UK Antibiotic (Mis) Use Health Warning hot on the heels of Antidepressants

[Firestormm]

You know I can't help but feel that 'modern medicine' has come full circle now. Yesterday we had the following warning from England's Chief Medical Officer. Why the heck she was telling the general public when it's doctors who prescribe the darn things I don't know. Same applied last week I think it was, to the over-prescribing of anti-depressants when appropriate counselling would apparently suffice.

The common-denominator? Well. A couple spring to mind. First, that GPs have swallowed the belief in 'modern medicine'. That 'science' has the answers and a drug will provide a solution in a convenient one-size-fits-all approach.

Second, that GPs believe they no longer have control. That they don't have the time to do what they used to do (assuming that wasn't some sort of 'Golden Age' of healthcare i.e. one that never really existed or wasn't as successful as is often sold), namely to listen to patients, to examine properly, and to prescribe only when absolutely necessary, and not willy-nilly.

But, in relation to the prescribing of drugs, do patients actually demand certain pills? Do they hold their doctors to ransom and refuse to leave until they get a prescription? I found yesterday's pronouncement and the way in which it was broadcast to the nation, quite laughable to be honest. For sure, resistance to antibiotics is building. Some strains of infection are totally resistant - MRSA for example.

But who's responsible for that? Patients? or Doctors? Hmm....

BBC: Antibiotic resistance warning from health chiefs


http://www.bbc.co.uk/news/health-20358772

 

[Shell]

When Vets stop giving antibios whole-scale to intensively farmed animals, I might take this fashionable view on antibiotic prescription. Until then...
As for antidepressents - part of the problem there is giving the first one that pops into the docs head without the patient getting a full assessment.

 

[justy]

You have a good point Shell, humankind is ingesting antibiotics in large quantities through meat, fish, eggs and dairy products as well as prescriptions by GP's, and this has to stop. When going on an anti candida diet the advice is very strongly to only eat limited organic meat as well as organic dairy and eggs. I am a vegetarian and i only ever eat organic dairy and local organic eggs (easy here in the country, and thieyre not expensive like in supermarkets)

I do believe though that the medical profession has a lot to answer for in the over prescription of drugs. Antibioitcs were dished out like sweeties in the 70's - i had multiple courses as a child for tonsilitis and chest infections. Antibiotic resistent bacteria is a very dangerous threat - its not just MRSA, there is also a type of antibiotic resistant TB now as well, and many are finding that one course of antibiotics is not enought to clear up an infection.

In the past, many people died of infections - i would have been one of those people as i have had many serious lung infections and pneumonias in my life as well as two very serious kidney infections, so i am grateful and continue to need to use them regularly. But many others are given them so that they get better 'quicker' when thier immune systems would have eventually cleared the infection itself, aided by appropriate rest, diet etc. In the hectic world we live in, people dont want to take two weeks off work to recover, or look after a sick child - they just want to get better right away.

Years ago i took my eldest son, who was 12 to the doctor for something he had wrong and the GP wanted to know if he was allergic to any antibiotics - the GP was visibly shocked when i said he had never had any before - the get to that age in this world without having taken them seemed shocking to him.

My thoughts on antidepressants misuse is that this has also been very overly prescirbed - particuallrly in the young. Its not just that the worng ones have been given, but very strong eveidence now shows that many popular brands work no better than a placebo, or that their efficacy is so limited that it is countered by the harm they do in side effects. I have been a voctim of this doling out of antidepressants and dont wish anyone to have to experience what i did.

Once again - talking therapies, such as counselling are shown to be just as, if not more effective than drugs, but once again, this approach takes time, patience, money and compassion. (BTW i do not include CBT as a real talking therapy - at least not the way it is done by the NHS)

I'm sure this thread will bring a lot of discussion,
Take care, Justy.

 

[alex3619]

Hi justy, I suspect some of it is indeed social attitudes. Its not just that people do not want to take time off work to recover. Its that they are expected to take drugs and soldier on. Some of that is due to employers wrongly thinking this helps (via reduced sick leave payments) when I think the stats show the loss to productivity make this a bad strategy. Some of it is due to decades of pharma advertising ... those "soldier on" adds for example. If an employee told an employer, or partner, or whoever, they didn't want to take antibiotics and recover faster, how would they be treated? Its not socially acceptable to refuse treatment. In an age of medical litigation with spiralling legal insurance costs for medicos, many docs also feel pressured to give antibiotics. Better safe than sorry. So they contribute to the problem.

