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.
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.
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.
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.
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.
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.