I agree doctors don’t know what they’re doing. My doctor gave me amoxicillin for longish sore throat without doing a strep test, then when symptoms took a turn for the worse in the form of fever (possibly because I’m in contact with one of those antibiotic-abusing breeding grounds of resistant bacteria) she prescribed me something wikipedia described as “last-line” with vast side-effects on everything from blood sugar to nerve damage. (To her credit, this is apparently a heavily-marketed blockbuster drug that all the cool doctors are over-prescribing. :rolleyes:) On the bright side, tho, it really cleared up my skin.
But how that justifies doing the same, I am not sure.
IANAD or a Pharmacist but I was an EMT. The point of taking the full course of the antibiotics prescribed is to make sure you decisively kill the bacteria that is causing you problems. You might kill 75% of them in a few days but the ones that are left are the ones more resistant or in areas where antibiotic delivery isn’t always easy. By continuing to take them you make it more likely that the ones with minor resistance to the drug die off as well rather than having the opportunity to reproduce in large numbers and come back with a vengeance.
And of course antibiotic abuse poses risks for both the abuser and the community that he or she lives in. Given international air travel, that community is fairly wide. Some may not be bothered by this.
The problems with securing drugs from across the border are milder provided the buyer takes care to always take a full treatment.
IME (my experience only) internists tend to prescribe with greater acuity than general practitioners. IANAD
Who are you to determine if you are cured? Just because you’ve gotten rid of the symptoms doesnt mean you dont still have the bug, and the ones left are resistant. If the doctor tells you to do the whole run, then do the whole run.
Also, refill? Sounds like bullshit to me. Most antibiotic runs are prescribed as a one-off just to avoid pill hording. Something tells you are you bullshitting us and you just take enough to stop the symtpoms and squirrel away the rest. I hate people like you. My gf and my dad bought caught MRSA beause of people like you. THanks dude.
Oh dear god. (BTW, making the excuse, “well, the doctors will do it anyways!” is pure bullshit)
Also, doesn’t over use of antibiotics run the risk of developing an allergy? I think that’s how I ended up allergic to penicillian – I had TWO infected teeth when I was about 17, and had to have them yanked, and had such a long course of antibiotics, I wound up breaking out in hives. So now I have to take clindamiacin (spell?).
(Of course, when I was 21 and my wisdom teeth were coming in, they called, my mother forgot to tell the woman I was allergic, and they gave me a scrip for penicillan which she got anyways – and yes, once again, I broke out.)
I dont know about how much pharmacopia training the average GP gets, but when I was a teenager, I had the usual Acne problem. My family doctor refered me to a dermatologist, who perscribed me bucket loads of antibiotics, from penacylin , amoxicillin,tetracycline, and scads more that I cant remember.
This was roughly several years in duration before the nuclear option became available for treatment of acne, which was accutane. Took six weeks for that treatment to eradicate my condition.
Which all of the above really means is that doctors probably have a school of thought as to how to treat any one given condition, which in todays medical community might be concidered heresy for overusing antibiotics.
They’ll get about 2 semesters worth of classes from October to May of Pharmacology classes. And they’ll have had a year’s worth of classes on Microbiology, and a year’s worth of Pathology, and hopefully a year’s worth of Pathophysiology as well. Those 4 classes together should give someone a better idea of what to expect with medications and diseases and how to react once a treatment begins and complications arise and all those sorts of fun things.
And then they’ll have be be able to prove that they know the material by Passing the USMLE (US Medical Licensing Exam) Part 1, 2, and 3 (Plus, I think a SHELF Exam- National Exam in a specific Subject). They’ll also have worked for 2 years in various clinics as interns basically learning the meds (or risk getting pimped by the Chief Residents and such). So about 1 year of book learning, and then 2 years of clinical usage and also 4 National Exams before graduating w/ an MD.
That’s the general amount of training they’d get for Pharm.
