the phrase "opportunistic infection" quite a lot - as I recollect the idea was that you might have something viral, but by giving antibiotics prophylactically you could prevent things from getting worse as a result of a secondary, bacterial, infection. Is there a germ (heh heh) of sense in the idea?

I know, for example, that opportunistic infections can (could?) be a very serious thing in HIV. Is this also more broadly true of other viral infections - can they "weaken the immune system"?

Paging Qadgop.....

j
It's not nonsense, since a Strep throat can often occur during a cold or flu for example. BUT the problem is that bacteria get resistant to antibiotics, and antibiotics also kill off your good gut bacteria. Both of which werent widely known until recently.
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Old 07-18-2019, 03:18 PM
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Is there some rule of thumb for remembering which diseases are caused by bacteria, which are caused by viruses, and which have other causes? Because there are a lot of them, and sometimes it's hard for a layman to keep track.
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Old 07-18-2019, 03:43 PM
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Is this completely nonsense though?

I'm not for a moment suggesting that this should be standard practice, but back in the day you used to hear the phrase "opportunistic infection" quite a lot - as I recollect the idea was that you might have something viral, but by giving antibiotics prophylactically you could prevent things from getting worse as a result of a secondary, bacterial, infection. Is there a germ (heh heh) of sense in the idea?

I know, for example, that opportunistic infections can (could?) be a very serious thing in HIV. Is this also more broadly true of other viral infections - can they "weaken the immune system"?

Paging Qadgop.....

j
I'm obviously not Qadgop, but I am a pharmacist.

Some viral infections do weaken the immune system, even in an otherwise healthy person, and prescribing ABX is done at the doctor's discretion.

p.s. A lot of antibiotic resistant is due to their inappropriate use in livestock.

Last edited by nearwildheaven; 07-18-2019 at 03:44 PM.
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Old 07-18-2019, 06:02 PM
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In January the last two years, I came down with some sort of illness that was symptomatically exactly the same in both years. The first time I tested positive for strep throat, but the second time I didn't. I was annoyed at the Nurse Practitioner telling me it was "good news" that I didn't have strep, because to me that meant I wasn't leaving there with something to treat my illness and I'd just have to wait it out in bed. I can imagine people with less knowledge about these things to demand that they absolutely must have strep throat because they for sure knew they had the same thing last year. I was more of the opinion that I really didn't have strep throat the previous year, but I'm open to also believing it was a coincidence and that's simply how my body's responding to infections now. I used to get some sort of cold every year but it felt considerably different; it had been a few years since the last time I got one, so maybe things changed.
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Old 07-18-2019, 07:22 PM
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My father (a physician) had a big tub of penicillin he dipped into whenever we got sick with a sore throat or ear ache (1960s). I think I eventually grew to know that bacteria and viruses were different things, but I didn't know which was making me sick at any particular time.
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Old 07-19-2019, 11:44 AM
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And it was once common practice for doctors to just automatically prescribe antibiotics "just in case" whenever you came in with pretty much any illness whatsoever, without testing whether your infection was bacterial or viral.
Prior to widespread understanding about antibiotic resistance, this was probably a good practice. If you don't know if it's viral or bacterial and the side effects of the treatment are minor (as they are with man antibiotics) treat just in case.

This is still the right thing to do in severe cases or individuals with potentially delicate systems. A few years ago I was hospitalized with an unknown illness that wasn't definitively diagnosed for a few weeks, and they immediately started me on broad-spectrum antibiotics. They didn't know what it was, and if it had been bacterial, it might have killed me before they figured it out.

It was not. In fact, my illness was caused by an allergic reaction to an antibiotic. I fully appreciate the irony, and I'm lucky that I wasn't allergic to the broad-spectrum one, or it probably would have killed me.
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Old 07-24-2019, 11:00 AM
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Is this completely nonsense though?

I'm not for a moment suggesting that this should be standard practice, but back in the day you used to hear the phrase "opportunistic infection" quite a lot - as I recollect the idea was that you might have something viral, but by giving antibiotics prophylactically you could prevent things from getting worse as a result of a secondary, bacterial, infection. Is there a germ (heh heh) of sense in the idea?

I know, for example, that opportunistic infections can (could?) be a very serious thing in HIV. Is this also more broadly true of other viral infections - can they "weaken the immune system"?

Paging Qadgop.....

j
I can't speak to whether antibiotics are routinely prescribed "just in case" for HIV patients - but as a lifelong asthmatic, who occasionally develops a secondary infection when I catch a cold: they are not. When I do need to see a doctor due to URI symptoms / asthma flare, it seems to be somewhat random as to whether they decide I need antibiotics, steroids or both. I've encountered odd prejudices both ways, like the time an on-call doctor prescribed an antibiotic vs prednisone as a first step because he'd supposedly seen too many horror stories of osteoporosis after multiple bouts of short-term steroid use. Another time, when I'd been getting sicker and sicker for 2+ weeks, an urgent care doc did steroids first (OK) then when I was sicker 2 days later, STILL was reluctant to give antibiotics.

I don't know what these various doctors would have done had I *pushed* for antibiotics. As an asthmatic, my assumption is that steroids are most likely the right first step, and except for that one odd experience, most doctors seem to share that preference. I think with a patient with any kind of lung disease, however, they're more watchful and more willing to do "just in case" antibiotics because the chances of a secondary infection truly are greater than in the average person.

Last edited by Mama Zappa; 07-24-2019 at 11:04 AM.
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