Antibiotics for a Cold

[Derleth]

*Originally posted by Bob Scene *
According to the CDC, triclosan, which has gotten to be a common additive in all kinds of “anti-bacterial” products, can select for strains of bacteria that are cross-resistant to various different antibiotics. Derleth especially should appreciate the fact that it also selects for mycobacteria that are resistant to isoniazid, one of the main drugs used for tuberculosis.

So we’ll overuse triclosan until it becomes useless and then we’ll have fucking triclosan-resistant TB.

Well, we’ll never develop tuberculosis-resistant lackwits. That’s for goddamned sure.

**Nevertheless, I refuse to buy hand soap, hand lotion, bath soap, dish liquid, cutting boards, toothbrushes, toothpaste, mouthwash, cigarettes, toys, cat dishes, pillows, pillowcases, sheets, towels, socks, slippers, gloves, underwear, sponges, humidifiers, carpeting, high chairs, deodorants, shoes, kitchen knives, vacuum cleaner bags, mops, telephone mouthpieces, floor mats, ceiling tiles, toilet brushes or pacifiers that aren’t loaded with the stuff because, you know, germs are icky. **

That’s why your body has a really neat bunch of interlocking defenses collectively known as the immune system. Most people’s immune systems are in perfectly good order (even if they don’t waste money on megadoses of vitamin C) and can protect them from all sorts of nasty stuff. Americans especially, I’ve noticed, are too goddamned paranoid about germs. For the past few centuries, we’ve been living with vile, disgusting horses! Our immune systems protected us because medical science wasn’t yet up to the task! Hell, the fact that anyone survived childbirth before Lister and antiseptic practice is a pretty damned good indication of how well our immune systems work.

(I know it was a joke. I realize that. I just have to blow off major amounts of steam.)

t- keela
P.S. If you are a fucking anti-biotic junkie. Take them through the whole course. I can’t even begin to count the number of people I know who start feeling better and just decide, “that’s it, I’m well now.” and quit taking their script.

Preach it! Go and preach it to the lackwits! That is fucking why we get resistant strains: People fucking kill the weak and leave the strong behind. It’s natural selection in action, morons! It’s a goddamned proof of evolution right under their mucous-dripping noses!

Too bad natural selection can’t seem to weed out the lackwits.

[culture]

This thread is exactly why national health care is A BAD IDEA. I never, never, never want to pay for the nit-wit morons who run to the doctor every time they get a cold, cought, runny nose or fever. Did I say morons? I meant stupid morons.

I never go to the doctor unless I do not get well on my own in 4-6 days. Guess what, I go to the doctor b/c I am sick about once every 8-10 years.

[Velma]

I don’t know why people even want to take antibiotics if they don’t have to, I hate taking the damn stuff. Luckily now that my tonsils are out I haven’t needed them since, but I always had yucky side effects, and after a while of getting stronger and stronger ones I became very intolerant of them and really had stomach problems for a long time, resulting in other medication so I could tolerate the antibiotics…a frustrating cycle. Augmentin is evil in pill form to my body, I will never take this again. As a result there is only one type of antibiotics I can tolerate, so I hope I don’t get anything it can’t kill. They kill more than the “bad” bacteria, you know! Some bacteria in you is good!

[Bob_Scene]

There is some good news when it comes to antibiotic resistance. Bacterial populations tend to lose their resistance to antibiotics that they aren’t exposed to (and in fact can do so very quickly in a laboratory). Some nursing homes have reduced the numbers of resistant bacteria floating around in their facilities just by rotating the antibiotics they give their patients, and at least one European country with the dreaded socialized health care has had some success at reducing resistance just by imposing some restrictions on prescribing antibiotics for certain conditions.

It’s entirely possible that if we were to quit carpet-bombing the planet with antibiotics, we might survive as a species long enough to get wiped out by one of the other things everyone’s sure is going to kill us all.

[t-keela]

I swear today I was watching the news and a “doctor” I don’t know if he was a Dr. or not , BUT anyway he was discussing a study that just came out about the USELESS anti-biotic soaps that people use. The study showed that antibiotic soaps are no more effective than regular soap.

If anything, it is actually doing more harm than good, for the exact reasons we are discussing here.

I haven’t searched it out yet, don’t worry…I WILL. Just thought I’d throw that in the ring. Maybe someone here is up on this.

I will be when I get back~later

[CrazyCatLady]

Well, t-keela, I’ve always heard that washing your hands with regular soap was just as effective, PROVIDING YOU WASH YOUR HANDS CORRECTLY. That means warm running water, enough soap to get up a good lather, and scrubbing for at least 10-15 seconds, washing between the fingers (not just the palms and backs of the hands), and under the nails. It’s the soap and water that does the trick, not the antibiotics.

