Jeez, I do not believe that you’re doing this maliciously but this just proves how badly we need anti-biotic awareness programs. This could be a HUGE problem really soon, even in modernized countries.
Why can’t you see if you need antibiotics if you’ve been practicing medicine for 25 years? What does your doctor know that you don’t?
If I look in the bathroom mirror and see that my tonsils are the size of golf balls, I don’t need to pay my doctor some money to know that I need antibiotics.
Maybe that’s not really a tonsil infection, you might say, but the doc will try antibiotics first; same as I will. And I’m not getting out of bed with a fever and going to sit in his office and read Time Magazine about how Hillary Can Still Win the Nomination for an hour, sit on that little fucking half bed-couch for 20 minutes and finally walk out of there with a script that I have to go to the pharmacy and fill for pills that are already in my medicine cabinet.
Fuck the monopoly system that pays a doctor 200 bucks for something that I could do myself, but I have no choice because of our drug laws. Fuck 'em.
Most cases of tonsillitis are viral, not bacterial. And one cannot tell the difference just by looking. The standard of medical care is to screen for a strep infection (which would need antibiotics) with a rapid strep test or other means, and not treat with antibiotics unless it is positive for strep.
Sorry, but your statements here show that you lack the knowledge necessary to self-prescribe antibiotics.
(To make them gain weight faster). This sounds like a really stupid misuse of these valuable drugs.
The whole mess made me wonder-could we genetically engineer harmless versions of these disease germs and release them? Then they might overwhelm the bad germs-sort of like beating them by joining them!
Every time I have had swollen tonsils, the doctor has always prescribed antibiotics to see if it clears up. He has told me, in fact, that we could do a test for strep, but if it is strep, these antibiotics will cure it, so we don’t need to test. This was when I was paying cash for visits. Now that I have insurance, strangely tests always Need to Be Conducted.
I understand the general idea that since antibiotics can be abused, the doctors need to tightly control it, but it doesn’t happen in practice. Several people at work actually CALL their doctor, describe a symptom, and the doctor phones a antibiotic prescription into their pharmacy. What kind of control is that?
Unfortunately jtgain is likely speaking the truth: one need not travel out of the country to find doctors who are as big of idiots as any patient. Not prescribing is often a lot more work. Really.
And to be honest, what exactly is the evidenciary basis of prescribing 14d of antibiotic for a sinus infection over 10, or 7, or none? (Answer: there is none.) Or for an ear infection? (Same.) How many of us have ever even checked out the literature? Good docs following state of the art guidelines are often prescribing without any evidence that antibiotics do any good over non-treatment and sometimes even in face of evidence that it does not. Length of treatment is often an arbitrary tradition passed on by docs before us but never tested comparatively to shorter or longer courses or no treatment at all even. Or tested and showing little to no benefit over placebo in other than narrow subsets.
Patient abuse is regrettable. Doctors overprescribing outside of clear guidelines in much of the world is sadly endemic. Doctors here who should know better prescribing outside of guidelines is at least decreasing but is still a reality. But even the best docs following the state of the art guidelines are often giving out antibiotics with scant evidence of its efficacy and for arbitrary treatment durations. That much is a sytems problem and needs to be addressed.
All painfully true. My ID professor (John Bartlett) taught that the chief reason for prescribing amoxicillin in all too many cases was to get the patient out of one’s office.
But now that we’re finally making some headway in cutting back on unnecessary prescribing of antibiotics, and understanding better the situations where they truly are not needed, it’s certainly not the time to reverse course and give patients the responsibility for deciding if they need antibiotics or not.
This is the Z-Pak’s primary function these days. It’s just so easy to write.
I’d be thrilled if I could get everyone in my town to just give amoxicillin for colds. Our local population is particularly demanding of antibiotics for every little sniffle, and they want the latest and greatest (that is, “strongest”) antibiotics they can get. We also have a lot of mid-level practitioners (nurse practitioners and physician assistants) who are happy to give them whatever they want, so there’s a bit of an arms race. It isn’t unusual around here for someone with a cold to get a shot of Rocephin in the office and a week of Avelox.
If they end up with me instead, and I recommend OTC decongestants and Kleenex, they’ll go to one of the M-LPs the next day to get their ridiculous $200 antibiotic regimen and then tell everyone in town what a horrible doctor I am–“he won’t do nothin’ for you”. (This is yet another reason I’m leaving private practice.)
My only solution is that health plans/Medicaid/etc. need to stop paying for expensive antibiotics without a damn good reason for them. If the patients had to pay that $200, they might think twice about what they really need.