The key w/ Antibiotics seems to be that there’s isn’t one magic cure all out there, but a systematic version of trial and error of what to use. There are some potent AB’s out there, but the problem is we only have a limited supply of different types of Antibiotics and the risk of having a bug become resistance to one of our “last hope” antibiotics would REALLY bite us in the arse. Of course, if we REALLY wanted to be efficient about which Antibiotic to use- we’d just take a culture for every patient that gets sick and send it off to the lab for several days (up to weeks though for some bugs) and they’ll culture the bacteria and send back a sheet telling you all the different strains your specific bug is resistant to and what it’s weak against.
Only problem with that? The cost and the timing. You’d have to pay for those lab fees and you’d have to just sit there being sick while we figured out what it was.
Most patients when they go to the doctor hope to get better sooner than that- so that’s why many Docs try to give broad spectrum antibiotics or try to figure out what the bug is and give the medications that would be effective against general strains of that bug (maybe things that he’s been commonly seeing lately or such).
But every now and then you’ll get someone who comes in with some ridiculously resistant strain usually due to behaviors such as not finishing their regiment of antibiotics properly or someone who’s caught a strain from someone like that. :shrug: then yeah- you gotta do the lab works and culture it to see what you can do vs. those sorts of things.
Has that been consistent over the past several decades , or is this more recent curiculum. Not that I have a problem with what the doc perscribes or does not, Im just more curious about the old school doc’s vs the jeune ecole,are they required to take courses to keep up with latest developments/treatments or individual dependent.
Don’t know, I just know it’s been the current curriculum.
I know antibiotic usage has definitely been a hotter topic in the 90’s onwards as more and more drugs are becoming resistant to our usual methods. Pretty much consistent w/ the rise of MRSA (Methecillin resistant Staph Aureus). So my guess is that’s your best bet to start looking around for more information.
On a few occasions, I’ve had a doctor take a culture and give me a broad spectrum antibiotic to take until the culture results came back. That seems to work as the best compromise…I certainly don’t enjoy sitting around, getting sicker, while waiting for culture results.
Once again, you do NOT need to hoard the meds. You do not NEED antibiotics, not unless your doctor has prescribed them. You already have shown your ignorance in how they work. :mad:
If you’re not even going to take them properly don’t even bother.
MRSA of incredible resilience is also found in hospitals and locker rooms… because these areas are disinfected with bleach and other oxidizers. Anything that survives the type of heavy chlorine-based cleaners used in these environs is the elite of the elite of the elite… and they are left to multiply without competition. When an athlete or hospital patient comes down with it, they are facing a very elite strain.
I have a bottle with 40 caps of 500mg Keflex prescribed for my 13 yo who can’t swallow pills. When I told her doc that and I was thinking of just skipping the antibiotic anyway, she insisted that another script for an liquid antibiotic would be ordered to my pharmacy asap. I told her don’t bother there is no evidence of infection, but she insisted anyway. I called my pharmacist and said I don’t want to pick up the script, and they said ok we’ll keep it here in case you need it.
The problem with my kid was the backing of a 10k gold earring had been pushed inside of her earlobe and there it remained for a week. The Doc dug it out (called it surgery and charged me $200) and decided just in case it was infected she’d prescribe a strong antibiotic. But it wasn’t red swollen or painful?! Today her earlobe is fine,perfect, no problems.
So what to do with the unused pills at home, the pharm said to toss it in the trash but I kept thinking about my friends with no insurance. But otoh stores like walmart and meijer do offer some prescriptions practically free these days. BUt its the Dr’s visit that will set you back at least $100 just to sit on the gurney and answer their questions.
This is my point exactly. Most docs hand out antibiotics like they are candy anyways. A hundred for the doctor’s visit, and they usually prescribe the latest and greatest $50 antibiotics, so for an uninsured person, you are out $150. Which, if you had a decent job and could afford $150, you would have insurance. It’s a double whammy.
Everyone else can go ahead and keep being the good little sheep of the medical establishment and pay your doctor for doing nothing, or let your insurance pay your doctor for doing nothing. That is one of the things that keep driving up health care costs.