[D_Odds]

Here’s an article on antibacterial soaps:
http://www.cnn.com/2002/HEALTH/10/24/antibacterial.soap.reut/index.html

[light_strand]

D_Odds, I have to disagree with your article. I personally have done research on the antibiotic triclosan, and it is indeed antibacterial, and more effective than regular soap. However, you do need to lather, and wait before rinsing to make the soap work.

Besides, this is one of the poorest designs I’ve seen for an antimicrobial experiment, and I’ve literally done hundreds of them.

For their study Larson’s team followed primary caretakers in 222 New York City households. Half got an antimicrobial soap for daily hand washing and half were given plain soap. Neither was labeled.

The two groups were tested after washing one time and after one year of regular use of the assigned soap.

After a year, both groups had fewer germs on their hands, with no differences between the antibacterial soap group and the plain soap group, Larson said.

In fact, it’s kind of silly to think that it can be both ways. you can’t have an antibiotic that is ineffective, and yet it produces antibiotic resistance. It either is antibiotic, or it ain’t.

Also, just to clear up a common misconception, not taking the entire prescription of antibiotics does not cause resistance, it just makes it much more probable that you will get sick again. In other words, even though you may be feeling better, you may not have killed off all of your infection. So if you stop taking your prescription you allow the infection to grow back. This doesn’t not have anything to do with resistance.

[Bromley]

*Originally posted by culture *
**This thread is exactly why national health care is A BAD IDEA. I never, never, never want to pay for the nit-wit morons who run to the doctor every time they get a cold, cought, runny nose or fever. Did I say morons? I meant stupid morons.

I never go to the doctor unless I do not get well on my own in 4-6 days. Guess what, I go to the doctor b/c I am sick about once every 8-10 years. **

I think that you’re wrong, but it depends on what your trying to prevent. We have national health over here and, as a patient (i.e. IANAD), it seems to me that it removes some of the pressure from the doctors to pander to their patients. It effectively turns the entire population into a captive patient population. If someone like QtM has previously given in to patient pressure to medicate (or at least thought about it), then I’d say that was a good reason not to have a pay per visit system.

Sure, you might think that no direct payment encourages hypochondriacs, but they still have to give up their time and I’d imagine that the doctors kick them out fairly sharply.

[t-keela]

Just in for a quick cite:
http://www.infections.bayer.com/treatment/approp_use_antibiotics_en.html

Note the passage about surviving bacteria may become resistant if the full course of antibiotics is not taken.

Be back later.

[t-keela]

I guess I’ll just wait for the news tonight to rerun the study.
(I know a little something about this stuff.)

The one in question was released today…that’s why I mentioned it. It supposedly removed any doubts about the effectiveness and/or harm caused by these a/b soaps. I was about half asleep in my recliner at noon today, so I didn’t get the whole story.

Damned rainy days…can’t work…put’s my ass to sleep. Besides, I was UP ALL NIGHT.
gonna run, maybe I can catch the evening report.

Peace

[light_strand]

I’ll note whatever the hell you want me note, I’d like you to explain to me how that happens.

It doesn’t. Think about it. If a bacteria is resistant, it won’t die no matter how long you use the antibiotic. Taking the entire course of antibiotics is actually more likely to result in antibiotic resistance.

[Qadgop_the_Mercotan]

*Originally posted by light strand *
**I’ll note whatever the hell you want me note, I’d like you to explain to me how that happens.

It doesn’t. Think about it. If a bacteria is resistant, it won’t die no matter how long you use the antibiotic. Taking the entire course of antibiotics is actually more likely to result in antibiotic resistance. **

Untrue. Some bacteria will die quickly on being exposed, but some will have developed partial resistance to dying off quickly. Give it for 5 days, then stop, and some bacteria which were weakened but not yet killed by the bacteria will then recover, and reproduce, passing on their partial resistance to the drug. Repeat ad nauseum, and pretty soon you’ve got full-blown resistance.

This phenomena has been documented over and over in the lab. Isoniazid for tuberculosis is a classic example of resistance developing because of failure to finish the drug regimen.

Horsburgh RC. 2000. The global problem of multidrug-resistant tuberculosis: The genie is out of the bottle. The Journal of the American Medical Association. 283(19): 2575-2576.

QtM, MD

[Qadgop_the_Mercotan]

Here’s another nice article on how TB developed resistance to antibiotics:
http://www.smw.ch/pdf/2000_49/2000-49-247.pdf

It states that the most common reason for the development of drug-resistant TB is failure to complete drug therapy.

[t-keela]

damned post eating …grrrrr

3rd times a charm

First of all…I never brought up anyone here, never quoted, or even said they were wrong. But, it seems we have an expert in our midst. Actually done research in the field. hmmm cool!