The most common treatment to deal with severe local infection a century ago, without antibiotics, was amputation. Systemic infections that did not resolve on their own were fatal.

This is of course why some think badly of PWMEs. We have very good reasons to avoid CBT and GET, yet those reasons are not widely known, and so we face stigma and prejudice due to that misunderstanding.

Bye, Alex

 

[Shell]

Interesting discussion starting here. I agree Justy that in the 70s and certainly in the ''80s and even the '90s when I was still working antibiotics were badly prescribed and over prescribed.
The most shocking case I came across was a lady who was very sick indeed, practically housebound. She had a psychi illness (can't remember what) so the CPN went out to see her and taking a look at her meds found she was on something like four different antibiotics. She had taken one for a chest infection and not understanding the use had put in for repeat prescriptions. She had another for a UTI and was on repeat prescriptions for that too. Then she had gone back feeling unwell so the doc put her on a third antibiotic without taking her off the other two and then a fourth when that one apparently didn't work!! The CPN went to see the GP and there were "words" apparently. He did stop the prescriptions but never apologised. The lady started to feel much better without all those drugs doing her system in!

I think there are a number of reasons for resistant strains. First farming does have a lot to answer for. Then there's all those antibacterial sprays we use and then there's the weird use of antibiotics in medicine.
Of course a lot of places sell antibiotcs over the counter. I remember people coming back from holidays in Spain all set up with antibios so they wouldn't need to see a doc!
A friend of mine (who died recently) nearly died a few years ago after a leg amputation because she got MRSA after surgery. Now, there are a couple of antibiotics that do treat MRSA but they are needed quickly via IV. Instead the hospital put up a broad spectrum IV antibio (cheaper I assume) and then found she didn't respond. Who'd-a-thunk-it?
Fortunately her daughter is a nurse and demanded to know what the drug was and then (she's a tough Irish girl) proceeded to give the consultant a medical lecture. The correct antibiotic was finally given but it was much too late and my friend nearly died. Finally the other antibiotic was added in and she recovered. It was a slow and awful process made much worse by not providing the correct treatment straight away. The more the infection has taken hold the harder to treat obviously.

One case of resistant TB I came across (father and son) was made worse by docs not properly dx the TB in the dad. I can't remember exactly but I think the son's TB was dx properly and that lead to the dad getting the correct treatment and saving his life. Finally the man and his son were treated with the correct antibiotic and did recover but if the dx proceedures aren't done quickly enough bad things happen.

My future daughter in law (98 days to go) is already resistant to all but 2 antibios for her repeat infections but when she explains what happened in the early days it's not surprising. She has been ill since she was around 5 years old and has only just (she's 20) been referred to a specialist consultant! 15 YEARS of infections before she can get a proper assesment.

Finally - and I've said this before here - the business of prescribing cheap broad spectrum antibios for all infections is a bad idea and then prescribing them for 5 days so that the infection isn't properly treated is - to my mind - akin to gving the infection a vaccine against the antibios. I think it's more than coincidence that when I finally got a doctor to prescribe a full ten days at full strength (even though it was broad spec and not targeted) that I've not had another chest or throat infection for nearly three months; the longest I've gone for over two years.
Patients asking for antibios when they don't need them can be an issue-and Alex is right on the money about the "go to work on a pill" adverts. Not to mention the fact that people spread their infections around willy-nilly because they can't or won't stay home. But I think it's small fry compaired to the massive lunacy in farming and medicine.

 

[justy]

Shell our messages crossed and i hadnt read your before i posted.
I also think thats its quite possible we have lost some of the other means of treating illness and infection e.g by the use of herbs etc. Yes in the past people died from infections or had amputations (dangerous in themselves without adequate hygiene) but surely people were either hardier or had other means of treatments - otherwise the population would have been seriously compromised.

I've always hated the old soldier on message - it doesnt teach people to take care of themselves properly. Using medications to mask symptoms and then going back to work not only increases your chances of being sicker for longer, but exposes everyone else to illness as well. Of course the message that you must just push through anything and everything has damaged and conintues to damage many PWME - we still feek quilty for not getting better or not getting over it - and if we manage to jetison the guilt then we have friends and family and society to remind us not to just 'allow' ourselves to linger and be ill.

All the best, Justy.