When I lived in Florida, it seemed that every time I had a cough or cold of some sort and got sick enough to see the doctor, I was always prescribed a Z-Pak. When my family and I went down for Christmas, we got sick shortly after arrival and went to the same doctor we used to go to, who gave me a Tri-Pak and gave my 14-month-old liquid Zithromax, his first dose of antibiotics ever. None of us got better from the antibiotics and about a month after I got home, I went back to the doctor here with a persistent cough. That doctor gave me amoxicillin, twice a day for 10 days, and I finished that course. The cough slowly went away over about a three-week period.
Then, yesterday, I awoke with a sore throat, swollen tonsils and really tender lymph nodes. (Can I be excused? I seem to have the plague.) The doctor did a quick strep test, which was negative, but she took a strep culture and also had blood drawn to test my white-cell count. I told her about both recent courses of antibiotics, and she prescribed a Tri-Pak for me.
Should I be worried that I’m just making whatever this is, along with whatever smaller bugs living in my body, resistant to Zithromax by taking this? (I’ve already taken two of the doses and will take the third tomorrow, so don’t worry, I finish my courses of antibiotics as directed.) I was also a little peeved about giving my son Zithromax for his first-ever dose of antibiotics. Why not use penicillin or amoxicillin so it’s not the end of the world if he becomes resistant?
YES! G_dd_m_t, this p_sses me off. Cough or sore throat from bacterial infection is less common than viral infection, and ought to be confirmed before giving antibiotics.
OTOH, azithromycin is not a bad choice for this, since the short dosing regimen makes for excellent patient compliance – and the bigger problem with drug-resistant bacteria is caused by people who start a course of antibiotics without finishing it. IANAD, though, and there may be other reasons for using or not using azithromycin.
I agree that your doctor needs to slow down on the prescriptions, but a lot of time patients are so persistent that they just don’t want to deal with it anymore. I recently went to the doctor for a nasty cold/flu, and they say the CDC requires doctors to wait 5-7 days before prescribing antibiotics. I was a little upset because (being a Microbiologist) I had a feeling what I had was bacterial (since my wife recently needed antibiotics). Well I waited…and waited…and waited…and went back to the doctor…and waited…and got better on my own But only after about 10 days, ugh.
The sad part about antibiotic overprescription is that drug comanies hardly research them anymore for several reasons:
doctors hold back the new drugs to be used in only in resistant cases, so drug companies aren’t making money.
people are only on antibiotics for a week or so, so drug companies aren’t making money.
Lipotor and other lifelong drugs are where the money is at.
Of the contry’s 11 largest pharmaceutical companies right now (according to Science 3 weeks ago), out of 400 compounds currently in production only 5 are antibiotics. So the next time you think you need antibiotics, wait 5-7 days to be sure.
I should clarify by saying that it was three different doctors who gave me the prescriptions, but I told the last two about the earlier prescriptions and made sure they understood I’d already taken antibiotics and not felt better.
In Florida, right before Christmas, it seemed everyone in the doctor’s office was complaining of a mixture of sinus infection / runny nose / cough / sneezing and when I filled the prescription at Walgreens, the pharmacist told me I was lucky to get the prescription for the Tri-Pak, because the Z-Paks were sold out. When I mentioned all of that to my aunt, who sells blood analyzing and other medical equipment, she said she thought that was poor judgement on the part of the doctors, because Zithromax is meant for severe infections, not colds.
So if I go to the doctor in the future with a nasty cold, I should wait to fill the antibiotic prescription?
(In addition, the doctor I saw yesterday - who may become my primary care physician - prescribed a topical cream for my acne, without my having complained about it. Let me tell you, nothing puts a spring in your step like having someone tell you unprompted that your acne looks really, really bad. I just wish she could have given me a prescription for a better haircut and some clothes from Banana Republic.)
Antibiotics are clearly overprescribed, Zithromax somewhat so (when an antibiotic is indicated).
Many ear infections not causing pain, 70% of throat infections, and sinus symptoms of less than 2 weeks often don’t need antibiotics. If Zithromax didn’t improve your ifnection, it is likely no other antibiotic would have either – the conditions were probably viral.
Zithromax is a good antibiotic for these conditions when an antibiotic is required. It is considerably more expensive, and not really better at killing bacteria, than erythromycin. The once a day dosing, less stomach irritation and shorter course of treatment are advantages for some people.
But only after about 10 days, ugh.