The cite I linked to was BAYER PHARMACEUTICALS

Apparently they don’t know what the hell they’re talking about either. If you didn’t like the first one then try this:
http://www.keepantibioticsworking.com/News/news.cfm?News_ID=147

and when you’re done try this as well:
http://news.bbc.co.uk/1/hi/health/background_briefings/antibiotics/163910.stm

there dozens more just like 'em…the jest of it is this:

If you don’t finish the full course. You risk the chance that a few germs will survive. Those can and often do remultiply and grow stronger due to their previous exposure to the anti/bio.

I suppose you could say they were resistant in the first place, but that’s not necessarily true. YOU/whoever (stupid shit for brains)
by not continuing treatment and making sure that you were “clean” that all the bacteria were in fact dead. YOU/dumbfuck just possibly created a new germ that your old MEDS won’t kill’

The second cite goes into detail as to how TB and other epidemics may be coming our way. They give most of the credit to abuse and misuse of a/b’s

ESPECIALLY PATIENTS WHO DO NOT COMPLETELY FINISH THEIR PRESCRIPTION!!!
then again…who knows Bayer Pharmac. , the FDA, JAMA , light strand, Dr. Seuss etc.
fuck it…I’m gonna go get me a shot of…t-keela

Peace

[DoctorJ]

Citing JAMA in the Pit? My EBM-crazed attendings would weep with joy. (I mean “EBM-crazed” as a good thing.)

Dr. J

[t-keela]

What say Dr.J

Care to comment on this particular subject?..what w/ the MD background you could be a helluva asset!

Kinda new 'round here, been here since June of this summer.

What’s “EBM-crazed”, duh?

[MsWhatsit]

EBM? Expressed breast milk?

Yes, as someone already pointed out, MRSA is methicillin-resistant staphylococcus aureus. (I have also heard it referred to as multi-resistant staph, and I don’t know if that’s a newer or older term.) Nobody is sure how Whatsit Jr., as a one-month-old infant, managed to get colonized with it, but it could have been from one of the nurses on the maternity ward, or one of our friends who is a nurse, or scariest of all, from some member of the general public. MrWhatsit and I were both tested for it and came up negative, so it wasn’t from us.

The infectious disease specialists who talked to us were mildly curious but didn’t seem too surprised by the whole thing. One of them shrugged and said, “This stuff is out there now. We’ve been seeing more and more of it in members of the general public.” Whereas previously you usually only saw it in people who had been hospitalized for a long period of time, I think.

A six-week course of vancomycin (nothing like administering IV antibiotics to your infant son every three hours, lemme tell you) knocked out Whatsit Jr.'s infection, but what’s really scary is the prospect of vanco-resistant staph, which, depending on who you talk to, is either highly unlikely or just a matter of time.

SO QUIT TAKING ANTIBIOTICS FOR VIRAL INFECTIONS AND THROW AWAY YOUR ANTI-FREAKING-BIOTIC HAND SOAP, GODDAMMIT!

The Whatsit family sends you their sincere thanks.

[Qadgop_the_Mercotan]

EBM= Evidence Based Medicine

i.e. doing something because there’s evidence that it works, not because the theory says it ought to.

[DoctorJ]

Yes, evidence-based medicine. The attendings in my residency program are noteworthy for not taking a piss unless there’s good evidence to support the benefits of a piss under those circumstances. They like to make copies of journal articles and put them in patient’s charts. They cite studies from obscure journals on rounds, off the top of their heads, complete with page numbers. This is a big reason that I’m here–I want to be them.

In keeping with that philosophy, we don’t give out a lot of antibiotics for colds, since the evidence just isn’t there. Yes, our patients might get miffed about it every once in a while, but that happens. We’re not hurting for business.

There are a lot of reasons why people go to the doctor, but one big one is for validation. A nasty cold can really make you feel lousy, and there’s a feeling of “if I really felt that bad, I’d go to the doctor”. Somehow, the act of going to the doctor makes it OK to feel that bad, to curl up in bed and be grumpy, etc.

That’s why I never belittle a patient’s symptoms by saying it’s “just” a virus, or “just” a cold. Colds and viral illnesses can still suck, and just having someone agree that it sucks can be beneficial. You can send someone away feeling better, without even pulling out the prescription pad.

Of course, there are some who will leave the doctor’s office and go to the nearest emergency room to get an antibiotic prescription. I’ve heard people justify giving out scripts by saying that they’re preventing an ER visit.

In our hospital, staph is MRSA until proven otherwise. It seems like it always turns out to be MRSA, but that’s probably recall bias at work. There is vancomycin-resistant enterococcus out there, and believe me, you don’t want it.

Other than that, what everybody else said. A great thread.

Dr. J